February 2011 Nugget

February 2011

Is This Dentist Real?

Inside:

AB 2637 — Changes to allowable RDA Duties PLUS: Call to Leadership — Are you ready to serve?

don’t miss these upcoming events! continuing education

member forum

March 4, 2011

March 18, 2011

5

RPDs — Still a Good Option in the Age of Implants

CE, Co

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Presented by: Alan Carr, DMD, MS Course Objectives: • Unique differences between RPDs and other prosthetic options • Why reports of periodontal disease in RPD wearers exist, and whether there is a true causal nature to the relationship • Key clinical/patient features that put patients at risk for dissatisfaction when provided with RPDs

Build Your Own Employee Handbook Presented by: Mari Bradford (CEA) Topics will include: • Benefits and Risks of an Employee Handbook • Policies Required by State and Federal Law • Recommended Policies • What NOT to put in a Handbook 8:30am–1:30pm • 4 ceu (20%) SDDS Office

8:30am–1:30pm • 5 ceu (Core) Hyatt Regency Sacramento

member forum March 24, 2011

general meeting March 8, 2011 Benign & Malignant Tumors of the Neck & Skin Presented by: Barbara Burrall, MD

Spous Nigh e t!

4

CE, 20

The Numbers of your practice: The good, the bad, avoiding the ugly Presented by: John Urrutia, CPA (Mann, Urrutia, Nelson, CPAs)

Course Objectives: • Recognize normal variant cutaneous structures, a range of benign cutaneous tumors and a range of cutaneous malignant tumors, including melanoma and non-melanoma cancers • Perform a general head and neck skin cancer screening

Topics will include: • The best structure for your business • Red flags when someone else is “handling” your numbers • How your practice and your personal life work together • What your CPA should be doing • The right time for investing: expanding, building, partnering

6:00pm–9:00pm • 2 ceu, Core Sacramento Hilton — Arden West

6:30pm–8:30pm • No ceu Sacramento Hilton — Arden West

%

Table of Contents

THE NUGGET February 2011 Volume 57, Number 2

Features 7

Testimony by Guy E. Acheson, DDS at DBC Meeting Guy E. Acheson, DDS, MAGD, FACD, FPFA

8

The Tip of the Spear Guy E. Acheson, DDS, MAGD, FACD, FPFA

Specials 10

Don’t Just Sit There… Learn!

Robert C. Harris, CAE (The NonProfit Center)

15

What is Privileged Communication?

Yasica Corum (Risk Management Analyst, TDIC)

32

It’s the Law: When All Goes to Hell in the Handbasket Petra von Helmburg, DDS, JD (Reprinted with permission from Chicago Dental Society)

Regulars 4 5 6 13 14–15 15 16 19 22 23 24–25 25 26–27 27 28 30 30 30–31 34 35 36

President’s Message From the Editor’s Desk Cathy’s Corner Foundation Update Being Social Our Condolences YOU: The Dentist… the Business Owner Board Report YOU: The Dentist… the Employer Announcements Committee Corner Committee Meeting Schedule Vendor Members Vendor Member Spotlights We’re Blowing Your Horn!

Advertiser Index Link of the Month Membership Update Event Highlights Classified Ads SDDS Calendar of Events

The Nugget is a four-time International College of Dentists Journalism Award Winner: Golden Pen (Honorable Mention, 2007) Article or series of articles of interest to the profession

Outstanding Cover (2007) Remarkable cover

Overall Newsletter (2007) Exceptional publication overall

Platinum Pencil (2010) Outstanding use of graphics

* featured on cover www.sdds.org

February November 2011 2007 | 3| 3

President’s Message Community Service Members of the Sacramento District Dental Society have a long history of community service. According to Dr. Kent Daft, our resident historian, in 1911, Sacramento City School Board established a dental clinic.

Members of SDDS worked in that dental clinic until its closure in 1929. During the Depression, members used the dental equipment from the school clinic to form a new dental clinic to serve children, which they staffed on a rotating basis until its closure in 1955.

In the early 1970s, Sacramento’s C Street Dental Clinic was organized with the help and support of SDDS. Some of our members volunteered there and some worked as paid staff. Sadly, that clinic was closed in 2009 and was relocated to a new location with limited services. We still have members working there.

20 years ago, Dr. Steve Cavagnolo and other members started the dental clinic for Davis CommuniCare Health Centers and we have continued our support there.

Since the 1990’s, our members have participated in Donated Dental Services, providing free complete dental services for underserved mentally and physically challenged patients and geriatric patients.

Some SDDS members have actively joined forces with medical and public health organizations in pursuing water fluoridation of our community, working tirelessly with

First 5, City Councils, Board of Supervisors and the water district board members.

Other members have visited public officials to lobby on various health care issues. The hearings, planning and lobbying take a great amount of time from their practices and their family.

Our Dental Society’s charitable arm, Sacramento District Dental Foundation, has existed since 1969. We continue to provide dental care and community education through SDDF. We started our annual Smiles for Kids day in 1991. In addition to free dental care for kids up to 18 years old on the Smiles for Kids day, kids with extensive needs are scheduled to individual offices for follow up care. Our member orthodontists each take in one new patient per year pro bono. Last year, we provided over one million dollars in free dental care in the five counties covered

by SDDS. In 2010, we started Smiles for Big Kids — a program for parents of kids who participate in Smiles for Kids, as well as the elderly and others.

Since 2008, our members have acted as advisors to The Effort’s Community Health Center in planning and establishing Federally Qualified Health Center Dental Clinics (FQHCs). It is a joy to see that with the support of Sacramento Children’s Dental Task Force and First 5 Sacramento, two clinics have opened in 2010 and three more will be coming in these next two years.

RAM is coming!

Remote Area Medical (RAM) is holding two 4-day clinics in our area in 2011. They are in need of volunteers to help provide free services to children and adults.

By Wai M. Chan, DDS In 2009, our members founded an inschool dental clinic in Sacramento School District, staffed by volunteer dentists. They provide free dental care for underserved high school students.

In 2010, a few members have partnered with the Gathering Inn, planning a free dental clinic in Placer County. This year, SDDS kicks off the “1st Tooth or 1st Birthday” campaign, bringing awareness to the public, the medical community and our dental community on the importance of children visiting dentists by the time they are one year old.

We have members who volunteered for the Coalition of Concerned Medical Professionals, providing free dental care for underserved adults.

We have members who provide dental screenings for various community health fairs. Some have volunteered for the school career days. There are many members who provide pro bono services in their offices to patients in need.

These are our silent heroes. They are not noticed by the news media. They are not recognized by the legislators and special interest organizations. They do this out of their love for humanity. They have made a difference in our community.

I am proud and humbled to have these heroes as my fellow members. Don’t let the special interest groups say that, as a profession, we do not care for our community. They can talk their talk, but we have actions to prove that we walk the walk. 

Sacramento, CA (Cal Expo) April 1–4, 2011 Oakland, CA April 9–12, 2011

dental Volunteers Needed: Dentists/OMS (65) RDHs (20) DAs (65) www.ramusa.org

To pre-volunteer for these expeditions, please call RAM/CALAOMS: (916) 772-8197

4 | The Nugget

Sacramento District Dental Society

From the Editor’s desk

By Guy E. Acheson, DDS (Pictured)

Jim McNerney, DDS

Associate Editor

Is General Dentistry Dead?

The lead story of AGD IMPACT, August 2010 was about mid-level providers. Did that cover photo of the dejected dentist staring at his empty dental chair (shown below) get your attention? Another way to introduce the topic would be to ask the question, “Should you encourage your children to pursue dentistry as a career?”

One of the most troubling trends in dental politics is the issue of creating mid-level providers. This agenda is being pushed by national foundations that refuse to engage with dental organizations and push for change through legislation, bypassing the regulating ability of state dental boards. Midlevel providers are their vision of solving the crisis of dental caries in children that they feel is due to limited access to dental care.

My personal view is that this effort addresses the problem of early childhood caries in exactly the wrong way. The mid-level provider agenda emphasizes the surgical model of treating disease when the effort should be on prevention. It is as if the proper response to cardiovascular disease and heart attacks should be to build more hospitals and increase surgical capacity by creating a surgical nurse practitioner. Lifestyle choices,

August 2010 issue of AGD Impact www.sdds.org

dietary habits, poor oral hygiene practices and cultural attitudes are the genesis of tooth decay. In my view, 90% of prevention of dental caries is behavior modification.

Interestingly, most of the behavioral changes needed to prevent dental caries would also help prevent obesity, diabetes and cardiovascular disease. Four of the most costly diseases in America are fundamentally the result of poor lifestyle choices and are all best addressed by education. Why is it that Americans demand technological and surgical repairs for diseases that are essentially preventable? This is the most expensive and least effective approach to disease a society can take.

California has all the elements needed to solve the caries problem. We have more than enough dentists. Our dentist to population ratio is 1:1250 compared to 1:1639 for the entire United States. We have a workforce category that can allow a dentist to be more than twice as productive in providing restorative care through the RDAEF. We have specialists in preventive care and education that have the authority to practice independently in underserved areas and in public health care settings, the RDHAP. What we are missing is the organization and funding to put these existing workforce categories to effective use. It takes money to hire people to do the work that they are already authorized and trained to do. A new workforce position of mid-level provider will only drain more money and time in developing educational programs and there still will not be money to pay for the services of these new personnel. It takes political will and courage to push a prevention agenda in a society that screams, “Don’t tell me how to live!”

Two programs in California that seem to be shining lights in developing and implementing real solutions to the children’s caries problems are Project Headstart with their case management model and First Five Sacramento. Both emphasize establishing

a Dental Home for children before age 12 months and both stress education of the family in preventing dental caries.

Wouldn’t it be wonderful if, when the Pew and Kellogg Trusts begin lobbying for mid-

Why is it that Americans demand technological and surgical repairs for diseases that are essentially preventable? level provider legislation in California, they were met by legislators who pushed back by telling them that we are solving the problem very well with existing workforce models?  Dr Guy Acheson received his DDS degree from the University of the Pacific in 1979 and subsequently completed an Air Force general practice residency. He has practiced in Sacramento for over 30 years with a focus on conscious sedation and hospital dentistry. He is a California Dental Board Evaluator for inoffice IV conscious sedation. He has earned both Fellowship and Mastership in the Academy of General Dentistry, the former requiring 500 hours of continuing education courses, the latter an additional 600 hours, 400 of which must be hands-on. He is retired from the Air Force Reserve Dental Corps with the rank of full colonel, a founding member of the SacramentoSierra component of the California AGD, and currently serves on the Board of CAGD as vicepresident. With two grown daughters, he fills the void flying sailplanes, having completed flights of 500km and more than 5 hours duration, as well as the Symon’s High Altitude Award for climbs above 32,000ft. He currently pilots a Rolladen-Schneider LS-8. Additionally, having foot-climbed 32 of California’s 58 counties’ high points (including Mt Whitney and White Mt), his goal is to stand on the highest in all 58.

February 2011 | 5

Cathy’s Corner

Amador • El Dorado • Placer • Sacramento • Yolo

Leadership

By Cathy B. Levering

SDDS Executive Director

February marks the beginning of our “volunteer” season… and do we have the opportunities!

By the time you receive this issue of the Nugget, our Smiles for Kids (SFK) Day will be over — our member dentists and staffs will have seen and treated about 1000 kids. About 500 volunteers will have participated on SFK Day. Smiles for Kids “Adopt a Kid” is beginning this month — offering continued care to “finish the work” that was done on SFK Day. Another 400 doctors participate with SFK Adopt-a-kid, including specialists.

Next month, we will be doing the SFK Orthodontic screening — and another 70 kids will receive orthodontic treatment, beginning this summer.

70 orthodontists volunteer for this.

Smiles for Big Kids (SFBK), developed especially for the parents of SFK and the elderly, shoots off from this point. Another 300 dentists participate in that.

The point I make here, humbly, is that … well… WOW! I am deeply grateful to be part of an organization that can do all that we do. And we can’t do it without our members’ stepping up and saying… “I’ll help.”

Thank you!

And, there is another volunteer opportunity coming up — RAM (Remote Area Medical) is coming to Sacramento (held at Cal Expo) on April 1–4th.

This project is headed up by our friends at CALAOMS (the Oral Surgeons Association of California) and it is a great undertaking. (In addition to the Sacramento area event, they will then pack up and move the project to Oakland the next five days.) RAM will provide dental care, vision services (including glasses), mammograms and diabetes testing.

Volunteers are needed for set up the two days before, and 80-100 dentists (including specialists) are needed for every day. Hygienists and assistants are also needed, as well as general volunteers to do intake, triage and running.

Since the event is on a Friday, Saturday, Sunday and Monday, we hope that the volunteers will have scheduling opportunities to volunteer for one or more days.

This event was held in LA the last two years, and more than 7000 people stood in line for treatment. It is anticipated that in Sacramento and Oakland, large numbers will again attend. If you can attend and help, the flyer to sign up is inserted in this issue of the NUGGET. Again, thank you!

Happy February!

President — Wai Chan, DDS Immediate Past President — Terrence Jones, DDS President Elect — Victor Hawkins, DDS Treasurer — Gary Ackerman, DDS Secretary — Kelly Giannetti, DDS Editor — James Musser, DDS Executive Director — Cathy Levering

EXECUTIVE COMMITTEE

Dan Haberman, DDS, MS Carl Hillendahl, DDS Jennifer Goss, DDS Kenneth Moore, DDS Craig Johnson, DDS Viren Patel, DDS Wallace Bellamy, DMD Brian Royse, DDS Kim Wallace, DDS

Board of Directors

Kevin Keating, DDS, MS Donald Rollofson, DMD CE: Jonathan Szymanowski, DMD, MMSc CPR: Margaret Delmore, MD, DDS Dental Health: Dean Ahmad, DDS Ethics: Volki Felahy, DDS Foundation: Robert Daby, DDS Leadership Development: Terrence Jones, DDS Legislative: Mike Payne, DDS, MSD / Gabrielle Rasi, DDS Membership: Lisa Laptalo, DDS Peer Review: Bryan Judd, DDS / Brett Peterson, DDS Dental Careers Workgroup: Robin Berrin, DDS Beverly Kodama, DDS Budget & Finance Advisory: Gary Ackerman, DDS Bylaws Advisory: Adrian Carrington, DDS Fluoridation Advisory: Kim Wallace, DDS Forensics Advisory: George Gould, DDS / Mark Porco, DDS Strategic Planning Advisory: Victor Hawkins, DDS/ Gary Ackerman, DDS Golf Tournament: Damon Szymanowski, DMD SacPAC: Donald Rollofson, DMD SDDF Gala Fundraiser: Wes Yee, DDS Smiles for Kids: Donald Rollofson, DMD

Trustees Committees Standing

Ad hoc Advisory Task Forces Workgroups

Special Events Other

Nugget Editorial Board

SDDS Staff

James Musser, DDS

Cathy Levering

Editor

Paul Binon, DDS, MSD Donna Galante, DMD Alexander Malick, DMD James McNerney, DMD Christy Rollofson, DDS Oladimeji Sorunke, BDS Ash Vasanthan, DDS, MS

Executive Director

Della Yee

Program Manager/ Executive Assistant

Melissa Orth

Publications Coordinator

Lisa Murphy

Member Liaison/ Peer Review Coordinator

Erin Castleberry

Member Liaison/ Smiles for Kids Coordinator

Editors Emeritus: William Parker, DMD, MS, PhD • Bevan Richardson, DDS Advertising rates and information are sent upon request. Acceptance of advertising in the Nugget in no way constitutes approval or endorsement by Sacramento District Dental Society of products or services advertised. SDDS reserves the right to reject any advertisement.

The Nugget is an opinion and discussion magazine for SDDS membership.

Opinions expressed by authors are their own, and not necessarily those of SDDS or the Nugget Editorial Board. SDDS reserves the right to edit all contributions for clarity and length, as well as reject any material submitted.

The Nugget is published monthly (except bimonthly in June/July and Aug/Sept) by the SDDS, 915 28th Street, Sacramento, CA 95816 (916) 446-1211. Subscriptions are free to SDDS members, $50 per year for CDA/ADA members and $125 per year for nonmembers for postage and handling. Third class postage paid at Sacramento, CA.

Postmaster: Send address changes to SDDS, 915 28th Street, Sacramento, CA 95816.

6 | The Nugget

Sacramento District Dental Society

© 2008 Sacramento District Dental Society

SFK, SFBK, Ram, etc…

Sacramento District Dental Society

Testimony

by Guy E. Acheson, DDS at DBC Meeting My name is Dr. Guy Acheson. I am a general dentist who is in private practice in Rancho Cordova, California. I am the current Treasurer of the California Academy of General Dentistry. Although I am a Board Member of the California Academy of General Dentistry, I am speaking today as an individual.

There are several areas regarding AB 2637 that I would like to speak to today. I would first like to speak about my concerns regarding the supervision of RDAs as stated in AB 2637.

Then, I have several concerns regarding the RDAEF program, specifically with regards to how they are educated and graduated from the training programs as well as regarding some of their new duties. Let me be clear that I am a supporter of expanded duty dental auxiliaries.

My practice has employed an RDAEF from the beginning of the program and she continues to be a valued member of my staff.

My first concern is the change in level of supervision required for RDA duties. As I understand it, AB 2637 allows the supervising dentist to decide what level of supervision is needed for each duty performed by an RDA, where the previous law allowed the Dental Board to specify the level of supervision required for each specific duty. This troubles me because of the risks of supervising dentists abusing this authority which could put the public safety at risk. I will use just two examples.

First is the duty of Denture Adjustments.

On the surface this seems like a very safe duty to give general supervision to, but my experiences as a general dentist over the last 33 years makes this a much more involved duty than just adjusting the plastic parts of a denture. To begin with, there are many different philosophies on how a denture should be fabricated with regards to coverage of soft tissue, variable loading of tissues, extension of borders and flanges, as well as widely divergent occlusal designs. If the RDA does not recognize the design with which the denture was fabricated, a simple grinding away of some plastic could significantly alter www.sdds.org

the function of the denture in a very negative way. I believe a dentist needs to inspect the denture and specify what adjustments are to be made based upon the dentist’s recognition and understanding of these design issues.

I also ask; can an RDA recognize and distinguish a sore spot or gingival irritation that is from a mal-adjusted occlusal situation, versus a denture flange overextension, versus residual ridge remodeling, versus a primary or secondary infection, versus significant oral pathology such as oral cancer? In my career I have had two cases of oral cancer that have presented as a denture sore spot. I feel all denture adjustments require an examination by a dentist who is trained to recognize all these issues.

My second example regards the duty of fabricating and placing temporary restorations. I can imagine a large pediatric or adolescent restorative case where multiple deciduous and permanent teeth could be prepared for stainless steel crowns. The dentist could declare these stainless steel crowns to be temporary restorations, turn the case over to an RDA, consider this to be a duty requiring only general supervision and the dentist leaves the building to have lunch while the RDA places multiple stainless steel crowns.

With the prospect of these restorations being in place for years, not the typical three to four weeks that a temporary crown is in place while a definitive crown is fabricated, the potential for injury to the patient because of poor marginal adaption, improper occlusion, inadequate cementation, overextension or residual subgingival cement is significant. A requirement for the supervising dentist to be present during the completion of these duties reduces the risk of abuse. Perhaps stainless steel crowns need to be singled out as being different that other temporary restorations.

I now want to address some concerns I have regarding RDAEFs and the duties of placing and finishing direct restorations.

The educational standards in AB 2637 make

By Guy E. Acheson, DDS distinctions between didactic education, and laboratory exercises, and go on to say that clinical experience is to be satisfied by practice on typodonts mounted in mannequin heads.

No actual clinical experience on a human patient is required. I have taken hundreds of hours of dental education on typodonts

My overarching concern is for public safety. mounted in mannequin heads and can state that they do not adequately duplicate issues of pain control, tissue management, hemorrhage control, maintaining a dry field, airway management, and problems of limited access due to anatomic variations or patient behavior. In addition, the procedures of bonded restorations are highly technique sensitive. The multiple steps involved with maintaining a dry field, etching of dentin and enamel, judging whether the etching step was adequate, how much to dry tooth structure or bonding components, the proper placement of composite restorative materials, and judging the adequacy of the final restoration just cannot be duplicated on plastic teeth.

Dental schools recognize this and have extensive requirements for practice on human patients before considering a student to be competent. University of the Pacific School of Dentistry has a minimum of 130 restored surfaces to be completed on human patients before clinical competency is even considered.

These 130 restored surfaces are only the absolute minimum standard for human clinical experiences and many would agree that this is barely adequate to assure basic competence and assuring public safety. I simple cannot conceive of considering any practitioner to be competent in a procedure when they have not be instructed, practiced, and demonstrated their skills in actual clinical situations. continued on page 20

February 2011 | 7

The Tip

Of the Spear 2010 was a very important year for Dentistry in California. Two of the most significant events in our profession have taken place that have the potential to dramatically change the dental workforce model we are all used to.

Whether they are viewed as opportunities or attacks will depend on your view of what it means to be a dentist and what dentistry’s future should be in California. The troubling fact is that most California dentists don’t have a clue of what I am going to write about. One has to do with changes that are already the law in California and the other suggests one possible future for dentistry in California.

The second item represents the very pointy tip of the spear that powerful lobby groups have thrown in our direction to force their model to solve the problem of early childhood caries in the United States.

By Guy E. Acheson, DDS as well as fitting and cementing endodontic master cones and accessory points using lateral condensation.

Take a moment to think about this. Read the previous paragraph again and let it sink in.

In the practice of restorative dentistry, which is the very core of most general dentist’s practices, the dentist is needed to complete an examination, develop a treatment plan and come to an agreement with the patient as to what treatment will be provided. After

that a hygienist can provide local anesthesia (this was previously allowed). The dentist will prepare the teeth for composites, amalgams and crowns. Then, under the new law, the case is turned over to the RDAEF. The RDAEF will etch, prime, bond, matrix, place, cure, and finish composite restorations, as well as matrix, place, condense and carve amalgam restorations. The RDAEF will complete placement of retraction cord, obtain master continued on page 29

The first item concerns changes made in the duties and scope of practice of dental auxiliaries in what is known as AB2637.

AB2637 is sweeping legislation that dramatically changed the organization, training and oversight of dental auxiliaries.

Developed over five years with significant effort by CDA, it was passed in 2009 and became law in 2010. It created two new dental assistant categories; Orthodontic Assistant and Dental Sedation Assistant. It gives Registered Dental Assistants (RDA) the new duty of adjusting dentures extraorally. It changed the way RDAs are managed in that previously, the level of supervision for each duty by the supervising dentist was specified by the Dental Board of California. With AB2637 this changed to allow the supervising dentist to determine whether general supervision or direct supervision is indicated for each duty performed by an RDA. The most far reaching effect of AB2637 is expanding the duties of the Registered Dental Assistant in Expanded Functions (RDAEF) to include placing direct restorations of all materials (amalgam, bonded composite, glass ionomer), the fitting, adjusting and final cementation of indirect restorations, 8 | The Nugget

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February 2011 | 9

Don’t Just Sit There…

Learn!

By Robert C. Harris, CAE

The NonProfit Center

It’s true of so many things, but especially seminars and • Ask good questions. Do so silently to yourself, or write them down as they occur to you so you can ask at the appropriate moment. conferences: You get out of them what you put into them. To Question to learn, not to show off in front of colleagues. encourage attendees to make the most of your association’s educational opportunities, share these 13 tips to maximize the • Take good notes. You’ll lose great ideas before you ever have benefits of attendance. (You’ll probably even profit from the a chance to try them if 1) you dash them off illegibly, 2) you suggestions yourself.) never bother to read them when you get back to your office, or 3) you didn’t take any. Write notes as if you’ve been asked • Before you ever sit down at the conference, determine what to read them at your next staff meeting. You probably won’t you want to learn. Prepare by picking the right sessions for do that, but do share the “idea-gems” you learn with at least you, reading speaker bios, and anticipating some of the one other person. content and what you hope to find out.

• Find the best seat. Arrive early so you can find a spot you’re • Be open to new seeds of wisdom. By keeping an open mind, you may hear something that can change your approach to a comfortable in. To avoid distractions, sit near the front. If the project or motivate you to expand your interests. But if you handouts are on the table when you arrive early, scan them for don’t hear the information you want most during the session, content so you’ll be better able to follow the presentation. stay a minute or two afterward and ask the speaker if you can • Sit next to someone you don’t know. Stay apart from the talk or exchange e-mails later on. people with whom you came. Make new friends. Look for a potential mentor, customer, or contact. During the breaks, • Don’t stop learning just because you’re in the hallways or trade show aisles. Not everything is taught from the podium. Keep make a point of meeting at least one new person. your notebook in hand and ask questions of the people you • Turn off distractions. Put away your calendar, Blackberry, meet outside the formal sessions. If exhibitors are present, the newspaper, and trade journals so you can really focus on the information they provide and their handouts might give you presentation. Don’t worry about anyone else; concentrate on new ideas and facts. becoming the best you can be for yourself.

• Listen with the intent to really learn and improve yourself. • Contact the meeting’s sponsors. They have a decided purpose for participating in the conference. Recognize the sponsors, Pay attention specifically for one or two good ideas from thank them, find out what’s new with them and what they every session. The best way is to take notes and be quiet. At might be able to do to help you. the end of the day you may have a dozen new facts, resources, and inspirations. Sometimes you have to hear the entire • Finally, apply new concepts and information not just to your job but also to your personal life. If you let it, what you learn presentation before you understand the original concepts. can add value to many areas of life beyond the office.

Don’t cut off the thought or start critiquing too soon.

• Don’t be a know-it-all. When you hear a familiar fact, don’t tell yourself, “I already knew that.” Rather, ask yourself, Reprinted with permission from Robert C. Harris, CAE; chairman of the “How good am I at that?” Self-evaluation is one of the keys Nonprofit Center in Tallahassee, Florida. www.nonprofitcenter.com to self-improvement. Pick out what will work for you and concentrate on applying the new and relevant information.

SDDS HR hotline: • Turn down your sensitivity meter. You’re attending to get information, not to be offended by a remark or word. Don’t expect everything to be politically correct. Don’t criticize the presenters; instead, help them make dynamic presentations by listening and nodding your head when you agree or by asking good questions.

10 | The Nugget

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Sacramento District Dental Society

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February 2011 | 11

RAM is coming!

Sacramento, CA (Cal Expo) April 1–4, 2011 Oakland, CA April 9–12, 2011

Remote Area Medical (RAM) is holding two 4-day clinics in our area in 2011.

They are in need of volunteers to help provide free services to children and adults.

CALIFORNIA VOLUNTEERS NEEDED!

Dentists/OMS (65) RDHs (20) DAs (65) If you are not available to volunteer, please consider making a donation to the RAM CA Expeditions The California Association of Oral and Maxillofacial Surgeons (CALAOMS) is the host coordinator for this expedition. Please help us support these clinics by volunteering for a day, or multiple days at either or both venues. We need MDs, RNs, DDS/DMDs, OMSs, RDHs, DAs, Ophths, ODs, Opticians, Op Techs, and general volunteers. To volunteer, find up to date information, or to donate, go to www.RAMCaliforniaVolunteers.org.

For more information on services, or to donate medical services, donate food, or to make a contribution, call:

Pamela Congdon CALAOMS Executive Director, RAM Host Coordinator

(916) 783-1332 (800) 500-1332 pam@calaoms.org

www.RAMCaliforniaVolunteers.org • www.RAMusa.org 12 | The Nugget

Sacramento District Dental Society

Sacramento district dental society foundation

A charitable 501-C3 organization

a few words from the prez 2011 Foundation President

On behalf of all the needy kids and adults treated by SDDF over the years, I want to express their sincere appreciation for restoring their smiles and improving their dental health. Not only do you “fix” teeth, you often change lives. As incoming President of SDDF, I marvel at the huge strides that SDDF has made. Initially formed to administer a small orthodontic fund which treated one patient a year, SDDF has now performed about $10 million of charitable dental treatment. Smiles for Kids has been so successful that it has become a model for the nation.

It seems to me that SDDF is currently at a crossroads in its history. We can rest on our laurels and slowly lose our effectiveness, or we can renew our commitments, reenergize, and catapult ourselves to successes never imagined by our predecessors. I choose success and humbly ask every SDDS dentist for their help. First, please become SDDF dues paying members either by checking SDDF on your dues statement or responding to dues notices

sent in SDDS mailings. Take the opportunity to meet the kids in your community by volunteering for dental screenings, Smiles for Kids, or by adopting several kids who need our help but have huge barriers to dental care. If you have adults in your practice who have fallen on hard times, apply for a general dentistry grant from SDDF. If you are a specialist, call the SDDS office to offer your expertise in treating the indigent. Volunteer for RAM on April 1–4 as Cathy details in her article. Last, please attend the SDDF Gala on October 1, 2011 and bid generously.

When you donate your money to SDDF, you get immense satisfaction if you watch your dollars at work. If you join us in the trenches to screen or treat patients one on one, you will be paid handsomely. You will receive little or no money, of course, but you will be paid. Patients and families will offer their sincere thanks, but, in addition, you will receive a feeling that I cannot fully describe a feeling of deep fulfillment and satisfaction. When legislators ask you what you have done to improve access to dental care, point to the Sacramento District Dental Foundation and explain the commitment of our volunteers. Then as your legislator: “What have you done?” 

Welcome, 2011 Foundation Board!

Robert Daby, DDS President

Matthew Campbell, Jr., DDS Vice President

Robert Gillis, DMD, MSD Treasurer

Kelly Giannetti, DMD, MS Secretary

www.sdds.org

Board members: Adrian Carrington, DDS Kevin Keating, DDS, MS Terry Jones, DDS Gordon Harris, DDS Victor Hawkins, DDS Dennis Peterson, DDS Wesley Yee, DDS Gayle Peterson (Associate Member) Damon Szymanowski, DMD (Golf Chair)

SFK Receives Large Grants for 2011!

$25,000 California Endowment

NEW!

By Robert Daby, DDS

$25,000 Mercy Catholic Healthcare West

$10,000 California Dental Association

Oct 1

2011

Save the Date!

February 2011 | 13

NEW FEATURE! Engage social media marketing to establish branding, build your practice and protect your reputation

Being Social Top 10 Social Media Pitfalls Reprinted with permission from California Employers Association (SDDS Vendor Member)

If you were to make a list of up-and-coming business trends, social media strategies would probably be near the top. However, thousands of companies are rushing headlong into the profile-creating, newstweeting, blog-posting frenzy...only to find that their valiant efforts are not getting the results they had hoped. If you’re looking for fans, followers, and friends to build a Social Nation around your business, don’t panic, says Barry Libert, author of Social Nation: How to Harness the Power of Social Media to Attract Customers, Motivate Employees, and Grow Your Business.

“When it comes to building a successful social network for your company, you need to understand that there’s a lot of prep work to be done, “Libert explains.” You can’t just set up a Facebook profile for your company, tweet once or twice a day and expect public interest in your company to shoot through the roof.” Think about it this way: if you were in charge of your company’s booth at a trade show or conference, you wouldn’t just slap your company’s logo onto a piece of poster board, place your business cards on the table and hope for the best, would you? Of course not.

“If you want to become a meaningful part of social conversations and interactions,” explains Libert, “you’ve got to know who your target ‘fan base’ is, where they spend their time online, and what sorts of content and programming is valuable and relevant to them, and will foster their continued interest and participation. You also need to make sure you have the wherewithal to commit to growing and sustaining your Social Nation, and you’ve got to make sure that you have buy-in from within your company. And that’s just for starters.”

14 | The Nugget

Libert is eager to share the top 10 social media pitfalls he’s seen organizations fall victim to in the past.

Running a Social Nation like a traditional business.

If you want to run a social company, you first need to understand that almost everything you do is a two-way street. That is to say, you’re not going to prosper if your products and services are designed solely by folks on the inside. You need to embrace the perspectives and contributions of your employees, as well as those of customers and partners.

Underinvesting in social initiatives and abandoning them too soon.

Understand that a Social Nation is organic.

Early on, you’ll need to invest a good deal of time, thought, and money in attracting fans and followers — and your efforts will need to be sustained. Only after you’ve built a firm foundation will your social network begin to sustain itself through participant contribution and recommendation. Successful strategies include posting quality content that people want to consume, letting customers tell their stories and post their grievances, and then responding to their criticisms. Also, make sure that prospects are able to learn about your business through customer and employee testimonials. Lastly, remember that using multiple approaches — for example, a blog, Facebook profile, and interactive website — will reach more people.

Neglecting to find ways to encourage and inspire your Social Nation’s followers and fans.

Realize that your fans and followers are essentially volunteering their time and energy to serve as developers, sounding boards, and advertisements for your company. So for goodness’ sake, respect what they have to say and take their input to heart!

Relying on a “build-it-andthey-will-come” mentality.

You need to purposefully reach out to potential community members and make it worth their while to accept your invitation.

“Rolling out a community and just expecting people to join as friends or followers is a flawed philosophy,” confirms Libert.

“Marketing 101 principles still apply. That means you need compelling incentives to have people join your community. You also

Your company doesn’t have the luxury of waiting until it is “convenient” to go social. need an aggressive programming strategy, one that includes defining your key audiences and targeting them through all available channels, to ensure that they know that you want to build a relationship with them.”

Delaying the process of going social.

Contrary to what you may wish, your company doesn’t have the luxury of waiting until it is “convenient” to go social. Why? Well, you have competitors, right? And if you don’t start gathering loyal followers and fans now, there’s a good chance that some other company will woo them first. One of the best strategies for going social as quickly and effectively as possible is to designate employees and subject matter experts to act as community success managers focused on fostering community growth and member satisfaction. Separate from your sales and support teams, these community leaders should have the ability to advise members of the community on how to best participate with the company and with each other. If you do things well, you’ll find that they’ll generally serve as internal and external advocates for others in your organization — be it employees, partners or customers.

Underestimating the power of a Social Nation.

If you believe that social networking is just a window dressing that your company “needs” (but not really), then think again.

Social media and community collaboration bring many benefits, including brandbuilding, customer loyalty and retention, Sacramento District Dental Society

cost reductions, improved productivity and revenue growth.

Neglecting employees, partners, investors or customers when building your Social Nation.

What is

Privileged Communication?

Set up a focus group of employees to serve as community leaders who will shepherd your company into the social networking world, but don’t put all of the power in their hands. Social Nations are organic organizations, so the more people who are empowered to influence yours, the better. “You’ll find that leaders will emerge from your community population — whether they are employees, partners, customers or prospects, “promises Libert.

By Yasica Corum (Risk Management Analyst, TDIC)

Relying on traditional approaches when designing your Social Nation.

Doctor-patient confidentiality begins when a patient seeks the advice, care, and/or treatment of a dentist. This applies to dental consultations as well.

Patients seeking dental treatment or advice should not fear that their dental concerns, medical conditions or personal information will be disclosed to others. The expectation is for dentists to hold that personal health information in confidence and use it exclusively for the benefit of the patient.

A decade ago, you probably would have been horrified at the thought of releasing ideas and products into the hands of your customers before they were as complete as you could get them. With social networking, that approach is now becoming obsolete.

Developing your own social software and analytic solutions.

You wouldn’t dream of placing “remodeling the office” or “handling legal issues” in the Do-It-Yourself category, would you? Not too many would. Instead, you’d hire someone skilled in those areas. Do yourself a favor and use the same strategy when it comes to building your own Social Nation.

Getting caught without partners to help you succeed.

Make sure that you truly treat your community members as partners, not just as fans or numbers. Yes, integrating into the social web (Facebook, Twitter and other social networks) is key to your company’s future success, but being connected to the social web is only a part of what you need to do. Shifting your business strategically, culturally and operationally are key components to the equation.

“We are on the cusp of a new business era,” concludes Libert. “Building a new Social Nation isn’t just about a paradigm shift in technology. It also requires a business and cultural shift in how your company is organized and run. Now is the time for leaders and their organizations to find a way to connect to individuals — be they coworkers, investors, customers, or partners — on personal and social levels. Do all of this with an appropriate amount of forethought and planning, and you’ll succeed in creating enduring social and emotional value for your organization.”  www.sdds.org

Privileged communication is the exchange of information between two individuals, which is confidential due to the nature of the relationship, such as a doctor-patient relationship.

Maintaining confidentiality covers not only what a patient may reveal to the dentist, but also what a dentist may independently conclude or form an opinion about, based on an examination or assessment of the patient. Confidentiality covers all of the dental record (including radiographs, lab reports, and billing) as well as all communications between the dentist and patient. It includes communication between the patient and dental staff and phone conversations between dental staff and

third-party payers. The duty to preserve privacy even continues after a patient is no longer part of the practice.

Divulging health information is a privilege belonging to the patient, not the dentist. Only the patient may waive that privilege. In general, dentists should not release health information to a third party without getting a release signed by the patient. A common exception occurs when two dentists are treating the same patient and they consult each other regarding treatment. To obtain a sample “Release of Patient Records” form, visit the Risk Management section of the TDIC website at www.thedentists.com.

Medical issues warranting special confidentiality include mental health information, drug and alcohol abuse records, and HIV test results. Do not release this information unless you have express written permission from the patient or the patient’s legal representative allowing you to do so.  If you have questions regarding the information presented in this article or you need to discuss another Risk Management issue affecting your practice, please call the TDIC Risk Management Advice Line at 800.733.0634.

Our Condolences Marie Alice Koch Marie Alice Koch, wife for 60 years of SDDS Past President Dr. George Koch, passed away peacefully on January 5, 2011.

Marie graduated from UCSF Nursing School before she and Dr. Koch moved to Carmichael in 1955. They remained there for 50 years.  Photo taken at SDDS Holiday Party, Dec 2010

February 2011 | 15

you

You are a dentist. You’ve been to school, taken your Boards and settled into practice. End of story?

The Dentist, the Business Owner

Five Financial Resolutions for the new year

Not quite. Are you up to speed on tax laws, potential deductions and other important business issues?

In this monthly column, we will offer information pertinent to you, the dentist as the business owner.

By Violetta Sit Terpeluk, CFP®, MBA, CRPC® Financial Advisor, Ameriprise Financial (SDDS Vendor Member) It’s the start of a new year and we all know what that means: time to make some resolutions.

We’ll confidently pronounce our vow to shape up, eat right, save more money and cut out the excesses so we can be a better version of ourselves in 2011. Alas, best intentions aside, we’re all prone to the “resolution slide”—that gradual decline in dedication which creeps in as the year wears on. (For evidence, compare traffic levels at the gym on January 2 and February 2).

Fortunately, from a financial perspective, there are easy steps you can make to help get your house in order. These require little time commitment, so no excuses.

Stop Paying ATM Fees. Withdrawing from an ATM outside of your bank’s network commonly results in a fee of a few dollars.

If your own bank tacks on a surcharge for going out of network (many do) you could be looking at an overall cost of four dollars or more per transaction. If you make two such transactions per week, you’re shelling out $416 over the course of a year just to retrieve your own money. A better option is to work with a national bank that has a large network conveniently located ATMs or with local bank or credit union that has formed alliances to grant you no-charge ATM usage.

Don’t Overpay Your Taxes. That rebate check you got from the IRS last spring was like free money, right? Wrong. It’s actually reflective of the fact that you overpaid your taxes throughout the year, in essence giving the government an interest-free loan. Don’t make the same mistake again. Work with a qualified tax professional to adjust your withholdings so you receive only a small refund on your taxes. That way, throughout the year, you can put your money to better use through investments that offer compounding and greater returns over time.

16 | The Nugget

Look for Package Deals. Get an estimate on the cost of consolidating your home phone, Internet access and long distance, cell phone plans with one provider. Do the same insurance; look for a carrier who will reward you for bundling your car, life and home insurance policies with them. Do the math to make sure you’re getting a good deal in exchange for your loyalty.

Check your credit. Under the Fair Credit Reporting Act, you are entitled to one free credit report from each of the three nationwide credit reporting companies — Experian, Equifax and TransUnion—every 12 months.

Use their online tools to keep an eye on your credit score and report any errors.

Seek help. A qualified financial advisor can help you create or update a personalized financial plan that includes reviewing your insurance policies, banking relationships investments, loans and budget to help you find everyday savings that could prove valuable.  Violetta Sit Terpeluk, CFP®, MBA, CFPC® is licensed/registered to do business with U.S. residents only in the states of CA and WA. Brokerage, investment and financial advisory services are made available through Ameriprise Financial Services, Inc. Member FINRA and SIPC. Some products and services may not be available in all jurisdictions or to all clients.

Ameriprise Financial does not provide tax or legal advice. Consult your tax advisor or attorney. © 2010 Ameriprise Financial, Inc. All rights reserved. File #110669 Violetta offers complimentary initial consultations to SDDS members and is available to speak to study clubs. Please contact her at (916) 787-9988 ext.2 or violetta.s.terpeluk@ ampf.com.

member forum March 24, 2011 The Numbers of your practice: The good, the bad, avoiding the ugly Presented by: John Urrutia, CPA (Mann, Urrutia, Nelson, CPAs) Topics will include: • Interpreting your business numbers • Red flags when someone else is “handling” your numbers • The best structure for your business • Balancing practice and personal life • What your CPA should be doing for you • Cost control for optimum profitability • The right time for investing: expanding, building, partnering 6:30pm–8:30pm • No ceu Sacramento Hilton — Arden West

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www.sdds.org

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February 2011 | 17

18 | The Nugget

Sacramento District Dental Society

Board Report January 4, 2011 The first Board meeting of the year was called to order by President Wai Chan. Dr. Chan introduced and welcomed new Board members Drs. Jennifer Goss and Wallace Bellamy.

RAM Representatives from CALOAMS Dr. Steve Leighty (SDDS Affiliate member) and Ms. Pam Congdon addressed the Board and answered questions about the upcoming RAM (Remote Access Medical) event being held at Cal Expo on April 1, 2, 3, and 4th. They encouraged SDDS’ participation. Approximately 80 dentists are needed each day, as well as auxiliary staff. Board members asked for clarification and plans. Organizers need to raise $200,000 for the Sacramento event, to pay mostly for supplies and food for the volunteers. It is anticipated that 700 volunteers per day will be working. If anyone has any contacts, they are encouraged to help.

TREASURER’S REPORT Dr. Ackerman reported that we are not closed out for 2010, but the projections for the fiscal year end look like we will end with a small surplus, funding our reserves and enabling a donation to the SDDS Foundation.

EXECUTIVE DIRECTOR’S REPORT Cathy Levering reviewed the bylaws, obligations and policies regarding serving on the Board. She also reported on the following: • Committee placement — All committees are fully staffed and meetings are scheduled throughout the end of the year.

• 1st Tooth or 1st Birthday Campaign — this campaign begins in full force in January. All SDDS member dentists have been educated and notified via numerous modes (i.e. emails, faxes, Nugget articles) this past fall. The next step is outreach to the medical community, to the pediatricians, OB-GYNs, and GPs. The message is that it is important to teach parents that children should make their first visit to the dentist at age 1 or by the 1st tooth. Demonstrations of the knee-to-knee exam will be made at the general meetings, as well as continued education to the membership. The message is important; it is our intention that the dental community is consistent with the message. This doesn’t mean that every dentist needs to treat kids at age 1; certainly they can refer to pediatric specialists or others who are comfortable seeing younger patients. What is important is that the education to the parents begins at age 1.

Our hope is that this message will prevent tooth decay usually not identified until age 3 or more. SDDS is working with First 5 on this, and the Dental Health Committee is working to deliver education to those doctors who would like more information.

www.sdds.org

UNFINISHED BUSINESS • Task force — Premedication /prophylaxis issue – Dr. Kevin Keating reported on his task force recommendations. It was M/C to accept the Task Force report as presented. Drs. Musser and Keating will dedicate the March issue of the Nugget to this topic.

• RAM — Dr. Don Rollofson reported that he attended the RAM organizational meeting at CALAOMS (see above).

• Yolo County Fluoridation efforts — Dr. Kim Wallace reported that Woodland and Davis are securing surface water rights that may facilitate future fluoridation options. The committee, headed

by Yolo County First 5 staff, has met in November and will meet again in January.

NEW BUSINESS • Nominating (LDC) Committee Nominations – Dr. Terry Jones presented nominations for the nominating/LDC committee. It was M/C to approve the following members to serve with Dr. Jones (chair) on the 2011 Committee: Drs. Wai Chan, Vic Hawkins, Matt Campbell, Bob Daby, Wallace Bellamy, Jennifer Goss, Kristy Whiteman, Herlin Dyal.

ADJOURNMENT The meeting was adjourned at 8:40pm. The next meeting will be on March 1, 2011 at 6:00pm. Dr. Kerry Carney, CDA Executive Committee and Journal Editor, will be a special guest.  The next meeting will be on March 1, 2011 at 6:00pm.

February 2011 | 19

continued from page

7

Even more challenging to me is the notion that all of these clinical duties can be taught to the RDAEF students by instructors who could have no actual clinical experience in these procedures. As I understand the requirements for instructors in these programs, they can be limited to only fellow RDAEFs who have at least two years of teaching experience. There is no requirement for actual clinical experience.

I do not feel that expertise in treating plastic teeth, in plastic mouths, with plastic soft tissues transfers well to treating actual human beings.

The instructors must have significant clinical experience with all procedures that they teach and I feel a dentist is needed to provide the depth of knowledge and experience required of many of these duties.

My next concern is the new duty of endodontic obturation by RDAEFs, specifically the sizing, fitting and cementing of endodontic master cones and accessory points. It specifies doing this using the technique of lateral condensation. In general, I concur with the comments already submitted by the California Association of Endodontists.

Endodontic obturation is a very difficult clinical skill for dentists. Indeed, so difficult that a great number of dentists choose not to do any endodontic procedures. The consequences of poor technique can be grave and a short list would include extrusions of gutta percha, overfills, underfills, as well as perforations and cracked roots from the improper use of spreaders and condensers.

There is also such a great range of endodontic obturation techniques that defining exactly what is the technique of lateral condensation and what constitutes fitting and cementing a master cone is up to debate. Just one example would be a technique of warm gutta percha obturation that involves fitting and cementing a master cone as well as placement

of accessory points with a spreader. However, heat is used to plasticize the gutta percha so that it is even more possible to allow the now softened gutta percha to be extruded out the apex as well as the possibility to cause thermal damage to the tooth, periodontal ligament and surrounding bone. Yet, that is within the definition of lateral condensation. Here again is a duty that is very complex, the students have very limited laboratory experience, NO clinical experience, and could conceivably be taught by fellow RDAEFs with absolutely no clinical experience.

An addition, it leaves the onus of assuring competency and public safety to the hiring dentist. How will the hiring dentist be assured of competency when the new licensee has had no human clinical experience? The dentist is forced to test the competency and safety of the new licensee by allowing them to practice on patients. Shouldn’t patients know that these auxiliaries have had no prior actual human experience? Should there be an informed consent before allowing treatment by these new licensees?

I think the Dental Board has a duty to assure the safety of the public. This statute puts public safety at risk by virtue of requiring no actual clinical practice and testing, and by allowing instruction by instructors who conceivably have no actual human experience.

The Dental Board has a duty to correct this

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20 | The Nugget

Until this statute is changed, the Dental Board must use regulations to specify the training and testing necessary to assure public safety. 

To wrap this up… my overarching concern is for public safety. AB 2637 is especially problematic because by statute it impedes the Dental Board’s ability to assure public safety by certifying licensees are competent to perform authorized duties when they have not been educated in a manner or tested in an environment that can actually demonstrate any level of clinical competence.

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lack of assuring safety of the public. As I see it, the statute must be changed such that it is assured that licensees are trained to clinical competence and that the you, Dental Board, can assess, test and confirm the competence of these new practitioners.

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February 2011 | 21

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you

You are a dentist. You’ve been to school, taken your Boards and settled into practice. End of story?

Not quite. Employee evaluations, hiring and firing, labor laws and personnel files are an important part of being an employer. Are you up on the changes that happen nearly EVERY January 1st?

the dentist, the employer

Do You Have an Extra $80,000

In this monthly column, we will offer information pertinent to you, the dentist as the employer.

to Give to the State of CA? That is the potential check you could write to the Labor Commissioner if you are currently paying your hygienist as an salaried/exempt employee and they are not receiving overtime, meals, rest breaks, etc. and they file a complaint with the Labor Commissioner’s office. Sound outrageous? It is! It’s a crazy amount of money you may have to pay, but if you are not paying your dental staff on an hourly basis, ensuring they take their required breaks and receive overtime for working more than eight hours in a day, you are playing a risky game.

Employees can now claim up to three years of lost wages when they file a complaint with the Labor Commissioner. What is considered a ‘lost wage?’ If you have your employees work an extra half hour without paying them, but ‘let them leave early another day,’ your employees have lost wages. If your employees start the work day at 8:00am and you do not have them start their lunch break until 1:30pm, you have broken the law regarding meal periods and you will owe your employee an extra hour of pay – for every meal break that has not commenced before the completion of the fifth hour of work.

35

Any time an employee is not compensated according to the wage and hour laws of California, they can file a complaint with the State. Not only will you have to pay them their past due wages, but the State will add on some extra interest and penalty fees as an added bonus.

Wage and hour laws have become increasingly complicated in California over the past few years and who knows what the future will hold with a new administration coming in to office. How can you protect yourself?

By contacting the SDDS Human Resource Hotline whenever you have questions about your office personnel practices and also by joining us for one of our upcoming HR Audio Conferences. Audio Conferences are scheduled throughout the year. In one short hour, you can receive a wealth of information to help you stay compliant with the confusing world of California Labor Law and stay out of the Labor Commissioners hearing room! The Hotline can be reached Monday through Friday from 8:00am to 5:00pm at 1 (800) 399-5331. 

HR Hotline Monthly Call Totals

2010 HR Hotline Call Summary

From Mari Bradford (California Employers Association) Wage & Hour . . . . . . . . . . . . . . . . 70 Handbooks/Policies/ID Theft . . . 42 Leave Laws . . . . . . . . . . . . . . . . . . 29 Termination . . . . . . . . . . . . . . . . . 28 Hiring . . . . . . . . . . . . . . . . . . . . . . 23 Discipline Issues . . . . . . . . . . . . . 20 UI Claim/LC Notice . . . . . . . . . . . . 16 Health Benefits . . . . . . . . . . . . . . 10 Other . . . . . . . . . . . . . . . . . . . . . . . 10 Vacation/PTO . . . . . . . . . . . . . . . . . 8 Poster/Records/Forms . . . . . . . . . 5 Surveys . . . . . . . . . . . . . . . . . . . . . . 8 Training . . . . . . . . . . . . . . . . . . . . . 6 Work Comp . . . . . . . . . . . . . . . . . . 5 Investigation . . . . . . . . . . . . . . . . . 1 Drugs/Alcohol . . . . . . . . . . . . . . . . 0 Alternative Work Week . . . . . . . . . 0

What can the HR Hotline do for you? Provide you with answers to your questions regarding breaks, meal periods, performance problems, attendance issues and so much more! Simply call (800) 399-5331 and talk to a live person about any HR issues that you are currently dealing with and they will help you out!

What are the top HR issues dentists are facing today? Hygienists — do you pay them on a hourly basis vs. a salary (hint — you should be paying them hourly), how does an office schedule break times when you are trying to schedule patients and make money, what to do when an employee constantly calls in sick with the Monday Flu?

30 Number of Calls

25 20 15

Why should I call? Get advice on an employee who is driving you crazy. Get a second opinion on what you have been doing for years, that you think “is the right way but are not quite sure”.

10 5 Monthly Average

Dec

Nov

Oct

Sept

Aug

July

= 2010

June

= 2009

May

= 2008

Apr

Mar

22 | The Nugget

Feb

Jan = 2007

Who has called? The HR Hotline has take over 500 calls from SDDS dentists in the past two years - so don’t worry, you aren’t alone in your HR challenges. Call today!

Sacramento District Dental Society

Announcements: Dentists urged to discontinue use of products

3rd Annual CDA Foundation Dental Motorcycle Ride

The FDA advises dentists to discontinue the use of dental products manufactured by the Rite-Dent Manufacturing Corporation. The move comes after federal marshals raided the company’s facility in Hialeah, Florida.

The FDA is also advising health practitioners to discontinue the use of alcohol prep pads, alcohol swabs and alcohol swabsticks supplied by the Triad Group following a voluntary recall.

More info: www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ ucm237894.htm

Ken Sanford, DDS Memorial Ride: $400 per rider includes CE, reception, barbecue and Dentists Motorcycle Ride Group Membership.

Dentists exempt from Red Flags Rule CDA is pleased to announce that dentists will be exempt from the Federal Trade Commission’s Red Flags Rule that goes into effect Jan. 1, 2011.

President Obama signed into law the Red Flag Program Clarification Act of 2010, which clarifies and narrows the definition of a “creditor” and thereby excludes dentists and other small businesses.

Under the Red Flags law, creditors and financial institutions must implement written identity theft detection and monitoring programs, designed to help business and organizations detect and respond to patterns, practices or specific activities that could indicate identity theft.

The ADA has estimated the nationwide savings in implementation and compliance costs associated with this exemption to be $72 million for dental offices alone.

More info: www.govtrack.us/congress/bill.xpd?bill=s111-3987

March 24–27, 2011 Death Valley National Park • $400/rider Speaker: Tom Lenhardt, DMD (Dental anesthesiologist & CDA Trustee) More info: Ron Mead, DDS (slo-oms@charter.net)

Dentist Volunteers Needed — RAM California Remote Area Medical (RAM) is holding two 4-day clinics in our area in 2011. They are in need of volunteers to help provide free services to children and adults.

Sacramento April 1–4, 2011

Oakland April 9–12, 2011

If you are not available to volunteer, please consider making a donation to the RAM CA Expeditions The California Association of Oral and Maxillofacial Surgeons (CALAOMS) is the host coordinator for this expedition. Please help us support these clinics by volunteering for a day, or multiple days at either or both venues. We need MDs, RNs, DDS/DMDs, OMSs, RDHs, DAs, Ophths, ODs, Opticians, Op Techs, and general volunteers.

More info & to volunteer: www.RAMCaliforniaVolunteers.org

CSUS Pre-Dental Wine Tasting Event Fluoridation allowable level adjusted by the EPA The California Dental Association continues to support community water fluoridation and the recommendation by the Department of Health and Human Services to recalibrate the ratio of fluoride to water in community water systems.

Currently, the recommended optimal range is 0.7 to 1.2 parts per million. The new recommended level is 0.7 ppm.

Because water is now one of several sources of fluoride, along with toothpaste and mouth rinses, the new recommended lower levels of fluoride will still provide an effective level to reduce the incidence of tooth decay, while minimizing the rate of fluorosis in the general population. Dental fluorosis in the United States appears mostly as cosmetic, barely visible white spots or markings on the tooth’s enamel.

The EPA recently announced that it will review its current maximum allowable level of fluoride in water — 4 parts per million (2 ppm in California) — but the announcement does not question the safety of optimal water fluoridation.

Fluoride remains a proven safe and effective way to prevent dental disease and is recognized by the Centers for Disease Control and Prevention as one of 10 great public health achievements of the 20th century. Currently, almost 75 percent of the U.S. population and 58 percent of Californians (21.5 million) receive fluoridated water, up from 27 percent of Californians in 2002.

More info: www.ada.org/fluoride.aspx.

www.sdds.org

Proceeds to benefit “Project Backpack,” which provides backpacks with dental and school supplies to children at Smiles for Kids Day.

April 8, 2011 More info: www.csus.edu/org/predental/

“Targeting Smiles” Sporting Clays Tournament To benefit California Dental Association Foundation

May 21, 2011 Rio Vista, CA • Price TBA More info: CDA Foundation (916-554-5951 • www.cdafoundation.org)

1-800-399-5331

Call the SDDS HR hotline with all Your burning questions!

February 2011 | 23

Looking for your 2011 Directory?

SDDS Nominations are open

Don’t worry, you haven’t missed it!

(Sacramento — Yolo — Placer — Amador/El Dorado) — Four (4) Positions Open (2 year term, 2012–2013) on the SDDS Board of Directors

Last year, the print date for the SDDS Membership Directory was adjusted from January to May. This coincides more closely with the membership dues schedule and annual program calendar, and will therefore be a more accurate resource for SDDS members.

You can expect to receive your copy of the 2011 Directory during the month of June.

A candidate for any office in the Society must be an active or life member in good standing.

DIRECTORS:

Subject to the provisions and limitation of the California Nonprofit Mutual Benefit Corporation Law and any other applicable laws, and subject to any limitations, of the Articles of Incorporation or Bylaws regarding actions that require approval of the Members, the Corporation’s activities and affairs shall be managed, and all corporate powers shall be exercised, by or under the direction of the Board of Directors. The Board of Directors shall meet as often as is necessary to conduct the business affairs of the Society (currently five times per year). A majority of Members shall constitute a quorum of the Board of Directors for the transaction of business.

Trustee to the CDA Board of Trustees: One (1) Positions open (3 year term) Trustees shall serve as members of the managing/fiduciary body of CDA, vested with the authority to conduct the business of the association within the policies established by the CDA House of Delegates. A Trustee serves as a voting member, develops policies, procedures and regulations for the operation of CDA and monitors and sets policy relative to the finances of the association.

DELEGATES TO 2011–12 CDA House of Delegates (hod): Four (4) Positions open (2 year term) The Delegates to the CDA shall represent the Society in the House of Delegates of the CDA. In the absence or inability of a Delegate to serve, a regularly elected Alternate Delegate shall act as a Delegate. In the absence of the necessary number of Delegates, the President of the Society will make such temporary Alternate Delegate appointments as needed. The Delegates and Alternate Delegates shall meet each year prior to the annual meeting of the CDA at the call of the President. The Society may instruct the Delegates concerning its policies, and the Delegates are to make every effort to carry out the Society’s instructions.

CDA COUNCIL POSITIONS: If you are interested, contact CDA or SDDS for information — CDA is always looking for Council members.

Deadline: February 28, 2011

24 | The Nugget

Sacramento District Dental Society

Committee Corner

You asked for this!

Nugget Survey 2009

Leadership Development Committee: A Call to Leadership Every association depends on the willingness of its members to volunteer. SDDS has been so successful because so many of you have done just that. With your support, SDDS has made great strides in fulfilling its mission: to serve our members and enhance the oral health of the community. Unfortunately, that mission is never completely accomplished; we always will demand new voices that help us understand our members’ concerns and our community’s needs.

Those of us at SDDS who have already been given the honor to serve in leadership positions are keenly aware of the selfless time and energy that so many of our colleagues devote to making our Society so special.

Along the way, their participation has not only enhanced our prestige but also enriched the social fabric that binds us together. In other words, they are the leaders we hope will heed this call to action.

On the adjoining page we have provided a list of positions our society is looking to fill. The duties and responsibilities are also specified.

Please take a few moments to consider applying for these positions or nominating someone you feel is particularly qualified. In the next few months we will be considering applicants for these positions and we would welcome your input. Those individuals we select will be going to the Board of Directors for approval in April or May so please respond promptly.

By Terrence W. Jones, DDS Leadership Development Committee Chair

2011 sdds Committee Meetings: Board of Directors

Golf Committee

Mar 1 • May 3 • Sept 6 • Nov 1

Future meetings TBA

SDDS • 6:00pm

SDDS • 6:00pm

CE Committee

Leadership Dev. Committee

Mar 22 • May 24 • Sept 20 • Nov 29

Feb 10 • Mar 7 • Mar 29

SDDS • 6:00pm

CPR Committee

SDDS • 6:00pm

Mass Disaster / Forensics Committee

SDDS • 6:30pm

Future meetings TBA

Location TBA • 6:30pm 2011 Meetings TBA

Dental Health Committee SDDS • 6:30pm

Feb 7 • Mar 21 • May 16 Sept 12 • Nov 14

Membership Committee SDDS • 6:00pm

Mar 15 • May 17 • Sept 21 • Nov 15

Ethics Committee

Nugget Editorial Committee

Apr 27 • Sept 28 • Nov 16

May 17 • Sept 27

SDDS • 6:30pm

SDDS • 6:15pm

Foundation (SDDF)

SacPAC Committee

Apr 5 • Sept 12 • Nov 17

2011 meetings TBA

SDDS • 6:00pm

SDDS • 6:00pm

Committee meetings, CE courses and more available 24/7 on the SDDS website.

Visit www.sdds.org and click the “Calendar” button.

Be bold and seize the day! 

Medical Building Available For Sale x x x x x

5400 Park Dr., Rocklin, CA www.sdds.org

$99 Per Sq. Ft. 4,592 Sq. Ft. Great Street Visibility 1 Block from Rocklin HS Beautiful Window Line/ Greenbelt

Gordon Stevenson Senior Vice President Healthcare Real Estate Specialist TRI Commercial 2250 Douglas Blvd., Suite 200 Roseville, CA 95661 916.677.8150 Tel gstevenson@tricommercial.com

Helping Those That Help Others (30 Years Real Estate Exp.)

February 2011 | 25

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2009

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construction

2002

Banc of America Practice Solutions

Phil Hoover • 415.891.8789

since www.bankofamerica.com/practicesolutions

2011

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Human Resources

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12/3/10 10:11 AM

D ENNIS NELSON

CPA, APC PLANNING & CONSULTING ASSOCIATES

Kim Parker, Executive VP Mari Bradford, HR Hotline Manager

since

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800.399.5331 www.employers.org

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Lisa Saiia, Director

since

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916.443.1113 www.dentassist.com

2011

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916-624-2800 800-649-6999 4095 Del Mar Ave. #13 Rocklin, CA 95677 www.descodentalequipment.com

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26 | The Nugget

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Chris Nunn 916.367.4540 www.eaglewestgroup.com

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David Olson

since

2004

Lucas Rayburn

Jim Alfheim, President of Sales & Marketing

916.773.3343 www.principal.com

RelyAid

since

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Magazine

Kathy Olson

Becki Bell, Marketing Director 916.452.6200 www.sacmag.com

Star Refining

since

2009

800.333.9990 www.starrefining.com

Tekfix Team

Garrett Gatewood, President

Amin Amirkhizi, CEO

2010

Jim Ryan, Sales Consultant

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877.311.7373 www.supplydoc.com

800.775.6412 916.431.8046 www.relyaid.com

precious metal refining

Dental Supplies

since

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Sacramento Magazine

2002

916.626.3002 www.henryschein.com

Financial Services

Resource Staffing Group

since

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Principal Financial Group

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John Urrutia, CPA, Partner Chris Mann, CPA, Partner

Olivia Straine • Kerry Straine

since

Tony Vigil, President

Mano Vrapi

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Crest / Oral B

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Lauren Herman • 209.969.6468 Kevin McKittrick • 916.765.9101

Mann, Urrutia, Nelson, CPAs

916.960.2668 www.resourcestaff.com

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Dennis Nelson, CPA

Gordon Gerwig, Business Services Manager

since

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since

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First US Community Credit Union

James Ryan

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Liberty Mutual

800.736.4688 www.pattersondental.com

Marc Davis • Morgan Davis • Lynda Doyle

Dennis Nelson, CPA, APC

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home/auto/life Insurance

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since

2011

Vendor Member B

2009

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877.291.1099 www.tekfixteam.net

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Vendor Member A

since

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Transition Broker

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Philip Kong

Tim Giroux, DDS, President John Noble, MBA

Jason Wood, Esq.

Union Bank

since

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2010

Western Practice Sales

800.641.4179 www.westernpracticesales.com

since

2007

Wood & Delgado

since

2010

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vendor member spotlights: New this year!

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Vendor Member A

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Fixed Rates or A La Carte: For the Dental practice that wants to know the cost up-front for accounting and tax services, we offer special, fixed-rates specifically for Dentists. We also appreciate how important flexibility is to our clients — not every dentist wants to just turn everything over to their CPA. Some of the individual services we provide include: • Tax Planning • Tax Preparation • Accounts Payable Management (and Bill Payments) • Accounting / Bookkeeping • Payroll • QuickBooks training • Financial Planning • Performance Review • Retirement Planning • Children’s Education Planning • Tax Audit representation • Consulting • Practice buy/sell analysis Whatever your choice of services, you can be assured of prompt, reliable and accurate services.

Annual Financial Survey Results: In addition, our Annual Financial Survey of Sacramento-area Dental practices provides valuable insight into the region and how regional Dentists have been performing over time. Contact us for a complimentary copy today.

Dennis Nelson, CPA Vendor Member B

6611 Folsom-Auburn Road, Suite C • Folsom, CA 95630 Main Number (916) 988-8583 • Toll Free 800-464-8583 • Fax 916-988-8801 www.cpa4dentists.net

February 2011 | 27

Weâ&#x20AC;&#x2122;re blowing your horn!

Congratulations to...

Drs. Nicky Hakimi and the SDDS Membership Dr. Ike Rahimi for dancing the night away! When heâ&#x20AC;&#x2122;s not practicing Committee, for their successful â&#x20AC;&#x153;Fun Timesâ&#x20AC;? Ski dentistry, Dr. Rahimi teaches Zumba on the side. Alright, Dr. Rahimi â&#x20AC;&#x201D; letâ&#x20AC;&#x2122;s see those hips!

Trip to SugarBowl! (photo at right) Dr. Lora Foster Rode and her husband, Jim, who are Dr. John Cutter, for his new position with an affiliate of the Center for Disease Control; he is one of the two dentists responsible for the expecting their first child in June 2011! oral assessment units of 15 research centers across the United States.

Dr. Dale Thompson, for his 17-year-old grandson Dr. Lisa Laptalo, on opening her new practice, Dentistry for Dannyâ&#x20AC;&#x2122;s involvement with NASA! Dannyâ&#x20AC;&#x2122;s experiment, Children, in Sacramento! ď Ž which he dreamed up with a team of eight students during an internship at Institute for Systems Biology, Dr. McCurry (left) was accepted to be launched into space on the last enjoys the snow mission of Space Shuttle Endeavor this coming April. of Wyoming, Dr. Kevin McCurry, for the sale of his practice and his familyâ&#x20AC;&#x2122;s move to beautiful Wyoming. Dr. McCurry, weâ&#x20AC;&#x2122;ll miss you and Cheri, but sure Sacramento-7.5x4.875.pdf 1 you 3/9/10 do look happy there! (photo at right)

Have some news youâ&#x20AC;&#x2122;d like to share with the Society? Please send your information (via email, fax or mail) to SDDS for publication in the Nugget!

while Dr. Hakimi and friends (right) hit the slopes at SugarBowl.

9:47 AM

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28 | The Nugget

Sacramento District Dental Society

The Tip of the Spear continued from page

8

impressions, fabricate and place temporary restorations and later will fit, cement, and adjust the occlusion of the final restorations. All this is done under the direct supervision of the dentist. The capacity of a single dentist to provide restorative dental treatment is almost doubled if you assume the dentist is treating another patient while the RDAEF is working.

Now this is really powerful stuff. There are people and groups arguing that the reason for so much untreated dental disease in California is due to a lack of providers. That what is needed to solve the dental caries epidemic in California is to create a new dental provider, a non-dentist, who will expand the capacity of the dental industry to drill and fill our way out of this dental disease problem. Yet, here is a mechanism that exists today to essentially double the capacity of each general dentist in providing restorative dental care. But wait! It gets even better since a dentist is allowed to supervise up to (three) RDAEFs the capacity of a general dentist can almost be tripled!

Let’s do some math. The dentist to population ratio on average in the United States is 1:1639. In California it is about 1:1250 so we already have many more drills available that the national average. (These numbers are an average of what is available from the American Dental Association, the California Dental Association and the Dental Board of California.) Now assume that just 20% of the dentists incorporate just one RDAEF in their practice and utilize that staff person fully.

Now the dentist (Drill) to population ratio goes to 1:1042. Think about this. Using our existing dental practice laws we can easily achieve a higher dentist to population ratio than any state and have it all done under the direct supervision of a dentist.

The second significant Dental Workforce event happened with the approval of a pilot program to test the feasibility of new workforce models. California is one of only a handful of states that has a department with the express mission of allowing trial runs of job duties that currently are not allowed under California law. It is known as the Office of Statewide Health Planning and Development (OSHPD “osh pod”). A test of new job duties is known as a Health Workforce Pilot Project. The dental workforce demonstration project I am writing about is known as Health Workforce Pilot Project #172 (HWPP 172).

HWPP 172 is the continuation of a teledentistry project run out of Arthur A. Dugoni, School of Dentistry by Dr. Paul Glassman. His pilot project demonstrates the feasibility of supervising remotely sited dental auxiliaries via computer linkage and would temporarily allow two new dental duties: allowing dental auxiliaries to take radiographs on new patients without the prior order of a dentist and, allowing dental auxiliaries to excavate caries and place a temporary glass ionomer restoration. These duties would be tested over one year by having RDAs, RDHs and RDHAPs work in nursing homes, public health facilities and schools as remote dental teams that communicate with a “collaborating dentist” via web technology. There would be no dentist on site. This is heady stuff. When it comes to the prospect of Midlevel Providers, this is the tip of the spear.

This project also gets down to what many people feel is the very definition of a dentist… a dental surgeon. The removal of human tissue. This is not an RDAEF working under the direct supervision of a dentist removing dental caries. These are RDHs and RDAs removing dental caries via remote supervision. No local anesthesia. No dentist on site for backup. These patients then have a glass ionomer

www.sdds.org

restoration placed as a temporary restoration to stabilize the patient until they can obtain definitive treatment by a dentist.

Now I am sure that I am the only dentist who has had patients who are dumbfounded when told that the reason they have a painful swelling in their jaw is that they did not complete the endodontic treatment they were advised to have after having had a pulpectomy three years earlier and were told that that procedure was only temporary (and is documented in the chart). So in the situation presented by HWPP 172 there should be no confusion on the part of the patients or the parents of the patients that even though they did have a filling today, that it is only a temporary and they still need to see a real dentist for treatment.

In the end it will still come down to money. The temporary was free via a public health project, but there is no money for the definitive treatment. Even if there is money for the definitive treatment, should the public be paying twice to treat a single problem?

I am not trying to be an obstructionist in looking at alternative methods to solve the problem of dental caries in America. After looking at all the approaches to solving the problem of dental caries the best answer still seems to be that prevention is the best choice, and if you need treatment that you get appropriate treatment by a fully competent practitioner the first time. And what I mean by a fully competent practitioner is one that can handle virtually any outcome of starting a procedure. A two-tiered or three-tiered dental treatment model just doesn’t seem fair to the patients and certainly doesn’t seem to be cost effective.

Ladies and gentlemen, these issues are the tip of the spear.  The current laws regarding dental auxiliary utilization can be found on the DBC website at: http://www.dbc.ca.gov/formspubs/pub_ statutes20090101.pdf You can contact me at: drguyacheson@gmail.com or (916) 214-6663.

The Academy of General Dentistry is an organization by and for General Dentists only. For it to work, we must know how you feel on everything to do with you practicing dentistry. This is one issue that the CAGD Board feels has significant impact on our practice of general dentistry and we want to hear from you.

check the web! www.sdds.org February 2011 | 29

Advertiser Index Dental Supplies, equipment, Repair

Accurate Handpiece Repair . . . . . . . . . . . . . . . . . . . . . . . . 29 DESCO Dental Equipment . . . . . . . . . . . . . . . . . . . . . . . . 26 Henry Schein Dental . . . . . . . . . . . . . . . . . . . . . . . . . . 24, 26 Patterson Dental Supply, Inc. . . . . . . . . . . . . . . . . . . . . . . . 26 Procter & Gamble Distributing Co. . . . . . . . . . . . . . . . . . . 26 RelyAid . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26 Supply Doc, Inc. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17, 26

Financial & Insurance Services

20/20 Financial Advisors of Sacramento, Inc. . . . . . . . . . 9, 26 Ameriprise Financial . . . . . . . . . . . . . . . . . . . . . . . . . . . 26, 33 Banc of America Practice Solutions . . . . . . . . . . . . . . . . . . 26 Dennis Nelson, CPA . . . . . . . . . . . . . . . . . . . . . . . . . . 26, 27 Eagle West Group, Inc. . . . . . . . . . . . . . . . . . . . . . . . . . . 26 Fechter & Company, CPAs . . . . . . . . . . . . . . . . . . . . . 26, 34 First U.S. Community Credit Union . . . . . . . . . . . . . . . . 26 Liberty Mutual Insurance . . . . . . . . . . . . . . . . . . . . . . . . 26 Mann, Urrutia & Nelson, CPAs . . . . . . . . . . . . . . . . 21, 26 Principal Financial Group . . . . . . . . . . . . . . . . . . . . . . . . 26 TDIC & TDIC Insurance Services . . . . . . . . . . . . . . . . 18, 28 U.S. Bank . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 Union Bank . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17, 27

Human Resources

California Employers Association (CEA) . . . . . . . . . . . . . . . . 26

Legal services

Wood & Delgado . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27

Medical Gas Services

Analgesic Services, Inc. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26

Office Design & Construction

Andrews Construction . . . . . . . . . . . . . . . . . . . . . . . . . 11, 26 Blue Northern Builders, Inc. . . . . . . . . . . . . . . . . . . . . . 9, 26 Henry Schein Dental . . . . . . . . . . . . . . . . . . . . . . . . . . 24, 26 Olson Construction, Inc. . . . . . . . . . . . . . . . . . . . . . . . . . . 26

2010 membership Report

New Members: New members: 39 New Dual members: 1 New affiliate members: 2 New student members: 4 New Transfers: 26

total New members: 72

Members Lost: Transferred out: 13 Dropped for non-payment: 36 Reinstated: 7 • Net: 29 Deceased: 11 Applications Withdrawn: 0 Resigned Membership: 12 Dropped (Other Reasons): 6 Student to Active: 4

total Lost: 75

Practice Sales, Lease, Management and/or Consulting

DBC Consulting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20 Henry Schein Dental . . . . . . . . . . . . . . . . . . . . . . . . . . 24, 26 JoAnne Tanner, MBA. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21 Straine Consulting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26 TRI Commercial Real Estate (Gordon Stevenson) . . . . . . . . 25 Western Practice Sales . . . . . . . . . . . . . . . . . . . . . . . . . 27, 33

Publications

Sacramento Magazine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26,

Staffing services

dentassist . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26 Resource Staffing Group . . . . . . . . . . . . . . . . . . . . . . . . . 21, 26

Technology

Athena Global Media (AGM1) . . . . . . . . . . . . . . . . . . . . . . . 19 Tekfix . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26, 27

Waste management services

Absolute Securred Shredding . . . . . . . . . . . . . . . . . . . . . . . . . 33 Star Refining . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26

link of the month Continue your volunteer spirit with the RAM event — coming to Sacramento (Cal Expo).

Sign up to help at:

www.RAMCaliforniaVolunteers.org Stumbled upon a great link?

Email it to melissa@sdds.org, to submit it as a possible link of the month!

April 1–4, 2011 30 | The Nugget

Sacramento District Dental Society

Welcome to SDDS’s new members, transfers and applicants.

Important Numbers: SDDS (doctor’s line) . . . . . . . (916) 446-1227 ADA . . . . . . . . . . . . . . . . . . . (800) 621-8099 CDA . . . . . . . . . . . . . . . . . . . (800) 736-8702 CDA Contact Center . . (866) CDA-MEMBER

(866-232-6362) CDA Practice Resource Ctr . . cdacompass.com TDIC Insurance Solutions . . . (800) 733-0633 Denti-Cal Referral . . . . . . . . . (800) 322-6384 Central Valley Well Being Committee . . . . . (559) 359-5631

Keep us updated!

Moving?

Opening another office?

Offering new services?

Share your information with the Society!

We can only refer you if we know where you are; and we rely on having your current information on file to keep you informed of valuable member events! Give us a call at (916) 446-1227.

The more accurate information we have, the better we can serve you!

www.sdds.org

New Members Ricardo Andrade, DDS General Practitioner 9833 Horn Rd, Ste A Sacramento, CA 95827 (916) 368-2500 Dr. Ricardo Andrade graduated from the UCSF School of Dentistry in 2005 with his DDS. His general practice is located Sacramento where he practices with his wife and fellow SDDS new member, Dr. Denisse Montalvo.

Drs. Andrade and Montalvo live in El Dorado Hills.

Denisse Montalvo, DDS General Practitioner 9833 Horn Rd, Ste A Sacramento, CA 95827 (916) 368-2500 Dr. Denisse Montalvo graduated from the UCSF School of Dentistry in 2007 with her DDS. Her general practice is located in Sacramento where she practices with her husband and fellow SDDS new member, Dr. Ricardo Andrade. Drs. Andrade and Montalvo live in El Dorado Hills.

Shibani Sehgal, DMD General Practitioner Pending Office Address Dr. Shibani Sehgal graduated from the University of Pennsylvania School of Dentistry in 2010 with her DMD. She is currently seeking employment in the greater Sacramento area and lives in Sacramento.

Wel Gregory Senter, DDS co General Practitioner bac me 87 Scripps Dr, Ste 102 k!

Sacramento, CA 95825 (916) 565-1300 Dr. Gregory Senter graduated from the UOP Arthur A. Dugoni School of Dentistry in 1980 with his DDS. His general practice is located in Sacramento and he lives in Carmichael with his wife, Alisha.

Jonathan Vongschanphen, DDS Wel co General Practitioner bac me 2161 Sunset Blvd, Ste 300 k!

Rocklin, CA 95765 (916) 772-2838 Dr. Jonathan Vongschanphen graduated from Loma Linda University in 2001 with his DDS. His general practice is located in Rocklin and he lives in Roseville.

2011 New Member Dinner April 6, 2011 6pm • Old Spaghetti Factory

February 2011

New Transfer Members: Satbir Kahlon, DMD Transferred from Santa Clara County Dental Society General Practitioner 140 Folsom Rd Roseville, CA 95678 (916) 784-2129 Dr. Satbir Kahlon graduated from the Tufts College Dental School in 2002 with her DMD. She is currently practicing in Roseville after recently purchasing the practice of fellow SDDS member, Dr. Kevin McCurry.

Jooyoung Oh, DDS Transferred from San Joaquin Dental Society General Practitioner 15 W Main St Ione, CA 95640 (209) 274-2600 Dr. Jooyoung Oh graduated from Loma Linda University in 2005 with her DDS. She is currently practicing in Ione and lives in Elk Grove.

Samuel Oglesby, DDS Transferred from Tri-County Dental Society Endodontist 4001 Hwy 104 Ione, CA 95640 (209) 274-4911 Dr. Samuel Oglesby graduated from UCSF School of Dentistry in 1974 with his DDS and later completed his specialty certification in Endodontics at the Herman Ostrow School of Dentistry of USC in 1980. He is currently practicing in Ione and lives in Garden Grove.

New Student Member: Jesse Manton University of the Pacific, 2014 Navneet Sahota UOP Arthur A. Dugoni School of Dentistry, 2011

New Applicants: Israel Armijo, DMD Annie Barnes, DDS Stephen Barnes, DDS Grant Irwin, DDS — Welcome Back!

William Koett, Jr., DDS — Welcome Back!

Mignon Mapanao, DMD Feroz Nawabi, DDS Kenneth Silva, DDS Kirk Youngman, DMD

CLIP OUT this handy NEW MEMBER UPDATE and insert it into your DIRECTORY under the “NEW MEMBERS” tab.

total membership (as of 1/19/11): 1,571 total active members: 1,312 total retired members: 198 total Dual members: 2 total affiliate members: 12

total student/ provisional members: 2 total current applicants: 9 total dhp members: 36

total new members for 2011: 3 February 2011 | 31

It’s the Law:

When All Goes to Hell in a Handbasket A few days ago, I received a call from an orthodontist client, who was frustrated and anxious about the way a case had turned out and wanted advice on how to handle the situation: A patient was threatening to file a malpractice as well as a license complaint against him. What had gone wrong?

I have changed some facts and background information to protect his privacy, but the legally important details have been kept intact in order to give you an overview of the situation and provide guidelines in the prevention and handling of such cases.

According to Dr. Brown (not his real name), the patient had periodontal problems and lacked hygiene care, but was anxious to “get his teeth straightened.” Discussions ensued between the orthodontist, the general dentist and the patient regarding the patient’s oral care and his periodontal condition. The patient insisted that he was going to mend his ways and would do whatever it took to make the orthodontic treatment a success.

Dr. Brown went ahead with the placement of the brackets and the scheduling of successive appointments. Subsequent treatment notes indicate Dr. Brown’s dissatisfaction with the patient’s oral hygiene and missed appointments. The situation deteriorated over the next 18 months. The periodontal condition worsened, carious lesions began to show up, and the patient began to experience pain and discomfort. Dr. Brown had not seen the patient for four months, when he received a request from the patient that copies of his records were to be sent to another orthodontist, call him Dr. Black.

The patient was obviously dissatisfied with his treatment.

Dr. Black was appalled at what he saw: uncontrolled periodontal problems, carious lesions, broken brackets, etc. He indicated to the patient that the prior orthodontist had done a less than stellar job bordering on malpractice. The patient wrote a letter to Dr. Brown threatening legal action and asking for a refund of the monies paid for the unsuccessful and sub-par treatment.

32 | The Nugget

By Petra von Heimburg, DDS, JD

What went wrong? How should the case have been handled? What can be done at this stage?

hygiene regimen, he should have removed the brackets and terminated treatment.

Dr. Brown is an experienced orthodontist and the technical phase of his treatment is not at issue. The problems of the case are associated with the evaluation and handling of the patient. We do not work in a vacuum; we treat people with all their attitudes, expectations and foibles.

Obviously, such actions should not come as a total surprise to the patient. In fact, the dentist’s right to discontinue treatment in case of a lack of follow-through by the patient with treatment-related recommendations should be stated in the consent form the patient signs before treatment begins, and it should be explained to the patient in subsequent certified mailings. Again, it is important to establish the paper trail, to reiterate the reasons for the discontinuance of treatment and to impress upon the patient that this is necessary because of his own failure to live up to his end of the deal.

In this case, the first misstep occurred, when Dr. Brown relied on the patient’s assurances that he would do “whatever it took to make the orthodontic treatment a success,” when the evidence did not support the patient’s assertions. Dr. Brown and the patient’s general dentist should have insisted on a stable oral environment and signs of the patient’s commitment to the treatment, before embarking on the orthodontic regimen.

However, we all know how convincing patients can be, when they try to talk us into a treatment option which we know to be fraught with problems.

Communication between Dr. Brown and the general dentist was only sporadic, was not documented in the chart or supported by a letter exchange. To an attorney reviewing the records, there is nothing to indicate that there was any communication between the providers.

Proper treatment records require a paper trail documenting everything we do for our patients. Such details assist the patient in his or her future care as well as the dentist in the defense of his diagnosis and treatment of the patient. Both orthodontist and general dentist should have alerted each other regarding the patient’s deteriorating oral condition and his uncooperativeness with the treatment.

Frequently, a dentist is unsure about his obligations to continue treatment of a patient. Can he bow out at all and if so, when? The doctor-patient relationship is no more sacrosanct than a marriage, which can end in divorce. Hence, if done properly, a dentist can — and as we see in the above case — should discontinue treatment.

When Dr. Brown realized that the patient was uncooperative, continually broke appointments and did not maintain his oral

Finally, I would like to briefly address the behavior of Dr. Black, the subsequent provider.

Before any of us passes judgment on a colleague because of problems we see in the mouths of new patients, it behooves us to pick up the phone and call the colleague to discuss the case.

While in this case the action might not have prevented the patient from blaming Dr. Brown and threatening legal action against him, a phone conversation with Dr. Brown might have given Dr. Black an indication of what to expect from his new patient and would have alerted him to possible problems down the road.

Experience shows that an uncooperative patient does not always turn into a compliant one over night or after a change to a new provider.

As far as Dr. Brown is concerned, he is in a difficult situation because certain warning signs were missed and his treatment records were incomplete. At this time, this case is unresolved. But it serves as a lesson to all doctors and teaches us to avoid making similar mistakes in our practices.  Reprinted with permission from Chicago Dental Society. The above article does not constitute legal advice but is for educational purposes only. In order to obtain legal advice, a personal consultation with an attorney is required. The views expressed in this column are those of the writer and not necessarily the opinions of SDDS. Sacramento District Dental Society

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www.sdds.org

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Consult your attorney or tax advisor regarding specific tax issues.

Financial planning services and investments available through Ameriprise Financial Services, Inc., Member FINRA and SIPC. © 2009 Ameriprise Financial, Inc. All rights reserved.

Link to your practice website on www.sdds.org!

SDDS Members only: $300 for one year (renew for $100/year) See www.sdds.org/MembersOnline.htm for more information.

We deliver the most secure mobile confidential document destruction service, at affordable prices.

Please call: 916.631.0800 or 916.722.2737 February 2011 | 33

Event highlights January General Membership Meeting

January 11, 2011 — Hygiene Night 1

2

3

5

8

4

6

7

9

10

1: Drs. Jason Matsushino (left) and John Fuiks (right) arrive with their staff.

2: Drs. William Sloan and Elizabeth Johnson catch up after the holidays.

3: Dr. Richard Silva stops for a photo with his staff members, Sherry and Edwina. 4: Karen Roth, Dr. Sean Roth and Jessica McVey enjoy the social hour.

5: Dr. Wai Chan calls to order his first General Meeting as SDDS President.

6: Dr. Carl Hillendahl (center) with his staff. 7: Dr. Cindy Weideman presents the Helen Andrus Award to Debra Payne (First 5 Sacramento), for her dedication to children’s dental health in the community. 8: Dr. Wai Chan presents the Western Career College Hygiene Award to Amanda Spear.

9: Dr. Mitch Goodis demonstrates the “knee-to-knee” technique for infant exams. 10: What will he think of next? Dr. Jonathan Szymanowski gets the crowd excited for MidWinter 2011 — Under the Boardwalk.

34 | The Nugget

Sacramento District Dental Society

design your own dental suite offering generous tenant improvements for this 800 sq ft office space. Rent negotiation is available. The suite is in a three story midtown dental complex. (916) 448-5702.

11-10 Dream office shell — nicest / newest in sacramento! Build / design 2,000 sf to suit. Near Watt / El Camino, close to shopping. Great for new / existing practice, general / specialty. Call Dr. Favero (916) 487-9100. 02-C1 free rent — Fully equipped, 4 ops, Dentrix software, Arden area, great for starting new practice. Former location of 35 year practice. Contact Douglas Yee (916) 801-1707.

11-10

dentists serving dentists — Western Practice Sales invites you to visit our website, westernpracticesales. com to view all of our practices for sale and to see why we are the broker of choice throughout Northern California.

(800) 641-4179.

03-09 great location on madison ave in carmichael — 40 years established. No MediCal, no capitation.

Dr. retiring. Great, loyal patients and staff — will stay.

(916) 966-8567 mcdaniel.grant@yahoo.com.

12-10

operatory space to share with orthodontist or endodontist in general dental office on J Street and 51st Street. Contact Dr. Steven Brazis at (916) 731-5151 to discuss details if interested.

02-11 suite for lease — in Midtown Sacramento at 30th & P. Ideal for perio, endo or oral surgery. Improvements + allowance for modification. Signage, high visibility, on-site parking and freeway access. In the midst of Sutter’s medical campus expansion. (916) 473-8810. Lic. 01227233. 02-11

Stop the Screaming! In-office sedation services by MD anesthesiologist • Pedo/Adults • Medi-Cal Provider • 20 years experience • Call (800) 853-4819 or info@propofolmd.com. 05-07 Locum Tenens — I am an experienced dentist, UOP graduate and I will temporarily maintain and grow your practice if you are ill / maternity leave or on extended vacation.

(530) 644-3438.

04-10 Locum Tenens — Loma Linda grad, 1980. Temporary dentist for emergencies, vacations and maternity leaves.

(530) 823-0502.

02-11 #1 dentist partner / associate: Experienced GD seeking a long-term, mutually beneficial plan. To discuss possibilities or reserve a meeting, please contact Gayle: (916) 784-6982 or gayles@dmsolutionsinc.com. Temporarily, available for vacations, maternity leave or illness.

02-11

greater sacramento area multi-specialty office looking for an associate pediatric dentist and orthodontist 2–4 days/week. Ideal candidate is a skilled team player looking for long-term commitment. Fax resume to (916) 817-4376.

11-10

Have an upcoming presentation?

The SDDS LCD projector is available for rent!

SDDS HR hotline:

1-800-399-5331

Three days — $100 for sale: assistant chairs — Pelton chair with bone cloth, adjustable foot rings. Purchased 2002. $150.00.

Marcus with bone cloth, adjustable foot rings. Purchased 1995. $100.00.

12-10

You asked for this!

New Classified Sections!

Nugget Survey 2009

Contact SDDS at (916) 446-1227 for more information.

Call SDDS at (916) 446-1227 for more information or to place a reservation.

Vacation homes • Misc items for sale • Home rentals / sales • Tickets

Selling your practice? Need an associate? Have office space to lease? Place a classified ad in the Nugget and see the results! SDDS member dentists get one complimentary, professionally related classified ad per year (30 word maximum; additional words are billed at $.50 per word). Rates for non-members are $45 for the first 30 words and $.60 per word after that. Add color to your ad for just $10! For more information on placing a classified ad, please call the SDDS office (916) 446-1227.

Deadlines are the first of the month before the issue in which you’d like to run.

H

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A

L

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February 2011 | 35 3‘-8

SDDS member dentists can place classified ads for free! www.sdds.org

Members only please

PRSRT STD

915 28th Street Sacramento, CA 95816 916.446.1211 www.sdds.org

US POSTAGE PAID PERMIT NO. 557 SACRAMENTO, CA

Address service requested

sdds calendar of events

SDDS PRESENTS THE 31ST ANNUAL MIDWINTER CONVENTION & EXPO

UNDER THE BOARDWALK E E

February

3–4 31st Annual MidWinter Convention & Expo

Sacramento Convention Center 7 Dental Health Committee

6:30pm / SDDS Office 10 Leadership Development Committee

6:00pm / SDDS Office 11 Executive Committee Meeting

7:00am / Del Paso Country Club 21 President’s Day

SDDS office closed

March

1 Board of Directors Meeting

6:00pm / SDDS Office

For more calendar info, visit

www.sdds.org

4 Continuing Education

Removable Partial Dentures: Clinical Considerations

Alan Carr, DMD, MS

Hyatt Regency Sacramento

1209 L Street, Sacramento

6:30pm–8:30pm 7 Leadership Development Committee

6:00pm / SDDS Office 7 CE Committee

6:00pm / SDDS Office 8 General Membership Meeting

Benign & Malignant Tumors of the Neck & Skin

Barbara Burrall, MD

Spouse Night

Sacramento Hilton — Arden West

2200 Harvard Street, Sacramento

6:00pm Social

7:00pm Dinner & Program 10 Dental Health Sub-Committee

6:30pm / SDDS Office

You asked for this!

Nugget Survey 2009

15

Golf Committee 6:00pm / SDDS Office Membership Committee 6:00pm / SDDS Office

16

18

21

24

SDDF Broadway Series 9–5 8:00pm / Sac Community Center Member Forum Build Your Own Employee Handbook Mari Bradford (CEA) SDDS Office 915 28th Street, Sacramento 8:30am–12:30pm Dental Health Committee 6:30pm / SDDS Office Member Forum The Numbers of Your Practice: The Good, the Bad, Avoiding the Ugly John Urrutia, CPA (Mann, Urrutia, Nelson, CPAs) Sacramento Hilton — Arden West 2200 Harvard Street, Sacramento 6:30pm–8:30pm

Save the date for the 32nd annual MidWinter Convention Tons of CE & a great time! you won’t want to miss it! February 9–10, 2012 earn

2

ce units!

6pm: Social & Table Clinics 7pm: Dinner & Program Sacramento Hilton, Arden West (2200 Harvard Street, Sac)

March 8, 2011:

Benign & Malignant Tumors of the Neck & Skin

Presented by: Barbara Burrall, MD

Course Objectives: • Recognize normal variant cutaneous structures • Recognize a range of benign cutaneous tumors • Recognize a range of cutaneous malignant tumors, including melanoma and non-melanoma cancers • Perform a general head and neck skin cancer screening

March General Membership Meeting: Spouse Night