Dentistry North Texas
a business and lifestyle magazine for north texas dentists
Dentistry With a Passion for Perfection
Robert Zimbro National Target Mailing
Baylor College of Dentistry Announces New Hall of Famers
Business Insurance A Jargon-Free Guide
Becoming HIPAA Compliant
A Legacy Unfolds
2012 Southwest Dental Conference Review
Redefining the Workplace
The Impact of an Updated Dental Office
Congratulations to Monarch Dental for your feature in North Texas Dentistry. At Monarch Dental and Castle Dental we get dentists. We understand why you chose to make a career in healthcare. We get your capabilities, your expertise, and your goals. We work hard to provide the environment and culture that meets your definition of success. We understand that you want time for family, friends, all your lifeâ€™s activities and passions, along with your goal of building a successful career both professionally and financially. Itâ€™s time to discover how Smile Brands can help you practice, prosper and grow. Â‡2XWVWDQGLQJHDUQLQJSRWHQWLDO Â‡)XOOEXVLQHVVDQGFDSLWDOVXSSRUW Â‡&RPSUHKHQVLYHSDWLHQWILQDQFLQJRSWLRQV Â‡3HHUWRSHHUPHQWRUSDUWQHUVKLSV Â‡%UDQGUHFRJQLWLRQLQRYHURIILFHV in 18 states.
Â‡%HJLQQLQJFRPSHQVDWLRQJXDUDQWHHV Â‡&RQWLQXHGVXFFHVVDQGJURZWKQDWLRQZLGH Â‡'HGLFDWHG&OLQLFDO%RDUGRI'LUHFWRUV Â‡&OLQLFDO %XVLQHVV/HDGHUVKLS&XUULFXOXP Â‡,QQRYDWLYHPDUNHWLQJGHVLJQHGWR maintain robust patient base
0LNH'XGD'RFWRU5HFUXLWHU_PLNHGXGD#VPLOHEUDQGVFRP_ SmileBrandsTexasDentistJobs.com *HW6RFLDOZLWK6PLOH%UDQGV&DUHHUV
Dentistry North Texas
Pride Dental ON THE COVER
Dentistry With a Passion for Perfection
5 BAYLOR COLLEGE OF DENTISTRY 12 COMMUNITYâ€ˆNEWS
COVER Photo: Ray Bryant, Bryant Studios
Announcing the newest Hall of Fame inductees
COVER FEATURE: Pride Dental Dr. Masoud Attar and Dr. Allen Sprinkle have a passion for perfection, providing complete patient centered dental services.
A Legacy Unfolds 2012 Southwest Dental Conference Review
Robert Zimbro, owner of National Target Mailing Helping dentists reach their target market and their goals for success
SMILES IN THE SPOTLIGHT
A Case Presentation In a dramatic case, Dr. Fayette Williams and Dr. Herman Kao restore the smile of an oral cancer patient who presented with a tumor of the mandible.
CONSTRUCTION & DESIGN
Redefining the Workplace An updated dental office benefits both patients and staff
Business Insurance: Understanding the Fundamentals A jargon-free guide to insurance coverage for business owners
How to Prepare Your Practice for 6 Key Trends that will affect dental markets in 2012
PRACTICE MANAGEMENT On Becoming HIPAA Compliant
May I See the Wine List?
NORTH TEXAS DENTISTRY
from the publisher
Dentistry North Texas
Publisher | LuLu Stavinoha Photographer | Ray Bryant, Bryant Studios Contributing Writers | Tina Cauller, Kim Clarke, Joy Ellis, Marc Fowler, Jennifer Fuentes, Dr. Danette McNew, Beth Thiel, Dr. Fayette Williams & Dr. Herman Kao, David Yandry
It was good to see many of you at the Southwest Dental Conference and I appreciate the kind words and feedback on North Texas Dentistry. I hope you completed your CE requirements for 2012 and benefited from the wealth of information presented at the conference. Be sure to check out the photos by Ray Bryant of Bryant Studios and follow-up article from Conference Chair, Dr. Danette McNew… the Southwest Dental Conference was once again a big success!
North Texas Dentistry kicks off 2012 by featuring Pride Dental, the practice of Dr. Masoud Attar and Dr. Allen Sprinkle. Located in Arlington, Pride Dental utilizes the latest technology in a state of the art facility. Both doctors and their team were great to work with and you could feel the warm and caring atmosphere of the office. Patients’ needs are definitely the priority at Pride Dental!
Robert Zimbro, owner of National Target Mailing, is this month’s featured Profile. Robert is The dental postcard guy. He has great marketing ideas and delivers a superb product. Details follow in his Profile!
Smiles in the Spotlight presents a dramatic case of Dr. Fayette Williams and Dr. Herman Kao. Discover the process these surgeons used to restore a smile to an oral cancer patient. It is very impressive.
Also in this issue, Baylor College of Dentistry announces the induction of Dr. Patricia Blanton and Dr. Bill Binnie into the Hall of Fame. In another article, Business Insurance, Understanding the Fundamentals, the writer offers great information to answer your questions on the different types of insurance. Enjoy these articles and much, much more!
North Texas Dentistry is working on its line-up for 2012 and is looking for recommendations for cover stories, profiles, Smiles in the Spotlight cases and engaging editorial. We would also like to share the great advertising opportunities available to those wanting to reach the North Texas dental community including this years Special Issue, The Ultimate Dental Practice. For more information or to make a recommendation, email: email@example.com or call 214-629-7110.
Although every effort is made to ensure the accuracy of editorial material published in North Texas Dentistry, articles may contain statements, opinions, and other information subject to interpretation. Accordingly, the publisher, editors and authors and their respective employees are not responsible or liable for inaccurate or misleading data, opinion or other information in material supplied by contributing authors. Copyright 2012. All rights reserved. Reproduction in part or in whole without written permission is prohibited.
Advertise in North Texas Dentistry For more information on advertising in North Texas Dentistry, call LuLu Stavinoha at (214) 629-7110 or email firstname.lastname@example.org. Send written correspondence to: North Texas Dentistry P.O. Box 12623 Dallas, TX 75225.
LuLu Stavinoha, RDH
Thanks to all of you who support North Texas Dentistry and make this publication possible! Keep smiling and have a great day!
Use your Smartphone
to find us at
www. northtexasdentistry.com LuLu
4 NORTH TEXAS DENTISTRY | www.northtexasdentistry.com
Newest Hall of Fame Inductees Baylor College of Dentistry announces the
By Jennifer Fuentes
On January 20, Emeritus Professors Dr. Patricia Blanton and Dr. Bill Binnie were inducted into the Texas A&M Health Science Center Baylor College of Dentistry Hall of Fame.
The ceremony, held during the health science center’s convocation in College Station, Texas, took on special significance for Binnie, as Blanton was a member of the search committee that recommended his original appointment as professor and chair of oral pathology back in 1979.
Department of Gross Anatomy in the ’80s, served the BCD Alumni Association as president, CODA as a site visitor and the National Institutes of Health as a study section chair.
Currently, Blanton's priorities are her Dallas-based periodontic and implantology
practice as well as serving in leadership positions with the American Dental Association and the American College of Dentists. When she’s not seeing patients or representing these national-level organizations, she spends any free time traversing
(CONTINUED ON PAGE 22) u
“She is obviously a lady of great taste and judgment!” says Binnie, who went on to become chair of diagnostic sciences, where he incorporated oral and maxillofacial radiology and the Oral Diagnosis Clinic with oral pathology. He served as interim vice president of academic affairs for the Texas A&M Health Science Center from 2000 to 2003, eventually retiring as vice president in 2006.
It’s safe to say Binnie has devoted his entire career to academics and the dental profession, serving in various capacities for Baylor University Medical Center, the Arizona School of Dentistry and Oral Health, the University of Nairobi, the World Health Organization, the Commission on Dental Accreditation, and a laundry list of others.
Blanton has always maintained a close relationship with TAMHSC-BCD and the dental education community. She chaired the
NORTH TEXAS DENTISTRY
Dr. Allen Sprinkle and Dr. Masoud Attar share a passion for dentistry and the desire to provide patient-centered dental services.
Photos by Ray Bryant, Bryant Studios
Dentistry With a Passion for Perfection
by Tina Cauller
ith its strong roots in tradition, the field of dentistry typically views the flood of new information emanating from research laboratories through a conservative lens. Just a few years ago, the notion that systemic health was linked to oral health was considered by most dentists to be an over-reaching and unproven assumption. However, new data substantiating the link between oral health and systemic health continues to emerge at an unprecedented pace. Today, the connection is widely accepted, having been documented by reputable researchers and clinicians across numerous disciplines. In 2000, the Surgeon General’s report, Oral Health in America, described the evidence linking oral health with heart disease, stroke, preterm births, diabetes and respiratory disease. The mounting body of research has been acknowledged in statements by the World Health Organization, Centers for Disease Control and the National Institutes of Health.
While many systemic diseases manifest in the mouth, the specific causal relationship between poor oral health and overall health is still being explored. After a study conducted jointly by Aetna and Columbia University College of Dental Medicine, researchers announced evidence in 2006 of the relationship between early peri6 NORTH TEXAS DENTISTRY | www.northtexasdentistry.com
odontal treatment and the overall cost of care for diabetes, coronary artery disease, and cerebrovascular disease.
At Pride Dental in Arlington, Dr. Allen Sprinkle and Dr. Masoud Attar approach dentistry from a holistic perspective that recognizes the connection between the mouth and the total body health, combining high-tech equipment and the latest advances in dentistry with personal, individualized care. The doctors at Pride Dental have a passion for perfection, providing complete patient-centered dental services from preventive and holistic dentistry to cosmetic, laser and implant dentistry for adults of all ages.
Dr. Attar has a personal passion for dentistry and a genuine enthusiasm for helping people attain optimal health. “Modern dentistry is an exciting confluence of science and artistry,” he notes. “I love what I do because we have the capacity to change peoples’ lives in a really meaningful way.”
While the practice utilizes the latest technology in a state-ofthe-art facility, Dr. Attar shares his perspective on its role in patient care. “Technology helps us provide care better and faster, but we must never lose sight of the fact that our reason
for being here is our patients.”
While he was pursuing his Ph.D. in horticulture and genetics in the mid-80s, Dr. Attar realized that rather than being isolated in a research laboratory, he wanted a career that would enable him to interact with people and still allow him to be a lifelong learner.
As a result of his extensive training and investigation of the latest research, he understands that oral health provides dentists with an invaluable window to the patient’s overall health. He is committed to helping patients optimize their wellness through education and awareness of this connection. “We need to educate ourselves and pay attention to how our lifestyle choices affect our health,” he notes. “From the ingredients in our food to the materials we use in dentistry, the substances we put into our body can have a critical impact on our overall health. By being aware and conscious of our choices, we can ensure the best possible health for each individual.”
The team at Pride Dental strives to assist patients with their needs so each visit is a positive experience.
After graduating from Baylor College of Dentistry and establishing a private dental practice in the Metroplex, Dr. Sprinkle saw the relationship between oral health and overall wellness firsthand. He found that as he got to know his patients, many reported some type of chronic head, neck or facial pain, which became a subject of interest. Many had been told that their pain was a result of stress and an unavoidable part of modern life, and some had been living with pain for years.
Among these individuals, he often found a common constellation of symptoms, including poor sleep quality and daytime fatigue. They suffered from a myriad of other difficulties including poor concentration, headaches, and acid reflux. Dr. Sprinkle knew that poor sleep quality is detrimental to wellness and can initiate an endless loop of disease, discomfort and discouragement. He sought a way to bring refreshing sleep to these patients as part of a journey back to optimal wellness. For patients affected by sleep apnea
Pride Dental, located in Arlington, utilizes the latest technology in a state of the art facility.Monarch Den-
tal has recently invested $5 million to deploy the most sophisticated technology in its North Texas locations, including highly advanced imaging systems.
or snoring, a specially designed FDAapproved oral appliance can help to keep the airway open so sleep is not disrupted. Custom appliances can also help provide relief from migraines and TMJ pain.
Some experts believe that breathing issues may underlie a host of common conditions, from high blood pressure to difficulty concentrating. “There is reason to believe that the body’s need for greater tone in the throat can trigger a number of prob-
NORTH TEXAS DENTISTRY
of a negative reaction.
Photos by Ray Bryant, Bryant Studios
Pride Dental uses the state-of-the-art DEKA laser that eliminates the cutting and suturing required for traditional surgical treatment. The DEKA laser uses the CO2 wavelength that is the optimal wavelength for soft tissue procedures due to its high absorption in water, which makes up over 80-90% of the content of soft tissue. It gives the ability to incise or ablate soft tissue with great precision and efficiency without unnecessary lateral thermal damage. As Dr. Attar points out, “Laser dentistry is a reality now. Laser periodontal therapy with PerioLase, in conjunction with scaling and/or PerioProtect, is extremely
Dr. Attar believes good communication is crucial to providing quality dental care and makes sure all questions are answered prior to treatment. lematic behaviors that are actually adaptations to an underlying problem,” notes Dr. Sprinkle. “Nail biting may provide relaxing relief by placing the throat in a position that is more conducive to efficient breathing. We think patients who report trouble concentrating, including children and adults diagnosed with ADD, are often affected by breathing issues. They commonly exhibit repetitive habitual behaviors such as eyebrow plucking that may serve as a respiratory stimulant.”
Because some patients may have sensitivities to materials commonly used in dental treatments, the doctors at Pride Dental strive to select the most biocompatible materials and work with patients to make sure there is no reaction to the materials used. They only place white fillings and ceramics and use fluoridefree preventative hygiene treatment to minimize the possibility
The intraoral camera is used to enhance patient understanding of needed treatment. effective and can often eliminate the need for surgery.” The doctors at Pride Dental are licensed providers for DEKA laser and PerioProtect.
Pride Dental uses the state-of-the-art DEKA laser that eliminates the cutting and suturing required for traditional surgical treatment. 8 NORTH TEXAS DENTISTRY | www.northtexasdentistry.com
At Pride Dental, patients enjoy the efficiency, confidence and comfort of the latest dental technology. The advanced Cerec machine uses CAD/CAM technology to create natural-looking, metal-free ceramic crowns in just a few minutes. Patients love the idea of getting their work done in one appointment. The Diagnodent is an advanced method of detecting cavities using laser light technology. Tek Scan is a new computerized bite scan and is an extremely valuable tool that aids in the diagnostic process by analyzing a patient’s bite. An unstable bite can cause broken restorations, pain, headaches, periodontal disease and TMJ disorders. PerioProtect is a revolutionary breakthrough for
Custom oral appliances help provide relief from migraines and TMJ pain.
the nonsurgical treatment of periodontal disease. It is effective and painless.
Pride Dental offers a full range of dental services including regular examinations and evaluations, panoramic and bite-wing x-rays, laser whitening, Invisalign速, testing for materials compatibility, laser periodontal gum treatment, nonsurgical periodontal treatment, extractions and surgical procedures, implants, TMJ and chronic facial pain treatment, and sleep apnea devices. n
At Pride Dental, patients enjoy the efficiency, confidence and comfort of the latest dental technology. The advanced Cerec machine uses CAD/CAM technology to create natural-looking, metal-free ceramic crowns in just a few minutes. Dr. Sprinkle discusses the relationship between oral health and overall wellness with his patients. www.northtexasdentistry.com
NORTH TEXAS DENTISTRY
Pride Dental is located at 1106 W. Randol Mill Road, Suite 100 in Arlington, Texas. For more information, visit www.pridedentaloffice.com.
To contact the office, call 817-461-9998 or send email to: email@example.com.
Allen Sprinkle, DDS
Dr. Sprinkle is a graduate of Baylor College of Dentistry and has years of continuing education pertaining to Biological Dentistry, Chronic Head and Neck Pain and Sleep Disordered Breathing. Dr. Sprinkle is in demand as a speaker at various events and is a consultant to various members of dental and medical communities. He has successfully practiced in the Dallas/Fort Worth area for the past 40 years and is devoted to helping his patients improve their lives through achieving a healthy mouth and body.
Masoud Attar, DDS
Dr. Attar is a graduate of the University of Minnesota School of Dentistry where he was also on the academic staff of Oral Medicine and Diagnosis for many years. As one of the first certified cosmetic dentists through the University of Minnesota and the prestigious Las Vegas Institute for Advanced Dental Studies in the mid1990s, Dr. Attar has provided outstanding service for his patients. His academic training includes extensive studies in biology, botany, toxicology, genetics and two years of comprehensive orthodontic instruction through the American Society of Orthodontics. Dr. Attar has successfully practiced in Minnesota and southern California for the past 20 years.
With Texas hospitality, Dr. Masoud Attar and Dr. Allen Sprinkle at Pride Dental offer a full range of dental services.
PROFESSIONAL AFFILIATIONS n n n n n n n n n n n n n
10 NORTH TEXAS DENTISTRY | www.northtexasdentistry.com
American Dental Association Texas Dental Association Dallas County Dental Society American Academy of Cosmetic Dentistry American Academy of Craniofacial Pain Academy of Biologic Dentistry and Medicine Academy of Clinical Sleep Disorder Dentistry Academy of Neural Therapy Academy of Dental Sleep Medicine Holistic Dental Society International Academy of Oral Medicine and Toxicology International Association of Functional Orthodontics American Society of Orthodontics
2012 SOUTHWEST DENTAL CONFERENCE REVIEW
The legacy of the Southwest Dental Conference continues to unfold. The 85th anniversary of the SWDC occurred on January 12-14, 2012. As with many people, I was looking forward to a fresh new year to accomplish and be the person I desire professionally as well as personally. This Conference ushered in the New Year with high hopes of just that. The Southwest Dental Conference was declared a success by speakers, participants and volunteers.
There are many definitions of success but from the online dictionary, success is described as the achievement of something planned, desired or attempted, or a favorable desired outcome.
I enjoyed hearing from speakers stating they thoroughly enjoyed being a part of our Conference and were pleasantly surprised at the warm hospitality and service provided.
I heard from participants that they were pleased with the variety of speakers and topics and encouraged knowing they had a seat because they had a ticket.
I received a “thank you” from many volunteers who explained that this Conference was easier to serve than they expected and offered their services for future conferences.
During the planning stage of this Conference, our strategic planning committee focused on a specific desired outcome: welcoming hospitality, effective continuing education and meeting the needs of participants by listening to prior evaluations. Therefore, in the manner of deduction, I consider the Southwest Dental Conference to be successful.
Dallas County Dental Society is the key to our successful Conference, as well as the following attributes: Be Prepared.
Do Your Best.
Don’t Give Up.
That sums it all up. Thank you Dallas for making our conference the best it can be.
Remember to be part of our next conference hosted at the Omni Dallas Convention Center Hotel on January 17-19, 2013.
Danette McNew, DDS
Chair for 2012 Southwest Dental Conference
12 NORTH TEXAS DENTISTRY | www.northtexasdentistry.com
Photos by Ray Bryant, Bryant Studios
NORTH TEXAS DENTISTRY
Helping dentists buy & sell practices for over 40 years. AFTCO is the oldest and largest dental practice transition consulting firm in the United States. AFTCO assists dentists with associateships, purchasing and selling of practices, and retirement plans. We are there to serve you through all stages of your career.
Toni P. Hamilton, D.D.S. has acquired the practice of (University of TX Health Science Center - Houston 2007)
Robert L. Allen, D.D.S. - Arlington, Texas (Baylor College of Dentistry 1970)
AFTCO is pleased to have represented both parties in this transaction.
â€œMy AFTCO Analyst found the office I wanted and we closed in under 60 days. There is no place better. Professional and knowledgeable.â€? Toni P. Hamilton, D.D.S. (Sachse, TX)
Call 1-800-232-3826 today for a free practice appraisal, a $2,500 value!
Thanks to that remarkable success, we are more than just a printing service or a bulk mail shop. We know the dental industry and understand the subtle but critical distinctions between different types of dental practices. Whether a practice is based primarily on serving families, cosmetic patients, or Medicaid patients, we can implement a plan to create internal marketing, external marketing and internet marketing campaigns that speak directly to potential patients.
National Target Mailing & DentistryPostcards.com 1507 Capital Avenue, Suite 103 Plano, TX 75074 (972) 424-5979 Robert@nationaltargetmailing.com www.nationaltargetmailing.com www.dentistrypostcards.com
Q. Our practice has potential – if only those potential patients out there knew more about it. How do dentists find expert help with marketing?
Robert: At National Target Mailing, we create marketing solutions specifically designed to meet the needs of dentists, and have created and executed effective, customized marketing strategies and materials for hundreds of dental practices all over the country. About six years ago, we started specializing in marketing for dental professionals and today, thanks to referrals from our satisfied clients, dental marketing now constitutes about 90% of our business.
For some practices, growth is a long-term goal, for others there is a genuine need to see appreciable growth quickly. Starting up a new practice can be challenging and demands a solid marketing plan to ensure that growth happens rapidly enough to sustain the business. A practice that has experienced a shortterm downturn may need to boost productivity in order to be profitable. Or, a practice may need to increase patients to bring on an associate or prepare to sell the practice. Regardless of the specific situation, we can address your needs with a customized plan.
Q. We have been hesitant to get involved with a marketing group. Dentistry is such a unique field, how could a marketing company possibly understand the profession, much less the goals of our unique practice? Robert: We have private practice dental clients with a single office and large dental practices with multiple locations. Through effective marketing, many of our clients have reached their goals to expand their practice. One client who has worked with us for nine years has grown from a single office to seven offices, another from a single location to 27 locations.
There is a saying, “A goal without a plan is just a wish.” We’ll explore your professional goals, and help you outline a plan to get there. For a new practice, we match their goals with an appropriately aggressive marketing campaign. We view our role as a partner in growing your business.
We offer a flexible, dynamic and responsive plan that can adapt easily to accommodate the changing needs of the practice. Whether a client chooses a one-time campaign or a monthly campaign, we never lock them into a rigid plan. If business slows down, we make sure the marketing can respond immediately and, if the office gets too busy, we can adjust the schedule accordingly.
Q. How can we make sure our marketing budget is used wisely?
Robert: We advise dentists to ask questions and become informed when setting out to choose a partner in creating a marketing plan. Too many firms will get a client in the door for a low price and then break the budget with add-ons, or lock clients in to a long-term contract that is carved in stone. Make sure that you are comparing apples to apples when you comparison shop for marketing support.
Our clients enjoy a working relationship with a single team member who provides expert, personal service. Rather than blanketing households with unwanted junk mail created from generic online templates and wasting marketing dollars in the hopes of reaching a few interested individuals, we design custom materials and mailing plans that precisely match the profile of the target audience.
The dental profession is impacted by regulations, laws and conventions that are constantly changing and evolving. Our familiarity with those requirements helps you avoid costly or marketing pitfalls and common mistakes. We help our dental clients establish consistent branding across websites and printed materials. Our approach ensures that every dollar of your marketing budget achieves maximum return. Robert Zimbro has been in marketing for 14 years, and founded National Target Mailing 12 years ago. He recently founded www.DentistryPostcards.com to help dentists easily create mailers that reach clients with high-impact print promotions that get measurable results.
National Target Mailing has experienced tremendous growth for three years in a row, and is perfectly positioned to help dental clients achieve their own goals. With its new 5,200 square foot manufacturing center located in Plano, and stateof-the-art mailing software and addressing equipment that saves time and eliminate production headaches, National Target Mailing is ready to serve dentists more efficiently and cost-effectively than ever before. For more information, call (972) 424-5979 or visit www.nationaltargetmailing.com and www.dentistrypostcards.com.
National Target Mailing/DentistryPostcards.com Robert Zimbro
NORTH TEXAS DENTISTRY
LEADERS IN NORTH TEXAS DENTISTRY CREATING UNFORGETTABLE SMILES
Defects of the face, neck and mouth are often created when removing tumors or as the result of severe facial injury. Proper reconstruction is vital to allow patients to maintain the highest quality of life and self-esteem. Dr. Fayette Williams is the only Oral & Maxillofacial Surgeon in the DFW area performing microvascular reconstructive surgery, and one of less than 30 Oral & Maxillofacial Surgeons in the nation trained in this state-of-the-art form of reconstruction. After finishing his six-year surgical residency, Dr. Williams completed an additional two years of fellowship training at the University of Michigan to learn this specialized surgery.
Microvascular reconstructive surgery is one of the most advanced options in restoring facial form and function following the removal of large facial and oral tumors. Tissues from the patient’s own body are transplanted into the orofacial defects to restore function and appearance. These transplants (known as “flaps”) can be in the form of skin, muscle, bone, or any combination. The flap is removed from the body along with blood vessels that supply nourishment to the flap. The blood vessels are reconnected to vessels around the facial defect under a microscope using sutures smaller than a human hair. Once blood flow is re-established, the transplanted tissue remains alive just as it did in its original location. Because the flap is completely freed from another part of the body, this technique is often referred to as “free flap surgery” or “free tissue transfer.”
When necessary for microvascular jaw reconstruction, Dr. Williams utilizes computer-guided virtual surgery to plan the reconstruction with increased precision and potentially reduced operating time. Using this advanced technology, Dr. Williams works closely with biomedical engineers from Medical Modeling on each case to offer truly customized surgical solutions for each patient.
While not all patients are candidates to undergo this form of reconstruction, Dr. Williams also performs many other forms of facial reconstructive surgery. The optimal reconstructive technique is tailored to each patient and chosen based on the patient’s wishes, goals, and available options.
16 NORTH TEXAS DENTISTRY | www.northtexasdentistry.com
Fibula ready for inset
Prosthesis on cast
Fibula with implants
CASE PRESENTATION This 44-year-old healthy female presented with a slowly enlarging mass in her chin. A panorex revealed a multilocular radiolucency extending across the mandible from #19 to #28. An incisional biopsy under local anesthesia revealed ameloblastoma. Her dentition was in good repair and cosmetically excellent.
TREATMENT PLAN Resection of this tumor required at least 1cm of normal bone in every direction, which was expected to result in a mandibular continuity defect spanning from #18 to #30. The patient was a public speaker and was devastated to learn she would lose most of her lower teeth. With conventional non-vascularized bone grafting, this would require resection of the mandible during the first surgery, bone grafting from the iliac crest during a second surgery three months later, placement of dental implants and soft tissue procedures 4-6 months later, followed by another 4-6 months for osseointegration. This normally requires 15-18 months of multiple operations before the patient’s dentition is restored. We performed an operation to resect the tumor, immediately reconstruct the defect with a fibula free tissue transfer, and immediate placement of dental implants into the vascularized bone all in one operation. A preoperative cone beam CT scan was used to fabricate models to virtually plan the resection and reconstruction.
Fayette Williams, DDS, MD
Final dentition Post-op pano
PROCEDURE The patient was taken to the operating room under the care of Drs. Kao and Williams. Her tumor was excised through the mouth, thus avoiding a large neck incision. The nerve canal on the right was unroofed to preserve the mental nerve, while the left mental nerve was sacrificed where it entered the tumor. Occlusion was maintained with a temporary external fixation device to hold the remaining posterior mandibular segments in their original relationship throughout the surgery. The left fibula was harvested along with the peroneal artery and vein which supply the bone. A 12cm segment of the fibula was shaped via wedge ostectomies to conform to the prefabricated custom mandibular reconstruction plate used to fixate the bone flap. This prebent plate with the fibula construct was placed into the mouth and fixated to the remaining mandible to re-establish bony continuity. A small 3cm incision was placed in the left neck to access the facial artery and vein. These vessels were anastomosed to the peroneal artery and vein supplying the fibula under a microscope with 9-0 nylon sutures. Once the bone flap was found to be viable and bleeding, four dental implants were placed and the incisions were closed primarily. The patient healed uneventfully from her surgery and underwent a minor soft tissue revision (vestibuloplasty) three months later to prepare for the restorative phase of treatment.
RESULTS A satisfactory smile was obtained only 4 months later, consistent with current osseointegration healing periods. A hybrid prosthesis was fabricated with laboratory support from Darrel Clark, CDT in Weatherford, TX. The prosthesis consisted of a milled bar fit to the dental implants. Additional abutments were laser-welded to the bar in an ideal position to support the dentition. She reports no difficulty with ambulation and is able to eat a full diet with her fixed hybrid prosthesis. As can be seen in the postoperative panorex, the obvious drawback of the fibula is the minimal height of bone compared to the dentate mandible. However, with modern implant and surgical technology these patients can have their dentition restored in one-fourth of the time span required by traditional reconstructive techniques.
Fayette Williams, DDS, MD is Clinical Faculty at John Peter Smith Hospital in Fort Worth, TX and Adjunct Assistant Professor at The University of Texas Southwestern Medical Center in Dallas. In 2010, he completed a fellowship in Maxillofacial Oncology and Reconstructive Surgery at the University of Michigan in Ann Arbor.
After returning from his fellowship, Dr. Williams joined the faculty at John Peter Smith Hospital in Fort Worth and the private practice of Facial & Oral Surgery Associates. Dr. Williams is the only oral & maxillofacial surgeon in the DFW area performing state-of-the-art microvascular reconstruction of the head and neck. He has lectured on a national level and has authored three textbook chapters on oral cancer and reconstructive surgery. At John Peter Smith Hospital, he is Vice-Chairman of the Cancer Committee. Dr. Williamsâ€™ passion lies in the treatment and reconstruction of oral cancer and their related defects.
Herman Kao, DDS, MD
Dr. Kao is a dedicated private and academic surgeon, which enables him to enjoy the full spectrum of dentoalveolar, dental implant, orthognathic surgery, trauma/reconstructive surgery, and cleft lip and palate surgery. With state of art technology, his practice utilizes computer virtual planning for dentalimplant and corrective jaw surgeries. Dr. Kao is also passionate about serving the underserved. He is a recipient of the Sally Hopper Golden Crown Award for his Pro Bono services to local dental health clinics.
Academically, Dr. Kao is Clinical Faculty at John Peter Smith Hospital where he performs and teaches major facial trauma and reconstructive surgery. He is actively involved in the education and training of the interns and Oral/Maxillofacial Surgery residents. Because of his dedication to patient care and satisfaction, he sits on the Patient Care Committee and the Physician Advisory Committee. In addition, Dr. Kao holds an appointment of Adjunct Assistant Professor at UT Southwestern Medical Center, where he gives regular Grand Round lectures to the faculty and residents.
For more information concerning this case, contact Dr. Williams at www.facialoralsurg.com or call 817.927.1325. www.northtexasdentistry.com
NORTH TEXAS DENTISTRY
construction & design
Redefining the Workplace
‘Find your happy place’ at Just for Kids
by Beth Thiel
e all know that a great looking office cannot take the place of delivering excellent health care, but what you may not realize is how profoundly the office environment can affect the morale of the staff and ultimately the level of care delivered.
Creating environments that appeal to the patient has always been a priority and undoubtedly an effective way to attract and keep patients. I think everyone will agree that investing in the office environment for the comfort of the patient is a justifiable expense. When you consider however, how the workplace environment plays a role in the performance of your employees, you may realize that this ultimately impacts the overall success of your practice. Although the results may not be as easily measured, they are in fact, very real.
Without question, it is simply more fun to come to work in a beautiful environment than a worn and outdated office. We invest tremendous amounts of effort making our home environment inviting, but with the average work week being 40 hours, the office environment also plays an important role in the quality of our lives. Nowhere is this statement more accurate than in healthcare.
It has been proven that higher levels of stress occur in poor work environments. This translates into lowered business performance, lack of motivation and decreased profitability. In contrast, the welldesigned workplace provides an environment for employees to work at peak performance where tasks are easier, employees are happier and fewer mistakes are made.
18 NORTH TEXAS DENTISTRY | www.northtexasdentistry.com
Author, speaker and business guru, Tom Peters, best describes the role of design in the workplace, “You want your people inspired and stimulated when they come to work. The physical environment as much as the work itself, plays a part in this.” You don’t have to be a business expert to understand the implications of this statement. Clearly, when your employees are excited to come to work, they become more thoughtful and courteous to your patients – and to one another. This sentiment breeds enthusiasm that is absolutely and unquestionably contagious.
Ask Dr. Jon Ousley DDS, MSD, pediatric dentist in Waxahachie, Texas. He has experienced unexpected results from his recent office renovation that continue to validate his decision to invest in his office – and his employees.
Years of wear and tear at the Waxahachie Just for Kids office combined with an ever growing patient base made the decision to renovate easy for Dr. Ousley. “We had increased our office staff as the patient base grew and were using every square inch of our lease
space” states Dr. Ousley. “We were working in tired and confined quarters and needed to invest in workspace efficiencies as well as an updated look. This included the waiting room, which required at least twice as much seating to accommodate both patients and their families.”
Along with workspace efficiencies, the overall décor of the office was also undergoing development. Furnishings and finishes were updated and new excitement was infused into the existing movie theme that has truly delighted patients, families and staff. The result has been an infectious enthusiasm that is carried into the community – making his patients, their families and employees natural promoters of the practice.
Agreed, there may be no direct measurable return on this investment – except happier people. Maybe not every dollar invested needs to prove a monetary return. Instead, perhaps job satisfaction simply promotes the recruitment and retention of talented employees who exude the pride and excitement of people who know that they are a part of something that matters.
Following the renovation of Just for Kids, an envelope arrived with individual hand-written letters of appreciation from each and every staff member in Dr. Ousley’s office. Each subsequent visit brings yet another enthusiastic greeting from his staff, always grateful for “giving them an office that makes them happy”. Additionally, I continue to receive messages from Dr. Ousley that yet another parent or patient noted how happy the office feels. Most surprising was a letter we received from the mother of a patient, expressing how
“joyful the office felt” along with gratitude for “making it so pretty.”
“It’s like a gift that keeps on giving,” notes Dr. Ousley. “New patients and recall patients who haven't seen the office in six months or more invigorate us with their compliments on the office! Thank you, Beth!”
Since launching the new Just for Kids in August, my favorite quote from the movie Finding Nemo, “find your happy place”, reminds me of Dr. Ousley, his staff, the patients and their parents. Just for Kids is proof that happy employees truly equal happy patients, resulting in patients who return and refer, giving Dr. Ousley an investment with a compounding return for years to come.
Who could have guessed that kids and staff members alike would “find their happy place” at the dentist. The workplace redefined! Thank you, Dr. Ousley. n
Thiel and Thiel is an award-winning architecture and interior design firm based in the Dallas/Fort Worth area that offers a comprehensive range of services including architecture, interior design, graphic design, procurement and installation services. Owners Beth and Kurt Thiel have handpicked professionals from across the design world to make up their team, who create complete brand strategies that are exclusive to each client and to each property. Go to www.thielandthiel.com to learn more about the firm’s extensive array of integrated services and review their substantial portfolio.
Protection is our Business Disability Life Health Long Term Care Malpractice
Our only business is working with TDA Members and their staffs. We are committed exclusively to servicing TDA membership’s needs. Let us review, compare and provide options for your coverage. Bob B b Michaels, Mi h l CLU Local Associate 214-696-5103
www.tdamemberinsure.com 1-800-677-8644 www.northtexasdentistry.com
NORTH TEXAS DENTISTRY
Understanding the Fundamentals
s a dentist, you’re extensively trained in the field of oral health from many years of schooling and practice. Your patients are not. So, when discussing treatment with them, you’re careful to provide clear and concise information so they’re well-informed without being weighed down by minutia. This time you’re on the receiving end, and the treatment is insurance.
The following information is a jargon-free guide to insurance for business owners. Understanding the fundamentals will make you better able to correctly assess your business insurance and make decisions about how to protect your investment. Although not an exhaustive examination, these are some of the key coverages that you should consider. General Liability
This is often called “slip and fall insurance” because one of the protections General Liability coverage provides is bodily injury if patients are injured on your premises if, for example, they slip and fall. However, a General Liability policy covers much more than just slips and falls. In addition to bodily injury, it also provides for property damage suffered by
third parties resulting from your business activities and that you’re legally obligated to pay. Coverage also includes personal and advertising injury for acts resulting in injury to others that is not of a physical nature, such as mental anguish, slander, libel, invasion of privacy and defamation. The third and final protection that a General Liability policy affords is for medical payments. Although coverage for bodily injury is already included, medical payments is a “goodwill” coverage that can be paid out regardless of negligence on your part. General Liability doesn’t cover your professional services, which are protected by a Medical Malpractice policy.
Building and Business Personal Property/Contents
This coverage is normally included on your Business Owner’s policy and is often called “property coverage” because it protects against damage to the physical property you own for various causes of loss (i.e. fire, wind, hail, theft). The Business Personal Property limit should include the items you own located at your premises, such as furniture, equipment, medical supplies and computers. If a tenant, your landlord should carry coverage for the building itself. However, if you’re responsible for
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by Joy Ellis insuring any build-out that you installed (i.e. cabinetry, flooring, etc.), it is important to discuss this with your agent to verify that these are included in your policy limit. Quite often, build-outs can simply be added to your Business Personal Property limit. If you own the building and are insuring it on your Business Owner’s policy, the limit should include replacement cost of the building as well as any permanently installed items (i.e. dental chairs, cabinetry, counters, etc.). It’s essential that your policy be written on a replacement cost basis. This means that in the event of a covered claim, your property will be replaced with like kind and quality, without depreciation.
This coverage is typically included in a Business Owner’s policy and applies to the loss of business income during the restoration stage following a covered claim. For example, if you have a fire at your location and are forced to close your doors for several months while your covered property is either repaired or replaced, your Business Income coverage will reimburse you for normal operating expenses, such as rent and utilities. This policy typically covers ordinary payroll for a 60-day period.
Employee Practices Liability Insurance
This covers the exposures you face as an employer and provides protection for liability arising from refusal to employ, wrongful termination, work related sexual harassment and discrimination claims. Keep in mind that even though you may not be found guilty of the accusations, the cost to defend can be substantial. This coverage can be added to your Business Owner’s policy or be purchased separately.
Hired and Non-Owned Auto Liability
Any business that even occasionally uses a vehicle not owned by the business should strongly consider this coverage. Hired and Non-Owned Auto Liability insurance provides coverage for claims against your business if employees have an accident while using either their own or a rented vehicle for business purposes. Even if driving their own vehicle, employees can sue your business if they were performing company functions, like going to the bank, when the accident occurred. This coverage can be added to your Business Owner’s policy.
Although General Liability covers injury to patients, it doesn’t cover work-related injury to you or your employees. Worker’s Compensation is a policy specifically geared toward covering work-related injury and occupational disease. In Texas, many businesses aren’t required by law to carry Worker’s Compensation, therefore, many simply go without. However, a serious work-related injury or occupational disease can cost you considerable amount of money as well as expose you to lawsuits by employees. One of the key benefits of Worker’s Compensation is that it’s a “sole remedy,” meaning if you have a Worker’s Compensation policy, an employee is barred from seeking damages against you for work-related injury or occupational disease.
This policy affords coverage for liability arising from errors, malpractice and mis-
takes in either rendering or failure to render your professional services as a dentist. This is a policy that you almost certainly already carry, but it’s crucial that you examine the liability limits of your policy and discuss the expense of increasing those limits with your agent. In the event of a malpractice claim, a seemingly adequate limit can be exhausted quickly. n
Joy Ellis, CIC is an insurance marketing professional who has worked with Higginbotham, an independent brokerage firm endorsed by TDA Financial Services, for four years. Her expertise is small busi-
ness insurance, including Business Owner’s Policies, Worker’s Compensation and Medical Malpractice, and she works closely with dentists to find coverage to suit their individual needs.
You can contact Joy at firstname.lastname@example.org or call (817) 728-2374 ext. 2364. For more information, visit www.TDAmemberinsure.com.
“I found Structures and Interiors’ staff of construction professionals extremely easy to work with. Structures and Interiors did a wonderful job designing my office and building it out in an amazingly short time period for this type of detailed construction. I am very pleased with their work and their always pleasant attitudes and eagerness to get things right and in the exact way I wanted them.” - barrie barber choate dds, msd, pa pediatric dentistry
www.structures-interiors.com 817.329.4241 www.northtexasdentistry.com
NORTH TEXAS DENTISTRY
(CONTINUED FROM PAGE 5)
the globe, presenting continuing education head and neck anatomy.
It’s been decades since Blanton and Binnie first began their association with the college, and from the looks of it, it’s a connection that will continue for years to come. n
Founded in 1905, Baylor College of Dentistry in Dallas is a college of the Texas A&M Health Science Center. TAMHSC-BCD is a nationally rec-
ognized center for oral health sciences education, research, specialized patient care and continuing dental education. The TAMHSC serves the state as a distributed, statewide health science center that is present in communities throughout Texas. Jennifer Eure Fuentes is a communications specialist at Texas A&M Health Science Center Baylor College of Dentistry. A 2006 graduate of Texas Christian University, she has worked in the communications and editorial field for five years.
Global Reach. Local Touch. Single Source.
NATIONAL CHILDREN’S DENTAL HEALTH MONTH
More than 50 percent of children ages 5-9 have at least one cavity or filling according to Oral Health in America: A Report of the Surgeon General. To help reduce cavities and dental illnesses among children in our local community, Children’s Dental Centre of Irving will donate more than 3,000 toothbrushes to kids in celebration of National Children’s Dental Health Month in February.
Dr. Reena Kuba, DDS, MS, the Centre’s pediatric dentist, is committed to working with the community and parents to create a positive, educational atmosphere to get children on the right path to a lifetime of optimal oral health. The majority of toothbrushes being donated will go to students attending early childhood schools in the Irving Independent School District.
“Cavities can be painful and expensive and are preventable. Starting dental visits early helps get children on the right path to healthy teeth and a beautiful, confident smile,” said Dr. Kuba.
Along with toothbrushes, the staff of Children’s Dental Centre of Irving will provide free student presentations and parent classes on dental health to schools and organizations.
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Children’s Dental Centre of Irving provides comprehensive dental care for children ages six months to 18 years. Dr. Reena Kuba, DDS, MS, is certified by the American Board of Pediatric Dentistry and is the founder of Children’s Dental Centre of Irving. Dr. Kuba is also a clinical assistant professor at Baylor College of Dentistry and was named one of the Best Dentists by D Magazine in 2011. n
Dentistry North Texas
Provided by Leading Doctors in North Texas
n High Resolution Photography n Step by Step Details of Treatment For more information on sharing your expertise in a future Smiles in the Spotlight contact
NORTH TEXAS DENTISTRY
How to Prepare Your Practice for
6 Key Trends
that will affect dental marketing in 2012
by Marc Fowler
The Google Panda Update The first phase of the Panda update rolled out in February 2011 and has been the talk of the online marketing world ever since. Google’s goal with Panda was to improve the relevancy of search results, by helping quality sites with relevant content rank high, while penalizing sites with low-quality, and/or duplicate content. According to Google: “We added new signals to help us make better predictions about which of two similar web pages is the original.”
The Panda update was said to have impacted 12 percent of search results and several websites with poor quality content saw website visitors fall 60% or more, almost overnight. What
this update really did was change search engine optimization (SEO) best practices forever. While it’s always been important, today having fresh, high quality, original content is critical.
Dentists need to beware of the cookie cutter dental website companies that use the identical website and blog content on dozens (or in some cases hundreds) of the dental websites they create. What you need to do: Ensure that the content on your website is unique to you. If you are unsure whether your website content is unique, visit Copyscape.com and paste the URL of one of your services pages into the box at the top and click “Copyscape Search”. If other dentist’s websites show up, you’ll know that your website has duplicate content.
Social Media “signals” play a bigger role in Search Engine Rankings With
Google making a huge push into the Social Media arena with Google Plus (aka Google+ or G+), we have confirmation of what we’ve assumed for some time: Social Media is becoming a more important factor for ranking well in Google. In addition to links from other websites to yours, Google is also looking at your social presence: Tweets, Facebook Likes, +1s, etc.
What you need to do: Establish accounts and begin participating in Twitter, Google+ and Facebook.
The Google Freshness Update The online marketing world has always said “Content is King”, With this update, that mantra should now be “Fresh Content is King”. The update rewards websites based on the freshness and relevance of the content. This is another modification of the formula to provide web searchers with more relevant content. In Google’s attempts to create that perfect search world, they’re holding the website owner’s feet to the fire by requiring a constant flow of new, high-quality content. In Google’s words: “This change impacts roughly 35 percent of total searches (around 6-10% of search results to a noticeable degree) and better determines the appropriate level of freshness for a given query.”
What you need to do: Establish a blog on your website and begin posting high-quality articles to it. This will keep your website fresh.
Google makes big push in Local (ie.
Google Places, Yelp, etc.) In their never ending quest to provide relevant search results (and make money), Google has placed increasing emphasis on local search results – particularly Google Places (aka Maps). Mid24 NORTH TEXAS DENTISTRY | www.northtexasdentistry.com
2011 Google made a major change to the way search results are displayed when they merged organic (website) rankings with Google Places listings. Prior to this change the Places listings stood on their own in the “7 Pack” at the top of the page, afterward the Places results were combined with the primary website rankings for the majority of search terms (keyword phrases).
Whereas in the past, optimizing your website had no effect on your Places listing and vice versa, today what happens on one affects the other. Therefore, it is more important than ever to ensure your Google Places listing is claimed, optimized, citations are built (your business information submitted to prominent listing directories) and that your business name, phone and address are consistent across these various listing websites.
What you need to do: Claim and complete your business listings on Google Places, Yahoo Local, Bing and Yelp. Then search for your business and see which additional directories you are listed on and ensure your name, address and phone are consistent across all.
Mobile Search Smartphone ownership has
more than doubled in the past two years. In 2009 only 18 percent of U.S. mobile subscribers owned a smartphone. Currently the figure is 44 percent. Over 50% of Google Maps/Places traffic is from mobile devices. The percentage of web searches from mobile devices has grown 25% year-over-year, now accounting for 26% of total search volume. Google says 40% of its mobile searches are for local information.
And, as you know, moms make a majority of the decisions regarding healthcare for their families, and they are always on the go. According to one recent study, 62% of moms access the internet from their mobile phones.
What you need to do: Visit your website from a smart phone and see if it is readable. If not, you’ll want to have a mobile version of your website built. Be sure and remove any flash, as Apple products cannot read flash. Again, ensure that your listings on local directories are claimed and optimized. n
Online Reputation Management 2011 was the year of the empowered consumer (examples: the occupy movements across the country, the Netflix backlash, etc.) and dentistry wasn’t exempt. With the proliferation of online review websites, prospective patients are able to read dozens and, in some cases, hundreds of reviews for the typical dentist. There are currently over 17 million reviews on Yelp alone.
So, it is not surprising that online reviews can have a huge impact on new patient flow – positively or negatively. You may have heard the old saying: “a satisfied customer will tell 10 people, a dissatisfied one will tell 100” – on the web that dissatisfied patient could “tell” thousands.
Reviews from your existing patients tell your potential new patients the level of service you provide and whether you can be trusted with taking care of their pearlywhites. Unfortunately, this is a two way street: a bad review can cost you new patients and even if untrue, can potentially destroy your image in the eyes of the public.
What you need to do: Do a Google search for your name and your practice name. Visit the websites that come up on the first page. If any of them have negative reviews, see if you can submit a response. We have a blog article on our website that coaches you on how to do this. Then proactively begin collecting reviews from your satisfied patients. Additionally, try to own as much real estate on the first page of Google, Yahoo & Bing as possible for your name and your practice name.
Special Offer for North Texas Dentistry Readers Valid through March 30, 2012
Call our office at 214.592.9393 and mention “North Texas Dentistry” and we will waive the fee for our online marketing audit. You can learn more about the audit at www.DentalWebsiteAudit.com www.northtexasdentistry.com
NORTH TEXAS DENTISTRY
On Becoming HIPAA Compliant A
by David Yandry
s with many things in life, HIPAA compliance is more a journey than a destination. Even once you’ve done the hard work of evaluating your practice for vulnerabilities, mitigating the risks, and documenting the whole process, it’s not enough to just put a stamp on your practice that says “Compliant” and call it a day. You must invest time in ongoing training and awareness programs, stay on top of changes to personnel, technology, and the pertinent legislation You must continually measure and address any additional risk to patient records that may be introduced or uncovered as a result of these changes, and of course, keep a record of it all as you go.
If you’ve done little more than buy a book, or roll out a few standard patient privacy forms, you’re behind the curve. Many practices will hire a consultant, or dedicate a current member of their staff to working through the process of analyzing and 26 NORTH TEXAS DENTISTRY | www.northtexasdentistry.com
establishing compliance. Typically, smaller practices have a few less considerations to deal with than larger practices, but most of the requirements apply regardless of practice size.
The whole process makes for a long and winding road, but even a journey of a thousand miles begins with a few steps. Here are some technical safeguards your practice should have in place, or should be strongly considering for implementation in your quest for HIPAA compliance:
Use encryption software to protect ePHI on your server. We recently saw a practice lose a server to a theft during an overnight break-in. When your data is encrypted on the server hard drives, there’s no way for the thieves to access the ePHI stored there without the unique password you create, even though they have access to the drives.
Install antivirus software on all PCs, tablets, notebooks and servers, and keep it current. Hackers and data thieves
are always plotting new ways to break into networks and collect sensitive data using trojan horses, root kits, data miners and viruses. Protect your network’s data from their efforts with antivirus software and make sure it stays updated so you’re protected via the latest antivirus signatures.
Create a backup and restore plan for your ePHI. Not only are you required to protect ePHI, you are also required to produce it for your patients in a timely manner should they request access to it. A good backup and restore plan can help you achieve both objectives. Make sure you not only have a good copy of the data, but periodically test the restoration of the data to make sure it hasn’t become corrupt. Ideally, you’ll have a copy of the data off-site as well, to protect against theft, fire, storm or electrical damage to your practice.
Create and maintain unique logins to your network and practice management application for each member of your staff. Unique logins are required in order to track who has accessed your systems, when they were accessed and what information was viewed. User logins should be disabled immediately when an employee is terminated or resigns.
Restrict physical access to the server storing your ePHI. You should literally keep your server protected under lock and key. Whether you do that with a small locking cage, in a locked closet that houses networking equipment, or in a dedicated room that can be locked from general access, it’s important to protect your server in this way and maintain documentation that notes the “who”, “when” and “why” of physical access to the server. Just be sure the server also has adequate airflow to protect against the damages of overheating.
Create and sign a Business Associate (BA) agreement with any vendors that may have access to ePHI. The BA agreement will outline obligations of both parties with respect to things like protecting ePHI and reporting breaches. Should your practice become the subject of an investigation by the Office of Civil Rights (OCR) due to a breach, this will be one of the first things they ask you to produce.
This list of recommendations is in no way meant to be a comprehensive test of compliance. As mentioned, these are only a few small, yet vital measures designed to help protect your ePHI as you strive for complete HIPAA compliance. Implement them all, and you’ll be on your way. Skip any one of them, and you could be creating a vulnerability that leads to a breach and a visit from the OCR. In any case, the mandate for full HIPAA compliance is here. Time to get going! n David Yandry is the President of Acclaim Networks, an IT service and support provider in Grapevine, TX. Acclaim Networks has been supporting the networking needs of dentists, orthodontists and oral surgeons in Dallas and Fort Worth for the last 10 years. They can be reached at (817) 488-1030 or online at www.acclaimnetworks.com.
Encrypt all outgoing emails that contain ePHI. This can be done through software installed on premises, or through a variety of hosted email providers. Emails can be intercepted both electronically and in person if anyone else has access to the patient’s computer. Encrypting your email insures that only the intended recipient is able to open and view the contents via a password they create.
Deploy a business-class firewall to protect your network. Many firewalls sold at big retailers that are sufficient for home use are not adequate for protecting a practice’s ePHI. You want a model that will perform IDS/IPS (intrusion detection services/intrusion prevention services) functions and proxy-based analysis of the data packets entering your network.
NORTH TEXAS DENTISTRY
MAY I SEE the WINE LIST? by Kim Clarke
ine lists are a lot like people. They can be friendly, exciting, adventurous, confusing, frustrating, maddening and downright outrageous. Some readers look forward to working their way through and finding a gem while others dread spending time examining the list only to come up empty. Like everything else, it’s easy if you know how. With some wine knowledge and a little experience you will find something you like at a price you’re willing to pay. If you’re a wine novice, however, you will probably rely heavily on the sommelier to spend your money wisely. Some do and some don’t. One way to select a bottle of wine is to pick something that a lot of other people choose. If you’re at a restaurant that doesn’t focus on wine, brands like Sutter Home, Franzia, Inglenook and Yellow Tail are the usual offerings. Based on volumes of wine shipped to America’s on-premise drinking establishments in 2008, White Zinfandel, Pinot Grigio and “Chablis” are at the top of the list. Only one red wine, Yellow Tail Shiraz, made the top 20 list. Not too exciting? Sorry, the numbers don’t lie.
28 NORTH TEXAS DENTISTRY | www.northtexasdentistry.com
At the other end of the spectrum, however, is a list compiled by Wine & Spirits magazine. W&S asked a group of wine-focused restaurants to report which wines are on their lists – not how much was sold but which ones were offered. One can infer that these wines are on the list because they are popular sellers. You’ll recognize these names (top 10 in order of frequency): Sonoma-Cutrer, Cakebread, Jordan, Silver Oak, Ferrari-Carano, Robert Mondavi, Veuve Cliquot, Chateau Ste. Michelle, Rombauer, Kendall-Jackson. With the exception of Silver Oak (red wine only) and Cliquot (Champagne), these wineries produce both white and red wine, any of which are usually safe choices.
Finding a wine you like is the easy part. Now you get to see if you like the price. My problem is that I usually don’t. I always experience sticker shock no matter how much I’ve tempered my expectations. I’m not looking for a bargain – I’m just looking for value. Wine list pricing doesn’t seem to follow any kind of formula or logic. Economics says that you’ll sell more if the price is low rather than high, but maybe there’s such low
price elasticity that it doesn’t matter. In other words, people don’t care about the price – they’ll buy what they want despite the cost. I find that difficult to believe, especially in this economy.
I checked out wine lists from three good restaurants in town – you’d easily recognize their names – and found the good, the bad and the ugly. I think it was just a coincidence, but their lists illustrate the wide range of pricing you’ll find. For example, one wine that’s become a best-seller in just a few years is Orin Swift’s The Prisoner – a zinfandel-based blend from California you can find in a wine shop for around $32. One of the restaurants offers this wine for $54, a markup that I consider quite reasonable (maybe even low) and one that probably sells a lot of this wine. On the other hand, the two other lists priced this wine at $85 and $93. Don’t know about you, but I wouldn’t pay that. I notice that almost all of the wines on the “bad” and “ugly” lists seemed priced this way, but even on these lists there were some values if you worked at it. One of the restaurants had a bottle of Edge Cabernet, the second label of a good California Cabernet producer called Signorello, priced at $56, a little more than double the wine shop price. Another decently priced listing was the Mountain Cuvee Cabernet from Chappellet – at $58 it was less than twice the wine shop price.
Restaurants certainly deserve to make a healthy profit on their wine sales and I’m not the first or the last person to express frustration at some of their pricing. My only point is that it is quite easy to pay a huge markup if you’re not careful and it’s not that easy to find a good value unless you’ve done your homework. Use the internet and check out the wine list ahead of time. Find wines on the list that you’ve seen in the wine shop and compare prices. The wine list that priced The Prisoner at $54 was full of good values across all varietals and the food there is great as well. I’m sure there are others, but it certainly takes some effort to find them. Happy Hunting! n
NORTH TEXAS DENTISTRY
Acclaim Networks....................................................29 AFTCO....................................................................14
Bob Michaels, CLU .................................................19
Bullseye Media .......................................................30
bloom a flower studio l
FRESH FLORAL ARRANGEMENTS TO BRIGHTEN YOUR RECEPTION AREA
FLOWERS FOR ALL OCCASIONS
30 NORTH TEXAS DENTISTRY | www.northtexasdentistry.com
Dental Logic ............................................................29
Destiny Dental Laboratory ......................................30
Dr. Ravi Doctor........................................................22 Higginbotham..........................................................22 Med Dent Advisors..................................................27
Med+Tech Construction .............................back cover
Nexus Dental Alliance .....................inside back cover Ray Bryant Photography .........................................11
Smile Brands ...................................inside front cover Structures and Interiors...........................................21 Tina Cauller.............................................................29
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A spotlight on Pride Dental the practice of Dr. Masoud Attar and Dr. Allen Sprinkle in Arlington Texas. Articles include information on typ...