Issu
WSDA 6 201 ril · · ap e5
The voice of the Washington State Dental Association
FUTURE VISION:
WHAT WILL HAPPEN TO DENTAL MEDICAID IN WASHINGTON?
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news
BEFORE...
YOUR VISION DELIVERED
DR. ALICE CHEN, INSPIRED DENTISTRY
C O N S TA N T I N E B U I L D E R S . C O M
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Big smiles at Dr. Aaron Lemperes’ Veterans event!
WSDA news
issue 5 · april 2016
editorial
5
guest editorial
30
2016 citizen of the year award
cover story
33
ada morning huddle highlights
6-11
Cover story by Rob Bahnsen
4
12-15
give kids a smile news
16-17
mount baker dentists give back
18-23
pndc news
25
35
newsflash
37
letters to the editor
39, 41, 43, 45
classifieds
special olympics appeal
40
in memoriam
nordic news
46
parrish or perish
Art Director/Managing Editor Robert Bahnsen
In the event of a natural disaster that takes down the WSDA web site and email accounts, the WSDA has established a separate email address. Should an emergency occur, members can contact washstatedental@gmail.com.
27-29
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. Bryan C. Edgar, President Dr. Bernard J. Larson, President-elect Dr. D. Michael Buehler, Secretary-Treasurer Dr. Gregory Y. Ogata, Immediate Past President Board of Directors Dr. Theodore M. Baer Dr. Marissa N. Bender Dr. Dennis L. Bradshaw Dr. Ronald D. Dahl Dr. Christopher Delecki Dr. Gary E. Heyamoto Dr. Eric J. Kvinsland
Dr. Dr. Dr. Dr. Dr.
Randall H. Ogata Cynthia R. Pauley James W. Reid Ashley L. Ulmer Amy M. Winston
WSDA Staff: Executive Director Bracken Killpack Senior Vice President/ Assistant Executive Director Amanda Tran Assistant Executive Director Kainoa Trotter Vice President/Chief Financial Officer Peter Aaron General Counsel Alan Wicks Vice President of Operations Brenda Berlin
Manager of Continuing Education and Speaker Ser vices Craig Mathews Government Affairs Coordinator Michael Walsh Public Policy Coordinator Emily Lovell Membership Ser vices Coordinator Rachel Gunderson Membership and Communications Coordinator Emma Brown Bookkeeper Joline Hartman Association Of fice: (206) 448 -1914 Fax: (206) 443 -9266 Toll Free Number: (800) 448 - 3368 E- mail/web: info@ wsda.org/wsda.org
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The WSDA News is published 8 times yearly by the Washington State Dental Association. Copyright © 2016 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: 2015: Platinum Pencil Award Honorable Mention, 2014: ADA Golden Apple Award for Outstanding Achievement in the Promotion of Diversity and Inclusion, 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 2016
a day in the life
editorial dr. mar y jennings
Should we contract out Medicaid administration?
Dr. Mary Jennings Editor, WSDA News
State budget proviso: “Within the amounts appropriated in this section, the health care authority in cooperation with the Washington dental services foundation, the Washington state dental association, and other interested stakeholders shall develop a plan to increase access to care by expanding the Medicaid dental network through contracting out the administration of the Medicaid dental program. This plan shall include but not be limited to engaging dental expertise in the administration, improving the provider and patient experience, aligning the benefit package with evidence-based care, and beginning to test innovative models of delivery consistent with the goals of the healthier Washington initiative. The authority shall also review options to include contracting with one or more Medicaid-managed care plans or a third-party administrator. The report summarizing the authority’s implementation plan and an estimate of the cost to execute this plan must be submitted to the governor and the appropriate committees of the legislature by December 1, 2016. The plan shall not be implemented until specifically authorized by the legislature”
Dr. Mary Jennings, WSDA News editor, welcomes comments and letters from readers. Contact her at her email address:mjenningsdds@gmail.com.
In the last third of the 2016 Legislative Session, there was a lot of fast-paced talk about the future of dental Medicaid. The discussion started when Delta Dental of Washington inserted language in the supplemental budget to conduct a Request for Proposal Process (RFP) to outsource the administration of the dental Medicaid program to a third party provider. Several discussions ensued between legislators, the Health Care Authority (HCA), insurance carriers and the WSDA. Ultimately, language was included in the budget to explore outsourcing options. Recommendations are to be made to the Governor and the Legislature by December 1 of this year (see sidebar). Senator Randi Becker and Representative Michelle Caldier were instrumental in ensuring the final language included appropriate legislative oversight and stakeholder input. The cover story of this issue of the WSDA News focuses on how four other states have outsourced the administration of their dental Medicaid. As you will see, outsourcing could be beneficial for Washington’s poor and the dentists who care for them. Then again, if poorly done, it could create even more confusion and headaches. I have questions! So many questions! My biggest concern is how much a for-profit company will take in administrative fees to run these programs. How will that compare to what it costs us now? What enhancements can they offer? Are the enhancements worth additional expense? As a Community Health dentist, I want a straightforward administrative fee and as much money as possible to go directly to patient care. If we focus funding on preventing and curing early dental disease, we could spend less money in emergency rooms and prosthetics, et al. We could have a chance to get on top of this access problem. If we burden the plan with high administrative fees then we really miss a huge opportunity to make a difference for low-income people. It is important that we examine why the system does not work. Only four states have lower Medicaid reimbursement rates for adults than Washington state. Washington’s current adult dental Medicaid budget cannot afford to cover two preventive care visits for every Medicaid-eligible adult in our state. If there isn’t enough money for prevention in the current system, how can we build a better system for our adults who need medically complex care without increased reimbursement rates? Take a look at Dr. Daniel Polsky from the Wharton School’s ongoing study of why doctors do not take Medicaid. He eloquently states that it is not because we do not “like” treating these patients. It is simply because with low Medicaid fees and difficult billing systems, we cannot afford to stay in business treating Medicaid patients. He has strong and dynamic data to prove it. It is important that the new administrator shares the data they gather with the WSDA and other concerned parties. We cannot solve problems blindly. The Affordable Care Act has an anti-fraud provision that has provided our state with two Medicaid fraud investigators. I want to be able to see how they use the data and insure that they interpret fraud correctly and fairly. Interpreting billing codes is not easy and we need more transparency and timely feedback to let our offices know when we may be inadvertently billing incorrectly. We must improve billing processes. Every dental office would love clarification of billing codes, streamlined billing processes and timely appeals. Just improving the billing system could help tip some providers to sign up for Medicaid. On the other hand, could these same metrics be used to leverage us to bill a percentage of Medicaid patients with some sort of mandated subsidy? There are several lessons from other states that we would be wise to learn from. Accountability in this program should not just be limited to dentists. The HCA, the administrator, dentists and patients should all have some way to give meaningful feedback to change the program without laborious effort. These are just a few of many thoughts and questions I have. I am sure you have a lot of questions too. What causes you to be or not to be a Medicaid provider? What would make you reconsider caring for Medicaid patients if you currently do not? We want to know. We need your feedback to be able to prepare for that December 1st deadline. This is a great opportunity to help create a Medicaid program that works for everyone. It could greatly improve the dental health of our states most vulnerable population. Let’s fix this!
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You might think that keeping the Pacific Northwest Dental Conference current and relevant is an easy task, but you’d be wrong. What is relevance, any way? And who sets the criteria? What’s relevant to you might not be to your staff, and vice versa. Last year following the PNDC, we went right to the source to ascertain what your needs were. We held four focus groups: two for dentists, one for hygienists; and one for assistants and front office staff. By going directly to the source and seeing what really influences your decision to attend the PNDC, we hoped to be able to use that to create an even better experience. We crossed our fingers and hoped you’d be willing to be forthright and give us lots of input. We needn’t have worried — we got an earful, especially from the hygienists. Truthfully, all four groups gave thoughtful, supportive feedback. We learned that CE is vitally important to you, that expanding the conference was something you would support, and that you wanted programming specifically tailored to your needs and the needs of your staff. Because of the information you provided in the focus groups, the Committee on PNDC made some key changes this year. By expanding the conference into Saturday, we’ve made it possible for dentists and hygienists to earn 23.5 credits. That’s 2.5 credits more than the state requirement. Even better? We’ve kept the cost low — $250 (before April 30) gets you into any of the lectures at the PNDC, and it’s even less for your staff. For many of us, adding Saturday lectures and workshops means not having to shut down our office for two days, which might make it easier to bring more staff to the conference. For some of you, relevance is tied to programming that ticks boxes for your entire team, so we used feedback from the focus groups to tailor programming specific to everyone’s role in the practice. Front office staff will benefit from insurance workshops, assistants can take lectures about provisional and composite layering, hygienists will have an ultrasonic series, as well as other instrumentation offerings, and dentists will have a live surgical demo, a Pankey experience, and much, much more. This is your show, after all. And please don’t forget about the Exhibit Hall. Exhibitors bring some of their best deals to the conference every year. We make it easy for you to explore them by holding half of the lectures and workshops in Meydenbauer Center, and by giving you plenty of time in-between start times to pay a visit. Exhibit Hall revenue (and money from the PNDC, of course) is a significant source of non-dues revenue, helping to keep your membership in the WSDA affordable year after year. But the PNDC isn’t just about continuing education, it’s a place to meet up, visit with colleagues and old friends, and share a laugh and a beverage after a fascinating day of learning. To that end we’ve got the beautiful Bellevue Photowalk on Thursday, the Sip and Save reception on Thursday evening, and the New Dentist Reception on Friday. Bring your team, and make this an event. You’ll learn, you’ll laugh, and you’ll make new friends. We’ve got a great program for the entire team this year, and we’re excited to roll it out in June. See you there!
Dr. Carrie York Chair, Committee on PNDC
“The PNDC isn’t just a great conference, it’s a significant source of non-dues revenue, helping to keep your membership in the WSDA affordable year after year.”
2016 PNDC JUNE 16, 17, 18
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guest editorial dr. carrie york
We can’t wait for June!
WHAT WILL HAPPEN TO DENTAL MEDICAID IN WASHINGTON?
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what will happen to dental medicaid in washington?
FUTURE VISION:
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cover stor y In Washington, where the State’s Health Care Authority (HCA) currently administers all aspects of the dental Medicaid program, a sea change could be looming. Legislation just passed in the 2016 Legislative session requires the HCA to develop a plan to increase access to care through contracting out the administration of the Medicaid dental program in collaboration with interested stakeholders. The plan requires HCA to review options including managed care organizations (MCO) or a third-party administrator (TPA), similar to how the state’s other Medicaid services are administered. To that end, the HCA and interested stakeholders, including the WSDA, the Washington Dental Service Foundation, and others, have been charged with developing and submitting an implementation plan and cost estimates to the governor and the Legislature by December 1, 2016.
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Editor’s Note: The devil’s in the details, and the acronyms used in this piece can be confusing. In Washington, we will begin looking at potentially adopting either a Managed Care Organization (MCO) model or a Third Party Administrator (TPA) model. MCOs can manage all aspects of Medicaid care – medical, mental and dental, while TPAs manage the administrative aspects of a specific benefit, in this case dental, for a separate entity. In Oregon, however, their dental Medicaid program uses Coordinated Care Organizations (CCO) in concert with Dental Care Organizations (DCO), and though they sound and function similarly to MCOs and TPAs, they’re not exactly the same. Here is the language included in the state’s proviso for an RFP, “Within the amounts appropriated in this section, the health care authority in cooperation with the Washington dental services foundation, the Washington state dental association, and other interested stakeholders shall develop a plan to increase access to care by expanding the Medicaid dental network through contracting out the administration of the Medicaid dental program. This plan shall include but not be limited to engaging dental expertise in the administration, improving the provider and patient experience, aligning the benefit package with evidence-based care, and beginning to test innovative models of delivery consistent with the goals of the healthier Washington initiative. The authority shall also review options to include contracting with one or more Medicaid-managed care plans or a third-party administrator. The report summarizing the authority’s implementation plan and an estimate of the cost to execute this plan must be submitted to the governor and the appropriate committees of the legislature by December 1, 2016. The plan shall not be implemented until specifically authorized by the legislature.”
what will happen to dental medicaid in washington? cover stor y
Ultimately the legislature must specifically authorize the plan. It’s a proposition that raises the hackles of some our members, in part because of our history with some of the players, and because the current Medicaid system is so broken already. Other states have already gone through a similar process and we wanted to know how the transition played out there. We spoke with professional staff in four states: Colorado, Michigan, Idaho, and Oregon. We’d like to learn from their successes and failures, and use what we gain to help drive our narrative going forward. The Colorado Dental Association, for instance, was able to use lessons gleaned from problems in Idaho’s transition to a TPA to insert language into legislation that protected them. We’d like to do the same. Additionally, we talked with Washington’s director of Medicaid, MaryAnne Lindeblad, to get her perspective on implementing a change in how the Medicaid dental program is administered.
Not all doom and gloom
What might surprise you is that it’s not all doom and gloom. In some states providers have been satisfied with the outcome. They’re getting reimbursed faster, portals are well-designed and easy to navigate, and both provider participation and patient utilization are up. There’s a caveat, of course. Those states have higher dental Medicaid reimbursement rates than Washington, and in some of the states, the transition applied only to children’s Medicaid. In all of the states, including Washington, increased access is driving the conversation. Here, the HCA hopes that streamlining administration will simplify the burden to the providers, help lower costs, and reimbursement rates will rise accordingly. In theory, that will increase both provider participation and member utilization, although there’s no evidence of this happening in the states we spoke with that have already shifted to an outside administrator model. In fact, the success or failure of a transition seems to generally align more with the state’s funding of dental Medicaid than with who was awarded the contract. As if you didn’t already know, dentists in Washington state have faced a dilemma for years. While many were willing to treat adult dental Medicaid patients, abysmally low reimbursement rates (hovering at about $.25 on the dollar for adults) make it impossible to run a business and accept many of those patients. The process of treating Medicaid patients is further complicated through the use of ProviderOne, a provider portal that makes it difficult to file a claim with the state, and often ends in delays or denial of claims. Some of the problems are so time-consuming that many dentists simply never apply for reimbursement, opting instead to write the treatments off as part of their practice’s pro bono work in the community.
Washington’s history with MCOs
When Washington state shifted a significant portion of their medical Medicaid to outside administrators in the early 1990s, Lindeblad managed the process for the state and recalled that it was a big change for the provider community, moving from their relationship with the Medicaid agency to contracted health plans. “There were many moving parts,” she explained, “from getting the providers, our members, and community partners used to dealing with a different delivery system, to acknowledging the kind of changes that would happen in that environment, to the time it takes to make the transition. It’s a lot for people to absorb. We were
very deliberate in our process, allowed for significant stakeholder engagement, and would likely follow a similar path with any major programmatic change such as dental.” At the time of the medical transition, there were existing programs in Spokane and Kitsap County, so the state chose to focus on King County. Lindeblad said, “We had an opportunity to build provider capacity and identify plans through an RFP process to contract with. We brought it up in King County first, so that we could have the opportunity to work with the plans, build our relationships with them, and monitor the plan’s performance. We felt it was necessary to make sure that all of our systems were working well before we expanded out to the entire state in ’94.” When asked if there was anything she’d change about the process, Lindeblad was pragmatic, noting, “I don’t know that I would change anything. You learn from every implementation that you do. These kinds of transitions take a degree of thoughtfulness and consideration.” Of import is having systems and processes in place for problem solving, so that when something comes up you have a mechanism for dealing with it rapidly. “You can’t let problems grow, you have to take care of them very quickly,” she said. “The most important thing is that our members get the services they’re entitled to and deserve.” When asked about drawbacks in the transition, Lindeblad cited only complications arising from providers working with several MCOs and their different approaches to services, which she admits can be an administrative headache. But, she said, the benefit to the state’s Medicaid community far outweighs any hiccups in switching administration models. “When I consider that our providers see more Medicaid plan patients than fee-for-service patients, that we have ways of measuring quality and outcomes which is more challenging in a fee-for-service environment, and that our providers are more accountable for the services they deliver, I’m satisfied,” she said. “There’s more access now. Well child visits are higher, immunizations are higher, emergency room visits are down, preventive visits overall are higher. We’re purchasing higher quality, more efficient and effective care. Accountability was key to the success of the model with contracts that incorporated deliverables and metrics to gauge the system’s proficiencies and inefficiencies.” MCOs also had enhanced communication with their assigned members. She explained, “Let’s say immunizations were down. In fee-for-service there wasn’t much we could do. We could send out a reminder letter, but plans designed other options to engage members including mailings, phone calls, reminders to their provider just to name a few. They have systems in place to contact them, and have regular member educational opportunities. Because they’re better positioned to communicate with members and providers, and have more tools at their disposal to engage, they can utilize innovative incentives to shift member utilization in a positive way. For example, we have plans that give an expectant mom a car seat when she completes all of her prenatal care.” According to Lindeblad, we are just starting the development of the plan. “We want to improve dental outcomes and access for our members,” she explained. “Any one of the three models could work. It’s just what might be more efficient and effective, what might be more acceptable to the dental community. The time may not be right for certain models. We’ll take a look at what’s out there, what could happen, and what the community’s capacity is.”
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In Colorado, where DentaQuest now administers the state Medicaid program, the plan transition in 2014 was nearly as rocky as its famous mountain range. Both sides of the transition – the state and TPA DentaQuest – faced some major hurdles as they transitioned the existing children’s benefit and launched a brand new adult benefit. Jennifer Goodrum, director of government relations for the Colorado Dental Association, reports that some of the challenges could be attributed to the accelerated timeline of the rollout. DentaQuest had just six weeks from award of the contract until launch. In these six weeks, DentaQuest was tasked with getting providers set up in their system, training providers to use a new portal, and inputting all the existing and new benefits into the system correctly. At the same time, Colorado’s state controller would not share EFT payment information with DentaQuest due to privacy concerns. All of that data had to be collected from providers and re-entered into the new system, which created major payment delays for many providers. Colorado anticipated some challenges, as they occur in any program transition. However, Colorado was fortunate in being able to learn from issues other states faced when transitioning their Medicaid administration and make provisions to preempt some other potential problems. “We learned that the state of Colorado was considering an administrative transition to a TPA model. Because of the historical perspective provided by other states, we were able to include legislative language that protected patients and the provider community if the state were to transition to a TPA, which they ultimately did. The legislative framework preserved the state’s policy-making authority, prohibited any mandates on providers to accept additional vendor plans in order to join the Medicaid network, and required the state to choose a single-vendor system as opposed to the MCO model,” Goodrum said. Given experience in other states and not knowing who the Colorado vendor would ultimately be, the CDA was concerned that if a TPA was given carte blanche to set benefits and reimbursement levels and oversee the credentialing process, the contractor would focus on profit, not patients. Even so, credentialing has been difficult for the state. In spite of efforts to streamline the application process for dentists, dentists were required to use a standard credentialing form used for all provider types. As such, the forms were cumbersome, as the bulk of the credentialing documents were inapplicable. To make matters worse, Colorado uses a different vendor for credentialing than program administration, which seemed to decrease efficiency and discourage cooperation, further delaying credentialing for some dentists. Adding to these challenges, the state of Colorado’s vendor for credentialing is scheduled to change in fall 2016, and the information maintained by the current vendor is not expected to transfer. The federal recredentialing mandate for Medicaid combined with a new vendor means that dentists, who in many cases just completed credentialing, are being asked to start from scratch in the process. These inefficiencies continue to create frustration in the provider community. In hindsight, Goodrum said that Colorado might reconsider the policy of segregating provider credentialing from the TPA. “Though transferring credentialing of providers into the TPA that you’re using isn’t a perfect solution, at least they’re accountable.” So where’s the good in all this? Well, once the dust settled, the
state found that both utilization and provider participation had increased. On the provider side, Goodrum shared that more than 30 percent of Colorado’s dentists are now enrolled to participate in the program. The state reported a 17 percent increase in dentist provider participation during just the first year of the adult dental benefit and an increase of 28 percent in the number of dentists who saw more than 30 Medicaid patients in their practice. First year utilization numbers for the adult benefit are reported to be comparable with utilization in some private plans, which Goodrum calls “impressive.” Goodrum said, “This uptake is great news for patients and dental access in Colorado. Providers are to be commended for their commitment and patience through a tough transition. Moving forward, we hope that the process is much smoother for providers, and we continue to work on providers’ behalf to make that happen.”
Innovative incentives
Of course, there are some important details that have led to the state’s success: Reimbursement rates for adults and children currently average in the low 50 percent range, while reimbursement for preventative and diagnostic procedures have been raised to 65 percent of UCR; Colorado legislators have generally been supportive of Medicaid dental benefits on both sides of the political aisle; Colorado’s rapid expansion of its Medicaid member base, which is currently about 25 percent of overall population at 1.3 million Medicaid clients, has driven substantial legislator attention to the program benefits; and the state invested funding (and obtained federal matching dollars) to fund an innovative program to incentivize providers to take Medicaid patients. The program, called “Take 5,” encouraged dentists who weren’t taking Medicaid patients to sign up and see how it had changed for the better. The hook? Dentists who saw five patients got an extra $1,000 payment. When they added 50 additional Medicaid patients, they received a total of $2,000 in extra payment, and if they served a total of 105 new Medicaid patients, they earned $3,000 total. Existing Medicaid providers were also eligible for the incentive program if they added new Medicaid patients to their practice. Additionally, Goodrum said, “We were able to add a denture benefit that was separate from the $1,000 cap that we have on the general adult dental benefit. Thanks to great legislative support, in addition to adding the adult benefit and guidelines for using a TPA model, we were able to increase reimbursement rates two years in a row. We were fortunate to have a perfect storm of legislative commitment around making the program work. We’re not all the way there. We want to have continued conversations about how to make rates sustainable long-term, especially if our Medicaid population continues to expand. There is no guarantee of this support continuing long-term, and there have already been challenges to the adult dental benefit in the state legislature. When there are budget constraints, as Colorado is facing, optional state benefits like adult dental are the first to come under scrutiny. We’re still very thankful to have done a lot with our legislators’ help and support in a short amount of time.”
Oregon: A multitude of players
In Oregon, where the transition to a hybrid CCO/DCO administration system has been evolving over the past 8 years, the
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what will happen to dental medicaid in washington?
Challenging rollout, encouraging results: Colorado
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In Colorado, where DentaQuest administers the state Medicaid program, the plan transition was nearly as rocky as its famous mountain range.
what will happen to dental medicaid in washington? cover stor y
last four years have seen a lot of changes on the dental side of Medicaid administration — but with 25 key players, the plan is Gordian in nature. As Christina Bodamer, managing director of government affairs and communications at the Oregon Dental Association, explained, “Dental care has been administered through managed care for quite a while, but we recently transitioned all Medicaid healthcare delivery systems — medical, mental, and dental health – to 16 different CCOs, who are given a chunk of money to provide any services that their population needs in a much more flexible manner.” There are some metric incentive dental requirements (including sealants and a foster care requirement for screenings), but a lot of autonomy is given to the CCOs to allow communities to determine their health priorities. However, only about half of the CCOs in the state have dentists represented on their boards, and according to Bodamer, it took them a while to realize that everything about dental is different, especially billing and coding. To help manage that, CCOs began contracting with Dental Care Organizations (DCO) to administer dental Medicaid. The problem, according to Bodamer, is the sheer number of players. “There are nine DCOs and 16 CCOs in Oregon. The 16 CCOs are free to contract individually with the nine DCOs, so it’s been complicated trying to coordinate contracts with as many of the CCOs as possible in Oregon,” she said. “Having so many stakeholders isn’t supposed to cut into the amount available for patients, but that’s challenging to ascertain. Each CCO has a different contract with each DCO, and their models and contracts are proprietary, so we don’t know what those contracts look like unless they are willing to share them with us.” And while providers are free to sign with as many or as few DCOs as they like, if a provider only wants to serve the Oregon Health Plan (OHP) community, they have to sign nine contracts with nine DCOs. Some CCOs have been exploring the option of creating their own provider panels, adding to the confusion. They haven’t successfully done it yet, but Bodamer has heard rumblings. That could add a new layer of complexity. Instead of dentists having to contract with a DCO, they could become a provider for the panel directly with the CCO. In Oregon, Delta Dental and DentaQuest service OHP and private insurance patients, and so far, Bodamer said, they’ve seen no effort to create mandates for providers around ratios of Medicaid to private patients. Even though the dental administration has been in place for two years, it’s still working on compiling data to determine how the plan is working for both providers and OHP members. Bodamer said, “What we keep reminding members is that more people having dental insurance is ultimately a good thing. That means more care can get delivered because more people are in the system. We’re still working on what kind of benefits the providers might get, but since CCOs have metrics, there are incentives when they reach certain benchmarks which should benefit the provider in the end.”
The CHC perspective in Oregon
Dr. Mark Koday, chief dental officer for the Yakima Valley Farm Workers Clinic, oversees several Oregon locations for the organization, and has watched the transition unfold there. We wondered, would he support the same model here in Washington? Communication was one of his key concerns. “As you know, the health centers
and the WSDA spent years developing the relationship we have with Medicaid, and who knows how long it would take to build a new relationship with a new group?” Koday said. “From what I’ve read in other states where the transition went more smoothly, they had the stakeholder groups facilitating the process. But if you just hand it over to another organization that could be a problem. In Oregon, while they gave the money to the CCOs and the DCOs, they did so with provisos about how the money could be used, so they ended up with a good set of quality metrics that are managed at the CCO/ DCO level. I know from the standpoint of our clinic that the communication has gotten better. But there was almost no communication before, unlike Washington, where the communication is pretty decent.” But Koday also worries about the administrative fees inherent in a system like Oregon’s, saying, “The biggest concern I have is determining where the money is coming from. If you want to increase reimbursement rates, you’re going to have to find more money. In Oregon, there are 25 different organizations, each with their own administrative fees, and that money has to come from somewhere. Bottom line, it all depends on how interested the state will be in funding oral health. A well-funded transition could be of great interest to our state’s dentists and very beneficial to our Medicaid population.”
Michigan: A familiar player
In Michigan, there are three Medicaid programs, but in this article, we’ll focus on just one: Healthy Kids Dental, a plan administered by Delta Dental with an 81 percent provider-participation rate (about triple the number of providers while managed by the state). The transition from a state-administered Medicaid plan to TPA administration started in 2000 under a waiver from the traditional Medicaid program, and only applies to children ages 0 to 22. Initially rolled out in just 22 of the state’s 83 counties, Delta was awarded the contract because it was the only company with a wideenough network, and it has remained a no-bid contract until this year, when the federal government pressured the state to put it out for bid. Now the programs cover almost all eligible children across the state, with kids over 13 in the three final counties receiving coverage in 2017. We reached out to Bill Sullivan, director of government and insurance affairs for the Michigan Dental Association (MDA), to ask about their relationship with Delta Dental, and to see how their administration of the children’s Medicaid plan is going. The verdict? It’s largely been positive. Sullivan told us that, like Washington, traditional Medicaid reimbursement rates were low, about 25 percent, and plan utilization was at about 35 percent. Sullivan said, “When Healthy Kids first started in 2000, the reimbursement rate was 90 percent. It dropped down to 60 percent in 2006, when the state wanted to expand the program again, but they didn’t have the money to do it. They were able to pay for the expansion by cutting the rate. Reimbursement times are good, billing is easy. It’s the regular Delta system they already use. The administrative side is very good, and changes put into effect when Delta began administering the program have helped boost the utilization rate to current levels.” Sullivan continued, saying, “In terms of the Healthy Kids dental program, dentists really like it. We like the fee schedule (and don’t want to see further cuts and would welcome increases), ease of administration, and that patients are issued a private insurance card instead of a Medic-
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A tough transition in Idaho
As we said earlier, CDA staff used Idaho’s transition problems as a model of what not to do. Specifically, they inserted language into their legislation to ensure that the state retained control of the benefit and rates to allow maximum flexibility, and to protect the integrity of the benefit. We spoke with Linda Swanstrom, executive director of the Idaho State Dental Association, and Dr. John Ukich, president of the Idaho Pediatric Dental Association, to get their take on their state’s transition to DentaQuest.
How Idaho’s plan works
The state sets the overall budget it is willing to spend on dental (approximately $43 million), and pays DentaQuest a per-participant fee. If more participants come into the system than the state budgeted for, the state has to pony up the difference, not DentaQuest. The state has service levels that DentaQuest (or any other third-party administrator) has to meet: They have goals on member utilization; and they have contract specifications to provide care within a geographic area that varies in size, depending on whether the area is rural or urban. DentaQuest collects the data and reports back to the state. Its administrative fee is maxed at 15 percent (approximately $6,450,000) of the total budget, but can be less than that, which is why it closely monitors every aspect under its control. The problem, says Ukich, is that this comes at a cost to both patients and providers. Ukich said that since being awarded the contract eight years ago, the company has reduced reimbursement rates 10 percent, moved to limit providers, and cut benefits to Medicaid patients. Swanstrom, who wasn’t in place when the transition happened, is in total agreement with Ukich’s assessment about provider panels. “They absolutely control the reimbursement rate,” she explained, “and they absolutely control who is credentialed with them and on the panel of providers. They have to manage an equation that includes a population of patients, the benefits they have to provide, and the budget they’ve been given. The knobs they turn to balance the equation are reimbursement rates and the number of dentists on the panel.” DentaQuest first closed the panel following the first three years of the contract. According to Swanstrom, “When they first came in to administer the contract, there was a lot of angst about how the state had run the program. DentaQuest opened the panel, and they lost money. They responded by shutting the panel down and cutting more than 100 providers from the panel. They really cleaned house, and there were a lot of upset dentists.” To add insult to injury, Ukich claims that dentists cut from the panel were sent a letter describing them as “over-providers” in the state of Idaho. The letter unilaterally terminated their contract with DentaQuest, with no option for recourse, and no clear definition of what an “over-provider” was. Were they saying the practices had committed fraud? Ukich said, “Our office wasn’t one of the ones that got dropped, but there were a number of practices taking Medicaid — some as much as 50 to 60 percent of their
practice — and overnight they were told they could no longer see those patients because they were ‘over-providing’ to the community. I would assume that they meant the dentists were committing fraud, but it was never clearly defined.” The ISDA was able to work with the governor’s office and DentaQuest to eventually ameliorate the situation, but the company has said it can audit anyone it suspects of the infraction in the future. In the wake of the house-cleaning measure, the company has been very deliberate in the way it allows providers back on the panel. “This has been a very sore point for providers in Idaho,” Swanstrom said. “They have a set of rules that determines how providers can get back on. It’s almost as if they are credentialing a location as opposed to a provider. If you have a location and you move, the provider doesn’t keep the Medicaid credential, the location does, which is a problem for dentists. If a new associate joins the practice, they don’t automatically get a credential, which can create headaches. It’s a problem because it restricts your capacity to treat patients, and it’s a billing nightmare.” DentaQuest counters that it’s expensive to credential providers and maintain them on a panel, and that cuts into the pool of money left for patients. Further, DentaQuest said that it’s hitting all of Idaho’s required metrics, and its data substantiates its claim that allowing more providers on the panel would only drive up costs, further reducing the number of Medicaid patients who could be seen.
Creating an advisory committee
Following the dustup, ISDA worked to develop a provider advisory committee comprised of dentists (a mix of specialists, GPs, and doctors from FQHCs), public health officials, hygienists, the ISDA, and stakeholders from DentaQuest. Ukich is skeptical of the committee’s ability to really move the needle, but Swanstrom points to some positive changes the group has been able accomplish, but admits, “Some change has come as a result from issues brought forward, but it certainly hasn’t resulted in the progress we hoped for. Still, the committee has been able to achieve some clarity about why DentaQuest denies some claims, and DentaQuest has made some reimbursement rate adjustments.” There are still hurdles to be met, she said, citing inconsistent case approval and requests to open the panel to more providers. “Some days procedures are approved, and other days they aren’t. It feels a little like winning the lottery,” she said. Now, with the contract up for bid and companies like Advantage Dental and MCNA throwing their hats into the ring in Idaho, what does Ukich’s best-case scenario look like? “My hope would be that there will be a realistic vision in terms of what it will take to meet the dental healthcare needs of Idaho’s Medicaid community,” he said. “There’s an adage, ‘Charity does not constitute a healthcare system,’ and that’s currently the situation that we have. My hope is that a new company might be able to influence Medicaid money budgeted by the state and the reimbursement rates.”
What will Washington’s path be?
One thing is certain. Although the road ahead in Washington may not be clear, we’re fortunate to have so many examples of what was done well and what wasn’t to cull from when making our recommendations to the state. In the months ahead, WSDA will share information as the process unfolds.
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what will happen to dental medicaid in washington?
aid card, which reduces the stigma associated with Medicaid. The biggest complaint about the program is that you have to be a Delta-enrolled provider to participate.” The MDA would also like to know how many of the dentists who are counted as Healthy Kids providers are actually seeing children under the plan.
cover stor y
In Oregon, while they gave the money to the CCOs and the DCOs, they did so with provisos about how the money could be used, so they ended up with a good set of quality metrics that are managed at the CCO/DCO level.
events across the state give kids a smile Photos, this spread: The colorful Toothapalooza crew has a blast at their annual event
Give Kids A Smile events are an important way for dentists to solidify community relations among uninsured and underinsured populations. Even with Medicaid funding for children, there are still a few who fall through the cracks. We’re proud of our members for taking the initiative to help those in need! 1 2 · th e wsda ne w s · issue 5, april · 2016 · www.wsda.org
EVENTS ACROSS THE STATE PROVIDE FREE DENTAL CARE
Dr. Judson Werner
On Feb. 5, 2016, Dr. Judson Werner hosted his 12th Annual Give Kids a Smile event. He partnered with the Boys and Girls Club of Bellevue and saw 14 children for free cleanings, exams, oral hygiene instructions, and fluoride. Werner donated more than $3,500 worth of care to youngsters who may otherwise have not had access to care. Thanks, Dr. Werner!
Toothapoolaza
The Snohomish County Dental Society and its Foundation partnered with the Imagine Children’s Museum in Everett for the fourth annual Toothapalooza /Give Kids A Smile program during the month of February. Each Friday in February, the Imagine Children’s Museum Art Studio featured dental health-themed art projects. Children also had the opportunity to participate in many fun and educational dental-related activities and experiments throughout the museum, including: how food and drinks can stain teeth; the effects of sugar; spinning the Wheel of Knowledge to answer dental trivia ques-
tions; painting a dental superhero using toothpaste and toothbrush; hearing dental-themed books for story time; and much more! On Feb. 17, the museum held a free community night featuring Toothapalooza. The goal of this event was to reach a wide range of families from varying income levels who might not otherwise be able to afford a visit to the museum. Visitors were greeted by dental health professionals and local dental assistant students, who demonstrated the importance of proper and regular dental care and check-ups. Dentists performed mini exams and provided information on resources for receiving follow-up care. Every child who attended during the Friday activities received a “goody bag” with a toothbrush, toothpaste, and floss. The Toothapalooza /GKAS program is designed for children ages 1 to 12 and their caregivers, with the goal of providing information about dental disease prevention and available treatments in a fun, hands-on manner. This is the fourth year for partnering with the Children’s Museum for this successful event. WSDA would like to thank everyone involved!
South Sound Free Dental Day
Light Dental Studios (in multiple locations) rounded up 75 staff members (14 of whom were doctors) and saw 140 patients in their event, which was not limited to children. Patients were seen on a first-come, first-served basis. Patients ages 14 and older got one free filling or extraction, while those younger than 14 received a free fluoride varnish. Go Team!
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events across the state
Every year in February, dentists across the state hold Give Kids A Smile (GKAS) events to provide screenings, cleanings, and other care to children who might not otherwise see a dentist. Even though Apple Care provides so much access in the state, there are still some families who are not covered. GKAS events help close that gap. From Bellevue to the South Sound, we heard from several groups who went all out. We’re honored that you’re our members, and thank you for your service to the community!
give kids a smile
GIVING KIDS A REASON TO SMILE!
events across the state give kids a smile
Photos this page: Dr. Judson Werner and his staff saw 14 children during their 12th annual Give Kids a Smile event. Opposite page, Light Dental Studios held a South Sound Free Dental Day that provided care to kids and adults
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give kids a smile
events across the state
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mount baker dentists give back veterans smile day
MAKING VETS WHOLE AGAIN:
Dentists in Mount Baker join with denturists, staff and volunteers to provide free dentistry to veterans On November 11, 2015 dentists in Whatcom and Skagit Counties participated in the Veterans Smile Day program. The program was started a few years ago to facilitate free dental care for veterans in need and to bring awareness to veterans’ needs. The Mount Baker District Dental Society (MBDDS) was able to partner in the event with a local community health organization, Whatcom Alliance for Healthcare Advancement (WAHA). WAHA coordinated patient care by recruiting patients from the local veterans services office and elsewhere within the community and scheduling the patients with participating dentists. Dr. Aaron Lemperes of Bellingham saw 27 patients and provided more than $8,000 in free care to veterans in need. Services provided included adult prophies, exams, radiographs, composite and amalgam restorations, and extractions. “The patients that we served ranged from World War II veterans to recently returned veterans. Each man and woman had a story to tell that touched us deeply. The toll that their sacrifices had made on their lives and families was clear. Many of the younger veterans were now in school seeking degrees in many different fields. It was humbling and rewarding for us to be able to serve these brave men and women. We plan to participate next year again,” stated Dr. Lemperes.
Dr. Peter Kim of Mount Vernon saw seven patients for numerous extractions, providing more than $7,700 in donated care. Dr. Kim said, “All of the gentlemen were very appreciative. One had all of his remaining upper teeth extracted, and we were able to refer him to Amy Varshock, a denturist at Denture Essentials, who is helping him to get a denture. He stated that getting a denture would ‘be a dream.’ It was truly gratifying to treat these deserving individuals and we plan to participate again next year.” Other dentists participating in Veterans Smile Day or providing follow up care for those treated on Veterans Day included Dr. Richard Simcock and Dr. Matthew Carlson of Mount Vernon, Dr. Darcie Morris and Dr. Noah Frerichs of Mount Vernon, and Dr. Darcie Galbraith, Dr. Mark Fairbanks, Dr. Terra Schmidt, and Dr. Mike Jorgenson of Bellingham. There was further support from Shofu, who donated dental materials, and Woods Coffee, who donated coffee and pastries for the veterans being treated. The MBDDS plans to participate in the Veterans Smile Day program again this year. For questions about organizing your own Veterans Smile Day event this year, you may contact Aaron Lemperes at aaron@lemperesdentistry.com.
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veterans smile day
mount baker dentists give back
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lecture highlights: betsy reynolds pndc news
Editor’s Note: We spoke with Betsy Reynolds about two lectures she’ll be bringing to the Pacific Northwest Dental Conference this June. Energetic and articulate, Reynolds is bursting with information about these two important subjects facing nearly every dentist. We sat down with her to ask her for a taste of her lectures and the kind of information attendees will learn.
What are different types of tobacco use besides traditional cigarettes, cigars and pipes? Hookahs Hookah use is exploding across the country. It is as addictive as other tobacco products, and twice as toxic. There are no filters, of course, and the second-hand smoke is much more dangerous. It’s a misconception that people use less – in one hookah session you actually smoke dramatically more than you would if you were smoking cigarettes for the same amount of time. And studies have found that some actually become addicted to the social aspect of hookah use. What started as a social phenomenon, is now becoming a physical and social addiction. Hookah has dramatically increased among high school seniors, up to 23 percent from 17 percent from 2010 to 2014. That’s partly because there is little oversight in hookah clubs, and because more people are buying their own hookahs. Smokeless tobacco Adolescent use of smokeless tobacco products like chew dramatically increased between 2008 and 2010, but then it leveled off between 2010 and 2014. We’re not sure why use has leveled off, but regardless, adolescent use remains higher than it has ever been. We really don’t know why — tobacco products can be harder to get than alcohol because they have to find someone to purchase it for them. It could be because smokeless products are cheaper and easier to hide. There’s no smell, but there are horrible oral consequences. There is so little data about the other types of smokeless products like patches, lozenges, strips, and sticks that adolescents use. One appeal is likely the candy flavors so prevalent in these products. The problem is there is simply no reliable data we can look at for trends in this area, but we’re worried about how this could escalate if unchecked. We’ll talk about what you can do as providers to discourage use, and what to look for.
Why do you think so many young people are attracted to e-cigarettes?
E-cig use has literally exploded since they were introduced in the US markets in 2007. We started seeing trends in sales skyrocket since 2008. From a marketing and sales perspective, it’s been an incredible success. The sale of these products is not regulated by the Consumer Product Safety Commission or the FDA. They’re expensive, which can be an effective deterrent for young kids, but anyone can buy them which has caused a huge surge in their use. There is blatant marketing to adolescents – they come in flavors like Hawaiian Punch, chocolate, and bubble gum, flavors traditionally viewed as attractive to children. Additionally, though they are marketed as an alternative to smoking there is compelling evidence that people who never smoked in their lives have picked up the e-cig habit. Once you pick up a hand-to-mouth habit it is very hard to kick. One other thing that I will discuss is the dramatic increase in poisoning in children from the e-cig liquid because of the flavoring. There were 56 cases in 2014 alone.
Why should dentists be concerned about prescription drug abuse? Isn’t that more an issue for physicians?
Dentists are a prime target for doctor shoppers now. That’s where a lot of addicts are getting their opioid prescriptions. The CDC recently released new guidelines in regard to opioid prescribing, in part because we’re now seeing 40 people a day die from opioid abuse. The new recommendations say the first line of defense in pain relief should be nsaids, or non-meds like exercise and changes in cognitive behavior. They recommend that opioid prescriptions should be for short-term use only, and that blood tests be administered prior to any new opioid prescription is written. They are calling for the lowest -possible dose, and for immediate release versus long acting dosage types. It’s a recommendation that we’ve been waiting a long time for, but it is only a recommendation, not a law. Almost 163,000 people died in the last five years due to opioid overdose, and more needs to be done to curb their use and over-prescribing. But opoids are not the only risk factor, you have to be careful because it’s easier than you think to overdose on alternative pain meds like nsaids and acetaminophen, too.
Is medication abuse happening across many different socio-economic levels?
Yes, but we’re now seeing high opioid drug abuse in the elderly and the wealthy. Opioids are not making any distinction between gender, age, affluence — they’re hitting everybody. One of the reasons people are so quickly becoming addicted is that when they are used chronically, the drugs dramatically lower your pain threshold, so the more you use, the more you need to relieve the pain. Because it is a drug-driven dose increaser, it’s a quick and easy cycle to drug abuse. We make up 5 percent of the world’s population, but we take 42 percent of the prescriptions and the most opioids of any other country.
Should dentists suggest to patients to try over-the-counter medications before reaching for the prescription pad? Absolutely, but with caution. Ibuprofen and Tylenol have their own set of issues with toxicity and interactions with other drugs.
How can dentists help prevent abuse of over-the-counter medications?
The trend in OTC drug abuse is really declining. Kids are getting away from it because the prime abuse was in cough medications containing dextromethorphan. Because those ingredients are used in the production of meth, regulations restricting the sale of the products has had a tremendous effect in the decline of use. Locking Sudafed and cough syrups at pharmacies and grocery stores has been a game changer. Still, we’ll talk about the lingering concerns in OTC drugs and what you should tell your patients. Up In Smoke: Current Trends in Smoking Habits Effecting Oral and Systemic Health Betsy Reynolds, RDH Saturday, June 18 from 9:00 a.m. - 12:00 p.m. • Code 43 CE Credits: 3 Hours Room: Meydenbauer 401-403 Drug Store Addiction: The Abuse of Prescription and Over-the-Counter Medications Betsy Reynolds, RDH Saturday, June 18 from 1:00 p.m. - 4:00 p.m. • Code 44 CE Credits: 3 Hours Room: Meydenbauer 401-403
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Betsy Reynolds
VAPE DANGER:
JUST ONE OF BETSY REYNOLD’S EXCITING OFFERINGS AT THE PNDC th thee wsda wsda ne new wss ·· issue issue 5, 5, april april ·· 2016 2016 ·· www.wsda.org www.wsda.org ·· 19 19
lecture highlights: betsy reynolds
JUNE 16, 17, 18 BELLEVUE, WASH wsda.org/pndc
pndc news
2016 PNDC
LIVE DEMO AT THE PNDC
pndc news
lecture highlights: dr. geoff berg
CAD/CAM: WILL YOU BENEFIT?
Dr. Geoffrey Berg Digital Implant Dentistry Geoffrey Berg, DMD Saturday, June 18 from 8:30 a.m. - 4:00 p.m. • Code 32 CE Credits: 6 Hours · Room: Meydenbauer Exhibit Hall
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Editor’s Note: Thanks to our generous sponsors - Henry Schein, Patterson Dental Supply, and Sirana, attendees of this lecture will have the chance to view several 3D technologies in class. We sat down to talk with Dr. Geoff Berg about his upcoming live demonstration CAD/CAM workshop at the PNDC. We wanted to know who would most benefit from the offering, and why?
What is the lecture about?
It’s technology from start to finish. We’re going to talk about CAD/CAM, guided surgery, and how cone beam 3D imaging integrates with everything.
Will this course be useful for a general dentist who doesn’t place implants?
This lecture has applications for general dentists. Even if you’re a general dentist who is not placing implants, 3D imaging is still the best way to prepare and plan your cases. If you’re a general dentist who doesn’t want to do surgery, you should still want to be fully involved in the planning and imaging. By combining CAD/CAM and cone beam, you can actually plan the case, starting from the crown all the way back to the implant, so that you know exactly what the outcome is going to be before you even start. And while there is increased radiation with the cone beam technology, I don’t believe there is an increased risk factor. When you compare what the dosage is to ambient radiation, a cone beam image is about the same radiation that you would get if you were taking a plane trip across the country. I think people don’t completely understand that – it’s really pretty minimal. Another example we like to use is that the amount of radiation you receive in a cone beam image is comparable to the amount you get when eating a banana. Especially with digital and the way they have reduced dosages over time, I really don’t consider it a risk factor any more. In fact, in Oregon we just got a letter from the state saying that placing lead aprons on patients is no longer required because the amount of radiation is so low.
I don’t have a CAD/CAM. Should I still take the course?
No CAD/CAM? You can still learn. Even if you don’t have a cone beam machine, they’re becoming so much more common that I really don’t know anyone who doesn’t have access. Just from a diagnostic standpoint, getting access to cone beam images and understanding how to read them and get the most information from them will help you in your practice. In the 10 years that I have been teaching cone beam, it has gone from there being one in Portland to dozens of imaging centers and specialists who have them. The access has gone up exponentially.
What’s so special about cone beam? Are there limitations?
The cone beam’s three-dimensional image takes all the guesswork out of the process. You see the whole picture and the accuracy is very much increased over traditional X-ray images, which means fewer surprises. There are barriers. Cost is one, but it’s coming down. The range is $60,000 to $100,000 for a machine. There are limitations to
the patient as well, because a cone beam image will have a higher cost to them than a traditional X-ray. But honestly, I’ve never had a patient turn down a CT scan when placing an implant because I’m doing it for their safety and the best possible outcome. It’s not something that is being done for fun or for show. The only limitation of the technology is in diagnosing bone density, although it gives a much better picture than a traditional x-ray does.
How will dentists know if this type of technology is right for their practice?
I don’t like to look at getting the technology as strictly a financial decision. You’re not going to make money by incorporating this tech into your practice, but if you’re doing implants, whether you’re doing surgery or just restorations, you would benefit from the technology. If you are ready to have a higher diagnostic power, and if you’re the kind of practitioner who finds yourself wanting to be able to diagnose better, the cone beam will do that for you. The number one thing when you’re incorporating this technology is researching and understanding all the ways you can use it in your practice, which is what you’ll learn in the lecture. Most dentists understand cone beam’s use in implants, but there are a lot of dentists who use them for endodontic procedures like root canals, to diagnose different bone and gum conditions, and to plan treatments more effectively. The way I see it, I’m not going to just hold off and use cone beam on an implant patient, I’m going to use it on every patient because it allows me to see things at a higher level.
What will dentists see and take away from the lecture?
Essentially, they will see a patient getting an implant treatment from start to finish, using all the latest technology. I’ll be bringing one of my patients in and showing how the scan process works, show how we can treatment plan on the computer, and show how we’ll fabricate a stint or surgical guide. The guide allows me to plan the surgery entirely on the computer, so that when we go to the patient’s mouth, we put the stint in and it guides the drills through the drilling sequence in such a fashion that you really can’t go wrong. It allows us to take what could be a difficult surgery and turn it into such a simple procedure that literally any dentist in the audience could get up on the stage and perform it without a problem. Finally, we’ll show how you can use CAD/CAM to complete the restoration to make the implant look as natural as possible. My goal is that any implant I place will look and function like a natural tooth – so well that a dentist looking at it wouldn’t immediately know that it is an implant. I think you’re going to really enjoy this exploration of the technology!
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lecture highlights: dr. geoff berg
JUNE 16, 17, 18 BELLEVUE, WASH wsda.org/pndc
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special olympics news how you can help
The WSDA is proud to announce that it is partnering with the Special Olympics Special Smiles program to help provide free oral health screenings to the 14,500 Washington athletes who are part of Special Olympics Washington. In order to be successful, we need member dentists and their teams to provide screenings at regional events across the state. There are four regions in Washington – Northwest (Mountlake Terrace North to the Canadian border), King County, Southwest, and East – and all have events throughout the year where oral health screenings can occur. Volunteer dentists are not required to bring any equipment or supplies, but donations of branded toothbrushes and floss are welcome. Forms will be provided to athletes who need followup care, and volunteer screeners are encouraged to serve as a dental home for the athletes in their area. Hygienists and staff are encouraged to attend and provide basic oral health education.
Sign up to help today! Please visit http://specialolympicswashington.org/sowa/calendar/sporting_events to find events in your area where you can volunteer. Contact Victoria Mehren – Special Olympics Washington director of health and training – at vmehren@sowa. org or 206.681.9381 to schedule a screening.
SPECIAL SMILES
WSDA partners with the Special Olympics Special Smiles Program
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2 6 · th e wsda ne w s · issue 5, april · 2016 · www.wsda.org
nordic news nordic website is live
In March, NORDIC rolled out its new website — the last of four to be overhauled by the WSDA. The site utilizes the same design cues that WSDA, WOHF, and WDIA share. The new design is clean and spare, easy to navigate, and fully responsive, meaning that no matter what you’re viewing it on – phone, tablet, laptop, or desktop computer – the site design automatically restructures content to make it user-friendly, searchable, and coherent.
Fast loading on all devices: desktop, tablet or phone
Bold graphics, which were once the bane of websites because they created long download times, are handled very efficiently on Squarespace, meaning that the site can be dynamic and attractive.... and still very fast loading on all devices.
Content-rich
All of NORDIC’s forms are available to download on the site, and you can request information on any of its products, as well. NORDIC will continue to offer its self-study risk management course online, and later this year plans to roll out a more simplified online test version. Additionally, you can find contact information for NORDIC staff, WDIA sales staff, and dates, times, and locations of all NORDIC’s educational programming around the state.
LAST, BUT NOT LEAST
Please visit the site
We want to hear your thoughts about the new site. Let us know if there is additional functionality we could offer that would make your online experience better at nordicins.com.
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THE REDESIGN OF NORDICINS.COM IS COMPLETE!
wdia news the need for long term care insurance
As you build your financial portfolio for your financial security now and in anticipation of enjoying a long retirement, you need to factor in the cost of care for when you need assistance in your home or become a resident of a nursing home or assisted-living facility. The average length of stay at a nursing home is 2.5 years, which in Washington state could cost you more than $272,000. You can designate money in your portfolio to cover the costs or you can purchase long-term care insurance.
For 2015, the average annual cost of a nursing home in Washington was $108,800; an assisted- living facility was $57,000; and in-home care with a health aide was $56,500. Long-term care insurance will help you meet the cost of your and your spouse’s care should you need assistance with daily living. It gives you the flexibility to choose when and where you receive care and provides emotional and financial support for your family.
70 percent of people over the age of 65 will require long-term care services at some point in their lives. Long-term care insurance is similar to disability or life insurance in that you pay a monthly premium to have a pool of money available to you when you need it. Unfortunately, “longterm care” is not an accurate description of the benefits provided on a long-term care insurance policy. “Family freedom coverage” may be more accurate. This type of insurance frees you from the substantial financial burden of paying for care, while it frees your family from the burden of caring for you at the detriment of their time, finances, and physical and emotional well-being.
41 percent of people receiving long-term care are between the ages of 18 and 64. Since the need for assistance, not age, is the trigger for receiving long-term care benefits, this insurance will cover you should the unexpected happen at any age. For example, if at age 47 an illness or accident leaves you needing care, you would be eligible to receive benefits. This would allow your spouse to continue working or caring for your children, while a professional caregiver comes to your home to help you with your daily needs, such as bathing, dressing, or getting in and out of bed. Washington Dentists’ Insurance Agency strongly encourages you to add long-term care insurance to your insurance portfolio. Along with disability and life insurance, long-term care insurance will protect you and your family from the large financial burden that an accident or illness may cause. Purchasing coverage will relieve your family members of having to center their lives on your personal care and give you the freedom to choose where you want your care to take place.
If you are ready to look at your long term care insurance options, please contact Washington Dentists’ Insurance Agency at 206-441-6824 or 1-800-282-9342
Sole broker for:
2 8 · th e wsda ne w s · issue 5, april · 2016 · www.wsda.org
Are you one of the 40 percent who isn’t prepared?
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wdia news the need for long term care insurance
THE NEED FOR LONG TERM CARE INSURANCE
2016 citizen of the year award nominate a peer today!
Nominate a peer today! WSDA Citizen of the Year Award Last year, WSDA was proud to have Dr. Jacqueline Angell (seen on the opposite page) as the recipient of the Citizen of the Year Award, the highest honor we can bestow as a state Association on one of our own. Angell, whose volunteer work has taken her to Africa, the Dominican Republic, Haiti, and right here in the Pacific Northwest, exemplifies the kind of dedication we honor with the award. The award exists to recognize a member dentist who has given outstanding service to a domestic and/or foreign community; to encourage others toward such activity; to reinforce values of volunteer service desirable in society; and to promote the image of dentistry.
Nominations: • Nominations can be made online: wsda.org/coy-nomination-form
Criteria for Selection: • The nominee must be a WSDA member. • The award will be based on civic activities, elective and volunteer, including, but not limited to: Service organizations Youth groups Schools Non-salaried government positions Church-sponsored community services Personal commitment to community service through volunteering Service to all 501(c)(3) foundations
Exclusions: • Activities within organized dentistry are not considered for this award, including any 501(c)(3) foundation of any dental societies. • Dentists doing volunteer work for an organization for which they are paid will not be considered unless the task force can clearly identify volunteer hours versus paid hours and/or the task force considers the amount paid to be insignificant.
Nominations: • Nominations may be made by an individual member or a component dental society. Former nominees may be renominated. Letters of support from organizations with which the candidate has been involved are encouraged. • Nomination deadline: June 3, 2016
Selection: • Selection of the state award winner will be made by the Task Force on Recognition of the Washington State Dental Association.
Presentation: • The award will be presented at the annual House of Delegates meeting.
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WSDA LOOKS TO ITS MEMBERS TO NOMINATE CANDIDATES
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2016 citizen of the year award nominate a peer today!
2016 WSDA CITIZEN OF THE YEAR AWARD
WSDA NEWS APRIL 2016
PROFESSIONAL RACTICE P PECIALISTS S
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Aaron Pershall - Randy Harrison NEW! RENTON, WA – Longestablished G/P collecting around $1M annually. Office boasts 5 ops, digital xrays, Sirona Orthophos XG 5 and Cerec (Red Cam). Exceptionally profitable practice with a robust hygiene program! VANCOUVER, WA – Excellent, quality driven G/P collecting $600K+, in a wonderful, high traffic location. OREGON – Excellent G/P, OMS & Ortho opportunities! KAILUA-KONA, HI – Fee for Service G/P collecting around $400K. Seller is motivated! IDAHO - Partnership and Associate opportunities available!
MAT-SU VALLEY AK - High volume G/P seeking a full-time associate with possibility to purchase. ANCHORAGE AREA – G/P collecting around $750K annually. Highly profitable, low overhead office has 7 ops (6 equipped); runs Eaglesoft. ANCHORAGE, AK – Excellent G/P collecting around $870K. Seller is retiring and relocating. Great cash flow! ANCHORAGE, AK – Excellent practice collecting over $900K working only 35 weeks per year. Practice has emphasis on Prosthodontic, but production mix is varied.
KENAI PENINSULA, AK – Wonderful rural G/P collecting around $1M. Low overhead practice is amazingly profitable! Digital x-rays, laser, pano and newer equipment. ALASKA OMS – Long-established, highly profitable OMS practice collecting over $2.8M. Beautiful, spacious, modern office and excellent staff. ANCHORAGE, AK – Well established G/P collecting $500K annually. Possible merger opportunity. KETCHIKAN, AK – G/P collecting $600K. Well established office has 4 ops, updated about 5 years ago.
www.PracticeSales.com Aaron@PracticeSales.com RandyH@PracticeSales.com
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Medicare Part D enforcement deadline delayed “Dentists are still required to comply with this regulation. Simply not doing anything will not be considered an opt-out.”
The Centers for Medicare and Medicaid (CMS) is once again delaying the enforcement deadline of the Part D Prescriber Enrollment Requirement. The deadline is now Feb. 1, 2017. Despite this delay, CMS is encouraging providers to submit either their enrollment applications or opt-out affidavits to their Medicare Administrative Contractor (MAC) by Aug. 1, 2017, to ensure sufficient time for processing. The MAC in Washington state is Noridian Healthcare Solutions. As a reminder, although Medicare only covers a very limited number of dental procedures, dentists are still required to comply with this regulation. Simply not doing anything will not be considered an opt-out. Dentists will need to submit the required documentation to their MAC whether they are enrolling as a Medicare provider or as an ordering/referring provider, or opting out.
ADA, other health organizations concerned about tobacco products
The ADA News reported that the ADA, along with 35 other health organizations, “asked the Food and Drug Administration to be more diligent about requiring tobacco companies to obtain approval before introducing new tobacco products to market.” In a Feb. 26 letter to Mitchell Zeller, director of the FDA’s Center for Tobacco Products, “the organizations shared that they are ‘increasingly concerned’ that tobacco companies are introducing new tobacco products into the marketplace without proper regulatory review.” The letter stated, “The premarket review provisions of the Tobacco Control Act are intended to prevent the tobacco industry from continuing to introduce new tobacco products that are more harmful, more addictive and more appealing, particularly to young people.” The letter also points out that several new products are noncompliant with the act, requesting the FDA to “please explain why no enforcement actions have been taken by FDA against these products and indicate what the agency plans to do to prevent additional products from entering the market without the required regulatory review.”
More than 65 percent of adults report visiting dentist in past year
Fierce Practice Management reported that the United Health Foundation recently released a report that “looked at preventive measures across all 50 states in terms of access to care, immunizations and prevention of chronic disease.” According to the executive summary released with the report, “Just over 65 percent of adults report visiting a dentist or dental clinic in the last year.”
Many baby boomers unaware Medicare does not cover most routine dental care
CNBC states that many people age 50 to 64 are unaware that Medicare does not cover most routine dental care, according to a recent survey by advocacy group Oral Health America (OHA). OHA president and CEO Beth Truett said, “Now with 10,000 people retiring a day, suddenly people began to say, ‘Wait a minute, this is not what I expected.’” According to Truett, only 10 percent of seniors have dental coverage when they retire. As a result, “many retirees are opting to avoid going to the dentist altogether, with 40 percent saying they haven’t been to the dentist in the last year.” Given this, the article provides four tips to help save on dental costs, including looking up prices, taking advantage of group discounts, using veterans’ benefits, and receiving care at dental schools. MouthHealthy.org provides information on dental care for adults ages 40 older.
Noncitizens in the U.S. foregoing dental care, study finds
The ADA News reports that a study published in the March issue of The Journal of the American Dental Association finds “noncitizens and naturalized citizens in the U.S. had a lower rate of dental service use and are more likely to have had tooth extraction when compared with U.S.-born citizens.” Lead author Dr. Fernando Wilson, an associate professor in the department of health services research and administration at the University of Nebraska Medical Center, said, “Our study shows that many immigrants, particularly non-
th e wsda ne w s · issue 5, april · 2016 · www.wsda.org · 33
citizens, are lagging behind U.S.-born citizens in utilizing dental services such as comprehensive examinations regularly.” Dr. Wilson added, “Our findings demonstrate a clear need for targeted clinical and policy-based interventions to mitigate the legal and economic barriers to care many immigrants face when seeking dental care.”
Poll shows dental hygiene highly correlated with Americans’ well-being
The Washington Post reports that the recent Gallup-Healthways Well-Being Index, which “ranks 190 metropolitan areas by the well-being of their residents based on a survey of more than a quarter-million Americans,” was released Tuesday and found the most satisfied Americans “share at least one unintuitive characteristic: good dental hygiene.” The Post says “Places where people have good dental health also tend to be places where they report being generally fulfilled.” The article goes on to list cities and states that rank highly in terms of well-being. At the top of the list for cities are Naples, FL, Salinas, CA, and Sarasota, FL. Florida, California, Colorado, and Texas were “home to many of the communities with the highest well-being scores.” Dan Witters, research director for the Gallup-Healthways Well-Being Index, said dental care habits are a “surrogate” for wellbeing, adding, “People who take good care of their teeth generally think they have higher well-being lives.”
ada huddle highlights issue 5, april 2016
ADA Morning Huddle highlights
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Kvinsland makes news
WSDA member Dr. Eric Kvinsland recently made the news while teaching a class on dental hygiene – in the same first-grade class he attended in Gig Harbor. Kvinsland has lived in the area all his life, and is thrilled to be giving back to the community. Read the entire piece here: http://www. thenewstribune.com/news/local/community/gateway/g-living/article65445577.html
WPHP names new director
success for years to come and be well-positioned to continue to serve the needs of your organization efficiently and skillfully.
The 2016 Leaders in Health Care Awards: Outstanding Achievement in Community Outreach
WSDA would like to congratulate two local leaders for the work they do in their communities. Both were recently honored by Seattle Business Magazine. Julia Colson, Project Director for the Seattle/King County Clinic took the top prize, and the Swedish Community Specialty Clinic was awarded to silver medal.
zations across the region participated, including providers of lab services, software designers, translation services, vaccines, and dental equipment. Swedish Community Specialty Clinic · Silver Medal The Swedish Community Specialty Clinic’s dental program, which has provided complex oral surgery care for more than 1,800 low-income adults, is a partnership among the Seattle-King County Dental Society, Project Access Northwest, Seattle Special Care Dentistry, King County Community Health Clinics, and Swedish Medical Center. The clinic, the first of its kind in the Puget Sound region, has provided more than $2.4 million worth of free dental care since its inception in 2012. With more than 30 dentists and oral surgeons volunteering their time and expertise, the clinic is able to provide complex dental care five days a week at no cost to eligible low-income patients. Please join the WSDA in congratulating Colson and all the staff at the SCSC. We’re proud of you and the work you do!
The WPHP Board recently announced that Dr. Chris Bundy will succeed Dr. Meredith as WPHP’s next medical director. Board-certified in geriatric psychiatry, general psychiatry, and addiction medi- Julia Colson · Winner cine, Bundy has served as WPHP associ- For the past several years, Julia Colson ate medical director since May 2014. Prior has helped bring free dental, vision, and to coming to WPHP, he served as associate medical care to nearly 8,000 people in a chief of staff at VA Puget Sound Healthcare, safe and respectful environment. She is the directing the mental health care service project director for Seattle/King County Clinic, a large-scale, volunteer-driven free line. During his tenure at WPHP, Bundy has event that was held during a four-day pedemonstrated a powerful combination of riod in October 2014 and October 2015 at clinical expertise, skilled management, KeyArena. The patients seen were primarand personal commitment to WPHP’s mis- ily the working poor who waited in line sion and vision. The Board is confident overnight at Seattle Center to be admitted. his experience and leadership will result In addition to volunteer dentists from in a smooth transition and organizational the WSDA, more than 100 partner organiTransitions | Appraisals | Consulting | Real Estate | Valuations
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th e wsda ne w s · issue 5, april · 2016 · www.wsda.org · 35
newsflash wphp names new director, more
newsflash
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Congrats Cindy MONROE — Congratulations to Dr. Cindy Folsom and Dr. Joe Szabo on their successful transition!
Current listings TACOMA — NEW! 4 ops, currently part-time, poised for growth, central Tacoma location. ISSAQUAH — SOLD Charming Issaquah location! Small, efficient, profitable practice, tremendous base to grow larger practice, 150 new patients YTD, Eaglesoft, great visibility, ample parking, most PPO plans
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Dr. Jennings,
I have written you several emails in the past, only posted one that I can remember. The following “stuff” is relative to the latest WSDA issue. I spent a bit of time serving on the original disciplinary board, some WSDA committees, Lewis Pacific component, etc., so I am quite familiar with in-house politics, dentally speaking. Bitched long ago about the forked tongue we spoke with in our WSDA mouthpiece, lots of pictures with drinks in hand, while pontificating the dangers of tobacco. I sent letters noting my disgust. For a long time the drinks in hand disappeared from the WSDA journal. Slowly, I noticed a comeback, but this month, eureka, no drinks in hand. Good work! Saddened by the obits, as all were known to me for many years. Editor’s letters: Parrish has and will probably always play with a different drum and that is OK, even though I think editorially that we really don’t need such in our journal. Appreciated the Dr. Wentworth article on ethics. Therein reflected another of my long- ago bitches about our CE presentations. Seemed that the bottom line of too many presentations was how to coin more “dough” and develop the “million-dollar practice.” I see far too much money grubbing and self-promotion as to supposed societal importance with many of our ilk. DDS allows membership in a working guild only. It does not automatically bestow other awards and social honors; such are earned. When it comes to the “second tier of dental care” in Alaska, I will admit to being quite vocal toward my Alaska Native friends relative to establishing something better than they had, especially in the villages. During my six years in BIA/BIE educational institutions, I observed one dental program that consisted of an annual visit from folks in a white van. We were herded by grade levels through the mobile clinic for a visual exam. If you were called back for the afternoon session, you were guaranteed (to lose) some teeth. Next year, same deal. At the high school in Kansas, there was a contract dentist who did specific days in the campus hospital. No routine exams were done nor OH emphasized. If you had a toothache or thought you might need to see the dentist, you took yourself to the clinic and signed in. I had a visible hole between my upper central incisors and re-
ported because I didn’t want to be “ugly.” Seated, hmmed at, hold still, drill, fill, one and only visit in my four-year continuous residency. Got much better treatment when I contracted scabies. I think you do a commendable job, and your mirror reflection should image a valuable person. My original major was journalism and business, with a future goal of managing editor of a Muskogee daily. Oops! International bully gets frisky on the 24th of June around midnight, (CDST), and on the 25th day of July I was a U.S. Navy recruit in Okie City. Around five years later, I matriculated at the U of Washington. Life does have some herks and jerks, and I am happy to be a Husky. Thank you,
— Dr. James L. Lee Chehalis
Dr. Jennings, I am a general dentist on the east side. My wife, a hygienist, and I own three offices, and I see patients at Sacred Heart Hospital every Friday. Our oldest office was opened in 1962 by my father. Our practice is open to all that need our help. Our patient ratio is 65/35 welfare/private pay. Because of the “shamefully low” reimbursements, we struggle in ways that our publicly funded dental school can’t imagine. There is no one at the school who personally subsidizes the treatment we give to welfare patients the way we do. If you would like to learn about the problems that we face every day, please write me back and we can set a time Thank you,
— Dr. Rich Condon
Dr. Jennings replied: Dear Dr Condon, I am the dental director of Lindquist Dental Clinic for Children. We have four offices. We are a private nonprofit and accept no federal or state aid. My dentists and I get the same low Medicaid rate that you do. I have been lobbying for enhanced Medicaid rates for all dentists for many years. In addition to my six years on WSDA’s Board of Directors, I served for four years on the ADA’s Council on Government Affairs. While there, I met with Lynn Mouden, DDS, chief dental officer for Medicaid and Medicare. I told him of our plight. I will continue to try to pry money out
th e wsda ne w s · issue 5, april · 2016 · www.wsda.org · 37
of our government to better cover our expenses wherever and however I can. I thank you and your wife for the good work you do for low-income people. You are a blessing to your community. Best wishes,
— Dr. Mary Jennings
Dr. Condon responded: Dr. Jennings, Thank you for your response. My wife and I are frequently tormented when we think about the reality that we will be the first generation in our family that won’t be able to afford to treat welfare patients. With the expansion of Medicaid through the ACA, more and more of our patients whose fees we used to use to subsidize the welfare fees are now on welfare themselves. The extra money that the FQHCs get makes it difficult for us to keep associates. We can’t offer the benefits (i.e., six weeks paid vacation from day one) that they can, let alone the guaranteed pay that is equal to the 10th year of a doc in private practice. Keep battling. Thanks — Dr. Rich Condon Dear Dr. Jennings, Thank you for your comments about marijuana in the March issue of the WSDA News. It’s refreshing to finally hear some common sense talk about the negatives associated with increased marijuana use and availability. It seems as a society we are collectively losing a grip on the overall health and safety of the public and of our children. Thank you for your voice on the subject and the wisdom you shared. Sincerely, — Robert K Andelin DDS Pasco
letters to the editor issue 5, april 2016
letters to the editor
3 8 路 th e wsda ne w s 路 issue 5, april 路 2016 路 www.wsda.org
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DENTISTS NEEDED — Large Dental Group seeks both part and full time dentists (general and specialized) throughout Washington, Oregon, California, Hawaii, Arizona, Nevada and Oklahoma. For more information or to apply, please email griffint@InterDent.com or call 360-449-5618.
DENTIST NEEDED — Seeking full time dentist for growing practice in Newcastle, WA Competitive compensation and benefits Please contact Ron Brush for additional information 971-295-9914 or via email BrushR@interdent.com.
DENTIST NEEDED — Growing general dental offices are seeking caring, competent dentist with great people skills to join our team at greater Seattle area. Excellent opportunity for potential partnership. Please email resume to mydental88@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. ELLENSBURG ASSOCIATE — Associate position available working Wednesdays and Thursdays with hours 8-5. Doctor will be working in a family practice with the ability to practice as one desires and is capable of. OS, Endo, Perio, Pros, Rest patients/ cases to work with. Overnight accommodations available. Send resume to dr.howey@hotmail.com. ASSOCIATE TO PARTNER — Splitting time between two practices on the beautiful Olympic Peninsula. Outstanding earning potential for the right candidate. Endo, surgery and implant experience a plus, excellent communication skills and patient rapport an absolute necessity. Please email CV and letter of interest to olypendentist@yahoo.com. ASSOCIATE — Associate needed with buyout potential. Successful family practice in NE Washington. Owner will only work enough to make sure the overhead is covered. We hope you like the great outdoors because we have it all. If you are looking for a change in scenery, and work with a great motivated staff, in a modern building. Send us a resume by mail or fax to #509-447-5661. ORTHODONTIST — We are looking for an orthodontist with at least 10 years of experience. We have two busy practices in Burien and Kent. Please send us your resume to BurienDentist@ yahoo.com. DENTIST NEEDED — We are looking for a dentist to cover a maternity leave from May to the end of July, (ideally: Monday, Tuesday and Thursday or Monday and Tuesday). We are open 4 days and have good patient flow. Our team is highly skilled with a passion for taking care of our patients. At the end of the maternity leave, this position will be open to a possible permanent 1 or 2 day a week opportunity. Candidates with a minimum of 2-3 years of experience preferred but we are negotiable in order to find the right fit. If the ideal person wants to start earlier, we are open. Please send your CV and resume along to s.everettdental@gmail.com. SPOKANE — Seeking full-time general dentist, able to work a varied shift schedule including weekends; must be able to do all aspects of general dentistry including molar endodontics and 3rd molar/surgical extractions; able to adapt to new systems and paradigms; great opportunity to grow and learn; 1-5 years experience preferable. Unlimited income potential! Send resume to Dr. Bradley J. Harken; bradharken@hotmail.com.
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DENTIST — Full time salary position with full benefits. Unique opportunity in the dental department at a small community based clinic on the coast of Washington State. Should have 3-5 years experience. Position entails delivering general dental services with some administrative duties. Good life style change with Olympic N.P. right next door. Be part of a full health care clinic with medical,social ,pharmacy, and dental services under one roof. Rewarding diverse experience with solid secure employment. Reply with a letter of interest and current resume. Reply to bconger@quinault.org. 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 A REFRESHING PERSPECTIVE — When you work at Willamette Dental Group, the organization’s progressive approach frees you to do what matters to you — and your patients. What makes this multispecialty group practice unique, and better, is a commitment to proactively facilitating the best possible health outcomes. Combined with a dedication to leveraging scientific data, skill, and the experience to make them happen, when you embrace the organization’s guiding philosophy, you free yourself to facilitate health outcomes—and open yourself up to a world of professional growth and success. Please visit www.willamettedental.com/careers or send your resume to agrundy@willamettedental.com. GENERAL DENTIST — Position available for busy private practice in Vancouver, WA. Candidate must have at least 1 year experience. Position is for a single provider practice. Need to be comfortable with surgical extractions and molar endo. Buy out option is available. Base salary with production incentive. Please email resume to declinic@gmail.com. PEDIATRIC DENTIST — Pediatric dentist wanted for busy multi-doctor practice. Beginning shifts available Monday 7.30-4.30; Saturday 8.00-3.30 to increase to four days a week. Our office is in beautiful Olympia, Washington. Please contact Dr. Jones directly at (360) 789-4841. OPPORTUNITY WANTED — TMJ/Orofacial Pain Specialist/ Dental Sleep: 2yr residency in Orofacial Pain and Oral Medicine from USC. Seeking suitable opportunities, full or part-time, near greater seattle area. Contact me at jsahni@usc.edu or 213284-4953. https://www.linkedin.com/in/jasjotnarula-072778b6 GENERAL DENTIST – Seeking general dentist position in Greater Seattle area with ten years of dental experience and three years Prosthodontics Residency training. View my CV: https://goo.gl/J0iocd Email: sunjjj111@gmail.com Mobile: (502) 314-5196.
classifieds issue 5, april 2016
Professional Management Associates, Inc
OPPORTUNITIES AVAILABLE
in memoriam dugger, werlich
in memoriam Dr. Edwin P. Werlich
Dr. Edwin P. Werlich was born on July 12, 1925 in Everett, Wash. The family moved to Seattle in 1932, and he graduated from Ballard High School in 1943. During his senior year, he enlisted in the Navy’s V-12 program. After a year at Wabash College in Crawfordsville, Ind., Werlich began the flight program and was finishing flight training at the N.A.S. in Corpus Christi, Texas when WWII ended. He elected discharge and enrolled at the University of Washington, where he received a dental degree in 1953. Following a year’s internship at V.S.P.H.S. Hospital in Seattle, Werlich opened a private dental practice in Port Angeles, Wash. After six years of practice, he returned to the UW and earned a master’s degree in orthodontics. He opened his practice in Everett in 1962 and worked until his retirement in 1992. While in dental school, Werlich had knee surgery. Two close friends suggested that while in the hospital, he should evaluate the nursing staff. As a result, all three friends married nurses. Sixty years, 10 children, plus grandchildren and greatgrandchildren later, with marriages intact, it was decided that this was probably the most expensive and successful orthopedic surgery on record. Pauline (Phillips) Werlich supported him, and when they opened their practice in Port Angeles, Polly was the receptionist, chairside assistant, and financial officer. They were a loving team through a wonderful life together and were blessed with two daughters, Amy Werlich and Jean (Jonathan) Way, plus two very special granddaughters, Maggie and Abby. While in Port Angeles, Werlich discovered steelhead fishing and became addicted. He acquired a U.S.A.F. life raft and converted it for fishing the Sol Duc, Bogachiel and Hon rivers on the Olympic Peninsula and the Sauk River near Darrington, Wash. Upon moving to Everett, a friend named Bob Vaara introduced him to fly fishing for summer-run steelhead. This led to a fishing cabin on the Stillaguamish River. Werlich caddied at the (no longer existing) Olympic Golf Club in north Ballard and worked at the club in various capacities. Golf became a big factor in his life, and he cherished the game and his golfing friendships. The couple enjoyed retirement with stays at the cabin, trips to North Carolina, the Bahamas, Europe and New Zealand. Werlich expressed the wish that all could have as fulfilling a life as he had been privileged to live and hoped they share his appreciation for great meatloaf and hamburgers.
Dr. Glen O. Dugger
Dr. Glen O. Dugger was born in 1927 in Centralia, Wash. to Guy and Velma Jones Dugger. He left on his next adventure on Dec. 1, 2015. Dugger attended Lincoln High School in Tacoma, where he played varsity football and met his future wife, Dolores. They had four children: Randy, Jody, Erin, and Regan. Following a brief stint in the Army, Dugger attended the College of Puget Sound (now UPS) and UW Dental School. Go Huskies! In 1962, he opened the Fircrest Medical Arts Center, where he practiced family dentistry until he retired. He was a longtime member of the Fircrest Town Council and proudly served one term as mayor. He was active in the Association of Washington Cities and served on the executive committee. He was also a long-time member of the
Pierce County Dental Society, the Washington Dental Association, the Fircrest Golf Club, and the Elks/BPOE Tacoma. Dugger’s last wish was to sit in a chair on the porch where he could see his beloved beach, the Olympic Mountains, his hummingbirds, and one more Fox Island sunset. Dugger was predeceased by his parents, brother John “Jack” Dugger, sister Donna Farley, and daughter Jody. He is survived by his brother Gregg (Gayla) Dugger; sister Marlene Edwards; beloved aunt Areta Stoves; children Randy (Kathy) Dugger, Erin (Bill) Reetz, and Regan (Joani) Dugger; grandchildren Kaiti (Chet) Lemon, Randi and Christopher Dugger, and Max and Molly Reetz; and great-grandchildren Carsten and Kyleigh Lemon, and Amedea Dugger. He also leaves a special niece, Kerry Farley (Rob) Rounds, and their daughter, Maddy.
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Call 888-327-2265 ext. 94595 | Visit usbank.com/ADA94595 We may change APRs, fees, and other Account terms in the future based on your experience with U.S. Bank National Association and is affiliates as provided under the Cardmember Agreement and applicable law. (1) Subject to credit approval. Accounts must be open and in good standing (not past due) to redeem points. (2) Your 0% introductory APR applies to balance transfers made within 30 days of account opening. A Balance Transfer fee of 3% of each transfer ($5 minimum) will apply. The introductory APR does not apply to purchases or cash advances. The rate will end early and increase to the APR for Balance Transfers or to a Penalty Rate APR if you make a late payment, make a payment that is returned, or your account exceeds its credit limit. Thereafter, the APR may vary and as of 1/1/2015, the undiscounted variable APR for Balance Transfers is 9.99%- 23.99% (based on your creditworthiness)]. We apply your payments to balances with lower APRs first. (3) Net purchases are purchases minus credits and returns. (4) Certain restrictions, limitations, and exclusions apply. Cardmembers are responsible for the cost of any goods or services purchased by Visa Signature Concierge on cardmembers’ behalf. The creditor and issuer of the American Dental Association Card is US. Bank National Association, pursuant to a license from Visa U.S.A. Inc © 2015 U. S. Bank National Association. ADA Business ResourcesSM is a service mark of the American Dental Association. ADA Business Resources is a program brought to you by ADA Business Enterprises, Inc.. (ADABEl), a wholly owned subsidiary of the American Dental Association. ADA is a registered trademark of the American Dental Association.
4 0 · th e wsda ne w s · issue 5, april · 2016 · www.wsda.org
BUSY FAMILY PRACTICE — Currently operating with one dentist, but is in need of an associate dentist to join our team. We’ve been voted Roseburg’s Reader’s Choice #1 Favorite Dentist for the past six years. Our building was newly built as of Jan. 2008 & we’re up to date with the latest dental equipment & procedures. We have a large patient database & we keep growing. Recent dental school graduates are encouraged to apply, as well as, those with a more substantial work history. Potential candidate must possess an excellent work ethic, friendly chairside manner & a team player attitude. Continuing Education is offered & encouraged. Guaranteed base pay with great incentive potential. Hours will begin as Part-Time, but could increase to Full-Time in the future. We handle the marketing & new patient generation. Contact us today! jody@drrandol.com. DENTIST NEEDED Tacoma - seeking FT or PT general dentist to join established family, cosmetic and implant dental practice. Dentist should be skilled and personable and willing to be an integral part of the practice and community. It would be ideal to find a dentist who wants a long-term opportunity and to call this practice home. Partnership buy in will be considered. Please e-mail resume and inquiries to: docvan99@aol.com. DENTIST NEEDED — Associate Dentist Part time/Full time - Vancouver, WA Join our team in a modern, Amalgam free office. Part-time with the ability to grow to full time. Our office has been built on customer service and making a connection with the patient 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 is a plus. If are looking for an opportunity with great earning potential please email your resume to drspitty@gmail.com. FLEXIBLE DAYS ASSOCIATE — Low income DSHS dental office in Renton, Kent, Tacoma looking for associate for 1-2 days a week. Any day from Mon-Sun. Pay is 40% of revenue. hughbc@gmail.com. DENTIST NEEDED — Join our mission driven team of ten dentists and well trained support staff in providing quality, comprehensive general and restorative dental care to our patients. 4/10 hour workdays provide a good life work balance and the opportunity to enjoy the areas recreational activities with your family. Comprehensive benefits, sign on bonus, Employer match 401(k), relocation, generous paid leave and CDE. HPSA score 23. Potential for loan repayment. For more information contact : Colleen Hazel, PHR, HR Generalist / 509.764.6105/chazel@mlchc.org. Or visit our website at www.mlchc.org to apply online. BELLINGHAM, WA — Associate wanted 1-2 weeks per month. General Dentistry. High tech modern office. Located in Fairhaven. Please contact Don Walters at 360-223-1160.
OPPORTUNITIES AVAILABLE
OFFICES FOR LEASE OR SALE
ASSOCIATE NEEDED — Established, modern Bothell general practice seeks cheerful, cooperative part-time associate. Contract with opportunity for future purchase. Please email resume to dr.mep012@ hotmail.com and we look forward to meeting you!
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.
FULL-TIME ASSOCIATE IN BELLEVUE — We are looking for full time associate in Bellevue to work 4+ days a week . 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. Ready to learn and be a part of the team. Outstanding earning potential. Please email resume to bellevuedentists@gmail.com. GENERAL DENTIST — Opportunity for an experienced general dentist to join a sparkling new office located downtown Seattle amidst the high rise buildings in a great location, with many perspective patients. Principal will be relocating existing busy practice to this new facility which is due to open mid 2016. Great opportunities for the right person! All interested parties, either looking for part time or full time, please email resume and any questions to Sybel1939@gmail.com. GENERAL DENTIST, SUNNYSIDE — Full time position. Work beside specialists. Offering a great schedule, great compensation and guarantee. Great opportunity to expand skill set as you work or a perfect opportunity for an experienced dentist to utilize a wide range of skills. For more information, please contact Jolene Babka at jbabka@applesmiles.com. GENERAL DENTIST, TRI CITIES — Great associate opportunity for a new graduate or a long term home for a seasoned dentist looking to be compensated well with less of the headaches and stress. Group practice composed of general dentists, orthodontists, and oral surgeons. For new grads it’s the perfect opportunity to learn your craft by working side by side with generalists and specialists while being paid very well. Base salary of $150,000 for new grads plus bonuses. Base salary of $175,000 plus bonuses for experienced dentists. Full benefits package and moving allowance. State of the art clinics and equipment. Mix of children and adult dentistry. Mix of State and private insurance. Position available in coveted Pasco, Washington facility this Spring. Please send inquiries to jbabka@applesmiles.com. ASSOCIATE DENTIST — Friday Harbor Dentistry seeks associate dentist to join our skilled, highly committed and busy office in the San Juan Islands. Are you looking for a practice that values quality, compassionate and patient-first dental care in a truly amazing place to live? 3-4 days per week of patient care with room for growth. Please send your cover letter and CV to fridayharbordentistry@gmail.com. GENERAL DENTIST, SPOKANE — Full time position. Work beside specialists. Offering a great schedule, great compensation and guarantee. Learn as you work or a great opportunity for an experienced dentist. For more information, please contact Jolene Babka at jbabka@applesmiles.com.
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DENTAL SPACE FOR LEASE — Well-established Dental Building located in beautiful Colville, Washington. 1700 to 2400 sq’ available for lease or purchase. 4-6 operators available plus lab. Asking $13.00sq’/NNN plus utilities & services. Excellent opportunity for startup or satellite dental practice. Contact owner: Stephen Call DDS (509)590-5322 mydentist@calldds.com. FOR LEASE, RENTON — Dental Clinic in booming Renton. Six operatoriums, reception, consultation rooms. Fully built out. $1800 per month. Located in Altitude Business complex: www.altituderenton.com. Good visibility from street. 7,000 cars per day. Call Chris 206 595-5791 Call Chris at (206) 595-5791 altituderenton.com. SUBLEASE — Sublease is available in Issaquah downtown for Thursday and Friday. Owner doctor is in Monday thru Wednesday. Specialists preferred. Please contact eundds@msn.com. GENERAL PRACTICE FOR SALE — Marysville/ Smokey Point. Attractive, 7 year-old start-up practice, collecting $870k. Easy freeway access from I-5 in a rapidly growing area. 5 operatories and approximately 1,800 sq. ft. For more details/information please contact: Jennifer Paine at (425) 2161612 or Jennifer@cpa4dds.com. OFFICE SPACE FOR LEASE IN RENTON — Second floor office space in new building in Renton. Perfect for new dental practice or satellite practice. I405 visibility and great traffic exposure. Close to Paccar and Boeing. Excellent lease terms available. For inquires call 206 795 4845 or email solynyk@msn.com. PERIODONTAL PRACTICE FOR SALE — North of Seattle, WA. Outstanding periodontal/implant practice for sale, North of Seattle collecting $711k on 3 days/wk. Located in the center of a busy medical/dental area near major medical facilities with high visibility. 298 patients in perio recall. 30% of production is implant procedures. 5 fully-equipped operatories. Digital radiography. Approximately 2,800 sq/ft. Features private meeting room (study clubs). Owner occupied. Real Estate also available. For more details please contact: Jennifer Paine at (425) 216-1612 or Jennifer@cpa4dds.com. FOR LEASE — Professional office space for lease. 1800 sq/ft , ample parking, tenant improvement allowance and one year free rent. This is a high quality medical/dental building in Everett WA. Call today: Downtown Dennis Real Estate. 425-257-2000.
classifieds issue 5, april 2016
OPPORTUNITIES AVAILABLE
WA-MAR-2016.pdf
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OFFICES FOR SALE OR LEASE
OFFICES FOR SALE OR LEASE
PROSTHODONTIC PRACTICE FOR SALE — Western WA. Immaculate, well-established and respected practice specializing in dentures; crown & bridge; implants and veneers. Featuring custom restorations. Collecting $1.385M. Four equipped/ fully computerized operatories with potential for 1-2 additional. Beautiful office is approximately 2,300 sq/ft. Excellent parking. Digital radiography & pan, intra-oral cams, lasers and electric handpieces. Exceptional geographic location. No contracted insurance. Contact: Jennifer Paine at (425) 216-1612 or Jennifer@cpa4dds.com.
FOR SALE — Fully equipped dental office for sale in Des Moines. Three operatories, dental chairs, panoramic x-ray machine, and sterilization, equipment included in purchase. No Patients Included. Approx. 810 sq.ft plus storage room. Asking $160,000. Email Steve Kikikis steve@omni-pg.com.
SELLING? — We have buyer’s looking for practices in Seattle, Tacoma, Puyallup, Mt. Vernon, Spokane, Tri-Cities, Bellingham and other locations. If you are thinking about a transition, give Rod Johnston of Omni Practice Group a call at 206-979-2660.
FOR LEASE — Auburn office space available in East Main Professional Center. Great office or medical/ dental lab or professional office. Features courtyard, reception, waiting, bullpen, bathroom, lab/work area. Email Steve Kikikis steve@omni-pg.com.
FOR LEASE, SEATTLE — Seattle dental office available for lease. 1500s/f includes nice buildout with 5 ops, reception desk, waiting room, 2 restrooms, private doctor office, and staff area. Highly visible corner unit in walkable neighborhood business district of Seattle. Long-term established practice on upper level attracts patients. See http:// www.commercialmls.com/Search/ListingDetailsFull/568794.
FOR LEASE — Class A Medical/Dental space in Tukwila. Blocks from I-5, top floor with 5,000 sq.ft, second floor with 2,500 sq.ft. TI available, $24 per sq.ft, $6 NNN. Email Steve Kikikis steve@ omni-pg.com.
FOR SALE - CENTRAL WASHINGTON - General dental practice for sale. Work 3 days per week with little competition, Fisherman/Outdoor Persons Paradise. Overhead Rate of 47%, Collections in excess of $400k. Contact Jim Vander Mey at (877) 866-6053 ext 2 or email jim@omni-pg.com for more information.
SPECIALIST OFFICE SPACE - Periodontist or Endodontist. 2,000-4,000 SF Prestigious Creekside Village the newest building in the heart of Mill Creek’s Town Center. Over 50 stores, shops and family services within a two-mile radius with many general dentists from which to draw. Visible from the Bothell/ Everett Highway, seven minutes from 1-405 and 1-5. Three minutes walking distance from the University Bookstore, Central Market and hundreds of condos, apartments and homes. Design your space. Generous terms with significant free rent. Contact Vien Bui (425) 3796062 or Michael LaMarche, DDS (425) 357-1818. FOR SALE — Pierce County Washington General Dental Practice For Sale. Annual collections of approximately $500,000. Three operatories, room for more. Great Location.Email Rod Johnston rod@omni-pg.com.
FOR LEASE — Auburn dental office with 1 year free rent, TI package available. Five operatories, on/off site parking. Dental equipment not included. Asking $2,843.75 per month. Email Steve Kikikis steve@omni-pg.com. FOR LEASE — Highly visible Lynnwood Dental office for lease. Plumbed for four operatories, including nitrous and O2. 1,400 sq.ft. $24 per sq.ft and $3.62 NNN. email Steve Kikikis steve@omni-pg.com. FOR SALE — Full leased investment opportunity in Maple Valley for sale. Mix of office and retail uses Asking price is 1.4 million for this visible building on .95 acres is 6,400 sq.ft Contact Steve Kikikis at steve@omni-pg.com. FOR LEASE — Woodmont Place Shopping Kent dental/medical suite along Pacific Highway for lease. 1,300 sq.ft with three exam rooms, darkroom, lab and asking $2,275 per month-modified gross. Contact Steve Kikikis at steve@omni-pg.com.
FOR LEASE – Kennewick partially equipped fully plumbed, four operatories, approx. 2200 sq ft, Nearly turnkey Email Steve Kikikis steve@omnipg.com.
FOR SALE — Visible Whatcom County general dentistry practice, Average annual collections of $540,000. Four operatories. Refers out most root canals and oral surgery. e-mail Rod Johnston rod@omni-pg.com.
FOR LEASE – Maple Valley Dental office for lease. start-up or move your existing practice. Fully built out with 5 operatories, Plenty of parking in plaza. Approximately 1,524 sq. ft. with favorable lease terms. Email Steve Kikikis steve@omni-pg.com.
FOR SALE — South Sound Perio practice and real estate available for sale. Collections over $1.5 million. Great referrals and low overhead. Building is also for sale. Call Rod at Omni 206-979-2660 or rod@omni-pg.com.
FOR LEASE – High end professional office for lease on Vashon Island. Waiting room, reception, 13 offices spaces, kitchenette, private parking plus street parking. 3600 sq. ft. Previously a family physicians practice. Email Steve Kikikis steve@ omni-pg.com.
INFORMATION — For a list of Washington Plumbed and equipped spaces available - e-mail Steve Kikikis at Omni Healthcare Real Estate steve@omni-pg.com
FOR LEASE – EAST KENT PROFESSIONAL CENTER High visibility office with space with signage. Approx 1288 sq. ft. on a modified gross lease, This building is right off of 104th Ave SE and SE 248st .TI allowance available. Email Steve Kikikis steve@omni-pg.com. FOR LEASE/SALE – Hickman Medical Center features two available building both built out for medical use. The buildings are just blocks from Harrison Medical Center The 4,456 sq. ft. and 3,141 sq. ft. Email Steve Kikikis steve@omni-pg.com
FOR SALE - Grays Harbor - Fee For Service General Dental practice for sale. Annual collections over $200,000, four operatories, lots of parking on busy street. Contact Rod Johnston of Omni Practice Group at 206-979-2660 or e-mail rod@ omni-pg.com. FOR SALE - West Olympic Peninsula General dental practice for sale. Annual collections over $800,000. Be the only dentist in town with no nearby competition. Good overhead, building also for sale, great staff. Contact Rod Johnston of Omni Practice Group at 206-979-2660 or e-mail rod@omni-pg.com.
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FOR LEASE, RICHLAND — Rare dental practice opportunity in Richland, Washington. Fully developed four operatory clinic available for long term lease. The office has large front office, staff lounge, dental lab, sterilization area, four operatories with some equipment available from previous tenant. Plumbed for Nitrous oxide, internet, digital x-rays including room for Pan/ceph. Community has high employment income and dental insurance benefits for workers. Are you ready to build your own practice. Contact: Dr. Ron Snyder –owner of building, at cybersnyderdds@frontier. com or 509-946-2258. FOR LEASE/OWNERSHIP — Multi-tenant commercial building. Location! Location! Location! This professional building is located in a large shopping complex that is anchored by Haggen Grocery, Starbucks, and McDonalds. This complex is located in a growing and developing area just east of Mill Creek and near the new Glacier Peak High School. It is ideal for medical/dental tenants needing between 2,000 to 6,500 SF to complement existing general dentist and Providence Medical Clinic. Partial ownership opportunity is available for a qualified tenant. Christian@KoviSolutions.com. FOR LEASE — Four ops downtown Bellevue — Brand new office, digital x-rays, NNN $7.78/ sq, ft. Dental equipment available, ready to go for a start up, specialist or office relocation. All equipment and instruments in office, fully furnished. Contact: Brandon Burrowes at bburrowes@wallaceproperties.com or (425) 455-9976. GENERAL PRACTICE FOR SALE North Seattle, Wash. An outstanding opportunity in a prime location. Three fully equipped, digital ops, room for four. Real estate also for sale. Please contact SeattleDentalOfficeSale@gmail.com. G/P PRACTICE FOR SALE IN BONNEY LAKE/ ENUMCLAW AREA — Annual collections over $550,000. 1,500 SF office with four fully equipped operatories plus digital X-rays. Well trained staff will continue and assist with the transition. Well established practice that has been in the same location for over 43 years. Excellent cash flow, outstanding collection policy, only dental office in town. Seller would consider selling building at same time as practice sale or give a right to purchase for a later date. Contact: Buck Reasor, DMD, Reasor Professional Dental Services, info@reasorprofessionaldental.com, (503) 680-4366.
classifieds issue 5, april 2016
OFFICES FOR SALE OR LEASE
Smile Protection
by Nakanishi Dental Laboratory
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OFFICES FOR SALE OR LEASE
SERVICES
FOR SALE — SE Washington general dental practice for sale. Annual collections of approximately $360,000. Four operatories. Be the only dentist in town. Small rural setting with outdoor activities. Jim Vander Mey at 360-941-2341 or e-mail jim@ omni-pg.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.
SELLING YOUR PRACTICE? Thinking of selling your practice? Already have a broker in mind? Even if you do… Here’s a dentist who is not a broker, who can help you find the best, as well as the most cost-effective broker for your particular. Norm Culver, DDS. After 20 years of conducting seminars and consulting with dentists on practice sales, no one knows the brokers better than Norm Culver. There is NO COST to you for this service. (206) 784-6941. www.normculver.com.
PROSTHODONTIC PRACTICE FOR SALE — Greater Seattle area. Outstanding practice with high gross & high net. Building is in a great location with plenty of parking and visibility. Building could eventually be for sale to prospective buyer. Experienced staff will stay on with the practice. Owner would stay on 1-2 days per week for up to a year to ensure a smooth and complete transition. Contact: Buck Reasor, DMD, Reasor Professional Dental Services, (503) 680-4366, info@reasorprofessionaldental.com. FOR LEASE, OLYMPIA — Ideal location on Martin Way near St. Peter Hospital, 2,000+ sq. ft. Five ops including chairs, panex and more. Perfect for startup/satellite office, future purchase possible. Contact Don at uncledgh@aol.com. G/P PRACTICE FOR SALE IN LINCOLN COUNTY — Owner is selling two separate practices both within 35 miles of Spokane, WA. Annual collections over $430,000. Four operatories. Well trained staff will assist with the transition and will stay with the practice after the transition. Excellent collection policy in place. Excellent cash flow for a practice of this size. Please contact Buck Reasor, DMD. Cell: 503-680-4366, email:info@reasorprofessionaldental.com, www.reasorprofessionaldental.com. G/P PRACTICE FOR SALE IN THE LONGVIEWKELSO AREA — General practice for sale with four fully equipped operatories. Annual collections over $550,000. Great location with excellent visibility. Well established practice that has been in same location for over 38 years. Well trained staff will assist with the transition. Seller owns building and would sell now or would sell in the future. Outstanding collection policy. Contact: Buck Reasor, DMD, Reasor Professional Dental Services, info@reasorprofessionaldental.com, (503) 680-4366. FOR SALE — Tukwila. Newly upgraded dental practice in Tukwila for sale. $725,500.00. Five+ ops with the latest in imaging upgrades, new computers, software and hand pieces. One of the last fee-for-service practices left. Seller will pay for new floor covering throughout, leave the security deposit for the new buyer on the lease assessment and help with the transition. Call today for a tour. Annie Miller, (206)-715-1444. SPACE SHARING OPPORTUNITY DOWNTOWN SEATTLE – Looking for a dentist with an existing practice to share our office space. This is not an Associate position. Restorative practice with In-House C&B, and denture processing lab, and technician. Modern downtown Seattle five chair office. Lease ending soon? Decrease your overhead now! Opportunity to buy into the facility for the right person. drnicolini@hotmail.com. FOR SALE — 4111 Bridgeport Way, University Place. Dental building for sale $575,000 in well established dental park, four ops with two more plumbed for future growth. Turn key, lab, private offices, break area, nice private outdoor area. Full basement included. Call Joel 253-653-3878 to arrange a tour.
GENERAL DENTIST SEATTLE AREA — Experienced dentist needed for a growing, well established, fee for service practice, generating 800k per year and 20 new patients a month. Two days a week (Thursday/Friday). Long term, highly capable staff. Great income opportunity. Please send CV to juliankys@hotmail.com. FOR LEASE — Quality professional office Space for lease in the heart of the Renton Highlands in the Highlands Professional Plaza medical dental building. Excellent place for an oral surgeon and/ or endodontist to open a satellite office or start up practice. Currently there are two GP dentists, a pedodontist, an orthodontist and a large physical therapy clinic. This building has a proven track record of successful businesses because of its location and quality. The building sits across the street from Bartells, QFC, and Starbucks. There are six elementary schools and four high schools within two miles. Get close to where the people live and enjoy fast practice growth. Call (206) 595-9100. AVAILABLE, SOUTHCENTER — Just available. 1200 square foot fully equipped 4 operatory dental space. Cerec , Panoral, 4 chairs, lights, nitrous, air and vacuum all available and in place. Please call Diana at Medical Centers Management (253) 508-1293. 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.
HAVE SEDATION, WILL TRAVEL! — Make fearful patients comfortable with IV Conscious Sedation. I am set up to come to your office and sedate your patients so that you can perform needed treatments the patients avoid due to fear. I have over 19 years experience providing safe IV Conscious Sedation. Serving Washington & Oregon. Richard Garay, DDS. (360) 281-0204, garaydds@gmail.com. OFFICE CONSTRUCTION CONSTANTINE BUILDERS INC. (CBI) — WSDA endorses CBI as their preferred builder of Dental facilities with over 25 years of experience from ground up buildings, renovations, remodels, and interior tenant improvement projects. All projects are completed on time and within budget. CBI provides the highest level of quality service with integrity that exceeds our client’s expectation. Please see our display ad on page two and website at www. constantinebuilders.com for additional information and how you can become another satisfied client. Telephone (206) 957-4400, O. George Constantine. ALLIED CLINIC BUILDERS — Premier healthcare contractors in the PNW for over 35 years. On time, on budget and providing quality that you can afford. Call today for consultation George McBee - Allied clinicbuilders@comcast.net (425) 941-3088.
EQUIPMENT WANTED WANTED _Pacific Community Services needs donations of dental handpieces, star Titan scalers, Cavitron inserts, restorative and extraction instruments, and equipment. You will get a donation receipt. email: pcsdental@gmail.com. (206) 274-8419. EQUIPMENT FOR SALE USED/REFURBISHED EQUIPMENT — Adec, Gendex, Pelton Crane, DentalEZ, Porter, Air Tech, Midwest, Midmark and etc. Lab equipment. Parts are also available for almost all equipment. Call Dental Warehouse at 800-488-2446 or http://cascade-dental.net. FOR SALE: GX-Pan Panorex $2700.00. Excellent condition, high quality films, have never had a problem with this machine. 70 - 98 kVp, Film Size 12 x 30cm, Wheel Chair accessible. ImageMax film processor included, also in excellent condition. Very affordable, dependable Pano/Procesor combinatiion for daily office use. (425) 745-9420.
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CLASSIFIED ADS IN THE WSDA NEWS Visit wsda.org/news/classifieds/ to place your ad and select the issues you would like your ad to run in. Follow up your submission with a phone call to Rob at (206) 9735220 to submit your credit card information (sorry, no check payments), and your ad will be placed. Sell your practice or fill a position quickly? Don’t worry, you’re only charged for the ads that run. We’re flexible, and the process is painless and cost effective. Pricing is as follows: Members: $50 for the first 30 words, $1 per word for each word over 30. Non-members: $100 for the first 30 words, $1 per word for each word over 30.
classifieds issue 5, april 2016
OFFICES FOR SALE OR LEASE
parrish or perish
What if politicians actually paid attention to dentistry?
We are right in the middle of the “silly season,” and we all can probably agree this is as “silly” as we have ever seen, and likely to get totally out of control in the general election. Fortunately, dentistry is generally too small to be caught up in the insanity of the process, but what if some famous politician’s or celebrity’s statement had come out just a little different. We could be in serious trouble! Let’s pretend a bit: Dr. Jeffrey Parrish “If everyone is thinking alike, then somebody isn’t thinking.” — George Patton
“America — designed by geniuses to be run by idiots.”
• “I will build the greatest wall around dentistry, and I will make WDS pay for it! You will get tired of winning!” Donald Trump (No wonder he’s so popular!) • “But we have to pass the bill authorizing DHATs so that you can find out what is in it, away from the fog of the controversy.” House Speaker Nancy Pelosi (The devil is always in the details, Madame Speaker.) • “If you like your dentist, you can keep your dentist.” President Barack Obama (Why do I fear some other future president may actually be the author of this statement?) • “Add one little bit on the end....You’re right phonetically, but what else....? There ya’ go.... all right! Vice President Dan Quayle ‘’correcting’’ a dental student’s correct spelling of the word “technique.” (I have to agree. I always preferred “technique” over “technic,” but whatever.) • “Do you mind if I sit back a little? Because your breath is very bad.” Donald Trump (Do you mind if I think your hair is very bad, Mr. Trump?) • “The point is that you can’t be too greedy.” Donald Trump (The point is you can be too greedy, and it’s a disaster if practiced by dentists in their practice.) • “Look, if you have somebody who doesn’t have health insurance, who doesn’t have a doctor or dentist, and in order to deal with their cold or flu or dental problem, they go to an emergency room – in general, that visit will cost 10 times more than walking into a community health center.” Bernie Sanders (So does that mean dentists will all be working for community health centers under your plan? Feelin’ the Bern here.) • “Some people can be president, some people can speak, some people, you know, anything that’s positive, man – a dentist, a doctor. Just hang in there and never give up, and find out what is your talent. First you got to find your talent and just stick with your talent, and I guarantee you’ll get there, man.” Juicy J (Don’t know who you are, Mr. Juicy, but I like your thought.) • “Owning a great golf course gives you great power.” Donald Trump (That explains why so many dentists play golf!) • And finally, “If Lincoln were alive today, he’d be turning over in his grave.” No, it’s not someone speaking about our current debacle. It was Gerald Ford speaking on Nixon and Watergate. Good luck making your decision as to whom to support. Remember what Bernard Baruch said, “Vote for the candidates who promise least; they’ll be the least disappointing.” But please do vote.
The views expressed are those of the writer and do not necessarily reflect the opinion or official policy of the WSDA.
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INSURANCE FOR EVERY STAGE OF YOUR CAREER:
Stage One: New Grads and Associates Are you covered? • NORDIC Professional Liability • Personal Disability Insurance • Term Life • Individual Medical Insurance As a dentist, you’re the expert on teeth, gums, and how the mouth works in concert with the body in terms of overall health. And while you know just about everything there is to know about the mouth, you may not know what your insurance needs are — and more importantly, how those needs will change depending on where you are in your career arc. Dentists just starting out need NORDIC Professional Liability, personal disability insurance, term life, and individual medical in order to be fully covered. That’s where the expert staff at WDIA comes in. Matt, Kerri and Heath can guide and educate you about the types of coverage you need no matter where you are in your career.
Matt French · Kerri Seims Heath Johnson 206.441.6824 · 800.282.9342 www.wdiains.com
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Sole broker for:
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