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The voice of the Washington State Dental Association

AL I C E P S UT O L L PU ON I T C E S E INSID

THE AFFORDABLE CARE ACT AND YOU: How Health Care Reform will impact you, your patients and your business

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news


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I was fortunate to have this creative team on my project Dr. Peter Jacobsen, DDS Northwest Family Dental Care

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Dr. Tyrone Rodriguez and family mug it up for the camera

WSDA news Cover story by Rob Bahnsen TOC photograph by Samantha Deyette

issue 1 · october 2013

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editorial

5

guest editorial

35

clinical corner

meet dr. tyrone rodriguez

37

in memoriam

hod: pictoral review

41

welcome new members

hod resolution summary

43

ripp program

wohf news

47

the source: mercer advisors

6-11 12-17 18 20-21 22 23-34

membership news cover story: the aca and you

49, 51, 53 54

classifieds parrish or perish

Like us on Facebook: www.facebook.com/WashingtonStateDentalAssociation WSDA News Editor Dr. Mar y Jennings Editorial Advisor y Board Dr. Victor Barry Dr. Richard Mielke Dr. Jeffrey Parrish Dr. Rhonda Savage Dr. Robert Shaw Dr. Mary Krempasky Smith Dr. Timothy Wandell Washington State Dental Association Dr. David M. Minahan President Dr. Gregory Y. Ogata, President-elect Dr. Bryan C. Edgar, Vice President Dr. D. Michael Buehler, Secretary-Treasurer Dr. Danny G. Warner,, Immediate Past President Board of Directors Dr. Theodore M. Baer Dr. Dennis L. Bradshaw Dr. Ronald D. Dahl Dr. Christopher Delecki Dr. Christopher W. Herzog Dr. Gary E. Heyamoto

Eric J. Kvinsland Bernard J. Larson Christopher Pickel Lorin D. Peterson James W. Reid Ashley L. Ulmer

Vice President of Government Affairs Bracken Killpack

Association Of fice: (206) 448 -1914 Fax: (206) 443 -9266 Toll Free Number: (800) 448 - 3368 E- mail: info@ wsda.org/w w w.wsda.org

Art Director/Managing Editor Robert Bahnsen

WSDA Staff: Executive Director Stephen Hardymon

Manager of Continuing Education and Speaker Ser vices Craig Mathews

In the event of a natural disaster that takes down the WSDA web site and email accounts, the WSDA has established a separate email address. Should an emergency occur, members can contact washstatedental@gmail.com.

Senior Vice President/ Assistant Executive Director Amanda Tran

Government Affairs Coordinator Michael Walsh

Dr. Dr. Dr. Dr. Dr. Dr.

Vice President/Chief Financial Officer Peter Aaron

Membership Manager Laura Rohlman

General Counsel Alan Wicks

Exhibits and Sponsorship Ser vices Coordinator Katie Olson

Vice President of Operations Brenda Berlin

Bookkeeper Joline Hartman

Vice President of Communications Kainoa Trotter

Office Coordinator Gilda Snow

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The WSDA News is published 8 times yearly by the Washington State Dental Association. Copyright © 2013 by the Washington State Dental Association, all rights reserved. No part of this publication may be reproduced without permission of the editor. Statements of fact or opinion are the responsibilit y of the authors alone and do not express the opinions of the WSDA, unless the Association has adopted such statements or opinions. Subscription price is $65 plus sales tax per year for 8 issues of the News. Foreign rate is $97.92 per year. Advertising is published as a service to readers; the editor reserves the right to accept, reject, discontinue or edit any advertising offered for publication. Publication of advertising materials is not an endorsement, qualification, approval or guarantee of either the advertiser or product. Communications intended for publication, business matters and advertising should be sent to the WSDA Office, 126 NW Canal Street, Seattle, Wash. 98107. ISSN 1064-0835 Member Publication American Association of Dental Editors. Winner: 2012: Journalism Award, Best Newsletter, Division 1, 2012: Platinum Pencil Award Honorable Mention (2), 2008: Best Newsletter, Division 1, 2007 Platinum Pen Award, 2006 Honorable Mention, 2005 Platinum Pencil Award, 2005 Publication Award; International College of Dentists

table of contents issue 1, october 2013

a day in the life


editorial dr. mar y jennings

House recap

The WSDA House of Delegates met September 19-21 in Chelan. This year we took time to discuss and celebrate our successes. Let’s talk money. We have money! Back in 2008 things were not so rosy. We had depleted much of our reserves to buy part of NORDIC. We set up a strong financial plan that is now coming to fruition. Our Reserve Fund stands at well over $700,000. Last year we paid off the $1,000,000 NORDIC loan — that investment has grown more than 10 percent since we bought it. With its expansion to Idaho, we anticipate even greater returns on our investment in the future. Our building has increased in value, and we were able to refinance at a lower rate. All of our rental spaces are leased. In total the WSDA has $5.3 million in assets as of August. We were all worried about the Pacific Northwest Dental Conference’s move to Bellevue. With 6,577 people attending, we met that meeting’s goal. We expect even bigger returns as we fine tune it and make it even better. We have raised that meeting’s net profit from $370,000 in 1999 to more than $750,000 this year. So what does this mean to you? Last year the House of Delegates voted to spend down what we considered excess reserves to hold off an increase in member dues. We do not anticipate a dues increase for at least five to six years. We are also looking at other projects to keep this momentum up. We had a great legislative year! Because the relationships we developed with legislators and the WSDA demonstrating good faith in being willing to work with our own mid –level plan if the need arose, we were able to continue to contain mid-level bills in committee. That is huge! Because of the rules in Olympia, those bills are still alive. Since we will not be changing legislators, we anticipate that we will be able to hold the line this year too. Do you realize that our leadership, along with our wonderful lobbyists, have been able to stave off non-supervised workforce models for more than 20 years? That is due to decades of relationship building, hard work, solid strategy and constant vigilance. Resting on laurels is bad business. This year we anticipate having as many as 500 people at Dental Action Day on January 31, 2014. Dean Berg will be closing the UWSoD for the day and encouraging all dental students to attend. The WSDA will provide bus service for all students who want to participate. Please plan to close your schedule and join us! In other good news, Adult Dental Medicaid and Medicaid Expansion funding was restored and expanded due to federal match money. SB 5615 was passed into law with the intention of adding funding to the Professional Primary Care Practitioner Loan Repayment Program. We are also working on bricks and mortar legislation to increase the expansion of dental residencies. Our legislators were very impressed with the concept of dental residencies helping both students and the poor. The Washington Oral Health Foundation (WOHF) experienced a breakthrough year. WOHF volunteers and staff go into the communities and educate. While it’s been difficult communicating the mission to members, WSDA members contributed more than $127,000 to the annual phonathon. The Foundation needs your help, consider giving some of your time. Please see their appeal on page 20. Your pocketbook will be a little fatter because we were able to keep the 0.3 percent

Dr. Mary Jennings Editor, WSDA News

“Do you realize that our leadership, along with our wonderful lobbyists, have been able to stave off non-supervised workforce models for more than 20 years? That is due to decades of relationship building, hard work, solid strategy and constant vigilance.”

continued on page 41

Dr. Mary Jennings, WSDA News editor, welcomes comments and letters from readers. Contact her at her email address:mjenningsdds@gmail.com.

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WSDA is Here to Help You with What Lies Ahead Those who have been tracking the implementation of the Affordable Care Act (ACA) and applicable state laws have looked to 2014 as a pivotal year, when many provisions of health care reform will begin impacting the general public. This upcoming year will bring significant changes to health care; some of these changes will be uniform across the country, while others will be unique to Washington state. These changes will affect our membership, both as providers and consumers of health care. Phrases such as “Health Benefit Exchanges,” “Essential Health Benefits,” “Accountable Care Organizations,” and “Washington Healthplanfinder” will become common health care vocabulary. Today, as we stand on the precipice of reform, it is imperative that we prepare for what lies ahead. At the WSDA, we have been preparing for these reforms for the past several years. Our Board of Directors and Committee on Government Affairs have been discussing health care reform implementation since the passage of the ACA in 2010. I have had the pleasure of chairing the WSDA Task Force on Health Care Reform and, for nearly a year, the task force and WSDA staff have deliberated the nuisances of the ACA and how it will be implemented in Washington. As with many dental and health care policies, Washington is on the cutting edge of implementing health care reform. Our state-based Exchange, called Washington Healthplanfinder, has often been ahead of other states and the federal government in developing the new insurance marketplace. Our legislators and other policy makers made statespecific decisions on health care reform years before many states organized committees to begin looking into implementation. All of this action has been noticed by dental and other health care organizations across the country. In the dental community, the ADA and other state associations have looked to Washington as a case study, and learned about important issues as they were deliberated here. Included in this edition of the WSDA News, there is a pull-out document called “The Affordable Care Act and You” to serve as your navigational guide for the ACA and how it is being implemented in Washington state. This document is organized into more than 40 questions and answers related to how health care reform will impact us as individuals, employers, and providers of dental care. A glossary has been provided at the beginning to clarify terminology that is frequently used when discussing health care reform here in Washington. A version of this report lives online in a new ACA section of the award-winning WSDA Source, which can be accessed online at www.wsdasource.org. The WSDA Source material will be updated throughout the year to provide the membership with up to date information. The materials we have provided cover very complex issues that can be very difficult to fully comprehend in one sitting. We encourage you to review and think through these issues in the days and weeks ahead. If you only remember a few points during your first review of these health care reform materials, I think the following points are the most important: • The insurance mandate included in the ACA is a mandate on individuals and not employers. Employers with less than 50 full time employees (FTEs) are not required to offer medical insurance to their employees. • Starting in January, all children in Washington state will be required to have dental coverage. Adults are not required to purchase dental insurance under the ACA. • Tax credits and subsidies for purchasing medical insurance will be available for individuals and employers though there are very specific criteria that determine if you are eligible. You may have several questions about health care reform that are not addressed by this edition of the WSDA News. If you need answers, the staff at WSDA and the Washington Dentists Insurance Agency (WDIA) are always available to help. The WSDA staff can be reached by calling 800-448-3368, and the WDIA staff can be reached by calling 800-2829342. Though the new health care reform environment may be confusing, the WSDA leadership and staff are ready to help walk you through this important year of transition and beyond.

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Dr. David Minahan President, WSDA

“Included in this edition of the WSDA News, there is a pull-out document called The Affordable Care Act and You to serve as a navigational guide to walk you through the ACA and how it is being implemented in Washington state.”

guest editorial dr. david minahan

Are you ready for reform?


profile hispanic dental association president dr. tyrone rodriguez

When WSDA News Editor Dr. Mary Jennings found out we were doing a story on dental wünderkind and Hispanic Dental Association President Dr. Tyrone Rodriguez, one of the questions she posed was unexpected — “Ask him what compels him to wear his tall hats” It’s true, they make a bold statement — especially here in the Pacific Northwest, where we’re more likely to sport gore-tex than a Stetson — making Rodriguez hard to miss when he walks into a room. He explains that his parents live outside San Antonio in Bulverde, Texas, and the hat is a way for him to carry around a little of them wherever he goes. But it is also an opportunity to be a little different, and it has had a great effect on his youngest and most fearful patients — it relaxes them. He says, “We tell cowboy jokes while we’re taking care of them, and it brings the tension level completely down.”

Photograph by Samantha Deyette

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Photographs by Samantha Deyette

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profile hispanic dental association president dr. tyrone rodriguez

Hispanic Dental Association President


Photograph by Samantha Deyette

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Bottom photographs courtesy of Dr. Rodriguez

profile hispanic dental association president dr. tyrone rodriguez

Photos, clockwise from top: Leonardo, Victoria, Dr. Rodriguez, Katherine and Nikolas, Dr. Rodriguez testifies to the Affordable Care Act Panel in the West Wing of the White House, performing dental mission work in Africa.


Immersed in the culture

So, how did this whip-smart champion find his way to Washington state? Born in Greenwich, Conn., Rodriguez was just two years old when his parents shipped him back to their native Colombia, South America to live with relatives so that they

could focus on achieving the American Dream. He recounts, “My mother was 16 and I was a handful — full of energy! It was a blessing in disguise — it allowed me to grow up, immerse myself in the culture, and perfect my Spanish.” When he was in 4th grade, he reunited with his parents, whose catering business took them all around the country until he was in high school. By his estimation, they lived in ten different states before he finished high school. All that moving gave him a special courage, and shaped who he is today. He elaborates, “I think that my upbringing — having to meet new people frequently and adapt to new surroundings rapidly — forced me to make choices and lead. There were times that it was tough — my parents weren’t always around, and I had to grow up fairly quickly. I saw that if I didn’t lead myself or my family members there was no one else there to do it.” He thrived — his parents instilled in him the importance of education, and worked to send him to the best schools they could afford, where he excelled in both academics (as a National Merit Semifinalist) and athletics. As far as college was concerned, however, his parents didn’t have the resources, and they made it clear that he would have to pay for it himself. But because he was a gifted athlete — Rodriguez was a former state champion and all-New England wrestler — he was one of the first Hispanic recipients of a college scholarship from the Jackie Robinson Foundation, and was able to attend Brown University. He was the first in his family to attend college.

Tragedy his freshman year

Like any college freshman, Rodriguez was excited to begin his studies. “Brown was an incredibly supportive and diverse environment — in terms of culture, thought, and thinking outside the box. It was amazing to have professors who were Nobel laureates, and to attend school with students from such diverse backgrounds.” One of the students in his biology class was the son of James Watson of Watson and Crick, the team that first suggested the double-helix model of DNA structure, Harry Chapen’s and Diana Ross’ daughters attended when he did, as did a prince from Greece. It was a vastly different world than the one he had inhabited. Then, during his freshman year, tragedy struck: his parents,

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13 month old brother, and grandmother were involved in a major airline disaster — the crash of Flight 52 over Long Island — 73 perished. Rodriguez explains, “The flight was returning from South America, when it ran out of fuel over Long Island after its landing had been delayed due to severe winter weather. Half of the passengers died, including my grandmother, who was flying for the first time in her life.” Rodriguez’ father and brother suffered multiple injuries, and his mother was in a coma for several weeks and ended up staying in the hospital for months, requiring multiple reconstructive surgeries. It was during that time that Rodriguez met neurologists and a neurosurgeon, and because of that connection first became interested in getting his degree at Brown in neuroscience.

Baylor and beyond

Upon graduation from Brown, Rodriguez took a position at Baylor College of Medicine, doing research in molecular physiology and biophysics. While the work was satisfying, then-governor of Texas, Anne Richards started a program that allowed people with an interest in math or science an opportunity to eliminate 20 percent of their student loan debt for each year teaching in the public school system. Rodriguez jumped at the opportunity, saying, “Being a school teacher allowed me to stay current, use my math and science skills, coach wrestling, start a family, settle down, and figure out what I wanted to do next, all while retiring my debt.” After three years, the culture in the classroom changed from open discussion and free thinking to a focus on standardized test scores. The change dulled Rodriguez’ interest in teaching, and he began to look at what his friends were doing — some were dentists, others physicians. The physicians seemed stressed, worried about changes in the way medical practices were managed and lack of autonomy, the opposite of what his dentist friends were experiencing, but he knew nothing about dentistry. So, like any overachiever, he took the DAT on his own, and later hand-delivered his scores to UT Houston Dental School. He enlisted their help getting into dental school, eventually choosing UT Houston. He wasn’t the traditional dental student just out of college — he was of a different mindset, but it worked to his advantage — allow-

profile hispanic dental association president dr. tyrone rodriguez

Rodriguez has an easy, genuine smile and a jovial, enthusiastic demeanor, so it’s hard to imagine anyone tense around him. But truth be told, he doesn’t need the hat to get noticed. Throughout his life, Rodriguez has been a standout: in school, as a researcher, as a teacher, and finally, as a dentist. He’s a maverick go-getter who started not one, but two chapters of the Hispanic Dental Association, because he saw the need to champion his people and culture. Because of the inherent cultural differences, he knew that Hispanics needed to find their voice in dentistry, and he knew it had to be done differently, embracing all Hispanic dental professionals — not just dentists — because of their connection to la familia. He explains, “Hispanics have a bond in common — we share a culture, we have a different perspective about how we see our community, and what we value. Both the Houston and San Antonio chapters of The Hispanic Dental Association were built around the concept of a dental home, with inclusivity at its heart. We have elected members and officers who are hygienists, dentists, and assistants. We don’t see each other as the letters behind our names, we see ourselves as sharing a commonality and the greater goal of helping our community.” But Rodriguez knows that it’s important to look beyond borders to be aware of what is happening nationally and internationally. He travels abroad for dental missions in Central America, the Caribbean, and even Africa. On the national scene, he was the only dentist invited to address the Affordable Care Act Committee during the National Hispanic Medical Association’s presentation on the ACA, and recently he was invited by Dr. Gerry Glickman, Past Chair of American Dental Education Association, to participate in a debate hosted by the Pew Charitable Trust debating a former Secretary of Health over dental workforce models. Without, as Rodriguez noted with a smile, “Discussion about the big elephant in the room.”


profile hispanic dental association president dr. tyrone rodriguez

ing him to excel, but have a more holistic, altruistic approach to education. “I wanted to make things better and get an education,” he explains. It was that desire to make things better that led Rodriguez to become student body president at University of Texas Health Science Center, serving almost 20,000 health professional students, and to found the Greater Houston Hispanic Dental Association — taking a leadership role even as a student. “Students have great power when it comes to molding a profession,” he says, “They just don’t know it.” Later, during his pediatric dentistry residency, Rodriguez again rolled up his sleeves and helped found the San Antonio chapter of the HDA— with an eye toward inclusivity that had worked so well in Houston.

Making inclusion work on a broader scale through ongoing partnerships

While he’s always appreciated the ADA, Rodriguez notes that the profession as a whole tends to be homogenous, and can leave minority members feeling disenfranchised, saying “If you look at the acceptance rates and the membership numbers it’s rarely a true reflection of the communities we live in and that can be frustrating. That’s why so many of us pour our energy into our cultural Associations — there are often too many limitations within the ADA’s structure and governance.” In an effort to forge even stronger alliances, Rodriguez and his colleagues over at the National Dental Association (NDA) and the Society of American Indian Dentists (SAID) entered into a partnership, combining their annual meetings together for the first time last year to create awareness at the Multicultural Oral Health Summit. It was a historic meeting, and one that all three groups are eager to reprise — as each group represents a growing population in the country with needs as diverse as their membership. Rodriguez says, “Let’s face it, we represent big communities — 52 million in the Hispanic community alone — one of six living in the U.S. today identify as Hispanic, and we need to determine the needs of all of our minority communities when it comes to oral health. We must have

providers who are culturally sensitive, who understand that research and data are necessary to evaluate distinct, cultural needs — for the health of our profession and that of our communities.”

The Hispanic perspective

But what is it that is so specific to the Hispanic Culture? “Like so many, the Hispanic community is centered in family,” says Rodriguez. “But in many other cultures, once you reach a certain age, it is time to leave the nest. In the Hispanic culture, the tendency is the opposite — the nest just gets bigger.” That means that when a patient from a Hispanic family is scheduled, if there is any uncertainty or fear about the appointment, the entire family will show up. Not just the mother and father of the patient, but aunts, uncles and grandparents, and other extended relatives — toda la familia — will be present at the practice to face the challenge. Rodriguez also cites the belief by some in the Hispanic community of old wives tales about oral health that persist — “There was a joint study by Proctor & Gamble and the Hispanic Dental Association Foundation which indicated that some Hispanics still believed that cavities could simply be brushed away, and other cultural misconceptions. So the Hispanic dental professional has different needs for both the patient and professional communities.” But the nuances between cultural factions can be hard to discern, and Rodriguez serves as a clearinghouse of information for dental colleagues trying to navigate the cultural waters. “A lot of friends of mine who aren’t Hispanic call me for clarity,” he says, “And I value them as providers because they are taking the time to try and serve their patient populations more effectively. We try to problem solve because my goal is to get as many folks in the Hispanic community into a dental office — it doesn’t have to be mine. I just want them to be healthy, and not have to suffer the ill effects and consequences of poor oral health. Especially Hispanics, who are disproportionately impacted by diabetes and cardiovascular disease, and their links to oral health.” In the dental profession, other nuances exist — Rodriguez continues,

“Many of the Hispanic dental professionals don’t appreciate higher levels of organized dentistry.” Rodriguez sees it as his mission to change that, by proselytizing that legislation enacted by well intentioned, but misinformed lawmakers can inadvertently affect dentistry adversely. He says, “When I tell people if they’re not involved in grassroots dentistry, others will make decisions for them, they often see the value in joining. I feel like they wouldn’t have joined without my recruitment efforts, and helping them to understand that membership and being involved in organized dentistry is something that is essential and vital to the preservation of our profession.”

Goals for the future

“I’ve always valued the role and importance of organized dentistry, no matter what association I’ve been a member of, and I am a member of many,” Rodriguez says. And while he credits an efficient hierarchy and chain of command at HDA as one of the reasons for his fast ascent to the presidency from thirteen years ago when he was the first national student trustee, he’s gotten where he is today because of his commitment, drive and energy — not only to the Hispanic community, but to the broader dental community as well. “There is a generational gap between the main body of the impacted or affected membership and the leadership, a disconnect. I’d like to help change that. Membership is an important aspect of organized dentistry because it creates solidarity and adaptability; good membership allows the leadership to make the right choices of the proximity to the front lines.” Additionally, Rodriguez sees how Washington’s progressive dental practice act empowers additional members of the workforce to care for the underserved, while safeguarding the doctor-patient relationship. Rodriguez feels so passionately about access to care and utilization of care that he created the acronym S.E.A.L. (Service, Education, Advocacy and Leadership) for the HDA. With his drive and commitment, we’re sure he will accomplish all of his goals and many others — we congratulate and applaud you, Dr. Rodriguez!

Photograph by Samantha Deyette

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profile hispanic dental association president dr. tyrone rodriguez

When Dr. Rodriguez accepted the HDA Presidency this October, he said “If I can see far away it’s because I have stood on the shoulders of giants. I would like to give credit to all my wonderful mentors, but most importantly to my lovely and supportive wife of 22 years, Victoria”


2013 hod pictorial review

HOD Photographs by Rob Bahnsen

This page, clockwise from top left: outgoing President Dr. Danny Warner gives incoming President Dr. David Miniahan his presidential pin, Dr. Danny Warner (l) accepts one of two Golden Apples Awarded to the WSDA by 11th District Trustee Dr. Roger Kiesling, Dr. Laura Williams places a rose for her friend and mentor, Dr. Terry Grubb, during the Rose Ceremony honoring the year’s fallen, Dr. Rod Wentworth addresses the House. Opposite page, clockwise from top: your newly-elected Board of Directors, Dr. Vic Barry addresses the House, and Dr. Amy Winston announces the reference committee results.

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2013 hod pictorial review

Full House

Delegates from around the state gathered in Chelan from Thursday, September 19 to Saturday, September 21 for the WSDA House of Delegates on what was — for many in the state — the last weekend of beautiful weather for the season. “Lake Chelan is a spectacular place to visit anytime of the year,” said Dr. Danny Warner, who presided over the event in his last official duty as President of the WSDA, “Being surrounded by the beauty of Lake Chelan and its hills, topped off a year full of rewards as WSDA President. It provided a perfect setting for the camaraderie of the House of Delegates.” The docket this year included resolutions returning from last year (according to House rules, if a resolution isn’t voted on, it automatically carries forward to the following year), and a slew of others that came from component societies and the Board. In addition to the many resolutions being debated at the House, a treasure trove of candidates for all of the open positions save one (Dr. Michael Huey ran uncontested for the seat on the Committee on Government Affairs), meant

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that delegates had to do their homework and listen attentively to statements and debates at the House. In the end, three new Board members were elected (Dr. Eric Kvinsland, Dr. James Reid, and Dr. Ashley Ulmer) while two were reelected: Dr. Gary Heyamoto and Dr. Bernard J. Larson. Debate on the resolutions was spirited and pleasant throughout (please see the following page for a recap of all resolutions), with a cross section of people from around the state opining over the two days — no matter what component society you’re from, you should be proud of your elected delegates, they served you well. Friday night’s Citizen of the Year dinner was capped off by a fantastic presentation and question and answer period by this years COY recipient, Dr. Ray Damazo. Damazo and his wife Gail (who was also honored at the féte for her tireless work in Africa at Ray’s side) even managed to get some dentists in attendance to commit to going to Africa with them in the future.


2013 hod pictorial review

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HOD Photographs by Rob Bahnsen

2013 hod pictorial review

Photos both pages, clockwise from upper left, opposite: Dr. Marissa Bender shares a laugh, Drs. Duane Pegg and Kathryn Wright, participants in the Annual “Rock, Paper, Scissors” contest to benefit WOHF square off, Dr. Tyler Shoemaker, winner of the “Rock, Paper, Scissors” contest holds up the placque, Dr. Danny Warner presents the President’s Award to Dr. Dexter Barnes, Dr. Sally Hewett (r) presents Drs. Bryan and Linda Edgar an award for their years of contributions to the Foundation, Dr. Joseph De Jesus addresses the House, Dr. Denny Bradshaw shares a laugh with Amanda Tran, former President Dr. David Houten at the Thursday night reception, sponsored by WDIA

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2013 hod pictorial review

Photos both pages, clockwise from upper left, opposite: Dr. Mary Smith addresses the House, Dr. Mike Buehler during the debates, Dr. Judson Werner addresses the House, Dr. Dennis Higgins (l) and Dr. Denny Bradshaw, Drs. Douglas Coe, Thomas Tilson, Tyler Shoemaker and Bryan Edgar at the HOD Classic, Dr. Mark Johnson swings at the HOD Classic, Dr. C.R. Anderegg addresses the House, Dr. Princy Rekhi, House Delegates listen in, Dr David Houten (standing) confers with Dr. Bruce Kinney (l) and Dr. John Carberry, Citizen of the Year Dr. Ray Damazo and Friend of Dentistry Award Winner Gail Sage Damazo

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2013 hod pictorial review

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2013 hod resolutions

HOD Resolutions

ADOPTED HD-01-2013

ADOPTED AS AMENDED HD-13-2013

ADOPTED HD-02-2013

RESOLVED, that the WSDA Board of Directors will review the potential impact of incorporating the ADA definition of dentistry into RCW 18.32.020 and report back to the 2014 House of Delegates.

Rules of the House of Delegates – September 2013

Definition of Dentistry

Committees and Parliamentarian for Annual Meeting of House of Delegates – September 2013

ADOPTED HD-03-2013

WITHDRAWN HD-14-2013

Acceptance of Audit for the Year Ending September 30, 2012

DentPAC Resolution

ADOPTED HD-04-2013

REFERRED TO TASK FORCE ON PUBLIC POLICY DEVELOPMENT HD-15-2013

WSDA 2013/2014 Budget

Positive Solutions for Dental Health

ADOPTED HD-05-2013

REFERRED TO BOARD OF DIRECTORS HD-16-2013

WSDA Dues for 2014

Non-Coverage of Critical Diagnostic Procedures

ADOPTED HD-06-2013

Nominations for Elective Office

REJECTED HD-17-2013

ADOPTED HD-07-2013

ADOPTED HD-08-2013

Reference committee note: The 2012 House of Delegates passed HD14-2012 which is identical to HD-17-2013. HB 1603 will be considered by the 2014 Washington State Legislature. The committee does not believe it is necessary to pass the same resolution twice and recommends a no vote.

ADOPTED HD-09-2013

Core Principles

ADOPTED HD-10-2013

Effective Use of DentPAC Money

Dental License Renewal Regulations Change

Location of the 2016 House of Delegates

WSDA Legislative Agenda for 2014

REJECTED HD-18-2013

Parliamentary Procedure (Bylaw Amendment)

REJECTED HD-19-2013

Reduced Faculty Dues (Bylaw Amendment)

REJECTED HD-20-2013

ADOPTED AS AMENDED HD-11-2013

Ethics and Jurisprudence Requirement for Continuing Education

RESOLVED, that WSDA encourage DQAC to classify ethics and jurisprudence education as clinical courses in determining acceptable continuing education for credit WAC 246-817-440 (4).

Unwritten Rule

REJECTED HD-21-2013 WSDA Transparency

REJECTED HD-22-2013 No Corporate Dentistry

ADOPTED AS AMENDED HD-12-2013

WSDA Supports and Promotes the Dental Home for All Children, Adolescents, and Special Needs Adults

RESOLVED, that WSDA supports the concept of a dental

home, which includes comprehensive oral health care, beginning no later than age one, and continuing throughout the patient’s lifetime.

REJECTED HD-23-2013

Fair Treatment of Dentists and Our Patients by Insurance Companies

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‘14 dental action day one profession, january 31 · 7:15 a.m. one voice Schedule of Events Join us in Olympia for our largest DAD ever! DAD is a great place to connect with your peers and meet students from UWSoD. Issues facing the 2014 Legislature include: • Health care reform • Dental insurance issues

6:45 AM

DAD Tent opens Capital Grounds

7:15 AM

Legislative Briefing Breakfast DAD Tent, Capital Grounds

11:00 AM

Networking event and issues forum

All Day

Appointments with Legislators

Register ONLINE Today!

http://www.wsda.org/dental-action-day-2014/

• Dental workforce • Funding for higher education and dental residency programs • Dental licensure fees and renewals

For details:

Call Michael Walsh at 800-448-3368 or email at michael@wsda.org

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wohf news calling all helping hands

WOHF at the Boys & Girls Clubs WSDA Members — You are invited to volunteer your skills to provide dental care and ensure good dental health through education for 200 children and their families. These children are members of the WOHF sponsored Boys & Girls Club. The dental clinic at the Rainier Vista location will appoint patients Friday and Saturday between 9:00 a.m. - 6:00 p.m., (including orthodontic care every third Friday) with assistance from U.W. dental students when scheduling allows. An eager and competent dental assistant is always present. For further information and to arrange your time to volunteer please contact Ruth Abate via email at ruth@wsda.org. Thank you for your commitment to the underprivileged children!

For the past three years, the Washington Oral Health Foundation has managed the operatory at the Rainier Vista Boys and Girls Clubs with varying success, but not for the lack of Herculean effort by everyone involved. Staffing shortages and a patient base that has been slow to warm to the idea of free dentistry have stymied greater success that those involved know is possible. “Part of the problem was that Boys and Girls Club staff weren’t getting effective training about how to promote and utilize the facility,” said Ruth Abate, Director of Operations and Community Outreach for the Foundation, “And because they are our boots on the ground, working closely with the parents, we knew we had to figure out a better way to get the word out.” Working closely with B & G staff, Abate feels confident that the wrinkles have been ironed out, and has turned her attention to staffing. “It really is a fantastic way to give back to the community, and it doesn’t have to mean a huge time commitment,” she says. The WSDA News recently reached out to some of the dedicated volunteers who have worked in the facility to get their thoughts about staffing the operatory, they follow here. Abate says,“Now, with a full schedule open (please see Dr. Chan’s letter, above), we need your help more than ever.”

CALLING ALL

HELPING HANDS

I have been volunteering at the Rainier Vista Dental Clinic since December 2011. The reason I volunteer is simple, I want to help someone and contribute to my community. I particularly enjoy my time at the Rainier Vista Dental Clinic because it reminds me of my time as a club member when I was young and living in Hawaii. I remember all those who had an interest in me and my well being. The clinic staff have been so helpful and the patients, especially the kids, all have been so appreciative and kind. It has been my pleasure to contribute my time to the clinic and I plan to continue to do so in the future. — Dr. Susan Vetter  Volunteering the Boys & Girls club has been very rewarding for me. Every time I go there, everyone is always so appreciative and hardworking; it makes what you do seem effortless and valued. The staff at the Boys & Girls Club go out of their way to make sure everything is how you’d like it to be, and in a small clinic setting like that, it really feels good. This place is clean, and the atmosphere is relaxed. You have all the instruments, technology, and space to take care of these kids. We work hard during the week, and I know adding another day can be tiring but going there you will feel lifted. What you do means so much to the children

and staff. The kids listen and really appreciate what you are doing for them. The best part of the day is when the child is done, and without anyone prompting them they will say “Thank you”. And they mean it. — Dr. Thoa Nguyen I am thankful that there are opportunities like the Rainier Vista dental clinic right here in our home town where I can use my gifts and talents to help other people directly. Every time I go there, I leave with the kids and adults I treat giving me more than I feel that I gave them. The people are so grateful and there is a tremendous dental need that I do not see in the suburbs. With only one chair, I get to focus entirely on the patient with out other distractions. Because of April Perry, the clinic runs well. She takes care of the schedule and is so helpful in assisting me with the patients and the charting. All I have to do is show up and do the dentistry. I always leave with a smile on my face. I am looking forward to helping improve the clinic by adding digital x-rays, and other needed dental supplies in order to improve the quality and efficiency of the clinic. Thanks to WOHF for providing this great place to serve those who are much in need of dental care. ­— Dr. Robert Odegard

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The Washington Oral Health Foundation (WOHF) has provided oral health education for children across the state for more than 15 years and is poised to renew its obligation to provide oral health information at schools in Washington. Many middle and high schools use WOHF presentations to supplement their health curriculum, and in some cases WOHF programs are the only anti-drug messages that students receive in school. These programs have activities and materials to make learning about oral health fun and engaging. WOHF now has updated PowerPoint presentations that supplement visits from dental professionals. The presentations are geared towards the following grades:

Preschool-Kindergarten

Fun pictures and videos for young children to learn about oral health.

1st Grade – 5th Grade

Standard oral hygiene information and space for activities.

6th Grade – 8th Grade

Highlighting the dangers of tobacco along with oral health messages.

9th Grade – 12th Grade

Comprehensive oral health and antidrug education. All of the oral health 3-D models, posters, and educational materials are now listed on our website. WOHF sends education materials to dental offices at no charge,

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wohf news wohf in schools

WOHF in schools

and also provides support for dental professionals before they give a presentation. “One of the ways we support our member dentists in presenting to children is by going over the presentation and materials ahead of time”, said Tom Tidyman, WOHF Director of Programming and Development. “Members who have never done a school presentation, or are a little rusty in presenting to full classes of children, appreciate the phone call and instructions that WOHF staff provide before their presentation. The only way WOHF reaches over 10,000 children per year is when dentists and their staff volunteer to present at schools in their area. We want to help you make a difference in your community, so visit www.wohf.org or email tom@wsda. org to get started.


membership news leadership institute, mentor program

Leadership Institute

Former Leadership Institute participant Dr. Ashley Ulmer shares a light moment at her first Board meeting

It’s that time of year again — when we begin to solicit applications for the WSDA Leadership Institute. Now in its fourth year, the Institute exists to develop future leaders of organized dentistry from the rank and file members of today. Preference is given to those who already have some experience in leadership roles at the local level. Former participant Dr. Ashley Ulmer was elected to the WSDA Board of Directors at this year’s House of Delegates, and other participants continue to make their mark at higher levels of organized dentistry. Your voices, ideas, and passion for dentistry are needed — we still face challenges including dental workforce issues, funding for higher education and dental residency

programs, third party payers, and uncertainty with the changes coming with the Affordable Care Act (ACA - see the pull-out section in this magazine) — and we need committed, vibrant leadership to navigate these issues. WSDA’s Leadership Institute can help shape you into a leader of the future by pairing you with a WSDA Board member who will shepherd you through six key activities tailored to developing emerging leaders. Mentors and participants will be encouraged to meet privately during the year to discuss perspectives, leadership issues and questions, and to further enhance the collaborative nature of the leadership process. And while it’s up to both participants and mentors to determine the scope of involve-

ment, the program seeks to foster leadership without overwhelming participants with too many activities. All program costs will be paid by WSDA, including airfare, hotels, meals and transportation. It is always vital to encourage leaders of the future, and this program lends structure to the process. Given the uncertainty of national health care and how it may affect dentistry, it has never been more important.

Apply today!

Apply for the 2014 Leadership Institute at www.wsda.org/leadership-institute. Applications must be received by November 22, 2013 to be considered eligible. Questions? Contact Kainoa Trotter at 800448-3368 or by email at kainoa@wsda.org.

Mentor program and reception Mentoring a UWSoD student is a great, easy way to help an up and coming dentist, give back to organized dentistry, and have a great time all at once. The program kicks off with the annual Mentor Reception at the Burke Museum on the UW Campus on Wednesday, November 20 at 6:00 p.m. Come mix it up, mingle, meet other mentors and the students involved in the program, all while taking in this amazing museum.

Program information: 1. Being a mentor doesn’t take a lot of time. You get to choose the level of engagement. Most students and their mentors commu-

nicate via email and phone. It’s up to you. 2. You don’t have to be a UW Grad to participate, you only have to be a WSDA member. 3. You don’t have to live in the greater Seattle area — mentors from all over the state have had successful, productive mentor relationships with UWSoD students. Phoning and emailing are perfectly acceptable. 4. No special skills are required. You’d be surprised at how effective you can be as a mentor — remember, you were once a student too. Don’t sell yourself short.

5. Mentors say giving back is filled with rewards, from a renewed sense of vigor to finding the perfect Associate. Be forwardthinking, participate, give back. 6. Women mentors are especially needed. The playing field is changing — there are more women than men in dental school today. They need your guidance and your perspective. Sign up today at www.wsda.org/mentorprogram. Have questions? Contact Laura Rohlman at laura@wsda.org, or at 800448-3368.

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THE AFFORDABLE CARE ACT AND YOU: How Health Care Reform will impact you, your patients and your business

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SPECIAL PULL-OUT SECTION


special pull-out section affordable care act and you

aca and you: overview The following document is intended to be a thorough overview of the implementation of the Affordable Care Act in Washington state. 2014 will bring about several changes in health care; some of these changes will be uniform across the country while others will be relatively unique to Washington state. WSDA hopes this document will help you navigate these changes and prepare you and your staff for what lies ahead. This document is organized into over 40 questions and answers related to how health care reform will impact you as an individual, employer, and provider of dental care. A glossary has been provided at the beginning to clarify terminology that is frequently used when discussing health care reform in Washington state. There will likely be several questions that this document does not address. If you cannot find an-

swers to these questions, please call WSDA or WDIA at 800-4483368. We are always happy to help. Though this document is accurate through when it was printed, there are bound to be changes and new revelations as health care reform continues. A living version of this report lives online in a new Health Care Reform section of the WSDA Source. The WSDA Source material will be updated throughout the year to provide you with up to date information. WSDA would like to thank everyone who helped develop this important document. Many hours were spent by the staff of WSDA and WDIA to create and answer the questions listed in this report. WSDA would also like to thank Ryan Greenway, CPA from Greenway & Company for his assistance in answering many of the tax related questions in this report.

The following are the four most important items we hope the membership takes away from this report: • The insurance mandate is on individuals and not employers. Employers with less than 50 full time employees (FTEs) are not required to offer medical insurance to their employees. • Starting in January, all children in Washington state will be required to have dental coverage. Adults are not required to purchase dental insurance under the ACA. • Tax credits and subsidies for purchasing medical insurance will be available for individuals and employers (More details are provided in the Q&A section). • Staff at WDIA and WSDA are always available to help answer your questions. You can reach WDIA by calling 800-282-9342 and you can reach WSDA by calling 800-448-3368.

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Accountable Care Organizations (ACOs): ACOs are entities comprised of health care providers (hospitals, physicians, home health agencies and others) who collaborate to provide coordinated care to a defined population for a bundled payment. More information on ACOs is available in questions #44 and #45.

Full-time employee (FTE): An employee who works an average of 30 hours per week or more.

Affordable Care Act (ACA, Obamacare): The 2010 federal legislation that kicked health care reform into action.

Inside the Exchange: Refers to medical plans and stand-alone dental plans purchased through Washington Healthplanfinder. Federal subsidies for purchasing individual health insurance can only be utilized through Washington Healthplanfinder.

Cost share reduction: A discount that lowers the amount you have to pay out-of-pocket for deductibles, coinsurance, and copayments on your individual health plan. If your household income is between 100%-250% of the FPL, then you would qualify for cost share reductions. You must purchase your medical plan on the Exchange in order to receive the reductions. Embedded dental benefit: A dental insurance benefit that is included as part of a medical insurance benefit. In 2014, all medical insurance plans sold outside of the Exchange will be required to include a pediatric dental benefit. Costs of an embedded pediatric dental benefit are spread among all enrollees regardless of whether or not they have children. Essential Health Benefit (EHBs): A set of health care service categories that must be covered by health insurance plans starting in 2014. Essential health benefits must include items and services within at least the following ten categories: ambulatory patient services; emergency services; hospitalization; maternity and newborn care; mental health and substance use disorder services, including behavioral health treatment; prescription drugs; rehabilitative and habilitative services and devices; laboratory services; preventive and wellness services and chronic disease management; and pediatric services, including oral and vision care.

Household income: Your adjusted gross income. 1040 Form line 37, 1040A Form line 21, 1040EZ Form line 4.

Office of the Insurance Commissioner (OIC): The state author-

ity that regulates insurance in Washington state.

Outside the Exchange: Refers to medical plans purchased through a broker outside of Washington Healthplanfinder. Though plans purchased inside and outside of the Exchange are very similar, there are some differences that primarily have to do with pediatric dental (refer to questions #36 and #38). SHOP Exchange: SHOP stands for Small Business Health

Options Program. This is the small business Exchange marketplace where small business owners can purchase group plans for their company. In 2014, Washington state will only have a SHOP Exchange in Clark and Cowlitz Counties. Kaiser Permanente is the only insurance carrier providing health insurance on the SHOP Exchange in 2014.

Stand-alone dental: A dental insurance plan that is purchased separately from a medical insurance plan. State law requires all pediatric dental insurance plans available in Washington Healthplanfinder are required to be stand-alone dental plans.

Exchanges: The Affordable Care Act requires each state to have an insurance marketplace for individuals and small businesses to purchase medical insurance. In 2014, Washington will have a statewide Exchange for individuals (called Washington Healthplanfinder) but only a small business Exchange in Clark and Cowlitz counties. Individuals and small businesses are not required to purchase insurance through the Exchange but subsidies dollars are only available when purchasing insurance through the Exchange.

Washington Healthplanfinder: Washington’s new health insurance Exchange marketplace run by the Washington Health Benefit Exchange, a public-private partnership. Washington Healthplanfinder can be accessed online at http://www.wahealthplanfinder.org or by calling 855-923-463.

Federal poverty level (FPL): A measure maintained by the US

Census Bureau to determine the number of American families who live in poverty. The level is determined by household income and the number of persons in a family or household. The following is the 2013 FPL numbers:

Household Size 100%

1 2 3 4 5 6

$ 11,490 $ 15,510 $ 19,530 $ 23,550 $ 27,570 $ 31,590

200%

$ 22,980 $ 31,020 $ 39,060 $ 47,100 $ 55,140 $ 63,180

300%

400%

$ 34,470 $ 45,960 $ 46,530 $ 62,040 $ 58,590 $ 78,120 $ 70,650 $ 94,200 $ 82,710 $110,280 $ 94,770 $126,360

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special pull-out section affordable care act and you

aca and you: glossary


special pull-out section affordable care act and you

aca and you: impact on individuals How does this affect me, my family, and my staff as health care consumers? 1. Who has to buy health insurance?

The short answer is that everyone is required to have health insurance starting in 2014. The longer answer is that individuals with low incomes will be covered by Medicaid, seniors will be covered by Medicare, and everyone else will have to demonstrate that they have insurance coverage or pay a penalty.

2. What’s the penalty for not purchasing health insurance?

Those who do not have insurance coverage will be required to pay an annual financial penalty, however exceptions will be made for financial hardship: 2014: $95 per adult and $47.50 per child (up to $285 for a family) or 1% of income, whichever is greater. 2015: $325 per adult and $162.50 per child (up to $975 for a family) or 2% of income, whichever is greater. 2016: $695 per adult and $347.50 per child (up to $2,085 for a family) or 2.5% of income, whichever is greater.

3. Do small business owners have to provide medical insurance to their employees?

No. Employers with less than 50 full time employees (FTEs) are not required to offer group medical insurance to employees. The employer mandate for companies with more than 50 FTEs begins in 2015.

4. How much will medical insurance cost?

know this:

Your premium for medical insurance depends on the plan chosen, age, tobacco use, geographic area and the number of family members. Those who qualify will be eligible for tax credits and/or cost share reductions.

1. Individuals are required to purchase medical insurance or pay a penalty. 2. Washington’s Exchange is called Washington Healthplanfinder. Individuals can purchase medical insurance through Washington Healthplanfinder or through a broker outside of the Exchange. 3. Subsidies for purchasing individual medical coverage are only available through Washington Healthplanfinder.

5. How do I know if I will qualify for tax credits or cost share reductions?

If your household income is less than 400% of the federal poverty level (see definition in glossary), then you are eligible for a tax credit for your individual health insurance. If your household income is between 100%-250% of the FPL, then you would qualify for cost share reductions (see glossary). You must purchase your medical plan inside of the Exchange in order to receive the credits and cost share reductions. A calculator has been created to help individuals determine their eligibility for health insurance subsidies. You will need to know your adjusted gross income for the calculation; this information can be found on the following 1040 tax documents: 1040 Form line 37, 1040A Form line 21, or 1040EZ Form line 4. The calculator can be accessed online at http://www.wahbexchange. org/index.php?cID=472.

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6. Will my insurance still have co-payments?

the lower costs. These lower costs are handled with the Advance Premium Tax Credit as previously discussed. But these tax credits can be applied directly to your monthly premiums, so you get the lower costs immediately. The amount you save depends on your family size and how much money your family earns.

Yes. Medical insurance coverage will still have co-payments. However, the ACA caps out-of-pocket expenses at $6,350. All copayments and deductibles go towards this out-of-pocket maximum.

7. How do individual tax credits work?

9. For individuals purchasing inside the Exchange, is it more beneficial to apply the tax credits to your monthly insurance premium or collect in full at the end of the year when you file your taxes?

Starting in 2014, individuals and families can take a new premium tax credit to help them afford health insurance coverage purchased through the Exchange. The premium tax credit is refundable so taxpayers who have little or no income tax liability can still benefit. The credit also can be paid in advance to a taxpayer’s insurance company to help cover the cost of premiums. The premium tax credit is an advanceable, refundable tax credit designed to help eligible individuals and families with low or moderate income afford health insurance purchased through the Exchange. You can choose to have the credit paid in advance to your insurance company to lower what you pay for your monthly premiums, or you can claim all of the credit when you file your tax return for the year. If you choose to have the credit paid in advance, you will reconcile the amount paid in advance with the actual credit you compute when you file your tax return. When you apply for coverage in the Exchange, the Exchange will estimate the amount of the premium tax credit that you may be able to claim for the tax year, using information you provide about your family composition and projected household income. Based upon that estimate, you can decide if you want to have all, some, or none of your estimated credit paid in advance directly to your insurance company to be applied to your monthly premiums. Premium tax credits are available to individuals and families with incomes between 100 percent and 400 percent of the federal poverty level (refer to the glossary for more information).

Most people likely will want to get the credit in advance because they wouldn’t be able to pay their entire monthly health insurance premiums without help, but if they choose, people can wait and receive the credit when they file their taxes. However, the credit is only available for months in which people are enrolled in a health plan offered in their state’s marketplace. People can also take a lower advance payment than the amount that is calculated based on their estimated income for the year and receive any remaining credit they are due at tax time. The amount of the advance premium tax credits that people receive is based on an estimate of the income the household expects for the year. The final amount of the credit is based on their actual income as reported on the tax return for the year the advance payment was received. People who receive advance payments of the credit will have to “reconcile” the amount that they received based on their estimated income with the amount that is determined based on their actual income as reported on their tax return. This means that people whose income for the year is higher than they previously estimated could have to pay back some or even all of the advance payments they received. On the other hand, people whose income ends up lower than estimated could get a refund when they file their taxes.

8. What tax benefits are available for those that purchase health insurance inside the Exchange?

10. What do I need to do if I am currently on an individual medical plan?

When you get health insurance coverage in the Exchange, you may be able to get lower costs on monthly premiums. This depends on your income and family size. In the Exchange you may be able to lower the costs of your health insurance coverage by paying lower monthly premiums. You’ll see the amount of savings you’re eligible for when you fill out your Exchange application after October 1, 2013. Prices shown for insurance plans will reflect

If you currently have an individual medical plan, your current plan and benefits will no longer be available as of January 1, 2014 (unless you have a grandfathered plan. See question #17). Your insurance carriers will have new plan options available for you. Most carriers will automatically transfer you onto the closest equivalent plan if you do not choose a new plan for yourself. You will be switched to a new plan on January 1, 2014 but you have until

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In general, if your income falls within the following ranges you’ll qualify to save money on your premiums in 2014 in the Exchange. The lower your income within these ranges, the more you’ll save. (The amounts below are based on 2013 numbers, and are likely to be slightly higher in 2014)


special pull-out section affordable care act and you

March 31, 2014 to decide what plan you would like with your carrier or with another carrier. If you do not qualify for tax credits or cost share reductions (see question #5), then it is simpler to choose a new plan outside the Exchange. If you do qualify for tax credits or cost share reductions, then you must choose your new plan inside the Exchange in order to receive the subsidy. Washington Dentists Insurance Agency can assist you with obtaining a plan both inside and outside of the Exchange.

11. If I am currently on my employer’s group medical plan, can I leave the group plan to purchase an individual medical plan?

If you are eligible to be on your employer’s group medical plan but choose not to be, then you can purchase individual coverage inside or outside of the Exchange. If you pay more than 9.5% of your household income for your portion of the group medical plan premium, then you can purchase an individual plan inside the Exchange and obtain tax credits and cost share reductions if you qualify for them. However, if your portion of the group medical plan premium is below 9.5% of your household income, then the group medical plan is considered affordable coverage and you would not be able to receive tax credit or cost share reductions when you purchase an individual plan even if you purchase coverage inside of the Exchange.

12. If I currently have a group medical plan for my office, can employees leave the group plan to purchase an individual medical plan?

Employees are not required to be on an employer’s group medical plan if they do not want to be, even if they are eligible. However, for the employer, you must have at least 75% participation of eligible employees on the group plan in order to maintain the plan and be compliant with the requirements of the insurance carrier. So if you have four employees on your group medical plan, one could come off and you would still be in compliance of 75% participation. If two employees come off of the group plan, you would no longer be in compliance.

13. What do I need to do if I currently have a group medical plan for my office? If you have a group medical plan for your office, your current coverage will remain the same until your 2014 group medical re-

know this:

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14. Can I buy a small group plan inside the Exchange?

For 2014, Kaiser Permanente is the only carrier offering plans inside the SHOP Exchange (SHOP is defined in the glossary). These plans are only available in Clark and Cowlitz Counties. In the future, the SHOP Exchange will be expanded to include more carriers and more counties.

15. In 2014, can health insurance tax credits for small businesses be used by employers who purchase group plans outside of the Exchange? At time of print, it is unclear if health insurance tax credits for small business will be available outside of the Exchange.

16. If you choose to offer group medical coverage to your staff outside of the Exchange, what percentage of the employee’s medical premium are you required to pay? The employer contribution requirement outside of the Exchange is 75% for employees with no minimum requirement for dependents. Some carriers require groups of 1-3 members to contribute 100% for employees with no minimum requirement for dependents. Washington Dentists Insurance Agency can assist you with obtaining a plan both inside and outside of the Exchange.

Dentists Insurance Agency can assist you with obtaining a plan both inside and outside of the Exchange.

21. How do I look for individual medical plans and apply for coverage inside of the Exchange? You can visit www.wahealthpathfinder.com to compare plans and apply for coverage. Your insurance broker can assist you in finding the carrier and plan that works best for you inside of the Exchange. Be sure to choose Washington Dentists’ Insurance Agency as your broker of record when applying inside of the Exchange.

22. What are the benefits of buying health insurance inside the Exchange? If an individual is eligible for tax credits and/or cost sharing reductions, they can only be obtained if a plan is purchased on the Exchange. You are also able to compare plans and receive quotes from several carriers in one place. Washington Dentists Insurance Agency can assist you with obtaining a plan both inside and outside of the Exchange.

23. When do I need to enroll for individual medical insurance inside or outside of the Exchange? The Open Enrollment Period for obtaining individual medical insurance is October 1st, 2013- March 31st, 2014. You must be enrolled within this period to avoid the tax penalty (see question #2). If you do not enroll during this time, you will not be able to enroll onto an individual medical plan until the next enrollment period. There are exceptions allowing for enrollment outside of the Open Enrollment Period such as losing group medical coverage, moving, changing employment, marriage, divorce, newborns or adoptions, etc.

24. How is coverage for multiple children in one family changing?

17. How do I know if I have a grandfathered medical plan?

If you purchased your individual medical insurance before March 23, 2010 and it has remained the same plan with no changes, then your plan is considered grandfathered and is not subject to the ACA. Your plan will remain available to you and you will not be required to transfer to a new plan in January 2014.

18. Will Health Savings Account (HSA) plans still be available in 2014?

Yes. Most carriers will continue to offer HSA Plans. ACA requirements may change existing HSA plan design and costs. Contact the Washington Dentists’ Insurance Agency to discuss your existing HSA plan.

19. What do I need to do if I currently have no medical coverage?

To purchase individual medical coverage, you must sign up during the Open Enrollment Period beginning from October 1, 2013 to March 31, 2014. You may purchase coverage inside or outside of the Exchange. If you do qualify for tax credits or cost share reductions, then you must choose your new plan inside the Exchange in order to receive the credits and reductions. Washington Dentists’ Insurance Agency can assist you with obtaining a plan both inside and outside of the Exchange.

20. How do I look for individual medical plans and apply for coverage outside of the Exchange? If you do not qualify for tax credits or cost share reductions, then you will want to purchase your individual medical insurance outside of the Exchange. You can purchase plans from a carrier directly, via their website or by paper application. Washington

For most individual plans, the individual rate is charged for the first three dependents 20 and younger. After that, additional dependents are not charged. The individual rate is charged for all dependents age 21 to 26.

25. Can I be denied medical insurance coverage based on medical conditions?

No, as part of the ACA, you cannot be denied medical insurance due to a previous or current medical condition.

26. Is there a waiting period for coverage of pre-existing medical conditions? No, as part of the ACA, there is no waiting period for coverage of an existing medical condition.

27. Will health insurance premiums be more “affordable” under the ACA?

This is yet to be seen. Medical plans available in 2013 will be very different than medical plans available in 2014 so an apples to apples cost comparison is difficult to make. Costs will also be very dependent upon age, geographic location, and tobacco use. Generally speaking, premiums for older individuals may decrease while premiums for younger individuals may increase.

28. Do small business owners have to provide medical insurance to their employees?

No. Employers with less than 50 full time employees (FTEs) are not required to offer group medical insurance to employees. The employer mandate for companies with more than 50 FTEs begins in 2015.

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newal. At that time, your current plan will be phased out and your carrier will offer you their new plan options with which to renew. You can stay with your current carrier, or you can look at other carrier options. Since Kaiser Permanente is the only carrier offering plans inside the small group Exchange in 2014 in Clark and Cowlitz Counties, most groups will be purchasing their coverage outside of the Exchange.


special pull-out section affordable care act and you

know this: 1. In 2014, no businesses are required to provide medical insurance to their employees. 2. In 2015, only businesses with more than 50 FTEs have to provide employees with medical insurance or pay a penalty. 3. In 2014, Washington’s small business or SHOP Exchange will only be available in Clark and Cowlitz counties. 3 0 · th e wsda ne w s · issue 1, october · 2013 · www.wsda.org


How does this affect me as a business owner? 29. Under the ACA, what tax credits are available for an employer?

The small business health care tax credit helps small businesses afford the cost of covering their employees and is specifically targeted for those with low- and moderate-income workers. The credit is designed to encourage small employers to offer health insurance coverage for the first time or maintain coverage they already have. In general, the credit is available to small employers that pay at least half the cost of single coverage for their employees. For tax years beginning in 2014 or later, the maximum credit is 50 percent of premiums paid for small business employers. To be eligible for the credit, a small employer must pay premiums on behalf of employees enrolled in a qualified health plan offered through the SHOP Exchange (the SHOP Exchange is only available in Clark and Cowlitz counties in 2014). The credit will be available to eligible employers for two consecutive taxable years. Here’s what this means for you. If you pay $50,000 a year toward workers’ health care premiums — and if you qualify for a 20 percent credit, you save $10,000. Even if you are a small business employer who did not owe tax during the year, you can carry the credit back or forward to other tax years. Also, since the amount of the health insurance premium payments is more than the total credit, eligible small businesses can still claim a business expense deduction for the premiums in excess of the credit. That’s both a credit and a deduction for employee premium payments. To be eligible, you must cover at least 50 percent of the cost of single (not family) health care coverage for each of your employees. You must also have fewer than 25 full-time equivalent employees (FTEs). Those employees must have average wages of less than $50,000 (as adjusted for inflation beginning in 2014) per year. Remember, you will have to purchase insurance through the SHOP Exchange to be eligible for the credit for tax years 2014 and beyond. Say you pay total wages of $200,000 and have 10 FTEs. To figure average annual wages you divide $200,000 by 10 — the number of FTEs — and the result is your average annual wage. The average annual wage would be $20,000.

30. Is it more advantageous (regarding taxes and tax credits) for an employer to include additional money in an employees paycheck for each employee to purchase individual health insurance or have the employer purchase a group plan?

The decision for employers with less than 25 full-time employees is largely based on the average income levels of the employees. Employers will be able to claim a small business tax credit if the average wages for all employees falls under the $50,000 threshold (refer to question #29 for more information). From the employee perspective, higher-wage workers with wages of $50,000 per year or more are likely to prefer employ-

er-provided health insurance to additional cash wages because employer-provided health insurance is tax-free and they are in a moderately high income tax bracket. Thus, these employees would likely not qualify for the advance premium tax credit (refer to question #5 for more information). Beginning in 2015, an employer with at least 50 full-time employees (employees working 30 hours or more a week on average during the year) must offer minimum essential health coverage to at least 95% of its fulltime employees. If an employer fails to do so and one or more employees secures assistance for coverage purchased through an Exchange, there is an annual penalty of $2,000 multiplied by the total number of full-time employees less 30. This being said, it is more advantageous for large employers to purchase a group plan and provide coverage to their employees. The new health care law presents significant financial issues that need to be evaluated by both employers and employees. Both must examine their own unique circumstances before making any decision relating to the new health care law. Thus each employer and employee should discuss their unique situation with their advisors.

31. What are the IRS forms that a small business owner needs to fill out to get tax credits for health insurance they provide to their employees? The Credit for Small Employer Health Insurance Premiums is calculated on Form 8941.

32. What are the W-2 reporting requirements under the ACA?

The Affordable Care Act requires employers to report the cost of coverage under an employer-sponsored group health plan on an employee’s Form W-2, Wage and Tax Statement, in Box 12, using Code DD. Many employers are eligible for transition relief for tax-year 2012 and beyond, until the IRS issues final guidance for this reporting requirement. The amount reported does not affect tax liability, as the value of the employer excludible contribution to health coverage continues to be excludible from an employee’s income, and it is not taxable. This reporting is for informational purposes only, to show employees the value of their health care benefits. The amount reported should include both the portion paid by the employer and the portion paid by the employee.

33. Are employers required to notify employees about the Exchange?

Yes. The Department of Labor requires employers to notify employees that the exchange is an entity where health insurance can be purchased. However, there is no penalty for employers who do not provide this notification to their employees. The Department of Labor has created notification forms that can be shared with employees. These forms can be accessed on the Source.

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special pull-out section affordable care act and you

aca and you: impact on employers


special pull-out section affordable care act and you

know this: 1. Only pediatric dental coverage is required in the ACA. Adult dental coverage is not mandated. 2. Pediatric dental insurance will be offered as a stand alone plan when purchasing through Washington Healthplanfinder. 3. Pediatric dental insurance will likely be embedded into medical insurance plans when purchased outside of the exchange. 3 2 路 th e wsda ne w s 路 issue 1, october 路 2013 路 www.wsda.org


How does this affect me as a dentist? 34. How will the ACA impact dental insurance in Washington state?

Starting in 2014, all children in Washington state will be required to have pediatric dental coverage. Adults are not required to purchase dental insurance under the ACA.

35. What must the pediatric dental benefit cover?

The Office of the Insurance Commissioner was given limited options in deciding what the pediatric EHB must cover. Ultimately, the OIC decided to choose the state’s CHIP plan (dental Medicaid) as the benchmark for what pediatric dental coverage must offer. Selecting the children’s Medicaid coverage does not mean insurance carriers will use Medicaid reimbursement rates. It is only a selection of coverage. All pediatric dental insurance must cover what the CHIP program covers. A dental insurance carrier must offer the following pediatric oral benefits: · Diagnostic services · Preventive care · Restorative care · Oral surgery and reconstruction to the extent not covered under the hospitalization essential health benefit · Endodontic treatment · Periodontics · Crown and fixed bridge · Removable prosthetics · Medically necessary orthodontia The benchmark plan for the pediatric dental benefit has the following visit limitations on services: · Diagnostic exams once every six months, beginning before one year of age · Bitewing X ray once a year · Panoramic X rays once every three years · Prophylaxis every six months beginning at age six months · Fluoride three times in a twelve-month period for ages six and under; two times in a twelve-month period for ages seven and older; three times in a twelve-month period during orthodontic treatment; sealant once every three years for occlusal surfaces only; oral hygiene instruction two times in twelve months for ages eight and under if not billed on the same day as a prophylaxis treatment · Every two years for the same restoration (fillings) · Frenulectomy or frenuloplasty covered for ages six and under without prior authorization · Root canals on baby primary posterior teeth only · Root canals on permanent anterior, bicuspid and molar teeth, excluding teeth 1, 16, 17 and 32 · Periodontal scaling and root planing once per quadrant in a two-year period for ages thirteen and older, with prior authorization · Periodontal maintenance once per quadrant in a twelve-month period for ages thirteen and older, with prior authorization

· Stainless steel crowns for primary anterior teeth once every three years; if age thirteen and older with prior authorization · Stainless steel crowns for permanent posterior teeth once every three years · Metal/porcelain crowns and porcelain crowns on anterior teeth only, with prior authorization · Space maintainers for missing primary molars A, B, I, J, K, L, S, and T · One resin based partial denture, if provided at least three years after the seat date · One complete denture upper and lower, and one replacement denture per lifetime after at least five years from the seat date · Rebasing and relining of complete or partial dentures once in a three-year period, if performed at least six months from the seat date

36. How will dental insurance be offered inside of the Exchange?

Under Washington state law, pediatric dental insurance sold through Washington Healthplanfinder must be priced and offered separately from medical insurance. This means that individuals (with children) who purchase medical insurance inside the Exchange will be required to select a stand-alone pediatric dental insurance plan as well.

37. Which carriers will provide standalone dental coverage inside the Exchange?

Delta Dental of Washington (WDS), Kaiser Permanente, Premera Blue Cross, LifeWise Health Plan of Washington, and Dental Health Services.

38. How will dental insurance be offered outside of the Exchange?

In 2014, all medical insurance plans offered in the individual and small group markets will have to include coverage for pediatric dental. Outside of the Exchange, pediatric dental will likely be embedded into medical insurance plans if the insurance carrier sells dental insurance and has an adequate network. Embedding means the cost of providing the pediatric dental benefit will be rolled into the overall cost of the medical insurance premium. Medical insurance carriers who do not offer dental insurance will have to subcontract with a dental insurance carrier to provide the pediatric dental coverage. Since pediatric dental is an EHB, all individuals who purchase medical insurance outside of the Exchange will have to buy the coverage regardless of whether or not they have children. In 2015 and beyond, consumers will be able to waive an embedded pediatric dental benefit if they have stand-alone pediatric dental coverage. The Office of the Insurance Commissioner will begin rulemaking on this topic in 2014.

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special pull-out section affordable care act and you

aca and you: impact on you


special pull-out section affordable care act and you

impact on you, continued

39. Will medical carriers now be required to provide dental insurance?

No. If medical carriers do not provide dental coverage, they will need to develop a contractual relationship with a dental carrier. For example, Group Health Cooperative is planning to work with United Concordia to provide their enrollees with pediatric dental coverage.

40. Where can adults purchase dental insurance?

In 2014, adult dental insurance will not be offered on Washington Healthplanfinder. Adult dental coverage may be offered on the Exchange at a later date. Adult dental coverage can be purchased outside of the Exchange.

41. Will adults with Medicaid coverage have a dental benefit?

Yes. The Washington State Legislature restored funding for a comprehensive dental benefit for Medicaid eligible adults that takes effect on January 1, 2014. The legislature also decided to expand Medicaid eligibility to more low income adults. Under the Affordable Care Act, states have the option to expand Medicaid eligibility to all adults who earn less than 138 percent of the federal poverty level. Initially, the federal government will pay 100 percent of the cost of Medicaid benefits for this expansion population. The federal match eventually drops to a 90 percent match in a few years. Restoring a comprehensive dental benefit for the existing Medicaid-eligible adults allows the state to also provide a comprehensive dental benefit for adults who are newly eligible for Medicaid under Medicaid expansion.

42. If dental coverage is embedded into medical coverage, will dental offices have to use medical codes for dental procedures?

No. Dental codes will still be used for billing dental procedures.

43. Is there a mandate for dental offices to have electronic health records (EHRs)? No. The ACA does not require dental offices to integrate EHRs into their practices. However, the ACA does provide funding for dental offices to transition to EHRs if they decide to do so. For more information about electronic health record incentive payments, please contact Bracken Killpack at bracken@wsda.org.

44. What are Accountable Care Organizations (ACOs)?

The ACA established a pilot program called the Medicare Shared Savings Program which encouraged the formation of Accountable Care Organizations (ACOs). In general terms, ACOs are entities comprised of health care providers (hospitals, physicians, home health agencies and others) who collaborate to provide coordinated care to a defined population for a bundled payment. ACOs are designed to align provider incentives with the provision of quality care (employing evidence-based protocols) rather than the volume of services. ACOs consist of two main features. First, ACOs are designated accountable provider entities that share responsibility for treating a group of patients. Second, ACOs have new payment approaches that are based on performance measures. This could mean that fee-for-service could be supplanted by reimbursement based on patient outcomes and performance.

46. What do I need to do to become a provider for insurance carriers? If you would like to become a preferred provider with insurance carriers in Washington, you must contract the carriers directly to obtain their provider application and requirements. The following is a list of many of the carriers providing dental coverage in 2014:

Delta Dental

Provider Services team at (206) 528-7394 or (800) 238-3439 http://www.deltadentalwa.com/Dentist/Public/Join%20 WDS%20Networks.aspx

LifeMap

Loretta Eline, (206) 332-5012 or Alan Hong, (206) 3323937 https://www.lifemapco.com/provider/join-network/advantages

Lifewise

Provider Relations Department: 877-342-5258, option 4. https://www.lifewisewa.com/provider/join-our-network/

Premera

Provider Relations Department at 877-342-5258, option 4. https://www.premera.com/wa/provider/

Regence

regence_credentialing@regence.com http://www.wa.regence.com/provider/contracts-credentialing/ http://www.wa.regence.com/provider/docs/dental-consultants.pdf

United Concordia

Contact Number: 1-800-307-8514 www.unitedconcordia.com/dental-insurance/dentists/joinour-network/

Dental Health Services

www.www.dentalhealthservices.com/dentists

45. Will ACOs impact dentistry in Washington state?

There is no publically available information to indicate that any ACOs in Washington state are providing dental care. Some ACOs in Minnesota, New Jersey, and Oregon intend to provide dental care.

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Figure 1

History of present illness:

Figure 2

Oral & MaxillofacialMaxillofacial Surgery, Lakewood, Wash.

This is a 58-year-old male who was completely unaware of a large swelling in the posterior tongue (Figure 1). The swelling is of unknown duration. It is soft in consistency and is well demarcated per radiographic imaging (Figure 2). The patient’s dentist noticed the swelling and recommended that it be evaluated. This “Clinical Corner” case was contributed by Dr. David Cotant of

Test your knowledge! An answer to this case study can be found on the University of Washington’s Web site at http://www.dental.washington. edu/departments/oral-surgery/case-of-the-month.html. Click on “Case of the Month” and look for the October 2013 entry.

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th e wsda ne w s · issue 1, october · 2013 · www.wsda.org · 35

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clinical corner issue 1, october 2013

Large and completely asymptomatic swelling of the posterior tongue


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Dr. Scott Frank Kanemori

Dr. Scott Frank Kanemori was born June 12, 1949 in Minneapolis, Minn. and raised in Seattle by Dr. and Mrs. Frank Kanemori. He graduated from West Seattle High school in 1967, University of Washington in 1971, and University of Washington School of Dentistry in 1975, where he became a dedicated Husky football fan. Kanemori practiced dentistry for 38 years in Seattle and Renton, and was voted one of the top 20 dentists in King County in 2007. He loved to spend his time on Whidbey Island surrounded by his family, friends and fishing. He is survived by his wife of 32 years Susan, their children Brandon, Christopher and Taylor and his mother Yoshi. After a year long battle with cancer, Kanemori passed away peacefully on July 8th with his family by his bedside. He will be deeply missed by all who knew and loved him.

Dr. Melvin T. Sinex

Dr. Melvin Sinex was born on November 10, 1920 in Auburn, Wash. to Ford and Clara (Heisserman) Sinex. He grew up in their house at the end of East Main Street with his brother, Bob, and sister, Juanita. He graduated from Auburn High School and then attended Pacific Lutheran College and North Pacific College of Dentistry. Sinex married Beulah “Johnnie” Johnson in Coeur d’Alene, Id. in 1945. After serving as a dentist in the Navy, he opened his dental office on Main Street in Auburn. He continued to practice dentistry in Auburn for more than 30 years. They raised three girls, and lived a lifetime of service to their church, Messiah Lutheran, and to the community. He was a loyal member of Kiwanis and the Auburn Chamber of Commerce. He was on the Auburn School Board for 13 years, a long time board member of the Auburn Respite Program, and friend to the White River Valley Museum. He loved his family and his friends, and his house was forever full of children and grandchildren. He died peacefully surrounded by his girls on Wednesday, April 24th in the home on “J” Street that he loved. He is survived by his daughters and their families: Janice and Casey Olinger; Linda and Warren Bieker; and Leslie and Bob Larson; as well as grandchildren and spouses: Michael and Stephanie Leeper; Mary Beth Leeper; Anne and Mike Miller; John and Ashley Bieker; Joel and Mindy Bieker; Mary

Jo Bieker; Sarah and Jason Fent; and Rebecca Larson; and three great-grandchildren: Tommy and Morgan Leeper; and Emrie Miller.

Dr. David L. Warrick

Dr. David L. Warrick, born April 5, 1940, beloved husband and best friend of Therese for 25 years, passed away peacefully surrounded by those he laughed with, lived for, and loved, on September 12, 2013 after a seven month battle with cancer. Warrick was born and raised in Seattle, Wash. He attended Queen Anne High School and the University of Washington. He earned his Dentistry degree from the University of Pennsylvania. He enjoyed a successful dental practice in the University district for 43 years where he had numerous longtime patients. He proudly served his country actively in the Army and in the Army Reserves attaining the rank of Colonel. He commandeered the 607th Dental Detachment and also served as ARCOM Dental surgeon. Here he touched many lives and formed lifelong friendships. A lifelong lover of flight, Warrick held a pilot’s license. When he couldn’t fly, he enjoyed going to air shows. In his retirement he became a docent at the Museum of Flight where he enlightened many visitors with his warm personality and lively storytelling. He also loved sports and travel and had many other interests. Warrick is preceded in death by his parents, Muriel and Lantz Warrick. Besides his wife Therese, he has three children: sons Lantz Warrick of Taipei and Kevin (Jocelyn), and a daughter Nicole, grandchildren Charleen, Lila and Reed. He is also survived by many extended family members and friends. Memorial contributions may be made in David’s name to the Swedish Cancer Institute or to a charity or choice.

Dr. Ralph Youdelis

Born in St. Albert Trail, Alberta, Canada, Ralph was the third child of Vincas and Teresa (Sapokas) Yuodelis, who had emigrated from Lithuania. He graduated with his DDS from the Univ of Alberta School of Dentistry in 1955, began a practice in Edmonton and soon met Elizabeth Anne “Nan” Lysnen to whom he was married for 57 years. he and Nan have five children (Christine, Robert,

th e wsda ne w s · issue 1, october · 2013 · www.wsda.org · 37

Terri, Joan and Gayle), 14 grandchildren, and one great grandchild. The family moved to Seattle when Ralph started postgraduate training at the Univ of Washington. On completion of the specialty programs in periodontics and prosthodontics, he was recruited to a faculty position. Dr. Yuodelis directed the UW Dental School graduate program in fixed prosthodontics and combined graduate prosthodontics program for more than a quarter-century. He was Professor Emeritus of Restorative Dentistry and Adjunct Professor of Periodontics at the UW. During his career, he received many accolades for his achievements - President of the American Academy of Fixed Prosthodontics, Fellow of the American College of Dentists and Fellow of the International College of Dentists, among others. In 2001, the American Academy of Fixed Prosthodontics bestowed on him the George H. Moulton Achievement Award in 2001 for his distinguished lifetime contributions. He gave hundreds of postgraduate presentations around the world, co-authored two major dental textbooks, and was chosen as UW School of Dentistry’s Distinguished Alumnus in 2002. The University of Alberta honored him with its Dental Alumni Association’s Outstanding Achievement Award in 1998. The legacy of this great teacher is felt by thousands of clinicians throughout professional dentistry. Over the past 50 years, his program attracted many graduate students from all corners of the world. His students continue demonstrating the quality of education at the UW and carrying on his teachings to others. The UW School of Dentistry gained international acclaim for its melding of the graduate programs in Periodontics and Prosthodontics and is in large part a tribute to his training in and mastery of the two disciplines. Dr. Yuodelis left a strong positive mark on advancing the quality of dental care world-wide. After retiring in 2005, he continued on as Professor Emeritus, dedicating time to training new generations of grad students (the other “Yuodelis kids”). He also enjoyed his retirement with Nan by spending the winters in Florida, fishing in Alaska with friends, golfing at Inglewood and enjoying opera. Yuodelis is survived by his wife Nan, children and grandchildren, brother Bill Youdelis, sister Donna Kadis and many loving nieces and nephews.

in memoriam drs. kanemori, sinex, warrick, youdelis

In memoriam


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th e wsda ne w s 路 issue 1, october 路 2013 路 www.wsda.org 路 39


4 0 路 th e wsda ne w s 路 issue 1, october 路 2013 路 www.wsda.org


temporary B&O surcharge from becoming permanent. My favorite part of the meeting was listening to WSDA Citizen of the Year, Dr. Ray Damazo, speak about the clinic he and his wife Gail Sage Damazo built in Africa. He is in his 80’s and said the last twenty years of his life were his most productive. I was charmed by his delight when we awarded Gail the rarely given “Friend of Dentistry” award. Dr.Damazo said that he was hoping that we would give him a paper award so he could rip it in two and give her half to show us that he could not have done it without her. He touched our hearts in so many ways. This year gave us highly competitive elections. Congratulations go to Vice President Bryan Edgar. Dr. Edgar is detail oriented and will serve us well. Dr. Greg Ogata looked fit and fine and is ready to take on his role as President-Elect. Mike Buehler won his election for Secretary/Treasurer. He amazes me with what must be an eidetic memory of the exact amount of money we have in various accounts and how much they fluctuate. Our new WSDA Board members are Drs. Ashley Ulmer, Eric Kvinsland and James Reid. Incumbents Drs. Bernard J. Larson and Gary Heyamoto also won their seats back. As editor, I attend board meetings and observe. Our last board meeting was the Friday after the House of Delegates. It was exciting to see our new board members speaking fluently on issues and how well this board is working together. With fresh leadership (including three board members under the age of 40!) and our stellar staff, our future remains bright. I can’t wait to see where we go from here!

9/26/13 10:52 AM

Welcome New Members Please join WSDA in welcoming the following new members into the community of organized dentistry

Clark County Dental Society Dr. Prashant Gagneja

Grant Dental Society Dr. Trevor Frideres

Kitsap Dental Society Dr. McKinley Self Dr. Kayla Shearrer

Pierce Dental Society Dr. Cynthia Alegre Dr. Lily Kwee Dr. Conway Upshur

Seattle King County Dental Society

Dr. Rebecca Slayton Dr. Asha Sethu Madhavan Dr. Reen Chung Dr. Ajay Dhankhar Dr. Jason Brester Dr. Devin Dickinson

Dr. Brolen Freimanis Dr. James Graves Dr. Constance Brester Dr. David Moore Dr. Atriya Salamati Dr. Michael Stevens Dr. Andy Trinh Dr. Jayna Sekijima Dr. Kathryn Jagow Dr. Charles Kim Dr. Hilary Linton Dr. Pamela Lloren Dr. Shannon Farazi Dr. Saudamini Gadgil Dr. Jamie Clark Dr. Amanda Guerrero Dr. Jessica Ahn Dr. Cindy Tseng Dr. Azmera Solomon Dr. Stephen Park Dr. Duane Bennett II Dr. Saraswathi Hanumanthegowda Dr. Joseph Haynes

Dr. Christopher Kinslow Dr. Annie Kwan Dr. Kyle Sorensen Dr. Stuart Taylor Dr. Jennifer Ward

Snohomish Dental Society Dr. Alexis Apatoff Dr. Stephanie Canton Dr. Dulce Duarte Mercado Spokane Dental Society Dr. Dulce Duarte Mercado Dr. Gary Keller Dr. David Gailey Dr. Nicholas Freuen Dr. Steven Bates Dr. Katherine Taylor

Spokane Dental Society Dr. Gary Keller Dr. Steven Bates

Thurston Mason Dental Society Dr. Joseph Szabo

th e wsda ne w s · issue 1, october · 2013 · www.wsda.org · 41

membership new members

$PAC-078_DENTAL_WA-StateDentalAssoc_BW_3.5x4.75_Nov-Dec2013.indd 1

editorial continued

editorial, continued from page 4


ripp program dr. john barrett and lindsay kelstrom

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4 2 · th e wsda ne w s · issue 1, october · 2013 · www.wsda.org


Left to right: Carol Eldridge, Brent Powell, Lindsay Kelstrom, Christine Allen, Rebecca Krajewski, Dr. John Barrett, and Kindra Sanders

This past July, first year UWSoD student Lindsay Kelstrom took two weeks out of her summer to shadow WSDA member Dr. John Barrett in Port Hadlock, Wash., as part of the Rural Internship in Private Practice (RIPP) program. RIPP was designed to give dental students a first person account of what life as a rural dentist is like — including all aspects of a rural practice, and just as importantly, how social life and community involvement differs from a metropolitan practice. Barrett, who grew up in suburban Houston in the 50s, remembers it as less a city, more rural, “It was surrounded by hayfields and ponds, and as a kid we could play and pretend to be anything out there.” That nostalgia for rural living and a love of nature and all things outdoors (don’t even get him started on his distaste for urban traffic) led him to Port Hadlock. His parents retired to nearby Sequim; and when Barrett would visit, he knew it was the life for him. “I didn’t choose the area based on where I thought I would have the best business opportunity, I chose it based on where I wanted to live. It was never about a rural practice, it was the quality of life. I wanted to live near the outdoors and away from crowds of people, which is oxymoronic when you factor in that I was trying to develop a practice.” But Barrett loved the slower quality of life, the lack of traffic jams, the feeling of independence and privacy — even though he says, “Everyone knows everybody else and their business,

but they don’t live right on top of you out here, as they do in the city. They’re separated by trees, foliage and fences, at least where I live. I like that.” For his part, Barrett wanted to participate in the program because he’s enjoyed mentoring in the past, “I got to do a little bit of that tangentially in Africa, and some different narrow circumstances, and I found that I liked it. As it turns out, I couldn’t have been happier with the experience. Lindsay was a terrific kid, we had a great time with her, and I feel like I made a lifelong friend. She was extremely attentive, really wanted to learn, and was proactive about getting involved in the office.” Barrett notes that Kelstrom’s two weeks were pretty typical of a rural practice, “ The first week she was here we were slammed, and the second week was the opposite — a staff meeting and people sitting around doing crossword puzzles, so she got to see what both sides of a rural practice are like. I think that was probably good for her — she is interested, at least on some level, in practicing in a rural area, and this gave her a snapshot of that experience.” Kelstrom, whose dad, sister-in-law and others in her extended family are dentists, grew up in Brush Prairie, Wash., outside of Vancouver. She found the idea of a rural practice appealing for many reasons; and when she heard about the RIPP program, decided right away to sign on. She says, “I think a rural practice is a calling for me because it ties in with my faith and my desire to deliver care to people with limited ac-

th e wsda ne w s · issue 1, october · 2013 · www.wsda.org · 43

cess. I grew up in Western Washington and would like to stay here; but in all honesty, I’ll go wherever I need to.” Kelstrom was most surprised at how advanced Barrett’s practice was, “I was actually surprised at all of the technology that he has - he has a laser and a Cerec, which I had never seen before. I was surprised at how advanced and up-to-date the practice was, but it is really smart — as one of only two dentists in the area, it was in his best interest to have more technology options. In fact, other than meeting Barrett, his family and staff, Kelstrom cited the tech in his office as one of her favorite aspects of the two-week internship, “ I really liked learning about the technology behind Cerec crowns — I had never seen it before, and I found it really interesting. And I felt like it was something that I had enough knowledge to understand because it involves dental anatomy, a course I had my first year of dental school.” Additionally, she enjoyed accompanying Barrett to his Rotary meeting and other social events, where she got first-hand experience of how small towns are interconnected, saying, “He’s been there a long time, and has helped generations of families, has seen kids grow up and have their own families, who then become patients.” She says that the experience renewed her interest in practicing in a rural area; and like Dr. Barrett, she’ll employ cutting-edge technology to stay current and bring the best possible dental care to her patients.

ripp program dr. john barrett and lindsay kelstrom

2013 RIPP Program participants


All because of you.

wsdanene issue1,8,october august ·· 2013 2013 ·· www.wsda.org www.wsda.org 4 4 4· ·thth e ewsda ww s s· ·issue


CELEBRA TIN

NCE LLE CE

G

TY YEARS OF X I EX S

Nakanishi Dental Laboratory, Inc. would like to take this opportunity to say thank you. This year we are celebrating our 60th Anniversary and 2013 NADL Lab of the Year award. None of it would have been possible without you, and we are looking forward to serving you in the future!

800.735.7231 | nakanishidentallab.com th e wsda ne w s 路 issue 1, october 路 2013 路 www.wsda.org 路 45


• inexpensive • disposable • non-toxic

SLEEP APNEA & SNORING

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made in u.s.a. - fda registered

Kianoosh Behshid, D.M.D. has acquired the practice of Heideh E. Eftehari, D.D.S. -

Bellevue, Washington

Arvind J. Petrie, D.M.D. has acquired the practice of Daniel J. Gallacher, D.D.S. -

Call 1-800-232-3826 or visit us online at www.aftco.net for a FREE Practice Appraisal, a $2,500 value!

Tacoma, Washington

AFTCO is pleased to have represented all parties in these transitions.

Download our new AFTCO app from iTunes or Google! AFTCO is the oldest and largest dental practice transition consulting firm in the United States. AFTCO assists dentists with associateships, purchasing and selling of practices, and retirement plans. We are there to serve you through all stages of your career.

“Over $1.5 Billion in Practice Sales” 4 6 · th e wsda ne w s · issue 1, october · 2013 · www.wsda.org


Academic experts call Social Security benefits ‘the best deal in town.’ Unlike other assets, Social Security benefits meet three critical retirement needs: • Benefits automatically increase with the cost of living; • Benefits are not subjected to market volatility; • Benefits are paid for however long you live. As you approach eligibility age, it is important to know the facts so you can factor this valuable form of income into your retirement planning. Following are four ways to make the most of your Social Security benefits:

Delay for a 75 percent raise

If you will be collecting your retirement benefit based on your own work record (as opposed to your spouse benefit), Social Security offers you bonuses for exercising a little patience. Early benefit eligibility begins at age 62, but comes with a 25 percent permanent reduction. To receive 100 percent of your benefit, you must wait until full retirement age – 66 if you were born between 1943 and 1954; 66+ two to ten months if you were born between 1955 and 1959. Receiving 100 percent of your benefit at age 66 is good, but waiting until age 70 provides four years of 8 percent annual increases in the form of delayed retirement credits. Your reward for waiting: A 75 percent increase in your benefit between age 62 and 70. This is in addition to any increases if you continue to work, and the cost-of-living increases that Social Security credits each year you wait to claim.

Know the facts about Social Security financing

Are you convinced that delaying your Social Security benefit until age 66 or 70 will increase your lifetime income, but you are still tempted to claim early because you have concerns about the system’s solvency? Social Security is facing a manageable shortfall – not bankruptcy. According to the Center for Retirement Research at Boston College, a nationally recognized authoritative source on retirement income, the latest Social Security Board of Trustees Report shows that the program “faces a manageable shortfall over the next 75 years.”1 Specifically, the Trustees estimate Social Security has enough reserves to fund all scheduled benefits for the next two decades. After that in 2033, the program’s surplus is projected to be exhausted. Yet this is not the full story. Behind the headlines, the Trustees further project that even after the reserves run out “…continuing income (from the dedicated payroll tax) to the combined trust funds would be sufficient to pay 77 percent of scheduled benefits.”2

Weigh the long-term effect on your savings

What if you must dip into savings to cover expenses while waiting to claim your Social Security retirement benefit? Researchers have studied this scenario and found that waiting to claim a larger benefit can reduce the amount you will need to withdraw from savings in later years.3 For example: a double-high-earner married couple delays Social Security benefits until age 70. They withdraw a 2 percent inflation-adjusted $100,000 for annual spending beginning at age 62. Thanks to the 25 percent increase from age 62 to 66, four years of 8 percent delayed retirement credits between age 66 and 70, and estimated annual 2.8 percent cost-of-living increases, after age 76, they will need to withdraw less from savings than if they began their benefits at age 62. By age 85, the cumulative total amount they would need to

withdraw from savings over the 23 years amounts to nearly half a million dollars less.4

If you already started your benefits…

If you claimed your Social Security benefit before full retirement age 66, the Social Security Administration offers several options for an increase. Reverse your decision if within the first year of claiming If it has been less than a year since you claimed your benefit, and you now want to receive 100 percent of your benefit at age 66, or 132 percent at age 70, Social Security offers you a one-time chance to start the benefit process over. To do so, you must repay all benefits received to date, plus any payments your family received. However, you will not be charged interest. You may also be entitled to claim a tax credit if you paid income tax on benefits received. Keep working or go back to work if you are between 62 and 66 If you are under full retirement age 66, you are subject to the Social Security earnings test. What most people do not know? The earnings test only temporarily reduces your monthly benefit. Specifically, when you reach full retirement age, Social Security recalculates your benefit amount, crediting you for any months you did not receive a benefit due to excess earnings. In contrast to penalizing you for working, Social Security will pay you a higher benefit amount when you reach age 66. Plus, if your new earnings are higher than earlier years in your record, the extra earnings may increase your monthly benefit. Voluntarily suspend your benefit if you are between 66 and 69 If more than a year has passed since you claimed your benefit, you are no longer able to reverse your decision. However, if you are between age 66 and 69, the Social Security Administration allows you to voluntarily suspend your benefit, permitting it to build 8 percent annual delayed retirement credits until age 70. The credits will be applied to your reduced early claimed amount, but these increases can make a big difference. If you are interested in learning more about how Mercer Advisors can help you navigate through the complexities of Social Security decision making, including scenarios, rules, and requirements specific to married couples, divorced individuals, and widows or widowers, please contact Yolanda Carbajal, CFP® in our Bellevue branch location at 888.642.4636 or at yolanda.carbajal@ merceradvisors.com.

1. Center for Retirement Research at Boston College, Social Security’s Financial Outlook: The 2013 Update in Perspective, June 2013. 2. Board of Trustees of the Federal Old-Age and Survivors Insurance and Federal Disability Insurance Trust Funds, 2013 Annual Report. 3. The Journal of Financial Planning, How the Social Security Claiming Decision Affects Portfolio Longevity, William Meyer and William Reichenstein, April 2013. 4. Assumes full retirement age benefits of $2,533 for husband and $2,000 for wife, life expectancy of 90 for husband and 95 for wife, and receipt of wife’s spouse benefit between age 66 and 70. Sources: The Official Website of the Social Security Administration, ssa.gov, The Social Security Program Operations Manual System, The Social Security Handbook, The 2013 Annual Report of the Board of Trustees of the Federal Old-Age and Survivors Insurance and Federal Disability Insurance Trust Funds, Center for Retirement Research at Boston College, Center on Budget and Policy Priorities, National Academy of Social Insurance. Information provided is based on current Social Security rules and assumes no changes in program formulas or funding levels. Mercer Global Advisors Inc. is registered with the Securities and Exchange Commission and delivers all investment-related services. Mercer Advisors Inc. is the parent company of Mercer Global Advisors Inc. and is not involved with investment services.

th e wsda ne w s · issue 1, october · 2013 · www.wsda.org · 47

the source mercer advisors

From The Source: How to increase your Social Security benefit


Their Words, Not Ours... “Rush Commercial has done 2 major projects for me: my dental practice and also office space for my consulting firm; Miles & Associates. Both projects were finished on time and under budget. I can give them my highest recommendation.” – Rhonda R. Savage DDS Former President of Washington State Dental Association

Whether it’s constructing a new building or remodeling an existing suite — we have you covered. Chris DeWald, VP, Business Development 253-858-3636 | cdewald@therushcompanies.com 6622 Wollochet Drive NW | Gig Harbor, WA 98335 therushcompanies.com

Commercial

4 8 · th e wsda ne w s · issue 1, october · 2013 · www.wsda.org


OPPORTUNITIES AVAILABLE

OPPORTUNITIES AVAILABLE

POSITION OPEN — Seeking an experienced dentist or prosthodontist to join an established group practice approximately 32 hours per week in Vancouver, Wash. Proficiency in oral surgery and dentures/partials preferred. Please send CV to jennifers@ wendeldental.com.

ASSOCIATE DENTIST EVERETT — Currently looking for a caring dentist with exceptional interpersonal skills. The position requires minimum of two years clinical experience to work three to four days a week. Long time practice with new digital systems, PPO and fee for service. Great staff and a competitive package for a personable doctor looking for a long term position with potential to buy in. Please submit resume to jobsfamilydental@gmail.com.

ENDODONTIST FOR NORTH SEATTLE AREA — To provide the most comprehensive dental care in the industry means having the best dental specialists working at our Gentle Dental affiliated offices. That’s why we take pride in working with Endodontists nothing short of exceptional. As an industry leader, Gentle Dental provides a large network of resources, including an experienced practice management staff, cutting edge technology, and outstanding benefits. You will also have plenty of dental professionals supporting you to confer and collaborate with as you continue to grow in your career. We seek high-caliber professionals possessing degrees or certificates from accredited colleges or technical schools/programs (as well as valid/current state license) with at least 1 year of dental experience. Gentle Dental has delivered high quality care with a personal touch for over 30 years. We have the resources you need to achieve true personal and career success. We aim to provide our network of affiliated doctors and staff with a competitive benefits package, which include: medical, dental, vision, life insurance, 401K plan, paid vacation and holidays, CE credits, and career opportunities to advance with the company. Contact: Ron Brush, Phone: (971) 295-9914, email: brushr@interdent.com or website www.gentledentalcareers.com.

ASSOCIATE DENTIST SW WASH. — Upbeat, state of the art practice, local dentist owner, large stable patient base, enthusiastic and lively team of experienced dentists and staff. Join us in our modern Fisher’s Landing Office in Vancouver,Wash. Focus on patients; grow a quality practice with opportunity for excellent income. Salary plus incentive, insurance paid. Full time four days, Washington license required. Reply only to msheehan816@gmail.com or fax Cascade Dental Group-Fishers Landing at (360) 604-7927. GREAT DENTISTS NEEDED — $1,000 Finder’s Fee. Richland, Wash. We need a great general dentist to join our practice. We have a thriving practice and we need help. Great opportunity for someone who wants to treat people with the best that modern dentistry has to offer. Ortho, implants, perio, endo, pedo, sleep, cosmetic, or just great restorative and hygiene, we provide all aspects of general dentistry to our patients. Spacious, modern office with digital x-rays, electric handpieces, digital charts, digital IO cameras, and more. One-of-a-kind patient experience with soaring windows, indoor live palm trees, and a 20-foot water feature – a truly gorgeous place to work. We handle the marketing, new patient generating and management hassle. Great income potential and great working conditions. We have it all! Hurry! First responders to refer someone we hire will receive a $1,000 finders fee. Send your name, your email, prospective doctor name and phone number to careers@ cadwelldental.com or fax (509) 627-6720. ORAL SURGEON NEEDED — I am general dentist looking for an Oral Surgeon to come into my office on a part time basis to do predominantly third molar extractions. I need some one who is mobile and can set up necessary equipment. I have a state of the office with a Cone Beam CT scan and am located in Olympia,Washington. arsmithdds@msn.com (360) 480-6774 DENTIST NEEDED — Apple Valley Dental & Braces is seeking a general dentist for our growing group practice in Eastern Washington. We offer a great salary and great benefits. We are looking for someone who is confident, energetic and a people person! Earnings are production based and we are busy! Please contact Jolene Babka, Corporate Manager, at (509) 823-4484 for further information. GENERAL DENTIST — Seeking an experienced General Dentist to join established group practice approximately 32 hours per week in Vancouver Washington. Please send CV to jennifers@wendeldental.com.

PEDODONTIST FOR SEATTLE NORTH AREA ­— To provide the most comprehensive dental care in the industry means having the best dental specialists working at our Gentle Dental affiliated offices. That’s why we take pride in working with Pedodontists nothing short of exceptional. As an industry leader, Gentle Dental provides a large network of resources, including an experienced practice management staff, cutting edge technology, and outstanding benefits. You will also have plenty of dental professionals supporting you to confer and collaborate with as you continue to grow in your career. We seek highcaliber professionals possessing degrees or certificates from accredited colleges or technical schools/programs (as well as valid/current state license) with at least 2 year of pedo experience. Gentle Dental has delivered high quality care with a personal touch for over 30 years. We have the resources you need to achieve true personal and career success. We aim to provide our network of affiliated doctors and staff with a competitive benefits package, which include: medical, dental, vision, life insurance, 401K plan, paid vacation and holidays, CE credits, and career opportunities to advance with the company. Contact: Ron Brush, Phone: (971) 295-9914, email: brushr@interdent.com or website www.gentledentalcareers.com. ORTHODONTIST NEEDED FOR SOUTH SEATTLE— To provide the most comprehensive dental care in the industry means having the best dental specialists working at our Gentle Dental affiliated offices. That’s why we take pride in working with Orthodontists nothing short of exceptional. As an industry leader, Gentle Dental provides a large network of resources, including an experienced practice management staff, cutting edge technology, and outstanding benefits. You will also have plenty of dental professionals supporting you to confer and collaborate with as you continue to grow in your career. We seek high-caliber professionals possessing degrees or certificates from accredited colleges or technical schools/programs (as well as valid/current state license) with at least 1 year of dental experience and completion of an Orthodontic residency program. Gentle Dental has delivered high quality care with a personal touch for over 30 years. We have the resources you need to achieve true personal and career success. Contact: Ron Brush, Phone: (971) 295-9914, email: brushr@interdent.com or website www.gentledentalcareers.com.

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PEDIATRIC DENTIST NEEDED: Busy multioffice Orthodontic practice is looking for a Pediatric Dentist to join the practice. Modern multi chair offices, existing large patient base and excellent staff awaits for the right individual for a great opportunity. Please email CV to : lotusking55@gmail.com. ASSOCIATE DENTIST — Downtown Seattle. Experienced associate dentist needed for a busy, well established, fee-for-service practice in downtown Seattle. Long term, highly capable staff. 4 days a week. Great income opportunity. Please email CV pugetsounddentists@yahoo.com ENDODONTIST NEEDED — Looking for a motivated and energetic endodontist. Compensation is on partnership basis with excellent earning potential. Please send us your resume to buriendentist@yahoo.com DENTISTS NEEDED _ Dental Professionals is recruiting dentists for temporary and permanent positions throughout western Washington – Vancouver to Bellingham and the Olympic Peninsula. No fee to you and you pick the days and geographic locations that you are available to work. This is a great opportunity to earn supplemental income or find a permanent position. If interested please call Bob at (206) 767-4851. GENERAL DENTIST — Experienced dentist needed for a growing, well- established, fee-for-service practice, generating 800K per year in Seattle area. Three days a week. Long term, highly capable staff. Great income opportunity. Please email resume to pugetsounddentists@yahoo.com.

classifieds issue 8, august 2013

OPPORTUNITIES AVAILABLE


FOR Lease Dental Office Space 2,230 RSF (suite 200A) on second floor with elevator access

Many amenities within easy walking distance on upper Queen Anne 3 parking stalls available on site and up to 12 in the immediate area Generous improvement money available for dental build out

Queen Anne Ave N

1st Ave W

Private deck

Crockett St

1905 Queen Anne Ave N

Contact

W Howe St

Michael Ramage

WSDA NEWS OCTOBER 2013 206.200.7801 mdramage@mindspring.com

PROFESSIONAL RACTICE P SPECIALISTS,

INC.

1-800-645-7590

Aaron Pershall - Randy Harrison NEW! SW WASHINGTON – Excellent, long time G/P collecting $400K+. Very nice, spacious, 4-op office with great access and off-street parking. SW ALASKA – Great G/P situated in a sportsman’s paradise! Collecting $700K+ working only 37 weeks per year! Associateship also available! FAIRBANKS, AK – Exceptional G/P collecting $1.8M+. Excellent cash flow and 100% fee for service! Newer facilities, CT scanner and more! Flexible transition options.

ANCHORAGE, AK – G/P collecting $550K in 2012. Nicely appointed office boasts 6 ops, pano, and plenty of space. Merge your practice into a beautiful office and add patients! NEW! JUNEAU, AK – G/P collecting around $1 Million. Great location with plenty of parking. Beautiful office boasts 5 ops, digital x-rays, pano, and plenty of space. Work back available as needed!

RURAL ALASKA – High profit practice collecting $350K+ working only 10 weeks per year! Includes small apartment and SUV. Perfect satellite practice! ANCHORAGE, AK – Exceptional G/P collecting $1.2M with low overhead! 5 ops, digital x-rays, pano and newer equipment throughout. NEW! KENAI PENINSULA, AK Wonderful rural G/P collecting around $500K in 2012. Long established practice includes a great staff, digital x-rays, laser, and pano.

www.PracticeSales.com Aaron@PracticeSales.com RandyH@PracticeSales.com

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OFFICES FOR SALE OR LEASE

OFFICES FOR SALE OR LEASE

DENTIST WANTED — Alaska Center for Dentistry, PC is seeking a full time associate dentist in our Wasilla location. Enjoy all that Alaska has to offer. This position has opportunity for financial growth and potential to buy into our practice. This is a full time position with a few double doctor days with the owner. Our staff is hard working and well trained. If you want to be part of an awesome team please contact Dr. Sage at (907) 529-2462. Visit our website: www.alaskacenterfordentistry.com.

DENTIST OPPORTUNITY IN GRAHAM, WASH. — Seeking experienced dentist for busy, well established, successful, fee for service, group dental practice. Full-time position available. Excellent immediate income opportunity ($180,000 to $375,000 + per year) depending on productive ability and hours worked. Secure, long-term position. You can concentrate on optimum patient treatment without practice management duties. Modern well-equipped office with excellent staff, and lab services provided. If you are bright, energetic with a desire to be productive, very personable, and people oriented, and have great general and specialty clinical skills, Fax resume to Dr. Hanssen at (425) 484-2110.

FOR SALE — Oak Harbor Dental Practice available for transition . This established, fully equipped office is near residential, schools, and multiple retail centers. Experienced 30 year plus practitioner is a proven income producer . The practice generates a great net income and is priced to sell! Room to expand facilities in a growing community. For additional information please call or email Linda- 206-399-5677 - linda@pnwpps.net or conradelledge@earthlink.net

DENTIST OPPORTUNITY IN PORTLAND, ORE — Do the clinical dentistry you want to do. We offer paths in which you can manage or open your own practice with profit sharing. Pdxdentist@yahoo.com. PART-TIME GP IN BELLEVUE — We are looking for an associate in Bellevue to work 2.5 days Wed-Fri. More days possible. We are a top office in our area. Beautiful modern office with state of the art technology. Fantastic patients and team. Fully digital. Must be highly skilled and experienced. Please email resume to bellevuedentists@gmail.com. SOUTH SEATTLE — Seeking qualified Pedo, Ortho and General Dentists. Fully digital office with experienced expanded team. Attractive stress free environment Competitive reimbursement. Full and part time. Opportunities for ownership in a growing company. Do not miss your chance. Call or email Jacob: (206) 349-2967, or info@fortdental.net. OLYMPIA, WASH — Seeking Associate/Partner Dentist. We are a well established practice with a large, growing patient base seeking a practitioner with exceptional interpersonal skills that is willing to commit to the potential of a long term partnership. Candidates must be comfortable and competent with all facets of general dentistry and share our passion for excellent patient care and superior dentistry. Our modern and attractive 8 operatory facility is home to a dedicated, skilled, long term team. We take great pride in providing an amazing patient experience and would require the same of any candidate. Experience is a must due to the pace we maintain and level of care we deliver. Please e-mail resume and CV to john@smileolympia.com. SPECIALISTS WANTED — Gentle Dental has open positions for: Periodontists, Endodontists, and Pediatric Dentists. If you are looking for a career opportunity we encourage you to get to know Gentle Dental. Our dental practices are very much like a private practice working together in a group setting. As a Specialist, you have the ability to focus on building that relationship with your patient without the hassles of practice management. For more information contact: Ron Brush Manager of Doctor Recruitment, Cell: (971) 295-9914 eFax: 877-233-3542 Email: brushr@interdent.com. OPPORTUNITY AVAILABLE — Opportunity for dentist interested in TMD/facial pain practice. Poulsbo Wa. Call (360) 981-8796, tmdclinic@aol.com.

OPPORTUNITIES WANTED GENERAL DENTIST — General dentist seeking long-term associate position in private practice. Experienced, personable, patientfocused. Available Monday–Friday on the Kitsap peninsula or greater Seattle area. Children and adults. Invisalign certified. ADA member. Resume available upon request. 360.990.3399 or dr.mjspaulding@gmail.com. OFFICES FOR SALE OR LEASE SELLING YOUR PRACTICE? — Do you want to sell your practice? I am a motivated, private Washington state licensed dentist with approved financing for purchasing a dental practice and building. Email keefejc@gmail. com or call Jason (509) 675-0029. Looking forward to hearing from you. SPACE TO SHARE — Nice, centrally located downtown dental office with good street exposure across from a major bus stop and a nice view from the treatment rooms. Well established general practioner cutting back. Excellent signage in windows and building lobby. Available up to 50% of a 5-day week. Seperate private office, phone line and number. Contact dentalofficeseattle@gmail.com FOR LEASE-A great opportunity available for a general dentist or specialist, office in Silverdale, WA, located on Dyes Inlet with a view of Mt. Ranier. Over 2000 square feet with four operating suites. Dentistry provided there since 1985. Contact David at toothexam@hotmail.com. FOR LEASE — Burien, Wash. Brand new, 2700 ft, six op dental office with pano room, lab, break room, two restrooms and private offices. Completely wired and plumbed for state of the art digital dental office. $10/ft NNN or $2,200/mo. Must see to believe and appreciate. Great opportunity for start up or relocation. Contact (206) 909-3863 FOR SALE — Methow Valley. Three op dental practice. Will sell for one third of the gross production. Contact: drjnickell@gmail.com. FOR LEASE —Vancouver, Wash. Next to Vancouver Mall. Brand new remodel 2,000 sq. ft., just move in equipment. Built-in cabinets, Pano room, private office. Very nice! neilgray@comcast.net.

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FOR SALE South Tacoma four ops general practice for sale. Practice has been in community since 1968. Annual collection $860K, all digital and paperless office. Please email your resume or question thinguy@gmail.com. REDMOND –Outstanding and unique opportunity to practice here in a completed, beautiful space in a great location with excellent parking. If you want to practice in Redmond or want to upgrade your existing location get more information by calling Sandy at (425) 883-4099. FOR SALE — Beautiful stand alone redecorated 2,000 sq. ft., open concept bldg with five ops and plumbed with N2O. This practice is nestled in the foothills of Mt. Rainier, just a 50-minute drive from Seattle. The area offers a recreational paradise, with skiing just 40 minutes away and great schools. 0ngoing practice for over 25 years with loyal patients and a experienced staff. For more details call (253) 797-1353. FOR LEASE — Great location, over 2000 square feet, five operating suites in beautiful Olympia, conveniently located on Martin Way close to St. Peter Hospital. Over 30 years of quality dental care provided here. Contact Don at uncledgh@aol.com. SPACE FOR LEASE, CENTRALIA — Dental suite available in a premium health-services property. Beautifully appointed 2,982 sf with six operatories plumbed with oxygen, nitrous, water and air. Visible location on main thoroughfare is known for its high-volume practices. Adaptable for specialties, which are needed in the market. Lease rate is $18/ sf/yr, modified expenses. For photographs and more information visit www.Century21Lund.com, or contact Greg Lund at Century 21 Lund, Realtors, office (360) 748-8619 or cell (360) 508-0752. LAB SPACE FOR LEASE South Everett (Silver Lake area). Formerly Hagstrom Dental Ceramics. Renovated two years ago. more than 12 general dentists within one mile. 1,100 sq. ft. Landlord is motivated. e-mail rjldds@ msn.com (425) 337-4200 FOR SALE — Downtown Seattle dental practice for sale. Long-established, small boutique practice with 3 operatories, Dentrix, Dexis, and Kavo handpieces. The office is nicely appointed with Stelty cabinets, and monitors and computers in the operatories. Asking $225,000, send all inquiries to: downtownseattledds@gmail.com.

classifieds issue 8, august 2013

OPPORTUNITIES AVAILABLE


parrish or perish, continued

parish from page 54 U n i v e r s i t y

seen Molly?), can’t spell or use reasonable English grammar, or are sexting on Instagram. Again, I have no idea if dentists or dental corporations (oh wait, they’re illegal!) are checking social media, but I’ll bet many are. As has been said a million times, anything you have put on the net is potentially there forever. We’ve all done lots of stupid things in our lives, but, thankfully, mine were never recorded digitally and put on the net so that you can look it up. I’m really quite boring when Googled or Binged. I am not for a moment saying one cannot be a professional and have a tattoo, I am merely suggesting you seriously consider who your patient base might include; a blonde, spiky Mohawk is not going to cut it in downtown Bellevue…or probably Omak. Unless you are planning on practicing on Seattle’s Capital Hill forever, if you must get inked, please put it on the bottom of your foot (ow, that would hurt) or somewhere where only your VERY significant other is going to see it. Not all your patients are going to be Whole Foods checkers or those previously mentioned prison guards. There will be lots of old grannies and sheltered homeschoolers (have I offended everyone now?) who have a certain vision of what their dentist should look like. Even a very conservative flower, or butterfly, or some Chinese letter makes a statement, and it will not be appreciated by everyone. If it’s highly visible, get to your dermatologist and get it lasered (better than a friend in college in 1966 who had his “removed” by multiple sessions of “dermabrasion”, i.e., intentional sanding of his upper arm over many months—hurt like hell!). And guard your social media like a hawk. Organized dentistry has tried to get all the beer and wine glasses out of our media photos so as to present a more “professional image” to the general public who might see them. (By the way, no one is putting this journal in their waiting room, I hope. This is for us internally, not the general public.) Quit with all the “sorority poses”, Ladies. Keep your tongue in your mouth on your selfies; we all know what a horrible germ cesspool that is. Stop the fake gang signs, Guys. No one will really think you have gone “on the wagon” if you no longer advertise your favorite “brewskie” in your pix. And if I see any of you imitating Miley Cyrus or grabbing yourself like some rapper, I’ll dermabrade that tattoo personally. We’re professionals, people.

o f

W a s h i n g t o n

sChooL of Dentistry

ContinUing

D e n taL

FALL 2013

eDUCat ion SEPTEMBER 13 Modern Day Treatment Planning & the Role of 3D Imaging in the Dental Practice Lars Hollender, DDS, PhD; Johan Aps, DDS, MS, PhD; Maria Mora, DDS, MS; Scott Ganz, DMD and Peggy Lee, BDS, MSD, PhD This course is co-sponsored with the American Dental Association – JADA Live Seminar Series 27 Recreational Drugs: OMG! Windows Into Our Brains? Bart Johnson, DDS, MS OCTOBER 4

Annual Washington Dental Service Practice Management Seminar MORnInG TOPIc: necessary Skills for Running a Successful Dental Practice William van Dyk, DDS AfTeRnOOn TOPIc: Successful communication in the Dental Office

Sandra Phillips, MPA and Tara Aal, CPC, CHCC

11 The Art of Dental Therapeutics – Modern Dental Pharmacology Peter Jacobsen, DDS, PhD 25 Untangling the confusion of Today’s Restorative Materials Ed Swift, DMD, MS NOVEMBER 1

To Biopsy or not to Biopsy: Interactive Soft Tissue Oral Pathology for the Dental Practitioner Dolphine Oda, BDS, MS

2

Digital Dental Photography I-Chung (Johnny) Wang, DDS, PhD

15 clinical Grand Rounds in Oral Medicine Faculty of the UW School of Dentistry Department of Oral Medicine 22 WSDHA Annual course MORnInG TOPIc: Orofacial Myofunctional Therapy Joy Moeller, BS, RDH AfTeRnOOn TOPIc: neck, Back & Beyond: Preventing Pain for Peak Productivity

Bethany Valachi, PT, MS, CEAS This course is co-sponsored by the Washington State Dental Hygienists’ Association. Online Courses at www.uwcde.com including Bloodborne Pathogens!

Registration Information: REGISTER Telephone: (206) 543-5448 Toll Free: (866) 791-1278 NOW! For more detailed course information and to register online visit www.uwcde.com

SCHOOL OF DENTISTRY UNIVERSITY of WASHINGTON

University of Washington is an aDa CerP reCogniZeD ProviDer ADA CERP is a service of the American Dental Association to assist dental professionals in identifying quality providers of continuing dental education. ADA CERP does not approve or endorse individual courses or instructors, nor does it imply acceptance of credit hours by boards of dentistry.

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OFFICES FOR SALE OR LEASE

EQUIPMENT WANTED

FOR LEASE NEW SPECIALIST SPACE (oral surgeon, endodontist , pedodontist)- Prestigious Creekside Village in Mill Creek’s Town Center. Free parking, more than 50 general dentists in a 5-mile radius. Over 45 stores, shops and family services within a threemile radius. Visible and accessible from the Bothell/Everett Highway, seven minutes from I-405 and I-5 and 3 minutes walking distance from the University Bookstore, Central Market, many restaurants and hundreds of Condos, apartments & homes. Generous Terms and Tenant Improvement Allowance. Vien Bui (425) 379-6062.

FOR SALE OR LEASE, PUYALLUP — Great location. Satellite or Specialist Office. 1,900 Sq. ft. with two fully equipped operatories with plumbing for a third. Large Lab, new computers with Dentrix software and Dexis Digital X-ray. Email: toothfairy1410@gmail.com.

EQUIPMENT WANTED — Looking for w ide ra nge of used equipment. Adec, Kavo, Midmark, Pelton Crane, Midwest, Gendex, Air Techniques, Apollo, Porter, Cerec, Sirona. If you want to sell equipment, call (206) 260-3563.

OPPORTUNITY — Dental office for sale in Burien. 15+ years in the same location. Grosses over $350,000 a year, six operators and laboratory. Owner is retiring but will stagy for transition. Some financial available. Call JD at (206) 992-8771.

SERVICES

FOR LEASE — (oral surgeon, endodontist, pedodontist) 2,350 sf with 720 sf executive office suite above. Located directly on Highway-Nine in Clearview Plaza in the Starbuck’s building. Traffic count over 35,000 cars/day. No other specialists on this corridor for over 18 miles. Serves, Mill Creek, Woodinville, Clearview and Snohomish. Space for Lease Clearview Plaza. Vien Bui (425) 379-6062. FOR SALE — Attractive dental office: 5701 Bedford St., Pasco, Wash. New construction in 2003. 3,450 sq.ft main level with 1,350 sq.ft basement. Complete details can be obtained from: Victor C. Robisch, DDS, (509) 547-8955 or Derrick Stricker, NAI Tri-Cities, (509) 4308533 or derrick@dirkstricker.com. SPACE SHARING OPPORTUNITY — Presently working three days/ week and have ample room to share space in our five chair downtown Seattle general practice office with in-house lab and technician. Bring your patients and staff and share the rent, utilities and supplies. Contact Rick Nicolini, DDS at (206) 310-5709 or drnicolini@hotmail.com. OFFICE SPACE TO SHARE — Excellent opportunity for specialist who wants to work one or two days a week or a start-up practice for any practitioner. Front office support. Contact Breezy at (425) 481-1038 or email office@gentletouchdental.com. FOR SALE — Renton Highlands High Quality Family Dental Practice. Long-time owner retiring. Strip mall location with outstanding pedestrian and drive-by exposure. Collecting $1,050,000 annually and low overhead. Four Ops, lab, sterilization, office/consult room, business office and reception. Pano. Email C/V or summary to: sam@cpa4dds.com. FOR SALE — General practice in Tacoma. Established (13 years) satellite practice near JBLM in Lakewood. Associate relocated recently. Three chairs, lots of parking spaces, owner financing available. Call 206 779 5742. NEXT/ANNIE MILLER & ASSOCIATES — New dental practice listings and sites for sale in Bellevue, Kirkland, Federal Way, Renton and Tukwila. Call today for tours and info. Annie Miller, Re Max Eastside Broker’s Inc. (206) 7151444 or email at annie@nextnw.com.

FOR LEASE — 300 Pelly Ave N. Dental suite available in Renton, walking distance to the prestigious Landing, as well as Boeing. 1,361 sq. ft. on 2nd floor, with only two other dentists in building. Three operatories, open configuration, plumbed with electrical, air, vacuum, and plumbing. Corner lot with heavy traffic flow. Rate is $23.26/SF/Y NNN, Triple Net is $5.60 (incl utilities). Contact Dennis Schmuland (425) 417-1206. NEXT/ANNIE MILLER & ASSOCIATES — Providing consulting services to the dental community for the past 35 years. New practice start-ups, practice transitions, sales and valuations. Dental space planning and architecture; real estate leasing and acquisitions, employment benefits; staffing resources and training; financing. Call today for your free consultation…we can’t mint money for you, but we can sure save what you have now! Annie Miller (206) 715-1444. Email: annie@nextnw.com. EQUIPMENT FOR SALE USED/REFURBISHED EQUIPMENT — Adec, Gendex, Pelton Crane, Dentalez, Porter, Air Tech, Midwest, Midmark and etc. Lab equipment. Parts are also available for almost all equipment. Call Dental Warehouse at 800-488-2446 or http://cascade-dental.net. MOBILE DENTAL SYSTEMS — Mobile dental operatory suitable for a variety of locations ie..assisted living, missionaries. Excellent condition stackable containers. Approximately 45 lbs Contact (360) 981-8796. FOR SALE — Porter Navicom communication system with seven call stations, Apollo TL 42 air compressor, Air Techniques Vacstar 50, two Adec Track Lights, two Pelton and Crane Track Lights-A ll in good working condition. If Interested, please call (360)459-3400. FOR SA L E — A ll NobelBiocare: 20 08 Osteoset 200 motor with all components; complete surgical drill kit (<25 implants placed); never used set of osteotomes; 13 tapered groovy implants (sizes 3.5, 4.3 and 5.0) plus a complete surgical cassette with instrumentation, some grafting materials, etc. Everything you need to place an implant tomorrow. $8500.00 femam4@aol.com

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LOCUM TENENS DENTIST — Want to take a vacation? Need a knowledgeable, reliable ad personable dentist to help with your practice while you’re away? Experienced locum tenens dentist will provide exceptional care to your patients. Over 25 years of private practice general dentistry. Serving all of Washington and Oregon. References available upon request. Contact Bob Houtz, DDS at (360) 457-9568. MOBILE I.V. SEDATION — Have your patients treated in your office with safe and proven techniques. Set your practice apart from others. Attract new patients. Increase quality referrals. Neil E. Bergstrom, DDS (360) 825-6596. NAK ANISHI DENTAL L AB — Nakanishi Dental Laboratory has been a proud WSDA sponsor for the majority of our 60 years in business. This year we were voted #1 laborator y in the nation by NADL and are CDL and DAM AS certified. We are a technology based full service laboratory in Bellevue and Kent. w w w.nakanishidentallab.com 800-735-7231 GUEST DENTIST — Will fill in at your practice for maternity leave, injury, illness, family emergency, etc. 35 years of general dental practice experience. Personable and patient oriented. Dr. Ed Kardong (206) 842-6300. OFFICE CONSTRUCTION CONSTANTINE BUILDERS INC. (CBI) — WSDA endorses CBI as their preferred builder of Dental facilities with over 25 years of experience from ground up buildings, renovations, remodels, and interior tenant improvement projects. All projects are completed on time and within budget. CBI provides the highest level of quality service with integrity that exceeds our client’s expectation. Please see our display ad on page two and website at www.constantinebuilders.com for additional information and how you can become another satisfied client. Telephone (206) 957-4400, O. George Constantine.

classifieds issue 8, august 2013

OFFICES FOR SALE OR LEASE


Geezerly musings and some advice

This column has wandered into dangerous waters in the past, and I’m sure I have offended an occasional reader with my ramblings on sensitive topics. Well, I’m heading back into the deep end of the pool this month. To my millennial readers especially, take no personal offense. I’m here merely for discussion and thought provocation. I recently attended a wedding of a close friend’s daughter. Her contemporaries were everywhere; that’s what weddings are for: celebration with friends (and the parents’ friends just to keep them happy). There were many young professionals including several newly minted lawyers with whom I had the opportunity to briefly converse. I kept trying to imagine these young lawyers, especially the women, (Parrish, you’re such a sexist; you need to be censored. Hardymon?) in court handing a piece of evidence to a geezer judge and having a large tattoo on her forearm jump into his field of vision even if she had on long sleeves. Believe me, there were plenty of other tats in evidence on lots of bodies, but, given generally acceptable wedding attire, there was lots more female skin exposed than male. Tats are obviously becoming more accepted in general society, but they still are visually a shock to many in my generation and even others younger. As a certified geezer, I don’t get the entire phenomenon, but I’m going to be in “the home” soon so my opinions will not matter much longer. But I did read with interest a recent study by a British sociologist, Dr. Andrew Timming, who reports his research into a broad range of HR personnel’s decision-making processes revealed a general dislike of VISIBLE tattoos on potential employees, saying the wearers appeared “dirty” and “thuggish” (the HR folks’ words even if they were otherwise okay with tats). Unless you were applying for a position as a prison guard, you likely were less likely to be hired because of the fear of what your dermatological art says to potential customers based on their stereotypical reaction to tattooed people as “thugs and druggies.” Too many geezer, geezerette and straight-laced customers represent a potential problem for their businesses! While no one in the dental hiring business was surveyed by Dr. Timming, I wonder what experiences with regard to body art our younger dentists may have encountered in interviewing for their various first practice opportunities. Was it even mentioned? While I haven’t hired anyone in 15 years, I could imagine the reaction of my staff if a young assistant interviewed with a neck spider web or tear under her right eye!! And even if it’s not visible under scrubs, no dental staff interacts strictly dressed in scrubs; the tats are “coming out” eventually, and the judgments will follow. I also saw a discussion of a survey by Jobvite, “a social job recruiting platform company” — whatever that is! Anyway, 42 percent of job recruiters “reconsidered a job applicant in both positive and negative ways, based on what they saw on the candidate’s social networks.” 94 percent of hiring folks are reviewing Facebook, LinkedIn, Twitter, Instagram and other social media to see if you are talking about guns, have no pix without a beer in your hand, discuss your drug use (Anyone continued on page 52

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50 IS THE NEW 40: It’s also the ideal time to purchase Long Term Care insurance. Are you covered? Washington Dentists’ Insurance Agency will make sure you are. You’re in your 40s, and healthier than you’ve ever been. So it may seem counter-intuitive to shop around for the Long Term Care coverage, but it’s actually the best time. At WDIA, we can guide you and help you make decisions for your future. Call Matt or Kerri today for a complimentary Long Term Care insurance assessment. They’ll help you navigate through the myriad choices, and connect you with the best products available. Call us today!

Life Disability Long Term Care Professional Liability Practice Loan Protection Health Savings Accounts Business Owner Coverage Group and Individual Medical Risk Management Consultation Medicare Supplements and MedAdvantage Employment Practice Liability

Matt French · Kerri Seims 206.441.6824 · 800.282.9342

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Washington Dentists’ Insurance Agency: LONG TERM CARE INSURANCE

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2013 october news issue 1 <RE>