Articulator Volume 24, Issue 2

ARTICULATOR MDDS Connections for Metro Denver’s Dental Profession

4th Quarter, 2019 Volume 24, Issue 2

EDITION Topic of Is Your Google My 12 The 16 Dental Insurance Business Profile Usually Brings a Frown to the Face

Working for You or Against You?

to 18 Learning Embrace the Generational Friction Factor

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4th quarter 2019

what's inside?

12

pg.

12 The Topic of Dental Insurance

pg.18

Usually Brings a Frown to the Face

16 Is Your Google My Business Profile Working for You or Against You?

Advertisers Directory

18 Learning to Embrace the ..............

Generational Friction Factor

20 You Can’t Run a Portfolio Like a Business, Part 2 of 2

22 The Most Important Reason to Keep the Schedule Running Smoothly

ADS Precise Transitions adsprecise.com................................. 28 Arizona Dental Association bit.ly/WRDE20CO.............................. 30 Berkley Risk Services of Colorado colorado.berkleyrisk.com.................... 30 Best Card bestcardllc.com................................... 4 Carr Healthcare carrhr.com........................... Back Cover CDA Enterprises cdaonline.org.............Inside Front Cover

departments 4 RMDC Chair Message 6 Reflections 9 Member Spotlight 10 Member Matters

Colorado Dental Association cdaonline.org.................................... 27

Colorado Prosthodontic Society oloradoprosthodonticsociety.org............ 29 Copic Financial Services Group copicfsg.com..................................... 25 CTC Associates ctc-associates.com............................... 5

Co-Editors Amisha Singh, DDS; Allen Vean, DMD Creative Manager CT Nelson Director of Marketing & Communications & Managing Editor Cara Stan

24 Non Profit News

MDDS Standing Officers

26 Tripartite News

President-Elect Kevin Patterson, DDS, MD

28 Event Calendar 31 Classifieds

President Nelle Barr, DMD

Treasurer Pat Prendergast, DDS Secretary Janie Boyesen, DDS, DMSc

Dental Lifeline Network dentallifeline.org............................... 24 Dente Vita denteveita.com.................................. 25 Dentists Professional Liability Trust of Colorado tdplt.com.......................................... 15 Denver Implant Study Club disc.events........................................ 14 The Docsites docsites.com..................................... 11 Front Office Rocks frontofficerocks.com........................... 23 Healthcare Medical Waste Services, LLC hcmws.com......................................... 8 Northwestern Mutual shawncopeland.nm.com........................8 SAS Transitions sastransitions.com.............................30

Editorial Policy All statements of opinion and of supposed factare published under the authority of the authors, including editorials, letters and book reviews. They are not to be accepted as the views and/or opinions of the MDDS. The Articulator encourages letters to the editor, but reserves the right to edit and publish under the discretion of the editor.

Advertising Policy MDDS reserves the right, in its sole discretion,to accept or reject advertising in its publications for any reasons including, but not limited to, materials which are offensive, defamatory or contrary to the best interests of MDDS. Advertiser represents and warrants the advertising is original; it does not infringe the copyright, trademark, service mark or proprietary rights of any other person; it does not invade the privacy rights of any person; and it is free from any libel, libelous or defamatory material. Advertiser agrees to indemnify and hold MDDS harmless from and against any breach of this warranty as well as any damages, expenses or costs (including attorney’s fees) arising from any claims of third parties.

Inquiries may be addressed to: Metropolitan Denver Dental Society 925 Lincoln Street, Unit B The Articulator is published quarterly by the Metropolitan Denver Dental Denver, CO 80203 Society and distributed to MDDS members as a direct benefit of membership. Phone: (303) 488-9700 Fax: (303) 488-0177 mddsdentist.com ©2019 Metropolitan Denver Dental Society Printing Dilley Printing

Member Publication

3

RMDC CHAIR MESSAGE

You Ask and You Shall Receive!

By Dr. Lindsay Compton

J

anuary is a great time of year! We are entering into a

for 80’s arcade and lawn games complete with giant PacMan, Donkey Kong,

new decade and everyone is looking for a fresh start and

Jenga and other fun features great for team building and adding a light-hearted

new beginnings. Where do you see your career now and

spirit to the convention. We also are excited to announce a couple of Saturday

where would you like it to be? How will you get there? The

features including an Expo Hall only pass and a purchasing promotion – show

Rocky Mountain Dental Convention (RMDC) can help you

proof of purchase for $500 and get a $50 gift card from RMDC.

take your career and your practice into the next decade with new innovations and the most current science in the practice of dentistry.

My favorite addition to this year’s schedule is the Fast Track courses. In my tenure on the RMDC Programming Committee we’ve

In the spirit of new beginnings, the Convention Arrangements Committee and I want to continue to grow and evolve RMDC. We want to make sure that we are looking far and wide for the best practitioners and clinicians to teach our advanced dental community. We tirelessly attend continuing education to perfect our craft. We’ve scouted meetings all over the United States and Canada to make sure that our program is fresh and inspiring. I often pinch myself when I realize how fortunate I am to practice in a community with colleagues who care so deeply for their patients and teams.

We also want to enhance your RMDC experience. There is

"The Rocky Mountain Dental Convention (RMDC) can help you take your career and your practice into the next decade with new innovations and the most current science in the practice of dentistry."

so much happening at the meeting, it’s quite frankly hard

often come across a topic that has either been requested by members or a topic that is on the horizon. So many times, these topics don’t have enough content to fill a three-hour course, and although it is an important topic, it doesn’t make it into the program. To remedy this problem, we’ve added short one-hour courses. We are still able to present and bring this topic to attendees and be economical about it. I also feel that the short courses allow the program to be more flexible to everyone’s desires and schedules.

Come to the 2020 Rocky Mountain Dental Convention (RMDC) and be prepared to be overwhelmed (in a good way!). We have something for every member of the dental team. Spend time with the program beforehand and build

to find clever ways to make sure you know how many options you have at

your schedule on the mobile app so you can maximize your experience. Don’t

any moment in time. In the digital world, we’ve spent time perfecting the

miss out on anything. You owe it to yourself and your new beginning. If we

mobile app to make sure it's user-friendly and you can easily find what you

missed something or if you have a suggestion, please stop me or a member

are looking for. When you are in route to your classes, signage will tell you

of the MDDS Board of Directors and let us know. We work the entire year

what else is available in a concise matter because you don’t know what you

for you, and we want this to be your best RMDC yet! Stay tuned into RMDC

don’t know.

on Facebook and rmdconline.com for new announcements and details about any of the features listed above.

With so many CE sessions, social events and the Expo Hall, who has time to eat? I see and hear too many of my friends try to make the difficult decision between vising the Expo Hall and finding lunch. We’ve heard your requests and you shall receive! This year you will be able to pre-order box lunches. At the convention you will be able to pick up lunch easily and have time to peruse the Expo Hall. You can try out the laser you’ve been eying and have time to check out that scanner you’ve been meaning to schedule a time to see in your

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In addition to now offering box lunches, the RMDC Exhibits Committee has worked tirelessly to add features to the Expo Hall to keep it fresh, fun and thriving. In 2020, you can expect favorites like the Thursday and Friday Expo Hall Receptions and The Summit: CE & Demo Stage to continue. Also, watch

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Dental

The 2020 Rocky Mountain Dental Convention Presents Marie Chatterley

Transitions

Friday, January 24th, 2020 1:30 P.M. Colorado Convention Center Expo Hall D

& MULTIPLE PRACTICE OWNERSHIP

A Workshop On Transitions And Multiple Practice Ownership At The 2020 Rocky Mountain Dental Convention Do your career goals include multiple practice ownership? The adventure begins with evaluating opportunities, approving financing, determining partners, and establishing a business plan for growth.

Most individuals start with one practice, develop their systems (or a foundation they want to duplicate), then move to purchasing a second practice.

About 40% of buyers who contact me say their vision Past President of the National Asociation of Practice Brokers is to own more than one practice. Before starting the journey of multi practice ownership, I would encourage all to investigate one question: why do so many providers start selling their extra locations within 1-5 years of purchasing them? I will be speaking at the RMDC on multi practice ownership and will address the obstacles faced when purchasing more than one practice.

Marie Chatterley

Here are the topics we will discuss in our January Workshop at the RMDC:

www.ctc-associates.com

• Finding the right location with the ideal number of operatories and net cash flow • Acquiring financing for growth • How to bring on loyal, productive associate providers • How to create staff loyalty when managing remotely • How to select the right time and right person to help manage your offices • Understand the reality of take home profits from associate locations • Learn how to establish clean financial records to position your business for a transition • What is the reality of selling multiple practice locations to a DSO or Investor group Please join us for this discussion highlighting what you can do to best plan for success as you add multiple locations to your business.

Please call to schedule a complementary transition planning meeting. (303) 795-8800

PRACTICE SALES + APPRAISALS + TRANSITION CONSULTING + ASSOCIATE PLACEMENT

Larry Chatterley

Marie Chatterley

www.ctc-associates.com | Telephone: (303) 795-8800 | Email: info@ctc-associates.com

Randon Jensen

REFLECTIONS

Are We Ready for Change?

In the past, I have tried to reflect on many of my experiences in our great profession.

As we approach the end of the year, I came across what I believe to be a superb guest editorial in the ADA Journal by Dr. Marko Vujicic, who is the chief economist and Vice President of the Health Policy Institute of the ADA. I thought it would be appropriate to look to the future instead of the past.

OUR DENTAL CARE SYSTEM IS STUCK

AND HERE IS WHAT TO DO ABOUT IT

By Marko Vujicic, PhD

I

n 1926, the work of William Gies1 helped chart a new

a significant share of adults and most seniors lack dental coverage.

course for dentistry. I think we are approaching another

Affordability issues are, by far, the top reason adults and seniors do not

“Gies” moment in which the dental community must

visit a dentist. Despite its major shortcomings,9 dental coverage still drives

face some hard facts and ask itself how effectively

dental care use.10 The idea that demand for dental care can be stimulated

the current system is improving the oral health of the

by simply convincing people that it is “worth it” or “it will save money in

American public. In my view, the current dental care delivery and financing

the long term” and that they should just spend more out of pocket is, in my

model will not drive significant, sustained improvements in oral health

view, a complete fantasy. The past 50 years have seen major expansions of

going forward like it did in the past, particularly for key segments of the

health insurance, most recently because of the Affordable Care Act. This has

population. We are stuck. And the changes needed to get unstuck are not

dramatically changed the consumer mentality toward health care services,

tweaks, but major reforms.

dental care included. The patient mentality tends to be that if it is not covered, it is less important. If US health policy treated comprehensive dental care as

Let us first look at some important trends. Dental care use is rising among

an essential health benefit, it would be covered by public programs such as

low-income and minority children, and racial and economic disparities

Medicaid and Medicare and would be a core component of private health

are narrowing. Dental care use among seniors is also on the rise. However,

insurance. This would significantly increase demand for dental care.

2

3

unlike for children, high-income seniors are driving this trend, meaning income disparities are actually widening. For adults (those aged 19-64 years)

Second, we need to define and systematically measure oral health in ways

dental care use has been fairly flat for several years. Cost is, by far, the top

that are meaningful and relevant for both patients and providers — but

2

reason adults avoid going to the dentist. But despite steady reductions in

mostly for patients. Providers, payers, and regulators are meticulous about

cost barriers to dental care for adults in recent years,5 there has been no

measuring what is done to patients (for example, prophylaxis, radiographs,

appreciable bounce back in utilization. Looking forward, demand for dental

root canal treatment) but not what is done for patients (for example, relieving

care among working-aged adults (the engine of the dental economy) will

pain, improving mouth function, lowering risk of caries). The health care

continue to be sluggish, especially for restorative care. In my view, the

train is steadily moving toward more of an outcome focus,11 and the dental

dental sector is in a low-level equilibrium. We will not see major expansions

profession is starting down this path, too. For example, the World Dental

in dental care use and sustained improvements in oral health in the coming

Federation recently adopted a new definition of oral health that takes the

years, especially among those with the highest needs, under the status quo

crucial step of incorporating physiological and psychosocial elements.12

model. The dental care system needs major reforms in four areas (See Box).

Specific measures for oral health are being developed by an international,

4

6,7

multiple stakeholder group.13 Such measures should be tracked at the First, we need to address the dental coverage gap. Only 10% of US children lack dental coverage, a rate that has steadily declined for decades. However, 8

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individual patient level and at the population level.

Reforms needed to drive major expansions in dental care use and meaningful, sustained improvements in oral health.

Address the Dental Coverage Gap

license. In addition, there would be stronger incentives to get dentistry out of its care delivery silo. If dental care providers are a bit more accountable for oral health status, all of a sudden it becomes vital to engage the rest of the health care system to help nudge people into dental homes. Imagine physicians referring

Consider dental care an essential health benefit for all age groups. Provide

all of their patients with diabetes into dental homes. Now, imagine if every CVS

comprehensive dental coverage in public health insurance programs and as a

did the same thing.

core benefit in private health insurance coverage.

Define and Systematically Measure Oral Health Define and systematically measure oral health in ways that are meaningful and relevant for both patients and providers, but mostly for patients. Measure what is done for patients, not just what is done to patients.

Tie Reimbursement, Partly, to Outcomes Make some small portion of provider compensation dependent on oral health outcomes or, at a minimum, on some intermediate measures that influence outcomes and are more within the direct control of providers.

Reform the Care Delivery Model

Make no mistake, I fully recognize that the action areas I have outlined are disruptive. This is not about tinkering around the edges; it is about systems change. However, I am convinced these changes are absolutely necessary if the goal is to get more dental care to more people, especially those with the highest needs, and to improve the oral health of the American public in a meaningful and long-lasting way. Some of the changes I have outlined are already under way in both the public16 and private17 sectors. The key question the dental community and health policy makers more broadly need to ask is this: who will lead the change?

Disclosure. Dr. Vujicic did not report any disclosures.

Get dentistry out of its care delivery silo. Engage the rest of the health care system to nudge people into dental care. Rise above scope of practice turf wars fueled by fee-for-service payment.

Third, we need to reform reimbursement so that it rewards what is done for patients rather than what is done to them: a model that is a little more focused on paying for oral health outcomes and a little less focused on paying for dental care procedures. I am not suggesting we abandon the fee-for-service model entirely. We are nowhere near ready for that kind of leap. Rather, we need to make some small portion of provider compensation dependent on oral health outcomes. There are immense challenges to this, no doubt. We know that oral health is influenced by a host of factors as broad as social determinants (for example, what neighborhood you live in) and as narrow as specific patient behavior at home (for example, flossing). Outcomes based reimbursement, therefore, puts providers on the hook for things they perceive as beyond their control. However, these challenges can be addressed.11,14 For example, reimbursement can be adjusted for risk and can be based not just on oral health, which can be thought of as the final outcome, but also on intermediate measures (for example, sealant rates) that are more within the direct control of providers.

Fourth, we need to explore different care delivery models. Once reimbursement is tied to outcomes rather than to procedures, a whole different set of incentives comes into play for providers. The financial incentive becomes to produce the biggest improvements in oral health at the lowest cost. The turf wars concerning which providers can do what procedures, fueled by the fee-for-service model, start to dissipate. Instead of “What do I do?” providers start to ask, “What am I part of?”15 Providers would have stronger financial incentives for prevention.

Article reprinted with permission of the ADA Journal, March 2018 Issue.

1. Gies WJ. The Gies Report: Dental Education in the United States and Canada. New York, NY: The Carnegie Foundation for the Advancement of Teaching; 1926.

2. American Dental Association. Dental care utilization in the U.S. Health Policy Institute Infographic.

November 2017. Available at: http://www.ada.org/w/media/ADA/Science%20and%20Research/HPI/Files/ HPIgraphic_1117_2.pdf?la.en. Accessed December 27, 2017.

3. American Dental Association. State of the U.S. Dental Market: Outlook 2018. Health Policy Institute Webinar. November 2017. Available at: http://www.ada.org/en/science-research/health-policy-institute/publications/webinars/state-of-the-usdental-care-market-outlook-2018. Accessed December 27, 2017.

4. Vujicic M, Buchmueller T, Klein R. Dental care presents the highest level of financial barriers, compared to other types of health care services.

Health Aff (Millwood). 2016;35(12):2176-2182.

5. American Dental Association. Cost barriers to dental care in the U.S. Health Policy Institute Infographic. November 2017. Available at: http:// www.ada.org/w/media/ADA/Science%20and%20Research/HPI/ Files/HPIgraphic_1117_4.pdf?la.en. Accessed December 27, 2017.

6. Guay AH. Where is dentistry going?: advice from the Cheshire cat. JADA. 2016;147(11):853-855.

7. Meyerhoefer CD, Panovska I, Manski RJ. Projectionsof dental care use through 2026: preventive care to increase while treatment will decline.

Health Aff (Millwood). 2016;35(12):2183-2189.

8. American Dental Association. Dental benefits coverage in the U.S. Health Policy Institute Infographic.

November 2017. Available at: http://www.ada.org/w/media/ADA/Science%20and%20Research/HPI/Files/HPIgraphic_1117_3.pdf?la.n. Accessed December 27, 2017.

9. Vujicic M. Time to rethink dental “insurance.” JADA. 2016;147(11):907-910.

10. Meyerhoefer CD, Zuvekas SH, Manski R. The demandfor preventive and restorative dental services.Health Econ. 2014;23(1):14-32.

11. Porter ME, Lee TH. The strategy that will fix health care. Harvard Business Review. October 2013. Available at: https://hbr.org/2013/10/thestrategy-that-will-fix-healthcare. Accessed December 27, 2017.

12. Glick M, Williams DM, Kleinman DV, Vujicic M, Watt RG, Weyant RJ. A new definition for oral health developed by the FDI World Dental Federation opens the door to a universal definition of oral health. JADA. 2016;147(12):915-917.

13. ICHOM. Our Standard Sets. Available at: http://www.ichom.org/medical-conditions.Accessed December 27, 2017.

14. Blumenthal D, LinthicumM, Kamal-Bahl S. Strategies to address the challenges of outcomes-based pricing agreements for pharmaceuticals.

Health AffairsBlog.April 3, 2017. Available at: https://www.healthaffairs.org/do/10.1377/hblog20170403.059449/full/. Accessed December 27, 2017.

15. Berwick D. Era 3 for medicine and health care. JAMA. 2016;315(13):1329-1330.

16. California Department of Health Care Services. Dental Transformation Initiative (DTI). CA.gov. Available at: http://www.dhcs.ca.gov/ provgovpart/Pages/DTI. aspx. Accessed December 27, 2017.

17. Pihlstrom DJ. Evidence based care within a large group practice. Permanente Dental Associates. Available at: http://www.mouthhealthykids. org/w/media/EBD/Files/EBDChampions2/7_PIHLSTROM.ashx. Accessed December 27, 2017.

About the Author Dr. Vujicic is the chief economist and the Vice President, Health Policy Institute, American Dental Association, 211 E. Chicago Ave., Chicago, IL 60611, e-mail vujicicm@ada.org. Address correspondence to Dr. Vujicic.

Please accept our sincere thanks for your support during the past year. Your comments are welcomed and encouraged. I can assure you that MDDS is in superb hands. We look forward to seeing all of you at RMDC. Our best wishes for a healthy, happy and wonderful holiday season.

~Allen

The care delivery model would adjust to move everybody to the top of their

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MEMBER SPOTLIGHT

What influenced your decision to get involved at the state and local levels?

Angelica Seto, DDS Seto Family Dentistry Denver, CO

What is one thing you did not expect about life after dental school? " I did not expect that I would meet so many wonderful people in the dental community who would soon become my family away from home. I was anxious about leaving my family in Texas to move to Colorado. However, the Colorado dental community has welcomed me with open arms to my new forever home."

What is your favorite part of your job?

"Interacting with my patients on a more personal level to develop a relationship built on trust. I enjoy treating high anxiety patients and creating that breakthrough moment where the patient feels comfortable and at ease under my care."

"Historically, women have been lacking in leadership roles. The steady increase in the number of female dentists has brought, and continues to bring, many positive changes to our profession. In order to expedite changes for women, it is important for us to seek involvement and leadership at all levels. Being a Hispanic female dentist brings my family and me great pride. I am the oldest female cousin in a large Mexican family.

I get immense pride out of paving the way to higher education and making a positive change in society for those younger than me."

What speakers are you looking forward to seeing at RMDC?

"I am looking forward to seeing The Madow Brothers' ‘The Insider's Guide to Dental Practice Success’. I am eager to learn what improvements I can make to build a practice that patients are excited to call their new dental home."

What would you be doing if you weren’t practicing dentistry?

What do you wish the public understood about dentists?

"Remember to whom you're speaking when you comment, "I hate the dentist." Many of us chose this career because we truly care and want to make a positive impact on people's lives. Dentists have "fillings" too!"

"If I hadn't gotten into dental school, I would have persued my master's in brewing and distilling. I would be working towards becoming a master brewer.

Fortunately, I was accepted into dental school. Now I take that same drive and direct it towards my work as a dentist. Becoming a master brewer is still in the back of my mind and could be part of my retirement plan."

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MEMBER MEMBERMATTERS MATTERS

MDDS Student Mingle - Cheluna Brewing Co, at Stanley Marketplace

Third and Fourth year, plus ISP CU dental students met and mingled with MDDS members and the CDA New Dentist Committee while enjoying food and craft beer at Stanley Marketplace’s Cheluna Brewing Co. Special thanks to Pacific Dental Services and Sunflower Bank for sponsoring.

MDDS October New Member Welcome Event Broadway Market

New members and dental students gathered at Denver’s hottest new food hall, Broadway Market, for good food and great networking at the MDDS October New Member Welcome Event. Thank you to Fotona, Peak Dental, Peebles Prosthetics and Wells Fargo for their support of this event.

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New Members, Welcome!

Dr. Malik Altoos Dr. Nicole Ameli Dr. Gabriela Andrade Dr. Monica Angelucci Dr. Alegandro Arango Dr. Kyle Aten Dr. Nicholas Avianto Dr. Andrei Baskakov Dr. Erica Beaty Dr. Gary Bedrosian Dr. Joshua Blane Dr. Daniel Blankenburg Dr. Brandon Braud Dr. Derick Bright Dr. Sarah Brusko Dr. Arielle Canoza Dr. Emanouela Carlson Dr. Raghavendra Challa Dr. Brook Chamberlain Dr. David Chen Dr. Amber Clark Dr. Marietta Cuiffo-Moradi Dr. Walter Daniels Dr. Jennifer Daratany Dr. Mark DeRocher Dr. Jill Dery Dr. Elizabeth Dinh Dr. Sirisha Dommaraju Dr. Christian Egbert Dr. Kristina Eidson Dr. Justin Escobar Dr. Michael Fangman Dr. Lisa Feheley Dr. Kelly Fenn Dr. Taylor Foster Dr. Jordan Gabriele Dr. Robert Geis Dr. Keira Ginsberg Dr. Brianna Godejohn Dr. Morgan Gonder Dr. James Gordon Dr. Rachel Hain Dr. Kaysie Hanle Mills Dr. Matthew Hasday Dr. Rachel Hass Dr. Thomas Blake Higgins Dr. Dan Hoang Dr. Randal Hodoval Dr. Shane Hoelz Dr. Marissa Holloway Dr. David Hulme Dr. Barbara Hymer Dr. Ahsan Iqbal Dr. Austin Ivey Dr. Jamon Jensen Dr. Kaia Jerde Dr. Thomas Jordan Dr. Kunjan Kakar Dr. Zack Kammer Dr. Jimin Kang Dr. Paul Karpinski Dr. Behrod Khankhanian

Dr. Artemis Khazaie Dr. Sol Kim Dr. Tetyana Korchynskyy Dr. Nikki Kumor Dr. Adriana Lamounier Dr. Scott Lazaroff Dr. Jean Lee Dr. Jennifer Leighton Dr. Simona Lekht Dr. Duane Lemieux Dr. Kevin Lin Dr. Veronica Longville Dr. Aous Manshad Dr. Alexandre Maymone Dr. Alex McNeely Dr. Lindsey Miller Dr. Donald Miloni Dr. Andrew Montalvo Dr. Matthew Murphy Dr. Leslie Murray Dr. Cody Murray Dr. Udaya Bhasker Narayanaraopetar Dr. Brandon Nguyen Dr. Tiffany Niquette Dr. Nina Olivieri Dr. Jessica Parry Dr. Joseph Parsons Dr. Kruti Patel Dr. Dhea Patel Dr. Amanda Phan Dr. Katie Plunkett Dr. Anila Poravanthattil Dr. Brandon Powell Dr. Liridon Qafleshi Dr. Yuliya Rabinovich Dr. Garett Rasnick Dr. Derya Redelius Dr. Daniel Rejamn Dr. Bridget Remming Dr. Lisette Ruiz Ibarra Dr. Jessica Sargeson Dr. Amber Schmidt Dr. Chelsea Shellhart Dr. Laura Silverstein Dr. Natalie Simpson Dr. Kristopher Smith Dr. Kevin Smith Dr. Stephen Spencer Dr. Anuj Suri Dr. Katherine Suslik Dr. Stephanie Thomas Dr. Matt Thompson Dr. Karina Thompson Dr. Kevin Tran Dr. Helen Vilchez Dr. Shannan Walker Dr. Harry Werner Dr. William Wiering Dr. Caitlin Wright Dr. Timari Yow Dr. Nataliya Zasadko

MEMBER MATTERS

MDDS/CDA Speed Mentoring

MDDS Presidential History Initiative The history of The Metropolitan Denver Dental Society includes a chronology of its many talented leaders. Individuals who chose to serve our professional dental community by becoming MDDS president deserve our special gratitude. Dr. Nick Chiovitti, a recent MDDS president, initiated a wall of recognition for all those dentists who made the sacrifice of time and energy to lead MDDS over the last 126 years.

Established MDDS and CDA members spent an evening sharing their wisdom and experiences with new dentists, students and residents.

Listing the presidents from 1893 to the present, this colorful wall display located in the MDDS building, is not only a tribute to these dentists, but a way for all members to get in touch with Denver’s history of organized dentistry. Expanding on the educational aspect of Dr. Chiovitti’s idea, past-president Dr. Michael Scheidt has started an effort to create an on-line virtual wall. We hope to recognize our past presidents with their curriculum vitae, personal stories and photographs.

Letters will be sent soliciting professional histories, photographs and other MDDS memorabilia. If you have any contributions for yourself or a past president you know, please email Cara Stan at marcom@mddsdentist.com.

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RMDC SPEAKER

THE TOPIC OF DENTAL INSURANCE

USUALLY BRINGS A FROWN TO THE FACE

By Doyle Freano, Jr., DMD

T

he topic of dental “insurance “usually brings a frown to the faces of most dentists and their teams. As a continuing education lecturer around the country, I have encountered hundreds and hundreds of dentists frustrated by even the mention of the term dental “insurance.”

This was not always the case as I began practicing dentistry in 1982. Dentists of that era welcomed the idea of third-party payments as employer-sponsored plans were generously funded, without in many cases, limits on the fees a dentist could charge and little oversight in the approval or denial of claims.

Governmental policy incentivized the concept by allowing the benefit to the employee to be credited in pre-tax dollars and to the employers as payroll taxes - a substantial savings to both groups. It is an established fact that patients with dental benefits utilized dental services more frequently than those without benefits. Employers, with pressure from organized labor, paid for the benefits to attract and retain better employees to their workforce.

It all started as a Win/Win proposition!

So much so that the 5.8 million Americans with benefit coverage grew to 67.9 million in 1978 (1) and then to 249.1 million Americans (77% of the population) by 2016. Of the 249.1 million in 2016, 164.2 million had private coverage with just under 84 million covered by public programs (2) But as we all know, costs escalated, and employers soon began to realize their costs must be contained. Insurers countered by asserting more control in the process including instituting yearly maximums, requiring more and more

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documentation and justification from dentists and creating “preferred provider networks,” which were formed to primarily give leverage against dentists in and out of network. Non-traditional capitation plans were introduced to reduce costs for the employers with the promise of steady payments to dentists based in part on the number of patients enrolled but countering with strict price control on the procedures covered. Government plans provide scant coverage and reimbursement levels below most practitioners’ costs of providing the services covered.

With price controls firmly in place and yearly maximums frozen at levels realistic 40 years ago, what once had been generally positive for the profession and patients has now become a huge source of discontent for both.

Dentists are extremely frustrated with the claims process because of slow pay, denials and unrealistically low reimbursements. Further, dental practices face ever increasing costs of computer technology hardware, software and additional employees to manage the process.

Patients are confused and frustrated by limitations on coverage, increased premiums and changes in the nature of the service provided. Corporations and practitioners struggle to maintain high quality care and service while seeing more patients in much less time. Patients perceive that “It ain't what it used to be” in service, longer waits, incomplete care and less personal attention in a setting that is already extremely stressful for them. Further, fueled by deceptive political promises from both parties and misleading advertisements by insurers, patients arrive at our offices with expectations of little or no out of pocket expense while receiving great care paid for by someone else. As we know, that is deceptive.

negative comments and body language from our communication with each other and our patients. We chose to be very happy when patients brought us their policies as they were very happy to have coverage. We embraced the predetermination process and learned to use photography as well as x-rays to simplify the approval process. We delighted when the plans down coded our procedures and realized it gave us the perfect chance to explain to patients Let’s start with the facts. There is no true dental “insurance” sold in this country that their plan paid for “cast crowns” meaning non-precious metals without with the exception of high-ranking military and political figures or top porcelain and amalgams with mercury instead of posterior composites. We executives of corporations. There are, however, many dental benefit plans sold emphasized that if we were a “preferred provider” or “in network,” that is that are called “insurance” by dentists and patients. Benefit plans are exactly the material the benefit plan covered. We explained that the materials were opposite from insurance in that they pay, after deductibles and co-payments, still adequate, but today, we had much improved ceramic and composite up to a defined yearly maximum. Insurance, whether for car, home or health, materials that were both much longer lasting and esthetic. We found patients pays after deductibles and co-payments without a set maximum in place understood since I was not under contract with their plan, I could use the very to compensate for the loss or the expense. This is important for dentists to best materials that also looked great and they could use understand so they can change their language because their benefits to offset the cost. We repeated the phrase patients equate their dental benefits with insurance “We are not on your list so we can be on your side.” This every day. Patients believe that they can, in the event "Let’s start with the resonated with our patients. of large dental expenses, receive more compensation facts. There is no true in services and reimbursements than they have paid It took time talking to each person, but I decided that in premiums. This is virtually impossible with the caps dental “insurance” was time well spent and allowed for it. I embraced and limitations in place. It is only common sense that sold in this country those conversations with a smile. I told patients we multi-millions of dollars in profits accrue to insurance were happy with any coverage their employer helped companies if they pay out less than they receive from with the exception of provide for them and that I would take responsibility for their insureds. Patients relate their dental plan to other high-ranking military documenting, filing and following up so they received true insurance contracts and it is a myth the sellers everything they were entitled to under their plan. I of these policies perpetuate or, at the minimum, do and political figures have patients remarking regularly they are glad I am nothing to dispel. Employers also present the plans to or top executives of independent of the contract, a phrase much better than their employees as dental “insurance.” “non-participating provider.” When patients expressed corporations." their frustrations to me, I advised them to be thankful Markco Vujicic, PhD, et.al. wrote in the Journal of they had help in paying some of their dental expenses. the American Dental Association that “The dramatic I emphasized that the employer likely paid part of the changes occurring in the health insurance landscape premium, the plans were much less expensive because they were in a group, provide a perfect opportunity to step back and reflect on the dental “insurance” and their payments came out of their check pre-tax, saving them at least landscape. I use quotation marks deliberately as both a health economist and a 30% in the process. I encouraged them to sign up for the best coverage they patient. I can safely say that dental insurance in its most typical form does not could afford. I also explained that these plans are negotiated on a yearly basis, meet the definition of insurance in any way. Technically, dental insurance is meaning the employer can switch carriers annually. Further, the employee really a benefit, but everybody calls it “insurance.” (3) might lose or change their job at any time and therefore everyone else viewed their plan only on an annual basis. On the contrary, I view my patients from a ADA Current Policy states that: lifetime perspective and only recommend the best care that lasts the longest, exactly what I would want for myself. I invite them to “manage” their own care "The design of dental benefits plans differs from that of medical plans: with advice from me, as I will act as a professional operating in their interest and with their approval.

-Dental disease does not heal without therapeutic intervention, so

early treatment is the most efficient and least costly.

Most importantly, I use analogies and rationales that make sense to every patient. I ask them if their car insurance paid for car washes and oil changes at -The need for dental care is universal and ongoing, rather than

100%, tires and batteries at 80% but crashes and injuries payments are capped episodic. at $1,000, do they have car insurance? If they have a heart attack and receive $1000 of emergency and cardiac care, do they have health insurance? I help -The need for dental care is highly predictable and does not have the

them understand that delaying care or using inferior materials lowers the characteristics of an insurable risk. price but becomes more costly if the delay results in more complicated work or replacement sooner by using inferior materials.

-The dental needs of individuals in an insured group vary considerably.

I think there is a better way and a path forward for dentists to find peace and prosperity while delivering the superior care we were trained to provide and our patients want, expect and deserve. It begins with communicating positively and truthfully about dental benefits.

-Patient cooperation and post-treatment maintenance is critical to the success of dental treatment and the prevention of subsequent disease.”(4)

In fact, if one looks closely at the claim forms and policy manuals, one will see the language has been changed to dental benefits. An EOB is just that, an explanation of benefits! Why do we persist in using the term dental “insurance”?

Ask yourself “How can I communicate this positively” to my team and patients?

I began in 2002 to eliminate the phrase “insurance” in my practice by educating my employees on the truth about these plans. They immediately understood it but that is only a fraction of the task. Next, all of us had to eliminate ALL

By being independent of the contract, I can refuse to use bonded ceramic crowns when the plans pay for “cast metal crowns” or composites when the plans pay for amalgams. If a restaurant owner issues a coupon for a free “beef” dinner will it be hamburger or a filet? To that end, I am committed to educating my patients on the differences in materials defined as restorations and to never provide a filet while receiving reimbursement for a hamburger!

As for patients looking for individual plans outside of an employer sponsored plan, I advised them to ask themselves if they thought any company would sell anyone a plan that would lose money in any circumstance for the insurer? I explained that individual plans were sold with waiting periods and limitations that were designed to “insure” the carrier could not lose money even if the patient used the yearly maximum. I reminded them the premiums were paid

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(Continued from page 13) in after tax dollars and encouraged them to phase their treatment with us and use third party financing for larger balances. Some understood but others left and tried those plans and many have returned after seeing for themselves the losing proposition financially they offered.

We as a team spent a lot of time learning how to answer the phone call that begins with “Is Dr. Freano in our network?” We realized that the true reason that patient called was that they had heard something really good about me and wanted to know if they could use their benefits with me. We invested one hour per week for all employees to go through the “GREAT Call Process” TM (5) learning to greet, build rapport, engage, ask and thank when handling all phone calls. We asked the patients to come for the initial exam, a 1.5-hour complete exam without hygiene, and accepted any constraints their plan placed on the fees for the first visit. My team emphasized that once the patient came into the practice and experienced our care and thoroughness, they would see we would live up to the reputation that stimulated their inquiry. We understood that offering a fee reduction on the front end on a onetime basis was much better than a steep discount for every service every day.

I invested heavily in my website(6), taping video testimonials of patients and videos of myself explaining all our processes. I asked our patients to write reviews and made sure we all lived up to them.

As a result, my practice is independent and fee for service with just over 65% of my patients with some form of dental benefits. We are not frustrated and angry, we are happy and delighted to help those that seek our care. My area in Lexington, KY is saturated with dentists. The University of Kentucky is graduating dentists regularly and the faculty practice is undercutting everyone’s fees because of an estimated two million dollars in subsidies provided by the University to their clinic.(7) My practice still continues to grow and it is a Win/Win for all involved.

I am convinced it is up to us to define ourselves! We know who we are as a profession. We are indispensable in society and, in my experience, the very best of the best in trying to help our patients through the difficult process of receiving dental care. We are highly skilled and trained, doing what few others want or are able to do for a career. We help people, including teaching people how to be healthy both individually with hygiene instructions and collectively with public health measures such as fluoridated water. We provide well-paying jobs with benefits for our employees. We must know, however, who we are as individuals and be willing to continue to deliver the best care to every patient in whatever situation they present themselves.

About the Author Doyle Freano, Jr., DMD is an associate faculty member of The Dawson Academy since 2004 and former president of the Alumni Association. Dr. Freano practices as a full-time dentist in Lexington, KY. He speaks nationwide about how to communicate effectively to patients about the true nature of dental benefits and how to position your practice positively whether you are an “in or out of network dentist.” Dr. Freano is a member in the American Dental Association, Kentucky Dental Association, and the Bluegrass Dental Society.

Footnotes: (1) Dental Clinics of North America October 1981 Volume 25-Number 4 “Third Party Dentistry” author Duane A. Schmidt DDS (2) 2017 Annual Report National Association of Dental Plans https://www.nadp.org/ docs/default-source/default-document-library/annual-report-2018_ web.pdf? sfvrsn= (3) Marko Vujicic PhD. et.al “Health Policy Perspectives Why we need more data on the dental insurance market” Journal of the American Dental Association 149(1) January 2018 https://jada.ada.org /article/S0002-8177(17)31067-X/pdf (4) ADA Current Policies Revised 2017 https://www.ada.org/~/media/ADA/ Member%20Center/Members/ar_2017.pdf?la=en (5) All Star Dental Academy TM allstardentalacademy.com (6) Complete Dentistry For All Ages dfreano.com (7) Lexington (Ky) Herald-Leader, March 7, 2019 “Ousted Dean Files Whistleblower Lawsuit”

NATIONAL SPEAKERS AGD CERP CREDITS GREAT LECTURES

NEW SCHEDULE COMING IN EARLY 2020 VISIT: DISC.EVENTS FOR REGISTRATION DETAILS

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Protect your practice.

Call the Trust today.

There are a lot of differences between being a Member of the Trust and just another policy number at a large, commercial carrier. Both give you a policy the Practice Law requires, but that’s where the similarity ends.

New and Established Dentists Not Currently Trust Members:

$0.00 First Year* *some restrictions apply; subject to underwriting approval.

Convert Now!

Who do I talk to when I have a patient event, claim or question?

The Trust: Local dentists who understand your practice, your business and your needs.

Them: Claims call center (likely in another state).

Besides a policy, what do I get when I buy coverage?

The Trust: Personal risk mitigation training, educational programs and an on-call team that “speak dentist.”

Them: Online support.

Do I have personal input and access to the company?

The Trust: Yes. You are represented by dentists from your CDA Component Society giving you direct, personal access to the Trust.

Them: Yes, via their national board.

How much surplus has been returned to dentists in Colorado?

The Trust: Over $2.2M has been distributed back to Colorado dentists as a “return of surplus” (after all, it’s your Trust, your money).

Them: $0 How long has the company been serving Colorado dentists?

The Trust: We were Established by dentists in 1987.

Them: It’s hard to say... they tend to come and go.

Dr. H. Candace DeLapp · 303-357-2600 www.tdplt.com

RMDC SPEAKER

IS YOUR G O O G L E MY BUSINESS PROFILE WORKING

FOR YOU

By Patrick Chavoustie

W

hen you type the name of your practice into Google’s search engine, what shows up? Most likely, the information includes the name of your practice, photos, hours, etc. But who decides what this online presence looks like? Thanks to Google My Business, that can be you! Google My Business (GMB) is a free, easy-to-use profile that Google launched in 2014 to help businesses and organizations like yours connect with local consumers across Google Search and Maps. Your GMB profile compliments your website to make sure your audience has instantaneous information about your practice, enticing them to contact you while improving your local exposure. As GMB continues to evolve into an all-inclusive platform that over 95 million consumers are utilizing daily, it’s crucial that your profile is optimized to achieve digital marketing success on Google - a search engine with over 90% of the world’s search engine market share. (GlobalStats)

5 Actions you should take to optimize your Google My Business Profile Claim it

claim it. The easiest way to tell if you have an existing profile is to visit https:// business.google.com/add. Enter the name and address of your practice and then select from the search results. If you have an existing profile, Google will notify you that “This listing has already been claimed.” If this is the case, you should request access and fill out the appropriate forms.

Verify your business

After you’ve created or claimed your GMB listing, the next step is to verify your account. There are nine ways to verify your listing, but the most common options include phone, email or postcard. According to Google, verified businesses are twice as likely to be considered reputable by users. Verification also intercepts anyone that may pose a threat to your practice with the intent to make unauthorized changes or claims to your profile. This step is extremely crucial for the protection of your business, but more importantly, for controlling your business and brand information. Before Google verifies your physical location, you cannot manage your photos, Insights, posts, customer reviews, FAQs, etc.; signals that make up 25% of all ranking factors for the Local Pack. =

Add content

The first step in optimizing your GMB profile is to claim it! Create an account Because GMB signals are a fundamental strategy in getting ranked on Google, and claim your business! A 2019 report by BrandMuscle found that only 61% it’s important to include as much information as you can within your listing. of businesses have claimed their business listing. Assuming that statistic is You can list and describe every service and treatment you offer, service areas, correct, by simply. creating an account, you’re already one step ahead of 39% hours, URLs and a bio about your practice. Doing so builds the credibility of your competitors Simply sign in to https://www.google.com/business/ using of your profiles to Google and your patients. The more relevant content you a generic company email (PracticeName@Gmail.com). The email you use to provide, the more likely Google is to put your listing in front of those practices create your listing will be considered the Owner of the business, so make sure around you. Investing in creating great content will pay for itself time and time you always know the login information. If you have an established practice or again. Keep in mind that whatever you post will be seen by anyone searching, have taken over someone else’s practice that has been around for several years, so make sure it's clear, consistent and correct.

By Solution Reach there’s a good chance your profile has already been created and you just need to

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OR AGAINST YOU?

Include pictures and Videos

We encourage dental practices to "Your GMB profile "Happy employees invest in high quality, professional compliments your photography and videos because are 85 percent more website to make businesses with photos see 35% more efficient, clicks through to their website. Excellent sure yourexperience audience images (no stock photos) of the dentists a 60 percent drop has instantaneous and the staff can resonate with patients in absenteeism and information about before they even step foot in your office. stay practice, twice as long in Your GMB listing is a great way to your enticing showcase these photos and highlight the their as theiryou less themjobs to contact personality of your brand to the 60% of happy colleagues" consumers that say local search results while improving your with great images capture their attention local exposure." and are more likely to encourage their decision. GMB even offers you the option to categorize your photos to make it easier to identify your team, customer photos and the interior and exterior of your practice. If you don’t have an extensive gallery of photos, focus your efforts on your cover and logo, as these will be the first two things clients see when searching for your practice. Often, the other photo displayed is a 360° street view of your practice. This feature offers an immersive experience that encourages more customer engagement - which is always a plus in today’s competitive online market. If you’re not interested in taking these 360° photos yourself, you can select a Google Trusted Photographer from https://www.google.com/streetview/contacts-tools/.

Encourage reviews

You only have one chance to make a great first impression! Make that happen long before a patient visits your practice for the first time. According to

BrightLocal, 92% of new patients read online reviews before choosing a dentist, making Reviews a top priority when optimizing your GMB listing. You can be the best dentist in the country, but your skillset can’t compete with the value of a 5 Star review. Use your listing as an opportunity to engage with your customer base by responding to their reviews if they are good and especially if they are bad. Show your appreciation for their business and acknowledge their critiques in a way that entices them to come back to see you. If you’re concerned about the number of reviews you’ve been able to acquire, try linking external review platforms like Facebook or reputation management tools. Star ratings are a quick, visual indication of the trustworthiness of your practice, so shamelessly promote yourself in this area by asking for reviews whenever you see a client.

After you complete these steps, Google your practice for a second time. What do you and your clients see now? After applying these tips, your listing will be a direct reflection of you and your practice, and you’ll see a noticeable difference in the amount of traffic Google funnels your way.

About the Author Patrick Chavoustie runs the daily operations as the CEO of BSN Enterprises, LLC and Omni Premier Marketing. His extensive background in Medical and Dental Marketing and Business Development, alongside his leadership style, positioned him for this role. Omni Premier Marketing has expanded from working exclusively with plastic surgeons to working with multiple medical practices and developing the premier dental website design and marketing solutions under his direction. When not assisting clients or teammates, Patrick is active with multiple non-profits in the community; helping others and giving back is very important and something he encourages employees to do.

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RMDC SPEAKER

LEARNING TO EMBRACE THE GENERATIONAL FRICTION FACTOR 1818

By Lisa Copeland, RDH

L

The right question to consider is, “How do we best appeal ast spring, I decided to plant "Each category has to each generation and appreciate them in their preferred a garden. Having grown up language?” First, we need know the various generations in the Northeast region of a unique potential to of the company. The Traditionalists and the Baby Boomers the US, with a father who is a contribute to company include our more senior employees. Generation X are now Pennsylvania Dutch farmer, I growth IF we speak taking on management roles in middle age and Y and Z was accustom to homegrown compile the younger team members. Each category has a delicacies year-round! I now live in the generational unique potential to contribute to company growth IF we in the Northwest region, where rain is abundant and language that best speak in the generational language that best appeals to sunshine scarce…farming would be challenging. appeals to them." them.

Before starting, I researched the planting zones and visited a local nursery to chat with the experts. After Let’s say you are a Baby Boomer Director of Sales, about purchasing the seeds most likely to thrive and the to provide feedback to a Generation Y, Professional Sales Representative. proper fertilizer and soil, I was ready to begin. Each morning started with Your interaction with him/her from a verbal, non-verbal and technological an evaluation for the need for watering, weeding and feeding to customize standpoint will influence their motivation and productivity. a plan accordingly. Within a month, my efforts were rewarded with a beautiful garden.

Take the Generational Challenge

The lessons learned were simple, but essential for success. Gardens need customized care based on the exposure to elements: weather, sun and soil.

If any of the essentials are missing, the garden will not thrive.

The same principles can be applied to our current work force environments.

In order for our teams to thrive, we must customize our generational language to create a harmonious team that is empowered to succeed.

A Generational Snapshot Looking at a generational snapshot in the USA, each generation has personalities influenced by multiple historic events.

• Traditionalists, 1927-1945: Great Depression, WWII • Baby Boomers, 1946-1964: Moon Walk, JFK / MLK Assassination, Vietnam War • Generation X, 1965-1977: Watergate, Oil Crisis, AIDS, Dot-Com, Gulf War • Generation Y, 1978-1999: Columbine, OK City Bomb, 911, Katrina • Generation Z, 2000-Present: Widespread terror alerts, Global unrest, Abundant global access to information

Generations are Colliding For the first time in history, we currently have four to five generations in the work force at the same time and the Friction Factor is real. Companies, large and small, are experiencing dissatisfied employees and high turnover rates. A recent study by Accenture reports the top four reasons people leave a job are: lack of recognition/appreciation, internal politics, lack of empowerment and they don’t like their boss. Most of the reasons that employees quit are under the control of the employer. From a generational perspective, we can customize our language and interaction with each group to support their needs and create a meaningful environment for all.

Below are six examples of how a company can more effectively communicate with varying generations.

1. Dress to meet the expectations of the oldest generation. Gen Y, if you have a meeting with a Baby Boomer: • Men - wear a button-down collared shirt, tie and jacket • Women - a conservative dress or dress shirt with a skirt or pants 2. Generation X prefer to maximize efficiency. Email and text are the preferred forms of communication.

3. The older the generation, the more they equate title with respect. Call each person by an appropriate title, “Mrs. Hall,” “Dr. Jones.”

4. When providing support information about your product, determine which type of resource speaks the right language. Tangible paper resources vs. technology. Traditionalists and Boomers are not as familiar/comfortable with technology as the younger generations. Choose accordingly.

5. Gen Y and Z are connected 24/7. Technology and flexibility are company cultures they seek.

6. Senior teammates build relationships first…business second. Follow up with a personal phone call vs. an email or text.

About the Author Lisa Copeland has spent 25 years sharing her expertise in diverse business cultures all over the world. Her unique experience as a competitive athlete allows her to share meaningful and memorable stories in her programs. In fact, her Ironman principles actually drive her lessons on the importance of communication and culture.

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FINANCIAL RMDC SPEAKER

YOU CAN’T RUN A PORTFOLIO LIKE A BUSINESS, PART 2 OF 2

By Scott Middleton, Principal, Director, Innovest Portfolio Solutions

T

he first of this two-part article examined the merits of businesses responding to buyers’ demands, while portfolio allocation decisions need to avoid chasing what is popular. Part two of this article examines the importance of identifying and utilizing the “right” people in business, while stubborn devotion to fund managers – through good times and bad – can be a secret to portfolio outperformance over time.

Human Capital

“Effective leadership is not about making speeches or being liked; leadership is defined by results not attributes.” —Peter Drucker (1909 – 2005) Considered a founding father of modern management theory, Peter Drucker spent his career studying the importance of human capital and challenging common thinking about how organizations should be run. He believed that organizations struggled because of outdated ideas, in-the-box problem solving and internal misunderstandings. His solution – and ensuing work with the heads of giants like General Motors, General Electric and IBM – stemmed from his conviction that people are an organization’s most valuable resource. Drucker’s work paved the way for today’s emphasis on the importance of leadership to companies’ outcomes.

Hiring and firing decisions have enormous opportunity costs for companies: resource drain, bruised employee morale, diminished productivity and, worst of all, unfulfilled potential and unrealized upside. A 2009 study by AIMM Consulting indicated that the cost of a mis-hire is 25-times base compensation for those earning less than $100,000 and 40-times base compensation for those earning between $100,000 and $250,000. Identifying

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and diminishing the impact of a noxious individual is important, but what differentiates the good from the great in business is the ability to get the right fit. The opportunity cost of a “do no evil” leader can be the difference between “cutting edge” and “run-of-the-mill.”

Take the case of Walt Disney Company. In 2005, Bob Iger replaced Michael Eisner as CEO of the production powerhouse. Nothing catastrophic happened under Eisner’s 20-year command. In fact, the company did well under his leadership: Disney acquired Miramax Films and many animated hits were released, including Aladdin, Toy Story and Monsters, Inc. The stock price grew substantially, though it largely tracked the growth of the S&P 500. However, by the end of Eisner’s regime, Disney was becoming eclipsed

by Pixar and shareholders feared the company was living off past successes.

Eisner was no longer the right fit for Disney and the opportunity cost of his “do no evil” approach was endangering the long-term success of the company.

Within Iger’s first year, he led Disney to acquire Pixar, which paved the way for later acquisitions of Marvel Entertainment in 2009 and Lucasfilm in 2012. These tactical acquisitions helped solidify Disney’s relevance amongst 21st century producers and realize the potential of the brand that Eisner was unable to tap. Shareholders have been rewarded under Iger’s leadership: the stock price more than quadrupled in value in little more than 10 years and vastly outperformed the S&P 500.

Manager Selection and Buffett’s “Fourth Law of Motion” In his 2005 letter to shareholders of Berkshire Hathaway, Warren Buffett added a fourth law to Sir Isaac Newton’s famed three laws of motion: “For investors as a whole, returns decrease as motion increases." With so much focus on finding the right fit in business leadership, the typical behavior with firing or

hiring investment managers is to fire underperformers once patience has run out. Investor impatience during periods of underperformance violates the principle “buy low, sell high.”

A study published in The Journal of Finance in August 2008, “The Selection and Termination of Investment Management Firms by Plan Sponsors,” surveyed the manager hiring and firing decision of more than 3,000 plan sponsors with hundreds of billions in assets under management over an eight-year period. When making fund manager changes, the newly hired managers had notably better performance track-records than the fired managers over the preceding one-, two-, and three-year time periods. However, these newly hired managers underperformed the fired firms over the one-, two-, and three-year periods following a change.

Impatience-induced manager churn can lead to significant underperformance over time.

"Part two of this article examines the importance of identifying and utilizing the “right” people in business, while stubborn devotion to fund managers – through good times and bad – can be a secret to portfolio outperformance over time."

Even the best funds inevitably spend some time out of favor. One notable example is Dodge & Cox Stock Fund. The highly respected large cap value fund, on top of underperforming in 2005 and 2006, lagged its peer group and the S&P 500 Value Index by more than 4% from November 2007 to 2008, losing 46.33%. For the three-year period of 2006 to 2008, the fund underperformed its benchmark by more than three percent annualized, ending in the 96th percentile (the bottom four percent) of its peer group.

Innovest noted that Dodge & Cox Stock Fund’s managers, philosophy and process remained unchanged during its period of underperformance. The recommendation was to stay the course with the fund, which was especially frustrating for clients who were already spooked by the bear market and were hungry for action. However, patience yielded excellent results for investors in 2009 when the fund returned to the top-quartile relative to peers and outperformed the S&P 500 Value Index by more than 10%. As of the end of 2016, the fund was in the top decile of large value managers for the trailing three, five and seven years.

Particularly over the short term, unexpected market events can waylay even the highest quality portfolios. Economic cycles can favor certain companies over others and sometimes a company’s thesis can take more time to materialize than anticipated. In investing as in life, bad things can happen to good managers.

Like a Bridge Over Troubled Waters: Rules to Avoid the Fourth Law of Motion Good advisors and successful investors use three proven strategies to avoid the trap of impatience-induced underperformance: 1) Remember that performance does not exist in a vacuum.

Do not focus primarily on performance when deciding whether to hire or fire a manager. Instead, center primarily on qualitative catalysts, such as the organization, people, philosophy, investment process, style consistency and asset base of a fund. If one or more of these factors has begun to deteriorate (in addition to, or even in isolation from performance concerns), find out why and decide if a change is warranted.

2) Distinguish characteristic performance from uncharacteristic performance, positive or negative.

Understand the nuances of manager processes: their biases and which market conditions should support, vs. harm, their approach. Investors pay managers to stick to their style in good times and in bad. Uncharacteristic performance can indicate a change in process, which might merit a switch.

3) Don’t live and die by comparison metrics. Relative performance versus an index or peer percentile reporting can exacerbate investor impatience.

Peer metrics are important for accountability and transparency, but they also frequently initiate a return-chasing mentality in investors whose funds didn’t place at the top of the pack. Rather, maintain focus on longer-term rankings and performance consistency.

Successful businesses are set apart from their competitors by the drive to respond quickly to consumer demand and the “quest for best” in executive staff. However, successful portfolio management requires a different, and somewhat counterintuitive, approach. This two-part article has focused on the skills necessary to avoid chasing consumer demand in asset allocation decisions and avoid chasing performance in manager hiring and firing decisions. In investing, acting on regret is usually an exercise that leads to poor results. Instead, a forward-looking view and patience are essential.

About the Author For more than 20 years, Innovest has provided excellent client service as well as forward-looking, innovative investment solutions for endowments and foundations, retirement plans and families. We are an independent provider of investment-related consulting services and work on a fee-only basis.

REGISTER TODAY JANUARY 23-25, 2020

rmdconline.com

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RMDC SPEAKER RMDC SPEAKER

THE MOST IMPORTANT REASON TO KEEP THE SCHEDULE RUNNING SMOOTHLY

By Laura Hatch

T

he difference between a good day and a bad day in

impact on the team is that it truly affects everyone. I’m not just talking about

most dental offices is dependent on how the schedule

mood, but also how each person gets their job done and whether the team

runs. In fact, the schedule impacts the day from

gets to go to lunch on time—or, some days, if they get lunch at all.

the very first moment it begins, when you hear the messages and there are cancellations or when the

Running behind in any area of the practice may not always be directly related

phone starts to ring and the patient on the other end says

to the details of one person’s job, yet a delay in the schedule typically adds

they are running late. From the start, no matter how great of a mood the

stress and chaos to the entire office. Again, it can make for a great day, when

doctor and team were experiencing when they walked into the office, it’s

it runs the way it should (which unfortunately is not very often), or it can be

likely to change very quickly as the schedule changes. In fact, I know many

the cause for a not-so-great day, which is more typical than not.

dentists who say their mood at the end of the day is a direct result of how the day ran. Was it productive? How stressful was it? Did the patients and

Most of what I’ve stated so far is a topic of agreement among most dental

procedures run on time? The tyranny of the schedule is a fact of life in most

professionals. We all know that the schedule runs the office, whether that

dental offices.

means it lets us cross the finish line with a triumph for the day or it runs us all ragged trying to make up for delays. But we often overlook the impact of

How can a piece of paper (or these days, a chart on your computer screen) hold such power over the dental team? The reason the schedule has such an

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22 4th 2ndQuarter Quarter2019 2019 mddsdentist.com mddsdentist.com

schedule changes on the most important people in the office: our patients.

This might seem obvious, but I am going to challenge all of us to consider

Having a well-run schedule is important in terms of an office running smoothly

exactly how much the schedule impacts customer service and our long-term

and hopefully being productive, but there are other benefits too. The two that

relationship with a specific patient, as well as their decision to refer friends and

stand out most for me are the well-being of our team members and the impression

family to us... or not. Think about it. The patient schedules time in their day to

that we make on our patients. In fact, those two elements are strongly

come to our office and typically that means taking away from their own work

connected to each other. You will have a happier, less stressed, more productive

or other responsibilities to take care of their dental health. They are told they

team that enjoys going to work if they know they are walking in each day to

can expect to be in the office for a certain amount of time. What if that doesn’t

an office that has control over their day. They know that issues will arise but

match what actually happens?

there is a plan in place for how to handle those issues. The culture of the office will be less stressful and more fun, which will not only benefit your employees but ultimately your patients, as they sense the quality of the

I could tell dozens of true stories about how the reality was much different from what the patient was told. What if we ask them to show up on time for their appointment, but we are not running on time and they have to wait 20 minutes before they are even taken back to a chair? What about when we tell the patient that a “brief” appointment will only take 30 minutes, but they arrive when the team is still running around trying to get everyone seen and the patient ends up being there 90 minutes? What kind of day do you think this creates for the patient? And more specifically for our team and our office long-term? How do you suppose the patient will feel about their experience? What do you think they will

"Running behind in any area of the practice may not always be directly related to the details of one person’s job, yet a delay in the schedule typically adds stress and chaos to the entire office."

say to others about it? “Sure, Dr. Jones is great and the team members are all really friendly, but they always seem to be running behind and

environment when they are in the office. They can tell when your team is enjoying work or when they are not, no matter how much your team and doctor may try to hide it.

Aside from being more likely to return to an office that feels fun and relaxing, it’s important for patients to feel that their time is respected and valued. Patients take time out of their day to come to the office for an agreed-upon amount of time, and when the office can get them in and out on time, they appreciate it and have a better experience. Remember, patients don’t know how to judge an office on clinical skill, but they absolutely know how they feel when they are in the

office and they will tell others about it—bad or good.

my appointments take too long. Maybe they are too overwhelmed to handle any new referrals. You and I should both try that new dentist down the street

What I want to leave you with is that when you hear over and over again

instead.”

about the importance of having a well-run schedule, it is not necessarily only about numbers and production. Of course, high production is one of the best outcomes that can come from having a great scheduling policy and system.

Ultimately, however, keeping the schedule running smoothly is about creating an environment where everyone will feel they are under control and being taken care of, including the entire dental team and the patients. Stress levels will go down and the experience for everyone will improve. Every dental office will continue to have issues each day that may mess up their schedule, but an office with a strong scheduling policy and plan is one that will know exactly what to do to get back on track, so you can finish the day on time and feeling good. And who wouldn’t want that?

About the Author Laura Hatch is known worldwide as the Leader in Dental Front Office Solutions and Training. A keynote speaker, author and coach, Laura is best known as the founder of Front Office Rocks™, a virtual training platform for dental teams. Front Office Rocks™ offers virtual training in all areas of the dental office and teaches exceptional customer service.

Using non-traditional methods, Laura loves to help dental teams learn the systems and methods to achieve unprecedented results. She has become a mentor to the dental industry. She created the Front Office Rocks™ training program to help take dentists and their teams to the next level.

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NON PROFIT NEWS

Thank You to all the practices that participated in the 2019 Freedom Day USA! Freedom Day Participants Appletree Dental North Belmar Park Dental Care Colorado Regional Oral Surgery – Arvada

Colorado Regional Oral Surgery - Lakewood Denver Dental Implants EC Family and Cosmetic Dentistry Eric W. Van Zytveld, DDS

Hill View Dental Northstar Dental Perfect Teeth West Ranch Dental Center Wynkoop Dental

Visit freedomdayusa.org to learn more about the largest nationwide military appreciation event.

“Because of DLN dentists, veterans like me are getting the dental services we need.”

Will you see ONE to CHANGE a life?

WillYouSeeONE.org

You can change a life

From clearing up painful dental infections and being able to eat again to rejoining the workforce – volunteering with

24

Dental Lifeline Network’s Donated Dental Services program will make a life-changing difference for the people we serve.

Let’s collaborate!

Improve your patient care without adding overhead expense – by partnering with DenteVita and the Practice of Dr. Aldo Leopardi, Prosthodontist. You can trust that you’ll receive the impeccable service you would expect from a seasoned specialist like Dr. Leopardi.

Our goal at DenteVita is to do everything possible to build your confidence and exceed your expectations.

Consider Dr. Leopardi’s expertise as an extension of your professional practice. The level of experience and precision that his Practice offers makes it easy for you to refer your patients with complete confidence.

Call our office at

About Dr. Aldo Leopardi Dr. Leopardi is the founder of DenteVita Prosthodontics. His focus is to provide functionally driven aesthetic solutions to patients requiring tooth borne fixed, removable, aesthetic and implant supported dentistry. With over 30 years of experience, from single tooth to complete rehabilitation, you can be assured that your patients are in the care of a skilled professional.

7400 East Crestline Circle, Suite 235 Greenwood Village, Colorado 80111 P. 720.488.7677 F. 720.488.7717 Visit our website: www.dentevita.com

720.488.7677 to speak to Dr. Leopardi and find out how we can build a successful partnership.

Don’t forget to ask about our referral packet!

Life

is better with DenteVita

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TRIPARTITE NEWS

TWO BENEFITS YOU CAN’T AFFORD TO OVERLOOK

By Greg Hill, JD, CAE, CDA Executive Director

F

inding quality, affordable healthcare and saving

on tdsc.com will vary on a product-by-product basis).

on dental supplies just became a bit easier for Colorado Dental Association member dentists,

thanks to two new product launches.

TDSC is a dentist-led organization built to provide stable competitive pricing on dental supplies only to members of organized dentistry regardless of practice size. TDSC’s collective purchasing power results in

Health Insurance

significant savings on dental supplies that can be reinvested back into the

On Oct. 1, the CDA Health Plan became available to members as well

practice and patient care.

as their families and staff. The National General Solutions Self-Funded Program, brokered by COPIC Financial Service Group, gives dental practices cost savings and flexibility, while providing quality health benefits.

The CDA Health Plan provides benefits usually only available to large employers, like plan administration and account management, one predicable monthly payment and quality benefits that meet the minimal essential coverages of the Affordable Care Act. As a CDA member, you receive a 10% discount on the plan.

Plans are offered on a group basis with a minimum of two enrolled employees and there are multiple plans to choose. Plans are “level funded,” meaning groups will have the opportunity to share in the

In just a few short months, over 100 CDA members

"The CDA Health Plan provides benefits usually only available to large employers, like plan administration and account management, one predicable monthly payment and quality benefits that meet the minimal essential coverages of the Affordable Care Act."

have purchased supplies through the TDSC website.

Collectively, they have saved nearly $70,000.

Visit tdsc.com/colorado to learn more and compare prices on the products you buy.

Both member benefit launches were the result of countless hours of research, conversations with members and discussions with the companies themselves to ensure that CDA member dentists had opportunities and pricing only available through membership. That’s the exclusive value you deserve from your professional association and we are proud and excited to offer these programs to you.

surplus at the end of the year should their claims run well. There are two nationwide networks to choose from: Aetna and

About the Author

Cigna, giving you access to a large national network of providers. We are

Greg Hill, JD, CAE has served as the Executive Director of the

also excited that CDA members will have access to two dedicated support

Colorado Dental Association since June of 2014. Prior to joining the

service teams through COPIC and National General.

CDA, Greg was employed by the Kansas Dental Association for 15 years and served as the Assistant Executive Director of the CDA and

More information is available at cdaonline.org/cda-health-plan, or by

Executive Director of its Foundation. Mr. Hill is a 1999 graduate of

contacting (720) 858-6299 or healthplan@cdaonline.org.

the Washburn University School of Law in Topeka, KS and a 1994 graduate of Kansas State University with a Bachelor of Science in

Dental Supplies

Economics. He became a Certified Association Executive (CAE) in

Earlier this year, the CDA partnered with The Dentists Supply

2016. In addition, he serves as Co-Chair and Treasurer of Oral Health

Company (TDSC) to bring you access to big savings on dental

Colorado; on the Board of Directors for the Colorado Dental Lifeline

supplies. Through TDSC, CDA members receive consistent and

Network and the Colorado Mission of Mercy; and is a member of

competitive pricing, free shipping on every order, a user-friendly 24-7

the Denver Tech Center Rotary Club. He and his wife, Gwen, are the

online store and an average 20% savings compared to MSRP (price

parents of daughter, Haven, and son, Camden.

comparisons are made to the manufacturer’s list price; actual savings

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26 4th Quarter 2019 mddsdentist.com

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EVENT CALENDAR February 12 CPR & AED Training -American Workplace Safety Mountain West Dental Institute 925 Lincoln Street, Unit B, Denver, CO 80203 6:00pm – 9:00pm (303) 488-9700 February 13 New Member Welcome Event Location TBD 6:00pm – 8:00pm (303) 488-9700 February 29 A Partnership Approach to Patient Care -Ms. Jamie Marboe Mountain West Dental Institute 925 Lincoln Street, Unit B, Denver, CO 80203 8:00am – 11:00am (303) 488-9700 February 29 Return on Hygiene: Uncover Your Hidden Potential -Ms. Jamie Marboe Mountain West Dental Institute 925 Lincoln Street, Unit B, Denver, CO 80203 12:00pm – 3:00pm (303) 488-9700 March 6-7 HANDS-ON Advanced Implant Placement Grafting: A Two-Day Workshop Utilizing Cadaver Specimens -Dr. Charles Schlesinger Mountain West Dental Institute 925 Lincoln Street, Unit B, Denver, CO 80203 8:00am – 4:00pm both days (303) 488-9700

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28 4th Quarter 2019 mddsdentist.com

April 3 HANDS-ON The Chairside Assistant's Role with Dental Implants -Dr. Brian Butler and Dr. Dennis Waguespack Mountain West Dental Institute 925 Lincoln Street, Unit B, Denver, CO 80203 8:00am – 11:00am (303) 488-9700 April 14 CPR & AED Training -American Workplace Safety Mountain West Dental Institute 925 Lincoln Street, Unit B, Denver, CO 80203 6:00pm – 9:00p (303) 488-9700 April 17 Botulinum Toxin (Xeomin, Dysport, Botox) and Dermal Filler Training, Level I -American Academy of Facial Esthetics Mountain West Dental Institute 925 Lincoln Street, Unit B, Denver, CO 80203 8:00am – 5:00pm (303) 488-9700

April 24 HANDS-ON The A-Z Guide for Same-Day Restorations -Dr. Justin Chi Mountain West Dental Institute 925 Lincoln Street, Unit B, Denver, CO 80203 8:00am – 3:00pm (303) 488-9700 May 9 HIPAA Compliance, Data Breaches & Identity Theft -Dr. Pat Little Mountain West Dental Institute 925 Lincoln Street, Unit B, Denver, CO 80203 8:00am – 11:00am (303) 488-9700 May 9 A Secret Pay Raise: How Embezzlers Think and Act -Dr. Pat Little Mountain West Dental Institute 925 Lincoln Street, Unit B, Denver, CO 80203 12:00pm – 3:00pm (303) 488-9700

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Botulinum Toxin (Xeomin, Dysport, Botox) and Dermal Filler Training, Levels II & III -American Academy of Facial Esthetics Mountain West Dental Institute 925 Lincoln Street, Unit B, Denver, CO 80203 8:00am – 5:00pm (303) 488-9700

May 29 - 30 HANDS-ON Dental Laser Certification: Utilize Today’s Dental Lasers in Managing Periodontal/Soft Tissue Conditions -Dr. Sam Low Mountain West Dental Institute 925 Lincoln Street, Unit B, Denver, CO 80203 8:00am – 5:00pm Friday 8:00am – 12:00pm Saturday (303) 488-9700

April 18 Frontline TMJ and Orofacial Pain, Level I -American Academy of Facial Esthetics Mountain West Dental Institute 925 Lincoln Street, Unit B, Denver, CO 80203 8:00am – 12:00pm (303) 488-9700

June 19 Nitrous Oxide/Oxygen Administration Training -Dr. Jeffrey Young Mountain West Dental Institute 925 Lincoln Street, Unit B, Denver, CO 80203 8:00am – 4:00pm (303) 488-9700

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Technology available but not limited to: Dentrix software, Implant systems (Nobel// Biohorizons/Zest), Planmeca CBCT, Dexis IO Xrays, Soft-tissue laser, Pelton & Crane dental chairs, Kavo handpieces, Wave-One Endo system, Nitrous, large laboratory, etc. Our friendly, highly-trained team is always available to assist you with the daily operations. We treat our patients like family, and continually strive to offer the best dental care. Professionalism, integrity, and honesty are integral to our daily procedures. Please send resume and cover letter to ddstroy08@yahoo.com. Please see our website at: www. laramiedental.com. All inquiries kept confidential.

Real Estate Growth by Acquisition in Denver (CO 1911) Collections $100K, Sales price of $19,000.00 including accounts receivable & call forwarding of the practice. For more information please call 303.759.8425 or email frontdesk@adsprecise.com.

GP for sale in Central Denver (CO 1910) 6 OPS, 3,600 sq. ft., $1.1M collections, Dr retiring.

For more information, please call 303.759.8425 or email us at frontdesk@adsprecise.com Perio practice for Sale: Denver Metro area (CO 1909) Annual Revenues $500K, 3 Ops, 1,323 square feet; ADS Precise Consultants, www.adsprecise.com, email: frontdesk@ adsprecise.com, 303.759.8425.

GP for sale in Colorado Springs (CO 1904) 4 Fully Equipped Ops, $250K in collections, 2540 sq. ft., Dr Retiring. For more information please contact frontdesk@adsprecise.com or call 303.759.8425

GP for Sale: Southern Colorado (CO 1738) Dr. retiring, annual revenue $325K, 5 OPS. For information please call 303.759.8425 or email frontdesk@adsprecise.com GP in West Denver for sale with Building (CO 1706) Purchase Price $700K for practice + $1.28M for building, $810K collections, 5 OPS, 2,000 sqft office + 800 sq. ft. basement, Dr retiring. For more information, please call 303.759.8425 or email us at frontdesk@ adsprecise.com Endo for Sale in Southern Colorado (CO 1907) 5 DTR, $475K in collections, Dr Retiring.

For more information, please call 303.759.8425 or email frontdesk@adsprecise.com GP for sale in Denver (CO 1906) Beautiful 5 Op in Denver Metro, Dr moving out of the area. For information email: frontdesk@adsprecise.com or call 303-759-8425.

GP and free-standing Building (sold with practice) for Sale: West Colorado Springs (CO 1803) Dr retiring, annual revenue $275K, 5 OPS. For information please call 303.759.8425 or email frontdesk@adsprecise.com GP for Sale: North Eastern CO (CO 1735) 4 Ops, approx. 900K in collections, Standalone bldg. sold w/practice. Dr. retiring, 303-759-8425, www.adsprecise.com, frontdesk@ adsprecise.com OMS practice, western mountains near Vail and Aspen, (CO 1350) Annual Collections $840K, 3 ops, 1260 sq. ft. email: frontdesk@adsprecise.com, 303-759-8425.

Equipment Digital X-Ray for Sale: $21500.00; Dexis CariVU Like new digital x-ray sensor for sale please contact Dr. Wachuta if you have any questions or would like more information. timwachuta@comcast.net

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