Articulator Volume 21, Issue 4

ARTICULATOR MDDS

Connections for Metro Denver’s Dental Profession

2nd Quarter, 2017 Volume 22, Issue 3

SEPARATION

ANXIETY:

5 Tips for Balancing Work Life & Personal Life

pg.16

12

The Why, How and When of Practice Valuation

15

Grow Your Practice in 2017 From Within

B

Grow your dental practice and your world.

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©2017 Commerce Bancshares, Inc.

2nd quarter 2017

what's inside?

10

p. features

10 MDDS Wet Return to the Denver .

St. Patrick's Day Parade

12 The Why, How and When of Practice Valuation

15 Grow Your Practice in 2017

.

From Within

16 Separation Anxiety: 5 Tips for Balancing Work Life &

....

Personal Life

18 Spine and Shoulder Health .. for Dental Practitioners

20 Serving Up Smiles

Practice Management Issue pgs.12, 15, 16, 18, 28 Advertisers Directory ADA ada.org/findadentist.......................... 25

- A Delicious Evening

ADS Precise Consultants adsprecise.com................................. 31

28 The Three "R's" of Success

Berkley Risk Services of Colorado berkleyrisk.com................................. 21

departments

Carr Healthcare Realty carrhr.com........................... Back Cover Catalyst Retirement Advisors, LLC catalystretirement.com....................... 15

4 President's Letter

Commerce Bank commercebank.com/dentistry....Inside Front Cover

7 Member Matters

Copic Financial Services Group copicfsg.com..................................... 14

CTC Associates ctc-associates.com/............................ 29 Dentists Professional Liability Trust of Colorado tdplt.com.......................................... 26 Denver Implant Study Club https://disc.events/............................ 29 Healthcare Medical Waste Services, LLC hcmws.com......................................... 5 Northwest Mutual shawncopeland.nm.com...................... 5 SAS Transitions sastransitions.com............................. 21

8 Reflections 9 The Relentless Dentist 14 Nonprofit News 19 Peer Review Puzzler 22 Clinical 24 Point/Counterpoint 27 In Memoriam 30 Event Calendar 31 Classifieds

Guest Editor Allen Vean, DMD Creative Manager & Managing Editor CT Nelson Director of Marketing & Communications Cara Stan MDDS Executive Committee President Sheldon Newman, DDS President-Elect Nicholas Chiovitti, DDS Treasurer Brian Gurinsky, DDS Secretary Nelle Barr, DMD

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 Printing Denver, CO 80203 Dilley Printing Phone: (303) 488-9700 Fax: (303) 488-0177 The Articulator is published bi-monthly by the Metropolitan Denver Dental Society and distributed to MDDS members as a direct benefit of membership. mddsdentist.com Š2017 Metropolitan Denver Dental Society Executive Director Elizabeth Price, MBA, CDE, CAE

Member Publication

3

PRESIDENT'S LETTER

By Sheldon Newman, DDS

It has Been an Honor and a Privilege

A

s I approach the end of my term as

Applied Strategic Plan. We established a new ASP this May to adjust to

President of MDDS, I look back upon

the changing times.

a decade of service as a member of the Board of Directors of this organization.

Plans to expand MWDI include increased offerings and rentals for dental

We have accomplished a lot during that

education. We are investigating the possibility of online streaming of

time, but as Bob Dylan sang, “the times they are a-changin’.”

courses from our facility.

MDDS has the primary mission to serve you, its members. In doing so

MDDS will continue to offer outstanding programming at RMDC. There

we have become one of the leading component societies in the American

are also plans for making a more dynamic and exciting experience in the

Dental Association.

expo hall. It has been redesigned for 2018, and we will continue to look for ways to offer additional technological enhancements.

For years, the Rocky Mountain Dental Convention has hired internationally recognized speakers to discuss all aspects of dentistry. Our Convention is something that all members should take great pride in. The exhibitors and sponsors of RMDC have enjoyed their relationships with MDDS, bringing their products and services into a hands-on experience on the exhibit floor. We honor them as they support our members’ premier continuing education programming.

The leaders and staff of MDDS have also created

The world of communication continues to have major

"You should take great pride in what your local Society has accomplished over the last decade, delivering the services that members want and need."

a world-class continuing education center, the

tectonic shifts in media and methods. MDDS is searching new technologies for enhanced digital communication and navigation through online and mobile applications.

These technologies will enhance your experience with MDDS and your colleagues.

To continue our organization’s growth, we especially encourage our younger members to become active.

To that end, we have increased our recruiting efforts of recent graduates by showing them how organized dentistry can be so advantageous to their careers. As we

Mountain West Dental Institute; unique to a component dental society.

all know, those first years out of school are a busy time trying to grow a

The MWDI has become successful in achieving the mission of offering

practice but that is also why they are precisely the time to be involved.

dental lecture, hands-on and clinical programs. Other institutes have

Beyond new dentists, we also ask our current members to engage more

seen the value of this outstanding venue and rent the facility to expand

in the organization. Take advantage of the opportunities we offer and

their own continuing education opportunities.

help us improve our services. It is critical that you not only let us know what you want from your Society, but become active members and

MDDS has maintained communication media with the Byte Register

partners in planning the future. It is MDDS’ mission to foster your

weekly e-newsletter and award-winning magazine, The Articulator.

engagement in this Society. No matter the model of your practice, we ask for your help in identifying the services we can provide to help you grow

You should take great pride in what your local Society has accomplished

professionally, especially early in your career.

over the last decade, delivering the services that members want and need. Most recently, we have created an online Career Center that will

It has been an honor and a privilege to serve you as a Board Member

allow you post jobs and staff to post resumes. Check it out at careers.

and Officer over the past decade. It sure has been exciting! As I step

mddsdentist.com.

down from the Presidency, I will not “go gently into that good night” as Dylan Thomas did. I intend to continue serving on committees. I ask

Current volunteer leaders of MDDS, along with Executive Director

you to join me in this to continue making MDDS a dynamic, vibrant and

Elizabeth Price, recognize that “you better start swimmin’ or you’ll

supportive Society for you and the profession.

sink like a stone,” another anecdote of Bob Dylan’s. Within two short years we accomplished almost all of the objectives set in our last 3-year

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2nd Quarter 2017 mddsdentist.com

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Fri., October 27 & Sat., October 28 8:00am - 5:00pm

ADVANCED GRAFTING AND IMPLANTOLOGY UTILIZING A CADAVER SPECIMEN Presented by Dr. Charles Schlesinger Held in partnership with

Register Online Today mddsdentist.com

MDDS

CAREER CENTER

Check out the newest member benefit at careers.mddsdentist.com

Find Qualified Practice Help Search Resumes Browse Open Positions Resume Tips and Interview Advice

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2nd Quarter 2017 mddsdentist.com

MEMBER MATTERS

MDDS/CDA New Dentist Committee Snowshoe Event– 3-19-17

New Members, Welcome!

Dr. Isaac Alldredge Dr. Zaid Al Salman Dr. Scott Arceneaux Dr. Neesha Bir Dr. Tonni Faber Dr. Justin Farmer Dr. Brandt Finney

MDDS and the CDA New Dentist Committee hosted a snowshoe hike at Echo Lake Trail near Mt. Evans.

Dr. Brett Kessler lead the group to scenic overlooks and members enjoyed networking and lunch afterwards.

Dr. Lei Fu Dr. Spence Gibbs

New Member Welcome Event McLoughlin's – 4-6-17

Dr. Christopher Gillette Dr. Elizabeth Huggins Dr. Michelle Kohler Dr. Amanda McCabe Dr. David Pelster Dr. Isaac Quintanar Dr. Amy Roberts MDDS members mingled during the New Member Welcome Event at McLoughlin's Restaurant & Bar.

Dr. Amy Rosinsky

Drs. Weissend, Baltz and Goergen network with event sponsor Tax Savings Professionals.

Dr. Chad Smith

CU Dental School Leadership Symposium – 5-3-17

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spring 2016 mddsdentist.com Fourth-year dental students and 2nd-year international students attended a pregraduation leadership symposium at the Mountain West Dental Institute.

MDDS Member Service Committee Chair, Dr. Ian Paisley, spoke to students on how organized dentistry has helped him grow in his career and served as a resource after graduation.

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7

REFLECTIONS

The Changing Landscape of Dentistry

By Allen Vean, DMD

N

Let me give you an example of the opposite side of the spectrum. I recently othing is more frustrating than to contact one of shopped at an office supply store near my practice. As I proceeded to the your vendors or service providers, be put on hold register with my items, the employee asked if I had a rewards account to which for what seems to be an infinite amount of time, I answered, “affirmative.” However, my phone number push more than five options, had changed. I gave him the old phone number and the all to leave a message that is "As we all know, account was accessed. I then gave him the new number to not returned. How about an e-mail that put into the account. His response was that he could not gets lost in cyberspace or a text that is our profession is not do this and I had to complete it online. Are you kidding never received? I am sure most of us are unlike all other service me? The employee, either by company directive or lack of familiar with these and other scenarios that may be even common sense, could not take care of the customer. Either more maddening. industries. We are in way, this was poor customer service and I will be trying a the people-pleasing different office supply store in the future. More recently, the There is a reason why companies such as Amazon, Apple, business, providing fiasco with United Airlines (United Express) is probably Chick-Fil-A, UPS, Netflix, Costco and Google receive one of the ultimate disasters in customer service and public high marks from their customers. Customer service and an invaluable part of relations nightmare for the company. satisfaction is their number one priority. Years ago, I was healthcare. Our patient’s in St. Louis for a retirement celebration for one of my most As we all know, our profession is not unlike all other service respected dental school instructors. I stayed at the Ritzwelfare and treatment industries. We are in the people-pleasing business, providing Carlton and was checking out quite early in the morning. needs should be our an invaluable part of healthcare. Our patient’s welfare and The young woman who was assisting me asked if I had a foremost priority." treatment needs should be our foremost priority. I have good stay and if there was anything she could do for me. always maintained that your practice is only as good as I responded that the hand cream in the room was terrific your weakest link. Companies can be hired that will make and I wondered if I could purchase a couple of bottles as anonymous contact with your practice either by phone or in-person visit to a gift for my wife. Of course, the gift shop was closed at that early hour, but she provide important feedback regarding customer service. It might be time for you promptly contacted a security guard. He politely took me into the gift shop, to perform a routine maintenance check. What aspects can be improved to give turned on the lights and said to pick out whatever I needed and take as much outstanding patient service? You might be surprised at what you discover. time as I required. Wow! Usually this is unheard of in today’s world.

MEMBER BENEFIT

HIGHLIGHT

The MDDS Shred Event is an annual member benefit and community outreach event which allows MDDS dentists to have their professional and personal documents destroyed for a low cost, with peace of mind and in compliance with the State Dental Board regulations.

The 2017 Shred Event Drop-Off Day is Saturday, July 22 from 9:00am – 12:00pm at Rocky Mountain Orthodontics. The cost of shredding is $7 for a bankersized box and $12 for larger boxes. Proceeds from this year’s event will benefit Colorado Orthodontic Foundation.

MDDS does not give advice as to which records may be destroyed. Each individual dentist and dental practice must make that determination. If you have specific questions, please consult legal counsel.

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THE RELENTLESS DENTIST

BUILDING YOUR PRACTICE VERSUS WORKING AT IT

By David Maloley, DDS, FAGD

M

odern dentistry is a multifaceted profession. It calls for a skillful combination of science, art, medicine and technology. However, building a successful dental practice requires much more than clinical skill, the latest dental technologies, or the most forward-thinking methodologies.

Clearly, all successful dental practices take more than just the individual dentists performing the work. A practicing dentist that performs astounding work is not immune to business failure. We all know highly skilled dentists struggling to make ends meet. Why?

dental team members hate reviews. The format of a 10/10 allows staff to express their concerns, receive recognition, and coaching in a non-threatening environment.

Improving Marketing & Online Reputation Formulating a content marketing strategy that is aligned with community events, trending neighborhood topics and your target market is the mark of a dental champion.

It will take time to plan these accordingly. However, the results can separate thriving dental offices from mediocre ones.

The “why” is due to the approach of just “working in” the practice. Do you own a dental practice or are acquiring one? If so, considering the following information diligently can help you to steadily grow your practice.

Make sure you have a system for collecting online reviews. Google, Yelp and Facebook reviews are just as important as word of mouth referrals. Get your team involved in collecting reviews. If your best patients know how much you value their comments, they’ll be eager to take time to complete a few sentences on the key review sites. Then, when you get a 5-star review, read and celebrate it at your morning huddle. It’s a positive way to start your day and build team morale.

Clearing Up Time To Grow

Improving Yourself

Even if you own a dental practice in name, it is quite possible to only be a glorified employee. How? Until you have set aside time to invest in growing the practice, owning a practice is akin to having a job with massive responsibilities.

One of the first obstacles to practice growth is inefficiency.

Every great business has processes in place that maximize the results. Hence, it is critical to develop management systems that enable you to either delegate or automate processes. Once these are in place, time killers linked to poor communication and workflow interruptions can be eliminated. If you fear delegation (common for dentists), focus on finding and developing a highly competent team that can reduce your workload.

Many dentist mistake improving themselves with acquiring more dental expertise or skill. There are several areas of self-improvement that do not encompass dental arts.

For instance, can you improve how you communicate with your patients? Can you become a better trainer or mentor to your team? Do you inspire your team to be better by your work ethic, unwilling to compassion and example?

"If you are change, your business will never be capable of giving you what you want."

Many dentists never create time to grow their business. To do so requires change. “If you are unwilling to change, your business will never be capable of giving you what you want" (The E-Myth Revisited: Why Most Small Businesses Fail). Once you have freed up time to work on your practice, you’ll be in position to gain a better understanding of how sound business practices equate to growth. Schedule out specific days to “work on” your practice just as you do to “work in” the practice on clinical days.

Improvements & Growth Most of the fundamentals for acquiring more dental market share has little to do with dentistry. In fact, much of building your practice will involve implementing general business improvements. These universal business principles often get ignored in dentistry; we did not need them to earn our degree or receive our license.

Improving Team Communication How your dental staff communicates internally will ultimately be reflected in how and what they communicate to patients. Unprofessional talk is a sure way to deflate patient confidence. Also, note that staff demeanor communicates more than words. Regular team meetings with your team and performance recognition can long way in improving the communication protocols and culture of your dental office.

In our practice, we schedule quarterly 10/10s. A 10/10 is simply a chance for each team member to meet individually with the doctor and discuss how things are going. Typically,

“When a business is struggling, most business owners shift their entire focus to strategy. But 80% of the time, the chokehold on your business is actually your psychology.” - Tony Robbins

Take care of yourself. Develop a morning routine that brings out the best in you. Go into the office feeling like a winner. Hydration, nutrition, exercise, meditation, gratitude journals, etc. are not commonly talked about at dental meetings or in trade journals.

Carving out time for these things will make a huge impact on your practice. Busy days require that type of “athlete mindset” from us. Make sure you are engaging your team with a language of growth and optimism.

There is a big difference between working at your dental practice and having that practice work for you. The latter leads to more occupational fulfillment, less stress and a better bottom line—if you are willing to change.

About the Author Dr. David Maloley hosts the very popular podcast, The Relentless Dentist Show.

David grew up working on a family farm in Lexington, NE. He attended the University of Nebraska in Lincoln, where he earned his bachelor’s degree and later his DDS. In 2003, Dr. Maloley completed an Advanced Education in General Dentistry residency in Ft. Jackson, SC, then served as a Dental Officer in the US Army for the next five years. While in the army, Dr. Maloley was stationed at dental clinics in Giebelstadt, Germany for two years and Vicenza, Italy for another two years, providing general dentistry services for the local military communities.

After he returned to the US in 2007, he worked at a private practice near Charlotte, NC for two years before relocating to Colorado to open Vail Valley Dental Care.

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MDDS'S WET RETURN TO THE DENVER ST. PATRICK'S DAY PARADE!

M

DDS members and staff, along with Commerce Bank, Peebles Prosthetics, Kids In Need of Dentistry (KIND), The Colorado Orthodontic Foundation (COF), Dental Lifeline Network, Howard Dental Center, Denver Indian Health and Family Services, Inc., and Spectrum AV braved the rain and cold to distribute oral health care information at this year’s Denver St. Patrick’s Day Parade. The MDDS access to care float traveled the parade route through Denver’s Lower Downtown district while volunteers handed out over 5,000 toothbrushes and toothpaste with low income resource information.

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Volunteers danced their way down 17th Street, passing out oral healthcare info along the way.

Participants tried to stay warm and dry on the MDDS Access to Care float.

MDDS President Dr. Sheldon Newman, passes out toothbrushes to excited parade-goers.

Despite being chilly, participants were all smiles on the MDDS Access to Care float.

Toothy and Molar Man brought a one of a kind energy 11 11 to the MDDS float!

THE WHY, HOW AND WHEN

A

By Kent Murphy

OF PRACTICE VALUATION n accurate assessment of your practice value is

• Lay the groundwork for financing needs such as a practice equity loan

essential when preparing for a key transaction

• Diagnose the overall financial health of your practice compared to others

such as a practice sale, as it provides a clear at any given point. A practice valuation can

A practice valuation can take a considerable amount of time and expertise

also be a critical business tool throughout the

to complete. It requires a deep dive into the tangible financial statements,

life of your practice. For example, it can: • Form a foundation for realistic retirement planning • Provide a basis for meeting insurance needs

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in the market

picture of your dental practice’s actual worth

12 2nd Quarter 2017 mddsdentist.com

assets and liabilities of your business, as well as an accounting of the financial impact of intangible assets such as your reputation, brand presence and patient goodwill.

How practice value is determined The true value of your practice is based on its profitability, defined as the financial return for owning and operating the business. In general, profitability encompasses the revenues that remain after: • Paying all customary operating expenses of the practice (including salaries) • Paying a fair market rent (even if you own the real estate) • Fairly compensating yourself as a practicing dentist Basically, the more earnings your practice generates, the greater its value will be.

Also included in the determination of practice value are the operational qualities that make a

"A practice valuation can take a considerable amount of time and expertise to complete. It requires a deep dive into the tangible financial statements, assets and liabilities of your business, as well as an accounting of the financial impact of intangible assets such as your reputation, brand presence and patient goodwill."

a commensurate purchaser income and the amount of time it would likely take for a purchaser to recoup their investment.

An accurate appraisal is the result of much judgment, deliberation and experience, and in the end, provides not only a final value but evidence of why that value is the only logical outcome.

It is important to understand that, depending on the methodology used, your practice value may not equate to the recommended sales price for your practice. For example, if intangible assets such as the location, reputation and goodwill of your practice are not accounted for in your valuation, the sales price may be somewhat higher, or lower, depending on the perceived value the market places on these qualities.

When to perform a practice valuation Most practice owners wait until they are ready to sell their practice to perform a practice valuation. But a valuation by a professional business

dental office an appealing investment for potential buyers, such as exceptional

appraiser who specializes in dental practices can also be a powerful management

management practices and a proven track record of steady profits. Highly

tool, even if you’re not planning to sell in the short-term. The valuation analysis

valued practices tend to exhibit services and technology that support an

can diagnose the financial health of your practice, giving you an understanding

efficient and smooth-running operation. They are typically:

of what improvements your practice needs now in order to position your

• Furnished with up-to-date equipment that is in excellent or good condition • Attractively designed with a fluid floorplan • Staffed by multiple doctors offering a full range of services • Managed by a professional office team with outstanding customer service

business for increased profitability and maximize your return at the time of sale.

Use the chart below as a general rule of thumb:

Dental practices that do not exhibit this level of efficiency and attention to detail generally won't to achieve the highest value assessment.

Three common approaches to valuation To arrive at an accurate determination of practice value, an assessment expert may use one, or a combination, of the three most common approaches to valuation: market comparison approach, asset-based approach and incomebased approach: • The market comparison method assesses the value of a practice by

For best results, consider contracting with a professional dental CPA or appraiser who understands not only proper valuation methodology, but also the current buying and selling market for dental practices. This will help ensure your practice valuation properly reflects the unique aspects of the industry.

comparing its annual revenues, net profits and discretionary cash flow to those of similar practices that have recently sold. The successful application

About the Author

of this approach requires a sufficiently large database of transactional data for

Kent Murphy is the Business Development Manager for Wells Fargo Practice

making comparisons and adequate experience by the valuation professional

Finance in Colorado, New Mexico and El Paso, TX. He speaks to healthcare

in identifying truly equivalent information.

professionals advising in practice planning strategies for emerging and established practitioners. His industry background offers practitioners a unique perspective

• The asset-based approach determines practice value by assessing the

as they approach some of the most important decisions in their professional lives.

cumulative value of the practice’s assets. This includes tangible assets such as technology, supplies, instruments, office and lab equipment, and intangible assets such as the value of reputation and patient goodwill.

•

The income-based approach assesses practice value by calculating

projected cash flow given today’s practice revenues, expenses, debt service,

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NON PROFIT NEWS

MDDS MEMBERS HELP VETERAN SMILE AGAIN

P

edro, from Brighton, answered the call of duty and served our country in the armed forces until 1967. He then spent many years driving trucks for paper companies until a work accident in 1980 left him with back issues. Pedro had surgery to correct his injuries, including several fusions in his spine.

volunteers: Dr. Jaclynn Spencer and Dr. Steven Nelson, Dental Lifeline Network • Colorado Board President and oral surgeon.

Aside from back problems, Pedro suffers from Stage 3 kidney disease. He must maintain a strict diet to keep his diabetes under control and has recently been diagnosed with leukemia. Pedro’s oral health also declined. He experienced extreme pain and had difficulty eating. Several of his teeth were missing and those that remained were loose or broken.

Pedro now spends most of his time at home with his wife. When able, he enjoys yardwork, completing puzzles and spending time with his granddaughter.

Although Pedro is a veteran, he does not qualify for dental aid from the VA as his disability is unrelated to his time in the service. He receives a small Social Security Disability benefit and couldn’t afford the dental care needed.

Pedro learned about the Donated Dental Services (DDS) program, applied and was soon accepted. He began treatment with two MDDS member

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Thanks to these generous volunteers, and the assistance of DDS lab volunteer Centric Dental Restorations, Pedro is smiling bigger than ever with his new dentures.

“These people are great; the dentists, everybody. They made me feel so good.

Couldn’t ask for anything better.” – Pedro “The DDS program has always been an important part of my practice. I feel very blessed that I can practice dentistry and enjoy it so much. If you have never done it, give it at least one try: take care of one of these patients, and you will see how rewarding it is.” – Dr. Nelson

PRACTICE MANAGEMENT

GROW YOUR PRACTICE IN 2017

FROM WITHIN

By Jody Antonacci, RDH, MBA

2

017 is upon us. This is a perfect time for dentists to begin planning and designing new growth strategies for their practices. Why not embark on an innovative new approach to promote market growth? Consider a plan that encourages development from within the office to achieve long term results. Internal changes will establish loyalty from both staff and patients.

a cap in one easy appointment. No need to return for a second visit. The office uses modern equipment. Saves you time and will work with most insurance plans. If you are an apprehensive patient, we offer IV sedation!

Call us.

"Create an environment

Instead try this advertising example which begins with “Why”: Our office proudly serves our community in a nurturing, caring, professional environment. Our Dental Team delivers an exceptional experience accompanied by the highest standards of care. (“Why”) At Smith Dental we are focused on total body health! (“How”) We use state of the art technology to quickly determine your needs. We discuss all treatment options with you to help you make a beneficial choice. (“What”) We are Smith Dental, providing excellent dentistry personally committed to your well-being. At Smith Dental, you are our top priority! Call us today!

“START WITH WHY,” by Simon Sinek, outlines around purpose, it builds how skillful leadership motivates all of us to take committed staff and loyal action. His concepts help dentists focus energy patient relationships. on becoming effective leaders. Sinek teaches us that it is important to define the Practice purpose, The result is a profitable, cause or belief to establish the “Why” behind what innovative, patient-centric we do. “Why” does this practice exist? Typically, practice able to sustain organizations advertise “What” they do and itself into the future."

“How” it is done. Seldom is the “Why” explained.

If you reflect back to dental school, “Why” did you Identifying, living and promoting the “Why” in your choose dentistry? What inspired this direction? practice will consistently attract dependable staff and devoted patients.

What brought you a sense of accomplishment? The answers to these Effective execution demands committed leadership. Grow the practice questions are the reasons your practice was established. from within! Simply start with “Why!” Once your purpose has been identified, put it to work. The “Why” culture provides standards and principles employees and patients can embrace.

About the Author “Why” we are here, becomes part of the mission statement. It identifies Jody Antonacci, RDH, MBA is with SAS Transitions Dental Practice a common thread to create a sense of belonging. The “How” clarifies Brokers. SAS provides practice transition support and sales across Colorado the manner in which we act to convey our purpose. Staff members feel and throughout the US. they are part of something larger than just the tasks they are performing.

The “Why” motivates behavior. Staff members become real Dental Teams striving for a collective cause. This new connection generates camaraderie and solidarity to produce achievement.

Great leaders promote a creative environment to foster innovation.

Successful leadership inspires action! Inspired individuals enjoy a sense of belonging and purpose not associated with external incentives.

External incentives cause people to act in a profoundly personal way.

Instead, create an environment around purpose, it builds committed staff and loyal patient relationships. The result is a profitable, innovative, patient-centric practice able to sustain itself into the future.

How will the “Why” draw new patients and differentiate the practice?

When patients can relate to the “Why” or the purpose of your practice, they will want what you provide. If a practice simply promotes “What” services are provided, the consumer may not be moved to take action.

Retirement Planning for Dental Professionals

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We are dedicated to consulting with dental professionals. We design personalized retirement strategies that serve people not products.

www.catalystretirement.com  (303) 617-7270 Securities offered through Kestra Investment Services, LLC (Kestra IS), member FINRA/SIPIC. Investment advisory services offered through Kestra Advisory Services, LLC (Kestra AS) an affiliate of Kestra IS. Catalyst Retirement Advisors, LLC is not affiliated with Kestra IS or Kestra AS.

Consider this hypothetical marketing piece: Smith Dental can make you

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SEPARATION ANXIETY: 5 Tips for Balancing Work Life & Personal Life

By Lisa Knowles, DDS

S

ep-a-rate.

So, yes, we do have to separate. But, there are down times — even if it is only during a brief hand washing between patients. There is space. There is

Just separate your work and your personal life. We

space to think about last night’s argument or yesterday’s missed softball game.

say this to others and others say it to us as if we can

There is time to think about a newborn’s needs or a loved one’s suffering. We

push a button to turn it on or turn it off. To a certain

can separate, but it’s not easy, and to think we can do it 100 percent of the

extent separating is a necessity in the day-to-day life of any

time is ludicrous.

dentist or dental professional. We cannot think about the death of a loved one or a relationship that is ending during a crown prep or mid-extraction.

As a matter of fact, it’s stressful to separate all of the time.

It’s dangerous to have our thoughts elsewhere, and it’s not fair to our patients to lose focus on their needs.

What can we do?

After practicing for 18 years and working with others in practice, I offer my

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16 2nd Quarter 2017 mddsdentist.com

conflicts seemed like unmanageable conflicts to her. Once we talked about

top five tips to help you deal with separation dilemmas.

these concerns, she actually realized she could be more successful in both As a dentist, it is difficult to find a substitute, especially if we are in a solo

areas if she delegated more tasks and engaged her family members in the

practice. In our minds, “the show must go on” or a lot of rescheduling has

duties that she always completed. She actually had a supportive spouse and

to occur. Here are ways to keep the show going without releasing too much

children. They simply did not know exactly how to help. Because we are

cortisol:

health care professionals, our strength of caring for others can become our Achilles’ heel if left unchecked. We have to express our issues, recognize

1. Leave space in your schedule for medical and health appointments (or

our inabilities to manage and care for everything and everyone and ask for

your kids’ appointments if you are the one in charge of family members’

help when needed. If we have unsupportive family members who do not

schedules). Many people wonder why dentists take a day off during the

help us when asked or when needed, that can also lead to problems at our

week. This is why. If the time is not spent working on the business side of our

work places. Our busy home lifestyles often require additional support from

practices, it can be spent working on our health. By working 8-5 Monday-

children, spouses, care providers, housekeepers, nannies and other kinds of

Friday, there is little time left to make it to appointments. Perhaps YOU have

supportive helpers.

no appointments or health issues to worry about, but many of your team members are working moms, and they have appointments to get to or get

5. Allow some time to talk during work hours. This goes against every vigilant work ethic I learned about as I grew up. “When you are at

their kids to as well. This space allows for the much needed flexibility so many of our team members need and want. Furthermore, nothing causes more stress than an unanticipated leave of absence from one of our teammates. When there is no flexibility in the schedule, team members often have to take whatever appointments are available or feel pressured to wait to go to a physician. We know what happens when

"To a certain extent separating is a necessity in the day-to-day life of any dentist or dental professional. "

still think this is a decent piece of advice to tell your kids as they start out in the working world. But, there is also a need for teams to get to know one another. It doesn’t mean everyone stands in the break room for a half hour, but it might mean there are scheduled times to talk — like during team meetings or holiday lunches or birthday celebrations.

These moments allow home and work lives to merge a bit

we delay health care: bigger and more costly problems occur. This preventive approach to health care should be modeled in our

work, you work,” my dad would say. And, looking back, I

more than when we try to completely separate the two.

practices to help everyone separate as needed. It’s easier to focus on our work when we know we have a day to catch up on appointments, errands or

Separation is difficult, and there are painful times in our lives that make it

wellness routines.

nearly impossible. Our home lives bleed into our work lives and vice versa.

Being conscious of these balancing acts is one way to ensure the priorities

2. Plan ahead for absolute schedule conflicts. It is always easier to add

remain in the right places and at the right times. I accept that life is never in

more time back in the schedule than it is to retract a schedule full of patients.

complete balance. And, instead of fighting the imbalance with self-defeating

For a return from elective surgeries, maternity/paternity leaves and family

thoughts, or spending sleepless nights trying to make one area more even

care needs, lighten the schedule as much as possible the first few weeks.

with the other side, I accept that this desire to have complete work-life

Come back after these absences on a part-time basis. Ease your way back

balance is never going to be perfect. Sometimes both places are in need,

in. As I said, it’s easier to add more time than to reschedule several patients.

and during those times, it’s important to reach out for help and delegate as

Consider working shorter hours at first, too. Our necks and backs are

many tasks as possible. Being a professional at home and at work requires

typically out of shape after an extended time away.

planning, a willingness to let go of the desire to personally complete each task and an ability to surround yourself with an amazing support team. With

3. Practice some type of mental stillness at least weekly, if not daily. I

these tips in mind, I hope you find more ways to manage the challenges and

am a big fan of mindfulness-based stress reduction techniques, but tai chi

stressors that will surely arise while striving to be the best at home and be

or simple meditation are other options when trying to separate work from

the best at work.

a stressful home life. These types of practices help us learn to stay in the moment and keep focused on what is occurring each minute rather than what happened yesterday or what could happen tomorrow. When we train our brains to focus on things we can control in the present moment, it is easier to separate from the chaos going on in our personal lives.

Knowles L. 5 tips for balancing work life and personal life. Posted online January 23, 2017 at http://success.ada.org/en/practice-management/dentalpractice-success/winter-2017/5-tips-for-balancing-work-life-and-personallife. Copyright © 2017 American Dental Association. All rights reserved.

Reprinted with permission.

managed everything and everyone in her household. She had little energy

About the Author Dr. Lisa Knowles has the unique ability to see the whole picture and the whole patient. She is a broad-spectrum, creative thinker. She writes nationally, speaks professionally and consults with teams who desire new ways of thinking about profit and performance. For more information,

left to give at work and had little patience left to share with our team. Small

find her website at IntentionalDental.com

4. Find and maintain healthy, supportive relationships. Our work can be stressful and demanding. We need partners and friends who understand our work environments and support our passions. In one of my practices, a hygienist had what we perceived to be unsupportive spouse. She constantly

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SPINE AND SHOULDER HEALTH FOR DENTAL PRACTITIONERS

By Nathan Lilley

P

rolonged sitting has been well documented as a definite source of musculoskeletal pain and dysfunction. For most people, sitting for a prolonged period of time will cause them to get into a slouched back posture due to local muscular fatigue and poor endurance. This posture will cause over-stretching of the ligaments in the neck and lower back, and stresses the intervertebral discs. A slouched posture will also encourage a forward head position and rounding of the shoulders, compromising the function of the rotator cuff. Occupations with prolonged sitting are more at risk for future issues in the neck, lower back and shoulders. We have treated numerous dental practitioners in our clinic for issues in the

cervical, lumbar and shoulder joints. Although all issues cannot be avoided, simple exercises performed throughout the work day can make a huge

difference in your overall musculoskeletal health and keep you out of our office. We recommend performing the following routine 3x per day while at work. The whole routine should take less than five (5) minutes and can really make a difference in staying healthy throughout your career.

Neck: Repeated retraction with extension • Sit on a chair or stool • Move your head slowly but steadily back as far as you can manage. It is important to keep your chin tucked down as you do this • While maintaining this position, lift your chin up and tilt your head backwards as in looking up toward the sky. Do not allow your neck to move forward as you do this. Hold position for 2-3 seconds • Return to the start position • Repeat 10x per session • Discontinue this exercise if pain is felt in the arms or shoulders

Shoulders: Doorway stretch • Position yourself in an open doorway with your feet staggered and with your elbows at shoulder height and resting on both sides of the door frame.

• Keeping your forearms flush to the frame, gently lean forward until a stretch is felt in your chest muscles (pectoralis musculature) • Hold position for 30 seconds • Repeat 2x time per session

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“W” • Stand in a balanced position • Keeping your elbows at your sides, rotate your hands outward to their end range of motion • At the same time, focus on pinching the shoulder blades back and together • Hold each repetition for 2-3 seconds • Return to the start position • Repeat 10x per session

Lumbar Spine: Standing Extension in Standing • Stand upright with your feet slightly apart • Place your hands at in the small of your back so that the fingers meet at the center of your spine • Bend your trunk backwards at the waist as far as you can, using your fingers as a pivot point • Keep your knees straight as you do this • Maintain this position for 2-3 seconds and return to the starting position • Repeat 10x per session, increasing the range on each repetition • Discontinue this exercise if pain is felt radiating into the legs About the Author Nathan Lilley PT, MPT, OCS, CSCS is Co-Owner/Clinic Director at Physio Pro Physical Therapy in Denver, CO.

CLINICAL

PEER REVIEW PUZZLER

Peer Review is a member benefit of the Metro Denver Dental Society. The following is a sample of an actual event, with real patients and real dentists that was reviewed and mediated by the MDDS Peer Review Committee.

Case

needed and the crown was filed down. The

The patient in this case was seeking treatment for a broken tooth (#19). The

patient then waited approximately one year

patient originally visited Dr. A in September 2013. The course of treatment

and, after experiencing consistent pain and

determined was to crown the broken tooth. According to the patient,

inability to chew on the left side, paid a visit to

impressions were taken and a temporary crown was placed on the preliminary

Dr. C in September 2014.

visit. The patient reported that the temporary crown fell off repeated as well as significant pain on affected tooth.

After an examination with Dr. C, the patient was informed that the crown did

During a follow-up visit a permanent crown was placed on tooth #19, which

Recommended treatment was to replace the crown on #19 and place one on #18

the patient reported also fell out. When the patient returned to Dr. A, a second

as well.

impression was taken and temporary crown was placed. After this visit, the patient contacted Dr. A with complaints of ear and head pain for which antibiotics were prescribed. Following the placement of the second permanent crown, the patient described symptoms of an ill-fitting crown along with continued pain and inability to eat on the left side of the mouth. At this point in treatment, Dr. A recommended the patient visit an endodontist for evaluation.

Upon the recommendation of Dr. A, the patient visited Dr. B for a possible root canal; however, after evaluation by Dr. B it was determined no root canal was

not properly cover tooth #19 and #18 was compromised in the fitting process.

The patient approached the Peer Review Committee for assistance based on the financial impact of the newly prescribed treatment plan. The total charges from Dr. A for the original work totaled $1,080.30, with the patient responsibility amounting to $559.40. The patient is requesting a full refund of $559.40 from Dr. A. No lawsuit or complaint with the State Board of Medical Examiners had been filed at the time of complaint to the Peer Review Committee.

Peer Review answer on page 27

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SERVING UP SMILES A DELICIOUS EVENING The MDDS Community Outreach Public Relations committee proudly hosted Serving Up Smiles this April at Coohills Restaurant in downtown Denver.

Guests enjoyed a 4-course meal, cocktails and networking - all for a great cause. Proceeds from the event benefited Dental Lifeline Network.

Metro-area dentists enjoyed excellent food and great conversation at Coohills Restaurant.

Serving Up Smiles sponsor, Commerce Bank, spends time with Dr. Kevin Patterson and guest.

Attendees network while indulging in a special 4-course dinner.

Staff from Peebles Prosthetics, Inc. and Dr. Katie Johnson mingle while enjoying a custom wine menu.

Guests spend time with friends all for a great cause.

Dr. Brian Kelly with Dental Lifeline Network thanks guests for their participation in Serving Up Smiles and donations to DLN.

Colorado ASDA leadership represented the University of Colorado School of Dental Medicine at Serving Up Smiles.

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CLINICAL

FIXED HYBRID; CONVERSION TO FINAL HYBRID PROSTHESIS By Rick Peebles & Steve Kelly

W

ith advancements in technology and procedures, creating a Hybrid Prosthesis has become very predictable. Proper interdisciplinary planning along with prescribed protocol will create esthetic results that are headache free. While each case is unique, the following steps demonstrate how to take a case from Conversion to the Final Hybrid Prosthesis.

Teflon tape.

CAD CAM MILLED Titanium Fixed Hybrid (Final Prosthesis) First Appointment 3 DAYS IN LAB • Doctor-Study models taken for fabrication of an open top custom tray • Lab- Fabricate open top custom tray An Open Top Custom Impression Tray is fabricated using a study cast or the Temporary Fixed Hybrid model. The impression copings can be linked together with floss and GC resin or flowable composite for greater accuracy. If you cannot visually see that all of the impression copings are seated fully, take a radiograph to confirm. A trial try-in of the custom tray to make sure there are no interferences with the impression copings (relieve tray if needed). Inject impression material around each coping prior to loading the custom tray. After fully set, remove impression tray and check for voids or material on any of the coping surfaces.

The Conversion: The first step is to fabricate a conventional denture.

Evaluation of the inter-occlusal space is necessary to allow adequate restorative space. Once fabricated the denture is duplicated in clear acrylic to serve as the surgical guide.

A trough is cut lingual to the incisal edge/buccal cusp position to ensure the screw access holes will be in the proper position. The flanges of the surgical guide are trimmed to 13-15mm to aid the surgeon on any bone reduction that may be needed. The surgical guide will also be used as the impression tray for converting the denture to a temporary screw retained Hybrid.

Second Appointment 4 DAYS IN LAB • Doctor- Final impression using impression copings ....and open top custom tray • Lab- Pour soft tissue model and fabricate screw retained record bases and verification jig

Steps: 1. Teeth are extracted, bone is reduced to allow 13-15mm .....of inter occlusal space.

2. Implants are placed allowing a good a-p spread.

3. Abutments are torqued to specs.

4. Radiograph taken to insure proper seat.

5. Impression copings are screwed on to each abutment.

6. The Surgical Guide is relieved to fit passively around .......the impression copings.

7. The incisal edge, midline and occlusal plane are evaluated and adjusted.

8. The impression is taken using a PVS Light body around .....the copings and a heavy body in the guide.

9. Prior to removal of the impression a Blu-mousse bite ......registration is taken.

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10. Temporary non-engaging abutments are picked up in the laboratory while ensuring a passive fit. Braided wire/fiber reinforcement is added to prevent fracture.

Attention is paid to the final contour to allow for good hygiene and proper healing of the surgical sites.

11. The Temporary Fixed Hybrid prosthesis is delivered the following day at the restorative dentist’s office. Even posterior contacts with a flat occlusal plane are recommended to minimize lateral occlusal loads during integration. The screws are normally hand tightened and the access holes filled with impression material or

A soft tissue cast will be generated using implant replicas and precision measured liquid and stone.

A screw retained baseplate is made with two nonengaging temporary abutments. The baseplate should be hand tightened and specific attention paid to the visual aid opening around the abutment to make sure it is fully seated in the mouth. Midline, high smile and occlusal plane should be marked and a Blu-Mousse bite registration taken. The shade and mold of the teeth to be used should be taken as well as a study cast. The baseplate is removed and verification Jig is seated using the one screw test. Hand tighten and evaluate the passivity of the jig one screw at time. A Pano is needed to confirm a full passive seat. If there is any doubt in regards to passivity, cut and lute back together. The final soft tissue cast will be altered in lab as needed.

Third Appointment 6 DAYS IN LAB • Doctor- Take bite registration marking midline and ....high smile line, select shade and try-in verification ....jig (section if needed and re-index) • Lab- Setup denture teeth on wax rim

First Appointment 3 DAYS IN LAB

Second Appointment 4 DAYS IN LAB

Fifth Appointment 5-6 DAYS IN LAB

Fourth Appointment 10-12 DAYS IN LAB

Sixth Appointment FINAL

The case is articulated and the denture teeth are set in wax for a try-in prior to fabricating the CAD/CAM Bar. The wax-up is made to mimic the final contours and the tooth positions of the final prosthesis. The shade, midline, occlusal plane and vertical dimension are confirmed. The verification jig can be re-confirmed if necessary. A check bite is taken with a Blu-mousse type material for final remounting.

Fourth Appointment 10-12 DAYS IN LAB • Doctor- Try-in of denture teeth in wax (take a check bite if needed) • Lab- Fabricate CAD/CAM Milled Titanium Bar and do a final wax set-up on top of the bar We are now ready to scan and design the Final Fixed Hybrid Prosthesis. The model is scanned using the proper scan bodies as well as scanning of the wax-up. The bar is designed with proper contours and extensions as well as posts for added retention and strength . The file is then sent to the milling center to be milled and polished. The bar is evaluated and confirmed to be passive by the one screw test. The denture teeth are then set-up on the milled titanium bar for a final wax try-in. Careful attention to final contours is critical. Final phontic and esthetics evaluation is done and the prosthesis is ready to be completed.

Fifth Appointment 5-6 DAYS IN LAB • Doctor – Final try-in of the bar with teeth set in wax • Lab- Process/ Finish Final Prosthesis The bar will be opaqued ensuring that there is no metal show through. The restoration is then processed using the Ivo-Base technique ensuring the least amount of shrinkage and distortion possible. The prosthesis is finished and polished ensuring maximum patient comfort and ease in hygiene. All areas of tissue contact are smooth and highly polished to ensure better patient care.

Sixth Appointment – FINAL • Doctor- Deliver Fixed Hybrid using final screws – torque to specs The prosthesis is delivered torquing each screw to manufactures specs. The occusion is adjusted ensuring Bi-Laterally balanced contacts on all posterior teeth. Screw access holes can be filled with Teflon tape and a composite plug.

Special instruction and training for the patient is needed to properly clean around each implant and under the prosthesis. This is very important for the longevity of the appliance and the patients oral health. The total start to completion time for the restoration is 6-8 weeks.

There are many different approaches for the treatment and fabrication of a Conversion to Final Hybrid Prothesis. By planning and following protocols the patients concerns will be minimized because the results will be predictable.

About the Authors Rick Peebles acquired his dental laboratory technology degree at Ferris State University MI. After moving to Denver and working as an in-house technician, Rick opened his removable lab in the office of a prosthodontist in 1984. Rick has been a Certified Dental Technician (CDT) for over 20 years, and Peebles Prosthetics Inc. has now grown into a full-service laboratory employing over 70 people.

Steve Kelly was born and raised in central Illinois. He moved to Denver in 1995 to focus on advancing his knowledge in all phases of dental technology. Steve has worked with some of the top prosthodontists in the country helping him to build a well-rounded knowledge of dentistry. He joined Peebles Prosthetics in 2013 as the technical operations manager to further challenge his passion for dental technology.

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POINT/COUNTERPOINT

TO HIRE OR NOT?

A PRACTICE OWNER’S DILEMMA There are many variables in running a successful dental practice. From practice location decisions and marketing to customer service and staffing.

These factors have the potential to make or break a dental office. Join MDDS as we explore differing viewpoints on whether to hire a dental office manager or take on those responsibilities as the practice owner.

POINT: Ian Paisley, DDS In making the argument for a dentist acting as their own office manager I must make it clear that, of course, it would always be great to have a great team member available to carry out all the difficult tasks included in managing a dental office, however this may not always be the best choice for the practice.

Using personal experience as an example, my business partner and I started a practice from scratch. Our potential revenue was very suspect in the beginning and we wanted to do everything in our power to avoid overextending ourselves financially. One of the ways we did this was by setting out to learn how to perform the duties usually carried out by an office manager. It helped having another dentist to share these duties with for sure, but by having the willingness to manage our team, supplies, payroll and all the bills, we were able to save a lot of money during the infancy of our practice. So, in a nutshell, there is a potential financial savings for a practice in its infancy.

A second reason for a dentist to carry out office managerial duties relates to the unfortunate presence of embezzlement throughout our profession. I have read countless articles in dental journals over the years cautioning dentists about team members, and especially those with the most access to the finances, illegally relieving dentists of their hard-earned dollars. Having the dentist(s) be in charge of the practice’s finances is one way to avoid falling into a nasty embezzlement scheme.

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Another reason for a dentist to carry out the management of their dental office would simply be for the interest they have in that type of leadership role. This might be more of a rare trait among dentists, given the scientific foundation of the practice of dentistry, but there are many dentists out there who derive enjoyment from the business side of the practice. Not to say that dentists who have office managers don’t attend to business responsibilities, but by taking on those other duties they can feel fulfilled in carrying out this additional responsibility.

In conclusion, I know I am arguing the exception to the rule. Most dental offices have office managers, they do a great job and the practice benefits from them. I hope to have simply pointed out a few reasons why ambitious entrepreneurial dentists might consider tackling some or all of those duties on their own. For the dentists who do choose to take this route, I highly recommend seeking out advice, training and education from professionals who have managed dental practices for years. Living here in Denver, home of the Mountain West Dental Institute and the Rocky Mountain Dental Convention, we have a wonderful source of this education right in our backyard. Not to mention the many local practice management consultants I’ve had the pleasure of getting to know over the last 12 years.

Working with a good consultant can provide the dentist with the tools necessary to build a foundation quickly by providing the structure and processes that will allow the doctor to delegate tasks while still maintaining control. If the dentist is responsible for constructing and implementing the processes that the practice is run on, the doctor will have a better perspective on where the weaknesses exist and can tie up loose ends before they get tripped up.

About the Author Dr. Paisley is a general dentist out of Brighton, CO where he co-owns Bromley Park Dental. Dr. Paisley is a past president of the Metro Denver Dental Society and remains involved in organized dentistry. When he is not practicing dentistry or supporting the profession he enjoys spending time with his family

and cheering on the Chicago Cubs.

COUNTERPOINT: Cri Boratenski I believe there are two primary reasons that doctors don’t hire an office manager: trust and control. Initially, when a practice is in startup mode, economy may be the primary driving factor, and during this time I think it’s entirely reasonable and even wise for a doctor to perform the duties of the office manager. The doctor must be capable of and willing to manage the office manager and, to do this effectively, they must have an understanding of the duties that an office manager will perform.

When a new practice is first starting out, patient flow will be slow, which provides a great opportunity for the doctor to learn the business management skills necessary to effectively run the practice.

Is dentistry your hobby or your career? I would argue that if it’s viewed as career and the doctor truly does enjoy the business side of private practice, they should always be looking for opportunities to replace themselves. That’s what good business people do to promote growth within their company and to allow them the ability to focus on the areas which they are truly best at and enjoy the most. A good office manager can double the clinical productivity of a dentist by assuming treatment presentations, HR and accounts payable functions which the dentist would otherwise be mired in. Time spent in these areas has a high opportunity cost.

can pay someone less than $140/hr to do pretty much any function in your practice. If your schedule is full of holes and you have downtime, the metric may need adjustment. You certainly want to hold onto any high security functions like writing checks and if you operate more of a boutique practice, you may maintain ownership of other high-touch functions like treatment presentations.

Embezzlement happens and it happens a lot in dentistry, probably because dentists aren’t trained in school on how to avoid it. It happens because there aren’t the processes and controls to prevent it. Too much responsibility gets lumped onto one person instead of being divided between team members and the dentist isn’t properly reviewing reports to monitor the paper trail. Saying that you’re never going to hire an office manager because you’re worried about embezzlement is like saying you’re never going to wear shoes because your worried about tripping over your shoe laces. Tie them in a double knot and check them periodically to make sure that everything’s nice and tight and you shouldn’t need to worry.

About the Author

Cri Boratenski is the Executive Director of Colorado Family Dentistry in Lakewood. A serial entrepreneur and world record holder, Cri also sits on the board of two non-profits and is a member of the Delta Dental’s DAAG (Dental Administrator Advisory Group). Before starting Colorado Family Dentistry

As your schedule fills up, determine what your time is worth by multiplying your profit margin by your hourly rate and delegate anything that you can pay someone less than you make per hour. For example, if you bill out $350 per hour and have a 40% profit margin, your time is worth $140 per hour. You

with his wife, Dr. Julia Kasper, Cri owned and operated businesses in mobile technology, pest control, tourism, transportation, and advertising. When he’s not glued to a computer, Cri can be found mountain biking, climbing, or skiing the Colorado Mountains.

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The new Find-a-Dentist tool makes it easier than ever for patients to find you. Take 5 minutes to update your profile with the information patients look for most: ü ü ü ü ü ü ü

Photo Business address Office hours Practice email Payment options Insurance types Languages spoken

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Articulator Winter 2015

26

IN MEMORIAM

Joel Chavez Dr. Joel Chavez, a general dentist who practiced in both Denver and Colorado Springs, passed away on March 8, 2017. Dr. Chavez received his dental degree in 1980 from the University of Colorado School of Dental Medicine. He practiced for a number of years with his father and retired in 2016. He was a volunteer for both the University of Colorado School of Dental Medicine and Kids in Need of Dentistry (KIND).

In lieu of flowers, memorials may be made in his name to The University of Colorado School of Dental Medicine, 13065 E. 17th Ave., Aurora, CO 80045 or Kids In Need of Dentistry (KIND), kindsmiles.org, 2465 S. Downing St., Ste.210, Denver, CO 80210.

Donald Cunningham Dr. Donald Cunningham, a retired general practitioner, passed away on February 21, 2017. Dr. Cunningham received his DDS from the University of Texas School of Dentistry at Houston in 1965. He served in the US Army and was an MDDS member for 48 years.

Coleman Dell Dr. Coleman Dell, a retired general dentist, passed away on February 25, 2017. Dr. Dell received his DDS from Creighton University in 1955 and practiced in both Denver and Wheat Ridge until he retired in 2002. He was a member of ADA, CDA and MDDS for 61 years.

In lieu of flowers, donations may be made in Dr. Colman's name to any of the following: The Regis University Scholarship Fund, 3333 Regis Blvd., Denver, CO 80221; regis.edu/Giving-Gateway/ Regis-University-Fund; Kids In Need of Dentistry (KIND), kindsmiles.org, 2465 S. Downing St., Ste.210, Denver, CO 80210; or Foothills Animal Shelter, foothillsanimalshelter.org/donate/, 580 McIntyre St.,Golden, CO 80401.

John Quigley Dr. John Quigley, a retired general practitioner, passed away on March 8, 2017. Dr. Quigley earned his dental degree from Marquette University in 1962. He served in the US Air Force and was an MDDS member for 50 years.

KEEP UP-TO-DATE EVERYTHING MDDS

Follow us @ mddsdentist today!

Answer to the Peer Review Puzzler (continued from page 19) The Peer Review Committee conducted interviews with both the patient and Dr. A, after informed them of the complaint filed. Dr. A granted a full refund of $559.40 and the patient signed release of liability forms to protect Dr. A against future litigation.

Litigation and claims on a dentist’s malpractice insurance can be an expensive and lengthy process – one that is best avoided. If you have questions about the peer review process or are interested in joining the committee, please contact Marlene Pakish, MDDS Finance & Operations, at finance@mddsdentist.com or (303) 488-9700 ext. 3268.

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PRACTICE

THE THREE "R’S"

OF SUCCESS

By Larry Chatterley and Randon Jensen

A

successful practice cannot live by numbers alone. It must establish and maintain certain core values. Values that are aligned with correct principles. In our combined 47 years of experience, we have discovered

truly successful practices are build on three foundational principles. We call them the "Three R’s of Success” – Relationships, Reputation and Referrals.

Any practice can advertise its services, but what really counts is what patients have to say about it. A good

It is a simple truth. People are more productive in a culture where they feel

reputation drives referrals and is always preceded by

recognized and valued for their unique contributions. Appreciated and

great relationships between patients, the doctor and staff.

engaged employees bring greater value to the business.

Consider the following, adapted from Intuit’s operating values:

In the book titled "555 Ways to Reward Your Dental Team," Drs. Nate Booth and Joe Blaes assert that when you put your team first, you will increase

“Many practices say that their most important job is satisfying the patient.

the level of service that is rendered to patients. When the team truly feels

But satisfying the patient is simply the minimum requirement for staying in

appreciated and valued, they will treat patients with more care and concern.

business. Therefore, don’t seek to just satisfy; seek to ‘wow’ them. Wow means

Staff will feel "wowed" when they are consistently shown appreciation and

creating patient enthusiasm and delight. It means giving patients dramatically

empathy when their efforts are acknowledged and praised, and when they

more value than they expect - whether measured by price, performance, quality

feel they are an important part of the practice. When they feel "wowed," they

or service. You know you are succeeding when you inspire your patients to go

will respond in kind to patients. The effect is a reputation that motivates

out and tell others about your practice.”

people to refer their family and friends. They have such a great experience in

your office, they cannot wait to tell others about it.

Patient referrals provide the ultimate insight into the type of culture a practice has, and are the most accurate gauge as to how well existing patients are

If you want to gauge your own level of care and concern for your staff and

treated.

patients, start by asking each employee to rate you from one to 10; with 10

being the highest. You may want to try this anonymously at first, if possible.

So how does a practice "wow" their patients to generate more patient referrals?

Once you have your score, ask for one or two things you can do to move that

Interestingly, in order for patients to feel “wowed,” the staff needs to feel the

number up a notch.

same way.

You will soon discover one of the greatest motivational acts you can do for In a series of studies, employees of many companies ranked the top three

your employees and co-workers is to help them feel appreciated and valued.

things they value most in a job as: 1) feeling appreciated for work done; 2)

When staff members feel they are treated well they have a desire to help the

feeling “in” on things, i.e., feeling engaged and invested in the company; and

patients feel the same way.

3) feeling understood and accommodated regarding personal problems.

Moreover, a Gallup study of nearly five million employees revealed an

About the Author

increase in recognition and praise in an organization can lead to lower

Larry Chatterley and Randon Jensen are managing members of CTC

turnover, higher customer (patient) loyalty and satisfaction, and an increase

Associates, a practice transition consulting company that has helped

in overall productivity and profitability.

facilitate over 1,600 practice transitions over the past 29 years.

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28 2nd Quarter 2017 mddsdentist.com

Thinking about SELLING your Dental Practice?

Call for a Complimentary Transition Planning Consultation.

Let Us Help

You Ensure Your

Legacy

Completed over 1600 transitions.

Appraisals • Practice Sales • Partnerships • Buyer Representation • Post-Transition Coaching • Start-Up Coaching • Associateships

Your dental practice is your legacy.

As dental practice transition specialists, we guide you through the complex process of selling your practice to ensure everything goes smoothly with the legacy you have built. www.ctc-associates.com (303) 795-8800 | marie@ctc-associates.com | larry@ctc-associates.com

CTC Associates Dental Practice Transition Consultants Larry Chatterley

Marie Chatterley

9233 Park Meadows Drive, Lone Tree, CO 80124 Phone: (303) 795-8800 | Fax: (720) 367-5336

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2nd Quarter 2017 mddsdentist.com

29

Be sure to check out the RMDC HANDS-ON COURSES being held at the:

MOUNTAIN WEST DENTAL INSTITUTE!

Visit MDDSdentist.com for a full schedule of other upcoming courses at the MWDI! • 140-seat Auditorium (can be divided in two) • Banquet Hall • 20-seat Executive Board Room • Hands-on Learning Lab Benches for 40 participants • Large Wet Lab • Four (4) Educational Operatories including one (1) equipped for surgery • 2D/3D Digital Imaging Suite • Planmeca PlanScan™ (mill & scanner) • Equipped to capture and stream live video • MDDS members receive a 15% discount • Multi-day & multi-room discounts • A/V always included • No catering restrictions • Free Wi-Fi • Two (2) free parking structures Metro Denver Dental Society | 925 Lincoln Street, Unit B, Denver, CO 80203 | (303) 488-9700

MWDI.ORG

EVENT CALENDAR JULY

OCTOBER

July 22 MDDS Shred Event Rocky Mountain Orthodontics 650 W. Colfax Ave, Denver, CO 80204 9:00am-12:00pm (303) 488-9700

October 6 Periodontal Disease: From Probing to Presenting to Planning Mountain West Dental Institute 925 Lincoln Street, Unit B Denver, CO 80203 8:00am-5:00pm (303) 488-9700

SEPTEMBER September 13 CPR & AED Training Mountain West Dental Institute 925 Lincoln Street, Unit B Denver, CO 80203 6:00pm-9:00pm (303) 488-9700 September 22 Sleep Explained: The Science of Dental Sleep Medicine Mountain West Dental Institute 925 Lincoln Street, Unit B Denver, CO 80203 8:00am-5:00pm (303) 488-9700 September 23 Straightforward Ultrasonic Debridement/ HANDS-ON A Simplified Approach to Ultrasonic Instrumentation Mountain West Dental Institute 925 Lincoln Street, Unit B Denver, CO 80203 8:00am-5:00pm (303) 488-9700

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30 2nd Quarter 2017 mddsdentist.com

October 27 Advanced Grafting and Implantology Utilizing a Cadaver Specimen Mountain West Dental Institute 925 Lincoln Street, Unit B Denver, CO 80203 8:00am-5:00pm (303) 488-9700 October 28 Advanced Grafting and Implantology Utilizing a Cadaver Specimen Mountain West Dental Institute 925 Lincoln Street, Unit B Denver, CO 80203 8:00am-5:00pm (303) 488-9700

NOVEMBER November 11 CBCT Boot Camp: Imaging for Implant Dentistry Mountain West Dental Institute 925 Lincoln Street, Unit B Denver, CO 80203 9:00am-12:00pm (303) 488-9700

November 11 Understanding the TMJ: An Imaging Odyssey Mountain West Dental Institute 925 Lincoln Street, Unit B Denver, CO 80203 1:00pm-4:00pm (303) 488-9700 November 14 CPR & AED Training Mountain West Dental Institute 925 Lincoln Street, Unit B Denver, CO 80203 6:00pm-9:00pm (303) 488-9700 November 17 Sleep Medicine II Mountain West Dental Institute 925 Lincoln Street, Unit B Denver, CO 80203 8:00am-5:00pm (303) 488-9700 November 18 Sleep Medicine II Mountain West Dental Institute 925 Lincoln Street, Unit B Denver, CO 80203 8:00am-5:00pm (303) 488-9700

CLASSIFIEDS Job Board:

Real Estate:

Arvada Dental Center is a well-established, state of the art, private practice looking for a full-time Associate. Our office is fully digital with digital radiography, 3 CEREC acquisition/milling/ oven units, and a Sirona OrthoPhos SL Cone beam machine. Our practice continues to grow and we see approximately 60-80 new patients per month. Arvada Dental Center provides all aspect of dentistry to our patients including family, cosmetic, periodontics, endodontics, orthodontics (Invisalign), implantology, and 4 in 1 implant supported dentures.

Dental Office for Rent: 3 operatory dental office for rent. Flexible schedule, owner works part time. Perfect for satellite office or specialist. Contact: forrent18@yahoo.com

Arvada offers a great quality of life with a small community feel.

Dr. Bennett offers great benefits including a negotiable salary, 401K, and continuing education stipend.

Candidates can submit or inquire about the position via email at Info@ArvadaDentalCenter.com or call 303-421-7611. Candidates may also learn more about our office on our website at www.

ArvadaDentalCenter.com.

General Practice for Sale: Denver, CO (CO 1629) Patient Chart Sale, Annual Revenues $550K, 3 fully equipped Ops, Dr. Retiring, Lease cannot be renewed. ADS Precise Consultants, www. adsprecise.com, 800-307-2537, email: frontdesk@adsprecise.com.

General Practice: SE Metro Denver, CO (CO 1621) Annual Revenues $800K, 4 Ops + room for 1 more, 1,500 square feet, Condo sold with practice, Dr. Retiring. ADS Precise Consultants, adsprecise.com, email: frontdesk@adsprecise.com, 800-307-2537.

General Practice: Metro Denver, CO (CO 1137) Annual Revenues $1.3M, 4 Ops. Heavy Ortho component. Great neighborhood!

ADS Precise Consultants, www.adsprecise.com, email: frontdesk@ adsprecise.com, 800-307-2537.

Visit mddsdentist.com/classifieds to place an ad.

Knowledge • Experience • Credentials • Trust More “Completed Transitions” and

“Years of Practice Transition Experience” of any brokerage firm in Colorado.

ADS Precise Consultants D D S , FA G D • J e d E s p o s i t o M B A , C VA • S t e v e S t e i n b r u n n e r C N E Pe t e M i r a b i t o

• Practice Sales Since 1986 • Practice Valuations

• Dental Building Sales • Transition Planning

• Start-Ups • Buy Ins/Buy Outs

Call us - 800.307.2537 Visit us - adsprecise.com All ADS companies are independently owned and operated

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Does your lease expire in the next 24 months?

If so, allow our team of expert negotiators to save you a substantial amount of time and money.

Carr Healthcare Realty is the nation’s leading provider of commercial real estate services for healthcare tenants and buyers. Our team of experts assist with start-ups, lease renewals, expansions, relocations, additional offices, purchases, and practice transitions.

DENVER & NORTHERN COLORADO Dan Gleissner 303.748.7905 Dan.Gleissner@CarrHR.com SOUTHERN COLORADO Kent Hildebrand 719.440.0445 Kent.Hildebrand@CarrHR.com

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