HOLIDAY ISSUE 2012 VOL. 45, NO. 2
You and your patients both have a lot invested in their smile. DSG’s proprietary Brux-eze® and Rem-e-deze® splints protect your patients’ restorations, and your bottom line. Restorations enhance your patients’ smile to the world, and represent an investment of their time and money. For you, their smile is a reflection of your time and expertise. It’s worth protecting. DSG’s years of expertise have produced a range of occlusal splints tailored to the needs of light, moderate or severe bruxism. • Offers protection for crowns, bridges, cosmetics, and natural dentition • Made from heat-cured thermoplastic material making it easy for patients to fit and difficult to break • Can be softened in warm water for easier seating • Rem-e-deze includes a hard occlusal surface for heavy bruxers and clenchers Excellent fit and high comfort of DSG’s exclusive splints results in high patient compliance, and less chair time. And, as always, DSG stands behind its products, giving you and your patients peace of mind.
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Dr. Jeff Smith
Dr. Seth Vruggink Dr. Derek Draft Dr. Aric Smith Dr. Brian Licari
President’s Message...................................................................................................... 2 Editor’s Thoughts......................................................................................................... 4
Advertising Editor Elaine Fleming Executive Secretary WMDDS 511-F Waters Building Grand Rapids, MI 49503 (616) 234-5605 email@example.com
The Adult Dental Services Program............................................................................ 5
West Michigan District Dental Society Executive Board 2012-2013 President Dr. Tyler Wolf President-Elect Dr. Margaret Gingrich Vice President Dr. Samuel Bander Secretary-Treasurer Dr. Kathleen Ellsworth Editor Dr. Jeff Smith Immediate Past Dr. Larissa Bishop President Directors Dr. Steve Conlon Dr. Leonard Bartoszewicz Dr. Brian Mulder Area Representatives Kent County Dr. Michael Palaszek Ionia-Montcalm Dr. John O’Donald County Mecosta County Dr. Erick Perroud Ottawa County Dr. Meredith Smedley
Learning About Good Oral Health..............................................................................10
MDA IV District Trustees
Dr. Brian Cilla Dr. Colette Smiley
Big Rapids Dental Study Club Officers President Dr. Erick Perroud Vice President Dr. Christa Stern Secretary Dr. Christa Stern Treasurer Dr. Erick Perroud Holland-Zeeland Dental Society Officers President Dr. Meredith Smedley Treasurer Dr. Robert Ankerman Secretary Immediate Past President Ionia-Montcalm Dental Study Club Officers President Treasurer Dr. Kirkwood Faber Kent County Dental Society Officers President Dr. Norman Wilhelmsen Vice President Dr. Michael Palaszek Secretary Dr. Kathryn Swan Treasurer Dr. James Papp West Michigan Dental Foundation Officers President Dr. John Marshall Vice President Mrs. Wendy Mc Ginnis Secretary Mrs. Carol Klein Treasurer Mr. Joe Van Laan The Bulletin of the West Michigan Dental Society is published six times a year (the winter issue, spring issue, summer issue, directory issue, fall issue, and holiday issue). The opinions expressed in The Bulletin are not necessarily the opinions of the West Michigan District Dental Society. Contributions to The Bulletin are welcome and should be addressed to The Bulletin Editor, 3050 Ivanrest SW, Suite B, Grandville, MI 49418. Requests for purchase of advertising space should be directed to the Advertising Editor, Elaine Fleming, (616) 234-5605. The deadline is the 1st of the month prior to publication. © 2012-2013 West Michigan District Dental Society Bulletin
Trustee Report.............................................................................................................. 6 Healthy Oral Health Habits for Seniors........................................................................9
Planning for the End of the Bush Era Tax Cuts.........................................................12 WMDF Announces 2012 Community Awards – $21,450.........................................18 Best of Tech 2012..........................................................................................................22 2012 Directory Corrections & Additions....................................................................23 Obamacare – What Is It All About?............................................................................24 Classified Ads................................................................................................................26 Advertiser Index............................................................................................................27 The Buying and Selling of a Business – Part Two......................................................28
About the Cover Griff checks out the sugar content of Red Bull. For more details, please refer to the article on page 10.
Mission Statement The Bulletin is the newsletter of the WMDDS and its mission is to inform the membership of upcoming and recent events, state & local issues related to dentistry, and as a forum for its officers, representatives, and members to discuss appropriate topics of interest to the membership. Communication & Advertising Policy The Bulletin will publish submitted articles from members and others that relate to the practice of dentistry, small business, social, or political issues affecting dentists, or other subjects of interest to the membership. All published items are subject to space restrictions and the community standards of the WMDDS. The editors reserve the right to reject any article or advertisement deemed inappropriate and to edit submissions as they see fit. Submission & Publication Policy: Articles and advertisements must be submitted no later than the 1st of the month preceding p ublication date. The Bulletin has six publications: the winter issue, spring issue, summer issue, directory issue, fall issue, holiday issue. Direct submissions or c orrespondences to:
WEST MICHIGAN DISTRICT DENTAL SOCIETY | HOLIDAY ISSUE 2012
Dr. Jeffrey S. Smith • 3050 Ivanrest SW, Suite B • Grandville, MI 49418 Phone: 616.531.1554 FAX 616.531.6947 • Email: firstname.lastname@example.org Include “Newsletter” in the subject line
If We Can’t Laugh at Ourselves … By Tyler A. Wolf, DDS, WMDDS President Dentist: “I have to pull the aching tooth, but don’t worry, it will take just five minutes.” Patient: “And how much will it cost?” Dentist: “It’s $90.” Patient: “$90 for just a few minutes work???” Dentist: “I can extract it very slowly if you like.”
Boss: “I thought, Miss Smith, that you wanted yesterday afternoon off because you were seeing your dentist?” Miss Smith: “That’s right, sir.” Boss: “So how come I saw you coming out of the movie theater with a friend?” Miss Smith: “That was my dentist.”
n a more relaxed departure from my last two articles, here’s a little cheese to enjoy with your best holiday wine:
A man went to his dentist because he felt something wrong in his mouth. The dentist examines him and says, “That new upper plate I put in for you six months ago is eroding. What have you been eating?” The man replies, “Lately I just can’t get enough of my wife’s special recipe Hollandaise sauce. I’ve been putting it on everything!” “Well,” says the dentist, “that’s probably the problem. Hollandaise sauce is made with lots of lemon juice, which is highly corrosive. It’s eaten away your upper plate. I’ll make you a new plate, and this time use chrome.” “Why chrome?” asks the patient. To which the dentist replies, “It’s simple. Everyone knows that ... there’s no plate like chrome for the Hollandaise!”
A husband and wife entered the dentist’s office. The husband said, “I want a tooth pulled. I don’t want gas or Novocain because I’m in a terrible hurry. Just pull the tooth as quickly as possible.” “You’re a brave man,” said the dentist. “Now, show me which tooth it is.” The husband turns to his wife and says, “Open your mouth and show the dentist which tooth it is, dear.”
“Open wider.” requested the dentist, as he began his examination of the patient. “Good God!” he said, startled. “You’ve got the biggest cavity I’ve ever seen – the biggest cavity I’ve ever seen.” “OK Doc!” replied the patient. “I’m scared enough without you saying something like that twice.” “I didn’t!” said the dentist. “That was the echo.” 2
Patient: “How much to get my teeth straightened?” Dentist: “Twenty-thousand bucks.” Patient heads for the door. Dentist: “Where are you going?” Patient: “To a plastic surgeon to get my mouth bent.”
A patient asked the dentist if it was nasty to have your hands in someone’s mouth all day long. The dentist answered, “I just think of it as having my hands in their wallet.”
Dentist: “Just let me finish and you will be a new man after these cosmetic procedures.” Patient: “Okay doc, but don’t forget to send your bill to the other man.”
Gerald: “Have you ever come across a man who, at the slightest touch, caused you to tremble in every fiber of your being?” Mabel: “Yes, the dentist.”
Dentist: “There goes the only woman I ever loved.” Assistant: “Why don’t you marry her?” Dentist: “I can’t afford to. She’s my best patient.”
Patient: “Doctor, I am very nervous. You know, this is my first extraction.” Young dentist: “Don’t worry, it’s mine too.”
Monster: “Doctor, doctor, I’m a blood-sucking monster and I have grown fond of doctor blood.” Doctor: “Oh what a shame. I’m only a dentist.”
Patient: “Doc, what should I do with all the gold and silver in my mouth?” Dentist: “Don’t smile in a bad neighborhood.” WEST MICHIGAN DISTRICT DENTAL SOCIETY | HOLIDAY ISSUE 2012
Bob: “I’m suffering from bad breath.” Ted: “You should do something about it!” Bob: “I did. I just sent my wife to the dentist.”
“Happiness is your dentist telling you it won’t hurt and then having him catch his hand in the drill.” — Johnny Carson
As the judge said to the dentist: “Do you swear to pull the tooth, the whole tooth, and nothing but the tooth?”
Man: “Darling, your teeth remind me of the stars.” Woman: “Because they gleam and sparkle?” Man: “No, because they come out at night!”
Patient: “Do you extract teeth painlessly?” Dentist: “Not always, the other day I nearly dislocated my wrist.”
Bible verse hanging in a dental office: Psalms 81:10 “. . . open thy mouth wide, and I will fill it.”
Why did the dentist make a poor date with the manicurist? Because they fought both tooth and nail!
A young man saw an elderly couple sitting down to lunch at McDonald’s. He noticed that they had ordered one meal, and an extra drink cup. As he watched, the gentleman carefully divided the hamburger in half, then counted out the fries, one for him, one for her, until each had half of them. Then he poured half of the soft drink into the extra cup and set that in front of his wife. The old man then began to eat, and his wife sat watching, with her hands folded in her lap. The young man decided to ask if they would allow him to purchase another meal for them so that they didn’t have to split theirs. The old gentleman said, “Oh no. We’ve been married 50 years, and everything has always been and will always be shared, 50/50.” The young man then asked the wife if she was going to eat and she replied, “Not yet. It’s his turn with the teeth!”
xsv xsv xsv
Anyone know the six most frightening words in the world? The dentist will see you now.
What did the tooth say to the departing dentist? Fill me in when you get back.
What did the werewolf eat after he’d had his teeth taken out? The dentist.
xsv At what time do most people go to the dentist? At tooth-hurty. xsv
Why do people dislike going to the dentist? Because he is always bore-ing.
What was the endodontist doing in Panama? Looking for the Canal.
A woman phoned her dentist when she received a huge bill. “I’m shocked!” she complained. “This is three times what you normally charge.” “Yes, I know,” said the dentist. “But you yelled so loud, you scared away two other patients.”
xsv What did the dentist say to the computer? This won’t hurt a byte. xsv What did the dentist say to the golfer? You have a hole in one. xsv
Q: What’s the difference between a dentist and a New York Yankee fan? A: One yanks for the roots and the other roots for the Yanks.
What does an orthodontist do on a roller coaster? He braces himself.
I hope that you all got at least a few laughs.
xsv What does the dentist of the year get? A little plaque. xsv
What do you call the Scottish dentist? Phil McCavity! WEST MICHIGAN DISTRICT DENTAL SOCIETY | HOLIDAY ISSUE 2012
As always, my ears and eyes are always open for any concerns, comments, or new jokes! My office number is 457-4600 and my email is email@example.com. Have a safe and happy holiday season!
If We Are Not Willing to Mold Our Own Future, Somebody Else Will Be Happy to Do It for Us. By Dr. Jeff Smith, WMDDS Editor
nother political season has come to an end, and now we will have to deal with the agendas of the people who were elected. Nationally it seems that 40% of the voters are on one side of the fence, another 40% is on the other, and the remaining 20% (who actually end up deciding the contest) haven’t made their minds up yet because either they don’t care, can’t be bothered paying attention to, or take the time to learn about the issues which often have a direct impact on their lives. As the economy continues to struggle, and each special interest group vies for the biggest slice of the pie that it can get, most of us happily walk around oblivious to the bullseyes that are painted on our backs. Our legislators and other officials are naturally going to respond to the loudest voices they hear. By not making ourselves heard, or putting up a fuss when a proposed law or regulation has an adverse effect on our profession, the powers to be must figure that we don’t care, so why should they? What threat can we possibly be, if by doing nothing, we allow ourselves to be penalized or constrained for the benefit of another more vocal group with an entitlement complex. Here are some interesting statistics from the University of Michigan School of Dentistry: 40% of last year’s graduates went into some type of public dentistry (i.e. the military, Indian Health Service, federally-qualified health centers, GPRs, or academia). Less than 5% started up a private practice from scratch. There are many reasons for this, including a shaky economy, increasingly high student loan debt, and fewer dentists with practices for sale than there are graduates who would be interested in associating or buying. Like it or not, the practice of and delivery of dental care is changing, and the traditional private practice model is shrinking. 4
Federally-qualified health centers should be applauded for the vital services they provide to low-income patients. New clinics are now operating in Greenville, as well as a second large facility in downtown Grand Rapids. Another similar clinic is in the planning stage for the Kentwood/Wyoming area. While these clinics receive about 15 to 25% of their financial resources from federal grants, 5 to 7% of their funding comes from privately-insured patients. As these federallyfunded health centers continue to expand, what impact will it have on our practices? The House of Delegates of the Washington State Dental Association in September of this year finally succumbed to pressure from outside non-dental advocacy groups for seniors, children, and minorities, as well as from national and state governments to allow for the creation of a mid-level dental provider who can, with limited training, perform irreversible procedures under the supervision of a dentist. While the WSDA fought against this new type of dental provider for several years, the association simply did not have the presence necessary with their lawmakers to ensure the defeat of a bill, which could have created an unsupervised mid-level provider. In short, the WSDA had to settle for damage control, and in the process, lost more say over the quality and delivery of dental services in their state. You are probably thinking that since there once was a push for a mid-level dental provider in Michigan several years ago, and that it since subsided, we don’t need to worry about that issue any longer. Maybe that’s true today, but what about the next time it comes up? And if you think that it won’t, somebody probably has a bridge that they would like to sell you. How difficult would it be to get up a little earlier once a year to attend a WMDDS legislative breakfast? There have been years when a greater number of our elected officials show up than we do. That must really impress them, and then we get bent out of shape when a proposed law or regulation has an adverse effect on our profession. In the thought-provoking words of our MDA president, Dr. Jeffery Johnston, the two greatest threats to dentistry are our own member apathy and idleness. (MDA Journal, Sept. 2012, pp.30-31.) Dr. Johnston’s message is a must read, and makes the point of this editorial better than I could ever hope to.
WEST MICHIGAN DISTRICT DENTAL SOCIETY | HOLIDAY ISSUE 2012
The Adult Dental Services Program Submitted by Jessica Lopez, Program Facilitator, Dental Assistant, Ferguson Dental Center Included are two orthodontists, two periodontists, two endodontists, and 13 oral surgeons. With such expansion, the program is in need of more specialist volunteers to work along with the volunteer dentists and their offices in referral situations. We are making a great difference in our community. As this year comes to an end, we will have brought care to over 100 patients in need.
he Adult Dental Services Program provides lowincome working adults, and developmentally disabled adults with preventative and restorative care on a sliding scale discount. This is based on their household size and income. If needed, the program will pay up to $750 in lab fees per patient. Providers in our community graciously sign up to treat a specific amount of patients per year of their choosing. The facilitator screens patients through Cherry Street Health Services and matches them with a volunteer provider according to their needs. The program has grown rapidly in the last few months, expanding to 105 total volunteer providers for this year.
What Can be Expected This Next Year in the Adult Dental Services Program? Provider sign-up sheets will go out again at the end of December for the year 2013. Many dentists signed up towards the end of this year already. Please fill out another form stating the remainder of the original commitment or make a new one for the year to come. This will ensure that the program has an accurate record of potential patients seen for the coming year. A Word From the Facilitator With the holidays around the corner and 2012 nearing its end, I am looking forward to increasing and expanding the program in 2013, as well as working hard with all the volunteers who give generously of their time and talents!
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2012 ADA House of Delegates Report By Dr. Brian Cilla, MDA Trustee
his year, the ADA annual session was held in San Francisco. As an MDA trustee, I had the opportunity to attend the ADA House of Delegates (HOD) as a member of the 9th District delegation. Also along for the ride from WMDDS were Doctors Steve Dater, Norm Palm, Deb Peters, and Colette Smiley. Steve has served for many years on our delegation, and this was his final tour of duty. Kudos are deserved for his many years of service on our behalf. As our most experienced delegation member, Steve was assigned the role of “strategist.” Apparently, one of his duties was to procure ringside seats at a local sports bar for the Michigan/ Michigan State football game. The enthusiastic crowd that gathered was largely due to Steve’s art of persuasion. As was expected, the outcome of the game was inevitable (Go Blue!). There was much weeping by the MSU contingent. And now for the rest of the report on the 2012 ADA HOD activities: Actions of the 2012 ADA HOD There were over 180 resolutions up for our consideration in San Francisco. Here is a summary of the more relevant resolutions: • Governance was a big topic this year. The ADA commissioned a $300,000 study by Westman and Associates. Many recommendations were made based on comparisons with peer organizations and extensive interviews or surveys of the ADA staff, BOT, HOD and members of councils and/ or committees. None of the resolutions related to these recommendations were enacted. Some were deferred for further study. 6
• The House approved a 2013 budget that assumes $119.7 million in revenue and $118.6 million in expenses. The Board of Trustees (BOT) and our ADA executive director, Dr. Kathleen O’Loughlin, have worked diligently at organizational cost containment. We live in interesting budgetary times, and this process is dynamic and will continue to evolve. • In order to ensure transparency with the budgetary process, the ADA will post in the delegates’ section of ADA.org (ADA Connect or the equivalent), quarterly financial reports, copies of all audit reports, and management letters associated with these reports within 30 days after Board of Trustees review. • An ad hoc committee, comprised of five HOD members, a Trustee, and the Treasurer, will be formed in order to study the approval authority for the ADA budget. They will review the work of Westman and Associates and the Board of Trustees relating to the ADA budget process. A principle task will be the identification and determination of alternatives with regards to the responsibility of the respective governing bodies (BOT and HOD), constitutional duties, and ultimate role in the ADA budget approval process and ADA Strategic Plan. Recommendations are to be reported to the 2013 ADA HOD. • A Capital Building Fund has been established without any special assessments. This will be a budget line item. It is intended to be for the maintenance and repair of the ADA’s buildings in Chicago and Washington DC. Funding will be based on net depreciation and capital expenditures for the budget year. • The Board has been urged to target the ADA’s liquid reserves at a level of 50% of the Association’s annual budgeted operating expenses, and to consider any excess in developing the following year’s annual operating budget consistent with the long-term strategy of dues stabilization and to ensure the financial stability of the ADA. • The House of Delegates approved a $10 dues increase for 2013. Another additional change is that working life members will be paying 75% of regular dues. Previously, this rate was set at 50%. • The ADA library was slated to come under the budget ax. However, the HOD resolved that the library collections WEST MICHIGAN DISTRICT DENTAL SOCIETY | HOLIDAY ISSUE 2012
and physical space should be maintained without disposition in 2013. The appropriate ADA agencies are to develop a transition plan for the library and their recommendation is to be reported to the 2013 House of Delegates. • The ADA President is urged to create an ad hoc task force, of no more than seven members of the Board and House, to investigate issues affecting councils raised in Westman Governance Study of 2012. The task force duties will be the following: 1. Whether or not (and how) to assign accountability for council performance and management to the BOT. 2. Whether the current size of councils is best for the Association and, if not, what size would be appropriate and how that would be accomplished. 3. To review existing policies on periodic review of council structure and operations, and recommend changes to them as needed to better assure a thorough and objective review of existing council structure. • It was resolved that the ADA shall appropriate up to $800,000 for the purpose of retaining an outside public relations firm. This action is intended to provide support in message development, proactive media outreach, creative development and production of materials, and the execution of programs to: 1. Build and enhance the reputation of dentists and the dental profession; 2. Position the dentist as a fully educated doctor who leads the team that helps patients attain and maintain the best possible oral health; 3. Demonstrate dentistry’s leadership in breaking down barriers to oral health for all Americans; 4. Build awareness of the importance of oral health to overall health; 5. Ensure that media portrayals of dentistry are fair and accurate; and 6. Rapidly address other communications and reputational challenges and opportunities as they arise. • The establishment of Dental Anesthesiology as a specialty was voted down. This was an issue that involved significant debate regarding the criteria and process for establishing a new dental specialty. The position of the HOD, as final arbitrator in these matters, was contrary to the consensus WEST MICHIGAN DISTRICT DENTAL SOCIETY | HOLIDAY ISSUE 2012
of the BOT and the Council on Dental Education and Licensure. Ultimately it was resolved that the process for determination of a dental specialty should be reviewed. This has been referred to the appropriate ADA agencies for further study and a report will be submitted to the 2013 House of Delegates. Of Local Interest • On Friday, December 14, the Area Agency on Aging will be holding its second Senior Dental Day at Grand Rapids Community College. Seniors will receive dental cleanings, radiographs, and screening exams by volunteer dentists and dental hygienists; GRCC students will provide the support. Cherry Street Health Services has agreed to see 30-40 patients for diagnosed restorative needs. • The Kent County Health Department is getting closer to having funding to begin work on a dental clinic. At the present time, they are $175,000 short of their fundraising goal. • In 2013, there will be a Native American Clinic opening at 311 State SE, Grand Rapids, providing medical and dental care for tribal members and their descendants. The clinic anticipates employing two dentists, one hygienist, and one assistant two days a week. Treatment fees will be reduced, based on a sliding scale. Miscellaneous Musings The Internal Revenue Service has issued post-election rules that allow for implementation of Affordable Care Act provisions, which includes a 2.3 percent medical device excise tax. This new tax takes effect Jan. 1, 2013. According to the IRS, this medical device excise tax is a manufacturer’s excise tax. The manufacturer of a taxable medical device will be responsible for reporting and paying the tax. Apparently, the proposed rule indicates that dental equipment, material, and supplies purchased by a dentist for use in the office will be subject to the tax. It appears that completed dental prosthetics or restorations will not be taxed. However, the materials that are used to make dental prosthetics will be subject to the tax. The IRS has clearly rejected the ADA (and other professional organizations) request for exemption to this new tax. Of course, we can expect this tax to be reflected in an
increased cost with the products that we purchase. A trickledown effect is inevitable. As is the nature with all business activities, increased expenses will ultimately require increased charges. I suspect that our patients will wonder why fees are being raised. Maybe we should encourage them to contact their elected officials about the unintended consequences of legislative initiatives. As is always the case, do not hesitate to call or write (firstname.lastname@example.org) if you have any questions, concerns or commentary regarding MDA or ADA activities. I hope that everyone has a happy and safe holiday season.
The Points of Light project
If you would like more information regarding our project or would like to register as a participant, please visit our website at: pointsoflightonline.org.
Good Ideas for Dental Practices
Good Idea # in a series of 15
“Meet with your CPA prior to each year end to project your federal and state tax liability and determine actions to be taken prior to year end to reduce taxes. Consider both the short term tax savings and long term tax impact.” For 14 more Good Ideas from Hungerford, please email Rick Chrisman at email@example.com, or call Rick at (616) 949-3200. 8
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THE GRAND RAPIDS PRESS HEALTH SECTION ARTICLE
Healthy Oral Health Habits for Seniors Print date December 2, 2012, The Grand Rapids Press
rush and Floss Daily Brushing and flossing your teeth is just as important for you as it is for your grandchildren. Even though it may have been years since you’ve had a cavity, your risk of cavities increases with age. One of the reasons is dry mouth – a common side effect of many prescription medications. Dr. Tyler Wolf, president of the West Michigan District Dental Society, recommends that you brush your teeth twice a day with fluoride toothpaste. “It’s a good idea to choose a toothbrush with soft bristles and a small head to get to those hard-to-reach areas,” said Wolf. Another suggestion for those who may have problems with arthritis, or other conditions that limit movement, is to try an electric toothbrush. It is important to clean between the teeth daily with floss. “If floss is too difficult to work with, try a floss pick or tiny brushes made to clean between the teeth,” said Wolf. Clean Dentures Daily Just as bacteria stick to your teeth, it also will stick to your full or partial dentures. Be sure to clean your dentures every day with cleaners made specifically for dentures. Do not use toothpaste for natural teeth or household cleaners, which are too abrasive and can damage dentures that can be expensive to replace. “Take your dentures out of your mouth for at least four hours every 24 hours to keep the lining of your mouth healthy,” said Wolf. It’s best to remove your full or partial dentures at night. Your dentist will provide you with instructions about how long your dentures should be worn each day.
When you visit your dentist for a check-up, it’s a good idea to bring the following information: • List of all medications, including vitamins and over-thecounter medications. • List of medical conditions and allergies. • Information and phone numbers of all health care providers. • Information about your emergency contacts. • Dental insurance or Medicaid cards. • Your dentures or partials, even if you don’t wear them. Drink Water with Fluoride No matter what age you are, drinking water with fluoride helps prevent tooth decay. Fluoride is nature’s cavity fighter. Grand Rapids was the first community in the country to fluoridate its public water supply in 1945. Quit Smoking It’s never too late to quit smoking. Smoking increases problems with gum disease, tooth decay, and tooth loss. It also slows down healing after dental procedures and can decrease the success rate of dental implants. Talk to your dentist about quitting. There are tobacco cessation programs, over-thecounter products, and prescription medications that your dentist may prescribe or recommend to help you quit for good. The Dentists’ Column appears in The Grand Rapids Press “Health Section” the first Sunday of every month with a disclaimer: Brought to you by the 600 members of the West Michigan District Dental Society in Kent, Ottawa, Ionia, Mecosta and Montcalm counties. West Michigan District Dental Society dentists are also members of the Michigan Dental Association.
Visit Your Dentist Regularly Wolf emphasizes that it is important to get regular dental checkups and to not wait until you have pain. “As you age, the nerves inside your teeth become smaller and less sensitive. By the time you feel pain from a cavity, it may be to too late to save your tooth,” according to Wolf. Your dentist will also check for more serious conditions like oral cancer and gum disease, which do not always cause pain until the advanced stages of the disease. By then, it’s often more difficult and costly to treat. WEST MICHIGAN DISTRICT DENTAL SOCIETY | HOLIDAY ISSUE 2012
Learning About Good Oral Health Submitted by Elaine Fleming, WMDDS Executive Secretary
ip All Day, Get Decay” was being heard throughout the Van Andel Arena on November 7th as thousands of area school kids attended the pre-game health and wellness fair prior to the matinee Griffins hockey game. At the WMDDS station, Grand Rapids Community College second-year dental hygiene students talked to the kids about making good beverage choices, oral hygiene, and handed out cool red drawstring backpacks with the Sip All Day, WMDDS, and Griffins logos. Thanks to the GRCC second-year dental hygiene students for the great job, and to the WMDDS Public Relations committee for supporting this project by purchasing the backpacks and handouts.
WEST MICHIGAN DISTRICT DENTAL SOCIETY | HOLIDAY ISSUE 2012
WEST MICHIGAN DISTRICT DENTAL SOCIETY | HOLIDAY ISSUE 2012
2012 YEAR END TAX PLANNING
Planning for the End of the Bush Era Tax Cuts Brian LaFrenier, CPA, Partner at Beene Garter LLP
ypically, accountants advise their clients to defer income and accelerate deductions whenever possible. Well, it might be time to throw conventional wisdom out the window. The Bush Era tax cuts are slated to expire at the end of 2012, and while certain provisions may be temporarily extended, there is no shortage of planning opportunities. If Congress allows the Bush Era tax cuts to expire, all individual taxpayers will see an increase in ordinary income tax rates. For example, taxpayers filing as married filing jointly with taxable income exceeding approximately $217,000 will see their tax rate increase from 33% to 36%. The tax rate for married taxpayers with taxable income over $388,350 increases from 35% to 39.6%. Furthermore, the marriage penalty relief that was provided under the Bush Era tax cuts is also set to expire at the end of 2012. In addition to rising ordinary income tax rates, taxpayers will be faced with increases in the capital gains and dividend tax rates in 2013. The long-term capital gains rate is scheduled to increase from 15% to 20% in 2013. Currently, taxpayers in the 10% and 15% ordinary income tax brackets do not pay tax on long-term capital gains, but will be subject to a 10% long-term capital gain rate in 2013. For capital gain property acquired after 2000 and held for five years, a maximum rate of 18% will apply. The Bush Era tax cuts created the concept of “qualified dividend income,” which currently allows dividends received from most corporations to be taxed at the taxpayer’s longterm capital gain rate. Prior to the Bush Era tax cuts, all dividend income was taxed as ordinary income. If Congress fails to extend these provisions, qualified dividend income will once again be taxed as ordinary income. Most notably, taxpayers in the highest marginal income tax bracket, who
currently enjoy the 15% rate on qualified dividend income, will be taxed at 39.6% for dividends received from the same issuer in 2013. These are clear examples of tax increases through rising rates. However, additional tax increases will be felt through a loss of deductions. Itemized deductions are not currently subject to an overall limitation. If the Bush Era tax cuts expire, a limitation on itemized deductions will once again apply. For higher income taxpayers, the total amount of itemized deductions will be reduced by 3% of the amount by which a taxpayer’s adjusted gross income exceeds an applicable threshold, adjusted annually for inflation. The total amount of itemized deductions will not be reduced by more than 80%. The inflation-adjusted threshold is projected to be approximately $174,450 for all taxpayers except those married filing separately in 2013. Without an extension by Congress, the phase-out of personal exemptions will return for higher income individuals. Personal exemption deductions are $3,800 each for 2012. Currently, the personal exemption phase-out is scheduled to start at adjusted gross income of $261,450 for a married filing jointly taxpayer, and $174,450 for a single taxpayer. There are several other provisions set to expire that will impact taxpayers in 2013. The child tax credit will be reduced from $1,000 to $500. The payroll tax holiday enacted under President Obama is scheduled to expire at the end of 2012. This initiative reduced the employee’s share of social security taxes from 6.2% to 4.2%. Its expiration will cost a taxpayer earning over $110,100 approximately $2,200 in 2013. Barring action by Congress and the President before the end of the year, the tax climate will become much less favorable for taxpayers in 2013. The upcoming changes provide advisors an excellent opportunity to consult with their clients on tax planning strategies that may result in significant tax savings. Now is the time to contact your advisor and review these opportunities. Brian LaFrenier, CPA, is a Partner at Beene Garter LLP with over 17 years of experience. He has a strong focus on serving dental and private medical practices. Brian has extensive experience in personal and corporate income tax, audit procedures and consulting, mergers and acquisitions, monthly bookkeeping and payroll services, financial statement preparation, and cash flow analysis. WEST MICHIGAN DISTRICT DENTAL SOCIETY | HOLIDAY ISSUE 2012
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Having acceSS to caSH tHat allowS you to finance your growtH. With Cash Flow Options from PNC and a dedicated Healthcare Business Banking team, we can help you take advantage of everyday untapped opportunities. Like helping ensure access to credit. So you can make improvements, expand, purchase or buy into a practice. For uncovering opportunities to help improve your cash flow and to learn more about PNC Advantage for Healthcare Professionals, visit pnc.com/cfo, stop by a branch or call 1-855-PNC-4DDS. SM
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All loans are subject to credit approval and may require automatic payment deduction from a PNC Bank Business Checking account. Origination and/or other fees may apply. PNC is a registered mark of The PNC Financial Services Group, Inc. (“PNC”). Cash Flow Options is a service mark of The PNC Financial Services Group, Inc. © 2012 The PNC Financial Services Group, Inc. All rights reserved. PNC Bank, National Association. Member fDic WEST MICHIGAN DISTRICT DENTAL SOCIETY | HOLIDAY ISSUE 2012
l a u n n A h t 4
T H G I N N O I T A I C E R P P A L A T N
Friday, March 8 at 7 p.m.
VAN ANDEL ARENA
The Grand Rapids Griffins invite your office to join us for all the fun and excitement of Dental Appreciation Night! Last season, over 500 dental professionals, their families and friends enjoyed this special game. This season’s Dental Appreciation Night will feature: • Special in-game promotions and $1 concession specials • Discounted tickets for your office • Ticket proceeds benefiting the West Michigan Dental Foundation • The first 500 WMDDS members, staff, family and friends will receive a drawstring backpack courtesy of the WMDDS For more info including discounted ticket pricing, please contact Andrew Rubinstein at 616.774.4585 ext 3023 or firstname.lastname@example.org 1.800.2.HOCKEY
Happier Patients— One Compound at a Time
Keystone Pharmacy, your accredited compounding experts! Using the latest technology and purest ingredients, we create custom medications for your patients, which are prescribed by you and conveniently delivered to your patient’s home. Call our pharmacist today! creams & gels • gummies, lollipops & lozenges sterile medications • suppositories, sprays and more
KEYSTONE PHARMACY Specializing In Your Health
4021 Cascade Road SE Grand Rapids, MI 49546 616-974- 9792 www.keystonerx.com
Your practice depends on the individualized service you provide each and every client. So does ours.
Tax Planning and Preparation
Sales and Use Tax
With extensive hands-on experience in the healthcare industry, our team focuses on the financial and operational challenges you face everyday. We are committed to providing industry-specific expertise relevant to you, without compromising your patient focus.
Accounting Software Installation and Support
Retirement Plan Design and Administration
For more information please visit BeeneGarter.com or contact Brian LaFrenier at (616) 235-5200.
Bookkeeping and Assistance Start-Up Consulting Choice of Entity Analysis Cash Flow Projections
Human Resources Succession Planning Business Valuation Estate Planning and Wealth Management
Copyright © Beene Garter LLP An independent member of Moore Stephens International Limited
Evolving your practice today for a healthier tomorrow.
56 Grandville Avenue sw . Suite 100 Grand Rapids, Michigan 49503 . 616 235 5200
WEST MICHIGAN DISTRICT DENTAL SOCIETY | HOLIDAY ISSUE 2012
Your Fantastic Dental team, what makes it work? Presented by Dr. Rhonda Savage, CEO of Miles Global January 11, 2013 | Frederik Meijer Gardens & Sculpture Park | CE Credits: 7 This lively session outlines what Miles Global finds as a common thread among their top clients who have the finest care along with a happy, productive work environment. But most of all, they also have a healthy bottom line. T – Time to Train and Teach: Patient education and verbal skills E – Expectations, we all have them for ourselves & our team… communication is key! A – Accountability provides for a successful practice M – Motivation: When morale goes up, the practice goes up! Attendees will learn: How to attain clinical excellence through comprehensive treatment planning | How to attract and retain the ideal dental team | The four best tips in scheduling | The key elements to effective communications | Systems of a successful practice: hygiene, reactivation, accounts receivables | Build fun and excitement into your practice After this inspiring and motivating full-day comprehensive course, you will get back to your practice and be amazed at the difference. Experience a day with your fantastic dental TEAM and find out how to make it work for your practice. This is a full day presentation – ideal for the dentist and the entire team. West Michigan District Dental Society is an ADA CERP Recognized Provider.
Thank you to our sponsors who have helped to make these programs available to us.
Registration Form NAME
ADDITIONAL REGISTRANT(S) AT THIS ADDRESS
MDA-member dentist – $225 Pay by credit card: � VISA � Mastercard
WMDDS retired member dentist – $100 CREDIT CARD #
EXPIRATION DATE/SECURITY CODE
NAME ON CARD
PAY BY CHECK: Make checks payable to: West Michigan District Dental Society. Remit to: Elaine Fleming | c/o WMDDS | 161 Ottawa NW | Suite 511-F, Waters Building | Grand Rapids, Michigan 49503 | Questions? Call 616.234.5605 or email email@example.com
1st staff member – $100 2nd-5th staff members – $90 6th-12th staff members – $85 13th staff member and over – $80 per non-member dentist – $450 TOTAL:
WMDF Announces 2012 Community Awards – $21,450 Submitted by Richard W. Panek, DDS, Chair, Community Grant Committee Grand Rapids Children’s Museum – Open Wide Exhibit – $1,700 The Open Wide Exhibit is an interactive learning experience promoting oral health to young children. It was on display from January 24, 2012 to April 15, 2012. During that time it was visited by over 45,625 children and adults. This exhibit is open yearly to coincide with Children’s Dental Health Month. Continuous expected wear and tear requires refurbishing of the exhibit. Funds granted will be used for repair and replacement of worn features as well as creation of a new exhibit feature.
he West Michigan Dental Foundation is dedicated to the improvement of oral health through the financial support of educational and service programs to address needs identified by the dental profession and the communities which it serves. The Foundation supports projects that impact oral health within its five-county service area (Kent, Ottawa, Ionia, Montcalm and Mecosta). Grants are generally limited to educational projects, treatment-based projects, supplies, and equipment. The Foundation does not generally support salaries, operations, or research-based projects. The WMDF Grant Review Committee met on Wednesday, August 1, 2012 to review the grant applications submitted. This year there were twelve grant applications, and ten grants were awarded. Applications were reviewed by the committee and the following grant recommendations were submitted to the Board of the West Michigan Dental Foundation. Baxter Community Center GAP Project – $2,000 The Dental Health “GAP” (Getting Accustomed Preventative) Project, partners with Baxter’s Jubilee Jobs program to provide care for unemployed job-seekers. The grant will subsidize reduced fees for needed dental care to restore oral health for these job seekers. WMDF previously granted $3,000 in 2011 to support the GAP program. The program has grown to serve the needs of 74 individuals since 2007. The goal is to fund care for an additional 20 individuals in 2011-2012.
Mel Trotter Ministries Digital Charting Software – $900 The Mel Trotter Dental Clinic is in need of a digital charting module for their Eaglesoft practice management software. This module will allow paperless charting, facilitating treatment plan communication among the volunteer dentists and staff of the clinic. Additional funds to complete the purchase are being tithed by a local church. Tooth Time – $2,000 This grant is to help the WMDDS fund the Tooth Time program at the Grand Rapids Children’s Museum. This program is expected to draw 1,500-2,000 area children and their parents and teachers in February of 2013. Kid’s Food Basket – $2,000 Kid’s Food Basket provides take-home sack dinners for children that receive subsidized school lunches. Twice a year they provide a toothbrush and small tube of toothpaste for the kids at holiday breaks. This December, over 4,000 children will receive break bags. Funds will be used to purchase brushes and toothpaste. Ottawa County Health Department – $6,400 The “Miles of Smiles” dental van program is used by the county health department to provide dental services to low income, at-risk, non-Medicaid eligible children in Ottawa County. Last year, $17,116 was requested and WMDF funded the program at $6,400, with the balance forwarded to the WEST MICHIGAN DISTRICT DENTAL SOCIETY | HOLIDAY ISSUE 2012
Delta Dental Foundation. This year $13,363 was requested, and a similar grant was approved. A Delta Dental Foundation mini-grant application will be submitted by WMDF on behalf of Miles of Smiles for additional funds. Grand Rapids Griffins Youth Hockey Foundation – $450 This grant will partially cover the cost of providing mouth guards to 350 youth hockey players. The WMDF has supported this program since 2006. Health Intervention Services (HIS) – $2,500 HIS provides care to uninsured individuals thru the use of volunteer providers and a reduced fee schedule. A grant of $2,000 is being given to support the cost of materials and supplies used in the care of these individuals.
The Health Department has already secured grants from the Grand Rapids Community Foundation for $150,000, and the ADA Foundation for $5,000. The total cost of the clinic is estimated at $1,050,000. Additional funding is awaiting approval in the state senate. Holland Free Health Clinic – $1,000 The Holland Free Health Clinic operates a PA 161 dental hygiene clinic that refers patients needing further care to volunteer dentists in the clinic or participating private practices in the community. Last year, over $143,000 of care was provided. The Free Health Clinic has been able to provide an 8:1 service value to donation ratio. This grant will be used to purchase supplies and equipment.
Kent County Health Department – $2,500 The Kent County Health Department is establishing a new dental clinic in partnership with Michigan Community Dental Clinics (MCDC) in the Kentwood/Wyoming area.
MARK YOUR CALENDAR West Michigan Dental Foundation Annual Golf Outing Friday May 31, 2013 Egypt Valley Country Club Watch for more information about this event! Mission Statement: An organization dedicated to the improvement of oral health through the financial support of education and service programs to address the needs identified by the dental profession and the communities it serves in Kent, Ottawa, Ionia, Mecosta and Montcalm counties.
WEST MICHIGAN DISTRICT DENTAL SOCIETY | HOLIDAY ISSUE 2012
Catch the Spirit in Novi! MDA 2013 Annual Session Suburban Collection Showplace, Novi • April 17-20, 2013
Michigan dentistry’s Biggest ce event!
Plus keynote speaker CoNNie PoDeSTA and others
Scott Benjamin, DDS Joseph Best, DDS, PhD M. Douglas Campbell W. Choong Foong, PhD Mary Govoni, RDA, RDH Derek Hein Timothy Kosinski, MS, DDS Glenn Lombardi Susan Maples, DDS Alan Mead, DDS Kenneth Myers, DDS William Nudera, DDS, Ms Christopher Smiley, DDS Jon Suzuki, DDS, PhD, MBA Domenica Sweier, DDS, PhD Anastasia Turchetti, RDH Stephen Ura, DDS Kelli Vrla Daniel Ward, DDS
Pre-Register Early! Online registration opens Dec. 20, 2012! Join your colleagues for great social events, a variety of topics and speakers and nearly 200 exhibits. New this year — one hour “Hot Topic” sessions — more information coming soon.
Repeal the 2.3 Excise Tax on Medical Devices The Affordable Care Act established a 2.3% excise tax on medical devices as defined by the Food and Drug Administration. According to the law, the tax will become effective on purchases beginning January 1, 2013. While the IRS has not yet issued the final rule on the implementation of this tax, the ADA believes the tax will be applied to dental devices, supplies, equipment, and materials. The ADA submitted extensive comments to the IRS maintaining that the tax should not apply to dental devices, or should at least be substantially limited with regard to them. In addition, the ADA recently joined over 700 organizations, including dental manufacturers and laboratories, in supporting the repeal of this provision. The House of Representatives already passed a bill that repeals the provision and is awaiting action in the Senate. At the same time, lawmakers have introduced separate bills in the Senate that would do the same thing. Because of the limited time remaining to this Congress before adjournment, however, it is likely that the repeal provision will be included in other legislation. Please click on this link (or type into your browser) to contact Senators Levin and Stabenow in support of the repeal of the 2.3% excise tax on medical devices: http://www.capwiz.com/dental/issues/alert/?alertid=62172116&type=TA Thank you for taking action in the support of our profession! Sincerely, Jeff Smith, WMDDS Editor
Born here. Growing here. The passion to do more.
Our local bank proudly supports the West Michigan Dental Community.
Specialties Include: • Custom designed deposits • Equipment financing • Financing of partner buy-in and practice purchase
• Flexible loan payments • Practice start-up loans • Real Estate Financing • Working Capital Lines of Credit
WEST MICHIGAN DISTRICT DENTAL SOCIETY | HOLIDAY ISSUE 2012
Cascade Rd at Spaulding - SE Northland Dr at Plainfield - NE Monroe Ave at Louis - Downtown Wilson Ave at 56th - SW
(616) 956-9030 foundersbt.com
Best of Tech 2012 Submitted by Greg Feutz, President, DDS Integration
Greg Feutz is President of DDS Integration, a Grand Rapids based dental technology company.
n each WMDDS Bulletin, I will be fielding your questions about technology, its place in the dental practice, and beyond. Send your questions to firstname.lastname@example.org and I’ll answer them on my blog, facebook, and in each Bulletin. This article is a little different. With the holidays coming up, here are some of the coolest tech products and gift ideas from 2012. Not all are new this year, and not all are even available yet, but I promise they’re all cool! Note: This will also be on our blog (ddsintegration.com/blog) where the links will be live, perhaps easier than typing them. Commercial-skipping DVRs: For the reality TV addict You’ve probably heard or seen commercials for the Dish Network Hopper with “Auto Hop.” This is one of many products out that, while DVR-ing your favorite shows, will also auto-skip the commercials while recording. This means you can add a few more precious seconds or minutes back into your life rather than watching (or manually skipping) commercials. I somewhat question the longevity of products like this for the following reason: The big networks (NBC, ABC, CBS, FOX) rely on commercials for funding. Those same big networks also have big contracts with service providers like Comcast and Dish. I would not be surprised if they put pressure on these service providers to eventually discontinue these items. Get ’em while they’re hot! Article: http://tinyurl.com/dyo9fwo Youtube vid: http://tinyurl.com/c67c26w Lytro light-field camera: For the photographer This one kind of blows my mind. I am a camera lover, have a few DSLRs, and generally really like photography. This cam-
era just might be a game changer. I will let the video linked below do the detailed explanation. On the most basic level, you don’t have to focus with this camera. Everything that is captured in the frame can later be chosen as the focus point. Demonstration vid: http://tinyurl.com/av99tun Explanation vid: http://tinyurl.com/bqqvlqw Website (go here and play with the pictures. Really cool!): http://tinyurl.com/6yz2yns Cloud printing: For the on-the-go mobile vagabond Cloud printing allows you to print from almost any webattached device. Computers, laptops, smartphones, and tablets can all print via cloud printing. The cool thing about it too, is you can print from anywhere to your printer, as long as you are connected to the web. For example, if you are at Frederik Meijer Gardens & Sculpture Park and snap a great photo of a butterfly with your phone’s camera, you can then, with a few taps, send it off to your photo printer at home. When you get home the print will be ready and waiting for you. Or you’re at the office and want to print a production report to your house so you can review it when you get home. There are lots of different ways of implementing this. Some printers have cloud functionality built in, while others can be shared out from a computer using a Google Chrome extension. Apple also has Airprint, although this is only usable if you are on the same local network as the printer. Google’s really is the most versatile, but the others are worth mentioning. Google cloud print: http://tinyurl.com/3b7rss5 Apple airprint: http://tinyurl.com/25tz3su HP eprint: http://tinyurl.com/bqwu9dc Microsoft Surface with Windows 8: For the tablet lover who needs some good ol’ compatibility If we’re all honest with ourselves we would admit that we ran out and bought tablets because they are cool, and then later asked, “OK, what am I going to do with this?” For the most part, we were able to find answers to this question. For most it’s web browsing, facebooking, youtubing, book reading, and generally fun stuff. For others it’s a way to eliminate some paper clutter by keeping to-do lists mobile, and if you’re like me, converting your piano sheet music collection to a digital format. WEST MICHIGAN DISTRICT DENTAL SOCIETY | HOLIDAY ISSUE 2012
Where we weren’t able to find too many answers, however, is on the business side. Whether it’s Apple or Android, there just isn’t app support for the software that you use on a daily basis. Dentrix, Eaglesoft, Carestream, and almost all other big players out there have failed to produce anything useful for an iPad or Android tablet. The Microsoft Surface may or may not solve this problem right away, but it does represent an easier target for our practice management friends to hit. The Surface runs on Windows 8, which all practice management will eventually have to run on, and it may even work now. Stay tuned to our blog as we’ve pre-ordered one of these tablets to test out with dental software in the next month or so. With Microsoft’s entrance into the tablet market, there will finally be a truly productive tablet for business use. Surface review: http://tinyurl.com/aw4vx6q Surface versus ipad video review: http://tinyurl.com/clq4lxp Eaglesoft blog article about Windows 8: http://tinyurl.com/c9afmpg
Google Project Glass: For… everyone? Or… no one? I’m a technology guy and I love technology, no doubt about it. Sometimes I do feel there is too much technology in our lives, as cool as it may be. Google’s Project Glass really tickles my “Wow that’s cool!” side, while also annoyingly scratches my “When is enough enough?” side. In the most basic terms, Google is taking everything your smart phone can do and putting it into wearable glasses. You can get status updates, do web searches, interact with your calendar, take pictures, and much, much more, all from the glasses on your face. A little crazy! The video linked below is pretty well done and really highlights the cool potential that these have. Article: http://tinyurl.com/9tbo29y Google marketing video: http://tinyurl.com/bp5az9c What are your thoughts? Comment on our blog or facebook article. We’d love to hear your opinions on Best of Tech or any other topic. Facebook: facebook.com/ddsintegration Blog: ddsintegration.com/blog
2012 Directory Corrections & Additions Changes indicated in bold New MemberS:
corrections: CALDWELL, CHARLES R 3875 BURTON ST SE GRAND RAPIDS, MI 49546 949-7510 FAX 949-6051 2249 WEALTHY ST SE, STE #130 GRAND RAPIDS, MI 49506 734-0243 FAX 458-9719 1235 W STATE HASTINGS, MI 49058 269-945-3521
CHRISTOPHERSON, ELIZABETH 3875 BURTON ST SE GRAND RAPIDS, MI 49546 949-7510 FAX 949-6051 2249 WEALTHY ST SE, STE #130 GRAND RAPIDS, MI 49506 734-0243 FAX 458-9719 1235 W STATE HASTINGS, MI 49058 269-945-3521
STOUT, THOMAS 12723 N BELLWOOD ST, STE 30 HOLLAND, MI 49424 399-8230 fax 399-8374
DAVIS LABORATORY CO 5830 CROSSROADS COMMERCE PARKWAY SW WYOMING, MI 49519 261-9191
WEST MICHIGAN DISTRICT DENTAL SOCIETY | HOLIDAY ISSUE 2012
CAO, ERIC M 306 MAPLEWOOD GREENVILLE MI 48838 616-225-9650 Heart of the City Health Center 100 Cherry Street SE Grand Rapids, MI 49503 616-965-8206 fax 616-940-5347
QUINN, ELIZABETH C HACKLEY COMMUNITY CARE 2700 BAKER STREET MUSKEGON HEIGHTS MI 49444 231-737-8603
NEUMAN, ALEXIS L 3030 BURTON STREET SE GRAND RAPIDS MI 49546 956-9183 fax 956-1527
Obamacare – What Is It All About? Submitted by Richard L. Chrisman, CPA MST Hungerford, Aldrin, Nichols & Carter, PC
he election is over and Obama is back for another four years. 2013 is fast approaching. It looks like Obamacare is here to stay. We need to prepare for it. The following is what you need to know about health care reform. Background One of Obama’s campaign promises in 2008 was to create a government program that would extend health care insurance coverage to everyone. The Patient Protection and Affordable Care Act (often referred to as Obamacare) was signed into law in 2010. It included a mandate that nearly everyone in the U.S. must have some form of health insurance by 2014 or be fined by the federal government. Attorney generals in 21 states filed suit to protect their citizens from being forced to buy health insurance from a private company. On June 28, 2012, the Supreme Court ruled that the federal government does not have the right to mandate that people must buy health insurance from a private company. However, it does have the right to tax those that don’t. Therefore, Obamacare was upheld. An Overview of Obamacare The Act was designed to bring health insurance coverage to the over 30 million people that currently don’t have it. Some of the provisions are as follows: • If people can’t afford insurance (families making less than 133% of the poverty level), the federal government will pay the states to add them to Medicaid. • People who don’t qualify for Medicaid, may qualify for tax credits (families making between 133% and 400% of the poverty level) to help them pay their premiums.
• Insurance companies cannot deny coverage for pre-existing conditions. • Parents can put their children (up to age 26) on their health care plan. • People with existing health insurance can keep it. • Businesses with 50 people or more are required to offer health insurance, but may receive tax credits to help pay the premiums. • Businesses with less than 50 people are not required to provide health insurance. • Taxes will be raised on one million individuals with annual incomes above $200,000 and four million couples with joint income over $250,000. They will now pay an extra 0.9% Medicare tax on income above the threshold. In addition, they will pay an additional 3.8% Medicare tax on all or part of their net investment income. • Those who don’t purchase insurance, and don’t qualify for Medicaid will be assessed a tax of $95 (or 1% of income) in 2014, $325 (or 2% of income) in 2015, and $695 (or 2.5% of income) in 2016. • Pharmaceutical companies will pay an extra $85 billion in fees over the next ten years to close the “donut hole” (coverage gap) in Medicare Part D. • In 2018, insurance companies will be assessed a 40% excise tax on “Cadillac” health plans. By definition, these are plans with values in excess of $10,200 for individual coverage and $27,500 for family coverage. • States will be required to set up insurance exchanges to make it easier to shop for private health insurance. • The law requires insurers to spend between 80% and 85% of every premium dollar on medical care (as opposed to administration, etc.). If the amount is exceeded, the excess must be rebated to their customers. Some Like It Those who are in favor of Obamacare are happy that over 30 million people will now have insurance coverage. They believe that health care costs overall will go down if health care insurance is made available to more people. Their logic is that those currently without coverage often use the hospital emergency room as their primary care physician; they generally don’t go to the ER until their problem has escalated. If these individuals WEST MICHIGAN DISTRICT DENTAL SOCIETY | HOLIDAY ISSUE 2012
had coverage, they would use a primary care physician, and would be getting treatment much earlier. This would be much more cost effective in their opinion. The law is expected to cost the federal government about $1 trillion over the next ten years. Those in favor of it believe the spending cuts and tax increases will cover that trillion with some left over, thus helping to reduce the federal deficit. Some Don’t Those who are not in favor of Obamacare believe: • Overall health care costs will rise. They believe the actual cost will be much higher than the $1 trillion projected. • That it is unfair to fund it by increasing the already heavy tax burden on higher income taxpayers. • That more government intervention will have a negative impact on health care. A government committee shouldn’t be deciding how much doctors get paid, the patients they treat, and the procedures they do. • Doctors are currently overburdened. Under the new law even more will be required of them, especially primary care physicians. They will be asked to work harder for less money. • The quality of health care in this country will gradually erode and tens of millions of Americans will find that they are much worse off under the new law. Tax Planning Ideas to Consider • If you have the ability to shift some employee compensation and/or self-employment income for 2013 to 2012, the new .09% Medicare tax will not apply to that amount. • Investment gains will be subject to higher tax rates if they are recognized in 2013. Consider triggering gains in 2012. • Tax-exempt interest is not subject to the 3.8% Medicare tax. Now may be a good time to review your investment portfolio to see if investing in tax-exempt municipal bonds makes sense for you. • Retirement plan distributions are also exempt from the 3.8% Medicare tax. So it may make sense to maximize your contributions to these accounts. • Every taxpayer has a different set of facts and circumstances that need to be considered. Please discuss these planning ideas with your tax advisor before implementing. WEST MICHIGAN DISTRICT DENTAL SOCIETY | HOLIDAY ISSUE 2012
Conclusion Obama has another four years to cement his legacy. Time will tell if Obamacare was the best decision for health care in this country. Good or bad, it will part of his legacy. Richard L. Chrisman, CPA, MST is the Managing Shareholder of Hungerford, Aldrin, Nichols and Carter PC, a Tax, Auditing and Business Consulting firm with offices in Grand Rapids and Greenville, MI. The firm is celebrating 70 years of helping local businesses, including many area dental practices.
West Michigan District Dental Society is now on Facebook Check us out and we’re sure you’ll “Like” us! 25
The classified ad rate is $10.00 up to and including 30 words; additional words 15¢ each. Space permitting, WMDDS members may place ads free of charge as a membership service. Ads should be submitted in writing and sent with payment to Elaine Fleming, WMDDS, 511-F Waters Building, Grand Rapids, MI 49503. Telephone numbers and hyphenations count as two words, abbreviations count as one word. Ads received after the first of the month prior to publication may appear in the following issue. Established Dental Office Space – 2003 Burton SE (between Breton and Plymouth). End unit with 720 sq. ft. and a full basement, on-site parking, adjacent 3 spaces occupied by established dentists. Great traffic counts on Burton in an established residential area. Call Bruce at 942.9492. General Dentist Seeking Associate Position in Grand Rapids area – General dentist residing in the Grand Rapids area is seeking an associate position for 1-2 days per week in the Grand Rapids and surrounding area. If you are looking for an associate for your practice, please call 616.975.2870. REF # GR Associate. Office Space for Lease – Up to 6900 S.F. available; will divide. Basement storage available. Newer class A building. Great visibility! Located at 1151 East Paris Ave SE (across from Bonefish Grill). Owner occupied. Call Dr. Sam Bander 616.949.5980 or e-mail email@example.com. Visit www.drsambander.com to take a look. Equipment for Sale – Two Belmont Pro II patient chairs, wing back style for sale. Model 037S. Better than good condition. Two casting units for sale and a porcelain oven for sale. Call 616.633.8132. Seeking Employment – General dentist with several years of experience seeking part-time employment in the West Michigan and surrounding areas. Proficient in all areas of general dentistry. A team player. Please reply to firstname.lastname@example.org. 26
Dental Office for Lease – Why spend $250,000 in dental build-out costs? Beautiful dental suite is now available for lease in Class A contemporary three-story brick and glass building located off of East Beltline Avenue in Grand Rapids Township. This ten-year old modern dental office includes 3 private ops, 4 chair open bay area, is plumbed for nitrous, air, water, power, CAT-5, vacuum, wet/dry lab and x-ray. The building is a contemporary 3 level with ample parking, 4 bathrooms, staff lunch area, private doctor’s office with restroom and shower, reception desk for check-in and out, and has a heated storage area if needed. Immediate occupancy. $16.25 per square foot, triple net. Please contact Scott Morgan at Colliers International at 616.292.3455 to schedule your visit. Dental Office for Lease – Time to move up? Busy northeast area dental suite at 1750 Grand Ridge Ct. NE, 3295 SF, ten-year old modern dental office available. 3 pvt ops, 4 chair bay area, plumbed for nitrous, air, water, power and vacuum, lab, x-ray, staff area, pvt. office, reception, storage available. Former pedo practice obtainable Jan. 1st 2011. Contact Dr. John Monticello 616.364.1700 or email@example.com Associate position wanted – Newly graduated dentist from UDM looking for full time position as an associate of progressive dental practice in Grand Rapids and surrounding areas. Please call 616.617.9725 or email firstname.lastname@example.org.
General Dentist – Looking to purchase a practice along the lakeshore (Grand Haven, Holland, Saugatuck area) or Grand Rapids area. Please contact email@example.com. Dental Office for Lease – with immediate availability. Near the “medical mile” on primary road with high traffic count and super visibility. Has been a dental office for over 40 years. Very good lease terms/rates. Would make awesome start-up or satellite. For more info, email firstname.lastname@example.org. General Dentist – Looking to purchase a practice or pursue transition in Grand Rapids area. Three years of experience. Please email to: email@example.com. For Rent – An upstairs air-conditioned dental office, approximately 1440 square feet in downtown Greenville, Michigan, 40 miles northeast of Grand Rapids. The office consists of 3 operatories, a private office, 2 laboratories, and a reception area. The office building has ample free parking. $800 per month. For Sale – Lab Master Foster Model Trimmer, Model # MT115, like new $600. ESPE Pentamix 2, $100. Contact 616.949.7510. Associate Position Wanted – Fourthyear at University of Florida COD and Michigan native seeking full-time associate level opportunities in greater Grand Rapids area beginning summer/ fall 2013. LRULE@UFL.COM or 248.568.0839.
WEST MICHIGAN DISTRICT DENTAL SOCIETY | HOLIDAY ISSUE 2012
Office Space for Lease AND Building for Sale –Dental suite available in great location! 1350 SF located in Ridgepark Professional Building at 2426 Burton St. SE. Fully equipped and furnished, 4 operatories, lab, private office, reception, business office, full basement. Call Dr. Sam Bander 616.949.5980 or e-mail: firstname.lastname@example.org. The building is also for sale. Great income opportunity. For Sale – Adec Continental Units (2); Belmont Prosthodontic Chairs (2); Dental Ez J Chair; Sirona X-rays (2); Adec Post mount light; Pelton Crane Post mount light; Adec Hygiene Unit; Osada XL-030 Lab Handpiece; Triad 2000 Curing Unit; Buffalo Model Trimmer; Baldor Lathe; Assistants Stools (2). Please call 616.633.8132. For Sale – Adec Continental Units (2); Belmont Prosthodontic Chairs (2); Dental Ez J Chair; Sirona X-ray; Adec Post mount light; Pelton Crane Post mount light; Adec Hygiene Unit; Osada XL-030 Lab Handpiece; Triad 2000 Curing Unit; Buffalo Model Trimmer; Baldor Lathe; Assistants Stools (2); DentalEZ HDX X-ray; 8 reception room chairs; Porcelain oven; AcuCam intraoral Camera; Whip Mix combination unit. Please call 616.633.8132. Seeking employment – General dentist with eight years of experience seeking part-time employment in West Michigan area. Enjoys practicing most areas of dentistry. Please email: email@example.com.
General Dental Practice in Grand Rapids Area – Established practice with gross receipts in excess of $600,000 with a healthy recall program, paperless office, 6 fully equipped operatories. For additional information please call 616.975.2870 or email firstname.lastname@example.org. For Sale – Sirona Cerec 3D Acquisition unit 3.8 updated software, MCXL Milling Machine with wireless interface. Excellent used condition. Less than 100 units milled. Transfer owner with Patterson, includes vita blocks and wall mount block board, $40,000/obo. Other used dental equipment for sale: 2 Royal and 3 Dental Eze chairs, 5 Pelton Crane pole mounted chair lights, 2 Adec and 2 Marus dental units, 1 Biotec unit, 1 Panorex J Morita Versa View, 5 ceiling mount arms and 3 wall mount arms for computer monitors, 1 Porter portable nitrous delivery system, 1 Aribex Nomad Handheld X-ray. Please call for more info, prices, or photos 616.634.0605. For Sale – Several items from orthodontic office. Siemens 10E Pan/Ceph x-ray, Ritter PA x-ray, treatment chairs and stools. Call 616.538.3545 anytime for more information. Dentist Needed – Full-time or parttime at State of Michigan Correctional Facility in Ionia, MI. Avoid headaches of private practice. For information please call Ken or Richard at 517.321.9313.
WEST MICHIGAN DISTRICT DENTAL SOCIETY | HOLIDAY ISSUE 2012
ADVERTISER INDEX The Bulletin wishes to thank our valued advertisers who support organized dentistry by helping to defray the cost of printing and mailing. Advertising in the Bulletin is seen by over 90% of the dentists in the West Michigan District. This includes five of the fastest growing counties in the state: Kent, Ottawa, Ionia, Montcalm and Mecosta. For information on advertising rates, call Elaine Fleming, WMDDS Executive Secretary at 234-5605. Target your Market – advertise in the Bulletin! Beene Garter.......................................16 DDS Integration..... outside back cover Davis Dental Laboratory................ inside front cover Founders Bank & Trust.....................21 Great Lakes Financial Insurance.........5 Henry Schein.............inside back cover Hungerford, Aldrin, Nichols & Carter, PC.............................................8 Keystone Pharmacy...........................16 MDA IFG............................................13 PNC Bank...........................................14
The Buying and Selling of a Business Part two: Sell Yourself Smart Submitted by Scott Hoag, Vice President, PNC Healthcare Business Banking
f you expect to sell your dental practice anytime over the next few years, the time to start planning may be right now – even if a sale isn’t imminent. In fact, experts suggest starting the process at least two years before you actually sell.1 One of the most time-consuming challenges is finding an appropriate answer to this question: What is my practice worth? The complexities buried within those five simple sounding words range from objective assessments of expensive equipment and office furniture, to more subjective questions about the value of your good name. Find Your True Value Your marketable assets fall into three general categories. As you build toward a fair sale price, you’ll have to consider each item within those categories and whether you plan to sell them as part of the deal, sell them separately, or hold onto them.2 The first category is hard assets, including X-ray machines, office supplies, electronic health records systems, drug inventories, and anything else that has a tangible value. Each of these items is open for negotiation. If the buyer isn’t interested in a specific item or isn’t offering the price you want, could you earn more selling it elsewhere? The second category is accounts receivable – revenue you’ve billed for but haven’t received. Whether you sell these uncollected revenues or decide to hold onto them is part of the negotiation. The third category, grouped under the umbrella of goodwill, includes the intangible but potentially valuable qualities that make your practice special: the sterling reputation you’ve developed over the years, the desirable location of your practice, and a solid patient list. There’s no by-the-numbers way to value these, so each needs to be considered carefully and factored into your negotiations.
a corporation, or other dentists, perhaps one who has worked as a junior member of your group and expressed an interest in taking over. A primary advantage to selling to another dentist is the relative control you have to exit on your own terms: A hospital or corporation may want you to stay on for a certain period after the sale for the purpose of providing patients continuity of service. Also, when you sell to another dentist in your practice, you have the good feeling of knowing the traditions of care you established will continue long after you’ve moved on.
1 Galloway, Amy N. “Selling Your Practice.” Medical Economics, July 10, 2011. http://www.modernmedicine.com/modernmedicine/article/ articleDetail.jsp?id=731290 2 Frooman, Matthew and Smith III, Stanley M. “Selling Your Practice? Planning is Crucial.” Medical Economics, Jan. 25, 2012. http://www.modernmedicine.com/modernmedicine/ article/articleDetail.jsp?id=756749&sk=&date=&pageID=2
Find the Right Buyer Whom you sell to is another major question, not just for the financial reward but also for the satisfaction in seeing the business you’ve spent years building continue to operate in good, capable hands. Potential buyers may include hospitals, 28
WEST MICHIGAN DISTRICT DENTAL SOCIETY | HOLIDAY ISSUE 2012
WE’VE MOVED STOP BY AND VISIT OUR NEW SHOWROOM! Henry Schein Dental 2689 Walkent Drive NW, Suite F Walker, MI 49544 Phone: 616-791-2358 Fax: 616-791-2973
Don’t miss our Year End Equipment & Technology Specials! Take advantage of Section 179 while you still can! Ask your Henry Schein Consultant for details.
©2012 Henry Schein, Inc. No copying without permission. Not responsible for typographical errors.
WEST MICHIGAN DENTAL SOCIETY 511-F Waters Building Grand Rapids, MI 49503
PRSRT STD US POSTAGE PAID GRAND RAPIDS, MI PERMIT # 657
Published on Jan 9, 2013