2015 WMDDS Spring Bulletin

SPRING ISSUE 2015 VOL. 47, NO. 2

Bulletin

Contents ­Editor

Dr. Jeff Smith

Associate Editors

Dr. Seth Vruggink Dr. Derek Draft Dr. David Huyser Dr. Brian Licari

President’s Message...................................................................................................... 2 Editor’s Thoughts.........................................................................................................  4

Advertising Editor Elaine Fleming Executive Secretary WMDDS 301 Waters Building Grand Rapids, MI 49503 (616) 234-5605 efwmdds@aol.com

Trustee Report.............................................................................................................. 6

West Michigan District Dental Society Executive Board 2014-2015 President Dr. Samuel Bander President-Elect Dr. Steve Conlon Vice President Dr. Leonard Bartoszewicz Secretary-Treasurer Dr. Tyler Wolf Editor Dr. Jeff Smith Immediate Past Dr. Margaret Gingrich President Directors Dr. Brian Mulder Dr. Lathe Miller Dr. Kathleen Ellsworth Area Representatives Kent County Dr. James Papp Ionia-Montcalm Dr. John O’Donald County Mecosta County Dr. Erick Perroud Ottawa County Dr. Kevin Rebhan

WMDDS News: We’ve Moved!...................................................................................17

MDA IV District Trustees

Dr. Brian Cilla Dr. Colette Smiley

Classified Ads................................................................................................................34

Big Rapids Dental Study Club Officers President Dr. Erick Perroud Vice President Dr. Christa Stern Secretary Dr. Christa Stern Treasurer Dr. Erick Perroud

Advertiser Index............................................................................................................35

Holland-Zeeland Dental Society Officers President Dr. Meredith Smedley Treasurer Secretary Immediate Past President Ionia-Montcalm Dental Study Club Officers President Treasurer Dr. Kirkwood Faber Kent County Dental Society Officers President Dr. Kathryn Swan Vice President Dr. James Papp Secretary Dr. Kathleen Eisin Treasurer Dr. Christopher Leja West Michigan Dental Foundation Officers President Dr. Michael Palaszek Vice President Dr. Sarah Mahar Secretary Mrs. Dawn Kamyszek 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. © 2014-2015 West Michigan District Dental Society Bulletin

Tooth Time 2015..........................................................................................................12 In Memoriam: Cyril Lixenberg....................................................................................14

2015-2016 WMDDS Continuing Education Programs.............................................18 Tangible Property Repair Regulations: What Do They Mean for Me?.....................23 What Dental School Never Taught You About Choosing A Financial Planner.......24 Legally Speaking............................................................................................................26 Technically Speaking....................................................................................................28 Estate Planning.............................................................................................................30

About the Cover 2015 Tooth Time at the Grand Rapids Children’s Museum. Photo courtesy of Dr. David Huyser.

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 ­publication date. The Bulletin has six publications: the winter issue, spring issue, summer issue, directory issue, fall issue, holiday issue. Direct submissions or ­correspondences to:

WEST MICHIGAN DISTRICT DENTAL SOCIETY | SPRING ISSUE 2015

Dr. Jeffrey S. Smith • 3050 Ivanrest SW, Suite B • Grandville, MI 49418 Phone: 616.531.1554 FAX 616.531.6947 • Email: jssmith@comcast.net Include “Newsletter” in the subject line

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PRESIDENT’S MESSAGE

Your mission, should you decide to accept it: ERADICATE DECAY FROM THE PLANET! By Samuel Bander, DDS, WMDDS President

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t is Monday morning in your office and you and your team are off to another busy week. You may have one, two, or three hygienists working. You have a full restorative schedule. It will be a day full of teeth – mostly bad, rotten teeth! I recently read two books, “In Defense of Food” by Michael Pollan, and “Younger Next Year” by Chris Crowley and Henry S. Lodge, M.D. I encourage you to read them both. So I ask myself questions. Why do teeth decay? Why is gum disease rampant? Does a brush and a piece of string really treat disease? Come on. Do I really teach my patients how to achieve health? My patients have good dental care and good dental health, but not great health care. Modern dentistry and dental reimbursement does not concern itself with lifestyle problems. Dentists don’t treat them, dental schools don’t teach them, patients aren’t motivated by them, and insurers don’t pay to solve them. It is no wonder that our society is plagued with rising medical and dental costs and epidemics of obesity, heart disease, tooth decay and gum disease. It is astonishing that we have an access to care problem right here in Grand Rapids – the first city to have fluoridated water! Why, after all these years, do we still have such a decay problem, especially among kids? In the two centuries since vaccines were first developed, over a dozen of what used to be the most common infectious diseases have practically been eradicated, according to data compiled by the Centers for Diseases Control. (see chart to right). Back in 1980, the World Health Organization officially declared that one of the deadliest diseases in human history, smallpox, had been eradicated. So I continue to ask myself questions. Is the need for so much treatment on a human body part that is essential to

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human survival (the teeth), a design defect in the human body? Did God mess up? Or is it the modern Western diet? I think it is the latter. The human body, and the mouth in particular, is an exquisite machine. It is designed for our survival. So I continue to ask questions. Why can’t we eliminate decay and gum disease? Is the food lobby too powerful? Is there too much pressure to eat a diet that destroys our mouth? Are dentists paid to drill and fill rather than educate? Are we fooling patients into believing they can do whatever they want and come in twice a year for a cleaning and fluoride treatment and that will solve the problem? Does dentistry do enough? Imagine a patient coming to your office and the treatment is diet counseling. You instruct them to eliminate any food in a box with ingredients you can’t pronounce. Eliminate refined sugar, pop, candy, etc. That is how you treat decay.

WEST MICHIGAN DISTRICT DENTAL SOCIETY | SPRING ISSUE 2015

PRESIDENT’S MESSAGE

So let’s go back to a new Monday morning. Your patient meets with a nutritionist/hygienist. Their diet is analyzed and you make diet modification recommendations. Between recall visits, the patient records their diet and is in digital communication with your diet specialist. Together, you work through the challenges of the Western diet, in order to preserve the body, so it can do what it was designed to do. The recall visit becomes a new experience. It is like a trip to the gym for your teeth. And we are on our way to eradicating dental decay! And finally, perhaps, even a vaccine. Just as John F. Kennedy challenged us to land a man on the moon and return him home safely by the time the 60s decade was out, I would like to challenge the dentists of West Michigan to eliminate dental decay. Sound ridiculous? Maybe, but it could change people’s (especially kids) lives. The dentists West Michigan are innovators and 9:58 creative 5WMDDSofBulletin Zac ad OUTLINED.pdf 1 4/15/14 AM

WEST MICHIGAN DISTRICT DENTAL SOCIETY | SPRING ISSUE 2015

thinkers. As I end my term as president, it is my hope that someone will read this article and be inspired to take on the challenge. “People are always glad to see me. They are either glad to see me coming or glad to see me going.” Well, now I am going. This is my final Bulletin article as president of the WMDDS. It has been a rewarding experience – one that I will treasure. Dentistry is my life, and the dentists of the WMDDS are more than just colleagues. Together we continue to make West Michigan a great place to live and practice dentistry. Thanks to all who give of their time to the WMDDS – you are making a difference! And who knows, someday a CDC headline may read: Dental Decay Eradicated – West Michigan Discovers the Key!

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EDITOR’S THOUGHTS

Our Future May Be More than We Bargained For By Jeffrey Smith, DDS, MS, Editor, West Michigan District Dental Society

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ecently, I read an interesting article in one of the magazines that was sitting in the waiting room. The cover shows the face of an infant, and the caption reads: “This baby could live to be 142 years old.” While the projected age for the child was based on studies that have so far been limited to mice, it is true that continuous developments in medicine and technology have extended our lifespans considerably. Here are a few facts for those of you who revel in trivia: An American born today will on average live 20 years longer than one born in 1925, and for the first time in U.S. history, the number of people over the age of 60 exceeds those under 15. Try to imagine sharing 28th Street, Alpine Avenue, and US 131 with a bunch of centenarians driving white Buicks (no offense to AARP or General Motors intended). An everincreasing aging population will probably do more to change our present culture than have all of the high-tech goodies that have come out in the last 25 years combined. Most of us who have been practicing for a while have seen the effects that many of the prescription medications used to prevent or at least slow down chronic disease have had on the oral health of our patients. Xerostomia and bisphosphonaterelated osteonecrosis of the jaw are two that quickly come to mind. Excellent dental treatment that was done only a few years ago has not held up in some of these people. As our patients continue to live on, we need to alter the way we treatment plan and restore them. Or to put it another way, 80 may be the new 60, and we can no longer count on our dentistry outliving our patients as they get older. Although fluoride in the water supply has dramatically reduced the decay rates seen in children and young adults, preventative dentistry will

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become paramount again as we try to extend dentitions well into our patients last years. Fluoride trays used at home to protect against cervical decay should be commonplace for any of our patients who suffer from dry mouth. We will need a thorough understanding and application of occlusion as we design our restorations to last as long as possible. There may be a resurgence in the numbers of removable prostheses that we deliver, utilizing dental implants when/if possible for increased stabilization and/or retention. As we dental professionals are also more likely to live well beyond what our parent’s generation did, the existing model of the typical 30ish year dental career may also have be lengthened. (Forget all of the urban legends that you have heard about dentists having higher than average rates of suicide, disability, divorce, and alcoholism than the population at large. They are bunk, and have been disproven in peer reviewed academic studies). Despite what our patients may think about our exorbitant incomes, it is probably not realistic for us to expect that we can retire with the same standard of living if we do live another 30 or more years after we hang up our handpieces. So how do we manage to pull off practicing for 40 or more years, and then enjoy a long, active, and enriching retirement? Research reported on in the above mentioned magazine does give us a few clues. We’ve all heard it said “You are only as old as you feel,” or “If your attitude was for sale, would you buy it?” It turns out that there may be some truth to these worn out clichés. As you relax, your blood pressure does drop, and as people emerge from depression, their immune systems improve. Daily meditation has been shown to downregulate a gene which codes for inflammation, which is one of the greatest drivers of aging. Meditation may also slow the rate in the decline of the gray matter in our brains as we age. Stress reduction therapies have been demonstrated to help in maintaining the length of the telomeres on the ends of our chromosomes, which help to prevent their damage, and prevent mutations as our cells divide. A study done on women who had optimistic attitudes revealed lower rates of heart disease, cancer, and mortality than their pessimistic/cynical counterparts. Nutrition and diet are also huge in our quest to live longer and healthier lives. Middle-aged Americans who eat a lot of WEST MICHIGAN DISTRICT DENTAL SOCIETY | SPRING ISSUE 2015

EDITOR’S THOUGHTS

animal based protein seem to be more likely to die of cancer and other causes when compared to others who eat a greater proportion of plant based protein. The Mediterranean diet which includes fish, fruits, vegetables, and extra-virgin olive oil has been documented to lower the risk of heart attack and stroke 30% when compared to a typical low fat control diet. The experts also agree with us dentists, in that we would all benefit from less added sugar (particularly fructose) in our diets. It seems that married men live longer than those who are divorced or single – especially from middle age and beyond, however, the same does not apparently apply to women. While women in the study who thrived in a good marriage stayed especially healthy, women who also stayed single, got and stayed divorced, or were widowed, often lived long lives without the burdens and troubles that seem to come with husbands. Go figure.

We all know of the benefits that regular exercise provides us in longevity and mental health, as well as our ability to deliver dentistry (and minimize down time from disability), so there is no point going into any greater depth on this topic in this short article. If we all want to live long, happy, and productive lives to the very end (hopefully less than 142 years!), we will need to embrace a lifestyle that includes a healthier diet, stress management techniques, regular moderate level exercise, and social support. Of the $3 trillion spent in the U.S. each year on health care, 86% goes towards the treatment of chronic diseases, many of which can be treated or prevented with lower cost interventions. If we have the foresight and discipline to incorporate some or most of the health tips described above, we can approach and live through our “golden years,” while enjoying a greater quality of life, and not just a longer lifespan.

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TRUSTEE REPORT

Spring 2015 Trustee Report By Dr. Brian Cilla, MDA Trustee is that the MDA has numerous services and offerings on the for-profit side of business and practical continuing educational opportunities. Additionally, the MDA provides a venue for dispute resolution and standard of care review. As a consequence of these discussions, the BOT has resolved that the MDA pursue engagement strategies with large group practices and/or dental service organizations to enhance membership participation and build positive relationships.

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t was a cold and snowy day when the MDA Board of Trustees (BOT) met in February. Fortunately, the weather has changed for the better. March Madness is in full swing. This report (written between NCAA games) is a synopsis of this most recent BOT meeting. Strategic Planning Session Michael Bills of MB Strategies led the Board, guests, and staff through an interactive exercise on strategic planning and leadership development. Mr. Bills has conducted strategic consulting in the Michigan association arena for over 30 years. The goal of this session was to generate ideas that could be incorporated into the strategic planning process. The attendees were divided into groups. Each group was tasked with generating ideas related to the following questions: • What trends do you see in the profession that may impact the MDA’s mission and strategic plan in the near future (5-10 years)? • How can the MDA do more to help members succeed? • How can the MDA create a culture that supports leadership development and good governance?

Many useful ideas were developed. The strategic vision for the MDA is a continuously evolving process and this exercise created useful collaborative discussions. Mega Topic: The Impact of Large Group Practices Over this past year, the BOT has been examining the role that the MDA can play with enhancing membership value to dentists in large group practices. A key question has been raised regarding what the MDA has to offer that is of value to those that work in this type of practice setting. The consensus

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Governance Update Speaker Deb Peters provided the Board with an update on the Bylaws Review Committee. The committee met twice over the past year to review proposed Bylaws amendments. These areas were reviewed: • The MDA Membership Advisory Committee forwarded a recommendation on assigning members to components. • The committee reviewed the authority of the MDA president to appoint additional alternate delegates to the ADA if deemed necessary. • The Committee developed language creating the duties for the Bylaws Committee. • Clarifying the difference between a working life member and a retired life member. • The section on dues and membership categories were evaluated with regards to dues and assessments. • Clarifying non-voting members of the House and removing the term “ex-officio”. • Determining whether or not the president and/or secretary/ treasurer are voting members of the Board. • Providing language that the Speaker of the House will name the chair of the Nominating Committee if the immediate past president is unable to serve. • It has been determined that each region will be responsible for determining the term for its Nominating Committee representative. • Language to make the MDA Bylaws consistent with the ADA Bylaws with regard to disciplinary penalties for members on probation. Speaker Deb Peters informed the Board that a resolution is a written motion and when components submit resolutions to the House of Delegates (HOD) these resolutions will now WEST MICHIGAN DISTRICT DENTAL SOCIETY | SPRING ISSUE 2015

TRUSTEE REPORT

contain a recommendation to the Board for action, rather than a call for action. There has been confusion as to who determines the number of alternate delegates elected to serve on the MDA delegation to the ADA House of Delegates. The Board of Trustees is responsible for approving the budget, thereby determining the number of alternate positions that are funded. This information is provided to the NomCom; it determines the candidate slate, forwards those names to the MDA HOD for approval, and the HOD elects enough candidates to fill these funded positions. The House cannot request the Board to fund additional alternates, as the budget for this year has been set. The House could, however, recommend that more alternate positions be budgeted for in the future, but the Board makes the final decision on the number of alternate positions that are funded. Speaker Deb Peters informed the Board that the Work Group on MDA Committees continues work on implementing the governance process and closing the gaps identified in the process. It is a very interactive group that wants to make sure that the Board has the appropriate number and type of committees. This Work Group will be reviewing the MDA Board committee structure. Some committees may need to be vetted every year and some may need to be standing committees. The Work Group will be reviewing and rewriting the Committee Operating Manual for Board approval, and will provide more information to the Board at its June meeting. Update on MDA Nominating Committee (NomCom) Dr. Norm Palm provided the Board with an update on the Nominating Committee. He noted that The NomCom voted on the applicants and created its slate to be presented to the HOD. Dr. Palm noted that all applicants to the ADA delegation were slated, all officer applicants were slated, and 12 of the 15 trustee candidates were slated. He provided an overview of the process since the December Board meeting: • The committee reviewed all applications. It decided on the interview questions and questionnaire for the interview process. Three questions were chosen for the applicants to complete in writing; one on the strategic plan, one on leadership competencies, and one on individual competencies. Each applicant was provided with the strategic plan and Code of Ethics. WEST MICHIGAN DISTRICT DENTAL SOCIETY | SPRING ISSUE 2015

• Each NomCom member was assigned one or two applicants to interview. • A Board Matrix was created for each applicant. This is a tool that is utilized for conducting a side-by-side comparison of the applicants. It included demographics, practice setting, competencies, other leadership experiences and community activities. This methodology was used to determine how well the individual will fit with the goals of the strategic plan and that they have an adequate skill set to contribute at a level commensurate with their background. Following the interviews, each NomCom member completed the Matrix for their applicant. The committee was provided with a completed Matrix for use at its Board candidate selection meeting. • The American Institute of Parliamentarians has descriptive information on how the NomCom should operate and it was used as operating procedure. • Committee members discussed their applicant interview. The committee then voted for the top nine (the minimum to be slated) and looked at the matrix to obtain an overall view of the Board. • The NomCom agreed that the nine candidates who received the largest number of votes should all be slated. Attention was then turned to the remaining six candidates. They were discussed and a decision made on each one individually. The next steps for the Nominating Committee include: • Evaluating this year’s process and provide input for change. • Dr. Palm will deliver a written report to the HOD. • A forum at the HOD will be held in order to introduce the candidates and provide them an opportunity to speak. The NomCom will provide detail on the vetting process and the House will be able to ask questions of the committee. As noted above, the process followed by the NomCom will be explained in a written report. Additionally, there will be a Nominating Committee Report and Presentation of Candidates that will be held immediately following the first HOD meeting at Annual Session. MDA Leadership Exploration and Development Program (LEAD) The LEAD program officially launched on September 5, 2014 and has received rave reviews from participants. Thus far

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TRUSTEE REPORT

the group has gone through an individual and group leadership training exercise, has been introduced to the structure and operations of the tripartite, has attended a Committee on Governmental and Insurance Affairs (CGIA) and MDA PAC meeting, and has attended the December Board meeting and holiday reception. These program participants have also completed many individual assignments, including attending IFG health care seminars and in-office lunch and learns, component meetings within and outside of their district, and fundraisers and in-district meetings with lawmakers. Lastly, they’ve presented ideas on how to address critical issues at the CGIA and MDA Board meetings. The group will round out its first phase of activities this spring. It will be spending a day at the MDA’s ad agency (SMZ) to gain a better understanding of how the MDA frames and manages public education campaigns. The LEAD group will also be going to the ADA Retention Recruitment Conference in Chicago. After the first phase of activities is complete, the group will break into its individual work groups. Each group will spend September through February working on creating a whitepaper that addresses one issue of strategic importance to the MDA. Each team will present its findings to the Board at its February 2016 meeting. The outcome of these presentations will be further investigated and/or action on the issue(s) by the MDA. The Board identified the following strategic planning topics for the LEAD groups to consider for team investigation and analysis: 11. What can MDA members expect from the ADA? 12. Should the ADA have specific contact people for each of the states so that there is one person at the ADA that is familiar with what the state is doing? 13. What are the best practices for components that do not have full time executives? How does the MDA keep these components up to date? 14. ADA Business Plan for recent graduates – lower interest rates for recent grads to start up a private practice or a large group practice? 15. Balance helping members succeed with financial stability and prognosis for financial stability for the MDA. 16. Self-evaluating (what is the difference between a specialist and a general dentist? Are you truly serving the general member or specialist?) 8

17. Board Self-Appraisal process and what it should consist of (intersection between group appraisal and individual appraisal). 18. Look at what MDA should be offering for new dentists that it is not already offering. What would be helpful to the new dentist? 19. Making MDA a 24/7 organization. Provide suggestions on how to do that and what would be helpful to members. 10. Methods by which members could receive a personal contact from an MDA staff person (i.e. anointed staff person for each component). A way to personally speak to every MDA dentist every three years. Member Assignment To MDA Component Societies In any given month, there are typically 12 MDA members that request a component transfer. This is an event that is becoming more common. Flexibility with MDA membership is something that our newer member dentists expect. There is a process (and associated paperwork) involved with changing from one component to another. If a member moves and doesn’t let the MDA know, the MDA will typically find out through other avenues. The topic is sufficiently important that the BOT resolved that the MDA Bylaws should be revised so that members may transfer membership from the component in which they practice, or are employed, to another component with the approval of the two component societies. New Dentist Committee What goes around comes around, or is it Déjà vu all over again? The BOT resolved, that the MDA establish a New Dentist Committee to begin operations following the 2015 Annual Session. MDA Insurance & Financial Group (IFG) Mr. Craig Start, President of the MDA Insurance and Financial Group, provided the Board with a brief report on IFG activities: • Eight-hundred offices and 3,374 individuals have signed up for the MDA Health Plan. • IFG moved its Medicare subscribers to the Amwins Program. • BC/BS business grew by 50% with over 638 individual contracts signed. WEST MICHIGAN DISTRICT DENTAL SOCIETY | SPRING ISSUE 2015

TRUSTEE REPORT

• IFG staff made or received over 15,000 health insurance related phone calls; this does not count cell phone activity. • The So-Fi contract has been finalized and should roll out at the end of the month. • AppRiver and e-Scopes, new member service programs, should both launch by the end of March. MDA Foundation Ms. Nancy Meier, Chief Development Officer, MDA Foundation, provided the Board with a brief oral report on activities: • Fundraising for 2014 was up 20% over last year. The Inner Circle has raised $26,000 to-date; more than ever in the history of the program. This program has the greatest potential to increase donations to the Foundation. • Voluntary contributions for 2014 ended up 16% from 2013. This represents about 1,700 members checking the voluntary contribution box on the dues invoice. • The raffle and golf outing promotions began earlier this year with the big push beginning at Annual Session. The raffle cash prize will be $17,000. Golf outing sponsorships to-date amount to $4,300. The golf outing will be held at the Indianwood Golf and Country Club, the new course in Lake Orion, Michigan. • Fundraising for the Foundation and the MOM program are now separated. Overall fundraising, not including the MOM program, is up 21%. • The Foundation has begun fundraising for the 2016 MOM. The Foundation is looking for an increased number of volunteers, as this MOM will see more people in 2016 with the event being held in Warren. The BOT has resolved that the MDA Foundation Board of Directors be charged with undertaking a performance audit (also called a financial and tax review) of the Foundation operations in order to assess performance against best practices. Additionally, the MDA Foundation is urged to establish a joint work group with the MDA in order to determine performance parameters and report the results of the audit. MDA Public Awareness Campaign Jenny Armistead, Director of Marketing and Communications, provided the Board with an update on the MDA Public Awareness Campaign. WEST MICHIGAN DISTRICT DENTAL SOCIETY | SPRING ISSUE 2015

• The new TV spots officially launched statewide in January. • Digital billboard advertising will run in conjunction with the TV spots. • All ads and messages have a call to action to find a dentist on smilemichigan.com. • In December 2014 there were over 33,000 unique page views for the Find a Dentist on the MDA webpage. In January 2015 there were over 44,000 unique views. • A local component marketing kit was emailed to area leaders. It contains all information on the campaign and includes newsletter copy, Facebook copy and preproduced radio ads. Components can contact Jenny for assistance in placing these ads. ADPAC Dr. John Carter informed the Board that the Washington Leadership Conference will be held April 27–29, 2015. ADPAC is the second largest PAC in the United States. It was stressed that it makes a difference when dentists participate and visit with their hometown legislators. MDA members have the highest percentage response rate, of all the states, for ADA action alerts. The ADA is currently transitioning from Capwiz to Engage. It will allow members to contact the regulatory commissions that affect rules as well as the legislators. Every employee or family member of a dentist can send alerts as well; they only need to be trained on how to sign up for the alerts. With the ADA you have to opt in to receive alerts and with the MDA you have to opt out. If more than one individual in an office signs up for the alerts, it is best to use a personal email and not a practice email as it will only recognize one unique email address. The Academy of General Dentistry (AGD) is currently debating about whether it will create its own PAC. MDA members were encouraged to let their state AGD representative know that this will dilute the voice of dentistry in Washington. The BOT was informed that the ADA has a campaign school for any dentist interested in running for a state position. This campaign teaches dentists how to run a campaign. Interested individuals can speak with Dr. Carter or contact the ADA Washington office. Currently, there are 30 states that have dentists in their legislatures.

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TRUSTEE REPORT

Legislative Update Bill Sullivan, Director of Government and Insurance Affairs, provided a brief update on legislative activity: 1. There is a projected $516M deficit for the 2015 State budget. This could affect the Healthy Kids Dental budget. MDA is hopeful but is preparing to be in defensive mode. 2. An Executive Order was signed to merge the Department of Community Health and the Department of Human Services. Because of this, many projects have been put on hold. 3. MDA is waiting for final information on the Medicaid rebid. 4. PEW has partnered with the Michigan Council for Maternal and Child Health to promote mid-level providers. It will begin research on providers of children for both health and dental. MDA has been invited to the table. 5. The Senate Health Policy Committee will be submitting a bill to get rid of the Certificate of Need. 6. The State of Michigan has approved a new certified amalgam separator that will remove at least 99% of mercury in wastewater. The existing amalgam separators are deemed compliant for ten years or until it is to be replaced, whichever comes sooner. The new law will be final by the end of the year and will take effect in three years. Monthly inspection is part of the new law and the ADA is currently challenging this. The MDA will meet with the Department of Environmental Quality for additional discussions. Mobile Dentistry April Stopczynski, Manager of Access and Prevention, reminded the BOT that as of this April, operators of mobile dental units must register with the state and have a memorandum of agreement (MOA) with a local dentist or entity that can provide or arrange for care in the community in which they plan to see patients. Water Fluoridation The MDA has launched a new, proactive campaign to ensure that Michigan citizens continue to enjoy the many benefits of community water fluoridation. With anti-fluoridation activity on the rise, it’s more important than ever that Michigan’s dental community leads the way on this critical public health concern. 10

This remains an issue for all areas of Michigan. The MDA was recently notified by the ADA, that Erin Brokovich (of movie fame) is posting anti-fluoridation comments on her Facebook page aimed at Flint residents. The MDA and ADA are monitoring this situation. Unfortunately, this issue also hits close to home. One of the candidates for Grand Rapids Mayor has a stated goal of eliminating fluoride from the public water supply. This is his only campaign issue. This will require close monitoring and action as necessary by WMDDS and the MDA. Delta Dental Delta Dental is legislatively considered to be a “nonprofit dental care corporation” and not an insurance company. As such legislation intended to cover all insurance companies must also contain a provision that specifically addresses Delta Dental’s special status, This has proven to be a significant and unintended complication for MDA legislative activities. As a consequence, the BOT has resolved the MDA should seek legislation to remove this nonprofit dental care corporation’s special status with regard to future insurance regulations in Michigan. MDA to Present Free Seminar on Genetic Testing The MDA will present a special free seminar, “Genetic Testing in Dental Risk Assessment: The Jury Is In” on Friday, April 24, during the 2015 MDA Annual Session in Lansing. The seminar features Dr. Thomas Hart, chair of the ADA Council on Scientific Affairs and incoming director of the ADA Foundation Volpe Research Center. Dr. Hart will review the science behind genetic testing and will discuss the findings of his researchers, published in the March 2015 JADA. Topics to be covered will include: • an overview of genetic testing; • what research shows about genetic testing in dentistry; • why researchers may draw different conclusions based on the same data; • how genetic testing is regulated; and • financial pressure and ethical concerns in genetic testing. Although the seminar is free to MDA members, registration is required. Two CE credits will be awarded for attendance. WEST MICHIGAN DISTRICT DENTAL SOCIETY | SPRING ISSUE 2015

TRUSTEE REPORT

This is my last report as your WMDDS MDA Trustee. It has been an honor and privilege to serve our Association in this capacity. During my six years on the BOT, I have had the opportunity to work with many dedicated volunteers and our exemplary MDA staff. Everyone should be aware that Elaine Fleming and our (past and present) WMDDS Board are highly regarded within the MDA organization. It has been my good fortune to work with Norm Palm, Connie Verhagen, Deb Peters, Chris Smiley and Colette Smiley during my tenure on the MDA BOT. They have set a high bar for accomplishment at the MDA. As a consequence, the MDA has been regarded as a benchmark for achievement by other state dental associations. I anticipate that the MDA will continue to flourish under the guidance of those that follow down this same path.

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TOOTH TIME 2015

Another Great Tooth Time Event! By Dr. David Huyser, Tooth Time Task Force Chair Photos by Dr. David Huyser

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t’s easy. All ya gotta do is tell ’em you want to keep your teeth – ‘Keep ’em clean and don’t eat a ton of candy’ – and then you get pictures of your mouth on a COMPUTER, win prizes (look at my glow-in-the-dark tooth!), get tattoos like this (points to forehead), dig for teeth, make a tooth necklace and play. Lots of play. Lots of time for Playdoh teeth and crazy mirrors and bubble machines that surround you, a grocery store and lots of games and toys in this place.” Advice from a departing student to an arriving newbee, Tooth Time 2015. Another Tooth Time. Fun and games for all. ‘The old’ includes the indispensible dental assisting students from GRCC (Thank you Julie Bera, conscription has its place – requiring volunteering develops good habits), the GVSU pre-dental and ‘other’ students. The Grand Rapids Children’s Museum provides essential organizational activities and an awesome venue. The Tooth Time committee docs and several of their staff members and A FEW volunteer dentists complete the list of highly valued participants. ‘The new’ is the addition of the Grand Rapids Junior League to the list of volunteers. We hope they will have a permanent presence and add a table of their own to further the discussion of nutrition. Products and supplies are provided by the “Give Kids A Smile” project of the ADA, Henry Schein, and Dr. John’s Candies. Tooth Time is primarily supported by the West Michigan District Dental Society and the West Michigan Dental Foundation. We could use you in next year’s event. Please contact the committee to join in the FUN!

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WEST MICHIGAN DISTRICT DENTAL SOCIETY | SPRING ISSUE 2015

TOOTH TIME 2015

WEST MICHIGAN DISTRICT DENTAL SOCIETY | SPRING ISSUE 2015

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IN MEMORIAM

Cyril Lixenberg Born in London, July 5, 1932 – Died in Amsterdam, January 10, 2015 Submitted by Timothy Chester Timothy Chester is Director Emeritus of the Grand Rapids Public Museum. He served on the 1995 and 2007 Grand Rapids Water Fluoridation Commemorative Committees and was the Recipient of the 2010 WMDDS Steel Water Award.

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his past winter, the West Michigan dental community lost a dear friend and muse when the Amsterdambased Dutch sculptor Cyril Lixenberg succumbed to cancer at age 82. Lixenberg, already a wellknown artist in West Michigan and in the Netherlands, marked dentistry forever when his design for the monumental sculpture Steel Water was selected for placement on the banks of the Grand River in downtown Grand Rapids in 2007. Lixenberg also marked our community with his zest for life, boundless good humor, quick wit, and through the enduring friendships he forged with his many admirers. Cyril Lixenberg (b. 1932) was a prolific Dutch artist who enjoyed critical success in both Europe and the United States both as a print maker and a sculptor of monumental steel works. He was a friend and supporter of Grand Valley State University in addition to being a familiar member of Michigan’s artistic community, having exhibited in Ann Arbor, Muskegon, Holland and Grand Rapids. Steel Water was his third major public sculpture commission in West Michigan, following on the success of Ontmoeting, commissioned by Holland Hospital in 1999, and Amaranth, created in 2002 for the exterior plaza of Mackinac Hall on Grand Valley State University’s Allendale campus. Cyril Lixenberg’s Steel Water was commissioned by the Mayor’s Grand Rapids Water Fluoridation Commemorative Committee and the West Michigan District Dental Society, with $250,000 in supporting funds provided by many private

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and public contributions. The 33' tall abstract work was placed on public land on the Riverside Plaza outside the then-new Grand Rapids JW Marriott Hotel to honor the City of Grand Rapids’ pioneering role in 1945 in advancing global health by becoming the first city on earth to fluoridate its public water supply. Lixenberg wrote that his sculpture “continues my life-long fascination with the contrast between shapes and counter shapes – positive and negative images of form that cannot exist without each other. Steel Water focuses on and celebrates the contrasts that appear in the transparent and opaque qualities of flowing water. It is a monumental reference to water as a basis of human life, to its never-ceasing flow in the adjacent Grand River, and to the means by which the health giving benefits of fluoridation have reached every person in this community. Open spaces between the ribbons of steel reference the transparency of water in motion.” The Fluoride Commemorative Committee defined its challenge as coming up with a new fine art sculpture that would complement the spectacular new JW Marriott Hotel that would be built adjacent to the site, while educating the public about the health benefits of water fluoridation. Committee members worked with Henry Matthews, Director of Galleries and Collections at Grand Valley State University, sending out requests for proposals to artists around the world. Matthews subsequently presented the committee with extensive portfolios from twelve artists. Following careful evaluation, the Committee selected three finalists who were invited to prepare site-specific proposals. Public presentations were made by the artists and public comments were solicited as their proposals and maquettes were exhibited at the Urban Institute for Contemporary Arts. Lixenberg’s site specific design was the unanimous selection of the Committee, and the project was soon under way. The finished sculpture and its handsome surrounding plaza were completed and dedicated on September 14, 2007, commemorating Grand Rapids pioneering role as the first city in the world to add fluoride to its public water supply system. The City, along with the U.S. Public Health Service, WEST MICHIGAN DISTRICT DENTAL SOCIETY | SPRING ISSUE 2015

IN MEMORIAM

the Michigan Department of Health, and the University of Michigan School of Dentistry began a ten year study to determine the effectiveness of fluoride in the prevention of tooth decay. Grand Rapids was chosen as a test site because of its large population of school-age children; its proximity to Lake Michigan, which is mostly free of natural fluoride and the proximity of Muskegon, which served as the control city. By 1955, the study had demonstrated a sixty-five percent reduction in tooth decay which led to the adoption of fluoridation as an accepted public health measure – considered the most effective in history. At the dedication, Lixenberg explained that “the idea of Steel Water, and of dentistry and oral health, is very much based on water. And this site was by the river, the Grand River, and that’s a wonderful situation to be given to be creative with. The river was literally the inspiration to make Steel Water.” Ten years later in 2014, the Grand Rapids Art Museum mounted an exhibition that explored the creation of Steel Water as part of a larger retrospective exhibition of Lixenberg’s art work organized by the Grand Valley State University Art

Gallery. Thousands of students and citizens exploded into thunderous applause that December as Lixenberg was awarded an honorary doctoral degree in art from GVSU. One year later, after Cyril passed on, his children celebrated his life at a memorial service in Amsterdam on January 18, noting that “he maintained his humor and his life-loving sparkle until his final breath.” A community-wide celebration of the life of Cyril Lixenberg for the benefit of those of us on this side of the Pond will be held on Sunday, May 3rd, 2015 from 3 until 5 p.m. in the Loosemore Forum of the L. William Seidman Center, 50 Front Ave., S.W. on the downtown Grand Rapids campus of Grand Valley State University. Free parking is available in the Mount Vernon lot. I hope that many of Cyril’s friends in the dental community will join the visiting members of his family in a tribute to the creator of our “own” artistic monument to dental health. WEST MICHIGAN DISTRICT DENTAL SOCIETY | SPRING ISSUE 2015

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WEST MICHIGAN DISTRICT DENTAL SOCIETY | SPRING ISSUE 2015

WMDDS NEWS

We’ve Moved!

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he West Michigan District Dental Society office has moved! The office is still located in the Waters Building. We are now in suite 301. Thank you to Meg Goebel, President of Paul Goebel Group, for her continued generosity and allowing the WMDDS office to move with them to their beautiful new office. West Michigan District Dental Society 161 Ottawa Avenue NW, Suite 301 Grand Rapids, MI 49503 Phone 616.234.5605 | Fax 616.454.6549 Follow us on Facebook Visit the WMDDS website at wmdds.org

WEST MICHIGAN DISTRICT DENTAL SOCIETY | SPRING ISSUE 2015

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2015–2016 WMDDS CONTINUING EDUCATION PROGRAMS

F r i d ay, J u n e 1 9 , 2 0 1 5

Do Dentistry, Not Time – Clinical Records Prevent Criminal Records Presented by Dr. Roy Shelburne Thousand Oaks Golf Club | 8:00 AM — 12:00 NOON | 4 CEU’s For information, call Elaine Fleming at 616.234.5605 or email at efwmdds@aol.com

F r i d ay, O c t ob e r 2 3 , 2 0 1 5

Practical Tips – For the Everyday Esthetic Dentist Presented by Dr. Robert Margeas Frederik Meijer Gardens & Sculpture Park | 8:00 AM — 4:00 PM | 7 CEU’s For information, call Elaine Fleming at 616.234.5605 or email at efwmdds@aol.com

F r i d ay, J a n u a r y 2 9 , 2 0 1 6

WHY ARE WOMEN SO STRANGE AND MEN SO WEIRD? HOW TO COMMUNICATE EFFECTIVELY WITH THE OPPOSITE SEX Presented by Bruce Christopher Frederik Meijer Gardens & Sculpture Park | 8:00 AM — 4:00 PM | 7 CEU’s For information, call Elaine Fleming at 616.234.5605 or email at efwmdds@aol.com

F r i d ay, M a r c h 2 5 , 2 0 1 6

Double your Production Tomorrow Presented by Wendy Briggs and Dr. John Meis Frederik Meijer Gardens & Sculpture Park | 8:00 AM — 4:00 PM | 7 CEU’s For information, call Elaine Fleming at 616.234.5605 or email at efwmdds@aol.com

Registration forms will be mailed 2 months prior to each course and will also be available online at www.wmdds.org. 18

WEST MICHIGAN DISTRICT DENTAL SOCIETY | SPRING ISSUE 2015

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Do Dentistry, Not Time: Clinical Records Prevent Criminal Records A Half Day CE Seminar | 4 Continuing Education Credits Presented by Roy S. Shelburne, D.D.S. | Friday, June 19, 2015 | Thousand Oaks Golf Club Dr. Shelburne went to prison on August 20, 2008 and was released on May 14, 2010. He learned a series of lessons the hard way. There are ways to protect and defend a dental practice and to prevent what happened to him from happening to you. You can protect your practice in the event of a Board complaint, insurance audit, malpractice claim, or criminal complaint. Dr. Shelburne found that his records and systems were faulty. He learned that it is critical and possible to implement protocols and form a defensive systemic approach to record-keeping. Know that if it’s not in your clinical record, you didn’t see it, you didn’t say it, you didn’t do it, it didn’t need to be done, and it doesn’t exist … from the legal perspective. To be prepared for any challenge, the whole dental team – not just the doctor – must be careful, concise, complete, and diligent. Learning and implementing this no-nonsense team approach to record-keeping could mean the difference between success and failure in the event of an action or challenge to your practice. Objectives 1. To understand that what you don’t know can hurt you and that ignorance is no excuse. 2. To learn to assimilate and maintain records that can both protect and defend. 3. Understand the necessity of due diligence and how to conduct records review and internal audits to insure accuracy and excellence.

West Michigan District Dental Society is an ADA CERP Recognized Provider.

Thank you to our sponsor who haS helped to make thIS program available to us.

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MDA-member dentist – $100

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non MDA-member dentist – $200 NAME ON CARD

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WMDDS retired member dentist – $50 TOTAL:

PAY BY CHECK: Make checks payable to: West Michigan District Dental Society. Remit to: Elaine Fleming | c/o WMDDS | 161 Ottawa NW | Suite 301, Waters Building | Grand Rapids, Michigan 49503 | Questions? Call 616.234.5605 or email efwmdds@aol.com

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WEST MICHIGAN DISTRICT DENTAL SOCIETY | SPRING ISSUE 2015

FINANCIAL NEWS

Tangible Property Repair Regulations: What Do They Mean for Me? Brian LaFrenier, CPA, Audit Partner, Beene Garter, LLP

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fter years in the making, the IRS issued the final tangible property repair regulations earlier this year. These regulations explain when you can take current deductions rather than capitalizing and depreciating an item, and they apply to anyone who pays or incurs amounts to acquire, produce, or improve tangible real or personal property (which are virtually all businesses). Your tax professional should have filed a Form 3115, Application for Change in Accounting Method, with your tax return this year to ensure you are in compliance. These new regulations have made significant changes to existing tax law and are lengthy and complex. They do offer unique tax planning opportunities going forward though. Below are a few key changes to be aware of as you start your tax planning for the 2015 tax year. To Capitalize or To Deduct? Amounts paid to improve a unit of property (UoP) must be capitalized under the repair regulations. An improvement is defined as an expenditure that betters a UoP, restores it, or adapts it to a new and different use. On the other hand, repairs or maintenance to property that does not need to be capitalized under any other code section can be deducted. Unit of Property (UoP) The UoP being improved or repaired takes special importance under the repair regulations. There is now a functional interdependence standard to factor in when determining whether an item must be capitalized or deducted as a repair. WEST MICHIGAN DISTRICT DENTAL SOCIETY | SPRING ISSUE 2015

Buildings When it comes to buildings, however, the regulations generally treat each building and its structural components as one UoP – the building. The regulations also list nine specific building systems that are treated as separate from the building structure. An improvement to the building is defined by its effect on those systems, rather than on the building as a whole. If a taxpayer restores a building structure, such as by replacing the entire roof, the expenditure is treated as an improvement to the single UoP consisting of the building. If the taxpayer makes an improvement to a building system, such as the heating, ventilation, and air conditioning (HVAC) system, that expenditure is also an improvement to the building UoP. Per-Building Safe Harbor for Qualifying Small Taxpayers This safe harbor would allow qualifying small taxpayers (those with an average annual gross receipts of $10 million or less in the three preceding tax years) to deduct improvements made to a building property with an unadjusted basis of $1 million or less. However, the safe harbor only applies if the total amount paid during the tax year for repairs, maintenance, and improvements to the building doesn’t exceed the lesser of $10,000 or 2% of the building’s unadjusted basis. This safe harbor can be elected annually on a building-by-building basis. Routine Maintenance Safe Harbor This safe harbor would allow certain expenses of routine maintenance to be deducted rather than capitalized. Routine maintenance includes recurring activities that keep business property in efficient operating condition (e.g. inspection, cleaning, testing, and replacement of damaged or worn parts). For a building structure, you must reasonably expect to perform the maintenance more than once during the 10-year period that begins when the structure or system is placed in service. For property other than buildings, you must reasonably expect to perform the activities more than once during the property’s class life for depreciation purposes. For more information on the tangible property repair regulations, visit: http://www.irs.gov/Businesses/Small-Businesses&-Self-Employed/Tangible-Property-Final-Regulations

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FINANCIAL NEWS

What Dental School Never Taught You About Choosing a Financial Planner (Part Two) By Bernard Bowhuis, CLU, ChFc, CFP®, CEO, Benchmark Financial Design Group, Inc.

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s you may recall, in my last article for this Bulletin, I addressed four areas of importance on how to choose a financial planner (see page 34 of the Winter Issue 2015, Vol. 47, No. 1). This behind-the-scene look included questions you should ask your advisor, or prospective advisor. The reason this is so important is that, while you are ultimately responsible for your own financial future, the right leadership can make the journey so much more enjoyable. The proper relationship and proper advice may let you retire when you want, live how you want, and pass on what you want for the next generation. These first four areas were: 1) Are you a fiduciary? Does the advisor place your interest ahead of his or her own? 2) How do you make money? Is the advisor paid by commission, fee, or fee-based? 3) What is the advisor’s educational background? Some credentials such as CFP and CFA are more meaningful than others. 4) How do you invest for your clients and for yourself? Is the process disciplined and does the advisor practice what he or she preaches? I consider these four questions to be the main pillars of deciding if I would want to work with the person for financial advice. If I am comfortable with the answers I receive, I would then look further. The next series of questions look deeper into how the advisor conducts their business. 5) What is your process for working with clients? Can you describe how you work? If the advisor is offering to help you reach your financial goals, find out more about the process they follow to help their clients. If someone asked you this question about your

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dental practice, you could probably describe in detail what they would experience. Your advisor should be able to do the same. This is one of the areas I feel you should trust your feelings. Still verify or ask for references to check the background of the advisor, but you need to have a good feeling as well. If there is something that gives you an uneasy feeling, I would suggest you walk away. Is the service an “a la carte” menu or a comprehensive financial planning model? How do they learn about updates to your situation? What information do they track about your finances that help them have a good picture of your situation? How do they quantify the progress that you are making? What kind of reporting should you expect? What financial subjects do they address with clients? What things do they not address? The point of this question is to help you gauge the level of experience and competence of your advisor (or prospective advisor). Qualified advisors should be able to go into great detail about why and how they service their clients a particular way. Not everyone has the same process, but good advisors know why they do things the way they do. 6) What happens to me if something happens to you? If an advisor were to have an accident and become unable to perform his or her duties, who would continue to service you and your practice? How much of the advice is documented into a system or format that can be easily understood by the succeeding advisor? Good financial advisors have a process in place for easily transferring all of your information, recommendations and financial planning goals and objectives. If you work with a boutique or small advisory firm, be aware of their documentation and backup systems. Some advisors keep too much of your information inside of their head and put your hard-earned money in jeopardy as a consequence. Whether you work with a big or small firm, each advisor should build a process to protect your security by having a good backup plan. Big firms have both advantages and disadvantages in this area. While many have a team approach which provides others familiar with your plan, this can also lead to less actual direction from the advisor you have hired. Who is actually providing the advice you are paying for? WEST MICHIGAN DISTRICT DENTAL SOCIETY | SPRING ISSUE 2015

FINANCIAL NEWS

7) What is the long term plan for your business? How does that affect me? This question can almost be combined with the one above. Many times in our industry we have found that people tend to work with advisors plus or minus 10 years their own age. For example, a 50-year-old advisor may find that most of his or her clients vary in age from 40–60. There are of course clients on both ends of the spectrum, but think of the age demographic much like a Bell curve. The long term plan for the advisor’s business then can have the same affect you may have seen with some of your patients. A dentist retires with no one to take over his practice; the patients are left to fend for themselves. I am sure you have also experienced when a fellow dentist leaves a practice and the patients don’t care for the new doctor. Knowing the advisor’s long term plan for the practice will allow you a better strategy for your own financial future. Many times the real work for the advisor begins when you retire. Even more so in an investment environment like we have had the last few years, it can be challenging to find ways to replace a doctor’s income and still maintain or grow net worth. 8) How do you stay current on technology and changes to the law? It seems every profession has its own continuing education (CE) requirements. For the advisory industry this can include insurance CE, FINRA requirements, compliance requirements from a broker/dealer, and designation requirements (for example, a CFP is required to meet a minimum of 30 credit hours every two years). I feel that a good advisor should do more than the minimum to stay current on changes in the industry as well as changes in various laws. Would you want to go to a dentist who has not updated or refreshed their skills since leaving dental school? Technology changes are not as imperative as CE. However, just like your cell phone, your TV, and even your practice, our industry can be on the front edge of innovation. We have access to programs that can let you see your full financial picture on your cellphone, can update your financial picture constantly, and let you communicate with your advisor at any time. WEST MICHIGAN DISTRICT DENTAL SOCIETY | SPRING ISSUE 2015

If I visited a dental office and the equipment was dated, I would be concerned about the quality of care I was receiving. As fast as the economic environment changes, I would want to know that my advisor could keep pace and provide the leadership I need. In Conclusion Dentists need good financial advisors they can trust. Today’s financial landscape is challenging and very complex. Your advisor will either become a great asset or a heavy burden to your finances. With a large number of qualified advisors to choose from, don’t feel you have to settle. Take time, ask questions, conduct an interview, and do your homework. Your relationship with your financial advisor should be long and profitable, and you deserve the best service available.

Investment Advisor Representative of and Securities offered through Founders Financial Securities. Member FINRA, SIPC and Registered Investment Advisor Benchmark Financial Design Group, Inc. Bernard Bowhuis, CLU, ChFC, CFP®, CEO 2358 S. Garden Ct., Jenison, MI 49428 616.667.8834 | 616.443.4334 bbowhuis@mibenchmark.com | www.ddsMoneyCoach.com

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LEGALLY SPEAKING

Properly Defining the Role and Duties of an Associate Dentist Submitted by Nicholas H. Vander Veen, Attorney, Smith Haughey Rice & Roegge Goal questions are just as important for the associate to ask and answer before joining a practice. If the associate is content with just being a component in a dental machine, then the practice where the employer is looking for a future partner is not going to be a good fit. In the same light, a motivated associate with designs of establishing his or her own practice is not going to remain in an atmosphere that does not provide the potential for ownership that he or she is seeking.

This article addresses the key points that I often see clients skim over when they approach me about hiring a new associate: what do I want from the associate and what can and should the associate do for the practice?

Roles of the Associate For the employer who merely wants an additional associate, it is common for them to prefer that associates have a very limited role in the day-to-day affairs of the practice. This is particularly common in corporate dentistry settings. Associates are essentially asked to do nothing but dentistry and leave administration, marketing and all other activities up to the management team. This approach leaves the senior or owner dentist in a position of absolute control over the affairs of the practice or in the hands of the preferred individuals. In the situation where the employer is looking for a partner or buyer, it is more common for the associate to have many more duties and responsibilities in the practice. The associate will not only be responsible for just clinical duties and charting, but also management duties such as employment policies, marketing decisions, and finance planning. These added roles allow for the associate to grow into the practice, but can sometimes lead to trust issues and conflicts between employer and associate when there is disagreement or the duties are not well defined.

Employer and Employee Goals The prudent employer does not make a decision to hire an associate dentist without first evaluating whether or not the economics and finances of the practice can support a second (or third, etc.) dentist. Therefore, the focus shifts to this question: Why bring on the associate? Does the employer merely want an additional practitioner to service an ever-growing population of patients, or is the employer seeking a potential future practice partner? Is the employer looking to find someone to buy and take over the practice outright? Answers to these questions will allow the employer to best shape the role and responsibilities they wish for the associate.

Defining the Responsibilities Once the goals and roles of the associate and employer have been discussed, the most important step in cementing and planning for a successful associateship begins. Properly and clearly defining the responsibilities and duties of the associate and employer in the employment agreement is crucial in ensuring that the parties have a clear understanding of each other and the measurements of success. For example, the employment agreement should not merely state that the associate shall be responsible for the treatment of patients and management of the practice. The definition of practice management duties is far too nebulous

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hen making the decision to take on an associate, the hiring dentist needs to consider a multitude of factors. Some of the most important points to evaluate are: 1. Will there be enough patients to support two or more dentists? 2. What are the goals of both parties? 3. What will be the respective roles and responsibilities of each party? 4. What will be the terms, conditions, and duration of employment? 5. Will there be a path to partnership or ownership? 6. How will we unwind the relationship in the event of termination?

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WEST MICHIGAN DISTRICT DENTAL SOCIETY | SPRING ISSUE 2015

LEGALLY SPEAKING

a concept unless explicitly defined and delineated in the contract. Practice management can range from collections, employment decisions, marketing, and buying supplies. When working with my clients, I often suggest a laundry list of activities and duties that are associated with the management of the practice and help my client pare down or specify in the case of an employer and include or remove in the case of an employee. Additionally, in the event that practice building is a goal that the employer has for the associate, then the activities that represent practice building should be clearly laid out in addition to the review procedures and metrics that will be used to measure the associates success in these activities. Will the associate be required to attend New Dentist Forum meetings, participate in case study groups, join professional organizations, or entertain referring dentists? Too often I have seen associateships fall apart because the initial understanding between employer and associate were not fully reduced to writing in order to preserve the parties’ understanding and memory of the goals of the agreement at the time it was made. A knowledgeable attorney or advisor can provide invaluable advice and direction in this area that can help secure a strong associate-employer relationship.

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Does your Disability Income policy have enough muscle? Does it last to age 70? Have its own OCC definition? Provide maximum income of $17K per month? Reflect your choice of Cost of Living Rider? Include a Catastrophic Rider?

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Will your Benefit Amounts do the distance? Does the Benefit Amount cover your family needs, per your Detailed Needs Analysis?

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Are you looking to trim your excess payments? Have you applied the WMDDS discount to save tens of thousands of dollars over the life of your contract?

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Would you like your Insurance Review to leave you feeling stronger and more confident?

Planning for the Buy-In or Buy-Out In the event that a partnership or practice purchase is desired by the parties, the prerequisites required need to be defined and in place at the time the employment agreement is entered. For example, if a partnership buy-in is the goal for the parties, I often suggest that clients include language that generally defines the factors necessary before the final buy-in package is offered. This language could include a formula-type approach that says if employee meets goals A and B (such as meeting production growth targets and marketing activity requirements), then employer will draft a buy-in agreement. This allows both sides to feel comfortable that there is a defined path to the end goal that can be followed and attained. In conclusion, just as in any relationship, clear and effective communication is essential for the employer and employee to have a successful association. A knowledgeable attorney can help you ask the right questions that are necessary to fully develop and define the relationship between the employer and associate dentist. Nick is a business law attorney in Grand Rapids who specializes in representing dentists and dental groups throughout Michigan and Illinois in associate agreements, partnership formations and practice purchases. He can be contacted at 616.458.5283 or nvanderveen@shrr.com.

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WEST MICHIGAN DISTRICT DENTAL SOCIETY | SPRING ISSUE 2015

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TECHNICALLY SPEAKING

Encryption Submitted by Greg Feutz, President, DDS Integration

Greg Feutz is President of DDS Integration, a Grand Rapids based dental technology company.

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hat is it? Gibberish, that’s what it is. Actually, it kind of, sort of, is. Encryption makes your data appear like gibberish. Ever open a Word document with the wrong version of Word and it looks like a bunch of wingdings or something? That’s more or less what encryption does to your data for those that don’t have the encryption key. The basic premise is to keep your data readable to those who are trusted but gibberish to everyone else. That way, if it’s ever lost or stolen they really can’t do much with it. How do I get some? It’s easy! Just call up your favorite tech company, DDS Integration and they’ll hook you up! But seriously, any tech company that does anything with dental offices should be able to take care of this for you. Here’s what you should get, in my suggested order of importance: • Backup encryption – Those little drives that you probably take home every night with your backup on them, you know? Those, in my opinion, are your greatest risk of having your data lost or stolen. Your backup software should encrypt those. However, it probably does not based on what I typically see. Get a newer, image-based backup software that can encrypt your backup. We use Macrium Reflect because of its overall great/fantastic/awesomeness. • Also, consider a fireproof/waterproof backup drive that you don’t even need to take home. Iosafe makes pretty affordable 3TB versions that have plenty of space for most practices. • Email encryption – Now you’re not going to lose more than 500 patient records via email (probably) but this would be a perfect place for a disgruntled patient to tip off HIPAA that you’re not in compliance, thereby opening the

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possibility of an audit. So, it’s important to encrypt any email you’re sending with patient information on it. Most are a pain because they require passwords and keys, but a few that we’ve found do not. Those are Zsentry (we currently implement) and Virtru (we’re testing). • Server encryption – This is important because all your data (hopefully) is stored here. It is unlikely that your server would be stolen, but it is possible. Therefore your server should be encrypted. With Server 2008 and Server 2012 this is easy since they have Bitlocker built in. Otherwise you can use Veracrypt (replacement to Truecrypt) to do the job. We’ve found Bitlocker to be easier and less likely to interfere with backups, but both can be made to work. • If your server is a workstation/server running Windows 7, you can upgrade to Windows 7 Ultimate ($100 or so) which then includes Bitlocker. • Workstation encryption – Hopefully you’re not storing anything on workstations, but in many cases I’ve seen there are xrays or letters sitting on the desktop. Like the workstation/server above, you could upgrade to Windows 7 Ultimate or use something like Veracrypt. I’ve yet to have a practice go to this length. Again, backup, email, and server encryption are the big three in my book (figuratively, I don’t really have a book). They’re not terribly costly or difficult to implement and live with. “Excitement/new shiny thing meter” will read between 0 and 1 but “risk/big fine” meter will likely do the same. Bottom line: If you’re 1) A dentist, 2) Have patients and, 3) Keep records of your patient visits, you should really be using encryption. Only you can assess whether you meet those criteria. Thanks for reading. Is your data (|qu=lxMn][ (encrypted, in Windings)? What are your thoughts? Comment on our blog or Facebook article. We’d love to hear your opinions on Encryption. Facebook: facebook.com/ddsintegration Blog: ddsintegration.com/blog

WEST MICHIGAN DISTRICT DENTAL SOCIETY | SPRING ISSUE 2015

WMDDS CPAs good ideas7.5X3.25.pdf 1 3/5/2015 2:27:22 PM

CPAs BRINGING NEW C

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“GOOD IDEAS!”

TO YOUR PRACTICE.

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RICK CHRISMAN, CPA MANAGING SHAREHOLDER rchrisman@hungerfordnichols.com (616) 949-3200

MARK YOUR CALENDAR West Michigan Dental Foundation Annual Golf Outing

Friday May 15, 2015 NEW LOCATION: Thousand Oaks Golf Club To register or for more information, contact Elaine Fleming at 616.234.5605 | efwmdds@aol.com 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 | SPRING ISSUE 2015

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ESTATE PLANNING

Use Your Snow Day to Plan Your Sunny Retirement Bill Hunter, Director of Personal Retirement Solutions for Bank of America Merrill Lynch

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his winter is predicted to be even colder than last according to the Old Farmer’s Almanac. As you’re prepping for winter while still trying to forget the polar vortex, there’s never been a better time to start dreaming of – and planning for – the ideal retirement location. Whether that dream includes a cottage in the country, a beach waterfront property or a modest home near your grandchildren, understanding the options, risks and strategies will help land you there quickly, safely and ready to make the most of your retirement years. Choosing the best retirement location depends on several variables, and sifting through them can be overwhelming. To ensure you choose the location that makes sense for both your personal and family goals, consider these three things before deciding where to retire: activities and work interests; tax implications; and health and assistance needs.

that downsizing a current home for a retirement property is an easy way to simplify your life; however; make sure to investigate the possibility of capital gains before putting out the For Sale sign. All too often, retirees begin choosing retirement locations based solely on income tax rates. But, states with little to no income tax often impose higher sales, property and municipal taxes, which can outweigh any potential benefits. If you are set on a general location, but the tax rates are too high, look at nearby towns. You will still have access to the activities and lifestyle you’re looking for, but at a much more reasonable price tag.

Activities and Work Interests Over seven in ten pre-retirees say they want to work in retirement. Many see retirement as a chance to try something new and even pursue career dreams they were unable to explore during their pre-retirement years. Nearly three out of five (58%) working retirees said retirement was an opportunity to transition to a different line of work.1 Being active in retirement can also involve volunteering time and resources to a nonprofit or charitable cause that you care about. Finding a cause close to home minimizes expenses associated with travel and helps build strong relationships that, ultimately, benefit you and the cause. Many retirees tell us they are interested in teaching – providing the opportunity to pass along their knowledge to the next generation while providing a good amount of flexibility with schedules. Most adjunct instructors can teach as many or as few classes as they like, which leaves time for other retirement dreams. However, if, if you want an even less permanent alternative, consider retirement commuting – spending only half of the year teaching.

Health and Assistance Less than one out of six pre-retirees (15%) has ever attempted to estimate how much money they might need for health care and long-term care in retirement, but considering your longterm health and wellness needs is a crucial part of retirement planning.2 The reality is that people are living longer, which means rising healthcare and assistance costs are inevitable. Consider that when you’re planning your ideal retirement destinations. After all, the Alaskan mountains might seem great today, but if the nearest healthcare facility is 200 miles away, the cost of your doctor’s visit could double or triple. Some clients assume that their adult children will take care of them. Others believe they will transition to an assisted community. Whatever the scenario, it is important that you ask the right questions and have the tough conversations sooner rather than later. Are your children willing and able to support you in retirement? Or if you’re considering an assisted care facility, are medical expenses included in the cost? These are critical factors to consider as you determine how, and where, you’ll retire. Choosing a location that meets your individual retirement needs and personal goals will ensure you live the lifestyle you’ve been planning for. And like most things, getting there involves starting early, asking the right questions and seeking expert advice.

Tax Implications Decisions clients make while planning for retirement often have unexpected consequences. For example, you might think

1 Work and Retirement – a Merrill Lynch retirement study in partnership with Age Wave, March 2014. 2 Health and Retirement – a Merrill Lynch retirement study in partnership with Age Wave, March 2014.

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WEST MICHIGAN DISTRICT DENTAL SOCIETY | SPRING ISSUE 2015

ESTATE PLANNING

For more information, contact Merrill Lynch Financial Advisor Edward S. Bujdos of the Grand Rapids office at 877.774.4201 or edward_bujdos@ml.com.

Edward Bujdos, CRPC, from the Eccker, Bujdos & De Jonge Group of Merrill Lynch, Grand Rapids office at 250 Monroe Ave. NW, Suite 600, Grand Rapids, MI 49503

The investments or strategies presented do not take into account the investment objectives or financial needs of particular investors. It is important that you consider this information in the context of your personal risk tolerance and investment goals. Always consult with your independent attorney, tax advisor, investment manager, and insurance agent for final recommendations and before changing or implementing any financial, tax, or estate planning strategy. Merrill Lynch Wealth Management makes available products and services offered by Merrill Lynch, Pierce, Fenner & Smith Incorporated (“MLPF&S”) a registered broker-dealer, Member SIPC and other subsidiaries of Bank of America Corporation (“BAC”). “Merrill Lynch” refers to any company in the Merrill Lynch & Co., Inc., group of companies, which are wholly owned by Bank of America Corporation. Investment products: Are Not FDIC Insured Are Not Bank Guaranteed May Lose Value © 2014 Bank of America Corporation. All rights reserved.

6th Annual Griffins Dental Appreciation Night On March 20, 2015, the Sixth Annual Dental Appreciation Night was held at the Grand Rapids Griffins hockey game and was attended by 569 dentists, their staff, and families, who joined in the fun and excitement. The West Michigan Dental Foundation received a generous donation from the Griffins in the amount of $1,138 as a result of ticket sales to dental offices for this event. In addition to Dental Appreciation Night, the West Michigan District Dental Society held a bone marrow drive organized by Dr. Steve Conlon. Assisted by dental assisting students from Grand Rapids Community College, 40 potential new bone marrow donors were signed up and took the first step toward giving someone a second chance at life. Thanks to Dr. Conlon and to the GRCC dental assisting students for making this event a success! Check out photos from the event on the WMDDS Facebook page.

WEST MICHIGAN DISTRICT DENTAL SOCIETY | SPRING ISSUE 2015

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Some of your most important connections can be found close to home Proud to serve the West Michigan Dental Community for more than 30 years.

Merrill Lynch financial advisors are committed to the individuals and businesses in West Michigan. We can help you build upon your success, prepare for the future and create a strategy that’s uniquely yours.

Eccker, Bujdos & De Jonge Group Merrill Lynch Scott S. Eccker 250 Monroe Avenue NW Senior Vice President – Suite 600 Wealth Management Grand Rapids, MI 49503 Senior Financial Advisor PIA Program Portfolio Manager 616.774.4201 Edward S. Bujdos, CRPC® Vice President Senior Financial Advisor PIA Program Portfolio Advisor

www.fa.ml.com/ebdgroup

Zachary D. DeJonge Financial Advisor Natalie Sinquefield Registered Senior Client Associate

Life’s better when we’re connected® CRPC® is a registered service mark of the College for Financial Planning. Merrill Lynch Wealth Management makes available products and services offered by Merrill Lynch, Pierce, Fenner & Smith Incorporated (“MLPF&S”), a registered broker-dealer and member SIPC, and other subsidiaries of Bank of America Corporation (“BofA Corp.”). Investment products: Are Not FDIC Insured Are Not Bank Guaranteed May Lose Value The Bull Symbol, Merrill Lynch Personal Investment Advisory, Merrill Lynch and Life’s better when we’re connected are trademarks of Bank of America Corporation. © 2014 Bank of America Corporation. All rights reserved. ARBKH4W4 | AD-12-14-0055.A | 470950PM-0314 | 12/2014

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WEST MICHIGAN DISTRICT DENTAL SOCIETY | SPRING ISSUE 2015

Legislative Breakfast Friday, May 29, 2015 Frederik Meijer Gardens & Sculpture Park 1000 East Beltline NE Grand Rapids, MI 49525 Please mark your calendar and make plans now to attend the WMDDS Legislative Breakfast. This is an important opportunity for WMDDS dentists and local legislators to meet and express views and concerns on the issues that affect dentistry. Please make every effort to attend. To reserve your place, please complete and return the attached form by May 20, 2015.

Name

Email address

Breakfast Buffet will be served starting at 8:00 am Cost: $16 per person Please make check payable to: West Michigan District Dental Society Return by May 20, 2015 to: West Michigan District Dental Society 161 Ottawa Avenue NW Suite 301 Grand Rapids, MI 49503 Questions? Contact Elaine Fleming 616.234.5605 | efwmdds@aol.com or Dr. Leonard Bartoszewicz, WMDDS Legislative Chairperson 616.245.9830 | doclendo@yahoo.com

CLASSIFIED ADS

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, 301 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.

For Sale – Family practice in Grand Rapids NE that is part time with great potential, located in an excellent highvisibility location. There is 2050 sq.ft. with 5 ops and a 6th op is plumbed in. Opportunity for more footage if desired. Call 616.485.4884 for details. Kavo Handpieces for Sale – 6000B have 5 at $400/handpiece, 6500B have 6 at $400/ handpiece, 647B have 8 at $200/handpiece, 640B have 2 at $200/handpiece, 649B have 2 at $200/handpiece. Call 616.453.6323. Dental Office Building for Sale – 1595 square feet on a very high traffic street. Has been a dental office since 1960. Very large signage, free standing brick exterior building with its own parking lot. Remodeled in 2010. New roof 2010. High efficiency furnace/ac 2009. Four equipped ops, dark room, lab/ sterilization area, reception, business office, staff room, private office, basement and a lot more. Would be great for starting a new office or relocating your office if you want to own your building. Please contact hanyb@juno.com or call 616.307.2213 and leave a message. General Dental Practice in Walker, MI – Two ops. Third room can be equipped. 825 active patients. New equipment. Well-maintained suite. Lease transferable. Asking $100,000. Interested parties please contact Dentaldad@aol.com.

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Part-time Dentist needed at Ferris State University’s Dental Hygiene Clinic – Dentist needed 1–2 days a week to provide legal clinical coverage, conduct and supervise clinical performance of dental hygiene students, and act as a dental resource person for clinical dental hygiene faculty, staff, and students. For further information, please email annettejackson@ferris.edu or call 231.591.2284. Detailed posting and application available at https://employment.ferris.edu/ Associateship opportunity in NE Grand Rapids – Busy, established practice; 3-4 days per week available. Potential for future partnership. Please call 616.742.6735 or email: beckwithfamilydentalcare@gmail.com Holland, Michigan – Associate dentist needed for busy practice one or two days a week. Would prefer Fridays. A bit early but will be retiring in three to five years. Fee-for-service practice with no medicare/medicaid. Please contact Kate at 616.399.4490. Dental Dreams desires motivated, quality oriented associate dentist – for its offices in Muskegon, Kalamazoo, Battle Creek, Saginaw, Flint, Ypsilanti and Eastpointe – outside Detroit. At Dental Dreams, we focus on providing the entire family superior quality general dentistry in a modern technologically advanced setting with experienced support staff. Our average colleague dentist earns on average $230,000 per year plus ben-

efits. Sign on/relocation bonus for certain locations. Please contact Kristyn McIntosh at 312.274.4530 or email kmcintosh@kosservices.com. Exciting Opportunities – for dentists, hygienists, and assistants to provide children with quality dental care in schools in Southeast and Western Michigan. No evenings or weekends. Email resumes to: jobs@smileprograms.com. Dental Equipment for Sale – After merging my two offices – I have four rooms full of dental equipment for sale. Everything is in excellent shape and working conditions (no junk). All equipment is still installed and can be tested before you buy it. Dental chairs, delivery units, lights, x-rays, cabinets, panoramic, Dent-X 9000 zoom, compressor, separate air dryer unit, suction, lab equipment and much more. Just ask and there is a chance I have it. Please email your questions to hanyb@juno.com. Panoramic X-ray Unit (Gendex GX Pan. 70, 98 kvp, Film Size 5” x 12”) for Sale – Was in a good working order when disassembled by dental technicians. No longer needed. Asking $1000 OBO. Please email hanyb@juno.com. Dental Office Available – in Rockford on 10 Mile Road. Available about April 2015. Approximately 3100 ft of office space and 1500 ft of basement. Call 616.866.0921.

WEST MICHIGAN DISTRICT DENTAL SOCIETY | SPRING ISSUE 2015

CLASSIFIED ADS

Pre-Dental Student Seeking Summer Dental Experience – I am a Presidential Honors student studying biomedical engineering at the University of Alabama at Birmingham, enrolled in their Early Dental School Acceptance Program. Over the past summers, I have shadowed multiple practices, including oral surgeons, orthodontists and general dentists. Last summer, I worked in an orthodontist’s office in the Chicago area. I am seeking to expand my pre-dental experience by working in a dental office or clinic over this summer in Western Michigan. Contact information: am.cruz@sbcglobal.net | 630.747.7903. Beautiful Professional Dental Suite – Great turnkey opportunity for any dental professional, with many extras in a growing N.W. Michigan community. High-visibility location is within minutes of world-class cultural events, federal & state parklands, fabulous dining, four-season outdoor activities & great schools. Call selling dentist directly at 231-313-8407 or email: jarickert@charter.net. View photos at: http://www.threewest.net/ our-listings/?propertyId=76019-sale Looking for a Dentist – to provide general dentistry services for our veterans at the Grand Rapids Home for Veterans 2-3 days per week at a per diem rate of $600. There is also a production bonus as well, but it will only add a minimal amount to the per diem. The best part about this posi-

tion is that it offers great flexibility in terms of scheduling, both in terms of the days and hours worked. In addition, changes to the schedule can be easily accomplished from week to week as well. Interested parties should contact 616.502.0069. Seeking Full- or Part-Time Employment – in a West Michigan general practice office, to contribute immediately to the success of an office with a willingness to work nights/ weekends to help bolster production and practice availability, as well as generate new patients. I have a desire to be included within the practice’s leadership team to contribute to decision making, developing strategies for practice growth, and to support team development and morale. I’ve been consistently regarded as responsible, personable, a producer, positive, professional, and upbeat. I am currently in a hospital based GPR and am comfortable with all aspects of dentistry, including endodontics and surgery. For a copy of my resume and to discuss possible opportunities in-detail, please contact me at grapdds@gmail.com – or call 989.225.0753. Thank you. For Sale – Lab Master Foster Model Trimmer, Model # MT115, like new $400. Contact 616.949.7510.

WEST MICHIGAN DISTRICT DENTAL SOCIETY | SPRING ISSUE 2015

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.......................................17 DDS Integration..... outside back cover Davis Dental Laboratory................ inside front cover Founders Bank & Trust.......................5 Golden Dental Solutions...................20 Great Lakes Financial........................27 Henry Schein.............inside back cover Hungerford Nichols ..........................29 Lake Michigan Credit Union..............3 MDA IFG............................................22 Merrill Lynch.....................................32 PNC Bank...........................................19 ProAssurance.....................................16 Professional Solutions.......................36 Studio 2 Dental..................................11

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The Flying Dentists Association presents Nationally acclaimed practice advisor and speaker

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Malpractice insurance is underwritten by Professional Solutions Insurance Company. 14001 University Avenue | Clive, Iowa 50325-8258 ©2015 PSIC NFL 9663 * PSIC is rated “A” (Excellent) by industry analyst A.M. Best for financial strength and operating performance . A.M. Best ratings range from A++ to S. Malpractice insurance is underwritten by Professional Solutions Insurance Company.

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