November 2015 Nugget

the

November 2015

Looking more at Corporate Dentistry

And What it May Mean to You Also: Member Benefits Scavenger Hunt!

A PUBLICATION OF THE SACRAMENTO DISTRICT DENTAL SOCIETY

Get Ready For Our

UPCOMING EVENTS NOV

6

FRIDAY 8AM-12:00PM

CPR BLS Renewal 4 CEU, CORE

For the Healthcare Provider Provider Course includes mandatory practice and testing with a one-way valve mask. All participants MUST have a mask, as required by the AHA. If you wish to obtain a regular mask or mask with an oxygen inlet for office use, they can be ordered through SDDS.

NOV

17 TUESDAY 12PM-1PM

General Meeting 3 CEU, 20% • $64

NOV

10 TUESDAY 5:45PM-9PM

Staff Night • Your Practice, Your Patients & Your Team: Getting to Know the Right Balance Presented by Kerry Straine, Straine Consulting This presentation will show you how your facility component, your patient base component, and your staff component must all come together giving you the right balance and predictable outcomes that every business must achieve.

Business Forum 2.5 CEU, CORE • $69

DEC

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HR Webinar 1 CEU, 20% • $40

Alternative Work Week Presented by Mari Bradford One hour online and audio seminar you can listen to with co-workers while you have your lunch or while you are on the road. You will only need a telephone, cell phone and/or computer (computer not required). All you need to do is dial, listen and ask questions if you desire.

Annual Holiday Party

DEL PASO COUNTRY CLUB • $110 (register by Nov. 20)

Silent Auction | Installation of Officers | Party!

It will be a wonderful evening of cocktails, dinner, dancing, friends & fun! Registration goes up to $130 per person after November 20th, so register early.

FRIDAY 6PM-11PM

Coming In January 2016...

Cyber Security: Protecting You & Your Patients

NOV

12 THURSDAY 6:00PM-9PM

Presented by Dennis Krohn, Jr., SD Reliance, and John Pefley, 360 Risk Partners A data breach can lead to substantial damages and losses to your dental practice, including going out of business. In addition, there are serious issues of state/ federal regulatory compliance, statutory penalties, attorney fees, IT forensic costs, statutory letter notification costs and potential patient/victim damages.

Continuing Education 5 CEU, CORE • $185

NOV

13 FRIDAY 8AM-1:30PM

The CSI Effect: Mass Disaster and Intimate Partner Violence Recognition Presented by Anthony Cardoza, DDS Topics will include forensic dental identification of decedents of varying postmortem states including: skeletal, fragmented, decomposed, burned remains and pattern injuries as they relate to bite mark investigation not only in human bites but animal bites as well.

JAN

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General Meeting • Tuesday, 5:45pm-9pm Hygiene Night • Preventing Hospital Acquired Pneumonia...One Clean Mouth at a Time (3 CEU, CORE) Barbara Quinn, RN

JAN

20 JAN

22

HR Webinar • Wednesday, Noon-1pm 2016 Labor Law Update (1 CEU, 20%) Mari Bradford, California Employers Association (SDDS Vendor Member)

CPR Renewal • Friday, 8am-12pm (4 CEU)

Contents November 2015 VOLUME 61, NUMBER 9

10 12 14

Dental Service Organizations Good or Evil?

Mark E. Arena, DDS

Pros and Cons of DSOs Patrick J. Wood, B.A., J.D.

Getting the Support I Need So I Can Take Care of the Patient

FEATURES

Darryl Ragland, DDS

COVER IMAGE CREDIT: ISTOCK

15 16 18 20 22 23

Nugget Editorial Board Carl Hillendahl, DDS • Editor-in-Chief Paul Binon, DDS, MSD Donna Galante, DMD Matthew Hall, DDS Brandon Martin, DDS, MS James Musser, DDS Hana Rashid, DDS Ash Vasanthan, DDS, MS

Awards

International College of Dentists (ICD) 2015 • Special Citation Award, unusual concept 2014 • Outstanding Cover, honorable mention 2014 • Golden Pen, honorable mention 2013 • Outstanding Cover 2012 • Overall Newsletter 2010 • Platinum Pencil Outstanding use of graphics

2007 • Overall Newsletter 2007 • Outstanding Cover 2007 • Golden Pen, honorable mention

Reprinted from ADA

15 Years With a DSO

Gary Pickard, Pacific Dental Services

Who Determines What Doctors Diagnose?

Nima Aflatooni, DDS

Are We Handcuffed?

Alan Kaye, DDS

DSO: To Sell or Not To Sell?

Frank Recker, DDS

Corporations & Membership Infographic

Specials 7 8 24

Google AdWords for Dentists

31

Important Things to Know About Your Website

Editors Emeritus William Parker, DMD, MS, PhD Bevan Richardson, DDS

Talking Points: ADA and DSOs

Member Benefit Scavenger Hunt Dear Editor... Responses from the October Nugget Johanna Sawatski, Google AdWords Partner Tina Reynolds, Uptown Studios

Regulars

4 5 7 9 25 26 28 32 33 35

President’s Message Cathy’s Corner You Should Know From the Editor’s Desk Volunteer Opportunities Event Highlights An Ethical Dilemma Foundation Job Bank Trustee Report

36 38 40 41 42 43 44 46 48

YOU: The Dentist, The Employer Committee Corner We’re Blowing Your Horn!

Membership Update Advertiser Index Vendor Members Spotlight Vendor Members Listings Classified Ads SDDS Calendar of Events

Article / series of articles of interest to the profession

The Nugget • Sacramento District Dental Society • www.sdds.org

President’s Message

Corporate Dentistry Challenges

Changes in Our Profession

W

hile we have been toiling away in our practices, concentrating on the essential tasks of practicing dentistry, SDDS has been looking out for its members. This issue of the Nugget, as well as the last, and the October General Meeting have been dedicated to shedding light on changes in our profession with regard to the emergence of large group (corporate) practices. The volume of information uncovered has been overwhelming. Without the insight provided by our Large Group Practice Task Force, this information would be nigh impossible

to sift through. This Task Force has been the culmination of four years of strategic planning, identifying the need to gather information on the shifting landscape of care and developing a method to disseminate the results in a useful manner to our members. Thank you to Task Force Chair, Dr. Peter Worth, and his committee for their very important work. SDDS continues to look forward to ensure that its members are always one step ahead of the changes and challenges in dentistry. Once again, SDDS provides an unparalleled member benefit. 

MIDWINTER CONVENTION & EXPO | FEBRUARY 18 & 19, 2016

Bring Your Staff!

Sign up 5 staff, get the 6th free!

Front Office Bootcamp Insurance Billing • Patient Expectations Collections • IT/Disaster/Encryption Perfect Scheduling • Yelp on Yelp

Early Bird Registration Extended

To November 15th!

4 | The Nugget • Sacramento District Dental Society

Practice Mgmt Track Being a Boss • Selling your Practice Associateships • Partnerships Leadership Tricks • Managing Conflict

Classes Scheduled

tHURSDAy, February 18 | 7:30am-5:30pm Friday, February 19 | 7:30am-4:00pm

ADMIT ONE

sec

row

seat

Questions

2015 SDDS President

18 19 16

Changes

Concerns

Shedding Light on

By Viren Patel, DDS

Cathy’s Corner LEADERSHIP President: Viren Patel, DDS Immediate Past President: Kelly Giannetti, DMD, MS President Elect/Treasurer: Wallace Bellamy, DMD Secretary: Nancy Archibald, DDS Editor: Carl Hillendahl, DDS Executive Director: Cathy Levering Dean Ahmad, DDS, MS Margaret Delmore, MD, DDS Volki Felahy, DDS Bryan Judd, DDS Beverly Kodama, DDS Matt Korn. DDS Lisa Laptalo, DDS Peter Worth, DDS Adrian Carrington, DDS Terry Jones, DDS

EXECUTIVE COMMITTEE

BOARD OF DIRECTORS

TRUSTEES

CPR: Greg Heise, DDS Ethics: Jag Heir, DMD, MD Leadership Development: Kelly Giannetti, DMD, MS Membership: Kristen Adams, DDS Peer Review: Brett Peterson, DDS

COMMITTEES

CE Task Force: Nancy Archibald, DDS Social Media Task Force: Kristen Adams, DDS/Bryan Judd, DDS 1T1B Task Force: Guy Acheson, DDS GMC Denti-Cal Task Force: Terry Jones, DDS/ Warren McWilliams, DDS Large Group Practice Task Force: Peter Worth, DDS Amalgam Advisory: Wai Chan, DDS/Viren Patel, DDS Budget & Finance Advisory: Wallace Bellamy, DMD Bylaws Advisory: Kelly Giannetti, DMD, MS Fluoridation Advisory: Kim Wallace, DDS/Rick Kennedy, DDS Forensics Advisory: Mark Porco, DDS Legislative Advisory: Steve Leighty, DDS Strategic Planning Advisory: Wallace Bellamy, DMD/Nancy Archibald, DDS

TASK FORCES ADVISORY WORKGROUPS

STANDING

Do “ They” Realize

The Value of Membership?

By Cathy B. Levering

SDDS Executive Director

As we were putting together this issue, the second on the topic of DSOs, I thought it would be fitting to address the topic of membership, and the changing trend in dentists who work for DSOs and their support and participation in organized dentistry.

Five years ago, SDDS did a study with the then-current corporate dentistry models in the Sacramento area: Kids Care, Access Dental, Western Dental and Pacific Dental Services (PDS). At that time Kids Care and Access Dental dentists were 100% members. PDS was about 50% but we “educated” their employee dentists and owner doctors and raised it to 60%. Western’s percentage was very low but we found that their dentists were very transient in the Western practice locations.

Fast forward to this past summer… our SDDS interns made phone calls to ALL the corporate dental locations in our area. Sad to say that the total average of those dentists who were members was down to 34%; see page 23 for more information.

Even those that had been 100% were down to below 40%. (And our total membership continues to be 80% of the market share!)

In September I met with several of the CEOs and top executives of the organizations and asked… what is it that we can do to “help” the dentists understand how important it is to support organized dentistry? What can we do to show our member benefits? How important is it for our member dentists to encourage their colleagues to be members? REALLY IMPORTANT! Our members pay their dues so that we can continue to advocate for them. CDA’s and ADA’s legislative efforts, SDDS’s advocacy with GMC and Denti-Cal, SDDF’s efforts to help the community and all the “stuff” that we do to assist our members, their practices and the patients IS what membership is. Those who aren’t members still benefit. They benefit until they need a job, a recommendation, a member benefit, discount or service, peer review or a simple referral (or design services for their new logo when they want to go out on their “own” and start a practice)!

Foundation: Kevin Keating, DDS, MS Golf Tournament: Damon Szymanowski, DMD SacPAC: Matthew Campbell, Jr. DDS Smiles for Kids: Donald Rollofson, DMD

SPECIAL EVENTS OTHER

Cathy Levering | Executive Director Justine Parker | Programs/Member Recruitment Beth Heneger | Membership/Peer Review Delia Ramirez | Member Liaison/SFK Jessica Luther | Graphic Designer Rachel Sheets | Graphic Designer Lourdes Camberos | Admin. Assistant (Future Dentist)

SDDS STAFF

I hope our members will start ASKING their colleagues if they are members – and if not, why not? 

Top 10 Member Benefit Countdown!

1. January: You received a FREE 2015 Employment Law poster!

2. February: SDDS Midwinter Convention & Expo!

3. March: Amy Morgan Pride Institute programs (now Sept. 17-18, 2015)!

4. April: SDDS Vendor Members!

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, 2035 Hurley Way, Ste 200, Sacramento, CA 95825 (916) 446-1211.

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.

Postmaster: Send address changes to SDDS, 2035 Hurley Way, Ste 200, Sacramento, CA 95825.

5. May: SDDS Job Bank!

6. June/July: The PAG! 7. August/September: OUR SDDS STAFF! 8. October: SDDS Design Department!

9. November: Membership! www.sdds.org • November 2015

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6 | The Nugget • Sacramento District Dental Society

Contact me today to ask about our free CE intro course on Nov. 20th!

Christina Vetter, 408-649-8921

YOU SHOULD KNOW Legislative Activity in October from CDA Reprinted with permission from California Dental Association.

1

Save Lives California Coalition In October, the Save Lives California coalition filed its final version of a ballot measure for the November 2016 election to raise the state’s tobacco tax by $2 per pack. The coalition had committed to pursuing a ballot measure if the Legislature was unable to pass legislation this summer, and with the lack of action at the end of this year’s legislative session, the coalition is moving ahead with the ballot measure campaign.

Medi-Cal In addition to increased Medi-Cal reimbursement rates that the new revenue would provide, we had the opportunity to add language to the measure that dedicates $30 million annually to the Department of Public Health specifically for the state dental plan and oral health programs overseen by the dental director. This would provide an unprecedented dedicated funding source for oral health programs in California.

Bills That Were Signed In other news, Sunday, Oct. 11, was Gov. Brown’s deadline to sign or veto bills for the year. A few bills of interest to dentistry were signed: • AB 679 (Allen) – Extends the deadline for providers to register for the state’s CURES prescription drug database from Jan. 1, 2016, to July 1, 2016 (supported by CDA).

• AB 179 (Bonilla) – The Dental Board of California’s sunset review legislation that raises the limit on dental licensure fees from $525 to $650 as of Jan. 1, 2016, and to $800 in 2018. The bill also exempts spousal care by dentists from the definition of professional misconduct (CDA did not take a position on the bill, but ensured that the spousal care exemption was included).

• AB 502 (Chau) – Sponsored by the California Dental Hygienists’ Association, this bill authorizes the creation of RDHAP corporations and establishes rules for them. The bill was substantially amended earlier this year based on CDA’s concerns to remove inappropriate expansions of RDHAP practice (current version supported by CDA).

• AB 768 (Thurmond) – Bans the use or possession of smokeless tobacco products on the playing field of a baseball stadium during a professional baseball game or practice (supported by CDA).

Early Bird

Registration Extended To

November 15th!

Bring Your Staff!

Sign up 5 staff, get the 6th free!

Specialty Advertising

By Volki Felahy, DDS (CDA Judicial Council Member) Specialty advertisement questions are frequently asked of the Judicial Council. Basically to make a long story short and give you some background information, in 2004 the Judicial Council/CDA removed the “Announcement of Specialization and Limitation of Practice” section of its Code of Ethics and in 2011 the Dental Board of California changed the guidelines due to a ruling in 2009 in Florida and to basically avoid a lawsuit.

So what’s NOT allowed in advertising is to announce that you are an Orthodontist or another of the 9 recognized specialties if you have not met the educational and standards set forth by the ADA.

What a general dentist Can do: 1) Announce services you do provide (i.e.

Orthodontics, Periodontics) without stating that they are an General Dentist.

2) Non-specialists are also not prohibited from using “practice limited to.”

Find the answers to the SDDS Member Benefits Scavenger Hunt insert. Fax back the entry form with the correct answers and be entered to win prizes.

Specialists on the other hand are not required to use “practice limited to,” nor are they required to limit their practice exclusively to announced specialty area(s) of dental practice. For example a periodontist can also practice restorative dentistry if they choose.

Hint: Look for the trail and X shown above to find the answers. www.sdds.org • November 2015

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CORPORATE DENTISTRY

Dear Editor...

Thoughts on last month’s issue I read it front to back and even missed most of my son’s soccer game.

- Matt Comfort, DDS

I have read the October issue of the Nugget. One glaring question that jumped out to me as I read and reread the various columns. The corporate offices seem to be able to open up anytime and anywhere.

In the information published I could not find the answer to these three questions: As some private practices struggle to fill their daily schedules, how are these corporate offices seemingly jammed packed with patients almost before they open? A second question I would like to have answered, what is the percentage of HMO patients, generally, in these practices? Finally, do these offices accept Delta Premier patients and, if they do, do they have an accepted fee schedule from Delta?

- Greg Maroni, DDS

This was a great issue of the Nugget.

Thanks.

- Lynn Yamamoto, DMD

I absolutely love the October Nugget!

- Gordon Lee, DDS

Gary Pickard (Pacific Dental Services) responded to Dr. Maroni’s questions (left).

The corporate offices seem to be able to open up anytime and anywhere. In the information published I could not find the answer to these three questions: Q. As some private practices struggle to fill their daily schedules, how are these corporate offices seemingly jammed packed with patients almost before they open?

A. One of the services provided by some DSOs to dentists who have chosen to contract with them is site selection assistance to identify locations that will best serve their community. Additionally, practices are generally marketed well in advance of opening, and offer modern technology, aesthetically pleasing offices, convenient locations, and flexible schedules (open 5-7 days a week, with early and late appointments), which appear to resonate with patients.

Q. A second question I would like to have answered, what is the percentage of HMO patients, generally, in these practices?

A. DSO supported practices are typically reflective of the communities they serve. As such, you would expect to see offices in California, a highly capitated state, to have a predominant number of patients with an HMO plan.

Because dentists decide which plans they want to join the percentage could vary widely from practice to practice.

Q. Finally, do these offices accept Delta Premier patients, and if they do, do they have an accepted fee schedule from Delta.

A. Dentists determine their level of participation and the fees they’re willing to accept. That being said, as the single largest payer in the state, Delta has the largest number of members, and the largest network of providers, so it only makes sense that DSO supported dentists would participate. It’s also in the best interest of the patient to be seen at a participating provider, so more often than not they do have an accepted fee schedule.

8 | The Nugget • Sacramento District Dental Society

From the Editor’s Desk THE

GOOD THE BAD UGLY

&

THE

A May 15 report from the Office of Inspector General (OIG) at the Dept. of Health and Human Services reports that more than 300 California dentists were paid $117.5 million for “questionable” billings to pediatric patients suggesting potential fraud. This group of 300 dentists represents 8% of the dentists and orthodontists reviewed by OIG with half of the practitioners employed by dental chains (five chains, two of which are under federal and state investigations). The OIG said that these findings do not prove that providers billed fraudulently or provided unnecessary treatment; they will investigate further. The OIG report calls into question “billing in a small number of dental chains.”

In addition, the OIG notes a “concentration of providers with questionable billing in chains raises concerns that these chains may be encouraging their providers to perform unnecessary procedures to increase profits.”

An Oklahoma dentist who worked for Ocean Dental gets 18 months for fraud1. Owner of Smiles and Giggles in Pasco County FL. was arrested for allegedly billing the State’s Medicare program for services not authorized or provided2. Carousel Pediatrics, providing both medical and dental services in Austin Texas, settled with Texas Health officials for $39K plus a withhold of $100,000 for alleged improper billing of orthodontic services. The settlement resulted in the closure of the dental affiliate3. Care Dental Clinics in Doraville and Duluth, Georgia, according to a WSBTV report, is under investigation for alleged fraud4. A $2.8 million malpractice verdict against Coast Dental was returned by a jury in

By Paul Binon, DDS, MSD

Guest Editor

DeKalb County, Georgia State Court5. Smiles Centers, based in Texas settled a lawsuit for “excessive” treatment. The complaint in that lawsuit alleged that Smile Centers “subjected these children to its production machine for one primary reason – to bilk Medicaid for

The allegations of fraud and abusive and unnecessary dental treatment that have become common place in recent years will impact all of us. financial gain. Small Smiles dental chain paid $24 million in 2010 to settle allegations of Medicaid fraud with 22 states and the Department of Justice6.

Abuses and fraudulent billings are not specific to dental chains. These same problems can and do occur in small group and solo practices in dentistry and medicine. As healthcare providers we have, for many years, had the trust of our patients and the public in general.

The allegations of fraud and abusive and unnecessary dental treatment that have become common place in recent years will impact all of us. It will be a sad note indeed if blatant greed is the undoing of the years of ethical and moral

conduct of so many by so few. Are we down a path of no return? I don’t think so. I believe that the vast majority of dentists are ethical and moral practitioners who put their patients’ welfare first and foremost. However dentistry does have some issues. I believe that we can and will make the necessary changes. Let us know what you think.  REFERENCES 1. D epartment of Justice, US Attorney’s Office, Western District of Oklahoma. Thursday, Oct 30, 2014. “Oklahoma Dental Clinics Pay over $5 million to Settle Allegations of False Medicaid Claims for Dental Restoration Procedure.”

2. S outhwest Florida Online - Sunday Morning News. Friday May 23, 2014. “Smiles and Giggles Dentist Arrested on Fraud Charges.” The Florida Department of Health’s Board of Dentistry voted on May 16, 2014, to suspend the license of Miranda W. Smith, D.D.S., in case number 2011-12390.

3. Ura, Alexa; The Texas Tribune, State, Carousel Pediatric Settle Medicaid Fraud Case. March 17, 2014 4. Stockman, Rachel; WSBTV, Atlanta, GA. “Local Dental Clinic Accused of Using Refugee Children for Medicaid Fraud”. Posted 10:41PM, Tuesday Sept 9, 2014 5. R ice, Julie; Posted in Malpractice. September 9, 2014. “$2.8M Verdict in Georgia for Dental Malpractice against Large Dental Firm Coast Dental.” “It should be duly noted that Defendant Coast Dental is not a small dental operation and has an excess of 130 dental offices reaching states as far as California including Florida, Georgia, and Nevada.”

6. Domino, Donna; Posted on DrBicuspid.com May 12, 2015. “Small Smiles agrees to $39M settlement in mistreatment lawsuit.”

Do you want a digital Directory on CD?

Fill out the inclosed insert to order one. www.sdds.org • November 2015

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CORPORATE DENTISTRY

By Mark E. Arena, DDS

(SDDS Member)

Dental Service Organizations

Good or Evil?

A Response to the October Nugget Issue

...one hundred percent of the public’s best interest and safety depends on us... maintaining the control of our own profession.

It can still be up to us, the licensed dentists.

We cannot look away and not pay attention.

We the licensed dentists, CDA our guiding body and political representative and the Attorney General’s office need to make sure these DSOs do not overstep or violate law.

We at Blue Oak Dental have been under contract with Interdent Service Corporation (DSO) for over fifteen years now and I would like to comment on the informative articles in the October Nugget publication. My name is Dr. Mark Arena, President of the Professional Corporation and doing business as Blue Oak Dental. For the most part the articles were accurate and well written. There are a few statements that I would definitely disagree with but would take a large article by me to express my points and differences for all of them.

For the most part the articles are based on personal experiences and preferences and your personal satisfaction will depend on how well you fit in to each environment.

When you work in a large corporate practice or in a professional corporation associated with a DSO you do have less business responsibilities (payroll, training front office, billing,etc, etc) but you also give up some individuality, control on some business matters and some of the advantages of self ownership like write-offs, depreciation and other tax advantages. In a corporate setting you are an employee and simply get a W-2 for tax filing.

10 | The Nugget • Sacramento District Dental Society

In the first article written by Kevin Cain, PhD, he is quite accurate in his description of DSOs and how they are set up with a dental professional corporation. Our agreement with Interdent Service Corporation is very much like he describes with a few exceptions.

First, I disagree with his statement that the DSO buys the goodwill and the patient records. You must make sure that your contract specifically identifies that you the dentist maintain the ownership of the dental records. You the dentist continue to be the goodwill when you continue working in this relationship and they cannot buy you or your dental license. The goodwill (a doctor’s name and reputation) is legally decided by where the patient loyalty lies and a patient always has a right to choose where they go for their dental care. This issue has been decided in the court of law. Also, the patient base (records and charts) must remain and be owned by the professional corporation (licensed dentists) not the DSO. Owning dental records or patient base is acting as an owner in dentistry and would violate state law in California. Only a licensed dentist can own dentistry in California.

Secondly, the hygienists and assistants are licensed professionals through the state dental board and the department of consumer affairs. Licensed professionals should remain employees of the professional corporation, not the DSO. If the hygienists and assistants are employees of the DSO

then that would give the DSO influence and control on clinical decisions and patient care relative to hygiene procedures, treatment directives, and assistant duties. If they were employees of the DSO, whose orders do they follow? The licensed dentist that should have the well-being of the patient, integrity and ethics, as their first priority or their employer, the DSO, which has the investors profit as their first priority. Therefore, hygienists and assistants must be employed by the professional corporation (licensed dentist), not the DSO, or it would be a violation of law in the State of California. However, because there can be a difference in opinion as to what part of the dental environment a DSO’s ownership can include and control within the laws, I think we in the dental profession (along with CDA and the Attorney General’s office), need to make sure a clear line is drawn and make sure these DSOs function within the laws and directives in the State of California. We must make sure that nondentists and unlicensed corporations are not allowed to own or act like owners in dentistry.

My final comment will be related to the last article Corporate Dentistry is Here to Stay. Yes, I do believe corporate dentistry is here to stay and that is why I believe we all need to take notice and make sure that the laws surrounding ownership and control of dentistry are clearly defined and strongly enforced. Over the fifteen years we have been contracted with

Interdent Service Corporation we have seen six different management teams and three different owners. Each management team has an obligation to their investors to improve the profits from the previous team. They have continually gotten more aggressive in their approach but we must always remember that the licensed dentists in this state have ultimate authority and control on clinical decisions including all business aspects of dentistry.

There is no question that the DSO is most interested in profits and investors return on investment and it is our professional obligation to not let a DSO control or influence our clinical judgement. Over the years we have continually had to remind Interdent about the laws in California and pushed back whenever they try to influence our decisions on clinical dentistry or our office as a whole. It is my personal experience that these DSOs are testing the boundaries of what is legal in California and may even try to change the laws influencing control and ownership of dentistry in California in the years to come. Again, I hope that CDA, the Department of Consumers Affairs and the Attorney General Office take notice of the actions of the DSOs in dentistry and make sure they function within the laws of California. There are many areas of the dental operation that the DSOs consider grey areas and thus indirectly try to influence clinical decisions and delivery of care. These grey areas need to be cleaned up, clearly

defined, and then enforced. If we ever let corporate investment firms (DSOs) gain control of dentistry the dental profession will suffer an irreversible change where we no longer control our own profession. None of these DSOs have gone to dental school or earned a degree in dentistry. The ownership and control in dentistry must remain with the licensed dentist. The integrity and image of our profession depend on this.

Most importantly, one hundred percent of the public’s best interest and safety depends on us (the licensed doctor) maintaining the control of our own profession. If DSOs are ever allowed to own or control dentistry, corporate investment and profit will become the overwhelming priority and our worst nightmare will be realized for the dental profession and the public as a whole. Yes, corporate dentistry is here to stay but the laws surrounding their involvement must be clearly and carefully defined, monitored for compliance, and strongly enforced. Good or Evil? It is still up to us! 

www.sdds.org • November 2015

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CORPORATE DENTISTRY

PROS AND CONS

of DSOs

By Patrick J. Wood, B.A., J.D.

Wood and Delgado (SDDS Vendor Member)

Patrick J. Wood is the founder of the law firm Wood & Delgado and has been representing dentists for 36 years. Mr. Wood received his B.A. degree from UCLA and his JD degree from Southwestern University. He was admitted to practice law in California in 1978. Wood & Delgado negotiates over 100 office leases each year, and is involved in approximately 100 dental practice sales each year.

2

In the late 1980’s, a phenomena in the dental industry began to occur with the introduction of dental service organizations (“DSO”), also known as “MSOs”, “large group practices” and “corporate dentistry.”

DSO’s offer management services to dentists in dental practices, and generally own all of the hard assets of the practice (i.e., dental equipment, fixtures, leasehold rights, etc.) while having no ownership or control over patient care. The DSO-managed dental practices are becoming more and more prevalent in today’s marketplace and although the American Dental Association does not specifically track the number of DSO-managed dental practices, the number of dental group practices having more than ten offices increased from 157 in 1992 to 3,009 in 2007. The purpose of this article is to provide an overview of DSOs. Generally speaking, almost every state permits some form of DSO-managed dental practices to operate within their state.

While DSOs are not traditionally favored by the dental industry “establishment,” in order for these arrangements to be legal, a dentist must be in charge of all clinical and related matters, whereas the DSO generally provides the management support. Six states - Arizona, Mississippi, New Mexico, North Dakota, Ohio and Utah permit practice by business corporations, in some form of ownership by non-licensees or corporate employment of dentists. However, such corporate dentistry/DSO’s have no control over the practice of dentistry by dentists in connection therewith. The more control the DSO has over the dentist, the more likely the court is to find that the contracts between the DSO’s and the dentists are void.

State dental laws and regulations prohibit the ownership of dental practices by nondental professionals in all but a handful of states, and even in those limited exceptions, the law is clear that clinical decisions are the exclusive purview of the licensed dentist. Non-clinical activities which are not considered professional matters (and over which the dental board has no authority), are handled by the DSO. It has been estimated

TheNugget Nugget••Sacramento SacramentoDistrict DistrictDental DentalSociety Society 12 ||The

that typically, 60% of a solo practitioner’s time is spent in patient care, with the other 40% on administrative duties, whereas in DSO managed practices, the clinical services performed by the dentist may be as high as 90% of their time in the office.

In order to operate legally in most states, DSO-managed dental practices will divide the activities along the following guidelines: Clinical Activities (Can only be performed by a dentist) • Patient evaluation and diagnosis • Determination of treatment options • Patient treatment • Hiring/firing/employment (including compensation) of dental professionals • Hiring, training and supervision of dentists and hygienists • Preparation and ownership of patient treatment records • Clinical protocols • Clinical QA and peer review activities Non-Clinical Activities (Can be performed by anyone, including a dentist) • Bookkeeping, accounting and tax preparation • Payroll administration and processing • Payor relations, billing and collections • Banking and financing • Creation and placement of dentistapproved advertising, promotion (social media), marketing • Information technology • Human resources • General office management • Property management • Housekeeping • Risk management: legal and regulatory, compliance, insurance

DSOs are here to stay. One article suggests that by 2025, 50% of all dental practices would be operated by DSOs. According to the ADA statistics, the average dental school graduate in 2011 had over $215,000 in student debt. This in turn puts tremendous pressure on the young dentist to pay back these loans and not incur additional debt by taking out a loan to start or buy a practice. Informal surveys conducted by the author of the senior classes at one dental school over a period of years had a common result, with less than 20% of graduating seniors seeing themselves as practice owners within five years of graduation, whereas 50% or more saw themselves in a DSO practice situation. While not a scientific poll, it does reflect what a lot of people in the dental industry have been observing in recent years.

Strengths and weaknesses of the DSO for the young dentist:

Pros for DSOs

&

MORE CLINICAL AND PATIENT TREATMENT

LESS ADMIN PRACTICE DUTIES

IN LARGER DSOs, MORE “COACHING”

REFERENCES 1. Bungalow to Big Box? DSOs Could Change the Face of Dentistry While Charting Progress, ADA June 13, 2014 2. Survey of State Laws Concerning Corporate Law of Dentistry, 2012, Moriarty Leyedecker 3. Investigative Report on the Corporate Practice of Dentistry, Academy of General Dentistry, 2013 4. W ill Large DSO Managed Practices be the Predominant Setting for Oral Health Care By 2025? Journal of Dental Education May, 2015 5. Toward a Common Goal: The Role of Dental Support Organizations in an Evolving Profession, ADSO, July 1, 2014 6. Todd Bosley “Navigating Your Dental School Debt” Journal of the American Student Dental Association, Summer 2012.

Cons for DSOs POTENTIAL FOR LESS BROAD BASED PRACTICE OF DENTISTRY, WITH FREQUENT REFERRALS TO SPECIALISTS WITHIN DSOs

ON CASE MANAGEMENT, CASE ACCEPTANCE AND PATIENT AWARENESS OF DENTAL SERVICES

LESS TIME SPENT ON MANAGING DENTAL PRACTICE

POTENTIALLY MORE CONTROL OVER THE SCHEDULE

NOT NECESSARILY LEARNING THE BUSINESS SIDE OF DENTISTRY

NOT REALIZING THEIR DREAM OF OWNING A DENTAL PRACTICE

NOT HAVING AS MUCH FREEDOM WITH THEIR TIME AS SOLO PRACTITIONERS HAVE

DSOs are here to stay. One article suggests that by 2025, 50% of all dental practices would be operated by DSOs. The DSO-managed practices may be attractive to the younger dentists coming out of school with a lot of debt and certainly they are a great training ground for the young dentist, as they typically provide intensive training in order to get the new graduate up to speed and help them with case acceptance. However, DSOs do not really afford true dental practice ownership to the dentist (other than patient records) and may not be as financially and professionally rewarding as solo practice ownership.  www.sdds.org • November 2015

| 13

CORPORATE DENTISTRY

Getting the Support I Need

So I Can Take Care of the Patient

Let’s face it. Change in dentistry is happening. It’s not your father’s dentist office anymore. As dentistry continues to evolve, so do the opportunities it presents. I am the product of that right now.

The Aspen Dental-branded practice where I currently work and Aspen Dental Management, Inc. (ADMI) came into my professional life at a time when I was open to change and intrigued by the manner in which I perceived dentistry to be going.

By Darryl Ragland, DDS

Managing Clinical Director, Aspen Dental-branded Practice Searcy, Arkansas (SDDS Member)

Dr. Ragland has been practicing dentistry for over 28 years. He graduated from the University of California at San Francisco in 1987.

He is a member of the American Dental Association, California Dental Association, Sacramento Chapter National Dental Association, and the Sacramento District Dental Society. Dr. Ragland is also a member of the Sacramento District Dental Foundation, it is a part of his life and professional career that gives him great satisfaction.

After 28 years in the dental profession, I have evolved from an associate just out of school making a modest salary and wondering if I could ever repay my school loans, to the struggles of opening my own office by renting space from another established dentist and trying to build a patient base from scratch.

Eventually, I reached a critical point where I needed to find a dental business model that allowed me to sustain my family, meet my financial obligations and hopefully provide me with the personal satisfaction and reward that made me initially choose the dental profession.

Ten years ago, I heard about a Dental Support Organization (DSO) out of southern California. Their appeal was in the fact that they took care of the day to day non-clinical business operations of the office and allowed me to focus on my dentistry. While my time with that DSO didn’t last as long as I had hoped, the DSO seed had been planted, and I realized there was another approach to doing private practice that could reinvigorate my passion for dentistry.

And that’s what brought me to the Aspen Dental-branded practice where I currently work that receives non-clinical business support from its DSO. Aspen Dental practices are independently owned and operated by dentists. These owner dentists and the dentists they employ (i.e. like me) have clinical autonomy. ADMI provides the non-clinical business support that allows me to concentrate on doing what I do best: taking care of my patients.

Imagine being employed by a successful practice that supplied you with a constant flow of new patients seeking your services and allowed you to deliver the type of dentistry that most people desire but few can afford.

14 | The Nugget • Sacramento District Dental Society

What convinced me that working for an Aspen Dental practice was the right place for me can be summed up in one phrase from their values: “We treat every patient like their own mother.” There are over 100 million Americans who have not been to the dentist last year because of barriers to access to dental care, and Aspen Dental practices open their respective doors to all of them in a nonjudgmental environment.

The number of independent practices supported by ADMI has grown by leaps and bounds over the past decade, from a handful of offices in the Northeast to approximately five hundred locations nationwide. The opportunity to be employed by a practice that

As the world of dentistry continues to evolve, I am thoroughly satisfied in the decision I made to plant my professional roots at an Aspen Dental practice. took care of my continuing education courses, malpractice insurance, medical, vision and even dental coverage was a welcome change.

Because I had not been able to fund my retirement account as I would have liked to have done, the opportunity to have a generous 401K package also made my decision to transition to an Aspen Dental practice even more enticing. And the hours I work are convenient which allows for a better quality of life at home.

As the world of dentistry continues to evolve, I am thoroughly satisfied in the decision I made to plant my professional roots at an Aspen Dental practice. 

3

Talking Points: ADA and DSOs Reprinted with permission from American Dental Association What is happening between the ADA and DSOs? The President has appointed a workgroup to meet with DSO representatives. We have two primary goals; first, to advance the best interests of the practitioner who is employed in a dental support organization business model and second, to represent the best interests of the public.

Who will represent the ADA on the workgroup?

ADA participants will include a Trustee, the President, President Elect, Council on Dental Practice Chair, CDP Subcommittee on Practice Models Chair, New Dentist Committee volunteer, and, potentially, a dental student.

How did this process start?

At last year’s annual meeting, the Council on Dental Practice sponsored a forum that

outlined the structures of different types of large group practices. The panelists represented the group practice models that had been identified (or described) by the ADA’s Health Policy Institute.

Each speaker said their operations took a hands-off approach on clinical decision making. That information led to the idea that the ADA and the DSOs could work together to formalize the position that the dentist is fully responsible for clinical decision making.

Why is the ADA talking to DSOs? The ADA advocates for all members in all practice settings, including DSOs. As all of you know, the number of associate positions available in small, private practices dropped significantly because of the recent recession.

But at the same time, more dental students were graduating with high levels of student debt. Many of them joined DSOs because they offered a steady and predictable income, which

was important because of their student loans.

Some new dentists will likely stay in a DSO practice for their entire careers while others may explore other options once their finances stabilize. These new dentists, ADA members, need the Association’s representation and all the support we can provide.

Is the ADA selling out to DSOs? The short answer is “no”. The complete answer is the ADA is committed to serving all its members by upholding the fundamental principles that are in the best interests of patient, and therefore their best interests.

There is merit in continuing dialogue with DSOs, even if we don’t reach a consensus on the issues. While open and frank discussions can be challenging and even frustrating, they are the best and most effective way to reach a mutual understanding. The ADA and the DSOs have different viewpoints on issues related to primary ownership, ownership of equipment and state regulatory oversight. 

www.sdds.org • November 2015

| 15

CORPORATE DENTISTRY

15 YEARS With a DSO

By Gary Pickard

Pacific Dental Services Director of Government & Industry Affairs (SDDS Vendor Member)

Gary Pickard has been in dentistry for almost 20 years, some of that working for private practice dentists in San Diego, CA. He currently works for Pacific Dental Services (PDS) as the Director of Government & Industry Affairs. In his time with PDS he has seen the company grow from 15 supported locations in Southern California to more than 420 locations in 14 states. In his tenure he’s overseen Marketing, Insurance Contracting, Patient Relations, and Payer Relations. Prior to PDS he’s worked in insurance, banking, and served in the United States Navy. He’s a graduate of Azusa Pacific University and holds a Bachelor of Science Degree in Organizational Leadership.

If you aren’t familiar with Pacific Dental Services (PDS), you probably know someone who is. PDS has been providing administrative support services to dentists in Northern California for over a decade.

We currently support 46 practices, from Sacramento down to Visalia and over into the Bay Area. We’re one of the largest and fastest growing Dental Support Organizations (DSO) in the country, and I believe one of the best. In my 15 years with the company I’ve heard supported dentists give various reasons why they’ve chosen to contract with PDS; I’m highlighting just a few for you today: our commitment to the industry, our management of administrative tasks so they can spend more time with patients, our servant leadership philosophy, and our belief in the sanctity of the dentist-patient relationship and their clinical autonomy.

Commitment to the Industry Our commitment to the industry begins with our Founder, CEO, and President, Stephen Thorne, the son and grandson of dentists. He grew up around the family business and appreciates the challenges dentists face running a dental practice.

16 | The Nugget • Sacramento District Dental Society

After post-graduate studies he began his professional career in the dental industry helping his father install a computer system in his practice. Shortly thereafter he contracted with another dentist, Dr. Carolyn Ghazal, who’s still supported by PDS today - 20 years later, demonstrating the longevity of our business model.

In our many conversations with other leaders in our industry over our two decade history and now operating across 14 states, we’ve been clear in our support of organized

We believe the dental industry is better with a strong trade association, benefitting professionals and patients alike. dentistry. We believe the dental industry is better with a strong trade association, benefitting professionals and patients alike.

To those who have chosen to be members, we support and encourage participation.

Management of Administrative Tasks There is no shortage of responsibilities for a dentist. They wear many hats when

Dentists have complete clinical autonomy and the final say on every aspect of their practice. they choose to own a practice – clinician, business owner, mentor, manager. In my experience few business owners, regardless of profession, are great in every area and more often than not contract out those areas they don’t enjoy or are less proficient in. Dentistry is no different. PDS-supported dentists are able to receive administrative services such as taxes, legal, maintenance, payroll, and more, all under one roof. This allows them to focus more of their time on patient care and actually doing dentistry.

offices to provide pro-bono treatment to needy members of their community. While there are plenty of opportunities to serve locally, we acknowledge some clinicians have a heart for international efforts. To support those dentists, the foundation, with help from supported team members, is active in Fiji, Ethiopia, and Guatemala.

In Ethiopia we partner with Charity: water to help bring clean water to villages across the Tigray region.

Servant Leadership

Sanctity of Dentist-Patient Relationship and Clinical Autonomy

I fondly remember taking a trip across the southern border 12 years ago when we built homes in Mexico. Today we participate in countless service and charity projects across the communities we serve and beyond.

Two years ago PDS took a gigantic step forward in helping supported practices better serve the needs in their community.

We started a foundation which procured a Motor Coach that was converted into a Mobile Dental Clinic. It is utilized nearly every weekend, facilitating the provision of pro-bono treatment to those in need and unable to pay for dental care. And twice a year, supported practices open up their

It is important to understand the PDS owner doctor model. Every office is owned by a dentist or group of dentists. The names on the door are those of the dentists, not PDS. Dentists have complete clinical autonomy and the final say on every aspect of their practice, including hiring associate dentists to work with them at the practice.

Our mission to help supported practices to be the provider of choice in all the markets we serve is a commitment to them and their communities. One of the ways the clinicians do this is by offering integrated specialties and comprehensive care to their patients.

The owner dentist is responsible for clinical

oversight of their associates and the general practitioners determine if / when to refer their patients to the specialist – whether it be internal or external.

Conclusion The last two decades has seen the digitization of charts and x-rays, the reform of our national health care system, and an increased awareness of the connection between one’s oral health and their overall health. It’s an exciting time for dentistry and I’m looking forward to seeing what the future holds for the industry. Regardless of what it is, I’m confident our industry will be stronger and better because of organizations like PDS. 

2

www.sdds.org • November 2015

| 17

CORPORATE DENTISTRY

Who Determines

What Doctors Diagnose?

Doctor. It’s a significant title. Just one word bestows upon an individual assumptions about education, skill, respect, and values. No other title in society carries with it such a charge.

By Nima Aflatooni, DDS (SDDS Member)

Dr. Nima Aflatooni is a graduate of the University of the Pacific Arthur A. Dugoni School of Dentistry and has a private practice in Gold River CA. Dr. Aflatooni is an active volunteer member for committees on SDDS and CDA. In his spare time, he enjoys hiking, dining out, traveling, and spending time with his fiancée Jenny and dog Odie.

We have a responsibility to our profession and our patients to safeguard our principles and ethics.

Throughout history, doctors were called upon to use their skill and knowledge to heal. However, we are now seeing a period in which incentives and restriction are calling into question the doctors ability to diagnose and treat patients as they were trained.

Throughout dental school, we were all taught the code of ethics and the principles of Autonomy, Non-maleficence, Beneficence, Justice, and Veracity. We learned what is acceptable and what is not. After those years we were free to practice based on the ideals we learned as doctors.

However, as doctors of dental medicine, we have another responsibility that many of our other colleagues in health care do not have: we have a responsibility to run a successful business so we can provide the optimal oral health care to our communities.

The business of dentistry is experiencing a paradigm shift away from solo practice and towards different models of ownership due to changes in the market, in competition, cost, and demand. We are not immune to market forces. For many years now, high demand and healthy reimbursements allowed many dental offices to operate successfully without efficient cost-effective systems. No longer can this be true. The rise of dental management organizations (DMOs) that control multiple offices has addressed this weakness in the dental business. They have brought to the dental industry the same business practices that are successful universally. In this way, costs can be controlled, and profits can grow at a predictable rate. This is important to strategically plan future growth as well as provide shareholders a return on investment.

But at what cost? What potential harm can come of this?

Recently, a lawsuit by the New York State Attorney General against Aspen Dental highlighted the potential harm. Non-dentists

18 | The Nugget • Sacramento District Dental Society

were allegedly pushing dentists to upsell and push treatment. In working at large dental chains, many of my colleagues and I experienced similar pressure to upsell and perform certain treatments. These managers would chastise associates for not meeting certain benchmarks, under-diagnosing or undertreating. As new graduates with limited employment prospects and high debt, we felt the pressure to acquiesce to these demands.

Every doctor makes decisions every day regarding what is in the best interest of their patients. These decisions should be motivated by restoring and maintaining health. Moreover, the doctor should be the one determining the course of treatment.

In the large corporate system, the main motivation is profitability. There are goals to meet and shareholders to answer to. Can this ever be in harmony with providing patient care?

It can if doctors are given the autonomy to treat patients as they were trained without the threat of termination, nor without interference by non-clinicians. It can if sound business practices work with ethical treatment to provide optimal patient care.

We as doctors are taught a code of ethics.

No one else abides by this code, therefore, no one else should dictate treatment to doctors directly or indirectly. We have a responsibility to our profession and our patients to safeguard our principles and ethics.

The rise of DMOs and large group practices are not necessarily a negative force. It is long overdue that sound business principles are applied to dentistry to lower costs and maximize efficiency. However, it is our responsibility as doctors to make sure these principles are in line with the ethics that define our profession. No one else is capable of doing so. 

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www.sdds.org • November 2015

| 19

CORPORATE DENTISTRY

By Alan Kaye, DDS

President, LA Dental Society

Are We Handcuffed?

Reprinted with permission from the Los Angeles Dental Society It’s no secret that the profession of dentistry is in the midst of a major overhaul. I hear it from every quarter: no jobs for recent grads, dilution of specialty referrals, dentists attempting anything and everything in their office, itinerant practitioners creating imaginative ways to sway doctors away from referring patients so as to maximize their profits, dental manufacturers taking over dental education, too much corporate money influencing our organizations, government intrusion, lack of Denti-Cal funding, dentists needing to join Medicare, etc. And if that isn’t enough, prodigious advertising.

So are we now a trade? What’s organized dentistry going to do next? As healthcare practitioners, are we handcuffed to a hopeless situation with corporate dentistry as the future? I think one of the biggest issues and question is, will dentists still be in charge of care? How do we maintain our professional jurisdiction while the corporations handle the business portion?

Well, I have a suggestion, doctor unionization! As much as I dislike the word it may be medicine and dentistry’s only way to maintain doctor control while continuing to deliver what is in the best interest of the patient. Personally, I don’t believe we should ever let the doctoring responsibility come under corporate regulation. Their motivation for profits will, in my opinion, always trump good care. Many of you may not be aware, but there has been an organization in existence for many years called the Union of American Physicians and Dentists. Here is a little history about UAPD. 4

“Founded by a private practice physician in 1972, over the last forty years the Union of American Physicians and Dentists has grown

20 | The Nugget • Sacramento District Dental Society

into the largest union representing licensed doctors in the United States. UAPD members work for the State of California, California counties, non-profit healthcare clinics, and in private practice. Affiliated with AFSCME and the AFL-CIO, UAPD is proud to bring the strength of the labor movement to the aid of working doctors in the interest of better healthcare for all.” Due to the climate change in the healthcare delivery system, UAPD may grow in numbers and become a force for change.

As healthcare practitioners, are we handcuffed to a hopeless situation with corporate dentistry as the future?

I know I may have ruffled a few feathers, but in my opinion, that’s what a President is supposed to do. Provoke and encourage people to begin thinking outside of the box.

Stagnation is not good for people or our profession. Unless the general population of dentists becomes more active in the events that will shape their profession for the future, I am afraid the tail will wag the dog forever. 

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www.muncpas.com www.sdds.org • November 2015

| 21

CORPORATE DENTISTRY

DSO: To Sell or Not To Sell?

Reprinted with permission from the American Academy of Implant Dentistry

By Frank Recker, DDS, JD

Q. A DSO seeking to buy my practice has approached me. I’m in my late 50’s and their proposal seems attractive. I have heard many negative things about these companies but would like to know what you think.

A. Many such approaches/offers to purchase appear to be extremely attractive to a hard working dentist who has built her/his practice up over many years. While not actively seeking to sell their practice, they are told they can obtain the value of the practice without future worry, while at the same time continuing to work as an employee for the new company but without all the management hassles. While this seems wonderful, the devil is often in the details.

First, check with your State Board to find out if they have had any difficulties with such DSOs in your state and if such an arrangement is legal and not in conflict with the State’s Dental Practice Act. Next, ask for a list of names of dentists from whom the DSO has purchased a dental practice. The seller dentist may be reluctant to speak with you, as generally there are some contractual provisions prohibiting such disclosure.

From my experience, the DSOs are tough when negotiating changes to their template contracts. Specifically, they are difficult when it comes to non-compete geographic zones

and duration of employment of the seller. You must have a lawyer review each agreement to be sure it is tailored to YOUR needs.

The DSO will need a dental corporation (PC) as an interface between the dental employees and the requirements of most state dental practice acts. That is the insulation that avoids the DSO being accused of directly hiring dentists. Find out who the dentist or dentists are behind the PC and check out their reputations and past activities.

The seller will not obtain the entire sale price at one time, as a holdback period and amount is typical. Since the DSO can terminate the

seller’s employment almost at anytime or for any reason, I have seen dentists forfeit all or portions of the holdback that were not paid at the time of sale.

My best advice is to obtain as much information as possible from the DSO: • Name and contact information of previous sellers • Sample contracts • Employment contracts And be certain to seek the assistance of an attorney familiar with these transactions. 

The Foundation for Allied Dental Education offers certification courses in our new Education Center located in Folsom. Our Dental Board-approved certifications include: • California Radiation Safety • 8-hour Infection Control and 2-hour Dental Practice Act for the unlicensed dental assistant • Pit and Fissure Sealants • Coronal Polishing Visit our website at www.theFADE.org for more information or contact our office for these and other courses including our regional events to meet the CE needs of the entire dental team.

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www.theFADE.org Sac District Dental Society Ad-Half.indd 1

22 | The Nugget • Sacramento District Dental Society

10/6/15 11:55 AM

Not shown: Surfside, no GPs Make a Smile, no GPs

TOTAL PRACTICES

SPECIALISTS

9 3

5

2

4

19/47

3

Specialists in Corporate Dentistry are SDDS Members

Surfside . . . . . . .

Make a Smile . . . . .

Access . . . . . . . .

Western . . . . . . .

Kids Care . . . . . . .

Pacific Dental Services

59

2 3

. . . . . .

. . . . . .

. . . . . .

. . . . . .

. . . . . .

. . . . . .

. . . . . .

. . . . . .

. . . . . .

. . . . . .

. . . . . .

. . . . . .

. . . . . .

. . . . . .

Corporate Dental

PRACTICES

60% 3 of 5 dentists at Surfside are members of SDDS 50% 2 of 4 dentists at Make a Smile are members of SDDS 16% 3 of 19 dentists at Access are members of SDDS 26% 9 of 35 dentists at Western are members of SDDS 46% 11 of 24 dentists at Kids Care are members of SDDS

. . . . . .

. 2 . 7 . 5 12 . 9 24

3 6 9 13

19 20 21 39

31

//

15

GENERAL PRACTITIONERS

20

MEM Gener BER Practi al tioner s

Not shown: Access, no Specialists

TOTA Gener L Practi al tioner s

CORPORATIONS&MEMBERSHIP out of

99

General Practitioners in Corporate Dentistry are SDDS Members

34% OF DENTISTS IN CORPORATE DENTISTRY

ARE SDDS MEMBERS

50/146 Dentists in Corporate Dentistry are SDDS Members Surfside

Western

Make a Smile

Kids Care

Access

Pacific Dental Services

Data does not include numbers from Smile Time

37% 22 of 59 dentists at PDS are members of SDDS

Info obtained via google search of websites and follow-up phonecalls made by SDDS to ALL, June – July 2015. www.sdds.org • November 2015

| 23

Google AdWords FOR DENTISTS

MARKETING

STRATEGY

A N IN T RODUCT ION

PROFIT & GROWTH

Make Searches for “dentist” Work to YOUR AdvantageI’m going to assume that you are in some way familiar with AdWords.

Either you currently have campaigns running, you used to, you might someday, or you’ve sworn off the whole hassle. If you don’t fall into one of these categories…take a moment to “google” AdWords…we’ll wait. Ok, Great.

By Johanna Sawatske Johanna Sawatske is a Google AdWords Partner, Founder of seemoreglass Marketing, Located in MN, specializing in paid search. She attended Western Oregon University, majoring in English Literature. Johanna’s interests include long distance running, reading and hiking.

As the center of a busy dental practice, you shouldn’t really have time to tinker with your advertising, online or otherwise. You delegate this time consuming and rather fussy activity.

Is AdWords even worth it?

How do you know? I’ll tell you.

If your practice is the only game in town, then NO, you do NOT need to use AdWords. If you are literally the only dentist within 20 miles of yourself…then do NOT spend ANY money on advertising.

But, if like most dental offices, there are a handful of other practices in your area, YES, you SHOULD use AdWords. The geographic targeting options will keep you from advertising to people across the country, and confine you to people across town.

6|7

Is your practice less than 5 years old OR have you added services recently? Are you located in a competitive market? Yup, AdWords advertising is for you.

24 | The Nugget • Sacramento District Dental Society

People who have conducted a search, scan the results page for what is most relevant to what they are looking for, and they start at the top left. Ads appear before organic results. You may have your site SEO’ed, be the first organic result and have local results, but still lose out on a new patient because they saw what they wanted just above you. Nearly 70% of searchers happen on Google. How convenient that they’ve provided an advertising platform built right in! In all honesty, I’m Google certified in AdWords, but am not reimbursed to sing their praises, I’m just fired up about the opportunity that AdWords gives to everyone wanting to advertise.

Top Reasons AdWords Will Work for You AdWords has made relevance the ONLY thing that matters.

AdWords will not put an Ad up for auction if it doesn’t meet the relevancy expectation.

On top of that, Quality Score, a scale of relevance 1-10, keeps the irrelevant riff raff

who only bid hugely, out of the top spots. Someone searches for “dental whitening in Hoboken,” you provide dental whitening in Hoboken. If your campaign is set up correctly, you’ve got just as good a shot at the top spot as anyone. And better than most.

AdWords Allows for Any Budget…to Compete You and your account manager determine the right daily budget for your practice’s growth goals. Then AdWords does its thing, puts your Ad into every auction you’d have a shot at getting a click from. Clicks are how Google gets paid, and how you get new patients in your seat.

Quality Scores will even the playing field, even if you’re up against the biggest, “baddest” dentist in town. If the campaign is well managed, the landing pages are optimized for user experience and the Ads have good copy, you’ll stand out from and above the competition.

AdWords Rewards Those Who Work at it I’ll not dwell on this, but an account manager that works on the campaigns daily is crucial to success. If a campaign is started and then left to its own devices to mature, it’ll shrivel and fail. Attentive changes and optimizations must be ongoing.

Volunteer opportunities SMILES FOR KIDS VOLUNTEERS NEEDED: Doctors to “adopt” patients seen on Smiles for Kids Day 2015 for follow-up care.

TO VOLUNTEER, CONTACT: SDDS office (916.446.1227 • smilesforkids@sdds.org)

SMILES FOR BIG KIDS VOLUNTEERS NEEDED: Dentists willing to “adopt” patients for immediate/emergency needs in their office.

TO VOLUNTEER, CONTACT: SDDS office (916.446.1227 • sdds@sdds.org)

Best Ways to Enhance Your AdWords Campaigns • Using A/B Testing on your Destination URLS. Make sure there is always a test in the works to arrive at a winner, then put it up against the next challenger. Having Landing Pages that are uniquely relevant to the search term, and link to your site is a better way to move searchers down the funnel to becoming loyal patients.

• Sparkling Reviews and endorsements from current patients are lovely. Use the Ad Extensions to display reviews, sitelinks, and Mobile Call extensions.

April 16-17, 2016 • Ventura County Fairgrounds October 15-16, 2016 • Stockton (Location TBD) April 21-24, 2017 • San Mateo Event Center October 5-8, 2017 • Bakersfield/Kern County Fairgrounds TO VOLUNTEER: www.cdafoundation.org/cda-cares Robyn Alongi (916.554.5305 • robyn.alongi@cda.org) AUBURN RENEWAL CENTER CLINIC

• Link to analytics to follow the path of each and every click, link your sight too. You’ll see valuable insights into what visitors do on your site, where they go, how long they stay and where they came from.

VOLUNTEERS NEEDED: General dentists, specialists, dental assistants and hygienists.

• Adding and researching keywords is great, even better is adding negative keywords. This is a way to PREVENT your Ad from displaying for certain searches. For example, a negative keyword “clothes” ensures that “whitening” searches will trigger your teeth whitening service Ad, not a potential for wasted spend on someone looking for whiter white t-shirts.

THE GATHERING INN

There are some excellent resources for the intrepid business owner who chooses to run their own AdWords marketing. My own blog www.seemoreglassmarketing.com/blog, I flatter myself, is decently current and informative. 

Definition: AdWords Google AdWords is Google’s online advertising program. Through AdWords, you can create online ads to reach people exactly when they’re interested in the products and services that you offer.

TO VOLUNTEER, CONTACT: Steve Holm (916.425.6766 • sholm@goldrush.com)

VOLUNTEERS NEEDED: Dentists, dental assistants, hygienists and lab participants for onsite clinic.

TO VOLUNTEER, CONTACT: Kathi Webb (916.743.5351 • kwebbft@aol.com)

GLOBAL BRIGADES VOLUNTEERS DENTISTS AND AUTOCLAVES NEEDED. TO VOLUNTEER ABROAD VISIT: www.globalbrigades.org TO DONATE AN AUTOCLAVE, CONTACT: Dagon Jones, DDS (dagonjones@gmail.com)

CCMP

(COALITION FOR CONCERNED MEDICAL PROFESSIONALS)

VOLUNTEERS NEEDED: GENERAL DENTISTS, SPECIALISTS, DENTAL ASSISTANTS AND HYGIENISTS. ALSO NEEDED: DENTAL LABS AND SUPPLY COMPANIES TO PARTNER WITH; HOME HYGIENE SUPPLIES TO VOLUNTEER, CONTACT: ED GILBERT (916.925.9379 • CCMP.PA@JUNO.COM) www.sdds.org • November 2015

| 25

2

1 3

4 Congratulations

to our raffle winner, Dr. Alpha, who said...

5

Donate it to the Foundation!

General Meeting

October 6, 2015 • Recruitment Night • Large Group Practice & Your Dental Practice 1 2 3 4 5

Drs. Berrin, Felahy, Gugale, and Adams.

Mary Robbins, Julie Handy, Melinda Heryford, and Dina Mann.

The speaker for the evening, Anders Bjork with Drs. McWilliams and Laptalo.

Dr. Heir was a victim of Drs. Adams’ and Gugale’s bunny ears, while posing with Drs. Kodama and Bellamy.

The registration table was a busy place that evening.

Bring your staff!

26 | The Nugget • Sacramento District Dental Society

Next General Membership Meeting: NOVEMBER 10, 2015 www.sdds.org/general-meetings 8

Did you miss the October GM?

Here’s what people had to say about it.

HELPFUL TO SEE THE REALITY OF WHAT IS ON THE HORIZON.

TRUE STATS, NOT JUST “THOUGHTS.” INTERESTING PERSPECTIVE.

HE WAS VERY KNOWLEDGEABLE. COULD HAVE BEEN A HALF DAY WORKSHOP.

I APPRECIATED GOOD SPEAKER, KNOWLEDGEABLE, HIS CANDIDNESS. ABLE TO ANSWER MOST QUESTIONS.

THIS IS ONE OF THE BEST PROGRAMS I'VE SEEN.

GOOD WARNING OF OUR CDA LEADERSHIP MAY BE “DRINKING THE KOOLAID”

IT GAVE ME AN UNDERSTANDING OF THE SITUATION. GOOD, MET EXPECTATION. AN IMPORTANT TOPIC THAT NEEDS TO BE FOLLOWED AND SDDS MEMBERSHIP NEED TO BE INFORMED.

Your Trusted Source For: • Commercial RE purchases • Construction loans • Business acquisition or expansion • Equipment/Inventory purchase • Refinancing • Working Capital

Business Financing from your neighborhood Credit Union Bob Miller, Business Development Officer (916) 576-5679 bmiller@firstus.org

A Proud Vendor Member of SDDS since 2004

www.sdds.org • November 2015

| 27

An Ethical Dilemma What Would You Do? The Dilemma: It’s 8:15 on Monday morning.

You just finished checking your inbox and taking those last delicious sips of coffee. Betty is your first hygiene check this morning. Her health history is significant for hypertension and acid reflux; both of which she treats with essential oils from the local co-op. Betty’s dental history includes an array of restorations and endodontically treated teeth. You’re greeted by a waft of patchouli upon entering the exam room. After examining Betty’s dentition, you request that four bitewings be taken. And so it begins…

HOW WOULD YOU HANDLE IT? A. Have Betty sign a “Release of Liability” form stating that anything that goes undiagnosed is her responsibility.

B. Say “OK!” and proceed with the clinical exam and cleaning.

C. Dismiss Betty from your practice.

D. Argue with Betty and convince her to proceed with radiographs.

Betty: But I don’t feel anything and nothing ever changes?

Choice D is ideal from an ethical perspective.

Take the time to help the patient understand that radiographs are not taken arbitrarily, but rather with thought and consideration for each patient’s risk factors and previous dental history. Question your patients and find the reason for their hesitation. Some reservations may be as simple as discomfort during the process or financial concerns. These obstacles can be easily remedied to connect with your patient’s needs.

Dr. Z: Our goal is to make sure we catch these problems before you can feel them. Once you are able to feel a problem, it usually requires more complex treatment. Without proper x-rays, it is as though I am blindfolded during today’s visit.

From a litigious point of view, choice C is optimal. Although a person may practice his/her patient autonomy in refusing x-rays, you the dentist are equally in the right to exercise your dentist autonomy and dismiss the individual from your practice. Be sure to

Betty: Why do we always have to take so many x-rays?

Dr. Z: We only take those radiographs necessary to be able to thoroughly diagnose and detect for cavities or other things we might see. Today I’d like Kim to take four “check-up pictures” of your posterior teeth. It has been two years since your last set.

28 | The Nugget • Sacramento District Dental Society

By Kristen Adams, DDS

Ethics Committee Member

thoroughly document the dismissal process and provide the patient with a formal letter of dismissal explaining your reasoning. If the dentist does not discharge the patient, he/she may be enabling substandard treatment” or negligence.

While choice A may seem like a simple resolution, there are underlying issues with this tactic. Practicing patient autonomy does not mean giving consent to negligence. Do not give up your responsibility to make proper treatment decisions. Educate your patient into accepting a treatment plan that is mutually beneficial.

Ignoring the issue at hand, like in choice B, perpetuates the problem. It is the dentist’s responsibility to educate the patient on the risks and benefits of thorough and regular radiographic records.

Finally, excellent communication skills should lead to treatment plan acceptance while enhancing the doctor/patient relationship on the journey to optimal dental health. 

DO YOU HAVE AN ETHICAL QUESTION? Do you have an Ethical Dilemma? Or a response to this article? Email us at nugget@ sdds.org to be heard!

Reaching the Peak in Building for the Dental Industry Construction Management Remodels and Renovatoins Tenant Improvements New Construction

BlueNorthernBuilders.com

916.772.4192

CA Lic #820947

Sacramento TMD Orofacial Pain Study Group New Comprehensive 12-month Course Starting January

L

ouis Gallia MD, DMD, FACS presents a comprehensive study club focusing on the complex diagnosis and treatment of Temporomandibular and Orofacial Pain Disorders. This course is intended to help participants to become TMJ masters. The interactive study club will provide lecture and hands on exposure to this interesting group of disorders. Whether you are a novice or experienced TMD practitioner, this course will greatly enhance your ability to diagnose and treat the TMD orofacial pain patient. This course will be comprehensive, with the goal being to give dentists the tools to safely and predictably treat a difficult patient population. We will be bringing in outside speakers to enhance the learning experience, as well as lectures, literature review and case presentations. Live demonstrations of techniques including splint design, Botox injections, trigger point injections, intra-articular steroid injections diagnostic blocks will be included. A demonstration of your knowledge will be shared to the group through the presentation of case studies. Given the intense nature the course, participation will be strictly limited, so maximum learning can take place.

48 Hours CDE | Free Tuition SDDS Members

916.570.3088 • www.SacTMD-OrofacialPainStudyGroup.com www.sdds.org • November 2015

| 29

Our Foundation needs you!

The Foundation is the charitable arm of your dental society. This non-profit branch of your society was created to enable us to do some wonderful things for our community.

SDDS members have been our greatest resource from the beginning. Together we have created a fund that has made some of our visions a reality. Please see the enclosed insert to make a donation.

Together we can make a difference.

“When it comes to Implantology, I am an expert. Credit Card Processing on the other hand, not so much. The Payment Exchange has changed my practice for the better and that of dozens of local Dental Professionals.”

— Dr. Pieter J. Linssen

Local, Licensed, Customized Service Kraig Speckert, President kraig@thepayx.com 916.635.8800 ext. 301 www.thepayx.com

30 | The Nugget • Sacramento District Dental Society

Merchant Services Made Simple The Payment Exchange offers businesses the latest credit card processing solutions in the industry today.

Call for SDDS Special Pricing!

YOU

THE DENTIST, THE BUSINESS OWNER

YOU ARE A DENTIST. You’ve been to school, taken your Boards and settled into practice. End of story?

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.

Important Things to Know About Your Website:

1

When someone types in Dentist Sacramento in a Google search and you are a dentist in Sacramento you really need to have your practice show up on page one or two of the search.

Much beyond that the viewer is not going to take the time to dig that deep.

2

Test your site and see where you come up - if you don’t show up until page 10 then you have some work to do.

Search Engine Optimization is the work that needs to be done to move your site up in the rankings to get to page one. It is not a quick fix but will slowly move you towards the top of the list.

3

Is your site Responsive in design? Responsive is when your site automatically reformats to work well on a mobile device like a smart phone or iPad. In March, Google announced that

4

5

any sites that are NOT responsive will be ranked after all sites that are responsive in design - so not being responsive in design will hurt your ranking. In the next two years almost 80% of the people using Google will be on a mobile device - so this is important.

Do you have a blog? If not - start one and connect it to your site. A blog is a way to have relevant content on your site that changes weekly or monthly. If you don’t have time to write the blog have some of your staff jump in and write it only three paragraphs - not much - not hard, but important to helping you get found.

Claim your social media pages - do you have a Twitter account - even if you will not use it claim it so no one else will get your page first. You should

By Tina Reynolds Uptown Studios (SDDS Vendor Member) claim Facebook, Twitter, LinkedIn and Instagram at the least - then when you are ready, they will be yours. Social media is here to stay - it’s time to start. 

Member Benefit If you have questions email tina@ uptownstudios.net for a FREE SEO website review on your site that will tell you what your issues are. This is a free service for members of SDDS. In future issues we will dig deeper into each of these subjects for you.

Uptown Studios is a full service marketing, web and design firm in Sacramento.

Visit us at UptownStudios.net

CHECK OUT OUR UPCOMING CE

NOV

10 TUESDAY 5:45PM-9PM

General Meeting

NOV

3 CEU, 20% • $64

Your Staff, Your Patients & Your Team: Getting to Know the Right Balance

12 THURSDAY 8AM-1:30PM

Presented by Kerry Straine (Straine Consulting)

Business Forum 2.5 CEU, CORE • $69

Cyber Security: Protecting You & Your Patients Presented by SD Reliance and 360 Risk Partners

NOV

13 FRIDAY 8AM-3:30PM

Continuing Education 5 CEU, CORE • $185

The CSI Effect: Mass Disaster & Intimate Partner Violence Recognition Presented by Anthony Cardoza, DDS

2|6

www.sdds.org • November 2015

| 31

Foundation of the Sacramento District Dental Society

Patty’s Story

The first thing you recognize about Patty is her big, beautiful smile. A hard worker by nature, Patty is a true ‘go-getter’, who takes pride in everything that she does.

A born-and-raised Sacramentan, Patty was a young mother, dropping out of the 9th grade to raise her two daughters. She was a stay-athome mom, although she was also battling a life-long addiction to alcohol. “My daughters always felt like they had to be the parents,” says Patty. After her daughters graduated from high school, Patty worked in a manufacturing factory for seven years—she was the first woman ever hired on the assembly floor, and was promoted often because of her positive work attitude.

But she continued to struggle with alcohol and, after her older brother was killed, she sank into a deep depression and lost her job.

Even worse, she lost her relationship with her daughters, and remained out of their lives for over twenty years.

She ended up homeless, surviving along the American River, and living in a tent for more than two years. “I was just a shell of the person I am now. Homelessness is incredibly lonely, and I felt as if I was completely invisible.”

At the end of those years, and through the supportive help of several drug-and-alcohol recovery programs, Patty officially became clean of drugs and alcohol. Finally stable, she was accepted into Women’s Empowerment (WE).

“Women’s Empowerment saved my life,” says Patty. She hadn’t worked in an office

2016 Smiles for Kids Screenings Have Begun

78 Schools 28,400 Kids 54 Dentist screeners

By Kate Towson

Director of Development, Women’s Empowerment

environment for more than eight years, but here at WE, she developed the skills she needed to find—and keep—a job. Before Women’s Empowerment, Patty was terrified of computers, but now—thanks to the computer literacy class taught by enthusiastic Intel volunteers—she’s a pro!

applying for jobs every day.” For the first time, in a long time, Patty has an income, a stable home, and is able to pay rent—something she is proud to do.

Our partnership with Sacramento District Dental Society Foundation helped Patty received a full-set of dentures, helping her smile become even more beautiful—and work-ready. “I feel like a confident employee now, and that makes a huge difference.”

Patty is proud to tell you that she has been clean and sober for more than two years. She is now reunited with her entire family—including her two daughters and her grandchildren. “I get to be a mother to them again, and I am so grateful for that.”

I feel like a confident employee now, and that makes a huge difference.

After graduating, Patty worked closely with our Employment Specialist, who helped her to secure a seasonal position with The River Cats at Raley Field for the 2014 baseball season.

“This job is a great stepping stone, but I’m still

“I am completely filled with gratitude for Women’s Empowerment,” Patty says. To remind herself of where she came from, Patty volunteers once a month at Loaves & Fishes to serve lunch and give hugs—often to people she used to live with by the river. “I’ve changed so much that many of them don’t even recognize me.”

When I asked Patty if she had a five-year goal for herself, she said, “Wow, I couldn’t do that before, have dreams or goals. I can now.” She told me that in five years Patty will be working steadily at a job she loves, and have a house big enough so that her daughters, her brother, and her grandchildren can come over to eat dinner and have sleepovers. 

Thank you to our Dental Labs who donate for SFBK!

AlphaTech Dental Lab Artisin Dental Works Brabant Dental Lab Carmichael Dental Lab Danilov Dental Dental Creations Hamai Dental Lab Joe Rodriguez Dental Lab

32 | The Nugget • Sacramento District Dental Society

Kustom Dental Properties Laguna DentalArts Merrill Dental Lab Mike's Dental Lab Mouer Laboratories, Inc. North Area Dental Lab Oral Arts Dental Lab Paramount Dental Lab

Pegasus Dental Lab Professional Dental Lab QRP Dental Lab Roseville Dental Lab Sedgewick's Dental Lab Sierra Dental Lab Tri-City Dental Lab Western Dental Arts, Inc.

Job Bank The SDDS Job Bank is a service offered only to SDDS Members. It is published on the SDDS website and provides a forum for job seekers to reach other Society members who are looking for dentists to round out their practice, and vice versa. If you are a job seeker, associate seeker, selling or buying a practice, contact SDDS at (916) 446-1227. For contact information of any of the job bankers please visit www.sdds.org.

By Mark Kujiraoka, DDS Smiles for Big Kids Volunteer

ASSOCIATE POSITIONS AVAILABLE

Dr. Kujiraoka’s Story: Helping Patty

Another heart warming story of one of our volunteer doctors helping to better the community. We hope you enjoy Dr. Kujiraoka and Patty’s stories from this incredible act of selflessness.

Patty came to our office through the Smiles for Big Kids program, about 2 years ago now. Her main desire was to “hopefully get new dentures.” Patty was edentulous at a very young age, and her existing full upper and lower dentures were “ancient” according to her. She joked that one of her upper front teeth was super-glued in place, and that she was missing one of the upper teeth all together. Patty was a model patient, and very respectful of the fact that we were working on her through the generosity of the SDDS Foundation and their ability to recruit dentists and dental labs to complete the work on patients such as Patty. The work we performed for her was both satisfying and rewarding, and although there was no monetary compensation, the big hug at the end of treatment made it all worthwhile.

Thank you Patty and thanks to the Dental Foundation for providing such a program to those in need. 

Are you a member of our Foundation?

It only costs $75 a year to be a member of our Foundation. Email us at sdds@sdds.org to become a member and make a difference.

Thank you for supporting the Foundation!

Communicare • West Sac/Davis/Woodland • full • Pedio Shama Currimbhoy, DDS • Sacramento • full • Oral Surgeon Christopher Cooper, DMD • Roseville/Lincoln • part/full • GP Abdon Manaloto, DDS • Roseville/Lincoln • part/full • GP Karla Nguyen, DDS • Roseville/Lincoln • part/full • GP Novan Nguyen, DDS • Sacramento • part • GP Flaviane Peterson, DDS • Roseville/Lincoln • part/full • GP Victoria Sullivan, DDS • El Dorado Hills • part/full Pedo Annie Barnes, DDS • Sacramento • full • GP/Endo/Perio Harold Hanefield, DDS • Sacramento • part • GP Timothy Herman, DDS • Lincoln • part/full • GP Hung Le, DDS • South Sacramento, Stockton • part/full • GP Gregory Peterson, DDS • Sacramento • part • Perio/Pedo Ricky Tin, DDS • Elk Grove • part • GP Steven Tsuchida, DDS • Elk Grove • part/full • GP Darryl Azouz, DDS • Rocklin/Woodland • full (2 associates, 2 days) • GP Paul Binon, DDS, MSD • Roseville • part/full • Prosthodontist Chapa-De Indian Health Program • Auburn • part/on call • GP Chapa-De Indian Health Program • Grass Valley • part/on call • GP Gwendelyn Enriquez, DMD • Roseville • part/full • GP Sukhjeet Kaur, DDS • Sacramento • part/full • GP Sonny Lim, DMD • Woodland • part/full • GP Alex Moradzadeh, DDS • Sacramento • part/full • GP/Endo/Pedo/OS David Roholt, DDS • Auburn • full • GP/Perio Christopher Schiappa, DDS • Pioneer • part • Endo/Ortho/OS Norman Spalding, DDS • Walnut Grove • part/full • GP Dennis Wong, DDS • Sacramento/Pocket • part (Sat./on call) • GP Wellspace Health • Multiple Locations • fill-in/part/full • GP

DOCS SEEKING EMPLOYMENT Russell Anders, DDS • part (fill in only) • GP John Nerwinski, DDS • part • GP Robert Nisson, DDS • part • Ortho Shahryar Khodai, DDS • Sacramento • full • GP Steve Saffold, DDS • Sacramento • GP Michael Sunwoo, DDS • full • Ortho Andrea Azevedo, DDS, MPH • part; 1-2days/wk. • GP & Pedo Amanda Chen, DDS • full/part • Ortho Steve Murphy, DMD • part/full • Endo Ronald Rott, DDS • part • Perio Brandon Webb, DDS • part/full • Endo

DOCS LOOKING TO BUY A PRACTICE Sevan Yergatian • Rocklin/Roseville • GP Michael Sunwoo, DDS • Sacramento • Ortho Brandon Webb, DDS, MSD • Roseville • Endo Darryl Azouz, DDS • Rocklin • GP Ryan Hecht, DMD, MS • Folsom, Sacramento, Roseville • Ortho Shahryar Khodai, DDS • Sacramento • GP

DHP’S SEEKING EMPLOYMENT Sammie Ghaysar-Lak • full • RDH Janice Dufort • full • RDH www.sdds.org • November 2015

| 33

You are not a policy number.

You are also not a sales goal or market segment. You are a dentist.

And we are The Dentists Insurance Company, TDIC, where business is about doing what’s best for you, our policyholders. Here, you receive the respect and care deserving of a member of your profession. You have access to an in-house claims team, razor-sharp legal team, and industry-leading resources to manage risk. Why go to such lengths?

Because with us, protecting dentists is all that matters.

Endorsed by the Sacramento District Dental Society

Protecting dentists. It’s all we do.

®

800.733.0633 | tdicsolutions.com | CA Insurance Lic. #0652783

Trustee Report September 18, 2015

Adrian Carrington, DDS & Terrence Jones, DDS

CDA Trustees

Highlights of the CDA Board of Trustees Meeting Actions Taken * All actions of the Board will be moved to the House of Delegates for ratification (board report 3) or separate resolution.

• 2016 CDA Operating and Capital Budget: The board approved the 2016 budget.

• Dentists Providing Influenza Vaccines: The board approved the request that CDA approve policy acknowledging that dentists have the ability to administer influenza vaccines.

• Committee on Volunteer Placement (CVP) Chair Requirements: The board approved the recommendation to allow the president the flexibility to appoint a chair from among the members serving on CVP and any trustee member of CVP to serve as chair of the Nominating Committee.

• Task Force Recruitment and Selection Process: The board amended and approved the recommendation to open an application period to aid in the selection of members to a task force and that CVP provide recommendations to the president in making appointments.

• Petition for Charter in the Western Los Angeles Area: The board approved

to forward the petition requesting a new charter in the Western Los Angeles area to the House with a recommendation to deny the petition.

• Peer Review Conflict of Interest Policy: The board approved that the peer review conflict of interest policy be amended to allow component officers and board members to concurrently serve on a peer review committee.

• TDIC/TDIC Insurance Solutions (TDIC/TDIC IS) Boards Selection of Public Members: The board nominated Kenneth Jones and Kevin Stockton to serve as public members on the TDIC/TDIC IS mirror boards (starting in January 2016) to be selected by the house and elected by the CDA Holding Company Inc. Board of Directors.

Discussions • Member Relationship Survey Findings Presentation: The board received and discussed an evaluation of benefits and services as learned in the recent research to help inform the strategic planning process.

WESTERN PRACTICE SALES John M. Cahill Associates

• 2016 Goals for CDA Executive Director Management by Objectives (MBOs): The board reviewed and discussed the proposed MBOs for the CDA executive director.

• California State Dental Director Update with Jayanth Kumar, DDS, MPH: California State Dental Director Dr. Jayanth Kumar provided the board with activities associated with state oral health programs.

• CDA Cares 2017 Event Locations and Dates: The Evaluation Committee approved the Bakersfield/Kern County Fairgrounds on Oct. 5-8 and San Mateo Event Center on April 21-24 as the CDA Cares dates and sites in 2017.

Closed Session • 2015 Mid-Year Review of the CDA Executive Director: The Evaluation Committee, in closed session, held a discussion of the mid-year self-assessment of the CDA executive director. 

What separates us from other brokerage firms?

Our extensive buyer database allows us to offer you

800.641.4179

A Better Candidate A Better Fit A Better Price Tim Giroux, DDS

Jon Noble, MBA

www.sdds.org • November 2015

| 35

YOU

YOU ARE A DENTIST. You are also an employer. Employee evaluations, hiring and firing, labor laws and personnel files are an important part of that. This monthly column, will offer current employment law information pertinent to you —

THE DENTIST, THE EMPLOYER

the dentist, the employer.

BER MEM IT! F E N E B

California Law

SDDS HR Hotline FREE TO SDDS MEMBERS!

on References

1.800.399.5331

By Kim Parker, CEO

California Employers Association (SDDS Vendor Member)

What Should I Say About an Ex-Employee?

When you receive a request for information about a former employee do you provide too much information or not enough? If your answer to this question is, “I have no idea”, you are not alone. We’ve created this article to help you learn more about the risks when it comes to requests for references on prior employees. We’ve also included tips to help you develop a strong reference check policy that reduces your risk of liability.

When an employee leaves your company, it’s a good idea to decide what you plan to say if other employers call you for a reference.

If the employee left on good terms, you and your former employee can agree upon a statement to explain the departure and/or you can simply tell the prospective employer positive things about the employee. If the employee was fired, however, you face a more difficult task.

Why are employers nervous about giving information on former employees?

The California Labor Code makes it a misdemeanor for an employer to make a misrepresentation that prevents a former employee from obtaining employment.

Under such circumstances, former employees can sue their ex-employer and recover three times the amount of any actual damages. In other words, employers can be sued if they make statements which are false or act with

reckless disregard for the impact their words have upon the prospective employer.

The Good News: California employers are protected if statements are based on credible evidence and made without malice. California law specifically states that this protection extends to statements about job performance, qualifications, and eligibility for rehire. For example, Civil Code Section 47(c) protects employers who respond to the question, “Is this person eligible for rehire?” The section states: “This subdivision authorizes a current or former employer, or the employer’s agent, to answer whether or not the employer would rehire a current or former employee.”

However, employers do not have this same protection if they make statements regarding an employee’s constitutionally protected speech or activities, including statements about an employee’s union. The National Labor Relations Board protects the rights of employees to engage in “concerted activity”, which is when two or more employees take action for their mutual aid or protection regarding terms and conditions of employment.

Caution on not giving enough information: If you choose to give a detailed reference, you need to know that California case law can find you liable for not providing enough information about an employee. For example,

if you give a glowing recommendation about work performance for someone you fired for inappropriate behavior, like sexual misconduct, and don’t mention the misconduct, you could be held liable for not telling the whole story. If the new employer hires your ex-employee and is later involved in a lawsuit, it would not be surprising to find that you would also be named in that lawsuit.

What about Letters of Recommendation?

While many employers think they “owe” an employee a letter of recommendation, this is definitely not the case. The California Supreme Court held that an employer writing a letter of recommendation owes the person who receives the letter of recommendation, “a duty not to misrepresent the facts in describing the qualifications and character of a former employee, if making these misrepresentations would present a substantial foreseeable risk of physical injury to the third person.” Id. At 591. So what does that mean? It means, if a good employee, who you would rehire, leaves your employment under amiable circumstances, by all means go ahead and write a letter of recommendation for them. But don’t write a letter for someone you would not rehire and put yourself at risk by writing a letter of false flattery for this person.

2

36 | The Nugget • Sacramento District Dental Society

CHECK OUT OUR UPCOMING HR WEBINARS

HR Webinar

Presented by Mari Bradford One hour online and audio seminar you can listen to with co-workers while you have your lunch or while you are on the road. You will only need a telephone, cell phone and/or computer (computer not required). All you need to do is dial, listen and ask questions if you desire.

Tips for Creating a Reference Check Policy A solid policy for reference checks should give clear direction as to who in your company has authorization to provide references for former employees and what information may be provided. There is no perfect method for dealing with job reference requests, but we’ve listed several tips to include in your policy to reduce your liability: - Be consistent. Decide who in your company will be responsible for references.

All employees need to know who that person(s) is and direct inquiries to that person. Keep a record of all requests for a reference and every response, in case of later trouble. You may also want to adopt a policy of providing references only in writing, so you have proof of exactly what was said.

- Keep it short and sweet. Adopt a policy

NOV

17 TUESDAY 12PM-1PM

Alternative Work Week 1 CEU, 20% • $40

Sign up online at sdds. org/events/hr-webinaralternative-work-week/

JAN

20 WEDNESDAY 12PM-1PM

of giving out only dates of employment, job title, final salary and whether or not the employee is rehirable. There is quite a bit of influence behind the answer on rehirability, you can convey valuable information to a potential new employer. Example: I would definitely rehire Kim, she was a tremendous asset to our company. Or, I would absolutely not consider Kim eligible for rehire with our company, under any circumstances!

- Just the facts. If you want to give out additional information, limit your comments to accurate, easily documented information.

Example: Kim received six promotions in her time with this company. Or, Kim received several written warnings regarding attendance issues, before her employment with our company was ended.

- Don’t let your emotions get the best of you. If you are still upset about an employee who you fired, don’t allow your

2016 Labor Law Update 1 CEU, 20% • $40

Sign up online at sdds.org/ events/hr-webinar-2016labor-law-update/

emotions to spill over into the reference.

Giving your “opinion” about a former employee could open you up to a lawsuit for defamation of character and slander. For example, it is better to say, “Kim failed to follow company policy”, as opposed to “Kim is incompetent.”

- Be truthful. Truth is a defense to almost any claim. However, if there were serious problems with a former employee, you may find yourself in legal trouble if you fail to warn the new employer and these serious problems resurface in the employee’s next job.

- Insist on written releases from employees. This may be difficult, but is probably the best defense. You can require former employees to sign a release – signed authorization that releases their former employer from liability for providing documents to a prospective employer. 

Sacramento Mobile Dental WE COME TO YOU!

Stephen Saffold, DDS

Mobile dental services providing experienced care to homebound and assisted living patients unable to easily travel to a traditional dental facility.

Disabled, geriatric and memory patients accepted. Normal dental fees with insurance reimbursement when available.

For more information visit our website at: SacramentoMobileDental.com

Appointments or questions, contact SacramentoMobileDental@gmail.com | 916-715-2359 www.sdds.org • November 2015

| 37

Committee Corner Committees Are Calling For Your Participation!

There is nothing stronger than the heart of a volunteer. With it beats the spirit of service, generosity and compassion...and the health and well-being of our community, our country and our world.

- Kobi Yamada

SDDS has many opportunities for you to give back to your profession. We need you to get involved; and we will make it easy for you to participate!

November is the time that SDDS begins to line up our calendar for next year, our volunteer placement on committees is completed, the new chairs are approved by the Board of Directors and they begin to roll out our 2016 plan. Last year, more than 300 SDDS members participated in committees, projects and events. Please get involved—we’d love your input and participation!

You, as an SDDS member, have an opportunity to contribute valuable knowledge and expertise for the betterment of your practice, organized dentistry and the profession of dentistry. Committee work activities provide the pulse for responding to the ever-changing issues that we face today and a chance to anticipate needs and shape our future. If you have never been involved in an SDDS committee, all you have to do is call and ask any member of the SDDS staff. We also have positions available should you like to serve on the Sacramento District Dental Foundation, which is the heart of SDDS. The Foundation organizes Smiles for Kids and other programs that give back to people who are underserved in our community.

Included in this issue you will find a sign up form describing the opportunities— in detail. So, come, jump in and enjoy working with your peers! 

ARE YOU USING YOUR ADVERTISING BENEFIT? SDDS MEMBERS RECEIVE A

5% DISCOUNT ON ADVERTISING

SDDS Members—General Practitioners and Specialists; Have you ever thought of advertising in the Nugget? What is your area of expertise?

Want to let other colleagues know?

Sign a year advertising contract and get a 15% discount and an additional 5% if you pay in full 38 | The Nugget • Sacramento District Dental Society

The Little Hoover Commission Improving the Denti-Cal Program The Sacramento Dental Society is pleased to announce yet another partner in their quest to improve the California Denti-Cal program.

Thanks to intensive lobbying of state legislators

by SDDS and CDA dentists frustrated with the program, an inquiry was requested. State Senator Richard Pan MD and CDA dentist and State Assembly Member Jim Wood DDS called for an investigation of the program by the Little Hoover Commission. On September 24th the Commission held a hearing at the State Capitol.

The Little Hoover Commission was created in 1962 in order to investigate state government programs and operations. The commission is intentionally bipartisan and has five citizen members appointed by the Governor, four citizen members appointed by the Legislature and two Senators and two Assembly members.

The Commission accomplishes its task primarily through public hearings, interviews of key players and expert witnesses as well as reviewing relevant literature. The Commission does not limit its investigation to pointing out deficiencies in the programs it investigates but strives to find avenues for improving

the existing program. Their investigations culminate in a written report delivered to the legislature that often recommends legislation to address the identified problems.

The focus of the Denti-Cal investigation is on the administrative structure of the Department of Health Care Services with an eye toward recommending improvements that will translate into better care for beneficiaries.

There is a long litany of complaints about the program that center on its poor utilization by the beneficiaries, poor provider participation, poor provider reimbursement, excessive paperwork and spotty to non- existent coverage in some rural counties. The Commission will publish its report in early spring 2016.

The Little Hoover Commission has an excellent reputation for creative problem solving, strong coalition building and crafting effective bipartisan legislation that makes a positive impact on the problems it investigates.

Denti-Cal may challenge that reputation but its great to have them on our side. 

By Terrence Jones, DDS

Chair, GMC/Denti-Cal Task Force

2015 SDDS COMMITTEE SCHEDULE LEADERSHIP Board of Directors (6:00pm) November 3

Executive Committee (7:00am) December 4

FOUNDATION Foundation Board (6:15pm) December 2

OTHER SacPAC (6:15pm) November 16

STANDING COMMITTEES Membership (6:30pm) November 18

Peer Review (6:00pm) November 18 • December 10

Remembering Dr. Steve Leighty

It is with great sadness that we have lost our dear member, Dr. Steve Leighty on October 15, 2015.

Dr. Leighty was a member and President of Butte Sierra Dental Society, and owned a practice in Grass Valley. At that time he was an affiliate member with SDDS, and supported SDDS efforts. In 2011, Dr. Leighty opened a practice in Auburn and joined SDDS as a full member. He also owned a practice in Roseville.

Dr. Leighty served on the Peer Review Committee, CE Committee, the Ethics

Committee, Ethics Task Force, and Legislative Advisory Committee… all since 2009. He was also the current President of Western States Society of Oral and Maxillofacial Surgeons and on the Executive Board for CalAOMS. Dr. Leighty was active with CDA and was, at the time of his death, serving as Reference Committee Chair for the 2015 House of Delegates.

Our hearts are with his wife Karen, son Michael, and his family and staff. www.sdds.org • November 2015

| 39

We’re Blowing your horn!

Congratulations to...

Richard Shipp, DDS, Nancy Archibald, DDS, Alan Rabe, DDS, Ramouna Karvar Roikjer, DMD, G. Curtis Croft, DDS, Camelia Cifor, DDS, Lisa Mayeda, DDS, Wes Yee, DDS, Bradley Yee, DDS, Kayla Nguyen, DDS, on volunteering their services for the care of the Rotary Foreign Exchange Students! This program, Exchange Smiles, started with the help of Joanne Tanner and Rotary District 5180. (1) Guy Acheson, DDS, on being awarded the first place trophy in Advanced Glider at the United States National Aerobatic Championships in Denison, Texas. Dr. Acheson will represent the United States at the World Glider Aerobatic Championships in Hungary in July 2016 (2)

1

Jim Coyle, DDS and Kent Daft, DDS, on winning the Spyglass Member/Guest Golf Tournament in Pebble Beach! (3) Our Foundation, on receiving $14,000 in dental materials from Dentsply for our Smiles for Big Kids program and in honor of Dr. Bob Gillis. Pictured are (left to right) Keith Clements of Dentsply, Mary Lou Gillis, Margaret Delmore, Mark Duane of Dentsply! (4) Steve Leighty, DDS, (RIP), on meeting ZZ Top! (5)

2

4 40 | The Nugget • Sacramento District Dental Society

Dean N. Ahmad, DDS, – on being elected President of a national dental organization called DENTAL APPNA, which is a collaborative organization between dentists and physicians!

3

5

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

New Members RAUL J. CONTRERAS, DMD

General Practitioner Transferred from Southern Alameda Dental Society 185 Palm Ave Auburn, CA 95603-3711 (619) 733-4676 Dr. Raul Contreras graduated from Temple University School of Dentistry in 2011.

CINDY HA, DDS

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

General Practitioner 5524 Assembly Ct. Sacramento, CA 95823-2625 (916) 642-1869 Dr. Cindy Ha graduated from Tufts College Dental School in 2014.

WES HILL, DDS, MD

Oral and Maxillofacial Surgery Transferred from San Gabriel Dental Society 2350 Professional Dr. Ste 400 Roseville, CA 95661-7747 (916) 786-3930 Dr. Wes Hill graduated from UCLA School of Dentistry in 2005, and University of Florida in 2011. Fun Fact: Dr. Hill was born in Ohio while his father finished dental school. The Cleveland Browns are his favorite sports team. Dr. Hill’s wife is also a new member, Dr. Diya Talwar.

UPDATED! Moving?

Opening a new office?

Offering new services?

Pending Applicants

TOTAL MEMBERSHIP (AS OF 10/12/15): 1,628 NEW MEMBERS FOR 2015: 79 TOTAL ACTIVE MEMBERS: 1,312 TOTAL RETIRED: 236 TOTAL DUAL MEMBERS: 4 TOTAL AFFILIATE MEMBERS: 12 TOTAL STUDENT/PROVISIONAL MEMBERS: 8 TOTAL APPLICANTS: 6 TOTAL DHP MEMBERS: 47 TOTAL POST GRAD: 3

MARKET SHARE: 79%

Endodontist Transferred from Santa Clara Dental Society Laguna Endodontics 9561 Laguna Springs Dr. Ste 100 Elk Grove, CA 95758-7961 (916) 683-4255 Dr. Saehee Kim graduated from the University of Pennsylvania School of Dentistry in 2008, and Temple University in 2015.

DIYA TALWAR, DDS

Share your information with the Society!

General Practitioner Transferred from San Gabriel Dental Society Pending Office Address

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!

Dr. Diya Talwar graduated from UCLA School of Dentistry in 2005. Fun Fact: Dr. Talwar is married to new member, Dr. Wes Hill.

Give us a call at (916) 446-1227

2015

Ayman Ghobashy, DDS Alex Keith, DDS William Koett Jr, DDS James Lai, DDS Voltaire Sambajon, DDS Fan Yang, DDS

SAEHEE KIM, DMD

KEEP US

November

9

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

GRAMMAR LESSON BY DARLE TILLY Here are some humorous reasons to use the serial or Oxford comma.

Found in a newspaper account of a documentary about Merle Haggard—

And the famous book dedication— To my parents, Ayn Rand and God.

Among those interviewed were his two ex-wives, Kris Kristofferson and Robert Duvall. www.sdds.org • November 2015

| 41

Advertiser INDEX Dental Supplies, Equipment, Repair Vendor Member Vendor Member Vendor Member Vendor Member Vendor Member Vendor Member

Analgesic Services Inc. . . . . . . . . . . . . . . . . . . . . . . . 44 Burkhart Dental Supply. . . . . . . . . . . . . . . . . . . . . . . 44 Desco Dental Equipment. . . . . . . . . . . . . . . . . . . . . . 44 Henry Schein Dental. . . . . . . . . . . . . . . . . . . . . . 19, 44 Heraeus Kulzer. . . . . . . . . . . . . . . . . . . . . . . . . . . 6, 44 Patterson Dental. . . . . . . . . . . . . . . . . . . . . . . . . . . . 44

Dental Services Vendor Member

Sacramento TMD Orofacial Pain Study Group . . . . . 29 The Foundation for Allied Dental Education. . . . . 22, 44

Financial, Insurance & Investment Services Vendor Member Vendor Member Vendor Member Vendor Member Vendor Member Vendor Member Vendor Member Vendor Member Vendor Member Vendor Member

Ameriprise Financial – The Chandler Group . . . . . . . 45 Bank of the West. . . . . . . . . . . . . . . . . . . . . . . . . . . . 45 Fechter & Company. . . . . . . . . . . . . . . . . . . . . . . . . . 45 First US Community Credit Union . . . . . . . . . . . . 27, 45 Innovative Solutions CPAs & Advisors, LLP . . . . . . . . 45 Kaneski Associates . . . . . . . . . . . . . . . . . . . . . . . . . 45 Mann, Urrutia, Nelson, CPAs . . . . . . . . . . . . . . . 21, 45 The Payment Exchange . . . . . . . . . . . . . . . . . . . 30, 45 TDIC & TDIC Insurance Services . . . . . . . . . . . . 34, 45 Wells Fargo Bank . . . . . . . . . . . . . . . . . . . . . . . . . . . 45

Human Resources Vendor Member Vendor Member

California Employers Association (CEA) . . . . . . . . . . 44 Resource Staffing Group. . . . . . . . . . . . . . . . . . . . . . 44

IT, Billing & Security Vendor Member Vendor Member

SD Reliance. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44 xTerraLink, Inc.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44

Legal Services Vendor Member

The Goldman Law Firm . . . . . . . . . . . . . . . . . . . . . . 28 Wood & Delgado . . . . . . . . . . . . . . . . . . . . . . . . . . . 44

Marketing Vendor Member

Uptown Studios. . . . . . . . . . . . . . . . . . . . . . . . . . . . 45

Media & Advertising Vendor Member Vendor Member

Comcast Business. . . . . . . . . . . . . . . . . . . . . . . . . . 44 Sacramento Magazine. . . . . . . . . . . . . . . . . . . . . . . . 44

Office Design & Construction Vendor Member Vendor Member Vendor Member Vendor Member Vendor Member

Blue Northern Builders, Inc. . . . . . . . . . . . . . . . . 29, 45 Healthcare Cabinet Co. . . . . . . . . . . . . . . . . . . . . . . 45 Olson Construction . . . . . . . . . . . . . . . . . . . . . . . . . . 45 Wells Construction . . . . . . . . . . . . . . . . . . . . . . . . . . 45 Western Contract . . . . . . . . . . . . . . . . . . . . . . . . 21, 45

Practice Sales, Lease, Management &/or Consulting Vendor Member Vendor Member

Henry Schein - Wagner . . . . . . . . . . . . . . . . . . . . . . 42 Integrity Practice Sales . . . . . . . . . . . . . . . . . . . . . . . 44 Western Practice Sales . . . . . . . . . . . . . . . . . . . . 35, 44

Real Estate Mike Anderson . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28 TRI Commercial . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42

Waste Management Services Vendor Member

Real Healthcare Specialist RealEstate Estate Healthcare Specialist Dental/Medical Building Sales/Leasing Dental/Medical Office Office Building Sales/Leasing

“The Gordon Group” The Gordon Group Helping Those Who Help Others

Helping Those Who Help Others

• 33 Years Real Estate Experience •

(UNITED STATES DISABLED VETERAN OWNED BUSINESS)

♦ 50 Years Combined Real Estate Experience ♦

(UNITED STATES DISABLED VETERAN OWNED BUSINESS) Dental / Medical Office Buildings Available:

2233 Park Towne Circle, Sacramento • For Lease • ±2,250 Sq. Ft. • Negotiable Tenant Improvement allowance

Sacramento Mobile Dental . . . . . . . . . . . . . . . . . . . . 37 Pacific Dental Services. . . . . . . . . . . . . . . . . . . . . . . 44

Education Vendor Member

Gordon Senior GordonStevenson, Stevenson, Senior VP VP

Star Group Global Refining . . . . . . . . . . . . . . . . . . 6, 45

42 | The Nugget • Sacramento District Dental Society

2295 Fieldstone Dr., Lincoln, CA

AVAILABLE FOR LEASE AVAILABLE FOR LEASE • For Lease: ±1,131 SF - ±7,739 SF 1600 CREEKSIDE 6403 COYLE AVE., CARMICHAEL • Medical, Dental or General Office DR., FOLSOM • Nice turn-key build outs

• ±1,449 & ±1,464 Sq. Ft. • ±1,198 - ±8,191 Sq. Ft.• Across the street from Sutter Medical • Located On Dignity/Mercy • Located On Dignity/Mercy Folsom Campus Campus 5400 Park Dr., Rocklin (Why Rent if U Can Buy) • Fully Built-Out Medical Office • Private Balconies • For Sale: ±4,592 Sq. Ft. • Private Balconies • Tenant Improvement •Funds Building Signage Available • Beautiful setting – seasonal greenbelt *Owner may do short term financing*

Visit our website www.gordongrouphcp.com to view more properties.

TRICommercial Commercial - Roseville TRI gstevenson@tricommercial.com 2250 Douglas Blvd., Suite 200, 916.677.8150 | BRE # 01092461 Roseville, CA 95661 916●677●8150 gstevenson@tricommercial.com BRE Lic. #: 01092461

VENDOR MEMBER SPOTLIGHTS:

About Heraeus Kulzer Dental US – Giving a Hand to Oral Health Your hands transform patients’ lives. Through restorative and esthetic treatments, you provide patients with beautiful smiles, self-esteem and improved quality of life.

The whole team, from dental laboratory to dental office, deserve materials that meet the highest quality standards.

It is our mission to support your daily work with innovative and reliable products that offer added value. Because oral health belongs in good hands.

Heraeus Kulzer also collaborates with health care providers, researchers and academic institutions to support community wellbeing and overall oral health. To that end, Heraeus Kulzer is a corporate supporter of the National Children’s Oral Health Foundation, a nonprofit organization that provides access to care for thousands of underserved children, and the Breast Cancer Research Foundation.

Heraeus Kulzer is also one of the leading dental alloy refiners in North America with over 50 years’ experience.

Products and Services • Venus Composites: Pearl, Diamond, Diamond Flow, Bulk Fill • Gluma Desensitizers: Liquid and Gel • iBond Bonding: Self Etch and Total Etch • Flexitime Impression Materials • Venus Whitening: Max, Pro, Ultra, plus home maintenance care items • Lunch and Learns • Educational Opportunities and Tutorials • Business and Marketing Support • Metal Refining Christina Vetter 409.649.8921 christina.vetter@kulzer-dental.com www.heraeusdentalusa.com

Uptown Studios specializes in graphic design, website design, hosting and management, video production, social media training and management, content development, brand development and marketing services. We care about what we do and our focus is always to make our clients look fabulous!

Products and Services: • Web Design • Graphic Design • Social Media • Video • Branding • Marketing • Print • Green Design

Benefits, Special Pricing and/or Discounts Extended to SDDS Members: Marketing services, including web design, branding and marketing, social media trainings and management, graphic design, video and multimedia, content development and print services.

If you have questions email tina@uptownstudios.net for a FREE SEO website review on your site that will tell you what your issues are. This is a free service for members of SDDS. Tina Reynolds (916) 446-1082 tina@uptownstudios.net www.uptownstudios.net

welcome our new SDDS Vendor Members!

www.sdds.org • November 2015

| 43

Tim Giroux, DDS, President John Noble, MBA 800.641.4179

www.integritypracticesales.com

Wood & Delgado

Debbie Kemper 916.993.4182

Patrick J. Wood, Esq. Jason Wood, Esq. 800.499.1474

xTerraLink, Inc. Rami J. Zreikat / Alnore Deen 916.608.9902 • 916.206.1858

Lisa Geraghty 916.817.9284 lisa_geraghty@cable.comcast.com business.comcast.com

Pacific Dental Services

44 | The Nugget • Sacramento District Dental Society W W W. S D R E L I A N C E . C O M

www.xterralink.com

Rayelle Theeck 916.705.4515 www.pacificdentalservices.com

www.dentalattorneys.com

Vendor Member since 2012 Vendor Member since 2003

THIS COULD BE YOU! Education

www.resourcestaff.com

Dennis Krohn Jr., President 916.367.4244

Comcast Business

www.westernpracticesales.com

Resource Staffing Group

SD Reliance Management www.sdreliance.com

Vendor Member since 2014

Western Practice Sales

Brian Flanagan & Kirsi Kilpelainen 855.337.4337

Vendor Member since 2003

www.employers.org

Integrity Practice Sales

Vendor Member since 2015

Kim Parker, Executive VP Mari Bradford, HR Hotline Manager 800.399.5331

Vendor Member since 2004

CA Employers Association

www.pattersondental.com

Vendor Member since 2014

Practice Sales

www.sacmag.com

Vendor Member since 2002

Becki Bell, Marketing Director 916.452.6200

Vendor Member since 2014

Media & Advertising HR & Legal

Sacramento Magazine

www.heraeusdentalusa.com

Vendor Member since 2007

Roy Fruehauf, Branch Manager 800.736.4688

Vendor Member since 2015

Patterson Dental

Christina Vetter 408.649.8921

Vendor Member since 2005

Heraeus Kulzer

Mark Lowery, Regional Sales Manager 916.626.3002

DENTAL

IT, Billing & Security

www.descodentalequipment.com

Henry Schein Dental www.henryschein.com

Practice Services

www.burkhartdental.com

The Foundation for Allied Dental Education LaDonna Drury-Klein 916.357.6680 www.thefade.org

Vendor Member since 2015

www.asimedical.com

Vendor Member since 2010

Tony Vigil, President 916.259.2838

Vendor Member since 2011

DESCO Dental Equipment

Dave Little, Branch Manager 916.784.8200

Vendor Member since 2004

Burkhart Dental Supply

Geary Guy, VP / Steve Shupe, VP 888.928.1068

Vendor Member since 2014

Dental Supplies, Equipment, Repair

Analgesic Services, Inc.

Philip Kong 916.533.6882 - cell philip.kong@wellsfargo.com

we love our SDDS Vendor Members!

The Dentists Insurance Company Chris Stafford 800.733.0633 www.tdicsolutions.com

Olson Construction, Inc.

Marc Davis / Morgan Davis / Lynda Doyle 916.772.4192

Gordon St. Cyr and Gary St. Cyr 916.853.9556

David Olson 209.366.2486

www.bluenorthernbuilders.com

www.dentalcabinets.biz

Claire Blocker 916.202.0624

www.wellsconstruction.com

www.westerncontract.com/studio

www.olsonconstructioninc.com

Metal Refining

Western Contract

Nicole Wells 916.788.4480

Vendor Member since 2015

Vendor Member since 2007

Wells Construction, Inc.

Vendor Member since 2013

Healthcare Cabinet Co.

Blue Northern Builders, Inc.

Vendor Member since 2011

www.uptownstudios.net

www.wellsfargo.com

Insurance Services

Tina Reynolds 916.446.1082

Vendor Member since 2015

Uptown Studios

www.thepayx.com

Vendor Member since 2015

Wells Fargo Bank

Kraig Speckert, President 916.635.8800

Vendor Member since 2010

The Payment Exchange

Vendor Member since 2015

www.kaneskiassociates.com

Vendor Member since 2013

916.774.6250 800.316.3129

Vendor Member since 2004

www.innovativecpas.com

Kaneski Associates

Star Group Global Refining Jim Ryan, Sales Consultant 800.333.9990 www.stargrouprefining.com

www.sdds.org • November 2015

Vendor Member since 2009

Ben Anders, CPA 916.646.8180

Vendor Member since 2009

www.fechtercpa.com

John Urrutia, CPA, Partner Chris Mann, CPA, CFP, Partner 916.774.4208

Vendor Member since 2014

Marketing

www.bankofthewest.com

Mann, Urrutia, Nelson, CPAs

www.muncpas.com

Office Construction

Vendor Member since 2005

www.firstus.org

Craig Fechter, CPA 916.333.5360

Innovative Solutions CPAs & Advisors, LLP

First US Community Credit Union Gordon Gerwig, Business Services Mgr 916.576.5650

Fechter & Company

Mary Alajou, VP Sacramento / Butte Area Manager 916.949.2687

Vendor Member since 2014

www.ameripriseadvisors.com

Bank of the West

Vendor Member since 2013

Thomas Chandler 916.789.9393, ext. 03197

Vendor Member since 2015

Financial Services

Ameriprise Financial — The Chandler Group

| 45

Classified Ads EMPLOYMENT OPPORTUNITIES

PRACTICES FOR SALE

FOR FOR LEASE LEASE

LOOKING FOR AN ETHICAL AND TECHNICALLY SOUND DENTIST to join an established general dentistry practice.

The position would be full time (32-40 hours per week), but I would entertain part-time as well. The practice just moved into a new office consisting of all state of the art equipment, including CAD/CAM dentistry. Call 858-699-1776 or email drjasoncass@yahoo.com 11/15

DENTISTS SERVING DENTISTS — Western Practice Sales invites you to visit westernpracticesales.com to view our practices for sale and see why we are the broker of choice in Northern California.

Please call 800.641.4179.

03-09

DENTAL OFFICE FOR LEASE: 5433 PALM AVE, SACRAMENTO 95841. 2,500 SF, 6 plumbed operatories, spacious reception area, office, breakroom & 2 large bathrooms. Ample parking, easy freeway access. Call 1.800.939.3111 securelease@aim.com 11-15

ON-CALL & PART-TIME DENTISTS NEEDED—For a non-profit community health clinic providing care to Native Americans and the economically disadvantaged. Visit www.Chapa-de.org/jobs or Email resume to HR@chapa-de.org.

06/07-15 WE CATER TO COWARDS. Here at Dental Excellence, we strive to provide the ultimate calm and comforting patient experience.

Looking for an associate with 3-5 years of experience. Must have confidence in their skills, gentle touch to accommodate our fearful patients and have a flexible schedule. Must be available to work on Saturdays. Email greenhavendental@ yahoo.com or call 916.395.5700.

06/07-15

SACRAMENTO DENTAL OFFICE BUILDING FOR SALE— 8,000 sq. ft. As is, needs your vision, two stories, elevator, near Arden Mall. Contact Joe Hruban at 530.746.8839 or joe@omni-pg. com, Omni Practice Group #01821307.

08/09-15 ADORABLE OFFICE in Elk Grove. Perfect for beginning or established Dentist. Fully loaded with all equipment and computers. Child friendly, Six chairs. 9340 West Stockton Blvd.

Call Holly at 916.684.5456 10-15

PROFESSIONAL SERVICES

WELLSPACE HEALTH ORGANIZATION (an FQHC) is taking applications for fill-in/part-time/full-time dentists. Send your resume/CV to kdubois@wellspacehealth.org.

01/15 DENTIST (MIDTOWN) Our amazing dental practice is in search of an awesome Dentist! We want a committed doctor to join forces and continue to evolve with our devotion to continuing our education! We’ll talk about hours and pay once we read your resume. This is a great opportunity to work in a true team environment. F/T or P/T position. Send us a current resume.

Our Musts: High level work ethic and a passion to be a life-long learner. Check us out at DiTomassoDental.com. Send resume to: drpam@ditomassodental.com 10-15

MONEY IS WALKING OUT THE DOOR. Have implants placed in your office and keep the profits. Text name and address 916.769.1098.

12-14

FOR FREE!

START YOUR OWN DENTAL PRACTICE without incurring any debt. Sublease available in El Dorado Hills. State of the Art Office, Digital X-rays, everything you need to start seeing patients right away. Call 916.677.7221 for more information.

08/09-15 SACRAMENTO DENTAL COMPLEX has one small suite which can be equipped for immediate occupancy. Two other suites total 1630 sq. ft which can be remodeled to your personal office design with generous tenant improvements. 2525 K Street. Please call for details: 916.448.5702.

10-11 LOCATION, LOCATION, LOCATION: DENTAL OFFICE AVAILABLE, 3000 L Street 1,535 sf with 5 operatories, recently remodeled.

Fully serviced lease with ample free parking. Contact Kelly Gorman 916.929.8100.

03-13

LEARN HOW TO PLACE IMPLANTS IN YOUR OFFICE OR MINE. Mentoring you at your own pace and skill level.

Incredible practice growth. Text name and address to 916.952.1459.

04-12

SUNRISE DENTAL PLAZA, SUITE #106 FOR LEASE, 7916 Pebble Beach Dr., Citrus Heights. Four operatories and a lab with 1304 square feet. Well established professional dental building. For more information, please call or email Marty at 916.966.5772 or mshep6944@aol.com.

08/09-14

POSITIONS WANTED

EQUIPMENT FOR SALE

LOCUM TENENS. UOP grad to work in your office while you are on vacation, sick or maternity leave or emergency. Great references. Please call 530.644.3438.

04-13

Brand New Endo motor and oven. Tulsa E3 Reciprocating torque control motor and handpiece, with obturating oven. In box, unused. $1200. Call: 916.601.0351 11-15C

BUSY PRIVATE PRACTICE in El Dorado Hills seeking exceptional, enthusiastic, detail-oriented, pediatric dentist to join our growing team! Please sen CV to dpetersonmsd@gmail.com or fax to 916.941.1443 11-15C

SDDS member dentists can place a classified ad

DESIGN YOUR SUITE IN A STATE-OF-THE-ART SACRAMENTO BUILDING near Watt & El Camino Avenue. FULL FINANCING AVAILABLE for 1750 sf. Come see it! Contact Dr. Favero 916.487.9100.

11/12-15, 01/02/03-16C

5|10

To place an ad in The Nugget Classifieds, visit www.sdds.org/publications-media/advertise

Selling your practice? Need an associate? Have office space to lease? SDDS member dentists get one complimentary, professionally related classified ad per year (30 word maximum). For more information on placing a classified ad, please call the SDDS office at 916.446.1227.

46 | The Nugget • Sacramento District Dental Society

Early Bird

325/ $18

$

d e n ti s ts

s ta ff

9

Extende November d1 to 5th!

We're building it... we hope you'll come!

To avoid duplication, either scan and fax (916.447.3818) OR mail your registration form OR register online at www.sdds.org.

ONE REGISTRATION FORM PER ATTENDEE. Please print clearly. This information will be used to print name badges.

Attendee Name:

Title/Degree:

Member Dentist’s Name:

ADA #:

Office Address: City:

State:

Phone:

Fax:

Email:

Zip: *Individual email preferred (not main office email)

SIGN UP 5 STAFF, GET THE 6TH FREE! • COURSE INFORMATION AND OTHER CONVENTION CORRESPONDENCE WILL BE SENT VIA EMAIL. EARLY

REGULAR

ONSITE

Extended to NOV. 15

(on or before JAN. 24)

(after JAN. 24)

Dentists (ADA Members)

$325

$379

$399

Dentists (ADA Members) — ONE DAY ONLY

$275

$295

$325

SDDS DHP Members

$169

$179

$199

Auxiliary/Spouse (ADA Member*) * if doctor is attending

$189

$199

$209

Auxiliary/Spouse (ADA Member**) ** if doctor is NOT attending

$199

$199

$219

FEES (circle the rate for the above attendee) INCLUDES FRESH FOOD!

Thursday ONLY

Full convention registration includes: • All food and refreshments • All courses • Expo floor full access

Friday ONLY

Dentist (Non-ADA Members)

$700

$800

$900

Auxiliary/Spouse (of Non-ADA Member)

$300

$350

$400

Lab Technicians

$279

$289

$299

complimentary

complimentary

complimentary

$100/day

$125/day

$150/day

Expo Only (No Meals) (ADA Members)

REFUND/CANCELLATION POLICY: Cancellations received in writing by January 10, 2016 will receive a full refund less $25 per registrant processing fee. Cancellations received after this date are nonrefundable, but substitutions will be allowed. There will be no refund for “No Shows” or for registrations made after this date.

Th 1:30–5:30pm • Fr 8:00–10:45am

Expo Only (No Meals) (Non-ADA Members)

PAYMENT METHOD:

Card #: Cardholder Name:

Check Enclosed

-

Bill Me (SDDS Members only)

-

MasterCard

-

Visa

TOTAL: $ Exp. Date:

/

3-digit Security Code:

Billing Address:

Please make checks payable to Sacramento District Dental Society (SDDS) 2035 Hurley Way, Ste 200 • Sacramento, CA 95825 • 916.446.1227 ph • 916.447.3818 fx • www.sdds.org

PRSRT STD US POSTAGE PAID PERMIT NO. 557

2035 Hurley Way, Suite 200 • Sacramento, CA 95825 916.446.1211 • www.sdds.org

SACRAMENTO, CA

ADDRESS SERVICE REQUESTED

SDDS CALENDAR OF EVENTS NOVEMBER 3 6

SDDS Board of Directors Meeting 6:00pm / SDDS Office

13 Continuing Education CE The CSI Effect: Mass Disaster & Intimate Partner Violence Recognition Anthony Cardoza, DDS 8:00am–1:30pm / SDDS Classroom

CE

CPR BLS Renewal 8:00am–12:00pm / SDDS Classroom

Kerry Straine (Straine Consulting) Hilton Sacramento Arden West 5:45pm Social / 6:45pm Dinner & Program

CE

SD Reliance (SDDS Vendor Member) 6:00pm–9:30pm / SDDS Classroom

2

Foundation Board Meeting 6:15pm / SDDS Office

4

Executive Committee Meeting 7:00am / SDDS Office

4

Holiday Party 6:00 - 11:00pm / Del Paso Country Club

13 Dentists Do Broadway: Elf

6:30pm / Sacramento Community Theatre 10 General Membership Meeting CE Your Practice, Your Patients, & Your 16 SacPAC Committee Meeting Team: Getting to Know the Right Balance 6:15pm / SDDS Office

12 Business Forum Cyber Security: Protecting You & Your Patients

DECEMBER

17 HR Webinar Alternative Work Week

10 Peer Review Committee Meeting 6:00pm / SDDS Office

CE

Noon - 1:00pm

18 Peer Review Committee Meeting

For more calendar info and to sign up for courses online, visit: www.sdds.org

6:00pm / SDDS Office

18 Membership Committee Meeting 6:30pm / SDDS Office

11

Early Bird Registration Extended

To November 15th!

General Meeting: Staff Night 3 CEU, 20% • $64

NOV

10 TUESDAY 5:45PM-9PM

Your Practice, Your Patients & Your Team: Getting to Know the Right Balance Presented by Kerry Straine (Straine Consulting) • Learn how to attract, develop and retain quality patients and quality staff • Learn the principles of teamwork that govern success • Learn how to orchestrate your team for maximum effectiveness • Learn how to achieve your potential

ARE YOU REGISTERED FOR STAFF NIGHT?

Bring all your staff! (tables reserved for 7 or more)

5:45pm: Social & Table Clinics 6:45pm: Dinner & Program Hilton Sacramento Arden West (2200 Harvard Street, Sac)