Oral Health Office October 2014

oralhealth

OFFICE w w w. o r a l h e a l t h g r o u p. c o m

OCTOBER 2014

The new

MCGILL FACULTY OF DENTISTRY

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CASE STUDY 6

Changing the value clients place on visits.

is that gienists face y h l ta n e d s e ons. est challeng commendati g re ig b e n e ie th g f y o h l One ly with ora lients lways comp ause many c a c e ’t n b o g d n ts ro n st clie eed to be tation skills n n se re p se ease. a C ey have a dis th r a e h to t n don’t wa

ISSUE

support dardize and n a st s lp e h ® hier em ® + Oral-B syst nts get healt e li C . e st c re ffi C o The em in the g their ntation syst se re p le in managin se a ro c e v ti the c a n a g y begin takin because the oral health.

SOLUTION

nt, over to the patie ts if sh ip h rs owne ence, when interval.

In my experi commended re ir e th n o 80% come

RESULTS

Find out how our programs are paying off for other practices at

www.HealthyPracticeNow.ca OHO_oct_Case6Beth_DPS.indd 1 OHO_Oct14_p02-3 P&G DPS AD.indd 2

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Beth Ryerse RDH, Professional Educator Beth Ryerse has not been compensated to appear in this ad.

We mean business.

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2014-09-23 12:37 PM 14-10-07 2:50 PM

oralhealth

OFFICE w w w. o r a l h e a l t h g r o u p. c o m

Features OWNERSHIP OPTIONS

8 The U.S. Experience: Non-Dental Ownership and Management of Dental Practices

Michael Carabash, BA, LLB, JD, MBA, CDPM

14 The “Investor DentistsTM” Phenomenon Timothy A. Brown

18 The Corporatization of Dentistry:

8

Ownership Options in the Dental Market David Chong Yen, CPA, CA, CFP

22 Alternative Ownership — Consolidation of Dentistry: Is It The Right Time For You? Lisa Philp

OFFICE DESIGNS

20 McGill University 28 DSK Dental PEAK PERFORMERS

32 Fostering Peak Performance Mariana Bracic

28

PRIDE INSTITUTE ‘BEST OF CLASS’ AWARDS 2014

38 2014 Top Technologies Revealed Lou Shuman, DMD, CAGS

BUSINESS MANAGEMENT

39 10 Practice Marketing Questions You Should Avoid Dan Pisek

Departments

32

5

Editorial: O wn It

6

News Briefs: O pencare.com, Image Gently Campaign, Changes4Life™

42

Oral Health Team News

43

Dental Marketplace

OCTOBER 2014 | Oral Health Office | oralhealthgroup.com

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Editorial

C atherine Wilson, E ditor

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on-dental ownership and management of dental practices is a ‘hot topic’, as the ladies of ‘The View’, would say. “In the US, non-dentist involvement in owning and managing dental practices is complex, unclear and perhaps even ineffectual.”

For many years, ‘investor dentists’ have been purchasing and owning dental practices. But what about non-dentists? What can they own or buy? As David Rosenthal wrote in The Professional Advisory just a year ago, from a legal perspective, the starting point is to understand what only a dentist or a dentistry professional corporation (PC) can own; and that is the professional dental goodwill of a dental practice. That goodwill includes custody and control of all patient records and files (including patient billing records and treatment plans), patient charts, x-rays and models, patient lists, and use of any dental practice names.

A dentist or PC are the only ones who can own the goodwill.

In this issue of Oral Health Office, four of the brightest lights in their fields offer their thoughts on this ‘hot topic’.

It has been proven that dental practices are one of the most exceptional investments a dentist can make, according to Timothy Brown.

“My informal study of the purchase price and the resultant excess earnings (Net operating income after debt service and owners compensation) reveals that the ROI of a dental practice has historically exceeded most any other form of traditional investment vehicle — in some instances by a wide margin.”

But as Michael Carabash reports, just over a decade ago, relationships between some dentists and non-dentists soured and all parties found themselves in court.

5

Own It

“For the first time, judges throughout the U.S. had to decide on the legality of non-dentists owning and managing dental practices, employing dentists, being partners with dentists, and fee splitting with dentists.”

Unfortunately, Michael says, the litany of litigation did not lay out a clear, consistent, and common-sense approach to the issue of non-dental ownership and management of dental practices.

Lisa Philp asks if it’s the right time, fit or future for you?

“The challenge for all of us who support, advise, consult, and coach you in dentistry is that there is NOT one right answer for every one. Each dentist, ownership set up, wealth accumulation plan, practice culture, operational output, demographics, and geographical setup is unique to each individual practitioner.

The dental industry has evolved. David Chong Yen says what started with traditional “hands-on” dentists (i.e. individual dentist owning a single practice) eventually grew into investor dentists owning multiple practices. Today, we have corporate owned dental practices with indirect connections to completely non-dental investors.

“The key to maintaining success in the market place is balance,” he writes. “Time will tell if having a “Microsoft” or “Apple” of the dental industry is a good thing or not, but for the time being it does present new options and alternatives for the dental industry.

“Provided this mix of buyers and sellers continues to exist, the dental market can sustain both individual owned and corporate owned practices to the benefit of all parties involved. In the end, the primary goal is and remains the provision of high quality dental care to patients.”

Amen.

oralhealthgroup.com | Oral Health Office | OCTOBER 2014

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6 News A BUSINESS INFORMATION GROUP PUBLICATION Editorial Director: Catherine Wilson 416-510-6785 cwilson@oralhealthgroup.com

Poll: Canadians Open Wide

Opencare.com, Canada’s innovative online matchmaker for patients and healthcare providers is ‘drilling down’ to create a comprehensive province by province check of the dental discipline. For patients, the company is conducting the National Patients’ Choice Awards rankings of the top 30 dentists in each major market. At the same time, Opencare.com created the National Dental Checkup poll, based on the perplexing questions that dentists would like to pose to patients (but are too polite to ask).

Setting a national benchmark with Canada’s largest city, Opencare.com proudly posted their Patients’ Choice Award Rankings of the Top 30 Toronto Dentists. The company asks Canadians from coast to coast to cheer or jeer for their local dentist on Opencare.com’s dentist data page. Nominations opened on September 29, 2014 and will remain open until Halloween, October 31st. All dental data will be used to help rank the top 30 dentists in every major market across the country.

Oral Health is pleased to congratulate one of our board members, Dr. Janice Goodman, of Janice Goodman & Associates, on making the Top 30 Toronto Dentists list. To view the full Top 30 Toronto Dentist Report, please visit www.opencare.com/dentists/toronto-on/

ADHA Partners with Other Dental Leaders in Image Gently Campaign

The American Dental Hygienists’ Association (ADHA) is proud to announce its support and involvement as a member of the Alliance for Radiation Safety in Pediatric Imaging, the Image Gently Alliance. The Alliance is expanding its scope to the oral health care community with its next campaign push, Image Gently in Dentistry. As a member of this Alliance, the ADHA is pleased to promote the importance of proper radiation dosage to children and to the more than 185,000 licensed dental hygienists in the United States for whom the organization serves as a voice.

The Image Gently campaign has developed online educational and scientific materials to help dental professionals optimize radiation dose used in imaging exams performed on children. Image Gently has also produced downloadable materials to help parents ask more informed questions of their dental providers whenever scans are recommended for their children. All of these materials, newsletters and other valuable information can be found at www.imagegently.org.

Green Shield Canada redefines wellness with Changes4Life™

Canada’s only national, not-for-profit health and dental benefits carrier, Green Shield Canada, announced the launch of an initiative aimed at supporting Canadians in better managing their health.

Under the banner of Changes4Life™, Green Shield Canada will redefine the concept of “wellness” by utilizing advanced analytics to target employee populations diagnosed with chronic disease, and even more proactive, reach out to those plan members at the highest risk. Using insights from its data of millions of extended health and drug claims, this will be the first attempt in its industry to strategically engage with the employees most in need of support.

In a further attempt to move wellness from a soft science to a more evidence-based platform, Green Shield Canada will employ the latest research on nudging plan members to adopt better health habits.

To learn more about Changes4Life™, visit www.greenshield.ca.

Editorial Assistant: Jillian Cecchini 416-442-5600, ext. 3207 jcecchini@oralhealthgroup.com Art Direction: Andrea M. Smith Production Manager: Phyllis Wright Circulation: Cindi Holder Advertising Services: Karen Samuels 416-510-5190 karens@bizinfogroup.ca Classified Advertising: Karen Shaw 416-510-6770 kshaw@oralhealthgroup.com Dental Group Assistant: Kahaliah Richards 416-510-6777 krichards@oralhealthgroup.com Account Manager: Tony Burgaretta 416-510-6852 tburgaretta@oralhealthgroup.com Associate Publisher: Hasina Ahmed 416-510-6765 hahmed@oralhealthgroup.com Senior Publisher: Melissa Summerfield 416-510-6781 msummerfield@oralhealthgroup.com Vice President/ Canadian Publishing: Alex Papanou President/ Business Information Group: Bruce Creighton OFFICES Head Office: 80 Valleybrook Drive, Toronto, ON M3B 2S9.

Telephone 416-442-5600, Fax 416-510-5140.

Oral Health Office is printed twice in 2014 and is designed to provide the entire dental team with business management information to make practices more successful. Articles dealing with investment planning, personal finances, scheduling and collection procedures, in addition to lifestyle issues, are geared to all practicing Canadian dentists, hygienists, dental assistants and office managers. Please address all submissions to: The Editor, Oral Health Office, 80 Valleybrook Drive, Toronto, ON M3B 2S9.

Subscription rates: Canada $20.00 for 1 year; $37.00 for 2 years; USA $23.00 for 1 year; Foreign $43.00 for 1 year; Single copy $12.00. Printed in Canada. All rights reserved. The contents of this publication may not be reproduced either in part or in full without the written consent of the copyright owner. From time to time we make our subscription list available to select companies and organizations whose product or service may interest you. If you do not wish your contact information to be made available, please contact us via one of the following methods: Phone: 1-800-668-2374; Fax: 416-4422191; E-mail: privacyofficer@businessinformationgroup. ca; Mail to: Privacy Officer, Business Information Group, 80 Valleybrook Drive, Toronto, ON M3B 2S9.

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Oral Health Office is published twice in 2014 by Glacier BIG Publication Holdings Ltd., a leading Canadian information campany with interests in daily and community newspapers and business-to-business information services.

ISSN 2291-1448 (PRINT) ISSN 2291-1456 (ONLINE)

OCTOBER 2014 | Oral Health Office | oralhealthgroup.com

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8 Ownership Options

the u.s. experience

Non-dental ownership and management of dental practices their decisions, judges reviewed the facts of the case in light of relevant State laws, legal precedents, public policy arguments, and advisory opinions from State Attorneys General. Unfortunately, and as discussed below, the litany of litigation did not lay out a clear, consistent, and common-sense approach to the issue of non-dental ownership and management of dental practices.

UNAUTHORIZED PRACTICE OF DENTISTRY

Many State laws prohibit a non-dentist from owning a dental practice.4 For example, Texas’ Dental Practice Act5

©moodboard/Getty Images/Thinkstock

H

istorically, there was very little U.S. case law surrounding the legality of business services agreements (“BSAs”)1 between dentists and non-dentist management companies. 2,3 Then, just over a decade ago, relationships between some dentists and non-dentists soured and all parties found themselves in court. For the first time, judges throughout the U.S. had to decide on the legality of non-dentists owning and managing dental practices, employing dentists, being partners with dentists, and fee splitting with dentists. In coming to

Michael Carabash, BA, LLB, JD, MBA, CDPM

OCTOBER 2014 | Oral Health Office | oralhealthgroup.com

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Ownership Options

says that a person practices dentistry if they own, maintain, or operate an office at which they employ or engage a dentist. Since only dentists can practice dentistry, non-dentists are therefore prohibited from engaging in these activities.

The Texas District Court used this law to strike down BSAs in a number of cases.

For example, in Robert C. Penny, et al., v.

Orthalliance, Inc.,6 the Texas District Court declared a series of business arrangements (including a BSA) illegal in their entirety and thus unenforceable because they allowed a non-dentist to acquire the assets of an orthodontic office, operate and maintain it for the dentist, and engage or employ the dentist.

The Penny decision was followed by Texas District Courts in David Becka, D.D.S., et al. v. Orthodontic Centers of America, Inc., et al.7 and David S. Turner, D.D.S., M.S. Inc. et al. v. OCA, Inc. et al.8 But the practice of dentistry is not defined consistently through the U.S., which results in BSAs sometimes being upheld.

For example, the Indiana Dental Practice Act 9 says that a person practices dentistry if they exercise direction or control over a dentist through a written contract concerning final decision relating to the employment of dental office personnel. In Orthodontic Affiliates, P.C. v. OrthAlliance, Inc.,10 the Indiana District Court upheld a BSA because it only required the non-dentist to employ business personnel (such as receptionists) and not persons employed to work on patients’ teeth (such as hygienists and assistants).

In Connecticut, the practice of dentistry is defined to include owning or carrying on a dental practice or business.11 In Orthodontic Centers of America, Inc. et. al. v. Thomas E. Christie et al.,12 the Connecticut District Court upheld a BSA because it gave the dentist ownership and control over the professional aspects of the practice and simply allowed the non-dentist to perform the business services of the practice.

Ohio’s Revised Code says that a person practices dentistry if they are a “manager proprietor, operator or conductor” of a dental practice.13 Ohio’s Attorney General issued an opinion, explaining that this provision refers to a person who exercises authority over matters directly related to patient care, not someone who engages in activities more closely related to the proper

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and efficient management of a dental practice. So in Terry Scotese, D.D.S. v. Orthodontic Centers of Ohio Inc., 14 a U.S. Bankruptcy Court upheld a BSA because there was no direct evidence that the nondentist controlled patient care or affected patient care decisions.

Finally, Georgia’s Dental Practice Act 15 takes a very clinical approach (akin to the Province of Ontario) by defining the practice of dentistry as performing operations on the human oral cavity or associated structures, tooth extractions, crown fillings, repairing appliances used on teeth, undertaking a physical examination of a patient, or diagnosing radiographs. So in T. Barry Clower, D.M.D., P.C. and T. Barry Clower v. Orthalliance, Inc.,16 the Georgia District Court upheld a BSA because the non-dentist did not perform any of these dental services; indeed, the dentist’s professional corporation was given exclusive control of all dental care — including selecting equipment, employees and hygienists.

ILLEGAL DENTAL PARTNERSHIPS

Generally, only dentists — either personally, through a partnership or through a professional corporation — can practice dentistry.

Sometimes, a BSA will be challenged because it allegedly creates an illegal partnership between a dentist and a non-dentist (who is unauthorized to practice dentistry).

State laws generally define a partnership as an association of two or more persons carrying on a business for profit. Courts generally examine several factors (e.g. the intention of the parties, whether the parties shared profits and losses, whether the parties participated in control or management of the enterprise, etc.) to determine if a partnership exists. The fact that a BSA specifically says that it does not create a partnership is not enough to preclude a partnership from actually existing.

As discussed below, much will depend on the specific facts of each case.

For example, Louisiana and Pennsylvania District Courts found that BSAs had been used to create illegal dental partnerships in Robert Amason, D.D.S., P.C. et al v. OCA, Inc. et al.,17 OCA, Inc. et al. v. Stanley Starr, D.D.S., et al.,18 Orthodontic Centers of Illinois, Inc. v. Christine Michaels, D.D.S., P.C., et al.,19 and Warren Apollon, D.M.D., P.C. oralhealthgroup.com | Oral Health Office | OCTOBER 2014

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10 Ownership Options

et al. v. OCA, Inc., et al.20 In those cases, the BSAs allowed the non-dentists to share in the profits and losses of, and have considerable control and management over, the practices.

The District Courts disregarded statements in the BSAs that it was not the parties’ intention to create a partnership and that the parties were independent businesses.

In the U.S., non-dentist involvement in owning and managing dental practices is complex, unclear, and perhaps even ineffectual But in Re: OCA Inc. et al., v. Hector M. Bush et al., 21 the Bankruptcy Court for the District of Louisiana came to the opposite conclusion. In that case, the dentist argued that a partnership existed in part because of language contained in old agreements, as well as statements made in the non-dentist’s public filings. But the Bankruptcy Court held that the old agreements were superseded by more recent agreement which clearly stated that the relationship between the parties was not a partnership. And the Court accepted that the public filings were an aberration and erroneously filed. In any event, evidence was adduced to show that the parties did not share the risk. Among other things, the non-dentist bore all of the risk when starting up certain offices, expenses were not shared, there was no joint ownership of capital, and the dentist ran his own show and retained control over final decisions. As such, the parties were not found to be partners and the BSA was upheld.

FEE-SPLITTING

Many States prohibit fee-splitting between a dentist and a non-dentist.

A number of Colorado District Court cases have invalidated BSAs (in whole or in part) because they permitted illegal fee-splitting and because it would be contrary to public policy to enforce them.

This happened, for example, in Mason

v. Orthodontic Centers of Colorado, Inc.22 In that case, the non-dentist argued that the BSA should be upheld because the law only prohibited the sharing of referral fees. But the Court rejected this argument, saying that this interpretation was not grounded in any authority, was at odds with the dictionary definition of “fee splitting”, and was nonsensical because it would allow a dentist to overtly enter into an agreement to share patient fees with their landlord, auto mechanic or barber, so long as it was not based on patient referrals. The non-dentist also argued that the fees payable were for marketing services, which was an exception to the fee-splitting prohibition in Colorado’s Dental Practice Act; 23 the Court rejected this argument too because the bulk of the monthly service fee was for other services unrelated to marketing. Finally, the nondentist argued that any professional discipline imposed on the dentist for improperly sharing fees should not void the BSA. But the Court found that the public interest in prohibiting fee splitting (which included the need for dentists to avoid financial conflicts of interest, the need for informed consent by the patient, and the necessity of avoiding non-professional interference in professional decision making) outweighed any private interests the non-dentist had in enforcing the BSA. As such, the fee-splitting portions of the BSAs were declared void as against public policy.

The Colorado District Court made similar rulings in Jonathan R. Weinbach, D.D.S., M.S. et al. v. Orthodontic Centers of Colorado, Inc., et al., 24 Mason v. Orthodontic Centers of Colorado Inc.,25 Theresa L. Shaver, D.D.S., et al. v. Orthodontic Centers of Colorado, Inc., et al., 26 and John Gentile, D.D.S., et al v. Orthodontic Centers of North Dakota, Inc. et al.27 While I have yet to come across a U.S. case where the BSA trumped public policy in these circumstances, interestingly enough, our own Ontario Courts upheld a management agreement despite allegations of improper fee-splitting. In Smilecorp Inc. v.

Pesin, 28 a dentist sought to void a management agreement on the basis that he had illegally fee-split with a non-dentist. But both the Ontario Superior Court of Justice and the Ontario Court of Appeal rejected this claim on the grounds that any alleged violation was

OCTOBER 2014 | Oral Health Office | oralhealthgroup.com

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Ownership Options

a professional responsibility matter between the dentist and the Royal College of Dental Surgeons of Ontario and did not involve the non-dentist or the Court’s determination of whether the management agreement (or parts thereof) was enforceable.

CONCLUSION

The cases above illustrate how Courts have come to opposite conclusions concerning the legality of BSAs. Undoubtedly the result of allowing individual States to define the practice of dentistry, coupled with different fact patterns and the occasional opinion from State Attorneys General.

But it is important not to miss the forest for the trees. The laws discussed throughout this article are meant to protect the public by preventing those lacking certain competencies from practicing dentistry and also preventing business arrangements from interfering with a dentist’s professional judgment.

To these noble ends, States have taken different approaches. Some States — like Texas and Colorado — seem to have adopted a more rigid approach. By shutting out nondentists, however, this approach may hinder improving access to high quality oral health care for the general public. 29 Other States — like Ohio, Indiana, Connecticut, and Georgia — seem to have taken a more flexible approach by preserving dentists’ authority over the clinical aspects of operating a dental practice while allowing non-dentists to deal with the business aspects. But this approach could lead to the further commercialization of the dental profession and endanger patients by putting profits first.

So where does that leave us? Acknowledg ing that , in the U. S ., non- dentist involvement in owning and managing dental practices is complex, unclear, and perhaps even ineffectual. 30 So where should we go from here? That’s a discussion for another article…

References

1. “Business S er vice Ag reements” and si m ila rly named agreements typically involve a non-dentist management company providing various dental office business and administrative support services (e.g. hiring and managing staff, leasing office space and equipment, providing bookkeeping, collections and other administrative services) to a dentist in exchange for a fee.

2. Throughout this article, I will use the terms “nondentist” to refer to these dental practice management companies.

3. See Peter M. Sfikas, J.D., “Court rulings differ on legality of dental MSO agreements”, Journal of the American Dental Association, Volume 136 (May 2005), p. 678.

4. See “Ownership of Dental Practices, Employment of Dentists, Interference with the Professional Judgment of a Dentist”, American Dental Association, Department of State Government Affairs, #22 (11 August 2011).

5. Texas Occupations Code, Dental Practice Act, Section 251.003(a)(4).

6. 255 F. Supp. 2d 579; 2003 U.S. Dist. Lexis 4719 (decided March 26, 2003).

7. 2005 U.S. Dist. LEXIS 46904 (March 31, 2005).

8. 2006 U.S. Dist. LEXIS 98129 (December 5, 2006).

9.

Indiana Code, Section 23.(a), (13), (F).

10. 210 F. Supp. 2d 1054; 2002 U.S. Dist. LEXIS 13627 (decided April 22, 2002).

11. Connecticut General Statutes, Chapter 379, Dentistry, Section 20-123(2).

12. 415 F. Supp. 2d 115; 2006 U.S. Dist. LEXIS 6397 (February 16, 2006).

13. Ohio, Revised Code, Chapter 4715: Dentists; Dental Hygienists, section 4715.01.

14. 2007 Bankr. LEXIS 2899.

15. Georgia, Dental Practice Act, Occupational Code, Title 43, Chapter 11, Section 43-11-17.

16. 337 F. Supp. 2d 1322; 2004 U.S. Dist. LEXIS 20038 (decided September 24, 2004).

17. 2008 U.S. Dist. LEXIS 86234 (October 24, 2008).

Prior history: In re OCA, Inc., 410 B.R. 443, 2007 U.S. Dist. LEXIS 83985 (E.D. La., 2007). Subsequent history: Motion denied by Amason v. OCA, Inc., 2009 U.S. Dist. LEXIS 10343 (E.D. La., Feb. 11, 2009).

18. 2009 U.S. Dist. LEXIS 8862.

19. 403 F. Supp. 2d 690; 2005 U.S. Dist. LEXIS 33078 (December 13, 2005).

20. 592 F. Supp. 2d 906; 2008 U.S. Dist. LEXIS 106054.

21. 78 B.R. 493; 2007 Bankr. LEXIS 3496 (October 9, 2007).

22. 516 F. Supp. 2d 1205, 2007 U.S. Dist. LEXIS 68121 (decided September 14, 2007).

23. Colorado Revised States, Title 12, Article 35, Section 12-35-129(1)(v).

24. 2007 U.S. Dist. LEXIS 70614 (September 24, 2007).

25. 516 F. Supp. 2d 1205, 2007 U.S. Dist. LEXIS 68121.

26. 2007 U.S. Dist. Lexis 71615 (September 26, 2007).

27. 2007 U.S. Dist. LEXIS 72322 (September 27, 2007).

28. 2012 ONSC 1966 (March 27, 2012), upheld by 2012 ONCA 853 (December 5, 2012).

29. See for example Cassandra Burke Robertson, “Private Ordering the Market for Professional Services”, Boston University Law Review, 94 B.U.L. Rev. 179 (January 2014).

30. Rigid laws have been easily circumvented by clever lawyers: BSAs have replaced direct employment agreements with dentists (which are generally prohibited) and have allowed non-dentists to effectively acquire the equivalent of an equity interest in the dental practice through a fee structure. See for example Andrew Fichter, “Owning a Piece of the Doc: State Law Restraints on Lay Ownership of Healthcare Enterprises”, Journal of Health Law, Vol. 39, No. 1, HOSPLW, Pg. 1 (Winter, 2006).

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Michael Carabash is a dental lawyer and holds a Certificate in Dental Practice Management. He has his own dental law firm, DMC Law (www.dentistlawyers.ca), and can be reached at 647-680-9530 or michael @dentistlawyers. ca.

Disclaimer: This article does not offer legal advice.

If you need legal advice, you should consult a lawyer.

oralhealthgroup.com | Oral Health Office | OCTOBER 2014

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ADVERTORIAL

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Dentistry is one of the only professions that accepts pain as part of the daily routine Dental professionals are confronted daily with a wide variety of patients, problems and tools that require modified, if not extraordinarily awkward postures in order to deliver effective treatments. What is the price of these physical acrobatics in the operatory? The awkward postures, repetitive motion and forceful exertions necessary to do your job can strain your musculoskeletal system, which inhibits the body’s natural repair processes. This often results in pain, limited mobility, headaches, fatigue, numbness, tingling and potential injury. Many of you reading this probably may experience one or more of these problems. Let’s consider one of the main hurdles to comfortable, efficient delivery of dental care.

Let’s start with the patient chair; what is its purpose?

Patient comfort, support, positioning, esthetics? The main function of the patient chair should be facilitating access to the oral cavity for the practitioner. The characteristics of the patient chair which allow for this are a thin, narrow back at the patient’s torso and head.

While patient comfort is important, it should not be at the cost of limiting your access to the oral cavity. A wide, thick padded patient chair will often require the operator to place their legs under the back of the chair. While this allows the practitioner to get closer to the oral cavity, it also requires them to raise the patient up in order to gain access and in doing so elevating their shoulders into an unnatural position of abduction (see photo). A wide back rest also causes dental professionals to bend forward and twist their spine in order to access the oral cavity (see photo). Neither of these positions allows one to maintain a properly balanced working posture. Another important chair feature to look for is an adjustable headrest that will support the patient’s head and neck and allow the dental professional to correctly position them for efficient treatment. Lastly, can the chair be easily adjusted for the left to right handed operator or to allow for improved access when working with a needy patient?

Next to the patient chair the most important chair to consider is the operator stool. The operator stool should be given as much consideration as the patient chair and not be an afterthought. The characteristics of the operator stool should provide the operator with support and comfort while in their numerous working postures.

The seat pain should be large enough to support the buttocks and upper thighs. The seat should adjust up and down as well as tilt slightly forward to allow the operator to have their hips slightly higher than their hips.

This position places the pelvis into a slight anterior tilt better balancing the natural curves of the spine (see photo). The height of the hydraulic cylinder should meet

the need of the operator to assume the previously described position. Taller individuals should consider a taller cylinder. When in doubt, ask your vendor for a trial period with the taller cylinder.

The back of the operator chair should adjust up and down as well as anteriorly and posteriorly. The reason is to provide support and cueing for the operator throughout the working day to help maintain their balanced sitting position.

Armrests are another option for the operator stool that are often overlooked or not considered. Many practitioners have spent their entire careers working without their arms supported. Research has demonstrated that dental practitioners spend nearly half of their working day in poor seated postures (Marklin).

Specifically, forward head with rounded shoulders, elevated arms, kyphotic upper backs and flexed lumbar spines. (See photo) The infamous “chicken wing” position. Poor working postures add additional stress to an already busy day. Arm support can be an invaluable stress reducer for the dental practitioner during the working day. It may add minutes, hours or even days of comfort for the usually uncomfortable practitioner.

Evidence has shown that arm support can facilitate a more appropriate, balanced work position while alleviating stress on the upper quarter of the practitioner.

There are many options for armrests so when considering armrests, one must determine the ability of the armrest to unload and support the weight of the arm.

The armrest must comfortably support the upper extremity and should have enough degrees of freedom of movement to not constrain the required movements of the practitioner. In other word, the armrest should not obligate the practitioner to move in a particular plane of movement. They comfortably support the arm and not place undue stress on the neuromuscular structures of the forearm. Additionally, the armrests should be able to be easily moved out of the way if they are not needed.

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So when considering outfitting the operatory, the question main question to be answered is not necessarily how comfortable is the patient but rather how comfortable is the dental practitioner and can they get close?

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064 OCTOBER 2014 | Oral Health Office | oralhealthgroup.com

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14 Ownership Options

The “Investor Dentists™”

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ur firm has been fortunate to work with most of the large players in Canada and many small-to-medium sized players who are trying to acquire dental practices across the nation to grow their enterprise.

One of the primary reasons that a dentist acquires multiple dental practices is that it has been proven that dental practices are truly one of the most exceptional investments that a dentist can make. My informal study of the purchase price and the resultant excess earnings (net operating income after debt service and owners compensation) reveals that the ROI of a dental practice has historically exceeded almost any other form of traditional investment vehicle — in some instances by a wide margin.

Investor Dentists™ have been active in Canada since the 1980s when Dr. Howard Rocket began opening dental offices in retail malls. Dr. Rocket and his partner, Dr. Brian Price, founded the Tridont Dental Centers Empire, which peaked at 107 retail dental practices with the help of over 500 dentists and over 2500 staff members. This company was first funded with private funds, then bank and leasing companies, then it went to the Toronto Stock Exchange to raise additional funds. I worked closely with Dr. Rocket for about a year and learned much from his wisdom and success. Tridont made a critical error when they expanded into numerous non-dental health care sectors, but every single one of those former dental offices continues to prosper in most of the former locations and they all continue to thrive as of today, the fall of 2014. The concept of investing in multiple dental offices did not fail, the investments in non-dental offices brought them down.

As to today’s Investor Dentists™, Dr. Rocket says; “no one has managed to go public since we did over 25 years ago but it’s just a matter of time before one of the highgrowth companies goes back to the markets to raise capital. One or two dentists can only borrow so much before the traditional lenders will reach their comfort level which prevents the Investor Dentist™ from making further acquisitions.”

Some of the readers may know that one Investor Dentist™ sent a press release this summer announcing a $121 million capital injection in their Canadian firm. Others will recall that the Ontario Teachers’ Pension Plan purchased Heartland Dental for $1.3 billion in 2012. While the OTPP is not an Investor Dentist™ the investment itself is identical to any other dentist buying one or more offices seeking a ROI. Today’s Investor Dentists™ are looking to acquire dental practices for wealth accumulation, cash flow, patient accumulation and all the accompanying buying power that comes with owning more than one dental practice. Examples of this are dental supplies, laboratory services and all the economies of scale that can be achieved when dozens of dentists are working within the empire, such that continuing education can be delivered internally as opposed to the traditional external methods, and the many other benefits of having a large enterprise as opposed to the traditional, independent or solo-operated dental practice. Many of those who have sold their practices to Investor Dentists™ report more freedom to focus upon the clinical aspect of dentistry while relieving themselves of the daily management burden. One of my clients calls it “Adminstrivia” and there is no doubt that owning a practice is a daily grind, particularly when it

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ists™” Phenomenon comes to human resource management.

Dr. Andrew Meikle, co-founder and coCEO of Dental Corporation says, “Our exclusive research indicates that Canadians want their dentists focused on patient-centric care. The DCC model alleviates the burden of administration, allowing our Dental Partners to have more time to practice and interact with patients and spend less time on the back-office element of their practice.”

Some of our clients who have sold to Investor Dentists™ report higher work satisfaction and many have remained as full or part-time Associates for years after a sale.

Working in a large organization is not for everyone and some professionals prefer the challenges of continuing as their own boss independent of outside influences. About 75 percent of Canadian dentists remain as sole practitioners and this is likely to remain the instance for many years to come.

I have discovered that Investor Dentists™ are legitimate business owners who allow the dentists in the organization to practice independently and according to provincial regulations and the codes of ethics prescribed by the national and provincial dental bodies.

Investor Dentists™ are genuine in their intentions and they do not encourage dentists to over-treat patients or encourage staff members to perform duties outside of the usual and customary dental office norms. I do not believe that a dentist working within one of these enterprises is suffering from any undue pressures such as production targets.

Graham Rosenberg, Dental Corporation co-founder, co-CEO & President, adds: “Our innovative business model eliminates earlier concerns of corporate dentistry by mandating complete professional, clinical and operating autonomy for all of our dentist partners. After all, it is dentists, not cor-

porations, that practice dentistry.”

Dr. George Christodoulou of Altima Dental had this to say; “patient satisfaction can be improved in a group practice environment as opposed to the limitations of a solo dentist who can’t offer all forms of treatment.

Convenience is important to today’s busy Canadian families and we at Altima are trying to serve patient needs. Practitioners also benefit as they have the ability to work varied hours and enjoy greater lifestyle options.

Our company offers full service human resource support and training that a solo dentist simply can’t access. With that said I remain amazed how well the typical dentist runs their office with the plethora of duties they manage.”

The Investor Dentist™ phenomenon is long overdue in Canada and in my opinion, is one which will continue to grow because of the investment potential of dental practice ownership which is proven to be one of the best investments a dentist can make. I predict that while less than 10% of Canadian dental practices are presently owned by these entities we will continue to see an ever-growing interest in the accumulation of privately owned practices by one or more dentists because of the incredible cash flow and investment potential.

In summary, the dentists of Canada should not fear the Investor Dentist™ business model and while at first it may appear intimidating, I believe that the various buying groups in Canada are a reputable force to be reckoned with. I have discovered while meeting and speaking with many of the principals who now own multiple practices, they are legitimate and ethical persons who purely wish to help Canadian patients benefit from access to dental care, much like the solo dentist of Canada has always focused upon.

Timothy A. Brown is the CEO of ROI Corporation and the owner of Profitable Practice book, magazine and CE programs. He can be reached at www. timothybrown.ca Investor Dentist is a Trademark of ROI Corporation

oralhealthgroup.com | Oral Health Office | OCTOBER 2014

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ADVERTORIAL

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18 Ownership Options

The Corporatization of Dentistry:

Ownership options in the dental market

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he market for dental practices has reached unprecedented heights in recent years. Fueled by demand from foreign trained dentists with a desire to become practice owners and a shortage of listings, high premiums and bidding wars are now common occurrences depending on the location. The market for dental practices and the industry’s strong financial performance has not gone unnoticed. The type of buyers has evolved from traditional “hands-on” single dentist practices to multi-practice investor dentists and now group/corporate owned dental practices with connections to non-dental/financial investors.

HOW DOES THIS AFFECT YOU?

Buyers The already short list of practices for sale gets even smaller as new options open up for existing practice owners looking at retirement and transitioning out of practice. Here is a list of dental buyers: Locally trained experienced associates: This group consists of graduates from Canadian/U.S. dental schools who have gained several years of experience working as associates for various practices. These dentists have used the work experience after graduation to hone their clinical skills as well as to gain an understanding of the ins and outs of running a dental practice. Some look to purchase a practice to which they associate due to their familiarity with the clinics.

Foreign-trained associates: This group has several years of clinical experience prior to obtaining their Canadian certification.

They are eager to purchase a practice once they become licensed to practice in Canada

and have the clinical and operational experience to run a practice. They represent a large group of buyers currently and maintain a desire to own their practice.

Investor dentists: This group consists of more experienced dentists from the above two sub-categories. The success and experience gained at one of their practices allows these individuals to own two or more dental practices within a relatively short amount of time.

They will either split their time overseeing multiple practices or be the primary provider at one practice while utilizing associates and other staff to operate the others. Their investment philosophy is to invest where they work and in what they know.

Group/corporate dentists: This group is the newest category of buyers in the dental industry. These group/corporate entities acquire dental practices to be part of their network. Collectively, group/corporate owned dental practices represent a very small percentage of the total practices throughout Canada; however we do see this as an emerging trend.

Some of these corporate entities are well financed, having obtained capital from various sources including outside private equity firms. This is a sign that non-dental/financial investors are looking at the dental industry with intrigue and opportunity. Group/corporate dental buyers may target practice owners contemplating selling but not fully looking to retirement by offering options to ease their transition.

For buyers looking to purchase, there have never been more bidders in the market place.

While this may be alarming to some, we

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Ownership Options

believe the dental market is large and diverse enough for private individually owned practices and group/corporate owned practices to co-exist. The majority of buyers are still individuals and provided they maintain a desire to own their practice, we believe the market will continue to be filled with buyers from all walks of life for the foreseeable future.

Sellers Practice owners who have built up their practices and patient base have never been in a better position. The introduction of corporate owned dental practices only adds more options. Current practice owners looking to sell can solidify their retirement nest egg and choose how the practice’s legacy will continue on in their absence by choosing the appropriate successor.

Selling to an individual: Many sellers prefer to continue the traditional ownership path of having a hands on individual dentist continue their legacy in their absence. They value knowing that the patients they cared for directly throughout their career are receiving similar personalized treatment that they are accustomed to. Sellers looking for individual buyers are highly selective and price may not trump everything; personality, clinical philosophy and fit are equally important.

Selling to an investor dentist: Investor dentists may submit the highest bid price.

They’ve accumulated capital from the success of running their existing practices. The buffer room from their successful practices affords them the opportunity to take more risks.

Their bid prices usually take into account synergies that are not available to other buyers.

For example, an investor dentist with a nearby practice may pay a higher premium because they can reduce overhead by sharing advertising costs, or they have the option to move the patients to their existing practice. In other words, they take all the patient fees but none or less of the fixed expenses such as rent. From a seller’s perspective, provided that the patients are still receiving high quality care, the individual providing the care may be just one of several factors to consider.

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Selling to a group/corporate buyer: Selling your practice to a group/corporate buyer is a new option that has become available. Typically, sellers get to cash in a portion of their investment/practice and receive the remaining equity in the form of shares/ ownership interest of the acquiring group/corporation. In addition, they retain a steady source of cash flow from the clinic by continuing to practice through compensation agreements with the purchasing group/corporation. The vendor/ dentist may be provided with certain performance targets that have to be fulfilled as part of the agreement. As the group/corporation owns the practice, many of the back room operations and administrative functions are taken care of by the group/corporation, allowing dentists to focus on patient care.

Some will argue that the growth of investor dentists and corporate owned dental clinics is taking away from the tradition of hands on owners who know their patients intimately. However, choice may not be a bad thing; many of the dentists who join corporate owned dental practices are seasoned practice owners just past their prime earning years looking for a change in lifestyle. They may be several years away from retirement but want a way to access the equity in their practice while still practicing the profession they love.

CONCLUSION

The dental industry has evolved. What started with the traditional “hands-on” dentists (i.e. individual dentist owning a single practice) eventually grew into investor dentists owning multiple practices. Today, we have corporate owned dental practices with indirect connections to completely non-dental investors. The key to maintaining success in the market place is balance. Time will tell if having a “Microsoft” or “Apple” of the dental industry is a good thing or not, but for the time being it does present new options and alternatives for the dental profession. Provided this mix of buyers and sellers continues to exist, the dental market can sustain both individual owned and corporate owned practices to the benefit of all parties involved.

In the end, the primary goal is and remains the provision of high quality dental care to patients.

This article was prepared by David Chong Yen, CPA, CA, CFP and Louise Wong, CPA, CA, TEP of DCY Professional Corporation Chartered Accountants who are tax specialists and have been advising dentists for decades.

Additional information can be obtained by phone (416) 510-8888, fax (416) 510-2699, or e-mail david@dcy.ca / louise@dcy.ca.

Visit our website at www.dcy.ca.

oralhealthgroup.com | Oral Health Office | OCTOBER 2014

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20 Office Design

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he new McGill University Faculty of Dentistry, located in a high-end office tower adjacent to the main entrance of its downtown campus in Montreal, Quebec, was designed in joint effort by the architectural firms of DFS Inc., and NFOE, with valuable input given by Dr. Jeffrey Myers, Associate Dean of Clinical Affairs.

Over ten years in the making and planning, the new clinic represents a monumental move in bringing together the different departments of dentistry to one central location.

The clinic is easily accessible via public transportation to its students and to the community requiring affordable quality care. Patients arrive and are warmly greeted by a 12’ high wood wall proudly displaying the major donors who helped the Faculty reach this historic milestone. The first floor of this multi-level facility boasts thirteen enclosed operatories shared by Oral Surgery, Oral Diagnosis and an Oral Facial Pain Clinic; surgical suites, a radiology suite with a Sirona Orthophos XG 5 Panography and a 3D Accuitomo CbCT, and an active learning classroom. This classroom is designed to encourage collaborative learning for both students and professionals, and is equipped to stream live footage from both the Simulation Laboratory and a completely outfitted surgical operatory. This incorporation of audio-visual equipment into the operatory allows students to have an upclose experience of the practice in real time.

Perhaps the most impressive space is the second level, which is host to 8,200 square feet of ergonomically-designed open operatories. Glass partitions allow natural light to flood into the deepest parts of the clinic.

With crisp white walls and floors broken only by the colours of the chairs, this large space more than adequately accommodates 39 dental chairs, with each operatory still maintaining a sense of privacy and intimacy. Also on the second level is the 3,300 square foot high-end Simulation Laboratory, designed to seat 40 students comfortably, and equipped with the latest high-tech simulation and teaching equipment.

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22 Ownership Options

ALTERNATIVE OWNERSHIP CONSOLIDATION OF DENTISTRY

A

Lisa Philp

multitude of Canadian dentists are reaching out to us at Transitions Group, with questions, inquiries and seeking confirmation regarding the myths and rumors about the term “Corporate Dentistry.” My goal is to clear up the confusion by outlining the options of a seller to transfer ownership, categorizing the choices of Corporate or “Alternative Ownership Transfer” models available with the questions to ask to choose the right fit and key considerations of self analysis to decide if it is the right time.

The most common theme of questions and comments about this topic have come in from a range of dentists who have taken the plunge to sell and are looking to share their experience, wondering what options are available in the current seller’s market, boomer dentists who want or need to work forever but don’t necessarily want to deal with the headaches of business of dentistry, and current practice owners who have chosen to not progress with the creative ownership transfer choices available in Canada today.

©Michael Blann/Getty Images/Thinkstock

Is it the right time, fit or future for you?

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These questions include: — W hat does “Corporate” mean?

— Is this the best time for me?

— W hat changes if I sell and stay on?

— W hat is the right buyer model?

— How is “alternative ownership model” a win-win?

— W hy would I sell my equity now and loose profits of my future?

Some comments from those who have sold to alternative ownership models are: • “ Selling the practice for someone else to manage was the best thing I ever did.”

• “I am rejuvenated to come and go to do dentistry and not have to worry.”

• “I sold too soon, wish I waited few more years” • “I was a rural practice and would not have found another buyer.”

• “I needed the lump sum NOW for personal issues and debt pay off.”

• “I didn’t plan for my retirement, so, having money now to invest elsewhere and staying on works for me.”

A successful solo practitioner who is 48-years-old, didn’t feel like it was the fit for him and sent me this response: “The corporate model is not right for me, it is essentially an advance of four to five years of hygiene revenue (profit), all while keeping the risk, guaranteeing the revenue and loss of ownership authority and autonomy.”

©Michael Blann/Getty Images/Thinkstock

The challenge for all of us who support, advise, consult, and coach you in dentistry is that there is NOT one right answer for everyone. Each dentist, ownership set up, wealth accumulation plan, practice culture, operational output, demographics, and geographical setup is unique to each individual practitioner.

It is important to take the time for you to assess: (1) P resent — where you are today (2) Future — choose what your want for a new, different and better future?

(3) Past — Decide what part of the past needs to be let go and what you want to bring with you.

Once you are clear, your team of experts (accountants, lawyers, wealth managers, insurance, consultants and coaches) can sup-

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port you with a customized solution that is the right fit at the right time for you.

Meanwhile keeping in mind a key “dental practice owner fundamental fact” as stated by David Lind, President of Professional Practice Sales, one of Canada’s leading dental brokerages: “Frankly, from a purely financial point of view, the best strategy for all dentists is to work in and own their practice as long as they can until illness, disability or death.”

Although this is ideal financially, we all know that dentistry has many other facets to consider of when to transition ownership. Things to consider are: stage of career, level of the provider’s physical health and fatigue, the need for work/life balance, mental exhaustion of management, and loss of desire to lead the people or the business.

I f keepi ng you r prac t ice ow nersh ip and continuing to work as a dentist until the end is not a plausible option for you, there will always be the traditional model available of “sell and go” or “sell and stay with reduced hours”.This process involves valuation, listing and sold via a broker or

The challenge for all of us who support, advise, consult, and coach you in dentistry is that there is NOT one right answer for everyone expert. Once the sale happens, the previous owner leaves, retires or stays on with reduced part-time hours to support the new owner.

The other options available for the dentists who still want to practice dentistry is the “Alternative Ownership Transfer” or what most call “Corporate Dentistry.” These models and companies are distinctively different and geared for the dentist who wants to stay to deliver dentistry, give up ownership now and have an offsite company take over the non-clinical responsibilities. This option may be enticing to many due to the regular comments we hear from dentists at all stages of career.

• “If I could just be the dentist, I would be much more patient centered and productive.” oralhealthgroup.com | Oral Health Office | OCTOBER 2014

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ADVERTORIAL

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26 Ownership Options

• “It’s not the dentistry and patients that are the issues… It’s all the other stuff!”

• “I just want to do the dentistry with no headaches.”

For simplicity purposes, I have categorized the hundreds of different buyers for alternative ownership in Canada into three key categories.

Why not take advantage of high market rates and premium working conditions without worrying about the day to day issues that are part of running a practice 1. INVESTOR The buyer is an individual investor who wants to own more than one location with the seller staying on so they can have multiple locations to operate. They are usually lone rangers who are purchasing based on solo funding from lending institutions, up to a maximum amount of $5-6 million.

2. CONSOLIDATED GROUP This type of buyer is two to ten dentists who have joined together, leveraging their combined funding power to purchase practices. This group generally has less than 25 locations nationally, and has sometimes risen outside capital. They are not quite big enough to carry the overhead of a full functioning centralized head office. Their management infrastructure is often one of owners or office managers who travel to various locations for management support.

Their expectation is for the seller to stay on as an associate dentist, and to maintain their production with a hope of growth, mainly due to changes in focus (just doing the dentistry) while being released of the other non-clinical facets of managing their practice. An example of one of the dozen choices of a consolidated group is Fine Touch Dental.

Andy Valliant, principal of Fine Touch states:

“Groups like Fine Touch Dental allow dentists to work the same way they always have for as long as they want. Why not take advantage of high market rates and premium working conditions without worrying about the day to day issues that are part of running a practice.”

3. CORPORATE MANAGEMENT COMPANY This type of buyer is a combination of dentists and business professionals who have set up a large corporate infrastructure with deep pockets of outside funding dollars. They have more then 40-50 locations nationally, and are currently privately owned. Their business model is large enough to support a centralized head office with an executive team. This team handles: human resources, bookkeeping, financial reporting, industry relations, branding, and operational ideas, with some form of business intelligence solutions. Examples of companies like this in Canada are: Altima Dental, and the newly formed Dental Corporation.

The alternative ownership transfer/corporate models are seeking dentists who just want to practice dentistry and are okay letting go of ownership perks, leadership, authority, drained by the human resources team, daily management, payroll, lack of growth with new patients, or have challenges making tough decisions about business.

All models require two key realities: 1. T he seller must be at their prime of their career and continue to produce chair-side dentistry while maintaining the historical production purchased in the value and intention that growth will occur due to a refreshed narrowed focus on restorative procedures and hygiene exams.

2. The seller is ready to let go of their ownership, responsibility as a boss, human resources, expense management, marketing, technology, compliance, business intelligence and operational management.

Regardless of your situation, some key questions need to be asked about which buyer’s model is the “right fit” for you.

Consider the following:

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Ownership Options

— W hich model of the three matches you the most?

— W ho are the principals involved in the new company?

— W hat’s their understanding of dentistry as a health care niche?

— W ho is/are the owner Dentist?

—W hat is the company’s purpose and vision?

— W hat is the amount they will pay you today for value?

— W hat are the expectations of you in the future?

— A re you accountable if revenue declines and how?

— W hat HR and management structure do they have in place?

— H ow will they help you manage the “change” process?

— W hat happens to the team members?

— W ho will the team report to for answers?

— W hat will change for the practice brand — W hat will change for patients? (Facility hours, financial policies etc.)

— W hat does 5-8 years from now look like?

Once you learn about the options available,it is then time to see if it is the “right time” by analyzing key considerations that involve: knowing the Canadian dental market with a current oversupply of dentists, saturation of urban centers and reduction of patient to dentist ratio.

Analyze your current financial situation of

personal cash flow needs, practice value amount and your current net worth.

Consider your plan in place for retirement as the national statistics show that 60 percent of business owners aged 55 to 64 have yet to start discussing their exit plans with their family, business partners and professional trusted advisors. (2012 CIBC report authored by CIBC deputy chief economist Benjamin Tal.) Trust and estate practitioner and expert, Peter J. Merrick, BA, FMA, CFP,TEP, FCSI, president of Merrick-Wealth.com, an exit planning firm in Toronto, states: “The stakes are too high from these findings for us to bury our heads in the sand. If these businesses don’t receive the proper leadership and stewardship in their succession planning, we could witness as much as a 25 per cent contraction in our economy.”

Other considerations involve asking, “Are you ready to let go of the helm of what you’ve built? Are you open to changes that are inevitable? How will ownership transfer impact the team, patients and facility?”

This is and will be the biggest decision a dentist makes in their career and deserves much thought, analysis and planning to make sure you make a choice that is the “right fit “and “right time” in alignment to your customized situation.

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If you would like our “Alternative Ownership transfer” worksheet covering all questions and critical considerations before making the decision, email us at info@transitionsonline. com or call our office at 1-800-345-5157. We look forward to supporting you with finding your “right fit.”

Lisa Philp is President of Transitions Consulting Group, a full service coaching company for dentistry. She can be reached at transitionsonline.com.

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28 Office Design

DSK

DENTAL

For anyone under the impression that only larger practices can make a beautiful statement, we offer a look at DSK Dental, located in Bayview Village Mall, in North York, Ontario. At less than 900 square feet of usable space, this dental office is an example of what can be done with creative planning and design.

The mall itself is an upscale collection of stylish shops and chic (some might even say “bling-y”) common areas. Celebrating the savvy woman shopper and luxe fashion, mall entrances light-heartedly sport the greeting “Hello, Gorgeous!” In keeping with this concept, Drs. Angela Kapoor and Anita Sharma (sisters and partners), envisioned their new boutique dental practice to be elegant and comfortable, with a touch of glam.

Interior designer Jean Akerman and her team oriented three state-ofthe-art “studio” operatories along one side of the hallway, which runs on a gently curved axis from the front reception area to the back. Compact but functional, the consultation room, stericentre, accessible washroom, private office and staff room are incorporated on the opposite side. To visually expand the space, several techniques were used: glass wall panels between each operatory make boundaries seemingly disappear; a curvilinear “river” of mosaic floor tile winds through the operatories at the foot of the rooms; white wall panelling imparts sophisticated detailing; high ceilings add spatial volume.

Sparkling elements like crystal chandeliers, custom glass waterwall, and cabinet pulls inset with Swarovski crystals, transform this practice into a little “jewel box” that embraces the fundamental concepts of oral health and wellness within stunning surroundings.

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Design and Planning: Jean Akerman Design Inc.

Equipment: Dan Burns Dental

Dental Planning: Sinclair Dental General Contracting: Tripar Improvements

Photography: Sergio Sabag

oralhealthgroup.com | Oral Health Office | OCTOBER 2014

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ADVERTORIAL

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There’s a Goldmine Hidden in Your Paper Charts!

Mine Your Gold with State-of-the-art Maxident™ Software

Do you remember the day you bought your first practice? There were emotions of elation, achievement, feeling proud and yet ‘fearful of the unknown’ all at the same time!

Dentists that are starting their careers today have the same emotions, ambitions and dreams. They love and want technology. They also want an attractive, ready-to-go practice where they can immediately treat patients and start generating income. “Fixer-uppers” are not appealing to today’s buyers.

If you are a mid-career dentist thinking about selling your practice in the next 10 years, you cannot leave practice improvements to the buyer. You need to make improvements today like adding software-based income systems into the practice, updating equipment in the office, and possibly renovating. These improvements will bring higher income today, improve your practice curb-appeal, and boost resale value. Maxident has experience in upgrading technology and can teach you and your staff the income-systems to help mine your gold.

Maxident’s Goldmine™ Dental Software Package transforms your practice into a high-income practice. Mine your gold with Maxident’s 3 exclusive income-systems to boost your income today, and make your office more attractive and valuable to a future buyer. Imagine your filing cabinet. At this very moment, there is hidden income languishing in your practice and your current software system does not make it easy to find!

Maxident’s Goldmine System organizes your 3 main income streams and turns them into production: 1. Never-Lose-a-Patient™ Recall and Appointment System, which will boost hygiene production; 2. Never-Lose-a-Treatment-Plan™ System, which will boost doctor’s production; 3. Never-Lose-an-Insurance Approval™ Management System, which will make sure you get paid for it all!

Maxident’s Goldmine Package uses state-of-the-art software technology which includes electronic data conversion, Goldmine Training for your staff which will transform your practice into a high-income practice.

Call 1.800.663.7199 ext 220 or visit www.maxidentsoftware.com Be sure to mention this ad and we’ll send you an invitation for an upcoming private webinar with Dr. Lorne Lavine, The Digital Dentist | www.dentaltechnologyconsultants.com

OCTOBER 2014 | Oral Health Office | oralhealthgroup.com

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32 Ownership Options

Fostering

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s an employment lawyer specializing in the health-care sector, I, along with my team at MBC Legal, have had the opportunity to work with hundreds of dental offices across the country. In doing so, we’ve helped practice-owners attract and retain top-performing staff through the implementation of employment policies and proper, written employment contracts.

In light of the theme of this issue of Oral Health Office, we wanted to share what we have found to be common characteristics of “high performing” offices. Whether you are the owner or an employee striving to take your career to the next level, we hope this article provides some useful tips on how to become (and stay!) a peak performer.

WORKPLACE POLICIES

Well-drafted workplace policies do several things to create an environment that motivates high performance. Perhaps most importantly, policies set out an employer’s

Mariana Bracic

expectations. We agree with many performance management experts who say that a satisfied employee is one who knows what is expected of them every day at work. Conversely, a lack of direction and guidance leads to inefficiency, frustration, and conflict as staff are left to determine for themselves what is expected.

While setting out expectations via policies enhances performance, it is important that workplace policies should not become a rigid set of detailed rules that constrain employees. Highly bureaucratic policies can be just as bad (or worse) than no policies at all when it comes to productivity and staff morale. We have seen policies that attempt to set out in precise detail an employer’s expectations as it relates to everything that may arise in the practice.

Such policies tend to frustrate and undermine staff as they become more focused on following “process” than on the task at hand. Our experience is that staff respond better to broad guidance that respects them

©Stockbyte/Getty Images/Thinkstock

PEAK PERFORMANCE

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Ownership Options

as professionals and relies on their expertise to fill in the minutia of their duties.

If drafted properly, workplace policies can also set a tone that encourages high performance by communicating to employees, both explicitly and implicitly, that they are respected and valued. As noted above, this may be accomplished by ensuring policies provide guidance without being overly regimented. Policies can also achieve this by telling staff that their employer will guard them against being subject to language or conduct that is unprofessional or otherwise inappropriate. Going further, workplace policies can (and, in our view, absolutely should) establish a process for dealing with situations in which an employee feels they have been subject to harassment, bullying, or other similar offensive behaviour. Employees who are confident their employer is looking out for their safety and happiness are much more likely to go above and beyond.

Finally, a well-drafted set of workplace policies can also foster high performance by setting the stage for ‘team work’. As great as individual all-star performance is, an employer is ultimately looking to get the most out of his or her staff as a team. Workplace policies that emphasize team work and collegiality can be very helpful in this regard.

For example, we recommend a policy that states staff are expected to be good team players and to offer their assistance to others whenever it may be required — even if a task is not normally part of their job. There is no room in a high performing team for a ‘diva’ who refuses to pitch in when needed.

©Stockbyte/Getty Images/Thinkstock

COMPENSATION STRUCTURE

In our experience, ensuring high performers are properly compensated goes a long way to creating and maintaining an all-star team.

Staff in dental offices are often paid an hourly wage that applies to all of their hours in the office, regardless of the work performed. While this method of compensation is perhaps the most straightforward from an administrative perspective, it does little to encourage high performers. For example, what incentive does a receptionist have to hustle to re-book patient cancellations if she will be paid the same amount regardless of whether the scheduled is filled? Similarly, why would a hygienist assist with patient recalls or re-stock the operatories during downtime if she knows her colleague is paid

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the same amount for reading a magazine during downtime?

To attract and retain high performers, it is instead much more effective to structure compensation in a way that rewards high performance while providing little or no incentive for inefficiency and loafing.

For example, it is becoming increasingly common for hygienists to be compensated based on a percentage of their production in hygiene billings. Under this method of compensation, hygienists who work hard to ensure they are fully booked are rewarded for their efforts while those who view downtime as ‘free-time’ are provided no incentive. Similarly, more offices are establishing two wage rates that apply to different types of work such as a “hygiene” wage and an “administrative” wage. In our experience, employers are generally happy to pay a higher-than-market wage for hygiene work in exchange for paying a lower wage during downtime when administrative tasks are performed. Again, a high-performer will ultimately be rewarded under such a system and the incentive to treat downtime as free time is lessened.

Regardless of specific compensation structures in place, to build and maintain a team of all-stars, the primary determinate of each team member’s compensation ought to be his or her value to the practice. Basing compensation solely on an employee’s seniority or position does little to encourage peak performance and is instead more likely to foster complacency and entitlement. In our experience, high performers actually prefer compensation structures that reward productivity and efficiency — if someone doesn’t want to be compensated based on their own merits, there’s probably a good reason why.

In our experience, ensuring high performers are properly compensated goes a long way to creating and maintaining an all-star team DISCOURAGE UNIONIZATION

While we don’t believe dental offices are good candidates for unionization, the topic has attracted some attention recently.

Despite sometimes hefty promises, in our oralhealthgroup.com | Oral Health Office | OCTOBER 2014

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34 Ownership Options

Mariana Bracic, BA (Hons), JD, is the founding lawyer of mbclegal.ca, which specializes in preventive HR-law for doctors, including best-practices contracts and policies.

view there is not a lot a union can improve for most dental staff. For example, dental staff are generally well compensated in comparison with other industries requiring similar levels of skill and education.

Furthermore, working conditions are generally quite favourable in terms of hours, duties, workplace safety, etc. Nevertheless, we believe it is important to address some of the reasons why employees often decide to unionize because the solutions to those issues are also conducive to improving staff performance.

First, employees often seek union representation when they feel their concerns are being ignored. Moreover, staff who feel like they do not have a voice are also less inclined to go the extra mile in terms of performance — and why should they when they are made to feel unimportant?

We therefore recommend employers regularly solicit employee feedback (whether in staff meetings or more informally) and be responsive to staff concerns by either resolving them or explaining why an issue can’t be resolved. In doing so, employers must be open to constructive criticism and compromise — although it’s ‘your business’, it’s important to remember that your office cannot function without its staff.

At the same time, communication cannot be a one way street. Staff should also bring any concerns to their employer or manager directly rather than allowing the issue to fester or simply complaining to co-workers (or worse, to patients). In our experience, an employee who is open and forthright with their employer is much more likely to be viewed as a valuable and trusted staff member than one who engages in office gossip.

Indeed, open and responsive communication on both sides goes a long way in preventing minor grievances from becoming huge distractions in the office.

Second, employees often seek union representation when they feel a sense of unfairness. Perceived injustice is also a quick and sure-fire way to drain staff’s motivation. Therefore, we recommend employers

avoid unjustly favouring (or punishing) one employee over others. For example, disciplining only one employee for conduct frequently displayed by others is unlikely to have the desired effect of improving that staff member’s conduct. Instead, a reaction of anger or withdrawal is more likely. By the same token, employers should properly reward high performers so that there is ‘fairness’ in terms of good work being rewarded. In addition to ensuring their compensation properly reflects an employee’s performance, as discussed above, rewards can come in the form of increased vacation, an ‘employee of the month’ award, or a simple compliment on an employee’s performance.

Generally speaking, dental offices provide great employment and staff appreciate that.

However, by being mindful of issues like open communication and perceived fairness, employers encourage their staff to optimize their performance and also reduce the likelihood they will feel the need to unionize.

CONCLUSION

Achieving high performance is multi-faceted and takes commitment on both the part of an employer and employee.

Employers should consider the effect of workplace policies: Do they set out clear expectations without being overly regimented? Do they help create an environment in which employees feel valued, respected and part of a team? Similarly, employees take the time to find out what is expected of them but remain flexible and offer assistance when and where it is needed.

In terms of compensation, a merit-based approach that doesn’t incentivize inefficiency is key. It is common to think it is just about rewarding good performance with pay increases, but employers and employees ought to be open to more creative compensation arrangements such as a commissionbased arrangement or multiple wage rates.

Combining well-drafted policies and sensible compensation structures with open communication and fairness really can go a long way to fostering peak performance.

OCTOBER 2014 | Oral Health Office | oralhealthgroup.com

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ADVERTORIAL

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It’s Time to Fire Your “Web Guy”: 4 Steps You may have hired someone to handle your online presence, or you might be doing it yourself, but if you’re not generating a steady stream of patients from it, you’re probably missing out. The bottom line: if you’re in need of new patients, the local search volume of people seeking a new dentist online is far too high for you to ignore. Here are the 5 steps necessary to conduct online marketing effectively and efficiently.

STEP ONE: T urn Your Website into a Conversion Machine Research indicates that you have only 15 seconds to woo a web visitor to take action (ie. call you for an appointment) before they decide to leave and look at another website. Flashy animations and fun graphics are not the way to go here. The basics should be visible; you want to have a phone number in the top right, proper placement of your services, and clear, articulate content that speaks directly to your visitor’s search query. Your typical prospective patient won’t know the name of your dental practice, so they’ll be using a general keyword search; “dental implants” or “tooth extraction”, for example. When they click on your site from a Google search, and the 15-second countdown begins, they must land on a web page that answers their query precisely — not an ambiguous Home Page.

These specialized pages are called “Landing pages” and they are critical to your success online.

STEP TWO — Be Mobile Optimized Trends in mobile technology have moved well beyond fad status, with smartphones now in the hands of more than 1 in 2 Canadians. These devices are increasingly being used to conduct local searches because they are convenient and always at our fingertips. Having a website that’s optimized for smartphone use is critical if you intend to find new patients online; because that’s how they’re searching for you.

See figure 1, notice that with this mobile website, your prospects can dial directly from the website, which is part of the reason that mobile clicks lead to phone

calls to your dental practice more often.

STEP THREE: G et Placed on Major Search Engines (Mostly Google) Now it’s time to drive quality traffic to your website (ie. people searching online for a dentist). The only way to get found online on day one is to go the paid click route, and that means Google AdWords. Start by setting up a Google AdWords account and then research bidding strategies for the keywords you want to show up for.

You’ll want to tailor your ad copy (the words that go in your ad) to your keywords, and direct clicks to landing pages that do the same STEP FOUR: Measure, Assess, Repeat Now that you have a high-converting website, a smartphone optimized mobile site, and a Google AdWords platform that’s churning out traffic to your site, it’s time to figure out what’s working and what isn’t. For Step 4, it all comes down to implementing tracking — everywhere — so you can see the complete cycle; from the initial search, to clicking on ad copy, browsing your website, taking action and, ultimately, converting that prospect into a new patient. You need to be able to see the entire system from top to bottom, so it would be a good idea to brush up on your data-mining skills in Google Analytics, monitor your AdWords performance and implement call-tracking and email-tracking software, not to mention call-recording for quality and monitoring purposes … and make sure they’re all integrated.

Or … don’t worry about any of this.

All of this can be overwhelming for an already busy dentist. OutRank by Rogers is an intelligent online marketing solution for Dentists who recognize the importance of being online — and getting it right online — so they can focus on providing quality care for their patients. Contact us today and we’ll connect you with a senior sales representative who will research and present market insights related to your business, allowing you to make an informed decision about how you market your dental practice online.

Call us toll free at 1-888-680-0274, or visit us at www.rogersoutrank.com Credit to Carrie Shaw, Director of Marketing, OutRank by Rogers

oralhealthgroup.com | Oral Health Office | OCTOBER 2014

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ADVERTORIAL

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How does Software Impact Dental Practice Success?

Successful implementation and optimal use of top-quality dental software has a major impact on the effectiveness of a dental practice over time.

With 30 years serving the needs of Canadian dentists, ABELDent Inc. has significant experience with both the long- and short-term views of dental practice success. Thousands of dental teams use ABELDent – many for decades – and often after disappointment with other software.

We examined the factors that practices usually consider when selecting dental software and asked: Are they the factors that will actually have the greatest impact on their practice success? How long does it take before the software selection can be called the right one? After a few months? A year? Or only after several years?

When dental practices share with us their most positive software implementation experience, a resounding recurring theme emerges:

Peace of mind Stability and Security. Your dental software data is a valuable practice asset. Protecting this asset is imperative, especially in a connected world. A software vendor should do more than just give you the means to collect data – they should also provide the means to protect it.

Usability and Intuitiveness. More than a collection of features, dental software is a means for you to make the best use of your practice resources. How something is done, and why, is as important as what the software does.

Consistency and Reliability of Support. No one wants to have to call for support, but it’s reassuring to know that responsive, reliable, professional support will be available 24x7x365 if you happen to need it.

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Change Management. Software changes over time. So do regulatory requirements, patient expectations and technology platforms – cloud-based vs local solution is one current example. No one can predict the future, but a dental software vendor should anticipate change, plan for it, and help its clients maximize the opportunities and minimize the risks that come with it.

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Of course there are other factors to consider when selecting dental software: features at the time of purchase, initial price and cost of training, to name a few. Yet, as important as they are, those factors will likely not be top of mind when you assess the impact that your dental software has had on your practice over time.

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Dental software is a long-term investment: In your practice. In your team. In yourself.

With so much at stake, it’s important to begin the decision process with the end in mind.

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9 Your best choice today and for as long as you practise dentistry.

1-800-267-ABEL (2235) ext. 1 www.abeldent.com/oho

inf OCTOBER 2014 | Oral Health Office | oralhealthgroup.com

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Superior Softw ar e for Your P e ace of Mind

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Quick to Implement * Easy to Use * Personalized Service

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14-10-07 3:24 PM

38 Pride Institute

2014

Top Technologies Revealed Pride Institute names this year’s honorees through an award process that you can rely on

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ith a focus on credibility and meaningful innovation, the Pride Institute’s 2014 “Best of Class” Technology Award — now in its sixth year — continues to recognize products that demonstrate excellence in their category.

A panel, comprised of the leaders in dental technology, after a year of research and evaluation, comes together to discuss, debate and decide what products merit recognition. All technology categories are considered, but if there is no clear differentiator that sets a product apart in its category, then no winner is selected. Each product honored as “Best of Class” features unique characteristics that differentiate it from the competition in a compelling way, and more importantly, creates value for the general dentist.

Organized by Dr. Lou Shuman, President of Pride Institute, the panel is committed to a selection method that is unbiased and rigorous. Throughout the course of the year, members of the panel review new and existing technologies in preparation for the vote. Panelists who receive compensation from dental companies are prevented from voting in that company’s category. Over the years, the panel has developed a rapport that makes space for important conversations about value of different innovations and how evolving categories become more or less valuable to the general dentist. The spirited debate that follows, results in a variety of products — obscure and well known, basic and aspirational — being honored.

The “Best of Class” founder, Lou Shuman stated that, “The foundation for our success is, and has always been, our formula: the technology leadership in dentistry, a rigorous and unbiased process, and not-for-profit. The commitment of the distinguished panel helps us maintain the integrity that creates true value.”

The panel consists of five dentists with significant knowledge of and experience in dental technology, including Dr. Shuman; John Flucke, DDS, writer, speaker and Chief Dental Editor for Dental Products Report; Paul Feuerstein, DMD, writer, speaker and Technology Editor for Dentistry Today; Marty Jablow, DMD, technology writer and consultant for Dr. BiCuspid; and Parag Kachalia, DDS, Vice-Chair of Preclinical Education, Research and Technology, University of

Dr. Lou Shuman Pacific School of Dentistry.

“Everyone on the panel is not only recognized as being an outstanding speaker and leader in the industry, but they are also actively seeing patients. When they say a product is worthwhile, it is because they see the value for the patient outcome and real-world impact,” said Dr. Shuman. “They are able to recognize the innovation that dentists need as well as push the envelope in what dentists should embrace as our profession progresses.”

“Selecting the winners is a great responsibility and taken very seriously. When the white smoke finally comes out of the chimney, the companies that survive are presented with the most prestigious award in the dental industry.”

This year’s winners are:.

1. DENTSPLY Caulk Aquasil Ultra Cordless 2. 3Shape TRIOS 3. Anatomage Invivo 5 4. Bien Air iOptima 5. Acteon Newtron P5XS B.LED 6. Acteon Soprocare 7. DEXIS CariVu 8. Kerr SonicFill 9. VELscope VX 10. Imaging Sciences Int’l i-CAT FLX 11. Sesame Communications 24-7 Healthgrades enabled 12. Tellcast.TV 13. Phillips Sonicare Airfloss 14. SciCan Statim G4 15. Doxa Ceramir 16. Kerr Demi Ultra LED 17. Ultradent VALO 18. Propel Orthodontics Excellerator and Excellerator RT 19. Liptak Dental DDS Rescue Honoree participation in the “ADA Pride Technology Expo” at the American Dental Association’s Annual Meeting offers face-to-face interaction with the winning products, as well as technology-centered education provided by members of the panel and esteemed consultants of Pride Institute. Courses at last year’s 2013 meeting sold out. This year’s event will be held from October 9th to 11th in San Antonio.

OCTOBER 2014 | Oral Health Office | oralhealthgroup.com

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Business Management

10

Practice Marketing Questions You Should Not Avoid

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t is a competitive game out there for sure. Dentistry will always be about providing excellent patient care, but today more than ever, it is also about superb business management.

Anyone in business is aware of one simple truth: your business would not exist without customers. These customers are the most valuable asset in any business and a professional approach to marketing is essential for locating and keeping customers.

With practice marketing now being more important than ever, you must ask yourself an important question; how are we doing with our own practice marketing? Are you achieving your goals or falling short? Below are 10 questions to ask yourself about the effectiveness of your current approach to practice marketing.

1) D o you have an entrepreneurial mindset in how you manage your marketing efforts?

The most successful doctors that we work

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with are great at seeing the big picture.

They have an excellent understanding of their present business situation, and are also receptive to new ideas to move their business forward and produce better results.

These doctors have specific plans, such as creating and following a budget, for achieving their goals. They are actionoriented and know how to make business growth initiatives happen, either on their own or by hiring professionals. In short, they see their practice as one of their most valuable assets and marketing as an investment to boost its value.

2) Does your brand identity project a professional image?

In today’s world, image is everything. A more experienced dentist may provide the best dental care, but an amateur dentist who makes a great first impression, will likely have the first chance to secure the prospective new patient who is looking for the best care and patient experience. oralhealthgroup.com | Oral Health Office | OCTOBER 2014

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40 Business Management

The more successful practices today have a name and a logo design that projects an image of confidence. We then ensure all aspects of the practice live up to this image.

From the office décor and the dental equipment to the people and the overall attitude of the practice, everything must work together to convey the image of success.

3) D o you have a great website?

Over 83 percent of Canadian households are connected to the Internet and Canadians spend hours online each day. Your practice website is the center point of everything that you do to market your practice. From advertising campaigns to simple patient referrals, marketing is about getting your name out there and introducing yourself to prospective new patients. Now that you’ve made the connection, people are able to go to your website and learn more about you.

Given the importance of your website, you can’t afford to take an amateur approach. When a viewer lands on your homepage, you have all of six seconds to make a favourable impression and convince him or her to go deeper into the website.

The website needs to be user-friendly and easy-to-understand.

4) Do you have the right social media presence?

Is social media a good fit for your dental practice? Social media shouldn’t be at the core of your new patient acquisition strategy, but rather act as a tool for patient relationship and referral building. You can use social media to take your patient communication to a higher level with a proactive approach that engages and informs.

If social media (i.e. Facebook) is a good fit for your practice, you must take an “all in” approach to managing it well. Appoint someone in your practice to manage your social media presence and make sure that there are posts on your Facebook page every day. Make sure the posts are informative, engaging and project the practice image that you desire.

5) A re your patients aware of the full scope of your offering?

Consider all that you have invested in your

practice by way of equipment, technology and training. Now think about the elective treatment and other dental related services that are available in your office. Don’t forget that you are also welcoming new patients.

Now ask yourself: How aware are my patients of these ideas?

For many practices, patient communication is simply the reminder call to the patient two days before the scheduled exam. The more successful practices take patient communication to a much higher level. They realize the great revenue building opportunity that exists inside the practice in the existing patient file. If you are not in regular contact with your patient file, your local area competitors probably are.

6) Do you have a complete patient referral program in place?

Your patients like you and the dental care that you provide. They are likely very happy to refer you to family and friends when the opportunity arises. The problem is, many of your patients don’t know that you are welcoming new patients, let alone looking for referrals.

Whether you are a dental office, auto dealership or a florist, every business appreciates new customers. To have a successful patient referral program, you must do three things; you must consistently promote the fact that you are welcoming new patients and appreciate referrals, you must consistently acknowledge the support of your patients by saying “thank you,” and you must devise a way to track the names of your referral champions.

7) How aware are the households in your local area of your dental practice?

People are living very busy lives and simplicity is key. Generally speaking, with all other factors being close to equal, convenience is a crucial component in a potential client’s decision-making process. That being said, the people that live within a five minute drive to your office represent your best new patient opportunities.

Make sure that your marketing plan has a component that focuses on getting the right message into these households and establishes your practice as their local

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Business Management

community dentist and best choice for quality care.

makes many people nervous, but this is not a high pressure selling approach. It is simply having a team that is confident in the practice. Your team must learn to pay more attention to selling opportunities and take positive action with those opportunities.

8) How aware and engaged is your team regarding your marketing efforts?

Do the people working with you know how well your dental practice is doing? Do they appreciate how competitive the market is and how challenging it is to attract new patients and run a successful business? Are they interested in the success of your practice, or merely punching a clock?

You are the leader of your team, and the first order of business is to show your team that you’re all in this together. Communication is key, and it starts with having regular meetings to communicate your goals and the plan for achieving these goals. The more team members that you have working with you, the more business building momentum you have within your practice.

10) Are you aware of your unique practice building opportunities?

As stated earlier, your local community is important to the success of your business.

Along with marketing to the local community, you also want to be perceived as an active member of the community. This means sponsoring local sports teams, getting involved in local festivals or coming up with other unique ways of giving back to the community.

Encourage everyone on your team to take notice of local community involvement opportunities. At your next team meeting, start a list and welcome ideas. From this list, decide to move forward on a couple of ideas. Don’t forget to share your community involvement on Facebook. Few people realize that a competitive advantage can be as simple as getting involved in the local community.

In this very competitive industry, it’s necessary to ask difficult questions and give yourself honest answers. Doing so will give you a truer understanding of your customers, lead to a new and dynamic approach to practice marketing and catapult your business to the next level.

9) D oes your team have a sales minded culture?

The purpose of marketing is to get the word out about your practice and all the great work that you do. The mailer piece has been noticed, the website has been perused and now the phone is ringing. Is your front desk ready and able to translate these calls into new patients?

From potential new patient inquiry calls, to the conversations that are happening with your existing patients, every day at your dental office is filled with selling opportunities. The idea of selling

oralhealth

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Setting You Up for Success

ADVERTISING

PREVENTING INJURY IN DENTISTRY

Doing a

TAX CHECK-UP

DON'T

Back Up

YOUR DATA!

BEYOND Posture & Time Management Are Niche Dental Practices THE FUTURE?

PEAK PERFORMER

ON GOOD AND BAD IDEAS

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MARCH 2014

Dental

Weighing In

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MARCH 2013

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OFFICE

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Dan Pisek is the Co-Founder and President of Full Contact Marketing (FCM), a firm that has consulted and facilitated work with more than 1,000 health related practices across Canada and the United States. With a focus on having a good game plan and a team approach to marketing, Dan takes the role of “Practice Marketing Coach” in working with growth minded practice owners to help them realize their full revenue potential. www. fullcontactmarketing.ca

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OFFICE

OFFICE

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OCTOBER 2014

The new

MCGILL FACULTY OF DENTISTRY

TECHNOLOGY UPDATE ISSUE

PROFILES +

The Art & Science of Dental Office Design PM. 40069240

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42 Team Updates

July 25, 2014 , Dental Group Assistant Kahaliah Richards and Kurt Roberts celebrated their nuptials at the Royal Ambassador’s outdoor garden at Innis Lake. The ceremony was followed by a reception at The Hazleton Manor in Vaughan, Ontario.

A D V E R T I S E R ’ S

Editorial Assistant Jillian Cecchini and Daniel Ilika were married August 23, 2014 at Holy Rosary Catholic Church, in Thorold, Ontario.

The reception followed at the Hilton Doubletree Resort in Niagara Falls, ON.

I N D E X

ABELDent. . . . . . . . . . . . . . . . . . . . . . . . . . 36-37 Confirm by Email . . . . . . . . . . . . . . . . . . . . 16-17

DENTAL MARKETPLACE HELP

Crest Oral-B, P&G. . . . . . . . . . . . . . . . . . . . . . 2-3 Dentsply Canada . . . . . . . . . . . . . . . . . . . . 24-25 KaVo N.A.. . . . . . . . . . . . . . . . . . . . . . . . . 12-13 Maxim Software. . . . . . . . . . . . . . . . . . . . . 30-31 OutRank by Rogers. . . . . . . . . . . . . . . . . 35, OBC Philips Oral Healthcare. . . . . . . . . . . . . . . . . . IBC TD Canada Trust. . . . . . . . . . . . . . . . . . . . . . . . 7

YOUR ADVISOR IS IN KAREN SHAW TEL: 416-510-6770 FAX: 416-510-5140 E-MAIL: kshaw@oralhealthgroup.com TOLL FREE CDN: 1-800-268-7742 ext 6770 TOLL FREE USA: 1-800-387-7742 ext 6770 WEBSITE: www.oralhealthgroup.com

NOVEMBER 2013 | Oral Health Office | oralhealthgroup.com

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D e n t a l M a r ke t p l a c e

Contact: Karen Shaw • tel: 416-510-6770 • fax: 416-510-5140 • e-mail: kshaw@oralhealthgroup.com Toll free: CDA 1-800-268-7742 ext 6770 • Toll free: USA 1-800-387-0273 ext. 6770

PROFESSIONAL SERVICES

ASS O CI ATESH I P S

GRANDE PRAIRIE, AB

www. oral health group .com

Establishing, buying or selling a practice Partnership, shareholder and cost-sharing arrangements Associate, consultant and employment agreements Professional incorporations

Three full time associates needed for our well established family practices, with travel to our satellite clinic in High Prairie, AB. Present associates will be leaving end of July 2014. Very busy practice with above average remuneration.

Please email drroy04@telus.net if interested.

ASS O CI ATESH I P S

MUSKOKA, ON

Are you professionally fulfilled? Are you practicing dentistry in fertile soil and at the level you desire? Fantastic career and lifestyle opportunity! Don’t hope any longer. Come share your passion and enthusiasm for dentistry with a connected like-minded highly trained team!

We are looking for an associate who enjoys people and loves dentistry Our thriving modern high tech family practice requires a GP who is confident with a strong clinical skills-set.

We are in Ontario’s playground where you can exceed your professional goals while enjoying a lifestyle desired by many. If you are growth minded come interview us and help us move to the next level. Future buy-in opportunity.

Please leave a detailed message about yourself, your experience & desires @ (705) 789-6070.

VANCOUVER ISLAND, BC We have 2 clinics one in Ladysmith and one in Courtenay both are located on Vancouver Island. We are seeking a full time associate for general dentistry. Busy clinics with opportunity for growth and investment opportunity in the future.

E-mail: orca.dental@shaw.ca Fax: 250-338-7130. Tel: 250-338-5011 office manager Nola.

DENTIST NEEDED ASAP — NOVA SCOTIA

Located in a prime area of beautiful Annapolis Valley just 45 minutes from Halifax, Nova Scotia. An experienced Dentist is needed to be the leader of a great team and prime clinician for a high volume clinic. As a bonus we offer a profit sharing formula based on overall clinic performance. Be busy the moment you start!

Contact info@finetouchatlantic.com or call (902) 835-4222 ext. 223

OSHAWA, ON Progressive Oshawa Dental office looking for a part time Dentist. Our office requires a Dentist Wednesday afternoon/evening hours and possibly 1 Saturday a month. Flexibility with days and hours is an asset.

Email: ocdental@rogers.com

BELLEVILLE, ON Full time Associate needed in Belleville Small well established practice, looking for a full time associate dentist to take over owners schedule.

Candidate should have strong communication skills and be proficient in all aspects of dentistry.

Please contact Trish at clinicaldirector157@gmail.com

EDMONTON, AB Looking for an associate (part/full time) to join our group of multidisciplinary practices which are focused on the highest quality of patient care and using the latest technology available. We are looking for a self-motivated, high-energy, clinically strong candidate who is interested in learning and continuing education. This is a great opportunity for the right candidate to grow with our expanding group and to work in a great environment. Buy-in opportunities are also available for the long-term associates.

If you are interested, please email your CV in confidence to edmontondentalcareer@gmail.com

SCARBOROUGH & BRAMPTON, ON ASSOCIATE & PEDODONTIST OPPORTUNITY Experienced associates and pedodontist required to work in supportive and progressive practice in Scarborough and Brampton on weekdays and weekends.

Candidates should enjoy every aspect of dentistry.

Fax resume to 416-443-9090 or e-mail: rose-2010@live.ca

NORTHERN ONTARIO FULL TIME ASSOCIATE WANTED

Well established busy practice 30 years, poised for growth!!! Remuneration package $20K-$25K per month range. Long standing, cheerful, professional, staff.

Experience northern hospitality and nature at her best. Graduates and Experienced Dentists welcome.

To book your interview please e-mail resumes to: nor_dent@hotmail.com

THOMPSON, MANITOBA

Full-time, energetic, detail oriented associate needed immediately for established, busy family practice with income potential up to $30,000 per month. Enjoy a fully booked schedule and ability to reach your goals as a dental professional. Experience preferred. Excellent opportunity. New grads welcome. Living and Travel Accommodations provided.

E-mail cv: thompsondent@gmail.com Fax (204) 677-4072, Ph: (204) 939-0083.

TRENTON, ONTARIO (1 hour east of Oshawa) FULL TIME ASSOCIATE Overlooking the Beautiful Bay of Quinte.

Great office to work at!!

We are looking for an energetic personality who possesses clear communication skills. Building relationships with our team and patients is the key to success. Our large modern facility is home to 3 dentists, 6 hygienists and a large support staff whom are highly motivated and very skilled. We offer all aspects of dental services to our patients. Our office is equipped with digital radiography, tomography capabilities, Dentrix computer system, General Anaesthesia, sedation & great working hours.

Position available immediately.

Please forward any inquiries to Sheena Woodward, office manager by phone: 613-885-1239 or email sheena@mikethemolar.com oralhealthgroup.com | Oral Health Office | OCTOBER 2014

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44 Dental Marketplace TORONTO, ON

Full time associate dentist needed for busy, modern established practice in Toronto. Complete range of services provided including orthodontics, periodontics, implants, laser dentistry, digital impressions, oral surgery and conscious sedation. An excellent opportunity for professional development concurrent with competitive income.

Call: 416-748-3353 or 1-866-866-8437.

VICTORIA, BC

Part-time associate required in one of the most beautiful areas of Victoria, and one of BC’s fastest growing communities. The position is for Fridays and Saturdays with the possibility of becoming full time. The position would be available immediately. Experience required and Cerec experience would be an asset. Must possess strong patient interaction and treatment presentation skills.

Please email enquiries and CVs to: toothfairy10manager@gmail.com

BARRIE, ON Looking for an orthodontist in Barrie.

Busy neighborhood.

Please forward your résumé to dental_manager@ hotmail.com

MISSISSAUGA, SCARBOROUGH, BARRIE, ON

LONDON, ON

LONDON, ON (and surrounding area) Dove Dental Centres is looking for full time associates for their progressive, modern, multi-location group of dental practices in London, Ontario and surrounding area.

Interested candidates should forward resume and cover letter to: dovedental@ody.ca

MISSISSAUGA, ON

GUELPH, ON

Part-time Associate needed for practice in central Mississauga.

Please forward your resume to: skymark3@winningsmiletor.com

Looking for an energetic and enthusiastic associate for a PT/FT position in our growing and busy office in the south end of Guelph.

Please send us your resume to associateinguelph@gmail.com

NORTH SCARBOROUGH, ON Busy Dental Office in north Scarborough is looking for a FULL TIME Dental Associate. Mon to Sat, Canadian graduate is preferred, Chinese speaking a must.

E-mail: dentistassociates@gmail.com BARRIE AND KESWICK, ON

Full time associate required for our Barrie & Keswick locations. Well established busy family practices with strong patient base.

Interested candidates please email resume to dentistneeded@live.com

SCARBOROUGH, ON

Exciting associate positions available for full and part time opportunities.

E-mail: yourdentaldream@gmail.com

Orthodontist required for general practice. Busy location. Excellent case load per month.

Text Donna at 905-999-2836

BRAMPTON, ON

ORILLIA, ON

Looking for associate 2 days per week on Mondays and Wednesdays.

E-mail: reception@addp.ca

Seeking part-time associate to work Wednesdays and Thursdays in a group family practice in London. Interest in oral surgery an asset. Contemporary office offers a wide range of services including CEREC CAD/CAM crowns and STA computerized anaesthesia.

Send CV/Resume to longodentistry@rogers.com

PETERBOROUGH, ON

WEST OF TORONTO — PART TIME ASSOCIATE

Busy, fully booked from day one. An opportunity to practice dentistry in a well-established office that thrives from a value-based & positive working environment. Modern technologies, exposure to cosmetics, implants, Cerec technology and the ability to refer from within to our many specialists.

Email to: bbc14dental@gmail.com

TORONTO, ON

Part time associate required 1-2 days per week for busy general family practice.

Please forward resume to dental_2010@live.ca

Full time associate dentist required to join busy family practice in Peterborough, Ontario. Our modern and well established practice focuses on providing the highest quality of patient care. The successful candidate will have strong clinical and communication skills, and be ethically motivated. No weekends. Transition to ownership for the right candidate.

Please forward resumes either by fax or email attention to: Emily Beatty — Dentistry on Sherbrooke, 1625 Sherbrooke St. Unit #8, Peterborough, Ontario K9K 0E6 Ph# 705-743-2495 Fax# 705-743-4172 emily@dentistryonsherbrooke.ca

VANCOUVER ISLAND, BC

We are looking for an Associate for our Cumberland Practice. Cumberland is located on Vancouver Island in the Comox Valley. Dr. Lathangue owns several practices on the Island and is looking for exceptional people to join his team. You must be knowledgeable in all aspects of dentistry and be dedicated to patient care.

Email resumes to: joan@dogwooddental.com

Part-time associate for downtown practice. Must be interested in all disciplines of dentistry and have comprehensive continuing education.

E-mail resume to: tooth_fixer@yahoo.com

NORTH BATTLEFORD, SK

Rayburn Dental Studio, a modern, community-based practice in North Battleford, SK, seeking a long-term associate relationship with a friendly, warm and highly-skilled dentist. We offer an exceptionally skilled team, healthy new patient flow, and high-tech, modern equipment. We provide opportunities to exercise your skills with the prospect of buying into the practice down the line.

If you are a self-motivated leader with a vision for your career, please call us!

Rayburn Dental Studio 1701 100th St North Battleford, SK S9A 0W7 (306) 220-8000 (306) 445-3422

OCTOBER 2014 | Oral Health Office | oralhealthgroup.com

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Dental Marketplace

SASKATOON, SK Associate required for modern, very busy practice with strong new patient flow.

Great opportunity in a University setting.

E-mail: associatedentist@ymail.com Fax CV: 888-880-4024.

OAKVILLE, ON

E xpe rie nce d de ntal a s sociate required for a well-established & prestigious family practice. We offer the latest technology and all aspects of dentistry. This position is for Saturdays from 9-5. Seeking a positive, energetic individual with 2-3 years experience, excellent clinical and communication skills who is eager to join our progressively growing team.

Email: oakvillesmiles@hotmail.com

COLLINGWOOD, ON F/T associate position available in Collingwood area. This is a very busy, family practice that is in need of a friendly, caring, experienced dentist.

If you’re interested in an amazing lifestyle as well as a great career, please forward your resumes to assoc.wanted@gmail.com

ST. MARY’S, ON

We are looking for a part time or full time associate for a growing practice in St. Mary’s, Ontario. The candidate must have excellent communication skills with staff and patients. Experience is preferred, but new grads are welcome to apply.

Please submit your C.V. to sandie@dentalofficeconsulting.com or sandiedocs@gmail.com

ASSOCIATES FOR HAMILTON & WATERLOO, ON

Associates required, for TWO VERY busy and modern practices with VERY strong new patient flow.

E-mail: associatedentist@ymail.com Fax CV: 888-880-4024

FORT MCMURRAY, AB

We are seeking a full time dental associate, with at least 3 years of experience in Fort McMurray. We offer a wonderful working environment with a very strong patient flow. We are a well established & rapidly growing practice. Candidates must be people oriented, and have great clinical and communication skills. Excellent opportunity for the right individual to make above average remuneration.

Please email resume: dentistneeded@hotmail.com

BURLINGTON, ON

Part-time associate required for evenings and some weekends.

Please e-mail resume to office@bertabacic.ca

PEMBROKE, ON

FULL TIME ASSOCIATE POSITION

Available in our well established practice in the beautiful Ottawa Valley. Our Current associate is moving out of town, full schedule guaranteed. The area is paradise for boating, fishing, hunting, and the outdoor enthusiast. We are looking for a Self-motivated, caring individual with the highest quality of all aspects of family dentistry in mind. This is an excellent opportunity to work with a great team that thrives on providing exceptional and comprehensive patient care. Looking for a career oriented dentist. This is an incredible opportunity for the right candidate.

Please email resume to dentalvisiondental@outlook.com

COBOURG AND NORTH YORK, ON

Two large family practices requires associates for Cobourg and North York practice requires highly experienced talented female dentist. Lots of incentive.

E-mail: Andyc@coradixgta.com

EAR FALLS, ON

Associate/locum dentist needed for mature practice with coverage needed about one third of the time or two to three weeks every five or six weeks. Accomodation provided,pristine wilderness, in NW Ontario 400km from Winnipeg, 45% of gross billings.

Send resume to Dr. Matthew Walkiewicz at e-mail: mattjw@kmts.ca

SMILES FIRST Located in Nobelton currently seeking a full time associate. Many opportunities to practice all aspects of general dentistry in a fast growing practice with a high volume of new patients. A great experience for any dentist.

Interested applicants please email resume to: info@smilesfirst.org Phone: 905-859-6777

45

TRENTON, ON

We are looking for a motivated dentist who enjoys all aspects of dentistry. Come work in a busy, state of the art facility with new technologies. We have an excellent and very friendly team and looking for the right fit to join our practice .

Please email us at ryounes@sympatico.ca

NORTHERN BC

Full Time Associate wanted for very busy Clinic in Northern BC. Above average remuneration and high production. All aspects of dentistry practiced here. Well trained staff and patients. Present associate moving on, so accepted applicant will be busy from day 1. Minimum 2 year commitment required. Experience is a asset but not necessary.

Please apply to marksara@telus.net

BURLINGTON, ON

Family dental office seeking Associate for Tue, Wed and Thurs for long term commitment.

Email: attndds@gmail.com

EDMONTON, AB

Part-Time Associate position available in New Downtown Clinic. Experienced or New Grads are welcome.

Interested candidates please email: amazingsmile@shaw.ca

WWW.LAURIERDENTALCLINIC.CA

MARKHAM, ON

20 minutes east of Ottawa. Very busy recently expanded dental clinic seeking dentist for long term, full-time position.

Multidisciplinary practice with the latest high tech equipment (2D & 3D x-ray).

Mentoring available. Above average remuneration.

Tel: (613) 446-3368 Fax: (613) 446-5006 laurierdental@videotron.ca

Associate required for well-established family practice for three days per week (Thursday, Friday and Saturday) for January 2015. Must be a good team leader and be comfortable with all aspects of restorative dentistry.

Submit resumé to: Toothydoc@rogers.com or phone (416) 433-1313 for more information.

Associate required for downtown Ottawa.

Please submit resume to norma@xyzdimension.com

OTTAWA, ON

oralhealthgroup.com | Oral Health Office | OCTOBER 2014

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46 Dental Marketplace TORONTO, ON

We are seeking a dynamite dentist with a flair for patient care! Particular focus and interest is geriatric dentistry.

E-mail: narcher@drarcher.ca

KINGSTON, ON

GTA ASSOCIATE

Part-time associate wanted in North York and Markham for Friday and Saturday. Endodontic and surgical skills an asset.

E-mail to: dentalmk@gmail.com

Full time associate required for large group practice in well established office in new building. Modern, digital, paperless office in growing part of beautiful Kingston.

Please contact: lorrie@cataraquidental.com

EQUIPMENT

TORONTO, ON

TORONTO, ON Office Liquidation – Equipment For Sale

WATERLOO, ON Dental Equipment For Sale

For sale: front desk, file cabinet; lab. cabinetry, cupboards.

All in excellent condition.

Please call: 416-595-1200.

6 Spaceline chairs & stools, compressor, suction, office furniture – desks, chairs, credenzas, autoclave, rotary file, filing cabinets, model boxes.

Please contact Bonnie at tel: 416-635-5821.

5 operatories of equipment including chair with accessories, intraoral xray units, custom built operatory cabinetry, instruments and Computer, as well as a Panoramic Xray Unit. Also Server, office computer, printer, fax, etc.

Interested parties please contact me at wkamouni@hotmail.com

PRACTICES & OFFICES

GREATER VANCOUVER, BC

Large and very well established general practice for sale in South Surrey, Panorama Ridge — a desirable and growing neighbourhood. Beautiful new hi tech facility in new building, completely digital and paperless, solid lease, 5 modern ops, loyal staff, >2300 ACTIVE patients. High Gross, high net — enough for two FT dentists.

Reply to Oral Health Office Box 25 — e-mail: kshaw@oralhealthgroup.com

TORONTO, ON

Incredible Opportunity, finished dental space (plumbed, wired, lease-hold) for lease in a busy established MD owned medical clinic. 4 Ops, Panorex room, dental reception area, sterilization room and more. Located in Toronto, Keele and Sheppard, ground floor, plaza, plenty of parking. Ideal for new graduates, very large potential insured patient base from cross referrals and surrounding area.

Please contact Dr. Wong at (416) 614-9686 or at dralbertwong@yahoo.com

ESTABLISHED MAPLE PRACTICE FOR SALE Dental office located in the heart of Maple, Ontario surrounded by a combination of new development and established residential areas.

This turnkey office has been recently renovated

by TriPar construction and is ready for the perfect candidate who is motivated to continue growing a well-appointed office in a family oriented community with plenty of opportunity for growth.

Fixtures include Caesar stone countertops, ceramic and laminate strip flooring, solid wood doors and TriPar built cabinetry. Brand new equipment including Dental chairs, Digital Panoramic X-ray Unit, Sterilization, Instruments, Handpieces and Cassettes. Fully digital and chartless office with optimized website.

An excellent opportunity for a dentist who is looking to become established quickly in a systemized environment.

Please email: Kris at info@docudents.com for more information.

www. oral health group .com

PRACTICES & OFFICES PRIME LOCATION AVAILABLE TO SPECIALTY DENTAL OFFICE ONLY

Lease premises in place. Plaza under construction and set to be ready for possession this fall. 1 hour north of Toronto. High density residential. Specialty Office Only.

Forward your interests to dental_manager@hotmail.com

TORONTO, ON

Professional space for sale at 600 Sherbourne Street. Asking $148.000.00 reasonable maintenance and taxes runs like rent. Around 540 sq. ft. Overlooking the ravine at the subway. Available Dec 1st.

Tel: 416-966-0300.

NORTH YORK, ON

Great 875 sq ft unit with 2 operatory equipped with top of the line Adec, digital x-ray and panorex, fully paperless, 4½ days work week, in a busy plaza.

Contact by email to: tom@roicorp.com

KINGSTON, ON

GENERAL PRACTICE — LIFESTYLE BY THE LAKE If you are looking for lifestyle by the lake, Kingston has so much to offer.

Well established general practice for sale in beautiful downtown Kingston,Ontario. This practice features: a great location with a spectacular view; efficient business and clinical systems; well trained team; four treatment rooms; patient restroom; doctor’s office; consult room; large greeting area; business area; staff room with private restroom and convenient parking.

Please contact: Dale Tucci at 416-450-8769 or dale@daletucci.com

OCTOBER 2014 | Oral Health Office | oralhealthgroup.com

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Philips Sonicare FlexCare Platinum More innovation. Less plaque between teeth.

INTERCARE BRUSH HEAD TECHNOLOGY

• Deeper interdental cleaning • Removes up to 7x more plaque between teeth 1

INNOVATIVE PRESSURE SENSOR

• Resonates when too much pressure is applied • Interactive guidance for proper brushing technique

ADJUSTABLE MODES AND INTENSITY SETTINGS

• Clean: Low, Medium and High • White: Low, Medium and High • Gum Care: Low, Medium and High

Philips Sonicare FlexCare Platinum removes significantly more plaque than Oral-B Professional Care 5000 in all areas of the mouth.2 Contact your Sonicare representative to set up a demonstration or to purchase a specially priced trial unit.

philipsoralhealthcare.com

(800) 278-8282

1 Than a manual toothbrush. M. Ward, K. Argosino, W. Jenkins, J. Milleman, M. Nelson, S. Souza. Comparison of gingivitis and plaque reduction over time by Philips Sonicare FlexCare Platinum and a manual toothbrush.

Data on file, 2013.

2 Defenbaugh J, Liu T, Souza S, Ward M, Jenkins W, Colgan P. Comparison of Plaque Removal by Sonicare FlexCare Platinum and Oral-B Professional Care 5000 with Smart Guide. Data on file, 2013. Single use study. © 2014 Philips Oral Healthcare, Inc. All rights reserved. PHILIPS and the Philips shield are trademarks of Koninklijke Philips N.V. Sonicare, the Sonicare logo, DiamondClean, FlexCare Platinum, FlexCare, FlexCare+, ProResults, Sonicare For Kids and AirFloss are trademarks of Philips Oral Healthcare.

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OutRank by Rogers* YOUR DENTAL

PRACTICE

*The Instrument that Brings You New Patients What is OutRank?

Think of OutRank as the instrument your business uses to make you visible to potential clients online. With OutRank, we craft an online presence to suit your business needs, then we build a campaign designed to drive qualified leads to that online presence.

In the spirit of total transparency and accountability, we give you access to a dashboard that shows you every call and email generated from the campaign we build for you.

$200 Ad Credit for the Readers of

How Qualified is a Qualified Lead?

OutRank & Google in Premier Partnership

Imagine a person is in need of dental implants, a service that your clinic provides. Like most people today, they open up their internet browser, go to Google and search for “dental implants (your city)”. Is this the kind of person that you want to receive a phone call from? These are the exact kinds of qualified leads that our technology can consistently drive to your business.

In today's connected world, people rely less on their friends for referrals and more on Google to find what they're looking for. OutRank is a division of Rogers Communications in Premier Partnership with Google Inc. We’ve made a multi-million dollar investment in technology that drives quality leads to your business, and together we're bringing clarity and transparency to the world of online marketing.

Get Your Practice Seen in Local Search Results

Call 1 888 680 0274 Use Code: “O-H-Magazine” rogersoutrank.com

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PARTAGEZ VOS DONNÉES AVEC VOTRE ÉQUIPE ET ÉCONOMISEZ AVEC LES FORFAITS PARTAGEZ TOUT POUR AFFAIRES POURQUOI PARTAGER LES DONNÉES ?

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ABONNEZ-VOUS MAINTENANT ET OBTENEZ 4 Go DE DONNÉES avec le forfait Partagez toutMC à 80 $ par mois2.

1-888-ROGERS1 APPELEZ au 1-866-737-4017 1-888-ROGERS1 rogers.com/economisez50 rogers.com/economisez50 CONSULTEZ rogers.com/Partage magasinsRogers.com magasinsRogers.com VISITEZ votre Spécialiste petites entreprises

L’offre s’adresse aux petites entreprises clientes admissibles (avec preuve d’identification de client d’affaires). L’offre peut être modifiée sans préavis. 1. À l’intérieur de la zone de couverture du réseau sans fil de Rogers.

La couverture n’est pas offerte dans toutes les régions. Des frais d’itinérance s’appliquent à l’extérieur du réseau sans fil de Rogers au Canada. Consultez rogers.com/itinerance pour obtenir de plus amples renseignements et pour connaître les tarifs d’itinérance au pays applicables. 2. En plus de vos frais de service mensuels totaux, votre première facture pour vos services sans fil comprendra des frais de connexion de 15 $ par ligne pour l’activation de votre service sur notre réseau (ne s’applique pas au service prépayé). Les frais de temps d’antenne additionnel, de transmission de données, d’interurbain, d’itinérance, les frais liés aux options et les taxes sont en sus et facturés mensuellement, le cas échéant. Des frais gouvernementaux mensuels de 0,40 $ s’appliquent pour le service d’urgence 9-1-1 au Québec. Toute utilisation supérieure au lot de données fournies est facturée à 15 $ le Go. Des frais s’appliquent pour l’utilisation de données en itinérance, rogers.com/itinérance. © 2014 Rogers Communications

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