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ACT ION

THE JOURNAL OF THE GEORGIA DENTAL ASSOCIATION

JANUARY 2013


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VOLUME 32, NUMBER 1 • JANUARY 2013

ACTION

on the cover

ACT ION

THE JOURNAL OF THE GEORGIA DENTAL ASSOCIATION

GDA ACTION (ISSN 0273-5989) The official publication of the Georgia Dental Association (GDA) is published monthly. POSTMASTER: Send address changes to GDA Action at 7000 Peachtree Dunwoody Road N.E., Suite 200, Building 17, Atlanta, GA 30328. Phone numbers in state are (404) 636-7553 and (800) 432-4357. www.gadental.org. Closing date for copy: first of the month preceding publication month. Subscriptions: $17 of membership dues is for the newsletter; all others, $75 per year. Periodicals postage paid at Atlanta, GA. Dr. David Bradberry GDA Editor 1070 Woodlawn Dr NE Suite 250 Marietta, GA 30068

Delaine Hall GDA Managing Editor 7000 Peachtree Dunwoody Rd NE Suite 200, Building 17 Atlanta, GA 30328

2012-13 Georgia Dental Association Officers Sidney R. Tourial, DDS, President Marshall H. Mann, DDS, President Elect Douglas B. Torbush, DDS, Vice President James B. Hall III, DDS, Secretary / Treasurer R. David Bradberry, DMD, Editor

GDA/GDIS Executive Office Staff Members Martha S. Phillips, Executive Director Nelda Greene, MBA, Associate Executive Director Delaine Hall, Director of Communications Skip Jones, Director of Marketing (GDIS) Courtney Layfield, Director of Member Services Victoria LeMaire, Medical Accounts Manager Judy Lively, Administrative Assistant (PT) Melana Kopman McClatchey, General Counsel Denis Mucha, Director of Operations (GDIS) Margo Null, Property and Casualty Accounts Manager Meg Robinson, Director of Governmental Affairs Patrice Williams, Administrative Assistant Phyllis Willich, Administrative Assistant Pamela Yungk, Director of Membership & Finance GDA Action seeks to be an issues-driven journal focusing on current matters affecting Georgia dentists, patients, and their treatment, accomplished through disseminating information and providing a forum for member commentary.

JANUARY 2013

The results are in for the dental workforce census conducted by Market Decisions and the Georgia Health Policy Center at the request of the Georgia Dental Association. The conclusion: Findings point to a lack of demand for dental care among patients as opposed to an insufficient number of dentists available to provide care. In fact, the census found that only 19 out of 4,044 dentists practicing in Georgia stated they could not currently accept new patients. Read more about the census results on page 14.

other features

sections

12

Unique Ben Massell Dental Clinic: 100 Years of Care

4

Parting Shots

5

Editorial

GDA Legislative Goals Include Board Autonomy, Tax Credits

6

News and Views

11

Calendar of Events

24

Annual Meeting Room Form

27

Classifieds

17 19

Association Issues Regulatory Reminders for the New Year

26

Georgia Mission of Mercy Volunteer Registration Opens

© Copyright 2012 by the Georgia Dental Association. All rights reserved. No part of this publication may be reproduced without written permission. Publication of any article or advertisement should not be deemed an endorsement of the opinions expressed or products advertised. The Association expressly reserves the right to refuse publication of any article, photograph, or advertisement.

Member Publication American Association of Dental Editors

index of advertisers Note: Publication of an advertisement is not to be construed as an endorsement or approval by the GDA or any of its subsidiaries, committees, or task forces of the product or service offered in the

advertisement unless the advertisement specifically includes an authorized statement that such approval or endorsement has been granted.

AFTCO Transition Consultants . . . . . . . . . . . .20

Georgia Dental Insurance Services . . . . . . . .32

Paragon Dental Practice Transitions . . . . . . .22

Center for TMJ Therapy . . . . . . . . . . . . . . . . .11

Great Expressions Dental Centers . . . . . . . .30

Professional Practice Management . . . . . . . .28

Craniofacial Pain Center of Georgia . . . . . . . .7

Thomas P. Hinman Dental Meeting . . . . . . . . .2

The Shaul Law Firm . . . . . . . . . . . . . . . . . . . . .9

Dental Care Alliance . . . . . . . . . . . . . . . . . . . . .9

Hospital Dentistry—Dr. Kurtzman . . . . . . . . .10

Southeast Transitions . . . . . . . . . . . . . . . . . . .21

Fidelity Bank . . . . . . . . . . . . . . . . . . . . . . . . . .18

Law Office of Stuart J. Oberman . . . . . . . . . .22

UBS Financial Services . . . . . . . . . . . . . . . . . . .

Full Spectrum Seminars . . . . . . . . . . . . . . . . .31

National Practice Transitions, LLC . . . . . . . .29

GDA Dental Recovery Network . . . . . . . . . . .16

Dr. Mark Padolsky—TMD Dentist . . . . . . . . .30


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editorial perspective Supply and Demand

R. David Bradberry, DMD

Supply and demand. Do these terms sound familiar? In college, taking Economics 101, one of the first sets of terms we learned was supply and demand. We further learned how each would affect the pricing and cost of the famous manufacturing ‘widget’. When supply goes up, demand drops and prices decrease. When supply goes down, increased demand typically brings about price increases. Now, how does this famous term apply to the provision of oral health care? In our case, the supply is the number of fully educated and trained doctors readily available to render oral health care. The demand is the number of individuals who seek out the care they need. In an ideal world this equation would balance perfectly with supply (doctors) = demand (patients). But the world, including our great state, is not perfect and the workforce census recently commissioned by the GDA bears that out. Dentists we have. Patient demand, we don’t. One may ask, why in a country so capable of educating dentists to deliver care and educating individuals as to their need for care, do we have underutilization of available care? Several organizations, like the private foundations Pew and Kellogg, have done a smashing job of convincing policymakers and the public that there is a dentist supply problem. To focus solely on workforce is to presume there is not also a patient demand issue. From my perspective and from a very great majority of those professionals in many health care disciplines that I speak with, the problem definitely lies on the demand side. I could be busier. Many of my colleagues could be as well. Why? What has caused patient demand to drop? I believe there are many reasons for the lack of demand, but it basically boils down to education and economics. Education means that we as a profession need to continue to provide relevant information to current patients and individuals in our communities. We need to instill in our patients the need to regularly maintain their oral health, and that dental care for them and their families is not optional. We need to teach individuals in the community about the importance of starting a regular oral health care regimen and visiting a dentist for their oral care needs. The

key is getting consumers to truly value the idea of dental care delivered by a dentist. Economics—this is a multi-faceted issue too. We have patients who think they can only obtain dental care if they have dental insurance. Too often, those with coverage find it doesn’t cover the care they need and is unreliable. We have patients deferring needed treatments due to job loss or general economic hardship. Georgia’s Medicaid and PeachCare for Kids providers—those who can become credentialed to begin with—have seen their fees that don’t actually pay for the care they deliver slashed and threatened with additional cuts. The workforce census commissioned by the GDA underlines what I have experienced firsthand and have heard throughout the state. Dentists are underutilized, underemployed, and can deliver more care. There is no dentist shortage at this time. The answer is not devoting energy and time and money to creating lesser trained providers to deliver a poor approximation of comprehensive dental care to Georgians. The answer lies in educating Georgians about what good oral health is, who can best deliver that care, and how consumers can obtain and maintain that care. Dentists have exceptional superpowers— we can save the state money, clear out hospital emergency departments, and make Georgia healthier and happier. We have the outreach tools. The ADA is planning a public relations campaign to bolster the profession nationwide that follows on the heels of the “2Min2x” patient oral health education campaign. In Georgia, the GDA has an advocacy network that educates policymakers about good oral health and good oral health legislation. Martha Phillips did a wonderful job describing that network in her commentary in December’s Action—it is online at www.gadental.org if you want to read it again. The fuel that runs that network is volunteer spirit, so I hope you have signed up for your district’s LAW Day. The schedule is also on the web site. Please get out and educate your community and your legislators. Make it a happy, healthy New Year.

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general news NEW GDA STAFF Meg Robinson Meg Robinson, JD, has joined the Georgia Dental Association staff as Director of Governmental Affairs. Meg will focus on GDA governmental affairs, public policy, and regulatory initiatives. She will work side by side with Executive Director Martha Phillips during the state legislative session and with General Counsel Melana McClatchey as a staff attorney when the session is completed. “We are extremely fortunate to have someone with Meg’s background join our team,” Martha said. “Meg will provide GDA members with additional resources they need to meet the challenges that health care providers face from governmental intervention. The stakes are higher than ever and the changes being pushed onto the profession of dentistry demand that we intensify our efforts.” Meg received her B.A. in public policy analysis from the University of North Carolina Chapel Hill in 2001. She received her J.D. from the Georgia State University College of Law in 2008. She most recently served as chief of staff and general counsel for State Senator Jason Carter where she oversaw policy and legal research, drafted legislation, and handled ethics and election law compliance. Before joining Sen. Carter’s staff, Meg was employed as an Assistant District Attorney—Juvenile Division with the Stone Mountain Judicial Circuit in Decatur. She served as a law clerk for the Honorable Wendy Shoob of Fulton County Superior Court and for Andrews, Knowles and Princethal in Atlanta. While pursuing her law degree, Meg served as executive director for the League of Women Voters of Georgia. “This role provided Meg with a valuable understanding of association work,” Martha said. In October 2005, Meg was named by Georgia Trend to their “40 Under 40, Best and Brightest” list of emerging Georgia leaders. She has served on the Advisory Committee for the Institute for Women in

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Public Leadership, J.W. Fanning School of Leadership, University of Georgia. Meg understands health care issues from a personal perspective. Her father is a pharmacist in North Carolina and she grew up with the children of Dr. Chuck Norman, the newly-elected American Dental Association president elect so she has more than a passing knowledge about dentistry. Meg is married to Jonathan Robinson and they have a daughter, Helen. The GDA welcomes Meg. She is an excellent addition to the GDA team and we look forward to utilizing her vast professional skills to help the GDA promote dental and patient interests in the legislative arena and in public policy.

The GDA welcomes Meg Robinson, JD, as the staff Director of Governmental Affairs. Meg will work on GDA governmental affairs, public policy, and regulatory initiatives with Executive Director Martha Phillips and as a staff attorney with General Counsel Melana McClatchey.

BUY CDT 2013 35 New Codes Don’t risk claims rejections—use the new dental codes that became effective on January 1, 2013. The new American Dental Association CDT 2013: Dental Procedure Codes provides standardized information and creates a common platform of understanding for health care providers, electronic health records, patients, and insurance companies. This book is the named HIPAA national standard for documenting dental procedures. Key

updates for 2013 (and they are significant— dental offices should strongly consider buying the new edition) include: • 35 new codes • 37 revised codes • 12 deleted codes • 7 new or revised service categories / subcategories. In addition to selling the CDT-2013, the ADA also sells the optional Dental Coding Made Simple Companion Guide. This publication can help dentists and dental staff members understand the coding system with information such as: The most common coding questions and answers; multiple coding exercises; an illustrated implant section; and the new HIPAA Compliant 2012 ADA Dental Claim Form with completion instructions. To order the new CDT products visit www.adacatalog.org or call the ADA Member Service Center at 800-947-4746. The CDT-2013 is $59.95 for member dentists, and the optional companion guide is $74.95.

PRESCRIPTIONS Security Paper The deadline regarding the use of state Pharmacy board-approved security paper for Schedule II Controlled Substance prescriptions has changed to March 31, 2013. Previously the deadline was December 31, 2012. This extension will allow lawmakers an opportunity during the 2013 legislative session to modify the requirement that mandates the use of the state Pharmacy Board-approved security paper. New legislation would likely allow health care providers, including dentists, the option of utilizing security paper that meets the Centers for Medicare & Medicaid Services’ (CMS) tamper-resistance standards or Pharmacy Board-approved paper. One positive—paper that meets CMS standards is readily available.


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Until the new March 31, 2013 deadline, the rule continues to allow a pharmacist to fill a prescription presented on a dentist’s existing prescription paper so long as the prescription contains a written statement on it that a health emergency exists. The pharmacist is then permitted to fill the prescription for an amount of medication to cover not more than 30 days. If you have any questions about the security paper issue, please contact the Georgia Board of Pharmacy at (478) 2072440 or Melana McClatchey at the GDA office at mcclatchey@gadental.org or (404) 636-7553.

ASSISTANTS Expanded Duties The Georgia Dental Association offers expanded duties training courses for dental assistants regularly during the year. The GDA will next offer a course February 8-9, 2013, at the Atlanta dental office of instructor Dr. Becky Weinman. For a registration packet and course rates, please contact Phyllis Willich at (404) 636-7553 or willich@gadental.org.

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ADA Antibiotics / Joint Replace Patients The American Academy of Orthopaedic Surgeons (AAOS) and the American Dental Association (ADA) have found that there is insufficient evidence to recommend the routine use of antibiotics for patients with orthopedic implants to prevent infections prior to having dental procedures. The groups found there is no direct evidence that routine dental procedures cause prosthetic joint infections. The AAOS and ADA’s recommendations are based on a collaborative evidence-based clinical practice guideline that focuses on the possible linkage between orthopedic implant infection and patients undergoing dental procedures. “As clinicians, we want what is in the best interest of our patients, so this clinical practice guideline is not meant to be a stand-alone document. Instead it should be used as an educational tool to guide clinicians through treatment decisions with their patients in an effort to improve quality and effectiveness of care,” said David Jevsevar, MD, MBA, chair of the AAOS Evidence Based

Practice Committee which oversees the development of clinical practice guidelines. “It has been long debated that patients with orthopedic implants, primarily hip and knee replacements, are prone to implant infections from routine dental procedures,” added Dr. Jevsevar. “What we found in this analysis is that there is no conclusive evidence that demonstrates a need to routinely administer antibiotics to patients with an orthopedic implant who undergo dental procedures.” • In 2010, there were more than 302,000 hip replacement and 658,000 knee replacement procedures performed in the United States. (1) • Infections can occur when foreign organisms enter the wound during or at any point following joint replacement, and can lead to additional surgery and prolonged antibiotic treatment. (2)

NEWS Continued on page 8

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NEWS Continued from page 7

• For studies of hip and knee included in this guideline, the mean rate of infection was 2%. (3) Elliot Abt, DDS, MS, MSc, who served as a member of the AAOS / ADA work group on behalf of the ADA, pointed out that the review committee conducted a thorough review of existing clinical research published in the peer-reviewed literature. “This guideline was based primarily on clinical research which examined a large group of patients, all having a prosthetic hip or knee and half with an infected prosthetic joint,” said Dr. Abt, a general dentist in Skokie, Illinois, and a member of the ADA Council on Scientific Affairs. “The research showed that invasive dental procedures, with or without antibiotics, did not increase the odds of developing a prosthetic joint infection.” This clinical practice guideline, with three recommendations, is based on a systematic review of the correlation between dental procedures and prosthetic joint infection (PJI). • Recommendation one, which is based on limited evidence, supports that practitioners consider changing their longstanding practice of prescribing prophylactic antibiotics for patients who undergo dental procedures. Limited evidence shows that dental procedures are unrelated to PJI.

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orthopedic infection rates,” Dr. Jevsevar said. The “Prevention of Orthopaedic Implant Infection in Patients Undergoing Dental Procedures” guideline replaces the previous AAOS Information Statement, “Antibiotic Prophylaxis for Bacteremia in Patients with Joint Replacement.” The full guideline is available at the AAOS web site www.aaos.org and the ADA web site www.ada.org. (1) HCUPnet. Healthcare Cost and Utilization Project (HCUP). 1993-2010. Agency for Healthcare Research and Quality, Rockville, MD. http://hcupnet.ahrq.gov/ Accessed November 29, 2012. (2) Della Valle CJ, Zuckerman JD, Di Cesare PE. Periprosthetic Sepsis. Clin Orthop 2004;(420):26-31. (3) American Academy of Orthopaedic Surgeons and the American Dental Association Prevention of Orthopaedic Implant Infection in Patients Undergoing Dental Procedures Guideline. Rosemont (IL): AAOS: 2012.

CENTRAL Dentist Reception The Central District held a New Dentist Social at the end of 2012. The event was organized by GDA Recruitment & Retention Committee New Dentist Liaison Dr. Katie Garvin and held at the Wild Wing Cafe in

Macon. Each invited dentist was welcome to bring a guest. There were 30 people in attendance, 21 of whom were dentists. Of those 21 dentists, seven had never attended this event before. This was the fifth year the district has hosted a New Dentist Social, and this evening was the most well-attended event to date. The district thanks DENTSPLY Tulsa Specialties for their generous sponsorship of the event and thanks these dentist attendees: Dr. John Ambrose Dr. Valerie Ambrose Dr. Jackie Bell Dr. Vin Bhasin Dr. Noelle Craig Dr. Lindsey Harrell Dahlstrom Dr. Ryan Davis Dr. Cameron Garvin Dr. Katie Garvin Dr. Stephen Golubow Dr. Meigan Johnson Dr. Amber Lawson Dr. Amy Lee Dr. Margaret Moore Dr. Emily Parks Dr. Tommy Peterson Dr. Thomas Pierce Dr. Beth Rainwater Dr. Paulomi Shah Dr. Ched Smaha Dr. Michael Wright

NEWS Continued on page 10

• Recommendation two addresses the use of oral topical antimicrobials (topical antibiotic administered by a dentist) in the prevention of PJI in patients undergoing dental procedures. There is no direct evidence that the use of oral topical antimicrobials before dental procedures will prevent PJI. • Recommendation three is the only consensus recommendation in the guideline, and it supports the maintenance of good oral hygiene. “Research is always changing and we need to work to improve clinical research databases, so in the future any type of prospective research done in this area will help shed light on prophylaxis and

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CDDS New Dentist Social Attendees included: Standing: Drs. Michael Wright, Emily Parks, Cameron Garvin, Katie Garvin, Amy Lee, Ryan Davis, and Ched Smaha. Seated: Drs. Tommy Peterson, Amber Lawson, Valerie Ambrose, Paulomi Shah, and Margaret Moore.


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NEWS Continued from page 8

CENSUS U.S. Population The U.S. population will be considerably older and more racially and ethnically diverse by 2060, according to projections released in December by the U.S. Census Bureau. These projections of the nation’s population by age, sex, race and Hispanic origin, which cover the 2012-2060 period, are the first set of population projections based on the 2010 Census. Furthermore, the population is projected to grow much more slowly over the next several decades, compared with the last set of projections released in 2008 and 2009. That is because the projected levels of births and net international migration are lower in the projections

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released today, reflecting more recent trends in fertility and international migration. According to the projections, the population age 65 and older is expected to more than double between 2012 and 2060, from 43.1 million to 92.0 million. The older population would represent just over one in five U.S. residents by the end of the period, up from one in seven today. The increase in the number of the “oldest old” would be even more dramatic — those 85 and older are projected to more than triple from 5.9 million to 18.2 million, reaching 4.3 percent of the total population. Baby boomers, defined as persons born between 1946 and 1964, number 76.4 million in 2012 and account for about one-quarter of the population. In 2060, when the youngest of them would be 96 years old, they are projected to number around 2.4 million and represent 0.6 percent of the total population. The non-Hispanic white population is projected to peak in 2024, at 199.6 million, up from 197.8 million in 2012. Unlike

other race or ethnic groups, however, its population is projected to slowly decrease, falling by nearly 20.6 million from 2024 to 2060. Meanwhile, the Hispanic population would more than double, from 53.3 million in 2012 to 128.8 million in 2060. Consequently, by the end of the period, nearly one in three U.S. residents would be Hispanic, up from about one in six today. The African American population is expected to increase from 41.2 million to 61.8 million over the same period. Its share of the total population would rise slightly, from 13.1 percent in 2012 to 14.7 percent in 2060. The Asian population is projected to more than double, from 15.9 million in 2012 to 34.4 million in 2060, with its share of nation’s total population climbing from 5.1 percent to 8.2 percent in the same period. (www.census.gov)


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Upcoming GDA / Dental Events FEBRUARY 2013 Fri, Feb 1: Give Kids a Smile Day Celebrations, Statewide. Wed, Feb 6: LAW Day, Southwestern District / Alliance.

Fri, Feb 22: GDA / Specialty Dental Groups / Lab Association Meeting, GDA Office. Wed, Feb 27: LAW Day, Western District / Northern District (Hall County Branch).

Wed, Mar 20: LAW Day, Central District. Thur-Sat, Mar 21-23: Hinman Dental Society Meeting, Atlanta. Wed, Mar 27: LAW Day, Eastern District.

Fri, Feb 8: GDA / GHSU Faculty Social, Augusta.

MARCH 2013 Fri, Mar 29: GDA Office Closed Half Day for Good Friday.

Wed, Feb 13: LAW Day, Southeastern District / Northern District (Northern Branch).

Tues, Mar 5: Northern District Executive Committee Meeting, GDA Office.

Wed, Feb 13: Clinic Day, Georgia Health Sciences University.

Wed, Mar 6: LAW Day, Northern District (Eastern / Central Branches).

Wed, Feb 13: Northern District CE Meeting, Villa Christina, Atlanta.

Wed-Sat, Mar 6-9: American Student Dental Association Annual Session, Atlanta.

Sat, Apr 6: GDA Board of Trustees Meeting, GDA Office.

Wed, Mar 12: LAW Day, Northwestern District.

Wed, Apr 17: Northern District CE, Villa Christina, Atlanta.

Wed, Feb 20: LAW Day, Northern District (Southern Branch) / GA Dental Society / North GA Dental Society.

APRIL 2013 Fri-Sat, Apr 5-6: ADA Conference on Recruitment & Retention, Chicago.

MAY 2013 Fri, May 3: GDA Officer Visit to Southeastern District Membership Meeting, Savannah. Mon, May 6: Northern District Executive Committee Meeting, GDA Office. Thu, May 9: Central District Executive Council Meeting, Macon. Mon-Wed, May 13-15: ADA Washington Leadership Conference, DC. Sat, May 18: Special Smiles Dental Screenings, Emory Campus. Mon, May 27: GDA Office Closed for Memorial Day Holiday. Fri, May 31: Finance Committee Meeting, GDA Office.

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Ben Massell Dental Clinic: Redefining the Charitable Care Model Like many charitable dental clinics, the Ben Massell Dental Clinic had its roots as a dental program tacked on to an established medical clinic—in this case, Atlanta’s Morris Hirsch Clinic in 1911. Patient demand forced the dental program to seek expanded, independent physical space and additional volunteer support over and over again during the ensuing decades. During its last and most significant expansion, clinic administrators set themselves several challenging goals, among them to create a comprehensive care clinic for the less fortunate that would be indistinguishable from a private office. “We feel that our model is unique in America,” said Keith Kirshner, Director of the Ben Massell Dental Clinic. “We were one small part of a larger medical clinic 100 years ago. Now, we are a large clinic committed to caring for the whole patient. We are a showplace of green technology and for the latest in dental equipment thanks to manufacturer donations. We provide care for thousands of patients with a minimum of paid staff and an extraordinary network of volunteer dentists. And our goal is to become an even more integral part of Atlanta’s health care system.”

Thousands of Patients Receiving Care in Every Specialty The Ben Massell Dental Clinic is the largest Georgia charitable clinic to offer patients volunteer care from every dental specialty that provides direct care, including providing orthodontics for children. There are 140 volunteer dentists who regularly offer their time and have provided $2.66 million in services, including 15,000plus procedures, over the last 12 months. “We have streamlined the process of appointing the hundreds of low-income individuals who seek care at the clinic,” said Mr. Kirshner. “We schedule a week’s worth of appointments every Monday based on patients who call in and who are then found to be eligible to receive care from the clinic. We also have 19 partner organizations that screen their clients for eligibility to receive care at the facility.” To obtain care at the clinic, patients must reside in one of 13 Metro Atlanta

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counties. They must show proof of county residency for at least six months, have no insurance to cover dental costs, and have a total household income at or below 125 percent of the federal poverty level. Despite the restrictions, demand for care is increasing. The clinic finds itself tasked with serving hundreds of clients who cannot pay for care, maintaining a safe and attractive venue for volunteers, offering the most current technology so practitioners and dental students feel confident using the equipment and materials provided, and continually raising funds to support clinic overhead. The clinic has acted to meet these challenges by forming dynamic community partnerships and making investments in infrastructure.

Clinic Aims High with Technology and Sustainability After its humble start as an “add on,” dentists Dr. Irving Goldstein and Dr. Marvin Goldstein, Atlanta real estate developer Ben Massell, and Jewish Family & Career Services (JF&CS, the clinic’s parent organization) helped the clinic secure larger space in Atlanta in 1956 and again in 1959. For 50 years, volunteers served nearly 6,000 patients annually in a two-story, 2,000 square foot clinic on Atlanta’s 7th Street that finally reached the end of its viability and capacity. In 2005, JF&CS CEO Gary Miller took the lead in helping the clinic find yet another expanded facility that would allow volunteers to reach more patients in updated surroundings. Thanks to a $5.5 million capital campaign chaired by Cathy Selig-Kuranoff, granddaughter of Ben Massell, the newest Ben Massell Dental Clinic opened in 2008. The surroundings were not the only thing new to staff and volunteers as the clinic opened. Digital records meant training for those used to the routines of the paper-driven clinic, but the transition from paper was an important component to appeal to practitioners and dental students who were more comfortable within the digital sphere. The administrators also chose to pursue LEED certification as renovations took place at the new clinic’s

14th Street location. The clinic was Atlanta’s first LEED-Gold (Leadership in Energy and Environmental Design) certified health care establishment and signifies the clinic’s long-term commitment to sustainability and minimal environmental impact.

Caring for the Whole Patient, Striving for Volunteers Clinic administrators have found consistently over 100 years that the patients who arrive “just” to receive dental care often suffer from a host of other health care ailments and assorted stresses brought on by economic hardship, poverty, homelessness, and drug abuse. The clinic added a full-time social worker to the staff to provide case management and referral services for patients. Through collaboration with Saint Joseph’s Mercy Care Services dental clients receive general health screenings, and a partnership with Georgia Lions Lighthouse means patients have access to free eye exams and glasses. After starting life as a medical clinic add-on, and splitting off to provide “just” dental care, the Ben Massell Dental Clinic has come full circle to offer comprehensive health care services to Atlanta patients. “A focus on the whole patient means a lot to our volunteers,” said JF & CS CEO Gary Miller, a staunch clinic supporter. “Once they see our facilities and equipment, and work with our staff, our close rate is phenomenal. The volunteers keep coming back.” While the clinic is grateful for the current roster of volunteers, new volunteer dentists in all specialties are welcome— visit www.benmasselldentalclinic.org for details.

Committing to 100 More Years of Success After 100 years, one realization is clear to the clinic’s administrators—a mission of service to the poor and expecting excellent, efficient outcomes are not exclusive goals. “Our investment in surroundings and services not only resonates with our volunteers, it impacts our clients,” said Mr. Kirshner. “We have seen our no-show rate


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decline, for one. We get excited to think about how we can continue to improve the health of a group of individuals who are suffering.” The clinic’s administrators have a solid sense of accomplishment, but acknowledge there are many challenges ahead and bold goals to meet. The clinic seeks to reduce the number of visits lowincome Atlantans make to hospital emergency rooms for dental pain and documenting the clinic’s role in that reduction as a way to fight for additional funding. The clinic wants to expand educational opportunities for students, and is partnering with Lutheran Medical Center of New York and Atlanta’s Grady Health System to host two full time Advanced Education

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General Dentistry residents starting in July 2013. To stay attractive to current volunteers and double or triple their volunteer list, the clinic continues to seek partnerships with manufacturers so as to showcase the latest technology. The next 100 years are certain to bring more change to this dynamic organization and to the delivery of care to the indigent in Georgia.

Celebrating Charitable Care and Volunteers The Ben Massell Dental Clinic celebrated 100 years of care on January 12 with a gala fundraiser. The event recognized Atlanta’s Dr. Emile Fisher, the first specialist to volunteer at the Ben Massell Dental Clinic.

Ben Massell Dental Clinic dentist volunteers provide comprehensive health care to thousands of indigent Atlantans every year. Find out more about the clinic at www.benmasselldentalclinic.org.

Gary Miller, CEO of Ben Massell Dental Clinic parent organization Jewish Family & Career Services, discusses a display describing how the clinic became Atlanta’s first LEED Gold-certified healthcare facility. The LEED (Leadership in Energy and Environmental Design) certification system is the nation’s pre-eminent program for the design, construction, and operation of high performance green buildings.

Dr. Fisher has remained a volunteer at the facility for 60 years. The GDA helped sponsor the gala and is proud to honor the work of the clinic and to recognize the charitable and philanthropic work of Dr. Fisher. The work of all of Georgia’s charitable clinics and dental volunteers is remarkable and moving. “So many of our great GDA members already volunteer at the Ben Massell Dental Clinic and at other charitable clinics around the state,” said GDA President Dr. Sidney Tourial. “Volunteering at facilities like the Ben Massell Dental Clinic is an excellent way for dentists to give back to the community.”

GDA President Dr. Sidney Tourial (r), Ben Massell Dental Clinic Director Keith Kirshner, and Gary Miller, CEO of Jewish Family & Career Services, in front of a wall honoring clinic donors and sponsors.

Volunteer Dr. Joe Looper Sr., assisted by Marla Parkison, cares for a patient. The clinic is seeking to double or even triple the number of area dentists, currently at 140, who volunteer at the clinic. GDA ACTION JANUARY 2013

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GDA Workforce Census Reveals 99.5 Percent of Georgia Dentists Can See New Patients

Findings Indicate Georgia Residents Underutilize Availability of Existing Dental Resources The results are in for the dental workforce census conducted by Market Decisions and the Georgia Health Policy Center at the request of the Georgia Dental Association. The conclusion: Findings point to a lack of demand for dental care among patients as opposed to an insufficient number of dentists available to provide care. In fact, the census found that only 19 out of 4,044 dentists practicing in Georgia stated they could not currently accept new patients.

“The GDA undertook this census to prove to policymakers that Georgia has a sufficient number of dentists to care for every patient in the state who wants and needs care,” said Dr. Tourial. “We believe that this census shows we do have, with our private practice dentists, our FQHC dentists, our public health departments, and the clinic at Georgia Health Sciences University, capacity to care for patients who seek that care.”

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Although there are 5,881 dentists identified by the Georgia Secretary of State’s Office and the Georgia Dental Association as having Georgia licenses, this census confirmed that there are 4,044 dentists who are actually in full or part-time practice in Georgia. The difference between the two numbers? The 5,881 figure includes Georgia licensed dentists who practice exclusively in another state, retired dentists who still hold a current Georgia license, dentists in the U.S. armed forces, dentists who are federal employees, and doctors who passed away after the GDA obtained the list of licensed dentists from the state in 2012. “Is there a dentist shortage in Georgia? The GDA believes this census demonstrates there is not a shortage of dentists who can provide care,” said GDA President Dr. Sidney Tourial. “The word shortage suggests there is more demand for dental care than an available supply. But our census shows, for instance, that 43 percent of our public health districts report that they aren’t busy because patients don’t show up for appointments. That does not show a lack of dentists. That shows a lack of demand, a lack of utilization of the care that is available.” Apart from the 19 private dentists who reported their practices full, 3,312 dentists reported themselves as busy but accepting new patients, 309 dentists reported needing accelerated growth, 31 dentists reported their practices were struggling, and 28 dentists reported they were looking for an opportunity to practice. The census was conducted at the behest of the Georgia Dental Association from March 2012, with results released in early January. The Association received financial consideration from the American Dental Association (ADA) and Georgia Health Sciences University (GHSU) to help fund the census. The GDA contracted with Market Decisions, Inc., to conduct surveys of private dentists. The Georgia Health Policy Center researched dentists practicing in Federally Qualified Health

Centers (FQHCs) and public health departments and districts in order to better understand the dental workforce. In addition, the GHSU College of Dental Medicine submitted data related to the number of patients treated at the dental school’s clinic staffed by dental students, and residents, which further demonstrates the current capacity for dental care in Georgia. All survey data was submitted to the Georgia Health Policy Center for study and interpretation. The Center, housed within Georgia State University’s Andrew Young School of Policy Studies, provides independent evidence-based research, program development, and policy guidance. The organization focuses on solutions to complex issues facing health care today including insurance coverage, long-term care, health care reform, children’s health, and the development of rural and urban health systems. Among the Center’s findings in the Georgia dental workforce census (see the complete list of the Center’s findings in the sidebar “Census Highlights of State Workforce Findings” on page 15): • 309 dentists report having significant excess capacity to see patients. • 31 dentists have so few patients that they are struggling to stay in practice. • Two-thirds of locum tenens dentists report they could work more days per week. • Out of every dentist surveyed, only 19 are not accepting new patients. • Patients of record can obtain a dental appointment in 5.4 days, on average. • A new patient can obtain a dental appointment in 6.1 days, on average. • Patients can be seen almost immediately for emergency care. “We learned a telling fact when the census revealed that 104 dentists not currently providing Medicaid services to Georgia children are willing to do so if the Care Management Organizations (CMOs)


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would open their closed panels and credential them,” said GDA Executive Director Martha Phillips. “This would add 12 percent to our current dental Medicaid provider network.” The census found that there are currently 885 licensed dentists who are credentialed as Medicaid and PeachCare for Kids providers in Georgia. In 2006, Georgia turned over the majority of its Medicaid program to the three CMOs Amerigroup, Peach State, and WellCare. These CMOs then elected to turn over

dental Medicaid administration to separate subcontractors. These subcontractors have changed multiple times since the CMO era began. The fragmented CMO system has been fraught with administrative difficulties and provider mistreatment. “We’ve gone from more than 1,800 dentists seeing Georgia Medicaid patients to less than half that amount in the years since the CMOs began managing the dental Medicaid benefits program,” said Mrs. Phillips.

The census also found that 16 of Georgia’s 159 counties had no dentist. Georgia has the second largest number of counties in any state, behind only Texas. Even then, however, the census found that no patient had to drive more than 22.9 miles, or approximately 35 minutes, to see a dentist. “We know that within those 16 counties, most of the residents also do not have a CENSUS Continued on page 16

Census Highlights of State Workforce Findings The workforce census commissioned by the Georgia Dental Association clearly demonstrates that individuals’ underutilization of dental services has nothing to do with a shortage of dentists in Georgia. Therefore, introducing mid-level providers into Georgia will not increase utilization of dental care. The issue of access to dental care can be addressed through other approaches, such as greater outreach, awareness, and oral health education. Some findings from the census that underline this finding: • Only 19 Georgia dentists are not accepting new patients. • Patients of record in Georgia can get an appointment in 5.4 days. • A new patient can get an appointment in 6.1 days. • Patients can be seen almost immediately for emergencies. • 309 dentists report having significant excess capacity to see patients. • 31 dentists report not having enough patients to the point they are struggling to stay in practice. • 28 dentists report they are not practicing and looking for openings. • Two-thirds of the locum tenens dentists report they could work more days per week. • 885 dentists accept Medicaid or PeachCare; 24.1 percent of the dentists receive $10,000 or less in revenue from seeing Medicaid or PeachCare patients. • 104 dentists not currently providing Medicaid services are willing to do so if the CMOs would credential them. This would add 12 percent to the Medicaid provider network.

• In the 16 counties without a dentist, most also do not have a primary care physician and the unemployment rates, with exceptions, are also higher than average. No patient has to drive more than 22.9 miles or 35 minutes to see a dentist. • In 18 public health districts, no dental services are provided in one district and two are only providing screening and education due to the budgets for dentist positions being cut. Some of the public health districts only provide services to children—no adults. Patients wait on average 2.5 weeks for an appointment with a public health dentist. One district sees patients with no wait. Forty-three percent of the Public Health Districts report they are not busy because patients schedule but do not show for treatment. • 15 FQHCs offer dental services. Four of these see patients with no wait; two FQHCs said they had resources but just need a greater volume of patients; one FQHC reported they had a 60 percent no-show rate for Medicaid patients. • FQHCs and Public Health facilities are heavily concentrated in the same areas and these are the areas with the highest number of other practitioners. • Federal designation of Dental Health Professional Shortage Areas (DHPSAs) is a complicated and ineffective system that does not accurately reflect a professional shortage. Three counties currently designated as DHPSAs—Clinch, Grady, and Sumter— exceed the one dentist per 5,000 residents based on survey data. On the other hand 28 counties without DHPSA designations might qualify merely based on the one-dentist-per-5,000-residents ratio.

• In the 35 counties without a Medicaid dentist, the maximum driving time is 57 minutes or 37 miles and the minimum is 12 minutes or 8 miles.

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CENSUS Continued from page 15

“This census was not meant to be a static document,” primary care physician,” said Dr. Tourial. “The counties, by and large, are economically challenged and would have issues supporting a viable health care practice of any size.” Several additional relevant findings came from surveying dentists employed by the 15 FQHCs in Georgia that offer dental services as well as Georgia’s public health dentists. Four Federally Qualified Health Center dental clinics can currently see patients for care with no wait. One dental public health district can currently see patients with no wait. Patients wait on average 2.5 weeks for an appointment with a public health dentist. Proponents of radical changes to the dental delivery system, such as private foundations that support the introduction of so-called mid-level providers—individuals not trained as dentists who are tasked with performing irreversible or surgical dental procedures—are likely to grasp at census findings of a low dentist-to-patient ratio in the state and the 16-county “no dentist” number and attempt to make a case for forcing new providers into the equation to improve access. However, the 2010 Georgia Dental Association “White Paper on Georgia’s Oral Health Status, Access to and Utilization of Oral Health Care Services” identified access to care as a multi-faceted issue. The paper underlined the fact that it is necessary to examine the various components that impact delivery and access to care. An understanding of the health status and the level of Georgians’ oral health literacy is an essential first step in developing an action plan. Utilization of dental care is affected by potential barriers that are unique to each patient. Barriers can include insurance, financial resources, education, transportation, geographic limitations, a patient’s age, cultural background, and fear of dental procedures. No one solution will solve all of these problems. “The GDA undertook this census to prove to policymakers that Georgia has a sufficient number of dentists to care for every patient in the state who wants and needs care,” said Dr. Tourial. “We believe that this census shows we do have, with our private practice dentists, our FQHC dentists, our public health departments, and the clinic at Georgia Health Sciences

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said Dr. Tourial. “This census will provide the GDA with additional information that will help direct our efforts to educate all Georgians on the importance of oral health care and help ensure that dentists and their teams are available to provide that care. The GDA remains committed to addressing all of the aspects of an individual’s personal situation that can affect how and why they seek, or don’t seek, dental care.”

University, capacity to care for patients who seek that care. “We do see areas where there are challenges, however,” Dr. Tourial continued. “Those areas revolve around increasing patient demand for and value of dental care. We need to raise awareness of the importance of seeing a dentist for regular dental care. Our messages need to center around education, awareness, and outreach. We are committed to taking the information obtained from our census and taking action.” The GDA, for instance, is already hard at work improving the oral health literacy of Georgians. The Association partnered with the ADA on its recent “2Min2X” oral health education campaign that has received national attention for encouraging brushing kids’ teeth for 2 minutes, 2 times a day. The GDA is implementing a program to improve the oral health of nursing home residents, as well as undertaking a second Georgia Mission of Mercy project in 2013. “This census was not meant to be a static document,” said Dr. Tourial. “This census will provide the GDA with additional information that will help direct our efforts to educate all Georgians on the importance of oral health care and help ensure that dentists and their teams are available to provide that care. The GDA remains committed to addressing all of the aspects of an individual’s personal situation

that can affect how and why they seek, or don’t seek, dental care.” The full Georgia Health Policy Center census document and the GDA white paper may be read at www.gadental.org.


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GDA to Tackle the Budget, Board Autonomy, and Tax Credits During 2013 Session Sidney Tourial, DDS, President Jack Bickford, DDS, Governmental Affairs Chair Martha Phillips, Executive Director

The Georgia Dental Association legislative agenda for 2013 is a challenging one. GDA members are invited to attend a GDA LAW Day to learn more about the issues outlined here that will impact your profession and patients. Contact Nelda Greene at greene@gadental.org or (404) 636-7553.

Goal: Create Autonomous Board of Dentistry The GDA has worked with the Georgia Board of Dentistry (Board) to draft language for legislation that would create an autonomous Georgia Board of Dentistry. The language is patterned after that used to create an autonomous state Composite Medical Board. Representative Dr. Lee Hawkins has agreed to carry the legislation in the 2013 session. Dentistry is a specialized field which requires the oversight of those in the profession to ensure appropriate competency and the safety and welfare of the public. The Georgia Secretary of State’s office has suffered huge budget cuts as has every other state agency over the past few years. These cuts have made it very difficult for the Board to be able to perform its duty of protecting the public. An autonomous board can set its own budget. This flexibility would allow the Board of Dentistry to be more responsive to patient concerns and assist the practitioners who are licensed under the Board. The Board of Dentistry would likely have to increase license renewal fees to provide for the increased budget demands of autonomy. The GDA Governmental Affairs Committee made the significant decision to combine dental board autonomy legislation with legislation from the Georgia Pharmacy Association that would also create an autonomous pharmacy board. After extensive discussions about the positives and negatives of introducing a combined bill, they determined that a combined bill

stands a better chance of success. While early discussions with legislators reveal there is a great deal of support for the legislation, the GDA needs you to attend a LAW Day and talk with your legislator about this critical legislation.

Goal: Fend Off Medicaid Budget Cuts Gov. Nathan Deal asked state department heads to cut 3% from their agencies’ Amended Fiscal Year 2013 and Fiscal Year 2014 budget requests. The Department of Community Health (DCH) was asked to submit an additional 2% budget reduction plan for the Medicaid and PeachCare for

Kids programs for FY2014. In response, the DCH Board is currently planning Medicaid budget cuts of $60 million in FY2014. While the DCH Board stated it did not aim to reduce payments to medical providers, including dentists, recent information from the Governor’s Office of Planning and Budget indicates that the Governor’s budget will propose a 5.84% cut to all Medicaid provider payments. The state feels this step is necessary to help fill the deficit created by the Governor’s decision not to renew the politically controversial “Hospital Provider BUDGET AND MORE Continued on page 18

GDA Monitoring Activity on Georgia’s Prompt Pay Law While this is not a legislative goal for 2013, the issue of a lawsuit threatening Georgia’s prompt pay law, passed in 2011, will certainly appear on the GDA’s radar. America’s Health Insurance Plans (AHIP), a national trade association representing insurers, filed a lawsuit against Georgia Insurance Commissioner Ralph Hudgens in August 2012 seeking an injunction to block implementation of the state’s Insurance Delivery Enhancement Act of 2011, commonly referred to as the Prompt Pay law. The statute was passed after significant lobbying efforts by the Georgia Dental Association and the Medical Association of Georgia. Set to go into effect in January 2013, the law requires self-funded health plans and their third party administrators to comply with the same payment rules as regular insurance plans for individuals and small businesses. Self-funded plans would be required to process and pay electronic claims within 15 business days and paper claims within 30 calendar days. According to AHIP, Georgia’s new law violates the Employee Retirement Income Security Act (ERISA), which generally exempts selffunded plans from state law that regulates insurance. In October, the American Medical Association and the Medical Association of Georgia filed a petition in the lawsuit seeking to intervene in the case as co-defendants alongside Commissioner Hudgens. Their motion to intervene is still pending. As this is a matter which could have national significance, the American Dental Association and GDA are investigating the manner in which the Associations can participate in this litigation.

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BUDGET AND MORE Continued from page 17

Dentistry is a specialized field which requires the oversight of those in the profession to

ensure

appropriate

competency and the safety and welfare of the public. The Georgia Secretary of State’s office has suffered huge budget cuts as has every other state agency over the past few years. These cuts have made it very difficult for the Board to be able to perform its duty of protecting the public. An autonomous board can set its own budget. This flexibility would allow the Board of Dentistry to be more responsive to patient concerns and assist the practitioners who are licensed under the Board.

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Payment Agreement (HPPA),” (or hospital provider tax) that expires in FY14. The HPPA was passed in 2010 as a mechanism to help offset a shortfall in the General Funds budget. Although some money came back to some hospitals, others suffered significant financial losses. The GDA does not support any cuts to Medicaid provider fees. The Access Healthcare Coalition, of which the GDA is a member, instead supports a “new HPPA,” or as it is called, the “Hospital Medicaid Financing Program.” To say there was unrest about the original HPPA is a mild description of the political and financial turmoil that took place when the agreement was implemented. As the GDA held discussions around the state in preparation for the 2013 session, we saw that few legislators had the stomach to vote for the HPPA again. We also saw that no one was stepping forward with a solution for the steep budget cuts that would be necessary if the HPPA was not included in budget proposals. That is when the coalition stepped in with an alternative plan. The “new HPPA” is not supported by all of the state’s hospitals but it is supported

by the Georgia Hospital Association and other significant hospital groups. The proposal would reduce the number of hospitals losing money from 68 to 48 and provide a $41 million gain to the hospital industry. This complex budget battle will certainly require significant dental lobbying efforts. We hope that as many GDA and Alliance members as possible will step forward to support the GDA’s position.

Goal: Establish Tax Credits for Dentists in Underserved Areas The GDA consistently seeks to enable dentists to practice dentistry in underserved areas of Georgia. One way the GDA will help dentists is by supporting legislation in 2013 to allow a $5,000 tax credit for up to five years for dentists who are willing to practice in a rural county and further reside in a rural county or a county contiguous to the rural county in which the dentist would practice. For the purposes of this legislation, a rural county is one with 65 persons or fewer per square mile.


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GDA Issues Regulatory Reminders for the New Year Stay on track with the GDA! The Association offers these selected tips for staying up to date on regulatory and practice issues for the coming year. Visit the newly revamped GDA web site at www.gadental.org for more extensive coverage on 2013 deadlines and details on regulations.

Workplace Posters: Don’t Pay a Cent for Them State and federal governments require employers to post certain informational posters in their offices for employees. Dentists may obtain these posters at no charge by using the web site links supplied. Do not be fooled by companies that use scare tactics about fines to intimidate dental offices into buying packets of posters. • The U.S. government requires employers to post notices about: 1) Employee Polygraph Protection 2) Equal Employment Opportunity 3) Fair Labor Standards Act 4) Job Safety and Health Protection 5) Rights Under the Family and Medical Leave Act (employers of 50+ individuals), and 6) Uniformed Services Employment and Reemployment Rights Act. Obtain them for free from the U.S. Department of Labor Web site www.dol.gov/oasam/programs/osdbu/sbrefa/poster/matrix.htm. • Georgia requires dentists to place these workplace posters: 1) DOL-154 (Employer Vacation) 2) DOL-4107 (Equal Pay for Equal Work Act), and 3) DOL-810 (Unemployment Insurance for Employees). Obtain these posters at the state Department of Labor Web site www.dol.state.ga.us/em/required_posters.htm. The state also requires you to post two Workers’ Comp notice posters: 1) WC-P1 “Panel of Physicians” with a list of six physicians (one must be an orthopedic surgeon and one a minority, if feasible) and 2) WC-BOR “Bill of Rights for the Injured Worker.” Obtain them at http://sbwc.georgia.gov (click on “Forms” and then “Board Forms”). Note: The DC Circuit Court of Appeals has temporarily enjoined the National Labor Relations Board rule requiring the posting of a workplace poster advising employees of their rights under the National Labor Relations Act. The rule, scheduled to take effect on April 30, 2012, will not take effect until the legal issues are resolved. See https://www.nlrb.gov/poster for details.

Excise Tax: What We Know So Far Dentists are bracing for the fallout from how the Internal Revenue Service will structure the health care reform law’s mandated 2.3% excise tax on medical devices. The excise tax, meant to help offset costs associated with expanding health care coverage, will affect the manufacturers and importers of “dental devices,” including dental laboratories. The GDA and ADA believe nothing in the tax will require dentists to report or file any documents with the IRS. However, dentists are likely to feel an impact financially as prices may increase on medical devices purchased for the dental practice. Once a final regulation is available for review, the ADA and GDA will inform the membership about consequences to dentists. The ADA provided an excellent overview of the tax in a recent ADA News article. Read it at: www.ada.org/news/7940.aspx.

Injectable Pharmacological Training for Dentists Before treating a patient with injectable pharmacologics such as Restylane, Fillers, or Botox, Georgia dentists must complete a 21-hour Board of Dentistry-approved course that includes, at a minimum, advanced instruction in the anatomy of head and neck, neurophysiology, patient selection, pharmacological effect and contraindications, and management of complications. Once a dentist has taken an approved course, he or she should obtain a certificate of completion from the course administrator. Within 30 days of completing the course, the dentist must submit to the Board a certified copy of the certificate of course completion. Visit the Georgia Board of Dentistry web site at http://sos.georgia.gov/plb/dentistry for details on complying with the injectable pharmacologics rule. You may also visit the regulatory section at www.gadental.org for additional information on the rule.

PCI-Compliance: Does It Apply to Dentists? PCI Compliance is a set of security practices agreed upon by Payment Card Industry Standards Council members and applied to merchants through their agreements with their credit card

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REGULATORY REMINDER Continued from page 19

State Dental License Renewal: 2013 provider. The standards focus on protecting credit card numbers and deterring identify theft and are required of every merchant that accepts credit cards as a form of payment. The Payment Card Industry Data Security Standard (PCI-DSS) is a list of 12 requirements that includes installing and maintaining a protective firewall, using anti-virus software, and encrypting the transmission of cardholder data, among others. You should discuss PCI-DSS with your payment gateway company.

CDT 2013: 35 New Codes. Buy It. The new American Dental Association CDT 2013: Dental Procedure Codes provides significant updates for 2013 including 35 new codes, 37 revised codes, 12 deleted codes, and 7 new or revised service categories / subcategories. If you have not purchased a CDT book in some years, now is the time to obtain another copy. Visit www.adacatalog.com or call the ADA Catalog at (800) 947-4746 to order yours for $59.95.

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Dentists and dental hygienists must renew their state licenses by December 2013. Dentists are required to obtain 40 hours of approved continuing education (22 hours for dental hygienists) as well as current CPR certification. Remember, dentists and dental hygienists can only obtain online continuing education for up to one-half of the total hours required for renewal. Visit the GDA web site at www.gadental.org and the Georgia Board of Dentistry web site at http://sos.georgia.gov/plb/dentistry for more details on continuing education requirements.

Sedation Permits: Do ACLS or PALS Satisfy CE Requirements? Under Board of Dentistry rules, a dentist who wishes to renew a sedation permit must take 4 hours of CE every 2 years in pharmacology, anesthesia, emergency medicine, or sedation. According to the Board, completion of ACLS does NOT count toward those 4 CE hours. While ACLS / PALS counts toward the dentist’s total 40 hours that must be earned for license renewal, it does not satisfy the 4 CE hours necessary to renew a sedation


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permit. The intent of the rule is to advance knowledge of sedation and ensure competency in preventing problems during sedation. ACLS advances knowledge in how to handle an emergent situation during sedation, not necessarily how to prevent it.

Citizenship Verification for License Renewal Georgia passed the “Illegal Immigration Reform and Enforcement Act of 2011.” A portion of this law requires that as of January 1, 2012, all applicants for a professional license, including dentists, and those applying for renewal of an existing license, submit to the Georgia Board of Dentistry secure and verifiable documentation establishing the individual is legally in the United States. A list of the approved secure and verifiable documents may be found on the Attorney General’s web site. Such documentation includes a United States Passport, a Driver’s License issued by one of the United States, and a Certificate of Citizenship. Dentists and dental hygienists who will renew their license on or after January 1, 2012, (or will obtain a new license) must comply with this new requirement. Affected individuals can upload an approved document during their online renewal, print it, fax it, or email it to the Georgia Board of Dentistry. Direct any questions about this process to the Georgia Board of Dentistry at (478) 207-2440.

Coupon Web Sites and Dental Practice Marketing The Georgia Board of Dentistry has a rule against fee splitting. The rule provides that “[a] dentist shall not give rebates or split fees with a referral source.” Fee splitting generally refers to a situation where a dentist pays a fee to a third-party for referrals on a per patient basis or a percentage basis. While the Georgia Board of Dentistry has not provided direct guidance on this issue, it is possible that Groupon-type marketing models may be perceived as fee splitting. A dentist who receives payment from a federal program such as Medicaid or Medicare must tread with extreme caution before jumping on a Groupon-type marketing bandwagon. The federal Anti-Kickback statute prohibits a dentist or any provider from offering or paying remuneration to entice a person to refer a patient who may be eligible for services under a federal health care program, including Medicare or Medicaid. Because of the split of revenue between the dentist and the advertiser, like Groupon.com,

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for each patient referred, this arrangement could pose significant problems. Dentists should also ensure that their marketing efforts do not run afoul of the Board of Dentistry’s regulations on advertising.

Infection Control Guidelines: See the CDC A dentist’s license can be sanctioned for failing to comply with the Centers for Disease Control and Prevention’s recommendations for preventing the transmission of certain diseases. See www.cdc.gov to obtain a copy of the CDC Guidelines for Infection Control in Dental Health Care Settings.

Homeland Security Form I-9 The Department of Homeland Security requires that every employer verify the identity and employment eligibility of every new employee at the time that employment begins. This includes all individuals employed by a dental office, but does not include independent contractors. Form I-9 was developed to verify that persons are eligible to work in the U.S. Each employee you hire must complete Form I-9 at the time he or she begins employment. Along with a completed Form I-9, each employee must also provide original documents that establish their identity and employment eligibility (acceptable documents include a U.S. passport, state driver’s license or ID card, U.S. Social Security card, and certified birth certificate. The employee may need to provide multiple documents). The employer must retain the completed form and copies of all eligibility documentation for three years from the date of hire and / or one year after the date employment ends. Visit www.uscis.gov/files/form/i-9.pdf for more details.

Address Changes: Board, GDA, and GDIS Keep your membership records current by informing the GDA if you move your office or home, or change your phone, email, or fax number. Call (404) 636-7553 or (800) 432-4357, visit www.gadental.org for a change form, or email willich@gadental.org. Please also inform Georgia Dental Insurance Services about such moves, which could affect your coverage. Call (404) 636-7553 or (800) 432-4357. Lastly, 2013 is a dental license renewal year. Make sure the Board of Dentistry has your correct contact information. Visit http://sos.georgia.gov/plb/dentistry to provide the Board with any updates.

Liability Coverage: Update Yours X-ray Regulations: Plan Ahead The Health Care Section of the Office of Regulatory Services (ORS) no longer performs routine periodic surveys of x-ray machines, but does perform initial state registration surveys and shielding design reviews. Dentists must have x-ray equipment inspected by the state before any new equipment may be used. Plan ahead—this process can take months because the state has few inspectors. Visit http://dch.georgia.gov for additional information on registering your equipment.

OSHA Regulations Have you scheduled your annual OSHA update? Is your paperwork documenting training in order? Are MSDS sheets complete? Are your employee medical records up to date (Hepatitis B vaccination, history of exposure incidents, etc)? Are your hazardous chemicals properly labeled? There have been changes to the labeling standard! (See www.gadental.org for an article explaining the changes.) Has your Hazard Communication Program been explained to staff? Is your Poster 3165 displayed? If you need help with any of these requirements, contact Nelda Greene at the GDA office at greene@gadental.org. In addition, the ADA sells an OSHA Compliance Manual for dental offices via www.adacatalog.org.

Tell your Business Owner’s and Professional Liability insurance carriers at least two weeks before you move your practice about your move and new location. You will not be covered at your new location until you notify your insurer AND they accept the risk. Georgia Dental Insurance Services clients: Call (800) 432-4357 or (404) 636-7553 with your changes. And if you receive additional training in dental procedures or discontinue doing certain procedures, notify your liability carrier, as you just changed the risk the company is insuring. The same goes if you change from full time to part time or vice versa.

Insurance Policies: Set Up Reminders Greet 2013 with all of your policies in a secure location. Keep a separate list of policy numbers, renewal dates, and claims department contact details in case you make a claim. Pay your premiums promptly this year. If you have moved, notify all of your carriers so bills arrive at the correct place. Remember to increase your insured exposure limits if the value of your property has increased from last year. And review your medical plan if you recently utilized it so you are aware of any limitations or requirements.

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Mark Your Calendars for an Exciting GDA Meeting in Hilton Head Matt Mazzawi, DMD General Chairman The GDA Annual Meeting takes place July 25-28, 2013, at the Marriott Hilton Head Resort & Spa on Hilton Head Island in South Carolina. Your Annual Meeting Committee is hard at work creating an event for dentists, dental staff, and their families to enjoy. Looking forward to tours? We are planning activities, trips, and fishing excursions with a local outfitter, Outside Hilton Head. This is a fantastic group to work with and we have eliminated virtually all of the minimum person requirements for the fun activities we have scheduled. We have secured great pricing too! Our Kickoff Breakfast on Friday, July 26, will be headlined by Bruce Wilkinson. Bruce is an entertaining speaker with fantastic reviews from every group he has addressed. He will also host a break-out continuing education session later on Friday. Bruce is sure to start the meeting off with a bang! Dr. Troy Schulman and his wife Robanne are planning an exciting State Fair for our Friday Fun Night. The most recent Fun Night drew 600 attendees. This event has become one of our signa-

ture meeting draws. We cannot wait for this year’s attendees to enjoy the attractions in store! On Saturday, attendees are invited to play golf at the famous Ocean Course at Sea Pines. This beautiful course is walking distance from the Marriott. The Saturday President’s Party will be an absolute blast when Yacht Rock Revue takes the stage! This band has packed out shows at venues including the Variety Playhouse in Atlanta, the Knitting Factory in New York City, Athens’ Georgia Theatre, Washington DC’s State Theatre, and Nashville’s Mercy Lounge. The energy on Saturday night will be incredible! Throughout the meeting dentists will have access to a variety of continuing education options. Dr. Michael Pruett, director of the General Practice Residency Program at Georgia Health Sciences University / Georgia Regents University is assembling an exciting group of lecturers and topics that will keep you off the beach and glued to your seats (if you so choose in this dental and dental hygiene license renewal year). The GDA’s “Esthetics Extravaganza” will showcase and highlight several of our talented Georgia clinicians. The Exhibit Hall will be a great place to find deals. Children will have a blast visiting the Fun Zone—Dr. Nancy Gallagher is busy planning games and attractions. Visit the GDA web site for an updated list of the vendors who are attending the meeting and supporting our association. Meanwhile, thanks to the vendors listed on this page for their early support of the GDA!

Mark your calendars now to spend a summer vacation with your friends and colleagues at the GDA Annual Meeting in beautiful Hilton Head Island, South Carolina. See the GDA web site www.gadental.org for updated information on the meeting, and use the room form on the opposite page to reserve a room at the GDA meeting host hotel.

BlueCross BlueShield of Georgia Convert-A-Check Georgia Dental Insurance Services Habif, Arogeti & Wynne, LLP Medical Protective PDQ Services Paragon Patterson Dental Phillips Oral Healthcare Pittman Dental Labs Straumann USA Transworld Systems UBS Financial Services, Inc. Zoll Dental / Bobby Morse

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Georgia Mission of Mercy Opens Volunteer Registration for 2013 Clinic The Georgia Dental Association and Georgia Dental Association Foundation for Oral Health are pleased to host the second Georgia Mission of Mercy (GMOM) June 13-16, 2013, at the North Atlanta Trade Center in Norcross in Gwinnett County. The first GMOM delivered much-needed dental care valued at more than $1.7 million to 2,179 low and no-income Georgians. That care was delivered by 1,383 volunteers, which included dentists from across Georgia, dental hygienists, dental assistants, dental laboratory personnel and technicians, dental equipment technicians, physicians, nurses, pharmacists, dental and dental auxiliary students, office staff, and hundreds of interested persons from the community. “An event the magnitude of GMOM will again require hundreds of clinical volunteers to provide treatment, along with several hundred additional community volunteers to help the event run smoothly,” said GMOM co-chair Dr. Karyn Stockwell, who is returning to helm the clinic this year as is Co-Chair Dr. Jonathan Dubin. “We are opening formal volunteer registration in mid-January and invite all GDA members to sign on to help.” An email notice will go out to all GDA members and a link will be added to the GMOM web site www.georgiamissionofmercy.org when registration opens. Doctors and staff are invited to visit the site for updated information about the charitable care event. Meanwhile, this list of answers to frequently asked questions about GMOM can help you stay informed.

Q: Remind me again, what is the Georgia Mission of Mercy? A: The Georgia Mission of Mercy, or GMOM, is a free, large-scale, two-day dental clinic for low or no-income adults who cannot pay for dental care. The goals of GMOM are to provide free dental care and oral health education to 2,000+ patients in just two days and highlight the oral health needs of the citizens of Georgia.

Q: What are the dates for GMOM? A: The dates are June 13-16, 2013. Clinic set-up will take place on Thursday, June 13 (no patient care will be provided on this day). Clinic treatment days will be held on Friday and Saturday June 14 and 15. Clinic tear-down will take place on Sunday, June 16 (again, no patient care will be provided on this day).

and many more volunteers. A full listing of open volunteer positions is posted at www.georgiamissionofmercy.org.

Q: How can I volunteer for the event? A: Formal volunteer registration is scheduled to open at www.georgiamissionofmercy.org in mid-January 2013. An email notice will go out to all GDA members and a link will be added to the GMOM web site as soon as registration opens. All interested volunteers who are 18 or older (clinical and non-clinical personnel) will need to register individually under a unique email address. That means even if an entire dental office plans to volunteer, each person from the office, including the dentist, must register separately using his or her own email address. The GDA encourages all dentists, dental assistants, dental hygienists, front desk employees, lab techs, and interested persons to become a part of GMOM. There is a job for everyone! A list of all the available volunteer categories and positions is available on the GMOM web site.

Q: I can’t volunteer in June. Is there another way I can help? A: Absolutely! GMOM needs support from hundreds of volunteers, but also needs to raise nearly $275,000 in monetary and in-kind donations to have a successful event. GMOM receives no governmental funds and is entirely dependent on grants and donations. Do you want to donate materials or services? A listing of the supplies needed for a successful GMOM is posted at www.georgiamissionofmercy.org. Can you donate funds to assist GMOM? A monetary donation form is also posted on the GMOM web site. All donations are tax deductible as permitted by law through the Georgia Dental Association Foundation for Oral Health, a 501(c)(3) charity.

Q: Can I tell my church / local charity / other group about GMOM? A: Our focus at this time is on volunteer awareness and fundraising. Patient outreach and public education will not take place until later in 2013. We will let you know when it is a good time to share information about GMOM 2013 with clinics, patients, and advocacy groups.

Q: What is the location for GMOM 2013? A: GMOM will take place at the North Atlanta Trade Center in Norcross, Georgia, in Gwinnett County near Interstate I-85.

Q: I have additional questions about GMOM. Where can I find answers? A: The GMOM web site at www.georgiamissionofmercy.org

Q: Who can volunteer to help at GMOM? A: GMOM will need assistance from hundreds of clinical and community volunteers to run smoothly and reach as many patients as possible. For example, in 2011, 346 dentists volunteered to provide care at GMOM. We will need at least this many doctors again in addition to dental hygienists, dental assistants,

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will be updated throughout early 2013 with information about the charitable event. Please visit the site regularly for GMOM news. Volunteers who register online will also receive regular email updates about the event. Dentists may also email gmom@gadental.org with their questions.


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classified ads How GDA members can place classified ads AD FORM: Submit all ads on a GDA Classified Advertisement Form. To obtain a form, call Skip Jones at (800) 432-4357 or (404) 636-7553, or email jones@gadental.org. (Note: The GDA may accept or reject any ad for any reason and in its sole discretion.)

AD DEADLINE: Ads and ad check payments are due by the first of the month before the publication month (i.e., Dec. 1 for January).

AD RATES: ADA member dentists pay $75.00 per 60-word ad per month. There is a 25 cents per-word charge for each word over 60. Non-dentist-owned companies (real estate firms, etc.) pay $195 per 60-word ad per month (additional word charges as above). Non-member dentists may not place ads.

LATE FEE: Ads for which full prepayment is not received by the first day of the ad’s publication month (i.e.; Nov. 1 for a November ad) will incur a $25 late fee in addition to the ad rate.

FORMS OF PAYMENT: Submit a check or money order with the ad form. (Make checks payable to GDA.) Credit cards are not accepted as payment.

WEB SITE PLACEMENT: Prepaid ads will appear on the GDA Web site www.gadental.org for the month the ad appears in print. Non-prepaid ads will NOT be placed online.

DENTISTS AVAILABLE FOR LOCUM TENENS Dentist will fill in for illness, vacation, or continuing education. Licensed, insured, DEA #. Call (404) 786-0229 or email breighard@gmail.com. Dentist Available Daily (DAD): Dentist available during vacations, emergencies, and CE courses. Leave your practice in well-trained hands. I am licensed, insured, and have a DEA registration number so I can write prescriptions. Call Dr. Richard Patrick at (770) 993-8838. DENTIST: Need Part Time Fill In? Vacation, Illness, Maternity? GENERAL DENTIST SOLD LONG ESTABLISHED PRACTICE. GA & DEA LICENSED. (Available Expanded Atlanta Area.) Cell: (404) 219-4097. Home: (404) 842-1196. Jesse Hader, DDS. Dentist available during emergencies, vacation, CDE courses. I have a current license, DEA certificate, and insurance. Contact me at (706) 291-2254 or cell (706) 802-7760. I hope I can be of service to you. Patrick A. Parrino, DDS, MAGD.

POSITIONS AVAILABLE Pediatric Dentist Needed: We have an outstanding full time opportunity for a Pediatric Dentist in our successful, well-respected, quality-oriented private pediatric dental practice for the right candidate. We are seeking a special, motivated, personable individual to join our success. We are a booming practice with tremendous growth and earning potential. We offer in office sedation. Excellent compensation and benefits. For more information, please contact Amanda Rentschler at amanda@kidshappyteeth.com or (678) 352-1090 / (678) 429-9931.

Full time associate dentist wanted for a multi-dentist, fee for service, high tech cosmetic restorative general practice located in Midtown Atlanta. We are a dental team dedicated to helping patients get healthy aesthetic dentitions through the use of the latest dental technology and quality dental labs. Our office is a Preferred Provider of Invisalign. CEREC and all ceramic restorations are the dominant restoration produced in our practice. We are completely digital and approaching paperless. All doctor operatories are equipped with the latest ADEC equipment, W&H electric hand-pieces, digital x-rays, LED lights, and computers with CAESY patient educational systems in 10 operatories. We use Cone Beam technology to help diagnose and treatment plan implant surgeries. Most all implant surgeries are completed in our office by a qualified implantologist and are subsequently restored by the associate doctors. The incoming new associate dentist will be taught how to use the CEREC CAD / CAM computer by a certified CEREC trainer along with how to incorporate digital extra-oral photography when presenting treatment plans. This is an excellent opportunity for a FT dentist to experience the clinical integration of the latest technology in dentistry. One of our FT dentists is leaving and the right dentist who has good restorative and communication skills is needed to take over that patient load. Good restorative experience is an absolute must. This associate doctor will average 35-45 fee-for-service new patients per month and work 5 days a week. We do not participate in any PPO or HMO dental plans. Interested parties email Sheila Miranda at: om.dds11@gmail.com or call her cell at (404) 671-2890.

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ASSOCIATE DENTIST NEEDED: Busy General Dentistry practice in Hiram, Georgia, is looking for an associate to add to our practice! Part-time with the possibility of future growth. Must be skilled and practice all aspects of general dentistry. Our office is a state of the art facility with digital x-ray equipment. Please email resumes to melinablack@bellsouth.net or call me @ (770) 439-6844. Pediatric Dentist needed for a busy multi-specialty practice located in Atlanta which provides full-service pediatric dentistry including hospital and sedation care. Full-time / part-time employment is available with great benefits and monthly bonus. Fax resumes to (404) 349-8459 or email resumes to info@familyandchildrensdentistry.com. For additional information please contact Jackie Williams at (404) 349-7777.

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Pediatric Dentist needed for a National Health Service Corps (NHSC) Site for a scholar HPSA Score 17; practice located in Greensboro, GA, which provides fullservice pediatric dentistry including hospital and sedation care. Full-time employment is available. Fax resumes to (404) 349-8459 or email resumes to info@familyandchildrensdentistry.com. or additional information please contact Jackie Williams at (404) 349-7777. Charleston, South Carolina: Join a pediatric practice with multiple offices. Join a fun, well-respected, paperless pediatric practice and live in a great city on the beach. The position is for someone looking for a great place to work in a friendly and comfortable working environment, competitive salary, & benefits. Email CV drisabel@coastalkidsdental.com or call (843) 816-KIDS (5437). Visit coastalkidsdental.com.

Dentist Jobs: Aspen Dental offers tremendous earning potential and a practice support model that empowers dentists to achieve goals. We eliminate obstacles for dentists to own their own practice. To learn more about our compelling proposition and to apply, please call (877) 332-9154 or visit www.AspenDentalJobs.com. EOE

PRACTICES / OFFICE SPACE AVAILABLE Northeast Georgia: Successful pediatric dental practice of 16 years closing. Doctor retiring. 1700 sq. ft. stand-alone building has four operatories. Area in need of pediatric dentist. Perfect for a satellite practice. For more information contact tomgale@windstream.net.

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Dental Office Ready for Occupancy in January ‘13. Lawrenceville just seconds off I-85 with high visibility on a heavily traveled road. Beautiful and modern space with 2160 sq. ft. and 6 treatment rooms plumbed and ready for cabinetry, equipment, and N2O2. Established dental location for the last 8 years. Dentist moving to larger facility. Elegant reception area with slate floors, tray ceiling, and cove lighting. Business office with Corian countertops will remain. Would like to see new lease negotiated. Available January 2013. Contact DentalExcellence4U@Yahoo.com. Available: CANTON: Gorgeous office grossing $393K, 4 operatories. GWINNETT: Grossing $520,000, 4 operatories. LAKE OCONEE AREA: Exceptional opportunity, grossing $823K. TUCKER: Grossing $350,000, 5 operatories. WOODSTOCK: Beautiful 5 operatory office grossing $400K. Contact Richane Swedenburg, New South Dental Transitions: (770) 6300436, info@newsouthdental.com. Check new listings: www.newsouthdental.com. COBB COUNTY PEDO PRACTICE FOR SALE. Terrific Pedo opportunity in Cobb County with 6 operatories for sale! The practice is in a medical complex and the 2,200 sq. ft. real estate is also for sale! Please call or email for details using reference # GA1020. For more information call (678) 482-7305 or email amanda@southeasttransitions.com. **NEW** AUGUSTA, GA, growing practice for sale. 4 equipped ops, with 2 additional plumbed. Gross over $500K per year. Please call or email for details using reference # GA1024. For more information call (678) 482-7305 or email amanda@southeasttransitions.com. SOUTH OF ATLANTA: Great 5-operatory opportunity south of Atlanta! This retiring doctor places implants, is all FFS / PPO, and collected $472K in 2011. Please call or email for details using reference # GA1019. For more information call (678) 482-7305 or email amanda@southeasttransitions.com.

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Inside This Issue • GDA Legislative Goals Include Board Autonomy, Tax Credits • Georgia Mission of Mercy Volunteer Registration Opens

DATED MATERIAL PLEASE DELIVER AS SOON AS POSSIBLE

ACTION

Suite 200, Building 17, 7000 Peachtree Dunwoody Road Atlanta, Georgia 30328-1655 www.gadental.org


January 2013