2013 - Nov/Dec TFDA

Florida

Dental

Association

TODAY’S FDA

DENTIST OF THE YEAR Membership Benefits Peer review VOL. 25, NO. 7 november/december 2013

“

Servir en nuestra Asociación Dental me ha dado la oportunidad de conocer dentistas de todas partes de la Florida y todos los Estados Unidos y trabajar con ellos para mejorar nuestra profesión.

WE KNOW lifE iNsuraNcE. WE KNOW DENTisTs.

PROTECTING WHAT’S MOST IMPORTANT Life insurance options from FDA Services help you plan for the things that matter most. Family.

Call us today to discuss your life insurance needs.

a Member Benefit since 1989 800.877.7597 insurance@fdaservices.com www.fdaservices.com A wholly owned subsidiary of the Florida Dental Association

contents cover story

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2013 Dentist of the Year: Dr. Idalia Lastra

news

literary

12 news@fda

66 Letters to the Editor

18 House of Delegates to Consider Bylaws Changes

columns

19 House of Delegates — Meeting Announcement 21 Licensure Renewal

3 Staff Roster 5

President’s Message

features

6 Legal Notes

23 How Can You Give Back to Your Community?

9 Information Bytes

24 What is So Stressful About Practicing Dentistry?

47 Diagnostic Discussion

26 New Membership Concierge

to Focus on Member Service

80 Off the Cusp

28 The Two Questions the Valuable Team Members Ask 31 Florida Mission of Mercy Wants YOU!

classifieds 74 Listings

32 Looking for Savings? — CAP Program 36 President’s Profile — Dr. Terry Buckenheimer 42 2013 Dentist of the Year — Dr. Idalia Lastra 53 Fluoridation: The Debate Goes On 58 Your Peer Review Program: How it Works 78 FNDC Exhibitors Support Organized Dentistry

Read this issue on our website at:

www.floridadental.org.

www.floridadental.org

*Translation of Spanish quote on cover: “Serving in our Dental Association has given me the opportunity to meet dentists from all over Florida and the U.S. and work together to improve our profession.” *Please note we neglected to mention in our September/October issue that Dr. Michael Siegel, one of the authors of the article, “Management of the Anxious Dental Patient,” will be a speaker at FNDC2014. He will be presenting on Friday, June 13, 2014. “Diagnostic Pearls in Oral Medicine” will be presented in the morning, and “2014 Common Oral Lesions” that afternoon. We apologize for this oversight.

Today’s FDA is a member publication of the American Association of Dental Editors and the Florida Magazine Association.

November/December 2013

Today's FDA

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candidates sought for fda leadership

florida dental assocIation november/december 2013 VOL. 25, NO. 7

editor Dr. John Paul, Lakeland, Editor

staff Jill Runyan, publications manager • Jessica Lauria, publications coordinator Lynne Knight, marketing coordinator

council on communications Dr. Thomas Reinhart, Tampa, chairman Dr. Roger Robinson Jr., Jacksonville, vice chairman Dr. Richard Huot, Vero Beach • Dr. Scott Jackson, Ocala Dr. Marc Anthony Limosani, Miami • Dr. Jeff Ottley, Milton Dr. Jeannette Hall, Miami, trustee liaison • Dr. John Paul, editor

board of trustees

FDA speAker oF the house Deadline: Feb. 28, 2014 Elected by the FDA House of Delegates Duties: preside over all meetings of the House of Delegates; serve as ex officio parliamentarian of the Board of Trustees; and review all proposed resolutions of the Board of Trustees, councils and committees of the House.

FDA eDitor Deadline: Feb. 28, 2014 Appointed by the FDA Board of Trustees Duties: editorial supervision of all FDA publications; appoint volunteer associate editors as needed; and maintain open communications with other entities affiliated with the FDA.

For more information, call Rusty Payton, FDA chief operating officer, at 800.877.9922.

Dr. Terry Buckenheimer, Tampa, president Dr. Richard Stevenson, Jacksonville, president-elect Dr. Ralph Attanasi, Delray Beach, first vice president Dr. William D'Aiuto, Longwood, second vice president Dr. Michael D. Eggnatz, Weston, secretary Dr. Kim Jernigan, Pensacola, immediate past president Drew Eason, Tallahassee, executive director Dr. David Boden, Port St. Lucie • Dr. Jorge Centurion, Miami Dr. Stephen Cochran, Jacksonville • Dr. Lee Cohen, Palm Beach Gardens Dr. Don Erbes, Gainesville • Dr. Don Ilkka, Leesburg • Dr. Jolene Paramore, Panama City Dr. Rudy Liddell, Brandon • Dr. Tom Ward, Miami Dr. Ethan Pansick, Delray Beach, speaker of the house Dr. Paul Miller, New Port Richey, treasurer • Dr. Bryan Marshall, Weekiwachee, treasurer-elect Dr. John Paul, Lakeland, editor

publishing information Today’s FDA (ISSN 1048-5317/USPS 004-666) is published bi-monthly, plus one special issue, by the Florida Dental Association, 1111 E. Tennessee St., Tallahassee, Fla. 32308-6914.

FDA membership dues include a $10 subscription to Today’s FDA. Non-member subscriptions are $150 per year; foreign, $188. Periodical postage paid at Tallahassee, Fla. and additional entry offices. Copyright 2013 Florida Dental Association.

All rights reserved. Today’s FDA is a refereed publication.

POSTMASTER: Please send form 3579 for returns and changes of address to Today’s FDA, 1111 E. Tennessee St., Tallahassee, Fla. 32308-6914.

editorial and advertising policies Editorial and advertising copy are carefully reviewed, but publication in this journal does not necessarily imply that the Florida Dental Association endorses any products or services that are advertised, unless the advertisement specifically says so. Similarly, views and conclusions expressed in editorials, commentaries and/or news columns or articles that are published in the journal are those of the authors and not necessarily those of the editors, staff, officials, Board of Trustees or members of the Florida Dental Association.

editorial contact information All Today’s FDA editorial correspondence should be sent to Dr. John Paul, Today’s FDA Editor, Florida Dental Association, 1111 E. Tennessee St., Tallahassee, Fla. 32308-6914.

FDA office numbers: 800.877.9922, 850. 681.3629; fax 850.681.0116; email address, fda@floridadental.org; website address, www.floridadental.org.

Advertising Information Applications available from your component dental association or the FDA website: www.floridadental.org/leadership-roster-forms

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Today's FDA

November/December 2013

For display advertising information, contact: Jill Runyan at jrunyan@floridadental.org or 800.877.9922, Ext. 7113 Advertising must be paid in advance.

For classified advertising information, contact: Jessica Lauria at jlauria@floridadental.org or 800.977.9922, Ext. 7115.

www.floridadental.org

Contact the FDA Office

800.877.9922 or 850.681.3629 1111 E. Tennessee St. • Tallahassee, FL 32308

The last four digits of the telephone number are the extension for that staff member.

Executive Office Drew Eason, Executive Director deason@floridadental.org 850.350.7109 Rusty Payton, Chief Operating Officer rpayton@floridadental.org 850.350.7117 Graham Nicol, Chief Legal Officer gnicol@floridadental.org 850.350.7118 Judy Stone, Agency Relations Manager jstone@floridadental.org 850.350.7123

Accounting Jack Moore, Chief Financial Officer jmoore@floridadental.org 850.350.7137 Leona Boutwell, Bookkeeper – FDHF & A/R lboutwell@floridadental.org 850.350.7138 Deanne Foy, Bookkeeper – PAC & Special Projects dfoy@floridadental.org 850.350.7165

Florida National Dental Convention (FNDC) Crissy Tallman, FNDC Convention Manager ctallman@floridadental.org 850.350.7105 Kaitlin Alford, FNDC Meeting Assistant kalford@floridadental.org 850.350.7108 Elizabeth Bassett, FNDC Exhibits Planner ebassett@floridadental.org 850.350.7106 Mary Weldon, FNDC Program Coordinator mweldon@floridadental.org 850.350.7103

Governmental Affairs Joe Anne Hart, Director of Governmental Affairs jahart@floridadental.org 850.350.7205 Alexandra Abboud, Governmental Affairs Coordinator aabboud@floridadental.org 850.350.7204 Casey Stoutamire, Lobbyist cstoutamire@floridadental.org 850.350.7202

Tammy McGhin, Payroll & Property Coordinator tmcghin@floridadental.org 850.350.7139

Ron Watson, Lobbyist rwatson@floridadental.org 850.350.7203

Mable Patterson, Bookkeeper – A/P mpatterson@floridadental.org 850.350.7104

Information Systems

Communications and Marketing

Larry Darnell, Director of Information Systems ldarnell@floridadental.org 850.350.7102

Member relations David Higgins, Director of Member Relations dhiggins@floridadental.org 850.350.7121 Josh Freeland, Membership Assistant jfreeland@floridadental.org 850.350.7111 Sandy Merrill, Membership Coordinator smerrill@floridadental.org 850.350.7110

800.877.7597 or 850.681.2996 1113 E. Tennessee St., Ste. 200 Tallahassee, FL 32308 Group & Individual Health • Medicare Supplement • Life Insurance Disability Income • Long-term Care • Annuities • Professional Liability Office Package • Workers’ Compensation • Auto Scott Ruthstrom, Chief Operating Officer scott.ruthstrom@fdaservices.com 850.350.7146 Carrie Millar, Membership Services Manager carrie.millar@fdaservices.com 850.350.7155 Carol Gaskins, Assistant Membership Services Manager carol.gaskins@fdaservices.com 850.350.7159

dan.zottoli@fdaservices.com

Angela Robinson, Customer Service Representative angela.robinson@fdaservices.com 850.350.7156

Ron Idol, Network Systems Administrator ridol@floridadental.org 850.350.7153

Kristen Barrett, Membership Services Representative kristen.barrett@fdaservices.com 850.350.7171

www.floridadental.org

Dan Zottoli

Allen Johnson, Support Services Supervisor allen.johnson@fdaservices.com 850.350.7140

Lynne Knight, Marketing Coordinator lknight@floridadental.org 850.350.7112

Stefanie Dedmon, Coordinator of Foundation Affairs sdedmon@floridadental.org 850.350.7161

risk experts Atlantic Coast District Insurance Representative

Jamie Chason, Commissions Coordinator jamie.peddie@fdaservices.com 850.350.7142

(FDHF)

Porschie Biggins, Membership Services Representative pbiggins@fdaservices.com 850-350-7149

Debbie Lane, Assistant Membership Services Manager debbie.lane@fdaservices.com 850.350.7157

Lisa Cox, Database Administrator lcox@floridadental.org 850.350.7163

Florida Dental Health Foundation

Kerry Gómez-Ríos, Membership Concierge kgomez-rios@floridadental.org 850.350.7136

FDA Services

Jill Runyan, Publications Manager jrunyan@floridadental.org 850.350.7113

Jessica Lauria, Publications Coordinator jlauria@floridadental.org 850.350.7115

Christine Mortham, Member Relations Assistant cmortham@floridadental.org 850.350.7100

Marcia Dutton, Administrative Assistant marcia.dutton@fdaservices.com 850.350.7145 Maria Brooks, Membership Services Representative maria.brooks@fdaservices.com 850.350.7144 Nicole White, Membership Services Representative nicole.white@fdaservices.com 850.350.7151 Pamela Monahan, Commissions Coordinator pamela.monahan@fdaservices.com 850.350.7141

November/December 2013

561.791.7744 Cell: 561.601.5363

Dennis Head Central Florida District Insurance Representative 877.843.0921 (toll free) Cell: 407.927.5472 dennis.head@fdaservices.com

Joe Dukes Northeast & Northwest District Insurance Representative 850.350.7154 Cell: 850.766.9303 joe.dukes@fdaservices.com

Joseph Perretti South Florida District Insurance Representative 305.665.0455 Cell: 305.721.9196 joe.perretti@fdaservices.com

Rick D’Angelo West Coast District Insurance Representative 813.475.6948 Cell: 813.267.2572 rick.dangelo@fdaservices.com

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Today's FDA

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www.floridadental.org

President’s message Terry Buckenheimer, DMD

The Leaders of the ADA and the FDA are Committed to Making Members Successful!

Not too long ago, I was on the 22nd floor of the American Dental Association (ADA) building in Chicago. I was seated at an impressively large oval-shaped table that accommodates 45 people, and positioned between the chief financial officer and the chief of governance and strategy management. As the ADA Trustee from the 17th District, I was joined by 16 other trustees from around the country, all of the ADA’s leadership and the executive director. Also in attendance were the division chiefs and senior vice presidents of all the divisions of the ADA and their key staff members.

We were studying information gathered for us from various sources about the effects of the Affordable Care Act (ACA) on dentistry and how we can minimize the negative effects it may have on our members. We were weighing as many of the parameters as we could in order to help our members succeed in this changing health care industry. The major goals of the ADA and the Florida Dental Association (FDA) are to assist our members in being successful and to remain the leading advocate for oral health.

Many hours are spent preparing for the ADA Board of Trustees meetings. Many presentations are heard and reports read about the numerous influences (usually generated from outside the profession) that impact the dental profession as a whole and each of our practices as indiwww.floridadental.org

viduals. How does the sluggish economy affect you as a small-business owner or as part of a larger group practice? How does the ACA affect you or the student debt load? We tackle complex issues, and solutions are often multi-faceted and very difficult to attain. Although our response to these issues never seems to please everyone, the desire to assist all dentists to be successful is the common goal that unites us.

The individuals around the board table in Chicago are no different than the board members of the FDA. They are dedicated dentists with unique talents and a willingness to give up valuable time away from their practices in order to do their best for the organization and profession.

These past several months serving as your FDA president and ADA trustee have been challenging — but also incredibly rewarding. It has provided me with a special view of the inner workings of all three levels of our organization. From this vantage point, it becomes obvious that some issues are better handled at the national level (the ACA, repeal of the McCarren-Ferguson Act and the Medical Device Tax), while others are better managed at the state level (Medicaid reimbursement, sovereign immunity and non-covered services legislation). Still, others are best resolved locally at the

component level (access to care, community water fluoridation and oral health education and prevention).

I consider it an honor to be able to represent our members before the U.S. legislators, as well as our state governor and Legislature. Along with the other individuals around the various board tables, I am dedicated to making the future of our profession as bright as possible. It’s somewhat frustrating when the solutions to some of these difficult issues are out of our reach, and it’s disappointing when our efforts aren’t appreciated by dentists who choose not to join us in the fight to protect and preserve our profession.

There are many benefits to membership shared in this issue of Today’s FDA, and I want to personally invite all dentists to join and take advantage of these benefits.

You won’t be disappointed! The unified voice of the majority of dentists in our state gives us power to resist the everincreasing number of outside entities using their influence to affect dentistry for their own benefit.

Join your colleagues today!

Dr. Buckenheimer is the FDA president.

He can be reached at tlbdmd1@gmail.com.

November/December 2013

Today's FDA

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Legal Notes

Florida and HIPAA Complaint Forms for 2013 Omnibus Rule Graham Nicol, Esq.,

Health Care Risk Manager, Board Certified Specialist (Health Law

Since the HIPAA Omnibus regulations took effect in September, members of the Florida Dental Association (FDA) have been asking for documents that comply with both federal HIPAA and Florida confidentiality law. All of the documents are available on the FDA website and are free of charge to members. They are uploaded as Microsoft Word documents so that you may add your information to them.

The sample forms described below can be found at http://www.floridadental. org/hipaa-forms. They include the regulatory changes of the Omnibus Rule and can serve as the baseline for covered entities working to come into compliance with the new requirements. In particular, the samples highlight the new patients’ right to access their information held in an electronic health record, if their dentist has an Electronic Health Record (EHR) in their practice. Covered entities may use these models by entering their specific information into the model and then printing for distribution and posting on their websites.

This material is copyrighted by the author and the FDA. You are authorized to use it ONLY if you are an FDA member.

Any other distribution, use or duplication is prohibited without the express written consent of the author and the

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Today's FDA

This FREE Member-only benefit available at floridadental. org/hipaa-forms.

FDA. Please do not give these forms to dentists who choose not to be FDA members. Your membership dues have paid for them and they are intended for use only by members.

The first of these orms found on our website, is a sample Notice of Privacy Practices (NOPP). Second, is a sample Acknowledgement of Receipt of Notice of Privacy Practices (Acknowledgment).

Third, is a sample Consent for Release of Medical Records and Information (Consent). The acknowledgement and consent forms are different. The acknowledgement form allows the patient to refuse to sign; the consent form does not. Assuming you want to accept the patient into your practice and you intend to seek reimbursement from a health plan, get their signature on the consent form if they refuse to sign the acknowledgement form. The fourth form is a sample Business Associate Agreement.

HIPAA does not nullify Florida law that gives patients more privacy protection.

In one crucial area of the law — billing third-party payers — Florida gives patients more privacy protection than HIPAA. For example, Florida’s Records Owner Law, subject to many exceptions, states that medical records:

November/December 2013

may not be furnished to, and the medical condition of a patient may not be discussed with, any person other than the patient, the patient’s legal representative, or other health care practitioners and providers involved in the patient’s care or treatment, except upon written authorization from the patient.

Notice that health plans, insurance companies, managed-care organizations, and third-party payers are not mentioned in this statute. Thus, while HIPAA allows medical records to be disclosed to health plans WITHOUT the patient’s written consent (remember that HIPAA allows the patient to refuse to sign the acknowledgement form); Florida prohibits it.

Florida requires the patient’s signature on a written consent form before information can be disclosed to a health plan.

It can be an assignment of benefits form, an entirely separate form, or language built into your patient information or health history forms. But you need your patient’s signature on a written form if you release personal health information (PHI) to a third-party payer for reimbursement.

The downside to incorporating the Florida-required consent to release records into the HIPAA acknowledgment form is that some patients will refuse to sign it. HIPAA requires that the acknowledgement form tell patients, “You may refuse to sign this acknowledgement.”

If the patient refuses to sign the HIPAA

www.floridadental.org

Legal Notes acknowledgment form and you intend to bill a health plan, your patient must sign a separate records consent form. You should have the consent form preprinted and ready to use if they refuse to sign the acknowledgement form.

The consent form cannot be used in lieu of the HIPAA acknowledgment form because it does NOT state that the patient can refuse to sign. Also, if your patient is paying in full out-of-pocket and has directed you not to bill their dental plan, then you do not need the patient’s signature on the consent form because you are not releasing PHI to a third-party payer.

The first document is the Notice of Privacy Practice, which can be customized.

You should: v add your practice name and logo. v use the owner dentist as the privacy official, but you can use someone else. v use the effective date of Sept. 23, 2013, or the date you first adopt the new NOPP. v keep the old NOPP and HIPAA documentation for six years from the date it was implemented or the date it was last effective, whichever is latest.

The minimum retention period for dental records is four years from the date of the patient’s last appointment or the date of the last service (e.g., emergency without an appointment) but HIPAA paperwork must be kept longer. v carefully review the section titled “Other Information,” because it incorporates Florida-specific law. Also, it assumes that your dental practice does not engage in marketing for third parties, fundraising, or have psychotherapy or substance abuse records. If this is incorrect, remove the reference from this section.

www.floridadental.org

The second document is the standard HIPAA Acknowledgement of Receipt of NOPP. It states the patient can refuse to sign. The third document is a Florida records consent form that incorporates the NOPP and requires the patient to sign if you intend to seek third-party reimbursement. The fourth document is the standard HIPAA Business Associate Agreement.

All of these forms are downloadable as Microsoft Word documents for free on the members-only side of the FDA website. You can add color or reproduce these forms in a pamphlet format, but you should use the language “as is” unless you have consulted with a health law attorney familiar with your practice and been advised to modify your procedures.

The government has indicated that you must post your new NOPP on your website and in a conspicuous place in your office. The Office for Civil Rights recommends posting it both in the examination room or operatory as well as the waiting room.

The following forms have been changed to comply with the Omnibus rule and also are available to members only at no charge on the FDA website: v Job Description for Privacy Official v Job Description for Employees with PHI Access v Employee Documentation of HIPAA Privacy Training v Limited Health Care Power of Attorney v Privacy Notices for Email and Faxing v Re-disclosure Prohibitions for HIV, Substance Abuse and Psychotherapy Records v Optional Rules for NOPP (e.g., if intending to sell practice) v Addendum Form to Amend Existing Business Associate Agreements

v Revocation Form v Request to Copy, Inspect or Summarize Records v Request for Accounting of Disclosures v Request for Restrictions on Use/ Disclosures v Request for Alternative Communications v Request for Amendment or Correction v Privacy Complaint form v Response to Records Request v Confidentiality and Non-Disclosure Agreement The sample language in these forms and use of these sample provisions is not required for compliance with the HIPAA Rules. In many instances, the language has been modified to protect the dentist.

The language may be changed to more accurately reflect business arrangements between a covered entity and business associate or business associate and subcontractor. Reliance on sample forms does not replace consultation with a lawyer familiar with the specific needs and circumstances of your individual practice or negotiations between the parties to the contract.

Also, remember that federal and Florida law change regularly and compliance is an ongoing process. As long as you practice, you will need to update forms to remain in compliance. Remain an FDA member and we will make sure you get what you need!

This article is for informational purposes only and is not intended to be a substitute for professional legal advice. If you have a specific concern or need legal advice regarding your dental practice, you should contact a qualified attorney.

Graham Nicol is the FDA’s Chief Legal Counsel.

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Information Bytes

Free CE ...

Is That Even Possible?

By Larry Darnell Director of Information Systems

It’s that time of the biennium — license renewal!

Do you have your continuing education (CE) requirements fulfilled? If not, we have the solution for you. As a Florida Dental Association (FDA) member, one of your many exclusive benefits is access to free online CE on our website! For your convenience, these courses are available 24 hours a day, making it guaranteed to fit into your busy schedule.

Each month, a new course is added to the list of CE available. We offer on-demand streaming of previously recorded CE programs from the Florida National Dental Convention (FNDC). You will hear the course’s full audio while viewing a video of the speaker’s presentation. Course materials, such as handouts, can be accessed to view or print for future reference.

In addition, we also offer new CE opportunities through the popular Today’s FDA feature, “Diagnostic Discussion.” You can view the article and diagnostic slides online, and then complete a quiz available on the FDA’s CE Portal to earn CE credit.

To access the CE Portal, go to the FDA’s website at www.floridadental.org and log in with the email address we have on file in the Membership Department. Your password is the default, Password1. Once you are logged in, go to “Benefits and Resources” in the menu bar across the top of the page. Select “Continuing Education” from the drop-down menu and then finally “Online Education.” Once there, you can select from a list of available CE courses. New courses are released at the beginning of each month, so be sure to check back often!

Once you have completed the requirements for an online course, you will be able to download and print your certificate. This course data is automatically added to your record in our member database. If you were to add up the value of these CE courses at a low estimated value of $30 per course hour, your membership could literally pay for itself!

If you have any difficulties accessing these courses or have questions about the CE Portal, please feel free to email me at ldarnell@floridadental.org.

Mr. Darnell is the FDA’s director of information systems and can be reached at 850.350.7102. www.floridadental.org

“

For your convenience, these courses are available 24 hours a day, making it guaranteed to fit into your busy schedule.

”

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news

@ fda

important news for FDA members

ADA Releases Landmark Report: Findings to Help Shape Dentistry’s Future

The American Dental Association (ADA) has just released a comprehensive, groundbreaking analysis of the dental care sector in a report titled, “A Profession in Transition: Key Forces Reshaping the Dental Landscape.” The report summarizes important findings of an environmental scan carried out by the ADA as part of the ADA’s 2015-2020 Strategic Plan development process.

This forward-looking analysis of the dental landscape is the first of its kind from the ADA. According to the report, this is a critical moment for dentistry — a time for the profession to define its future vision.

“Given the significant environmental changes on the horizon, including expected changes in the dental care delivery system, this analysis shows that the dental profession must prepare by shaping a proactive strategy to navigate the challenges and opportunities ahead,” said Dr. Robert A. Faiella, ADA president, 2012-2013.

Some of the key findings include: While more children have been visiting the dentist, primarily due to the expansion of public insurance programs, dental care use has declined among working-age adults, particularly the young and poor – a trend that emerged prior to the recent economic downturn. Dental benefits coverage for adults has steadily eroded in the past decade.

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Today's FDA

The Affordable Care Act (ACA) is expected to expand children’s dental benefits, both public and private, but it does not address the many key access-tocare issues facing adults. The ACA also is expected to promote increased coordination of care, providing an opportunity to bridge the gap between dental and general health.

The ADA’s Health Policy Resources Center, with oversight from the Strategic Planning Steering Committee of the Board of Trustees, managed the execution of the environmental scan, using a combination of internal researchers and external consultants to complete the analyses. The environmental scan team commissioned external studies from the consulting firm, Diringer and Associates, and obtained insights and analyses from a group of renowned thought leaders with diverse background and perspectives.

The ADA is communicating the scan’s findings via a full report, executive summary and video, as well as Diringer and Associates’ full report and executive summary. For more information please visit www.ada.org/escan.

Medical Malpractice Fight Going to Appeals Court The latest round in Florida’ long-running legal and political fight about medical malpractice is headed to a federal appeals court. Just days after a federal judge rejected part of a new malpractice law backed by doctors, the defendant in

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the case gave notice on Oct. 1 that he will challenge the ruling in the 11th U.S. Circuit Court of Appeals in Atlanta.

U.S. District Judge Robert Hinkle found that a key part of the law, passed by state lawmakers this spring and signed

by Gov. Rick Scott, was invalid because it conflicted with federal requirements aimed at protecting the confidentiality of patient information.

The new law has two main parts. One would tighten restrictions on expert witnesses who testify in malpractice cases, long a sore subject with doctors.

The other part — the issue involved in Hinkle’s ruling and the appeal — deals with a legal concept known as ex parte communications. Supporters have argued that such ex parte communications are fair because they would give defense attorneys access to information that plaintiffs’ attorneys already can review.

Also, supporters have contended that the information could help defense attorneys make decisions more quickly about whether to settle or proceed with cases.

But throughout the legislative session, plaintiffs’ attorneys argued that the process could lead to the disclosure of information to defense lawyers that would violate patients’ privacy rights. Part of that argument was grounded in a federal law, the Health Insurance Portability and Accountability Act (HIPAA), which seeks to prevent disclosure of personal medical information, except in certain circumstances. www.floridadental.org

On Oct. 3, in honor of Breast Cancer Awareness month, the FDA staff participated in Tallahassee's “Paint the Town Pink” day by wearing something pink to show their support.

Gender Breakthrough: Fort Myers Woman Leads Dental Corps Reserves A Fort Myers woman who became the Navy’s first female rear admiral of the Dental Corps Reserves on Oct. 5 said she is honored by the promotion and ready for a challenge. Priscilla B. Coe was officially promoted in a ceremony at the Women in Military Service for America Memorial, in Arlington, Va. Coe, 60, formerly operated a dental practice in Naples. She had held the rank of captain and served as Dental Corps Reserve affairs officer in the Bureau of Medicine and Surgery.

Although Coe has been in service to the Navy since 1982, the promotion to rear admiral came as a pleasant surprise. For Coe, the marriage of Navy and dentistry came naturally. “My father was in Navy medicine, and I grew up in a family who believed in serving one’s country,” she said, adding that while in medical school she found she enjoyed dentistry.

“In Navy dentistry, you must be prepared to provide service in any place in the world,” she said. “Our operations are worldwide, on sea, on shore or anywhere we are deployed. It is a lot different from private practice.” www.floridadental.org

She will serve as Navy Medicine’s reserve component deputy chief of staff, U.S. Navy Bureau of Medicine and Surgery in Falls Church, Va. She has retained her Florida dentist’s license and said she is undecided about returning to private practice here, but has not ruled it out.

Dr. Nissen Receives AAOMS Distinguished Service Award Larry W. Nissen, DDS, Chair of the International Association of Oral and Maxillofacial Surgeons (IAOMS) Foundation, and pastpresident of the American Association of Oral and Maxillofacial Surgeons (AAOMS) and the IAOMS, received the Robert V. Walker Distinguished Service Award on Oct. 9. The award was presented during the opening ceremony of the 95th AAOMS Annual Meeting, Scientific Sessions and Exhibition in Orlando, Fla. Dr. Nissen, who maintains a private practice in Merritt Island, Fla., was recognized for his significant and lasting contributions to the specialty of oral and maxillofacial surgery.

In addition to his leadership in the AAOMS and IAOMS, Dr. Nissen has been actively involved in a number of dental organizations. He is currently president of the Southeastern Society of Oral and Maxillofacial Surgeons and will complete his term as chair of the IAOMS Foundation in December 2013. He also is a past-president of the Florida Dental Association (2010-2011), Florida Dental Health Foundation, Florida Dental Society of Anesthesiology, Florida Society of Oral and Maxillofacial Surgeons, and the Brevard County Dental Society. Dr. Nissen is an Honorary Fellow of the Faculty of Dental Surgery of the Royal College of Surgeons of England. He has served as a delegate to the House of Delegates of the American and Florida Dental Associations, as well as the AAOMS.

Dr. Robert T. Ferris Receives ADA Distinguished Service Award Dr. Robert Ferris received the American Dental Association’s (ADA) Distinguished Service Award for 2013 during their annual session in Please see news, 16

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renew your membershIP for 2014!

“Investment” statements mailed in November.

Renew online at floridadental.org/dues

Together, the American Dental Association, the Florida Dental Association and your district dental association form a partnership with you that helps you succeed every day.

Your Practice It’s the “Power of 3” and It’s for members only!

1. AmericAn DentAl AssociAtion

2. FloriDA DentAl AssociAtion

3. District DentAl AssociAtions

What’s happening with the Affordable Care Act? As we move into a new era for health care, don’t you want a powerful ally at the table as new rules are written for the way we care for patients? Your membership strengthens the ADA’s position as the voice of all dentists.

Fantastic Savings! Most dentists could pay their dues with savings from using the services of the FDA’s Corporate Affiliation Program (CAP). And, now you can save 18-22 percent on dental supplies! Visit www.fdaservices.com for more information on CAP programs and insurance options for your practice, staff and family.

Close to Home! Looking for colleagues and maybe some of the best friends you’ll ever make? District dental associations offer you the chance to share meals, opinions, advice, support, politics, continuing education and family events at local venues with your professional colleagues.

Information Galore! Get free subscriptions to the Journal of the American Dental Association, the most-trusted scientific publication in dentistry, and ADA News. Plus, the ADA provides web content on practice management, continuing education, evidence-based dentistry and national laws and rules that affect your practice.

Free CE! You could fulfill almost all your requirements for licensure renewal with free CE from the FDA. Earn up to 30 scientific/clinical/practice management CE credits a year at the FDA’s online CE site. Also, get free pre-registration to FNDC, the best CE buy in the Southeast. FNDC also offers many opportunities for free CE onsite.

The FDA Peer Review program is run by your district and local dental associations. Members provide this service free to other members. You can often avoid costly legal fees and all the stress and headaches involved in a malpractice suit just by taking part in this process.

dentists across florida benefit from membership in three associations.

Dr. Beatriz Terry Miami Springs SFDDA

Dr. Cecil White Jr. Atlantic Beach NEDDA

Dr. Tanya Orr Santa Rosa Beach NWDDA

Dr. Yvette Godet Gainesville CFDDA

Dr. Federico Schmid Hidalgo Fort Lauderdale ACDDA

Dr. Nishith Patel Bradenton WCDDA

Membership Application? Not a member? Complete the inserted application that follows and mail or fax to the Florida Dental Association. Put money in your pocket and help your profession build a strong future.

Already a member? Give the application to a colleague who isn’t a member.

Benefits with Real Value!

the Power of 3!

member dIscounts

ProtectIng your PractIce and PatIents

MeMbers Pay • non-MeMbers Pay More

PractIce loan fees 50% off

Professional advocacy

eXPress shIPPIng 27% off

congress federal regulatory agencIes

dental suPPlIes 22% off

florIda legIslature state regulatory agencIes board of dentIstry

unIform aPParel 10% off ProfessIonal lIabIlIty 5% off

county/cIty government & regulatory agencIes

offIce suPPlIes 5% off your dIstrIct dental assocIatIon atl a n tIc coa s t c e n tr a l flor Ida n orth e a s t n orth w es t sou th flo r I da w es t coa s t

members only/no cost

800 800 800 800 800 800 30 hours free annually fda onlIne contInuIng educatIon fda new dentIst webInar serIes

ada ethIcs hotlIne

caPItal rePort e-newsletter PacPower e-newsletter

issues watch non-covered servIces fluorIdatIon affordable care act workforce medIcaId lIcensure

ada center for ProfessIonal success onlIne busIness resource

fda member servIces number: 800.877.9922 floridadental.org

ada’s new dentIst blog, “new dentIst now” fda websIte member lookuP

news bItes & Info@fda e-newsletter florIda and hIPaa comPlaInt forms news bites • for 2013 omnIbus rule

PrestIge of membershIP In a resPected ProfessIonal organIzatIon

legal resources

florIda natIonal

Peer revIew/PatIent dIsPute medIatIon avoid public litigation & attorney fees (est. $300 per hour)

automated marketIng set-uP fee $299 & communIcatIons

$134

questIons!

free contInuIng educatIon courses at fndc

$480 dental conventIon (Pre-regIstratIon)

health care legIslatIon

sovereIgn ImmunIty

800 800 800 800 800 800

no cost to members

$150

nonaccredIted graduates

members only/no cost

costs shown PaId by non-members.

dental schools

mId-level ProvIders

cost ProhIbItIve for IndIvIduals travel eXPense, tIme away from PractIce, research

long-term care Insurance 5% off

$74

ada contract analysIs attorney fees (est. $300 per hour)

today’s fda journal of the amerIcan dental assocIatIon (jada)

florIda laws & rules & legal faqs

MeMbers only/no cost

ada news

sIgnIfIcant savIngs for members MeMbers Pay

$1,050 $945

non-MeMbers Pay More electronIc claIms

(based on 350 claims per month)

$2,100

web desIgn & hostIng

$1495

$90

ada annual sessIon Pre-regIstratIon

$41

jada onlIne contInuIng educatIon

$800 $62

news from 13

October. Presented annually, this award is the highest honor conferred by the Board of Trustees.

His résumé includes a long list of appointments and leadership positions that benefit his profession and organized dentistry, including: liaison for the Florida Dental Association (FDA) to the Florida Board of Dentistry (BOD); appointments by two governors from opposing political parties to the Florida BOD; president of the American Association of Dental Examiners; past-president of the FDA; president of the American Academy of Periodontology; director and chair of the American Board of Periodontology; and ADA delegate. Dr. Ferris was elected second vice president of the ADA in 2004 and served as first vice president from 2005-2006.

Dr. Ferris has certainly been generous to dentistry. He donated $1 million in 2006 to benefit the Florida Dental Health Foundation and the American Academy of Periodontology Foundation.

Both foundations were partner organizations of a national campaign to secure the future of dental education.

Shop Carefully for Biomedical Waste Haulers The FDA has recently received complaints alleging that one of the bigger biomedical waste haulers uses an automatic renewal provision to increase pricing. We have been told that this company uses a three-year contract that automatically renews unless the dentist opts out prior to the third anniversary.

The problem is when the dentist does not opt out the company increases their rates by 18 percent!

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Today's FDA

Be aware that using the biggest company does not necessarily mean you will get the best service or be treated fairly.

While the FDA doesn’t have an affiliation agreement with a hauler, shopping around to make sure you get the best deal is simple. Go to http://www. floridahealth.gov/healthy-environments/ biomedical-waste/bmw-transporter-list. html.

You can search by the county where your practice is located. This link will provide you with contact information for all the registered haulers. Smaller companies are often more appreciative of your business, so shop carefully and read the fine print before you sign the contract. If you are treated unfairly, contact the Better Business Bureau, file a complaint with the Department of Health, or the Division of Consumer Services.

“Doc” Holliday Comes to the Panhandle Dr. Richard Thomas of Crestview, purchased John Henry “Doc” Holliday’s 19th century dental chair along with his weekly appointment book. Doc Holliday became well-known after he joined the Earp brothers in the infamous “Gunfight at the OK Corral” in Tombstone, Ariz.

Dr. Thomas has an exhibit room in his office designed around Doc Holliday’s chair, custom decorated with velvetflocked wallpaper and a pressed tin ceiling.

November/December 2013

Dr. Thomas and his staff hosted an open house for the permanent exhibit featuring Doc Holliday’s dental chair on Nov. 8, which was the 126th anniversary of Holliday’s death.

Online Classified Advertising Are you looking for a job? Need to hire an associate or partner? Want to sell your equipment? Maybe you’re trying to sell your practice, or you’re in the market to buy one. No matter what your situation, the FDA’s online classified system has the solution for you.

This system provides our advertisers the opportunity to place, modify and pay for ads – wherever or whenever it’s convenient for you! Along with these options, you have the ability to personalize your ad with enhanced features to make your ad stand out.

All active ads in the system will be published in the upcoming issue of Today’s FDA, at no additional charge. That’s two ads for the price of one!

Please visit http://www.floridadental.biz/ to get started today!

If you have any questions please contact Jessica Lauria at 850.350.7115 or jlauria@floridadental.org.

Welcome New FDA Members These dentists recently joined the FDA. Their membership allows them to develop a strong network of fellow professionals who understand the day-to-day triumphs and tribulations of practicing dentistry.

Atlantic Coast District Dental Association Hassan Al Maghazchi, Tamarac Isabel Boscio, Port Saint Lucie www.floridadental.org

David Burke, Lakewood Ranch Frank Carberry, Boca Raton Eun Choi, Fort Lauderdale Astrid Cortes, Boca Raton Saulius Drukteinis, Fort Lauderdale Shoham Elazar, Fort Lauderdale Joel Frand, Fort Lauderdale Kevin Koscso, Boca Raton Thomas Leonard, Sunrise Kevin Luba, Port Saint Lucie Gisele Oliveira, Pompano Beach Nirav Patel, West Palm Beach Tatiana Quintilliano, Pompano Beach Allison Sley, Okeechobee Lynn Solomon, Fort Lauderdale Central Florida District Dental Association Sapna Adappa, Ormond Beach Linda Gendreau, Gainesville Linda Hamang, Lady Lake Hagen Hastings, Rockledge Kathy Parsons, Port Orange Gabriel Sangalang, Orlando Andonis Terezides, Winter Park Monica Varela, Kissimmee Northeast District Dental Association MaryRose Alon-Alon, Orange Park Felipe Falcao, Jacksonville Michael Fetner, Jacksonville Stephanie Henley, Jacksonville Michael Patch, Jacksonville Kelly Standish, Orange Park Ashley Phares, Jacksonville Linh Truong, Jacksonville James Weaver, Jacksonville Northwest District Dental Association Jonathan Alvarez, Santa Rosa Beach Brian Beck, Tallahassee Gina Bertuglia, Pensacola Tonianne Cifrodelli, Tallahassee Kaitlin Forshee, Pace Sherin Mostafa, Panama City Trae Pappas, Destin Trent Savage, Tallahassee Robert Scott, Panama City www.floridadental.org

Rasamond Sonnen, Pensacola Rex Whiteman, Apalachicola South Florida District Dental Association Liza Aguilar, Miami Orlando Bienes, Miami Aicel Carbonero, Miami Alexandra Castillo, Coral Gables Richard Coba, Miami Aaron Cohn, Miami Vivian Diaz, Miami Ingrid Epelman Dorra, Aventura Celia Espinosa, Hialeah Rachel Hargraves, Miami Ramon Rodriguez, Miami Rosie Roldan, Doral Daniel Santoyo, Hialeah Edwin Smith, North Miami Beach Rodrigo Souza, Hialeah Wendy Swanson, North Miami Beach Jane Walker, Miramar Cynthia Yu, Hollywood West Coast District Dental Association Amy Ackley, New Port Richey Matthew Ahrens, Lakeland Justin Altshuler, Tampa Shervin Ardalani, Tampa Odessa Biandudi, Valrico Yamilet Blanco, Fort Myers Robert Bracho, Marco Island Troy Brown, Sarasota Daniel Bruin, Englewood Karine Calixte, North Port Alejandro Caribas, Tampa Kanwal Chawla, Lehigh Acres David Christian, Bradenton Don Dau, Tampa Jacqueline Dietz, Tampa Amit Doshi, Tampa Martha Ducatel, Seffner Ian Fawcett, Bartow Adriana Gabaldon, Naples Kali George, Tampa Monica Gonzalez, Pinellas Park Wade Hancock, Saint Petersburg Philip Hedger, Tampa Alison Heusner, Tampa

Helen Hoveida, Tampa Huy Huynh, Winter Park Shelane Jenkins, Sebring Lisa Kaduk, New Port Richey Ryan Lepore, Bradenton Reginald Ligon, Saint Petersburg Johella Liguori, Tampa Dana Lucy, Bradenton Clayton McEntire, Valrico Anelisse Martinez, Tampa Irina Matthews, Land O’ Lakes Samira Meymand, Brandon Paul Miller, Palm Harbor Abbey Morales, Port Charlotte Jennifer Naoom, Tampa Leslie Nevarez, Tampa Anala Panchumarti, Tampa Remal Patel, Land O’ Lakes Vijay Patel, Tampa Phong Phane, Saint Petersburg Raymond Santa-Cruz, Spring Hill Ronald Schalter, Punta Gorda Joel Smith, Tampa Adam Still, Sarasota Christina Suarez Watkins, Sarasota Julia Talalenko, Naples Nicole Toomey, Cape Coral Diem-Trang Tu, Clearwater Inga Ukolova, Tampa Rebecca Warnken, Lithia

In Memoriam The FDA honors the memory and passing of the following members: Alan Stoler Gables, FL Died: May 15, 2013 Age: 80

Ronald Behner Altamonte Springs, FL Died: July 28, 2013 Age: 70

Philip Stern Fort Lauderdale, FL Died: June 30, 2013 Age: 87

Rosalie Robbins Port Charlotte, FL Died: August 1, 2013 Age: 55

November/December 2013

Today's FDA

17

House of Delegates

House of Delegates to Consider Bylaws Changes Pursuant to the bylaws of the Florida Dental Association (FDA), all members are hereby notified that the FDA House of Delegates (HOD) may be asked to consider amending the FDA bylaws to: m change the terms and term limits of FDA officers. m regulate trustees serving as voting members of FDA councils. m delete hygiene section memberships. m delete allied dental team memberships. m address Board of Trustees (BOT) and Leadership Development Committee (LDC) roles in future executive director searches. m create the Executive Director Review Committee as a standing committee.

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November/December 2013

m remove barriers to membership. m change the selection process for delegates to the ADA House of Delegates m create a process to delay the nomination of secretary when the component having the present authority to nominate is unable to submit such nomination.

The FDA’s Articles of Incorporation allow the FDA Bylaws to be amended by a two-thirds affirmative vote of the HOD, provided the proposed amendments are sent in writing to the membership of the association and postmarked at least 30 days in advance of the HOD session or at any HOD session by a three-fourths affirmative vote provided the amendments were presented in writing to a previous session of the HOD and unanimous consent is given for their consideration.

www.floridadental.org

Next HOD Meeting The secretary of the FDA announces that the House of Delegates will meet Friday and Saturday, Jan. 24-25, 2014, at the Tampa Airport Marriott, 4200 George J. Bean Parkway, Tampa, Fla. 33607.

The FDA encourages all members to seek information about these important matters from their component’s delegates to the HOD and trustees to the BOT. The agenda for the HOD also will be available electronically at http://www.floridadental.org/ FDA/house-of-delegates-0.aspx.

Dr. Michael D. Eggnatz

The FDA Leadership Institute equips you for leadership in organized dentistry and other settings through a flexible, self-paced course of study, including 16 hours of online instruction.

Graduates of the Leadership Institute: 1.

complete all online courses provided by the Institute.

2.

complete an individual or group leadership project, including but not limited to, organizing membership recruitment efforts or political fundraisers, hosting GKAS events or holding a component or affiliate office.

3.

attend an in-person leadership development workshop.

FDA Secretary

Keep the Florida Dental Association and your profession strong with your continued membership.

time to renew!

Your Practice Together, the American Dental Association, the Florida Dental Association and your district dental association form a partnership with you that helps you succeed every day.

We offer four convenient ways to pay your member dues: 1. Credit card online 2. Credit card by mail, fax or phone 3. Check 4. Dues Installments by credit card

Questions? Link to our “frequently asked questions” at www. floridadental.org/dues or contact your FDA Member Services Center.

Applications available on the FDA Web site: www.floridadental.org/LI-enroll For more information, call Rusty Payton, FDA Chief Operating Officer, at 800.877.9922 • rpayton@floridadental.org.

Participants work in small groups during the 2010 Inperson Leadership Conference.

Phone: 800.877.9922 Fax: 850.201.5013 membership@floridadental.org

www.floridadental.org

November/December 2013

Today's FDA

19

hOt tOpics!  CERaMIC TREaTMEnT oPTIonS  THREE-aPPoInTMEnT DEnTuRES  “SEx” anD oRaL HEaLTH  DERMaL FILLERS  YouR onLInE CHECKuP  a WoMan’S GuIDE To HEaLTH

Mastering the Fine art OF dentistry with wOrld experts in their Field!

Irwin Becker, DDS Kirk Behrendt Samuel B. Low, DDS, MS, MEd Reneé Graham, RDH, MEd Gerard Kugel, DMD, MS, PhD Tieraona Low Dog, MD Nader Sharifi, DDS, MS Kelli Vrla, CSP, CRM

Creating a

Masterpiece SAVE THE DATE!

JUNE 12-14, 2014 | ORLANDO, FL 20

Today's FDA

November/December 2013

G AY L OR D PA L M S R E S ORT & C ON V E N T I ON C E N T E R

www.floridadental.org

Licensure Renewal

It’s Licensure Renewal Time Again …

What’s All the Fuss About?

By Rusty Payton

Chief Operating Officer

We are closing in on the end of the biennium, and licenses must be renewed.

While the basic requirements of 30 hours of continuing education (CE) credits and a renewal fee have remained the same, there has been some confusion among some of our members. The Department of Health invited the staff at the Florida Dental Association (FDA) and our editor, Dr. John Paul, to attend a demonstration of the 2014 renewal process to clear matters up.

The fuss and confusion revolves around the state’s insistence upon confirming that every dentist and hygienist is CE compliant at the time of licensure renewal. First and foremost, the confirmation of CE compliance at the time of renewal is OPTIONAL for the 2014 licensure renewal cycle. Although an electronic CE credit record maintained by the state may be incomplete or even non-existent, the licensure renewal program will allow a dentist or dental hygienist to opt-out of registering online CE courses prior to continuing the renewal process. The program may encourage registration and entry of the data, but a mechanism to bypass this process is available.

Additionally, the state added another potential layer of complication by expanding the workforce survey to include

www.floridadental.org

five questions regarding the dentist’s role in smoking cessation. Several of the new questions have multiple parts. As has been the case in the past, the workforce survey is optional; however, each screen of the survey has to be viewed. The questions can be bypassed by scrolling to the end of the screen and clicking on the continue button. Participation in the workforce survey is not mandatory.

Keep in mind, the data collected by the survey is reported in an aggregated fashion. The resulting data has proven effective in the FDA’s advocacy efforts, as it quantified the misdistribution of dentists. However, the Florida Legislature’s refusal to adopt a public records exemption for responses could result in the public release of individual answers.

Though this a highly unlikely outcome of a public records request, everyone renewing a license needs to weigh their decision to participate in the survey.

The state will be conducting a few webinars to educate dentists about the upcoming renewal process. The scheduled dates, times and links are: n Dec. 4, 12 p.m. EST - http://mqaweb.com/forms/view.php?id=348093 n Jan. 8, 1 p.m. EST - http://mqaweb. com/forms/view.php?id=348353 n Feb. 5, 1 p.m. EST - http://mqaweb. com/forms/view.php?id=348596

“ ”

Confirmation of CE compliance at the time of renewal is OPTIONAL for the 2014 licensure renewal cycle.

To register for one of these licensure renewal webinars, please go to http://.

As the final renewal deadline approaches (Feb. 28, 2014), the FDA will compare the non-renew list with our membership records and email a courtesy reminder to any FDA member who, according to the data, has not renewed. If you receive one of these, just consider it a friendly FDA reminder and another way that we are working for you.

Mr. Payton is the FDA’s chief operating officer. He can be reached at 850.350.7117 or at rpayton@floridadental.org.

November/December 2013

Today's FDA

21

Volunteering

How Can You Give Back to Your Community?

By Dr. Brittney Craig

“

After graduation from dental school, I moved back to my hometown, Tallahassee, and joined a private dental practice.

Since our office was closed one day a week, I decided working at the Gadsden County Health Department on my day off would provide me a great opportunity to work with children of all ages. As I began my job, I quickly realized how much help and attention these young ones needed, and I have grown to love them and enjoy providing them with dental care. I have seen firsthand the value of education as it relates to dental care and treatment for parents and children. This experience has opened my eyes to a world that needs to be reached by our dental community.

Volunteering is something I have always enjoyed. Therefore, when it was announced at my local dental society meeting there was an opportunity to work with Project: Dentists Care (PDC) at Dentists’ Day on the Hill (DDOH), I quickly signed up. Through PDC, a dental van was set up at the Capitol Building to provide dental treatment on this spewww.floridadental.org

We often are unaware of the small ways we can give back to our community or what opportunities are available.

”

cial day to foster children who had been previously screened. Along with other local dentists, I provided the necessary care for these children at no cost.

Additionally, PDC set up a special area near the van to talk with interested visitors about dental care and oral hygiene.

At the end of the day, many children had received the needed care they otherwise may have missed, and a number of other people became more educated about the importance of good oral hygiene. All of this was made possible through the efforts of PDC and the many volunteers in our community who see a real need for this service.

I am very passionate about working with children and the underserved, and I found that my participation in the annual DDOH was a perfect way to help out.

The program is set up so that dentists may sign up for the time(s) during the day that best fits their schedule to treat these foster children. This, of course, provides great flexibility and allows any dentist to participate as much or as little as he or she is able. This program is a great way to help children and educate the community about oral health, and its success rests with the professional and lay volunteers who are willing to give their time.

We often are unaware of the small ways we can give back to our community or what opportunities are available. However, thanks to PDC, we have an ideal way to help with DDOH. Any time you can volunteer is a huge help to make this day a success. I strongly encourage you to participate in next year’s event. Remember, while your volunteered time may represent only a fraction of your day, it can make a significant difference in a child’s health that stretches far beyond that fraction of time. Make a difference and participate!

Dr. Brittney Craig is a general dentist in Tallahassee and can be reached at bcraigdmd@gmail.com.

November/December 2013

Today's FDA

23

Membership

What is So Stressful About Practicing Dentistry?

By Dr. Steve Zuknick

Do any of you wake in the morning and immediately sigh, thinking of work and some aspect of your day at the office?

What is so stressful about practicing dentistry? Is it staff issues, meeting payroll or controlling costs without compromising patient care? Is it infrastructure: an air conditioner breaking, waterlines leaking or potholes in the parking lot? Or maybe it’s simply the difficulty of performing a distobuccal bonding on tooth No. 15 that dips subgingivally on that TMD patient who can’t open? All of these are worthy of a few moments of sleepless, nocturnal reflection.

I wager that there are a lot of other stressors that, if you began to think about them, would keep you up most nights. These anxiety-producing factoids are those that you can’t possibly control on your own. They are the political and legislative issues of the day and they affect all of us whether you realize it or not. The best news I call tell you is that, if you are a card carrying member of the trio of dental freedom fighters known as the ADA, FDA and your respective component (and affiliate), you can focus your worries on the stuff that “matters” and leave the rest to us.

So would you pay a little more than $100 a month for a service that would provide you with quality, discounted or free continuing education; access to the most reasonably priced life insurance available to dentists; third-party payer contract analysis; peer-review patient complaint service (to help avoid litigation and/or board of dentistry involvement); multiple social events allowing for copious camaraderie and fun; ADA Find-a-Dentist service; volunteer opportunities, etc. Does the fact that the $100+ also will give you peace of mind, knowing

24

Today's FDA

November/December 2013

that the stuff you can’t begin to control mentioned above is being tended to while you earn a living? I’d guarantee you that the political advocacy of organized dentistry is well worth the hundred alone. The rest of the package is just the gravy on top.

I could go on for hours about the benefit package offered by the national, state and local dental associations. If the average nonmember entrepreneur evaluated the financial merits of membership, you’d be hard-pressed to find one that couldn’t see the value. The hard part is getting the process started. Even in this dreadful economy, the value of membership is unbelievable, and maybe even more important than ever. So why are we hanging on to the edge at 57 percent membership in Florida?

The answer is actually pretty simple — it’s the implementation of the plan that is tricky. We know the package offered is unparalleled; the problem is getting you to read the pamphlet.

The best way to educate a nonmember is to start early while you are in school. However, being inundated with heavy class loads, busy schedules and late nights does not make for a good opportunity to sell you on benefits that will not “begin” until you graduate in 1-6 years (but we are fighting for your future now).

So, we attempt to hit you where it makes the biggest impact — your stomach. It’s pizza, subs and salads during “lunch and learns” or maybe at a meeting with some hors d’oeuvres and/ or some adult beverages. It’s food in exchange for your ears to listen to a message about strength in numbers. We attempt to make an impact with conversion drives and signing days to get you into the fold. It’s not a sales pitch for a product you don’t need. It’s protection and service your practice can’t live without.

We’d love for the loyalty to begin during school, because if it doesn’t, it’s an uphill battle going forward. The next opportunity we have is facilitating your membership by paying all or a portion of your dues during your first four years post-matricu-

www.floridadental.org

Membership

“

I’d guarantee you that the political advocacy of organized dentistry is well worth the hundred alone.

The rest of the package is just the gravy on top.

lation, making the transition from student to member dentist.

We pay 100 percent of your dues the first year, 75 percent the second, 50 percent the third and 25 percent the fourth. It’s meant as a way to lessen the financial impact while you build your earning potential without adding insult to injury on your debt load. The rub is that this lessens the value of membership.

Most American Student Dental Association (ASDA) dues are included in tuition, and if we don’t charge anything, you can go five years without actually “paying” for this service. You’ve always received the benefits and never “paid,” so why continue?

”

Well, it’s my job, along with the rest of the 57 percent, to tell you. Who wouldn’t see the value of $100 a month for advocacy, education, a chance to make a difference, camaraderie, and professional protection and support?

You wouldn’t, unless I — or my army of friends — made you read the pamphlet.

Dr. Zuknick is a general dentist in Brandon and can be reached at sjzdmd@aol.com.

Dentists’ Day on the hill 2014

Making a Difference TogeTher!

it’s a family affair! Bring your spouse!

Briefing

LegisLaTive visiTs

Tuesday, April 1, 2014 7 p.m. • Doubletree Hotel

Wednesday, April 2, 2014 sponsored by

Hotel Room Block Marriott Courtyard/Apalachee Pkwy. • $199 per night Call 800.321.2211 and request the “FDA” room block.

For more information: 321.452.5500 • Email: JWSRGN@aol.com • www.floridadental.org/ddoh

www.floridadental.org

November/December 2013

Today's FDA

25

FDA Staff

New Membership Concierge to Focus on Member Service You’re away on business and

staying at a prestigious hotel and you have a fancy for a night on the town — but where should you go and what should you do?

Naturally, you contact the hotel’s concierge.

Although we can’t promise the stay at a nice hotel, it is our pleasure to provide you with the services of our new membership concierge.

Arising from the desire to create a more personalized experience for our members, the membership concierge’s primary goal is to establish a unique and personal connection with both new and current members. By making this connection with new members at the beginning of their relationship with the association (and with current members in the various stages of their career), the concierge will reinforce the FDA’s commitment to the success of our members.

Kerry Gómez-Ríos, the FDA’s new membership concierge and newest employee, will establish a single touch-point for new members. Her primary purpose is to focus on member needs and highlight the benefits and opportunities available to them. She will ensure that each new member has obtained the highest satisfaction their membership can offer.

Ms. Gómez-Ríos can be reached at 800.877.9922, 850.350.7136 or kgomez-rios@floridadental.org.

“It ’s quite simple. It ’s the golden rule taken up a notch.”

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Today's FDA

November/December 2013

www.floridadental.org

FDA Staff

s o í R z e m Kerry Gó

Questions & Answers with

Any background information you would like to share (family, education, etc.)?

I am a native of Panama (of Panamanian, Chinese and Hawaiian descent) and fluent in Spanish. After attending the Florida State University Panama Canal Branch for one quarter, I decided I wanted to experience a real college campus, so I packed my bags and moved to Tallahassee. I had every intention of leaving “Seminole Country” after I graduated, but Tallahassee has become my home and I cannot imagine living anywhere else. I married my college sweetheart, who also is from Panama (we met in Tallahassee), and together we have a beautiful and precocious eight-year-old daughter.

What do you like to do in your spare time?

Affectionately calling ourselves the “Three MusketeeRios,” my husband, daughter and I love the beach and jet skiing. We enjoy traveling and going back to Panama as often as we can. We visit both sides of the family and also serve in our own family-created mission project called the Panama Pantry, which provides basic food items to families of limited means in the province of Veraguas. On most weekends, you can be sure to find us at an ice cream parlor, as we love ice cream and frozen yogurt (and yes, we make sure to brush after our indulgence)!

www.floridadental.org

What attracted you to this position?

I previously served as membership director for other state and national associations. My favorite part of those roles has been forging relationships and friendships. The position of membership concierge will allow me to focus on building relationships with existing members and new members just as they are coming in the door and providing them with personalized service and attention. Recently, I visited a new retail store in our area, I was quite touched when I was welcomed by a sales associate who not only took the time to greet me but also shake my hand. I want to be the first to extend that warm, friendly handshake to our new members and acknowledge them and their needs.

What does good member service look like to you?

It’s quite simple. It’s the golden rule taken up a notch. Treat others the way you’d want to be treated, but make the extra effort to seal that interaction with a personal touch.

What are some challenges you foresee?

Florida is a beautifully diverse state, but no two regions are the same. To have good outreach within our state, you have to understand the nuances of each region. Our goal is to help dentists throughout the state supersede these regional differences and unify them under the common goal of protecting and advancing their profession.

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FNDC2014 Speaker

The Two Questions the Most Valuable Team Members Ask

By Kirk Behrendt

Every once in a while, you might have an epiphany about what truly describes a great team member. Our team had one this week while talking about what a dentist might say about this. When we ask ourselves, “What makes a valuable team member?” we typically think of terms such as: “engaged,” “great energy,” “wonderful skills,” “understands the vision” and “gets things done.” These are all true. Yet none of those answers completely gets to the root of the question.

You can research all the colorful language found in dental literature and workshops, but if dentists could bluntly answer this question without any filter, this is what they would say: “He/she improves the quality of my life every day.”

This is the game-changing answer. When you improve “quality of life,” you become more valuable as a team member.

The key to making more money, being employed longer and enjoying higher levels of fulfillment in any job is value. When you bring value to the practice, you wholly improve the person the dentist can be for his or her patients, team and family.

You bring value to the entire life experience.

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Anal

Loca thetic

lgesics

al anescs

FNDC2014 Speaker

We teach children the same principle all the time. Don’t ask the world to give you something, instead ask the world, “What value can I bring?” When you see things this way, people see you in a different light. You’ll find they tend to seek you out.

You, in turn, become more valuable to them (and might be paid accordingly!).

Ultimately, you become appreciated in your quest for appreciation. So ask yourself these questions:

1. How can I improve the doctor’s life today?

The answers are easy if you continuously run this checklist: n

Where is the practice heading and how am I helping influence that journey?

What am I actively doing to help the practice reach those goals? n Is there anything I’m doing that hinders our advancement? n

Workable solutions to these questions improve the doctor’s life every day. The key is to keep asking the questions and collaborating as a team to answer them. This way we stay in that valuable zone. Once the questions and answers stop, so does the value, thus leading to the demise of the relationship.

I only recently realized the importance of this question, and our Lead Practice Coach, Sheri Kay, asks it at the end of nearly every conversation: “What else can I do for you today?” It is a soothing reassurance that someone is committed to becoming and remaining valuable in the relationship. It emotionally transcends the intensity of the tasks you have in front of you and has a calming effect. You’ve heard the saying, “Happy wife, happy life.” The same principle applies here — “Happy doctor, happy practice.”

2. How can I improve a patient’s life today?

The second key question every valuable team member should ask relates to the patient experience. Most of the practices we coach that are prospering in these economic times are focusing a much brighter light on patient care. They’re succeeding because they’re thinking beyond just the procedures that need to be performed in a given day.

They see it as a simple relationship dynamic. They want every life to be improved — even if just a little — simply by walking into their office.

In any relationship (especially marriage!) the key to making it work isn’t asking, “What am I getting out of this?” but instead, “What value can I bring to this relationship?” When both parties are committed to finding the answer, they become a team of “magic makers.”

We all want the magic, but don’t often know how to make it happen. My hope is that you recognize the right questions that result in the bearing of fruitful relationships around you. That’s when the magic comes. In serving others, we ourselves are truly served.

Kirk Behrendt is a dental practice coach, international speaker and author, and the founder and CEO of ACT Dental. He is one of the keynote speakers of FNDC2014 and will be presenting all day on Friday, June 13, 2014. His keynote session, “Win Every Season: The Keys to Team Success,” will be held first thing in the morning, followed by, “Being All That We Can Be.” His final course, “7 Breakthrough Steps To Create Your Best Year Ever,” will be held in the afternoon. Mr. Behrendt can be reached at kirk@actdental.com.

When you rise beyond performing dental procedures and think in terms of improving or enhancing the lives of others, you again become more valuable to the people you serve. Always remember the power of a simple offer, “What else can I do for you today?”

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r eg i ste r now to volu nte e r!

FLA-MOM’s First event Providing Free dental ServiceS For the UnderServed

who:

members of the florida dental Association and florida dental health foundation when: march 28-29, 2014 where: florida state fairgrounds in tampa, fl

register tO vOLunteer At www.FLAMOM.FLOridAdentAL.Org

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FLA MOM

Florida Mission of Mercy Wants YOU!

By Drs. Nolan Allen and Leo Cullinan, FLAMOM Co-chairs

Next spring, Florida will be hosting a Mission of Mercy event for the first time. This is made possible through the Florida Dental Association (FDA) and its Foundation, the Florida Dental Health Foundation (FDHF).

Known around the United States as MOM, these two-day events provide free dental care for hundreds of people. Over the course of two days in March, our goal is to reach a minimum of 1,600 people in Tampa and its surrounding areas.

We want YOU to be a part of this amazing event!

We want YOU to stand with your colleagues and serve this community!

And we want you to bring YOUR STAFF! Create your own team of dental professionals and laymen to represent your area and help us reach this goal. We want FDA members and nonmembers alike to join us for this great cause. The public needs to know that dentists and other dental professionals throughout Florida see the oral health need in our state and are doing something about it.

Without YOU, we cannot succeed in this endeavor.

1.

Drs. Nolan Allen and Leo Cullinan are the FLAMOM co-chairs and can be reached at mom@floridadental.org.

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First-dollar Coverage for Any Action Arising from Patient Care at MOM Planners of the Mission of Mercy Event (MOM) have heard your questions regarding insurance requirements and sovereign immunity for the upcoming MOM event in March 2014 and have addressed your concerns.

Thanks to an agreement between the Florida Dental Health Foundation (FDHF) and The Doctors Company, first-dollar coverage will be provided for any action arising from providing volunteer patient care at the MOM event. The Doctors Company’s professional liability coverage will pertain to these professionals under contract for the MOMs event through FDHF: dentists, dental hygienists, physicians, ARNPs, and physician assistants.

As part of our Volunteer Agreement, any dentist or medical professional planning to volunteer must have liability insurance that meets the financial responsibility per state requirements.

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CAP Program

Looking for

?

Savings

The Corporate Affiliation Program Can Help

By Scott Ruthstrom

Chief Operating Officer, FDA Services Inc.

One of the most underused benefits of Florida Dental Association (FDA) membership is access to the valuable programs that make up the FDA Corporate Affiliation Program (CAP). Simply put, CAP provides FDA members exclusive access to a variety of programs geared to enhance their dental practice and offer good value through special member pricing, all while providing non-dues revenue for the FDA.

Whether you are looking for a solid company to finance that new piece of dental equipment; about to order your next supply of disposables; looking for a fresh way to market your dental practice in your community; or, offer your patients a payment financing program to complete a necessary treatment plan — there is a CAP partner to fit your needs.

Most importantly, every company wishing to participate in CAP is vetted by FDA staff and the Council on Financial Affairs. This saves you time so that you don’t have to research these companies yourself — we’ve already done the homework.

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Depending upon the level of use, FDA members can save enough money to more than cover the cost of their annual membership dues. Do you need an electronic claims solution? Claim X can do it for less. Do you need a debt collection partner? IC System is ready to help today. How about uniform and apparel?

Lands’ End can outfit your entire staff.

From A-Z, the CAP programs cover the full spectrum. They can be profitable and effective partners in your practice.

For more information on the FDA’s CAP partners, contact Scott Ruthstrom, Chief Operating Officer of FDA Services Inc. at 850.350.7146, or via email at scott.ruthstrom@fdaservices.com.

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President’s Profile

Born to Lead ...

1.

Dr. Terry Buckenheimer 36

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President’s Profile

By Jill Runyan and Lynne Knight

Presidential Favorites

A newlywed, FDA President, ADA Trustee and the list goes on and on. How do you find the time to fit everything into such a busy life? Just ask Dr. Terry Buckenheimer.

n

Music: Music has always played a large role in my life.

I enjoy all types of music from Jazz to Blues to Bluegrass to Top 40, as well as easy listening and Classical.

I used to sing in the high school choir and perform in our Broadway musical productions. I also sang in the choir at church, and look forward to taking that up again when my schedule allows. My children are also very musical. They have been in groups that have produced records and toured around the country. Brad plays drums and sings, and Bryan plays piano, keyboard, drums, guitar, mandolin, mouth organ and trumpet — he could probably be a one-man-band!

n

Favorite Artists: James Taylor, Sting, Josh Groban,

Leadership Becomes a Way of Life Ask Dr. Buckenheimer why he became involved in leadership and he will quickly tell you that leadership is integral to his way of life. “I have accepted the fact that leadership is very normal to me. I don’t know if it is part of my personality or my inability to say, ‘No.’ ” After his first year of membership in the Florida Dental Association (FDA), he knew he wanted to get involved. He had always been an officer in his class in high school, college and dental school. When he learned about Children’s Dental Health Month (CDHM), it seemed like a fun way to become involved with organized dentistry.

Crosby, Stills, Nash & Young, Bruno Mars, fun., Justin Timberlake, Billy Joel and many more. n

“We had a very good group of young dentists in Hillsborough County who enjoyed the camaraderie that membership in a dental organization brings. We had parties, picnics, educational meetings and successful recreational sport teams. I was appointed CDHM chairman and added a few events that went along with our normal activities, such as a children’s parade float, free screenings at the state fair and a partnership with Crest for third-graders.”

Because of his interest and action-packed leadership style, he was given many more opportunities to lead other groups in the dental community. Dr. Buckenheimer was instrumental in establishing Save that Smile, a program to ensure the use of mouthguards at children’s sporting events. In addition, he coauthored the Foundation’s award-winning Mouth Wise curriculum for Florida elementary and middle schools. Dr. Buckenheimer is past-president of the Hillsborough County Dental Association and the Florida Dental Health Foundation. He was named the FDA’s Dentist of the Year in 2007 in recognition of his service to dental education and organized dentistry.

Since Dr. Buckenheimer calls Tampa home, who better to ask about his leadership and commitment than Lissette Zuknick,

Movie: Suspense – Bourne Identity; Sci-fi – The Terminator; Comedy – My Cousin Vinny

n

Book: Bible

n

Vacation Destination: Scotland, Paris, London, Italy (especially Tuscany, where my son performs archaeological digs), U.S. National Parks, North Carolina and any golf resort (especially Whistling Straits).

n

Food: Chicago steak, anything sweet (especially my mother’s cinnamon rolls, whoopee pies and pies) and Ben and Jerry’s Chunky Monkey ice cream.

n

Season: Fall

n

Memory: My kids laughing and getting dressed up for Halloween, and sneaking into the bedroom on Christmas mornings.

n

Leisure activity: Golf, sightseeing, playing with my dachshund, Heidi.

Please see president’s, 38

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President’s Profile

Presidential Focal Points n Making the transition from the Dan Buker era to

the Drew Eason era as smooth and successful as possible. The FDA has hired a very membership-conscious executive director in Drew Eason. Membership value and satisfaction are now an even bigger part of the mindset of the association and staff. A membership concierge has been hired to provide positive experiences when members and non members contact the FDA. n Increasing membership market share by developing

the FDA into an organization that dentists want to join and belong to. The FDA has hired a marketing group in Tallahassee that will provide professional consultation to improve all forms of communication of the FDA. n Developing a volunteer mindset, so that giving back

to our profession and communities is a common thought of our members. A successful Mission of Mercy (MOM) project, a flourishing Project: Dentists Care (PDC) program — educational and oral health improvement programs are all important projects of the Florida Dental Health Foundation (FDHF). n Improving the efficiency of the FDA in all of its

programs and communication efforts. Reviews of FDA departments and systems are in progress. This activity is meant to keep everyone providing a uniform and consistent message. It also aids in providing a level of superior service. Our executive director (ED) also undergoes periodic reviews conducted by the ED Review committee. n Using my unique position as FDA President and

ADA Trustee to unify all three layers of the tripartite into a very efficient organization that appeals to dentists and creates an environment of success for our members and the patients we serve.

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Karen and Terry enjoy golf and shared this special time together at the Masters golf tournament in Augusta, Ga.

President's from 37

executive director of the West Coast District Dental Association? “I’ve known Dr. Buckenheimer for at least 20 years, and have always had his name on a short list of ‘go-to’ volunteers who were willing to be a resource on a variety of issues pertaining to organized dentistry, especially tricky ethical situations.

Today, even though his leadership scope has changed, he still is a reliable source of information. His dedication to organized dentistry and the profession is truly genuine. I have witnessed his passion as well as his humbleness. I feel lucky to call Dr. Buckenheimer a friend and feel the association is fortunate to have him as a leader.”

Roots in Simplicity Lead to Success Dr. Buckenheimer was born and raised in a small town in western Pennsylvania. He spent his childhood in a simple, but rewarding, middle-class family. He knew that he wanted to be a dentist since childhood. Always a close-knit family, his mother and father now live in Brooksville and his sister lives in Tampa.

He received his BA in biology from West Virginia University in 1976 and graduated from the University of Pittsburgh School of Dental Medicine with his dental degree in 1980. He began a successful practice in south Tampa in 1981, where he still cares for patients alongside new owner, Dr. Christopher Bulnes. www.floridadental.org

President’s Profile

The newly blended family gathers at Terry and Karen’s marriage at their mountain home in North Carolina.

(From left to right) Karen’s son Robert, Dr. Buckenheimer’s son Bryan and Bradley's wife Allison, Dr. Buckenheimer (holding Heidi, their 14 year-old dachshund), Karen, Karen’s daughters, Christie and Jennifer and Dr. Buckeheimer’s son, Bradley.

Creating a New Family At the end of this summer, Dr. Buckenheimer married Karen Pesce, which brought together two families. Dr. Buckenheimer has two sons, Bradley and Bryan, and Karen has two daughters, Jennifer and Christie and one son, Robert. All of their children, along with several other family members, were at the Buckenheimer’s mountain home in North Carolina to celebrate their wedding day. Several friends from the FDA and ADA also made the trip north and from other parts of the country, to help the couple celebrate.

Photo: 1. From left to right, Dr. Buckenheimer, the late Dr. Dan Bertoch, Gerilyn Bird, Dr. Bird and Dr. Huot attend a W ashington leaderhip conference in Washington, D.C. Jill Runyan is the Publications Manager and can be reached at jrunyan@floridadental.org. Lynne Knight is the Marketing Coordinator and can be reached at lknight@floridadental.org.

Dr. Buckenheimer and wife Karen celebrate Halloween in New Orleans at Emeril’s restaurant, while attending the 2013 ADA conference.

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Short in

Stature,

Dentist of the Year

By Jessica Lauria

Publications Coordinator

Each year, from its thousands of members, the Florida Dental Association (FDA) honors one member as the “Dentist of the Year” for distinguished service to the association and the dental profession. For 2013, the FDA honored Dr. Idalia Lastra.

Idalia Lastra was just a child when her family fled the Communist regime of Fidel Castro in 1960. Like many other Cubans, they made their way to Miami.

The Lastra family didn’t settle there, however; they soon found themselves moving around the country quite a bit.

The family first moved to New York, but the cold weather drove them to warmer climates: California, then Florida, and finally to Alabama where her father, Dr. Jesus Lastra, was accepted into dental school.

the University of Miami and went on to attend dental school at her first choice, the University of Alabama. She received her dental degree and stayed in Alabama for her residency in orthodontics. Her intent had been to specialize in pediatric dentistry, but she discovered that her love for orthodontics was stronger.

Dr. Lastra moved back to Miami to be near her family and set up her private practice in orthodontics in 1980. She immediately became involved in organized dentistry, starting out as a newsletter editor and making her way through every position available. She has been a member of the American Dental Association (ADA) and the Florida Dental Association (FDA) for more than 30 years, with service on the Board of Trustees for five years and the Florida Delegation for 15 years. She has been a member of the Florida Dental Health Foundation since 1994, and served as the treasurer from 2005-2009. Dr. Lastra also has held leadership positions as president of the Greater Miami Dental Society, the South Florida Academy of Orthodontics, and the Dade County Dental Research Clinic.

In addition, Dr. Lastra lectures on the subject of orthodontics, and currently serves in academic positions for the Miami Children’s Hospital, the Miami Children’s Craniofacial Team, and is a Courtesy Clinical Associate Professor at the University of Florida College of Dentistry. She has held leadership positions with the Florida Academy of Dental Practice Administrators, the American College of Dentists Florida Section, and is a member of the American Association of Orthodontists and the Southern Association of Orthodontists.

Jesus Lastra, a dentist in their native country, attended the University of Alabama and received his dental degree so that he could become licensed in the U.S. He taught at the school for a few years before he was able to practice because, then, non-U.S. citizens could not take the dental boards and had to wait seven years to become a citizen. Congress then passed a law that allowed him to become a citizen before the seven-year period was completed, and he proudly still has the pen that the President used to sign the bill into law. Finally a citizen, he took the Florida Board exams and moved his family back to South Florida, where he set up his practice.

Taking note of her father’s unwavering dedication and love for dentistry, young Idalia decided to follow in his footsteps. After graduating from Coral Gables High School, Idalia obtained her Bachelor of Science in Chemistry at

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Please see lastra, 44

George and Idalia enjoy spending as much time with their grandchildren as possible.

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Dentist of the Year mates” and the women — you guessed, it — are “captains!”

Dr. Lastra and her second family, her dental staff.

Lastra from 43

Her volunteerism extends beyond dentistry. She served on the board of directors for the Archdiocesan Education Foundation from 1991 until its closing year in 2000. She currently serves a variety of other community organizations, including the Kiwanis Club of Key Biscayne and the Serra Club of Miami. She is devoted to her church, and has been involved in World Youth Day, a worldwide encounter with the Pope, which is typically celebrated every three years in a different country. She met her husband, George Barket, in her church and they have been happily married for 25 years.

She and George have two vacation homes, one in the mountains in North Carolina and one in the Florida Keys, where they relax and enjoy downtime.

But it hasn’t always been relaxing when she isn’t working — they took on the laborious task of restoring a boat, “The Sandspur.” Ask Dr. Lastra, and she’ll tell you that as much as she’d love to take credit for restoring the boat, her main part in the project consisted of having shirts made for the whole family with the boat’s name on it. “The Sandspur” has been a great source of bonding time with their family, which is reflected in the embroidery of their shirts: the grandchildren are the “crew,” the men are “first

One of Dr. Lastra’s biggest passions is her family. She is extremely dedicated to her family and her parents. She has four step-children, and she and George have nine beautiful grandchildren that she adores spending time with. Their family is always together — whether it’s going to a Miami Dolphins game, vacationing or anything in between. The family is so close, in fact, that they affectionately call her neighborhood “the compound” because of the relatives’ close proximity to one another.

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Dr. Lastra is admired by many people, and has touched many lives. She is a deeply respected friend, boss and colleague. “She is not only one of my mentors in organized dentistry, but she is a true friend and I love her so much,” says Dr. Jolene Paramore. Dr. Lastra and her staff have a great rapport and mutual respect for one another, and the work environment is such a positive one that it can be felt by all the patients who walk through the door.

The saying, “Big things come in little packages,” holds true for Dr. Lastra. She may be short in stature, but she is larger than life when it comes to her service in the community and organized dentistry.

There isn’t anything she does that is small in nature; she has a huge heart that genuinely loves her profession and each person in her life. Her influence on dentistry can be seen and felt by all those who know her.

Ms. Lauria is the FDA’s publication coordinator and can be reached at 850.350.7115 or jlauria@floridadental. org.

Spending time on their front porch in North Carolina.

From left to right: George, Dr. Lastra and her parents.

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QA

Dentist of the Year

& with the Dentist of the Year, Dr. Idalia Lastra

Q. A.

What made you decide to become a dentist?

I became interested in dentistry while watching my father and many of his Cuban friends struggling to go back to school — in a foreign language — so that they could practice in the U.S. They had such love for and dedication to dentistry — and were willing to work so hard supporting their families and going to school full time — that I knew there had to be something special in the profession.

All of my life, I have felt that dentistry was part of my family. We grew up with the children of my father’s colleagues as friends. We went to school together and vacationed together, and grew as our parents found their way back into dentistry in America. I have made some amazing lifelong friends in dental school and later while serving in organized dentistry. I am deeply grateful for the opportunity to practice dentistry and to have patients entrust their care to me.

Q.

You originally planned on specializing in pediatric dentistry. What made you change to orthodontics?

A.

After starting dental school, I fell in love with orthodontics. I had always thought that I would like to work with children, so my first intent was to specialize in pediatric dentistry. I worked for a female pediatric dentist in Miami one summer and she suggested that I also look into orthodontics. So, the following summer I worked for an orthodontist as an assistant, and found that I loved it even more. It was an opportunity to do something really positive for my patients and make an impact on their lives. I have loved every minute of it since.

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Q. A.

How has the presence of women in dentistry changed over the years?

When I first started practicing, there were very few female dentists in Miami and even fewer orthodontists. Many times, I was the only female at many of our continuing education meetings.

That has completely changed over the years. It is wonderful to see that the gender barrier has been broken and it is a pleasure to have so many women not only attending the meetings, but being leaders in organized dentistry.

Q. A.

How do you hope to impact dentistry?

If I could make one impact on dentistry, it would be to pass on the love that I have for the profession and the hope that it will continue to be a profession that we would want our grandchildren to enter. Dentistry is an important part of my life and my family. I would hope that it would be the same for generations in the future.

Q. A.

What is the greatest challenge facing dentistry today?

The greatest challenge is government intervention into the doctor-patient relationship. The average dentist today is not aware of the value of banding together in organized dentistry to advocate for our profession and our patients. Our lives are complicated and busy, and it is easy to get our continuing education online and never share experiences with colleagues at meetings. We start to see each other as competitors rather than colleagues and friends.

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mediation makes sense with the FDA Peer review Mediation Program MEDIATION VS. LITIGATION The Peer Review Mediation Program settles disagreements between patients and dentists more economically and efficiently than the legal system and is available only to FDA members.

This program is free of charge.

Only cases involving problems with actual treatment and procedures are eligible for mediation.

Mediation takes place at the local level, so problems can be resolved more effectively.

FOr MOrE INFOrMATION

about the FDA Peer review Mediation Program 800.877.9922 • fda@floridadental.org www.floridadental.org/peer-review

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Cases not eligible for the program include: malpractice litigation; formal regulatory investigations; disputes over dental fees; treatment that occurred more than 12 months before the patient’s last appointment with the dentist; and cases involving dentists who are not FDA members.

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Diagnostic Discussion

Diagnostic Discussion

By Dr. Nadim Islam

A 50-year-old Caucasian male presented at the office of Dr. Eric Fox in Coral Springs, Fla., with a thick, white, slightly raised and rough, and verruciform area on the midline of the dorsum of the tongue (Fig. 1). On palpation, the lesion was firm and felt like a coated area on the anterior dorsum. The patient mentioned that the lesion was causing slight discomfort. According to the patient, the lesion has been present for an unspecified duration and that he was a 35-pack a year smoker. The lesion did not rub off, as per the clinician. On further enquiry, it was elicited that the lesion has been present for more than a year and had become increasingly prominent.

His medical history is essentially non-contributory. An incisional biopsy was performed under local anesthesia and the patient was prescribed Vicodin tablets and duly advised, not to drive and to stay away from potentially hazardous activity while using narcotic medication. The tissue specimen was placed in 10 percent formalin and submitted to the University of Florida College of Dentistry, Oral and Maxillofacial Pathology Biopsy Service for evaluation.

Question:

Fig. 1

Based on the clinical history and presentation, what is the most likely diagnosis?

A. Trauma-related hyperplasia B. Verrucous carcinoma (VC) C. Hyperplastic circumvallate papillae D. White sponge nevus (WSN) E. Median rhomboid glossitis (MRG) Please see diagnostic, 48

Continuing Education Opportunity You can now earn continuing education credit for reading Diagnostic Discussion articles! Visit the FDA website at www.floridadental.org and click “Online Education” under the “Benefits and Resources” tab for this free, members-only benefit. You will be given the opportunity to review this column and its accompanying photos, and will be asked to answer five additional questions. If you have questions about this opportunity, email Publications Manager Jill Runyan at jrunyan@floridadental.org or call 800.877.9922.

Be sure you are logged in to the members-only side of www.floridadental.org to access the online CE.

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Diagnostic Discussion

diagnostic from 47

Diagnostic Discussion A. Trauma-related Hyperplasia Incorrect. Though the possibility of trauma exists due to the clinical appearance of a slightly raised lesion, the lack of apparent symptoms and absence of any obvious local etiology is not supportive of a diagnosis of a trauma-induced lesion. Constant chronic irritation from any source may take on identical appearance as the lesion presented here. But upon clinical examination and questioning of the patient, no source of trauma could be identified. In addition, trauma is almost always associated with significant pain, possible ulceration and discomfort, especially when noted with such an elaborate presentation.

B. Verrucous Carcinoma Incorrect. This entity is a low-grade variant of oral squamous cell carcinoma and is generally seen in people who chronically use chewing tobacco or snuff, typically in areas where the tobacco is placed habitually. Therefore, the dorsum of the tongue is not an ideal location for these entities. In spit tobacco users, however, a regular squamous cell carcinoma is 25 times more likely to develop than this low-grade variant. Although, the age is a close match as verrucous carcinomas (VC) are found predominantly in men older than 55 years of age. The most common sites of oral mucosal involve-

48

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ment include the mandibular vestibule, the buccal mucosa and the hard palate.

VCs may be present in the mouth for 2-3 years prior to the initial diagnosis.

The appearance is that of a diffuse: well-demarcated, painless, thick plaque with papillary characteristics. Lesions are typically white but may appear pink or erythematous. Leukoplakia or tobacco pouch keratosis may be seen on adjacent mucosal surfaces. Microscopically these have a “deceptively benign� appearance.

Because metastasis is an extremely rare event in VCs, the treatment of choice is surgical excision without radical neck dissection. Some believe that this entity may have a close relationship to human papilloma virus infections (HPV) as well.

C. Hyperplastic Circumvallate Papillae Incorrect, but good guess. The circumvallate papillae tend to be arranged in a V-shaped pattern with the apex at the midline of the tongue toward the posterior. These papillae are visible in the posterior aspect of the tongue and sometimes closely associated with the tuberculum impar. However, when hyperplastic, these appear nodular, discrete and reddish-pink. Individual or multiple such hyperplastic papillae often are noted and usually are associated with chronic irritation. The lesion noted here was too anteriorly placed.

D. White Sponge Nevus Incorrect. White sponge nevus (WSN) is an autosomal dominant disorder. Oral lesions most frequently occur on the buccal mucosa and typically are bilateral.

November/December 2013

Additional sites of less common involvement include the tongue, gingiva, hard and soft palate, floor of mouth, peritonsillar region and lip. The affected mucosa usually presents with white, elevated, wrinkled and spongy appearance, similar to the presentation in our case. The oral mucosa is affected most frequently, but involvement of the nose, esophagus, larynx, rectum, anus, vagina and penis have been reported. The oral lesions are asymptomatic and require no therapy. It is prudent to explain to the patient the nature of this condition so other clinicians do not advise additional diagnostic procedures. Interestingly, remission of WSN secondary to penicillin or tetracycline has been seen in some patients.

The microscopic presentation did not confirm the above diagnosis.

E. Median Rhomboid Glossitis (unusual presentation with prominent hyperplastic areas) Correct. Median rhomboid glossitis (MRG) usually represents a zone of central papillary atrophy of the tongue.

In this case, the presentation was more likely or closely similar to what is noted in hyperplastic candidiasis. Though the mildly erythematous areas are noted in the periphery of the lesion, many fissured areas are noted. Ideally, the atrophy presents as a well-demarcated erythematous zone involving the midline posterior dorsal tongue and is often asymptomatic.

The redness or erythema is mainly due to the loss of the papillae in this area. The lesion is usually symmetrical and appears rhomboidal in shape, hence the name. It

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Diagnostic Discussion

is now well-established that this central atrophy of the tongue takes place as result of candidal infection and is considered a part of the spectrum of erythematous candidiasis. Similar lesions maybe noted on the hard palate or the junction of the hard and soft palate resulting in what has been called “kissing lesions.”

The patients with median rhomboid glossitis often exhibit signs of candidal infection at other sites such as palatal tissues and angles of the mouth. Our case was a little unusual as there was more of a papillary hyperplasia noted with the location more anterior than what we would usually expect. This lesion should be treated with antifungal therapy, such as clotrimazole (Mycelex) troches five times a day for two weeks or with nystatin rinse three to four times a day for two weeks. The atrophic area usually resolves after antifungal therapy, although occasionally only partial resolution may be observed. This patient has been advised a two week follow-up post-antifungal usage. In some cases, such as this, even after complete resolution of the yeast infection, the hyperplasic tissue may require a surgical removal. Underlying systemic diseases and immune suppression should be ruled out. Chief among these are: diabetes, chronic steroid use, both inhalation types for treatment of asthma and systemic dosing.

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References: Guggenheimer J, Moore PA, Rossie K, Myers D, et al. Insulin-dependent diabetes mellitus and oral soft tissue pathologies: II. Prevalence and characteristics of Candida and Candidal lesions. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2000; 89:570-6.

Brown RS, Krakow AM. Median rhomboid glossitis and a “kissing” lesion of the palate. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1996; 82:472-3.

Dr. Islam

Morris R, Gansler TS, Rudisill MT, Neville B. White sponge nevus: diagnosis by light microscope and ultrastructural cytology. Acta Cytol32:357, 1988.

Kolokotronis A, Kioses V, Antoniades D, Mandraveli K, Doutsos I, Papanayotou

Dr. Bhattacharyya

P. Median rhomboid glossitis. An oral manifestation in patients infected with HIV. Oral Surg Oral Med Oral Pathol.

1994; 78:36-40.

Alkan A, Bulut E, Gunhan O, Ozdenb B. Oral Verrucous Carcinoma: A Study of 12 Cases. Eur J Dent. 2010 April; 4(2): 202–207.

Diagnostic Discussion is contributed

by UFCD professors, Drs. Nadim Islam, Indraneel Bhattacharyya and Don Cohen, and provides insight and feedback on common, important, new and challenging oral diseases.

The dental professors operate a large, multi-state biopsy service. The column’s case studies originate from the more than 10,000 specimens the service receives every year from all over the United States.

Clinicians are invited to submit Dr. Cohen cases from their own practices. Cases may be used in the “Diagnostic Discussion,” with credit given to the submitter.

Drs. Islam, Bhattacharyya and Cohen can be reached at MIslam@dental.ufl.edu, ibhattacharyya@dental.ufl.edu and dcohen@ dental.ufl.edu, respectively.

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Go to www.floridadental.org.

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October 1

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December 1

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Clearing the Fog on Different Types of Bone Grafting & Ridge Augmentation

Oral Surgery for the General Practitioner

Blood, Spit & Fears: A Painless OSHA Update

Dr. Gary Wayne Expires 1/30/14

Dr. Laney Kay Expires 2/28/14

Mastering Restorative Dentistry 2012: Treatment Planning the Materials, Techniques & Procedures Dr. Alan Atlas Expires 2/28/14

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Community Water Fluoridation by the Numbers Millions of Americans do not have access to fluoridated water in their communities, leading to higher rates of tooth decay and greater costs to taxpayers. Fluoridation can reduce states’ expenditures for emergency room care, Medicaid, and other public health services.

72,323,833

830,590

Number of Americans served by public water systems that do not provide fluoridated drinking water1

Number of Americans treated at hospital emergency rooms in 2009 for preventable dental problems2

25%

$

Estimated rate by which community water fluoridation reduces tooth decay throughout a person’s lifetime3

$6,105 Lifetime cost of treating one decayed molar5

1=

Spent

$

38 Saved

Amount of money communities save for every dollar invested in water fluoridation4

$

24

Amount of money saved annually per child by the Texas Medicaid program as a direct result of water fluoridation6

These data are as of Dec. 31, 2010, and are the most recent fluoridation census conducted by the Centers for Disease Control and Prevention. Centers for Disease Control and Prevention, “2010 Water Fluoridation Statistics,” accessed March 20, 2013, http://www.cdc.gov/fluoridation/statistics/2010stats.htm.

The Pew Charitable Trusts, A Costly Dental Destination: Hospital Care Means States Pay Dearly, 2012, accessed April 4, 2013, http://www.pewstates.org/research/reports/a-costly-dental-destination-85899379755.

3 Centers for Disease Control and Prevention, “Fluoridation Basics,” accessed March 11, 2013, http://www.cdc.gov/fluoridation/benefits/background.htm.

4 Centers for Disease Control and Prevention, “Cost Savings of Community Water Fluoridation,” accessed March 20, 2013, http://www.cdc.gov/fluoridation/fact_sheets/cost.htm.

5 Cost is from Delta Dental of California’s data of commercially insured patients (January-June 2012).

6 Texas Department of Health, “Water Fluoridation Costs in Texas: Texas Health Steps,” May 2000, accessed March 11, 2013. http://www.dshs.state.tx.us/dental/pdf/fluoridation.pdf.

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Fluoridation

Fluoridation: The Debate Goes On

By Casey Stoutamire FDA Lobbyist

After success in Pinellas County, the debate over water fluoridation moved just north to the city of Brooksville. Two years ago, in a last minute budget decision, the Brooksville City Council voted 5-0 to stop fluoridating its water system.

The vote came without any debate or publicity, and city officials did not make the health care professionals aware of its intent to stop its fluoridation program.

When all of this came to light, a team of local dentists, in concert with Hernando County Health Officials, went to work to bring fluoride back to the city’s water supply. The effort to stop fluoridation was led by Brooksville Mayor Lara Bradburn, an adamant opponent of fluoridation. There appeared to be some council members who continued to question the safety of fluoride; however, thanks to education by local dentists, several other council members were supportive of water fluoridation.

The debate over water fluoridation in Brooksville has become heated over the past several months. In March 2013, the Hernando County Health Department attempted to have fluoridation added as an agenda item on an upcoming city council meeting. The mayor denied this request. However, Florida Dental Association (FDA) member Dr. Johnny Johnson and other local dentists were able to testify in front of the city council and provide pertinent information on www.floridadental.org

“ ”

The FDA would like thank all of the local dentists and health officials who are advocating tirelessly for water fluoridation.

this issue. Additionally, they offered to get together with council members in private meetings to discuss the issue further. Also, Dr. Johnson sent a letter of support for water fluoridation to all city council members along with an informational DVD on the topic.

In May 2013, the city council held a water fluoridation workshop. The anti-fluoride position was presented by the mayor while the pro-fluoride position was presented again by Dr. Johnson, along with FDA members Dr. Pedro Lense, a dentist for the Hernando County Health Department, and Dr. Scott Tomar from the University of Florida College of Dentistry. After the presentations and a question and answer session, the city council was split on the issue with one council member still undecided.

Over the summer, numerous letters supporting (including a letter from the state surgeon general) and denouncing fluoride from various organizations and individuals were sent to the city council.

As a result, the mayor scheduled another water fluoridation workshop for Aug. 27. She was able to get Dr. Paul Connett, executive director of the Fluoride Action Network and an outspoken opponent of water fluoridation, to speak at the meeting. Originally, the mayor wanted to hold a presidential-style debate on the issue with Dr. Connett presenting the anti-fluoride view, and Dr. Johnson and other local health officials presenting the pro-fluoride view. This invitation was declined to avoid creating a mockery of a very important issue that is backed by scientific facts. Instead, they once again offered to testify in front of the city council to present the benefits of water fluoridation. During the August meeting, Dr. Connett made a one-hour presentation opposing water fluoridation and then answered questions from council members. Numerous local dentists and health officials attended the meeting, but unfortunately, the audience was not allowed to ask questions or have public testimony. The vote on whether to resume fluoridation or not was scheduled to occur when the city council met to discuss the budget.

On Oct. 7, the Brooksville City Council voted to restart its water fluoridation Please see fluoridation, 55

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Fluoridation

fluoridation from 53

program by a vote of 4-1. The FDA will continue to monitor this issue in Brooksville, as the one vote against was cast by the mayor. We would like to thank all of the local dentists, led by Dr. Johnny Johnson, for educating the city council members on water fluoridation. Without your help and hard work, this result would not have been possible.

Elsewhere in the state, the city of Avon Park (Highlands County) decided to end its water fluoridation program. The city manager informed the Department of Health that Avon Park had sought and received approval from the Florida De-

www.floridadental.org

partment of Environmental Protection (DEP) to end this program, but again did not consult with local health officials about the decision. Then, at the last minute, water fluoridation was added to the agenda for the September 2013 city council meeting. Several officials from the Highlands County Health Department, as well as local dentists, attended the meeting to advocate in support of water fluoridation. The debate is just beginning, but city health officials and the local dentists are organizing a unified effort to conduct an educational campaign to show that the benefits of fluoridation outweigh a decision to end it.

The FDA would like thank all of the local dentists and health officials who are advocating tirelessly for water fluoridation.

If you would like to become more involved with water fluoridation efforts, obtain a copy of the FDA Fluoride Advocacy Toolkit, or if there is a fluoridation issue in your community, please contact the FDA Governmental Affairs office at 850.224.1089 or gao@floridadental.org.

Ms. Stoutamire is a lobbyist with the FDA Governmental Affairs Office. She can be reached at cstoutamire@floridadental.org.

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iving. heir bad dr t h t i w s e t ce ra ou switch car insuran ee before y r f g t n i i t y a l r f t n i o t , e RVICES INC ever ywher uckers are tact FDA SE S n e o t C a .

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FDA SERVICES INC

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1113 E. Tennessee St., Ste. 200TALLAHASSEE, FL 32308 Tallahassee, FL 32308 800.877.7597 insurance@fdaservices.com

800-877-7597

insurancwww.floridadental.org e@fdaservices.com

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Peer Review

Your Peer Review Program: How It Works

by Luis E. Martinez, DMD, PA I have been involved in the Peer Review process for more than ten years. You can often avoid costly legal fees and malpractice suits by using this free service available only to members. This is usually where the description of the program ends, without much insight into what actually happens. Here is how Peer Review at the Pinellas County Dental Association (PCDA) works: 1. Usually, a patient calls the PCDA office with a complaint about a dental care outcome. Many times our secretaries can resolve the issue over the phone. As Peer Review chairman, I don’t see a lot of complaints until they are beyond minor mediation.

2. Once I get involved, I generally review the patient’s complaint and the dentist’s records; then, I begin using my mediation skills to try to resolve the issue. Generally, it involves money — as in, the refunding of money.

3. If the complaint is not resolved by refunding all or part of the money, the next step is arbitration. This involves bringing in the patient. A team of three dentists interviews the patient and evaluates the treatment. After the patient leaves, the dentist under review comes in and explains his or her side of the dispute and treatment.

4. The Peer Review team then recommends a solution, which could involve not only returning the money, but also what it would cost to correct the issue. A recommendation is made that neither the dentist nor the patient has to abide by.

I have learned a lot from my involvement in the Peer Review program, including improving my own record keeping. I offer a few recommendations gleaned from my decade of experience.

1. Peer Review doesn’t always have to be started by a disgruntled patient. A frustrated dentist who feels that everything has been done to satisfy the patient, with no success, also can recommend Peer Review.

2. Although it’s a natural reaction, a phone call from me (or your district’s Peer Review chair) shouldn’t be looked on as a bad thing. This is a service we provide to our members to help mediate problems, and most of the time avoid costly and emotionally draining litigation or Board of Dentistry complaints.

3. Don’t let your ego get in the way when trying to resolve the issue. It is not a direct reflection of your abilities as a dentist — and returning fees paid for service is much less troublesome than possibly having to pay someone else to re-treat along with refunding the original fee on top of that.

4. Be assured that when the evaluators review a case, it is in strict confidence. We all treat the situation as if we were the ones who had the complaint against them.

5. Always keep in mind when someone comes into your office complaining about another dentist’s treatment — next week, a disgruntled patient could be in a colleague’s chair complaining about you. Do your best to not pass judgment and give the dentist a courtesy call. It could make a real difference.

Peer Review is only possible when members work together to support each other.

Dr. Martinez is the Peer Review chairman for the Pinellas County Dental Association. He can be reached at GATOR2TH@aol.com. This column first appeared in an info@fda email bulletin on Aug. 22, 2013.

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Patient calls the component office with a concern.

Component staff decide if the situation falls under the duties of peer review and can start paperwork.* The case is sent to the peer review chair (volunteer dentist) in the area near the patient.

The peer review chair calls the patient to discuss the issue.

The peer review chair then calls the dentist to discuss the issue and see if he or she is willing to settle by refunding all or some of the fee.

If not, the chair convenes a peer review panel and collects information from the dentist who treated the patient.

The peer review chair negotiates a settlement to which the patient and dentist both agree.

Three dentists other than the peer review chair evaluate the patient anonymously, dismiss the patient and then evaluate the treating dentist’s records. They may also interview the treating dentist.

The peer review panel comes to a decision regarding the acceptability of the treatment and any recourse necessary.

The peer review chair writes up the evaluation and submits the report to the component.

The component notifies the patient of the proceeding’s outcome.

If there is agreement, and the patient is due a refund, the treating dentist will write a check to the component.

The component will secure a release of liability from the patient and then distribute the refund to the patient. The FDA dentist retains the original release form as a crucial part of the patient’s record.

If there is no agreement, no records generated by the peer review process can be used against the dentist in a subsequent malpractice lawsuit, even if the mediation/ arbitration failed.

* Only cases involving problems with actual treatment and procedures are eligible for mediation. Cases not eligible for the program include: malpractice litigation; formal regulatory investigations; disputes over dental fees; treatment that occurred more than 12 months before the patient’s last appointment with the dentist; and cases involving dentists who are not FDA members.

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Peer Review

meDIatIoN makes seNse

by Lynne Knight, FDA Marketing Coordinator Recently, I spoke with Peer Review (PR) chairmen from around the state about their experiences as mediators in the program.

While Dr. Edward Daniel thinks that PR is the best reason to join the FDA, Dr. Andrew Adelson says that one of his biggest obstacles is convincing the dentist that he is on their side and doing them a favor by helping to resolve a case, even it means they must apologize or refund money. Together, these dentists have almost 130 years of service in the Peer Review program: Dr. Philip Glatstein, South Florida District Dental Association Dr. Alan Price, Central Florida District Dental Association Dr. Andrew Brown, Northeast District Dental Association Dr. Andrew Adelson, Atlantic Coast District Dental Association Dr. Edward Daniel, EscaRosa Dental Society coNflIct ResolutIoN aND comPRomIse aRe tHe meDIatoR’s tools Dr. Daniel: Of the cases I see, 75 percent can be resolved without clinical review.

When I ask the patient involved in these cases what they want, they tell me that they want their money back. I then go to the dentist involved and explain to them that prior to clinical review, they can resolve the case by refunding the fees for the treatment in question. Usually the dentist will opt to refund the fees instead of proceeding with clinical review.

this members-only service is free. one hour with your attorney could cost up to $300.

WHat WoulD You saY to a DeNtIst ReluctaNt to use PeeR RevIeW? Dr. Daniel: It’s the best reason to join the FDA! PR is a very friendly, low-key, nonadversarial process that looks out for the best interests of the dentist and the patient. Ninety-five percent of cases are easy to resolve and it’s obviously better than the legal system.

Dr. Adelson: You are about to make the biggest mistake of your life! The other options are terrible! Board of Dentistry hearings are difficult; usually the least they will do is fine you for bad record keeping. And, if the patient calls a lawyer — even if you win, you will lose two years of sleep. When PR comes knocking, don’t slam the door.

Dr. Glatstein: If a dentist decides against PR, he’d best inform his carrier of the situation and it would be wise to inform his personal attorney, too.

Dr. Price: If PR is able to reach an acceptable compromise for you, the patient will sign a legally binding agreement before any money is refunded. Sometimes PR doesn’t work. If that happens, all the PR records are shredded.

Dr. Brown: Sometimes a dentist doesn’t want to use PR because he or she doesn't want another dentist to know about a problem in their office. Since PR is confidential, fewer people will know about it than if it becomes a malpractice case.

Dr. Adelson: I make sure both parties understand where the problem lies and what can be done to correct the situation. Someone usually admits to a breakdown in communication or a mistake in how something was explained. Compromise is the process and neither side may be totally happy with results.

WHat’s tHe bIggest PRoblem? all agRee, “It’s mIscommuNIcatIoN!”

Dr. Glatstein: With effective communication, most are pretty reasonable. I have a good track record in mediating. My objective is to get the patient back to the dentist, and to solve the problem.

Dr. Daniel: There is breakdown in communication when the dentist doesn’t listen to the patient well enough or address their concerns adequately. I don’t see much treatment that doesn’t meet the expected standard of care.

Dr. Price: The patient or the dentist may be angry, but I don’t pass on that animosity when speaking with the parties. I try to convince the patient and the dentist that compromise is necessary to make PR work — the dentist has lab costs; the patient’s confidence in the dentist is evidenced by seeing him numerous times. The dentist sometimes gets defensive about the quality of his work. I encourage him to refocus on placating his unhappy patient, which usually involves a financial compromise.

Dr. Adelson: Miscommunication happens when there are assumptions on both sides; the dentist assumes the patient knows or understands the procedure and the patient assumes the dentist understands their expectations.

Dr. Brown: I listen to both sides. Most dentists appreciate the mediation, even if something was wrong. In about 60 percent of our cases, something went wrong. I explain the exposure and risk of fighting the patient and encourage the dentist to settle the bill, write it off, offer a refund, or refer to another dentist.

Sometimes, a patient just needs to rant, and I am happy to listen. Sometimes, I may be able to unruffle some feathers. Sometimes, we have to let the patient know that their complaint doesn’t fall under peer review — like the letter we received complaining about a dentist having an affair with the letter-writer’s spouse.

Dr. Glatstein: The practitioner doesn’t fully understand the patient’s needs or make sure the patient understands the procedure. Many cases involve a patient who has expectations not realized. Sometimes heavy advertising creates an expectation and a patient ends up with something else, something unexpected.

Dr. Price: Some patients are dissatisfied with results; i.e., dentures are not like your own teeth and the dentist should explain possible problems at the beginning and not say that they will be as good as real teeth.

Dr. Brown: The treatment plan and costs should be discussed up front so there are no surprises at checkout. Your staff and front desk employees should be trained to communicate clearly, too.

Dr. Andrew Adelson is a general dentist in West Palm Beach. He can be reached at jockdoc101@aol.com.

Dr. Andrew Brown is an orthodontist in Orange Park. He can be reached at ddsbrown@bellsouth.net.

R. Edward Daniel practices family dentistry in Pensacola. He can be reached at eda9049237@aol.com.

Dr. Philip Glatstein is a general dentist in South Miami. He can be reached at mouthmavens@bellsouth.net.

Dr. Alan Price practices family and cosmetic dentistry in Winter Park. He can be reached at 407.645.4645.

Ms. Knight is the FDA’s marketing coordinator. She can be reached at lknight@floridadental.org. www.floridadental.org www.floridadental.org

For more inFormation

about the FDa Peer review Program 800.877.9922 • fda@floridadental.org www.floridadental.org/peer-review

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Peer Review

If Peer Review fails, can the records be used against you?

Graham Nicol, Esq.,

Health Care Risk Manager, Board Certified Specialist (Health Law)

On the previous pages, and in an August issue of the Florida Dental Association’s (FDA) informational newsletter, info@fda, we discussed the value of peer review services provided by the FDA, component and affiliate associations. After that, a member asked whether the records generated by the peer review process can be used against the dentist in a subsequent malpractice lawsuit, assuming the mediation/arbitration failed. This is such a good question that we thought we would publish the answer in Today’s FDA. FDA peer review is conducted according to the federal Health Care Quality Improvement Act (HCQIA). The HCQIA provides peer review volunteers with qualified immunity. At one point, the immunity against testifying or producing records was broader than it is today. Federal courts have whittled away some of the protection given under the HCQIA. For example, evidence generated by peer review proceedings may now be discoverable under HCQIA if a civil rights violation, antitrust, or breach of contract claim is subsequently asserted.

It is not unusual for a physician in a hospital setting who has lost his privileges to assert that the loss of privileges had nothing to do with quality of care and patient safety, but was instead discrimination against him as a member of a class protected by civil rights legislation. Such cases are reportable to the National Practitioner Data Bank and involve a loss of income and reputation. In contrast, FDA peer review is designed so that it is not reportable to the National Practitioner Data Bank, will involve at most a refund of fees previously paid, and is kept confidential.

But even if the federal law’s protection has weakened, protection under Florida law has not. In sections 456.073(11), 466.022, and 766.101(3), Florida Statutes, the Florida Legislature concluded that “effective peer review of consumer complaints by professional associations of dentists is a valuable service to the public.” Unless the confidentiality of those proceedings is protected, no one will volunteer or participate in peer review. Therefore, Florida law states: 1. Information obtained from the official records of peer review organizations or committees shall not be subject to discovery or introduction into evidence in any disciplinary proceeding against a licensee. Further, no person who voluntarily serves on a peer review committee or who investigates a complaint for the committee shall be permitted or required to testify in any such disciplinary proceeding as to any evidence or other matters produced or presented during the proceedings. …

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2. Official records of peer review organizations or committees include correspondence between the dentist who is the subject of the complaint and the organization; correspondence between the complainant and the organization; diagnostic data, treatment plans and radiographs used by investigators or otherwise relied upon by the organization or committee; results of patient examinations; interviews; evaluation worksheets; recommendation worksheets; and peer review report forms.

Similar law applies to protect the doctor in civil litigation, as well as the peer review volunteers and participants. Thus, the peer review information is first, non-discoverable (meaning no one is obligated to produce records or answer questions as a witness) and second, nonadmissible (meaning even if the patient leaks the information, it cannot be admitted in as evidence of wrongdoing by the doctor). The answer is that no records generated by the peer review process can be used against the dentist in a subsequent malpractice lawsuit, even if the mediation/arbitration failed.

The FDA Peer Review Program is available only to member-dentists. Dentists working together make the Peer Review process work.

Mr. Nicol is the FDA’s Chief Legal Officer and a Board Certified Specialist in Health Law. This column first appeared in info@fda on Aug. 29, 2013.

Look for future articles on Peer Review in Mr. Nicol’s Legal Notes column in Today’s FDA.

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get to know dan zottoli your atlantic coast district insurance representative Armed with a degree in Risk Management/Insurance Having grown up in South Florida, Dan moved back to his hometown following his graduation from Florida State University in December 2005. Armed with a degree in Risk Management/Insurance from one of the most prestigious programs in the United States, Dan has been assisting members of the Florida Dental Association in the Atlantic Coast District since January 2006. Dan came to FDA Services with an extensive insurance background.

He has been licensed since he was 18 years old and has worked in the financial services sector since then, even while attending school full time. With more than 10 years of insurance experience, Dan is well versed in all lines of insurance coverage and is often able to help his clients save on their annual premiums.

Dan is married with one child and resides in Royal Palm Beach. In his spare time, he enjoys spending time with his family and friends and playing ice hockey.

Dan Zottoli • AtlAntic coAst District insurAnce representAtive 561.791.7744 • Cell: 561.601.5363 • dan.zottoli@fdaservices.com

Dan

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Letters to the Editor

Letters to the Editor

By Dr. Eli White

Everyone is familiar with the old saw about the ostrich with its head in the sand to avoid reality. Unfortunately, it seems as though a significant number of Florida dentists are assuming this position in regards to Florida’s Medicaid program. This is understandable, given that so few practitioners are Medicaid providers. But the reality is that changes are coming that are going to make what is happening with Medicaid much more relevant.

until July 2013. As a Medicaid provider in a group practice for more than seven years, I can testify that the change has been traumatic. These events are probably going to affect a significant number of Florida dentists even though they are not currently Medicaid providers and do not plan to become providers.

At present, Florida’s Medicaid is limited to children up to 21 years old. Until January 2012, the program was administered, with the exception of some areas, by the Florida Agency for Health Care Administration (AHCA). With urging

by Gov. Rick Scott, the state Legislature passed bills that turned the administration of dental Medicaid over to two private administrative entities. DentaQuest and MCNA Dental were selected without any input from organized dentistry.

In addition, there wasn’t any consultation concerning the contracts between these companies and the AHCA, or the contracts that they wrote forcing wouldbe participating providers to sign in order to treat Medicaid recipients.

The Affordable Care Act (ACA), also known as “Obamacare,” became effective on Oct. 1 as the Health Care Exchanges opened to enroll patients. These patients will then be eligible for treatment through the exchanges on Jan. 1, 2014.

Dental care is included in these exchanges in various ways. Some Qualified Health Plans (QHP) will include dental care as part of the medical plan with their Essential Health Benefits (EHB) including pediatric care, unless there is a stand-alone dental plan offered by the exchange. Outside of the exchanges (individual and small group markets) everyone — including families without children — must purchase a pediatric dental benefit! Dental coverage, both in and out of the exchanges, is being treated differently than before, and there is confusion that the regulators have yet to address. Dentistry will have two levels of benefits as opposed to medicine, which has three levels of benefits.

The resulting change in administration was such a fiasco that the state Legislature granted a “grace period,” allowing the AHCA to continue administration along with DentaQuest and MCNA

The regulations have yet to be announced, and although confusing, the effects on practicing dentists are potentially significant for three reasons. First, a large number of patients now being

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treated as private pay or co-pay patients will enroll in the exchanges. Second, one of the objectives of the ACA is to increase the number of Medicaid-eligible patients. Some states have already raised the eligibility to four times the federal poverty level. For a family of four, this means a combined income of approximately $96,000. I suggest that this would include a significant number of private pay or co-pay patients. I can assure you that treatment of these patients as Medicaid patients will be far different from the way you treat them now. Third, it is not clear what entities will administer the dental plans in the exchanges or stand-alone plans. It is clear that if it falls to DentaQuest or MCNA (and there is strong evidence that they want this business), they will surely use the current dental Medicaid administrative structure as a blueprint for expansion.

I’ve made a list of what I think are the current difficulties of treating patients under administration by DentaQuest and MCNA: 1. Make no mistake, their first objective is to control costs. They are under contract to pay the reimbursement rates that were established by Medicaid with some allowances for adjustment. We experience payment for a restoration on one side of an arch and denial of payment for the same tooth on the opposite side, even though the amount of decay appears on the X-ray to be the same. I have experienced denial of space maintenance

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Letters to the Editor

for children 4 years old, even though the molar does not normally erupt until age nine or 10. The reason given is that “eruption is expected soon.” There is frequent denial of nitrous oxide sedation for children with emotional and mental handicaps because the “administrator finds it unnecessary.” Of course, one can appeal the denial and resubmit the claim. This is very time-consuming and administratively expensive when reimbursement is frequently below cost.

2. Reimbursement obstacles are rampant.

Despite the contractual requirement that payments should be made within two weeks or 30 days from submission of a “clean claim,” our office frequently gets claims paid months after submission. “Lost” payments are reported by many providers. When payment is finally made, it can be embedded with other payments, making it very difficult for staff to track. In a fairly large, exclusively Medicaid practice such as the one I participate in, it takes staff hours to decipher what we have been paid for. The payment record printout frequently runs 30-60 single-spaced pages.

3. There is lack of communication with the administrators. Phone calls are frequently not returned, and when they are, it’s from someone without any knowledge of the problem. Being put on “hold” for indefinite periods of time is routine. Our office has been told both verbally and in writing certain responses to problems, only to discover that the answers are incorrect. Providers report to me that this is common; of course, both DentaQuest and MCNA deny that these problems even exist.

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4. There is a significant increase in documentation and other “paperwork” than what was experienced before the change in administration.

5. Perhaps most frustrating, is the lack of any effective appeal process in dispute.

A provider’s only recourse is to quit the program, which many have done.

I believe that organized dentistry, specifically the Florida Dental Association (FDA), needs to immediately become proactive in addressing these problems.

As stated before, the ACA is being implemented as rapidly as the current administration can move it, even though it is fraught with problems. I genuinely believe, based on experience with the current Medicaid program, that the dental practice as we know it, will be irreversibly altered to the detriment of our patients and our profession unless we act quickly and as a united profession.

I suggest that the FDA immediately embark on an aggressive legislative program to attempt to correct some of the current Medicaid problems. We need an “official” ombudsman, or hopefully a legally-recognized committee, to represent dentistry in negotiating contracts between the state and these administrative entities, and to represent dentistry in the negotiation of contracts with providers. We need an appeal process for disputes between the administrators and providers.

unified request for action. This needs to involve more members than the contact dentists. The FDA needs to provide all members with an educational document for the dentist and “talking points” for the dentists to use when meeting with their representatives. To have this happen, the FDA needs to make this a primary project. Otherwise, we will remain in the ostrich position.

The FDA supports HB 27, which will keep dental coverage from being embedded into the medical plans as the state transitions to statewide managed care. We continue to work with both MCNA and DentaQuest to address the issues of our members and to make this system work as best it can for both the providers and the children of Florida. If you are experiencing problems with either MCNA or DentaQuest, please contact Casey Stoutamire at the FDA’s Governmental Affairs office at 850.224.1089.

Dr. White is a pediatric dentist and had two offices located in Merritt Island and Titusville. He retired from active practice in 2000, but joined a practice in Palm Bay on a part-time basis in 2005. He was appointed as the Public Policy Advocate for the Florida Academy of Pediatric Dentistry in 2012. He can be reached at DRELIJR@ aol.com.

This can only happen with legislative action. To get that action, the FDA needs to motivate its members to visit with their state legislators and present a

November/December 2013

Please see letters, 69

Today's FDA

67

Letters to the Editor

letters from 67

By Dr. Harry Geiger

Dr. Harry Geiger is a retired orthodontist in Jacksonville.

In the September/October issue of Today’s FDA, the article, “Your Team’s Personal Appearance” by Fred Heppner summarizes a topic that I feel should be closely observed by dental professionals. Dr. Laurance Jerrold has a monthly column, “Litigation and Legislation,” in the American Journal of Orthodontics and Dental Orthopedics. In his August article, “With This Ring,” he stated that a written protocol should be made available to all current and future employees as to what you, as an employer, expect from their appearance, behavior and conduct. Perhaps Today’s FDA could do an abstract on Dr. Jerrold’s article for our members.

Editor’s note: Views and conclusions expressed in all editorials, commentaries, columns or articles are those of the authors and not necessarily those of the editors, staff, officials, Board of Trustees or members of the Florida Dental Association. For full editorial policies, see page 2.

www.floridadental.org

All editorials may be edited due to style and space limitations.

Letters to the editor must be on topics and a maximum of 500 words. Submissions must not create a personal attack on any individual. All letters are subject to editorial control. The editorial board reserves the right to limit the number of submissions by an individual.

November/December 2013

Today's FDA

69

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MiAMi Winter Meeting

Feb. 21-22, 2014 • Jungle Island, Miami Speaker: Dr. Jose-Luis Ruiz www.sfdda.org • 305.667.3647 • sfdda@sfdda.org

nWDDA AnnuAl Meeting

Feb. 21-22, 2014 • The Grand at Sandestin Resort Speakers: Dr. Alex Fleury – New Dimensions in Endodontics; Dr. Joe Steven Jr. – Efficient Dentistry www.nwdda.org • 850.391.9310 • nwdda@nwdda.org

ACDDA Winter Meeting

FRIday, FeB. 28, 2014 embassy Suites, West Palm Beach Speakers: Rita Zamora & Dr. Michael Ragan – Marketing Your Dental Practice with Facebook & Social Media www.acdda.org • 561.968.7714 • acdda@aol.com

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FRIday, MaRcH 14, 2014 Weston Lake Mary Orlando north Continuing Education Session with Dr. John Burgess www.cfdda.org • 407.898.3481 lindaannelowell@gmail.com

neDDA/JDS/CCDS Continuing eDuCAtion Friday, March 21, 2014 • location TBd Hot Topics in Aesthetic and Restorative Dentistry with David S. Hornbrook, DDS, FAACD www.nedda.org • 904.737.7545 • ddeville@nedda.org

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72

Today's FDA

November/December 2013

www.floridadental.org

Opportunities

C lassified a dvertising

FLORIDA — A blockbuster opportunity. Full or part time for General Dentists, Endodontists, Orthodontists, Pedodontists, Periodontists, and Oral Surgeons. Generous compensation with unlimited potential. Guaranteed referrals. Join our group specialty care practice with a significant general

The FDA’s online classified system allows you

dental component. Established in 1975 in Aventura, Coral

to place, modify and pay for your ads online,

Melbourne. Call: Dr. Feingold at 561.665.0991. Email:

24-hours a day. Our intent is to provide our advertisers with increased flexibility and enhanced

Springs, Delray Beach, Boynton Beach, Stuart, Ft. Pierce and drfeingold@dentaland.net.

Implants and Periodontal Services. Periodontist looking for 1 day per week (Thursday) to place implants and perform

options to personalize and draw attention to

periodontal services in fee for service office. Ft. Lauderdale

your online classified ads!

perioddsmsd@gmail.com.

area or Palm Beach to Jupiter area. Please email implant.

Dentist/subspecialist on large “one stop shop” medical

The FDA online classified ad model is for “paid

campus. Looking for dentist and/or dental subspecialist to come aboard our $15,000,000 (3,000 patients/week flow

online advertising.” Effectively, the advertising

thru campus) “one stop shop” medical campus in Sarasota

rate you pay will entitle you to online classified

arts/culture in U.S. Surf to universityhealthpark.net. Call Don

ads with increased exposure. As an added benefit, we will continue to publish the “basic text” format of paid, online classified ads in our bimonthly printed journal, Today’s FDA, at no

Florida. Sarasota ranked #1 beach and #1 mid-size city for Harvey, MD at 941.724.3259.

Temporary/Fill-In Dentist. Solo Private Practice for 20+ years (sold 2009). Exiting Active Duty Military soon. Licensed FL, AL, GA. Phone: 770.656.5269, email: drglassdmd@yahoo. com.

Disability Insurance Attorney. What will you do if your

additional cost to you. All ads posted to the

disability insurance company denies your claim? When your

online classified system will be published during

alone. Disability Insurance Law Group represents dentists

the contracted time frame for which you have

insurance company has a team of attorneys representing its

posted your online classified advertisement.

financial security is at risk, the stakes are too high to go it at all stages of the disability insurance claims process. Your interests, shouldn't you? Contact us for a free consultation at 888.644.2644, info@dilawgroup.com, or www.dilawgroup. com.

Our magazine is published bimonthly, and

ANNOUNCING: Airway Management/Medical Emergency

therefore, all ads currently online will be

of 4 hours of continuing education in managing medical

extracted from the system on roughly the

Course - Tampa, FL. This 8 hour combined program consists emergencies and 4 hours of continuing education in airway management. The 4 hours in airway management includes

following dates of each year: Jan. 15, March 15,

2 hours of training in providing dentistry on sedated patients

May 15, July 15, Sept. 15, Nov. 15. The ads ex-

in airway management of sedated patients. Program is being

tracted at this time will then be published in the

new Florida Board of Dentistry Regulations for Sedation

following month’s issue of Today’s FDA.

with compromised airway and 2 hours of hands-on training presented by an anesthesiologist. This program meets the Permit Renewals Chapter 64B5-14.004 (6). randy@ sedationconsulting.com.

A GREAT OPPOTUNITY IN TAMPA BAY AREA. Assoc.

Please view the classified advertising portion

General Dentist desired by group practice w/ofcs in

of our website at http://www.floridadental.biz/.

wks pd vacation, 8 pd holidays & health ins., C.E. expense.

Clearwater, New Port Richey & Spring Hill. $160K-$200K, 3 No capitation. FAX RESUME TO 727.446.3359 or CALL 727.446.3259.

FINE OPPORTUNITY. Gen. Dentist who enjoys treating children for group practice w/ofcs. in Clearwater, New Port Richey & Spring Hill. $160K - $200K + bonuses, 3 wks pd vacation, 8 pd holidays & health ins. FAX resume to 727.785.8485 or CALL 727.446.3259.

74 Today's FDA November/December 2013

www.floridadental.org

Wonderful Opportunities. Opportunities with a growing

Orthodontist. We are seeking an energetic, team-oriented

Oral Surgeon Wanted (FL IV Sedation Permit Preferred). Oral

company. Full time with Benefits-Health, Life, Vacation and

Orthodontist who enjoys their profession and who will

Surgeon needed for a sprawling, mature, multi-specialty

Holiday, 200 Hours of CE, 401K. State of the Art Practices

work side by side with us to expand this specialty in our

private practice along NW Florida's Emerald Coast - Santa

and well trained team. These opportunities are throughout

practice in this long term opportunity. Our culture includes

Rosa Beach, Crestview, Pensacola. Florida Permit in IV

Florida. Please contact 904.545.6789 or 317.560.0901,

modern technology and a deep focus on our patients.

Sedation preferred, or willing to certify. Three to 4 days

email: cstarnes@heartlanddentalcare.com or sasmith@

Degree from an accredited U.S. Dental School, Orthodontic

per month needed. Schedule built around your travel and

heartlanddentalcare.com.

Residency completion, 3 years of experience. APPLY:

availability. Generous Terms. Send CV and/or inquiries to

https://audiologyjobs-audigygroup.icims.com/jobs/2307/

legacysolutions4biz@gmail.com.

Need an Associate? Need a job? There’s no fee for finding you a job! Call Doctors Choice Companies. Sandy Harris 561.744.2783 sandy@doctorschoice1.net.

Dynamic Dental Health Associates, a new private fee-for service group, is growing and expanding statewide in particular Jacksonville, Orlando, St. Petersburg, Sarasota, Port Charlotte and Fort Myers. Top Compensation, daily guarantee, health insurance, modern facilities with latest technology, great patient flow, no administrative headaches and professional mgmt. We also buy dental practices and create exit/transition strategies for solo and group practices.

orthodontist/job.

General Dentist Opportunity. Are you looking for a new

PEDODONTIST. We are seeking an energetic, team-

opportunity in Alabama? CSHM LLC is the practice

oriented Pedodontist who enjoys their profession and who

management company of 60 dental centers across 19

will work side by side with us to expand this specialty in our

states and D.C. Our mission is to ensure access to quality,

practice in this long term opportunity. Our culture includes

professional dental care for low-income, underserved families

modern technology and a deep focus on our patients.

and those seeking comprehensive care. If you would like to

Degree from an accredited U.S. Dental School, Pediatric

be part of a great team contact Joanna Lea at jlea@cshm.

Dentist Residency completion, 3 years of experience. APPLY:

com.

https://audiologyjobs-audigygroup.icims.com/jobs/2308/ pedodontist/job.

RUSSIAN speaking dentist. High-end multidisciplinary team seeking a motivated fluent RUSSIAN SPEAKING associate.

Please email Dr. Alex Giannini agiannini@ddpgroups.com

Dentist. Neighborhood practice in the Treasure Coast with

The center is located in an upscale area near Aventura. The

OR if interested in a Dentist position please email CV to

a full-time Associate Dentist position available. Clinical

practice recently underwent a modern and technological

careers@ddpgroups.com (or call 941.312.7838).

freedom and autonomy enjoyed in a traditional private

renovation. Our team coordinates and provides continuing

practice without the additional financial or administrative

education courses i.e. Invisalign, dental implants, cosmetics,

burdens associated with practice management. Unlimited

sedation, and prosth. We employ a wonderful and highly

production based earnings, a solid benefits package, a stable

trained staff that focuses on providing high quality care in

patient base, training opportunities, and long-term practice or

a state of the art environment. We will provide the practice

regional career growth. Please fax resume to 770.242.3251.

support needed for your success. Partnership opportunities

ASSOCIATE GENERAL DENTIST POSITION AVAILABLE: Our practice is a long-established private practice in the St. Augustine Beach, Florida area. We have a great team of professionals, a friendly patient base, a positive working environment and are in network with many PPO dental plans.

are available. Please email CV to Howard Corbeau at

If you are a general dentist with at least 4 years of experience

We are seeking a team-oriented Pedodontist and an

and are looking for an associate position in a time-honored

Orthodontist for Private practice in Miami with many active

private practice, we encourage you to apply. Submit your

patients. sheila@prodentgroup.com.

CV/Resume and contact information to morsedds@bellsouth. net or fax to 904.471.5240.

howardcorbeau@gmail.com: or fax to 888.800.4955.

General Dentist Needed, Boca Raton. If you love dentistry,

Endodontist. Neighborhood practice in Tampa Bay with a part-time Endodontist position available. Clinical freedom

have excellent chair-side and communication skills, and want to surround yourself with talented staff, we invite you to join our busy, state-of-the-art, paperless, practice. Part time or

Dentist Opportunities. Dental Partners is one of the fastest

and autonomy enjoyed in a traditional private practice

growing family dental practice groups in the Southeast. We

without the additional financial or administrative burdens

give you the ability to focus on patient care while earning

associated with practice management. Unlimited production

a base of $125K-$200K and the opportunity to earn more

based earnings, a solid benefits package, a stable patient

based on production. Benefits package of medical/vision/

base, training opportunities, and long-term practice or

Part-time Associateship Leading to Buy-In. Pediatric dental

life/FSA, 401K, professional liability and yearly CE allowance.

regional career growth. Please fax resume to 770.242.3251.

associate wanted initially on a part-time basis for a 25 year-

Relocation and student loan repayment assistance program may be available. Email resume to areimiller@dentalpartners.com or call Ashley Reimiller, Director of People Development 321.574.8003.

ASSOCIATE DENTIST NEEDED. Full time General Dentist needed for a 100% fee for service private practice on the beautiful space coast in Rockledge, FL (just south of Cocoa Beach and Merritt Island & minutes from Melbourne, Viera

full time. Compensation: $600/day minimum, depending on qualifications, plus high percentage of collections. Call 954.703.9309 or email smilesofboca@aol.com.

old Pediatric Dental practice located in Boca Raton. Excellent opportunity for the right candidate willing to commit to a long-term permanent relationship that includes an eventual buy-in of 50% of the practice. Interested parties should fax resumes to 561.483.5899 or call 561.289.5105.

Associate Needed for Boca Raton Office. Busy family and

& Satellite Beach). Our modern, state-of-the-art practice

cosmetic office in Boca Raton seeks outstanding dentist

is located in a free standing building, is digital, paperless

Florida - Orlando/Daytona/Jacksonville/Tampa/S. Fla.

with a gentle demeanor and touch. Must be excellent in

& equipped with televisions in all ops. The ideal candidate

Associateship not working? Not enough patients? Expanding

molar endo and surgical extractions. Great restorative and

must be capable of both simple and surgical extractions,

group practice with 42 offices and 10 new locations opening

cosmetic skills are also required. If you have a friendly and

molar endo and be proficient in all other areas of general

this year. Top salaries. Training and mentoring for new/

positive attitude then this is the office for you! We truly care

dentistry. Compensation is $500.00 a day guarantee or 35%

recent graduates. Both General Dentists and all Specialists

for our patients and do only high quality dentistry. Please

of production. You will be joining a well-trained, experienced,

needed. Fully digital offices. Call Dr. Andrew Greenberg

email resume to eastbocadentist@gmail.com.

highly motivated team. Please e-mail your CV and contact

407.772.5120 (confidential, fax CV to 407.786.8763), visit

info to 2001molardoc@gmail.com. All inquiries will be

www.greenbergdental.com or e-mail to andy@katsur.com.

PT Professor in Pediatric Dentistry at the UF Dental Center AEGD Hialeah. The University of Florida College of Dentistry

strictly confidential. We look forward to hearing from you.

is recruiting a part-time Professor in Pediatric Dentistry at

Endodontist-Christie Dental Established Group Practice.

the University of Florida Dental Center AEGD Hialeah.

Christie Dental is a multi-specialty dental group with

Responsibilities include graduate level didactic, pre-clinical

approximately 55 dentists and specialty doctors in 24 practice

and clinical instruction. Minimum requirements: DDS, DMD

locations in the Brevard, Ocala and Orlando, Florida

or equivalent and advanced training in pediatric dentistry.

markets. Christie Dental offers individuals and families a

Apply at https://jobs.ufl.edu, search for requisition number

full range of dental care, including general dentistry, hygiene

T1161 or visit www.dental.ufl.edu for more information.

and specialty care, such as pedodontics, oral surgery, endodontics, orthodontics and periodontics. kateanderson@ amdpi.com.

Orthodontist. We are seeking a part-time orthodontist for our practice in Pinecrest, FL. kmiro67@aol.com.

Dental Care Alliance is a group dental practice that was established in 1991 to provide comprehensive dental care to patients in 8 States. All DCA offices pride themselves on satisfying patient needs, providing high quality general and specialty dental services, and offering patient comfort that is second to none. DCA believes in providing a positive professional experience so that your goals can be achieved.

Please see classifieds, 76

www.floridadental.org

November/December 2013

Today's FDA

75

Your Classified Ad Reaches 7,000 Readers! classifieds from 75 Outstanding Associate Opportunity for an experienced General Dentist to join one of our highly successful affiliated practices in Ocala. Strong commitment to long-term dental

3-4 Days FFS office. South Central FL practice, 45 min

Seminole County FL (Sanford). Good opportunity to take

from Wellington, 1hr from Plantation, non-East coast feel.

over thriving practice of 38 years with good patient flow.

Amazing staff and patients. Great opportunity for Good Doc.

Doctor retiring. Building and practice separate, but both

Must do: Molar RCT, Dentures and extractions. Well above

available. Gross income 5-600k. Listed for 330k. Three ops.

average take home. kurthausy@hotmail.com.

Contact Dr. Roger Stewart, DMD 407.323.5340.

care for the whole family. Be chair side and make money

Brickell, Miami Dental Office for SALE. A professional

from day one. Highly trained and dedicated staff to support

For Sale/Lease

you. No Day-to-Day headaches of Managing a Practice.

Guaranteed base salary, with additional performance incentives based on production. dreelsj@dentalcarealliance.

FOR SALE: Carestream Health, Inc. Kodak 9000 C Pan/

com.

Ceph. Machine is 3D capable. Manufacture date: March

Oral Surgeon. Oral Surgeon needed for busy Margate

2009. $40K OBO. CALL TODAY! 863.382.9090.

dental practice. One day per week (Fridays Preferred),

Turnkey Office - Furnished and Equipped. Turnkey office

very experienced support staff, computerized, digital X-rays,

with beautiful furnishings, high-end finishes and modern

Friendly work environment call 954.973.0990.

equipment...all included in the price. Great area and the

General Dentist Position - Needed ASAP!! Great Income Opportunity! Dental Associate needed ASAP. F/T preferred, but will definitely consider P/T for the right person! This practice provides implants and general dental care for residents of The Villages, the fastest growing small town in

busiest road in SWFL. Fitted for 6 operatories, 1 of which is fully equipped with chair and supporting equipment. Lab, Data Vacuum all in place. Move in to an existing practice with 3-4 days’ worth of appointments. Seller Financing/Lease also negotiable. info@adampalmer.net.

dentist’s DREAM PRACTICE! With perpetual growth of the downtown Miami area, this 1,600 sq. ft., storefront layout has 20 ft. ceilings and packs exponential profitability potential.

This turn-key, ultra-modern practice is a masterpiece of design with the patient’s experience as its number 1 focus.

Whether this is your first practice, or second, you honestly cannot miss with this opportunity (4 ops, capable of 5). tbecher2@gmail.com.

Family Practice. Bradenton, Look no further, 20 year general practice, 6 ops, owner retiring. Busy thoroughfare, loyal staff to remain. Recently redecorated. Gross from $500,000 per year. Call 941.400.4855.

LARGE PRACTICE OWNERS. If you have possible interest in selling your practice for big money, please call me personally.

America (and surrounding area of Summerfield). You can

Dental Office Space for Rent. Dental space to share in our

focus on practicing high-quality dentistry and directing a

beautiful modern Tamarac location, ideal for general dentist

well-trained clinical team. As an associate, you’ll examine,

or specialist. Our office is equipped with the latest dental

diagnose, and provide treatment counseling to patients in a

technologies including digital x-rays and panorex, 3D cone

comprehensive manner. The office has a fantastic opportunity

beam CT scanner, denture lab with full-time technician

Sarasota, FL - The #1 Beach Destination in the USA!

for you to do a substantial amount of production. You’ll

on premises, computers and televisions in operatories

Established 30 year old practice with $302,000 Gross and

soon be on your way to running an effective dental practice!

and many other amenities. If interested please contact:

95% collection rate. Solid 3 day hygiene program with 1200

Our perfect associate would have at least 3 years of clinical

Tamaracdentalspace@gmail.com.

active patients. Loyal and excellent hygienist and front desk

experience and provide oral surgery skills, ability to perform endodontics and currently able to place implants or willing to learn ASAP! Requirements: Must be a DDS or DMD from an accredited school Licensed to practice in Florida. PLEASE

Key West, FL Dental Practice. Florida, Key West - Live and practice dentistry in paradise! Well-established, four-operatory dental practice with 1,850-square-foot, stand-alone building

(We work with both individual and corporate buyers statewide) Let’s talk! Kenny Jones 561.746.2102. www. doctorschoice1.net.

secretary. 1100 sq. ft. business condo unit also for sale.

Owner retiring. Contact Dr. Rotole at: rotoleswimsgood@ verizon.net or 941.256.6903.

for sale. Great office layout, high quality staff, room for

Practice Sale: Pembroke Pines, FL - 12 y/o practice in high

oceanali@live.com.

growth. Great opportunity! Call 305.394.2874 for details.

traff area. Beautiful w/ ample prking. Equipped w/ latest tech

I am looking for a part-time orthodontist to work in my

Naples FL Dental Practice For Sale On Best Offer.

SEND YOUR INFORMATION FOR CONSIDERATION

- Dentrix, digital intraoral & pano radiography & lasers. 8 days of hygiene. 35 new pts/mnth. Rev. $1.3M. Call Michael

Hialeah office. santoyo_d@ymail.com.

$89,000.00 (NEGOTIABLE) LIMITED TIME. ABSOLUTELY

ALABAMA - Associate Dentist. ALABAMA-General Dentist.

MOST EXCLUSIVE HIGH-END AREA IN NAPLES. View website

Cumberland Dental, a successful growing practice with clinics

for more details. www.NaplesFloridaDentalPracticeForSale.

Practice Sale- Central Florida Medicaid Based Pedo Practice.

conveniently located in Birmingham, Tuscaloosa, Oxford

com. Email: NaplesFloridaDental@yahoo.com.

9 Operatories in 3,800 SF Office. Owner Retiring! Gross

and Gadsden, AL, is looking for full and part-time General Dentists to join our team. We offer a generous compensation and benefit package, including malpractice, medical, life and disability benefits, and participation in a 401K with employer match Future ownership is a possibility for interested and qualified individuals. Actively seeking a Part-Time Associate Dentist to work Monday & Tuesday in our Gadsden, AL office.

Please contact Bonnie Kumar at 617.538.7380 or bkumar@ amdpi.com.

General Dentist position. 16 year Established Private Practice (1997). Full time or part time. Benefits for full time. Very busy practice. Prime location. Great opportunity for the right person. Experienced only (5years min). All phases of

REDUCED PRICE FOR IMMEDIATE SALE. 3 OPS, IN THE

West Coast Dental Practice. Collections in 2012 of 647,00.00. 5 operatories with computer monitors. Dexis;

Finnan at 561.722.0787 or Michael.Finnan@henryschein. com.

Rev. $1.2M+. Contact Michael Finnan at 561.722.0787 or michael.finnan@henryschein.com.

Dentrix. Incredible staff! 1600 sq. ft. building with 2013,

Practice Sale - Small General practice in nice professional

newly installed roof and 2 AC units also FOR SALE. View

building on US1 central Pompano. Great potential as a

practice details and photos on www.dentaldirect.com.

“startup” practice! Gross Rev. $160K. Contact Michael

Contact: Nancy Perron @ 941.224.9124 or nmpdental@

Finnan at 561.722.0787 or michael.finnan@henryschein.

gmail.com.

com.

Buyers and Sellers: We have over 100 Florida dental practice

Practice Sale - Brandon, FL - 6 Ops-Beautiful Reception Area-

opportunities, and the perfect buyer for your practice.

Lots of Space. Top-rated area schools. Parks - Ideal place to

Call Doctor’s Choice Companies today! Kenny Jones at

live, work & raise family. Easy access to Tampa and Orlando.

561.746.2102, or info@doctorschoice1.net. Website:

Driving distance of Gulf beaches. Gross Rev $624K. Call

doctorschoice1.net.

Michael Finnan at 561.722.0787 OR michael.finnan@

General Dentistry (High Prosthodontics). Over $350k+

henryschein.com.

earning potential based on 4 days/ week. The Villages. Call 321.945.9545 or fax resume: 407.302.9799.

76

Today's FDA

November/December 2013

www.floridadental.org

W. DAVID GRIGGS, D.D.S., Inc.

THE TRANSITION GROUP

Practice Sale / Associate Buy-In / Mergers Practice Appraisals / Transition Planning “I cannot remember a time when I had so much fun with any business dealings as you made this transition. “Thank you” is not nearly enough gratitude for the job you have done, and you made my life easier throughout this entire process. From the moment that I met you, to the present time, I have felt that you had my best interest at heart while keeping an honest concern for the buying doctor as well.” ­

— Dr. David McDonald – Oral & Maxillofacial Surgeon Tampa, FL

Visit Our Website for Practice Opportunities 30 Years Experience Over 2,000 Transitions Author of National Best-Seller: “Successful Practice Transitions” 105 Harrison Avenue Belleair Beach, Florida 33786 Phone: 727.593.5852 Fax: 727.593.9937 E-mail: clientservices@thetransitiongroup.com www.griggspracticetransitions.com www.floridadental.org

Griggs Practice Transitions, LLC - Licensed Real Estate Broker November/December 2013

Today's FDA

77

Support the Companies FNDC Exhibitors

That Support Organized Dentistry 3M ESPE

These exhibitors have made the commitment to attend the Florida National Dental Convention (FNDC).

Not only do these companies exhibit the latest in technology, materials and equipment, but many sponsor events and continuing education programs at the FNDC. Take a minute to see if your supplier is on the list. Make an effort to stop by their booth in the Exhibit Hall in June for show specials. Please support those entities that help make the FNDC a rewarding member benefit.

FDA Services Inc is a major sponsor of the Florida National Dental Convention.

A A-dec A. Titan Instruments Accutron Inc. ACTEON North America ADS Florida LLC Advantage Technologies Advantica AFTCO Air Techniques Inc. AMD Lasers, A DENTSPLY International Company Angie’s List Aseptico Inc. Aspen Dental Atlanta Dental Supply Atlantic Dental Sales Inc. / Brewer Design

B Bank of America Practice Solutions Bankers Healthcare Group Bayshore Dental Studio Belmont Equipment Corporation Benco Dental Bien Air Dental Bioclear Matrix System by Dr. David Clark BIOLASE Bisco Dental Products BQ Ergonomics Brasseler USA Bright Now! Dental/Smile Brands Inc.

C CareCredit Carestream Dental Centrix Inc. CliniPix Inc. Coast Dental P.A. Colgate Coltene Crest Oral-B CUTCO Cutlery

FNDC Exhibitors D Darby Dental Supply LLC Demandforce Inc. Dental Care Alliance Dental Equipment Liquidators Inc. Dental Sleep Solutions Dental USA Inc. DentalEZ Group DentalVibe DentaQuest of Florida Inc. DENTCA Inc. DENTSPLY Caulk DENTSPLY International DENTSPLY Maillefer DENTSPLY Professional DENTSPLY Raintree Essix Glenroe DENTSPLY Rinn DENTSPLY Tulsa Dental Specialties Designs For Vision Inc. DEXIS Digital X-Ray Digital Doc LLC Doctor’s Choice Companies Inc. Doral Refining Corporation DoWell Dental Products

E ELAVON Essential Dental Systems

F Florida Combined Life Florida Dental Association Services Florida Prosthodontic Association Forest Dental Products Inc.

G Garfield Refining Company Garrison Dental Solutions GC America Inc. Gendex Dental Systems Gentle Dental GlaxoSmithKline

H H2OCEAN Inc. Hager Worldwide Hawaiian Moon Healthcare Professional Funding Heartland Dental Henry Schein Dental Henry Schein Practice Management Solutions Heraeus Kulzer www.floridadental.org

Home Study Solutions Hu-Friedy Manufacturing Co. LLC

R RGP Inc. Rose Micro Solutions Royal Dental Group & Porter Instrument Co.

I ICW International Implant Educators Inada Massage Chairs Instrumentarium/Soredex Insurance Credentialing Specialist

S

K KaVo Kenwood/CGX Radios Kerr Corporation Kettenbach LP Knotty Floss LLC Kuraray America Inc.

L Lares Research Lasers4Dentistry/Technology4Medicine Lexicomp LumaDent Inc.

M Magic Massage Therapy MCNA Dental Plans Medidenta International Meisinger USA LLC Microcopy Midmark Corporation Milestone Scientific Modular & Custom Cabinets

N Nobel Biocare NSK Dental LLC

O OCO Biomedical Office Depot Officite Onpharma Inc. Orascoptic

P Patterson Dental Pelton & Crane Planmeca USA Inc. PNC Bank Premier Dental Products Company Professional Sales Associates Inc. Propel Orthodontics Prophy Perfect Pulpdent Corporation

Schumacher Dental Instruments SciCan Inc. Scientific Metals SDI (North America) Inc. Shamrock Dental Co. Inc. Sharper Practice Shofu Dental Corporation Sirona Dental Smile Reminder Specialty Appliances Orthodontic Laboratory Sun Dental Labs Sunrise Dental Equipment Sunset Dental Lab Superior Dental Design Services & Upholstery Co. SurgiTel/General Scientific Corp

T TD Bank The Doctors Company Tokuyama Dental America Inc.

U Ultradent Products Inc. Ultralight Optics U.S. Army Healthcare Recruiting U.S. Navy Reruiting Command

V Vitamix VOCO America Inc.

W Wells Fargo Practice Finance

XYZ Xlear/Spry Yodle Zimmer Dental

Blue indicates a Member of the FDA Corporate Affiliation Program

November/December 2013

Today's FDA

79

OFF the cusp John Paul, dmd, Editor

A Letter From Santa It’s the month that holds Christmas and dental Santa is hustlin’ Sure, there’s weeks left, but his to-do list is busting.

He started his beard early so there’d be time to spare A lot of it’s white, he’s just glad he’s got hair.

Can’t forget to make time for the family at home.

It seems like on weekends that I’m always gone.

If you ask my dear daughter where I am, she will tell, “Daddy’s gone to meetings, he’s at the hotel.”

The elves up in D.C. made out their long list — We’ll make your life better, but there’s one little twist, Just print out these forms and pass them around.

Have everyone read them and jot their names down And keep them forever in a triple-lock box ‘cause if one gets loose, we will fine you for all that you’ve got.

So at least one week of my plan will go something like this I’ll pack up my handpiece and go get a kiss — More like slobber from the daughter who’s still wearing onesies And a hug from the wife, and then just for funsies, The older princess and I will head out to the swing.

She won’t be six forever and I can’t miss a thing.

We won a few fights, most of the water has fluoride.

But, there’s no resting on laurels, we won’t get the free ride — Noncovered services, sovereign immunity, the Medicaid rate, thank goodness our team’s working hard up at state.

Here’s one last toast as I pack up my sled, Merry Christmas to you all and brush your teeth before bed!

And though charity is no answer to the state’s safety net Our MOM event will be great, that’s a very safe bet.

We’re not done with it yet, there’s a lot more to do — Gathering volunteers, many people like… you.

80

Today's FDA

November/December 2013

Dr. Paul is the editor of Today's FDA. He can be reached at jpdentz@aol.com.

www.floridadental.org

Any projected balance amounts or other projections shown herein are for illustrative purposes only.

“Qualified members” refers to members who have met the five-year continuous coverage requirement.

800.877.7597 • insurance@fdaservices.com • www.fdaservices.com