Issue 8, August 2012 WSDA News

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The voice of the Washington State Dental Association

news

DR. JOEL BERG UWSoD’s New Dean talks about the future

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WSDA ENDORSED

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Dr. Robin Henderson and her daughter, Sophie, had the honor of driving Sen. Mark Schoesler in Johnson, Washington’s 4th of July parade

WSDA news Cover story by Rob Bahnsen Cover story photos: Craig Mitchelldyer TOC photo by Scott Henderson

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letters to the editor

25

regulatory news

cover story

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clinical corner

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nordic news

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save the face race

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addiction in the practice

6-12

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restoring our veterans in memoriam

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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. Rodney B. Wentworth, President Dr. Danny G. Warner, President-elect Dr. David M. Minahan Vice President Dr. Bryan C. Edgar, Secretary-Treasurer Dr. Douglas P. Walsh, Immediate Past President Board of Directors Dr. Bryan D. Anderson Dr. Theodore M. Baer Dr. D. Michael Buehler Dr. Christopher W. Herzog Dr. Gary E. Heyamoto Dr. Mary S. Jennings

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

issue 8 · august 2012

editorial

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WSDA News Editor Dr. Mar y Jennings

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Bernard J. Larson Gregory Y. Ogata Christopher Pickel Lorin D. Peterson Steven D. Waite Laura Williams

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classifieds parrish or perish

wdia news

Director of Government Affairs Bracken Killpack Art Director/Managing Editor Robert Bahnsen

In the event of a natural disaster that takes down the WSDA web site a n d e m a i l a c c o u n t s, t h e WS DA has establishe d a sep arat e email address. Should an emergency occur, memb ers can contact wash stat e d ental@gmail.com.

WSDA Staff: Executive Director Stephen Hardymon

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Assistant Executive Director Amanda Tran

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Director of Finance Peter Aaron

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Director of Operations Brenda Berlin

Office Manager Leon Sandall

The WSDA News is published 8 times yearly by the Washington State Dental Association. Copyright © 2012 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.

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98107. ISSN 1064-0835

Director of Membership and Comunications Kainoa Trotter

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

Member Publication American Association of Dental Editors. Winner: 2008: Best Newsletter, Division 1, 2007 Platinum Pen Award, 2006 Honorable Mention, 2005 Platinum Pencil Award, 2005 Publication Award; International College of Dentists

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table of contents issue 8, august 2012

a day in the life

editorial dr. mar y jennings

The “uh-oh” moment

There is a little snap that I can both hear, and feel, through my forceps when a root breaks while I am pulling a tooth. It is a peculiar feeling for both hand and ear to send the same message of…uh-oh. The first time I felt the little snap I almost threw up. This is the mental picture I have anytime someone mentions a midlevel provider. This visceral memory is why I will never, in my heart of hearts, truly be able to fully endorse a midlevel provider. I am afraid of the uh-oh’s. I am not convinced that an undertrained individual will be able to navigate their way out of trouble and not hurt our patients.

But I am not stupid. I know that in this big world I have only one little opinion. My opinion is right, strong, and has the approval of at least nine out of ten dentists, but it has not been enough to stop the progression of the midlevel.

So where are we this year in our midlevel journey? In 2012, California, Connecticut, Washington, Kansas, Maine, New Hampshire, and Vermont all had some type of legislation involving midlevels. Only California had legislation that is moving forward.

The California legislature wants to revamp the health department, develop a state oral health plan, and authorize a university-based research study on several midlevel provider models. An initial draft required a study on midlevel providers, but is now written to “authorize” a study. The bill passed the senate, and has until August 31 to move forward.

There are other states that are having serious midlevel discussions that did not reach the 2012 legislature. They are New Mexico, Missouri, Colorado, North Dakota, Ohio, Michigan, and Pennsylvania. So far, a total of seventeen state associations report some kind of midlevel activity including Alaska and Minnesota.

Our neighbor, Oregon, passed midlevel legislation through mediation in 2011. The agreement is that the Oregon Health Authority is permitted to develop workforce pilot programs.

I had another visceral “uh-oh” reaction when I read the names of the coalition partners working with the Pew Foundation in California. They include the Atlantic Philanthropies, the Packard Foundation, the Hilton Foundation, Verizon, and many more. It looks like our midlevel horse not only left the barn, but has found friends with money, influence and power.

So let’s look at the big picture. Virtually everyone I meet on the street tells me dentistry is too expensive for the average citizen, and impossible for the poor. Now, almost 50 million people are in poverty. Pew and Kellogg are networking with friends. The dental profession is divided between hygienists and dentists on this issue. Our legislators want both a solution, and resolution, to this problem after investing years and years in debate.

The midlevel provider issue is no longer about the right thing to do for our patients. It’s all about politics and policy, and the perception that a midlevel provider will help solve the access problem. Our sincere little voice of reason is promoted as non-progressive and self-serving.

In light of all the development this year, the question before our WSDA House of Delegates is “whether WSDA wants to shape the parameters of the midlevel provider that passes in Washington State, or continue to oppose the current proposal and live with the outcome should it pass?” That is the wording in WSDA’s resolution HD-13-2012.

Since this magazine is widely distributed, I will not go into the details of HD-13. I think each of you must think, come to your own conclusion, and discuss it with your delegates.

But you know me; I will always tell you what I think.

I know we have worked extremely hard in other states to limit legislation to studies and pilot programs. I think studies, et al., are just a formality. I believe a midlevel provider of some type is a foregone conclusion in most legislators’ minds. Never you mind about those troublesome details.

The Rolling Stones remind me “you can’t always get what you want.” I do not think we will be able to continue to hold the line in this political climate on the progression of the midlevel provider.

I think we owe it to our patients and profession to come up with a viable midlevel plan.

We need to be in a position to be invited to the table to negotiate what skills, supervision and oversight a midlevel provider might have. HD-13-2012 puts us in that position. Dying on our swords does not.

Remember that last line? “But if you try sometime you might find…you get what you need.” I think HD-13 gets us what we need.

Dr. Mary Jennings Editor, WSDA News

“I think we owe it to our patients and profession to come up with a viable midlevel plan. We need to be in a position to be invited to the table to negotiate what skills, supervision and oversight a midlevel provider might have.”

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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Dear Editor — I thought the membership might be interested in a post-mortem about our decision to quit WDS in the spring of 2011. Like all of you, we were terrified we’d lose most of our patients, our practice, our house, etc. But in a nutshell, our decision to quit worked out far better than my wildest dreams.

Prior to the WDS bombshell, about 50 percent of our patients had dental insurance, and half of those were with WDS, so we knew this would affect 25 percent of our patients.

Either way, I figured the money was going away. My choice boiled down to either working myself (and staff) to death trying to break even (work for free?), or I could relax, probably take a few more days off (anticipating an empty appointment book), and be in about the same position financially. We chose the latter and told WDS to take a hike.

Initially, there was all kinds of confusion. WDS, in their ever-helpful way, sent each of our (WDS) patients a letter explaining why they should go to the guy down the street. The implication was they would not be seen in our office. Very carefully worded, factually accurate, but wildly misleading. Thanks a lot. But the biggest surprise was that our formerly filed fees were “downgraded.” In other words, if we had a crown filed at WDS at $1,093, WDS suddenly decided that the UCR for us renegades should now be much lower, $675.

Forty percent of $675 is a much smaller number than 50 percent of $1,093. Multiply that effect by all of your procedures, and you get an empty feeling. One that says these guys are playing hardball, and out to punish those who dared to quit. Whoa!

So what happened? Well, we lost five families. But, two families tried someone else, and then asked if they could come back. The net loss was three families, where I was expecting a loss of 100-200 families.

We also lost three individuals who have stayed away. In the transfer of records, I was startled to find out how many new crowns and bridges were needed on one transferring patient (yeah, right). Plainly put, WDS has created a huge incentive to overtreat. Even a blind man can see that one.

Net results? Our year-to-year and monthto-month figures are about what they were before we quit. We’re down less than five percent, but we also took a lot more time off for vacation. The reduction was because of time away, not lack of patients or lack of production. The appointment book is humming, and basically we can’t see any difference, except we expect WDS to basically not cover anything. Financially there is no impact I can see or really measure.

The biggest impact, by far, has been on the front desk, with the confusion, questions and misinformation. Believe me, it was total chaos up there. We almost had to add an extra person to deal with WDS questions and to explain why we didn’t want to work for free. Everybody wants to talk, talk, and talk. Long story short, we essentially tell the patients, “Look, we haven’t changed a single thing in the office. It was WDS’ idea to cut your benefits, not ours.

Talk to your employer and ask about selecting a different plan next time.”

Would I quit again, knowing what I know now? In a heartbeat. Was it easy? No. Was it scary? You bet. Plenty. Are things as good as pre-April ‘11? Not quite, but almost. Production is the same, the appointment book is the same, and most of the questions have been answered. Obviously, it is harder on the patient’s pocketbooks, so we feel added resistance in that area.

For us, it turned out better than expected, which is why I decided to write.

— Dr. Ed Brinson Bellingham

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Dear Editor — I would like to congratulate Dr. Stephanie Marvin for her well-written letter to Dr. Parrish in your July issue of your WSDA News magazine re: Dr Jeff Parrish’s column in an earlier issue.

With Dr. Parrish’s response to her I am reminded of the old adage, “When you find yourself in a hole, stop digging.” Aside from his admission of his hypocrisy and his comment regarding the declining educational support from the legislature, I find that I can not agree with anything he said.

His reference to the recently passed Affordable Health Care Act, with the derisive term and slur Obamacare (“death panels” anyone?), with no admission of its benefits, is an insult to the hundreds of courageous people who worked so hard to deliver a bill that addresses the deficiencies of our current health care system.

His comment that this Health Care Act “is based on forcing our young adult children to pay for expensive older adult’s medical costs” is pure bunk. These “children” are 27 year-old young adults who need to assume that wonderful well worn Republican value of “personal responsibility.” At that age Jeff was flying jets in the Air force and I was “drilling” teeth in that same Air Force.

Yes, “there aren’t enough tax dollars to pay for everything.” We need those of us who can afford to pay more taxes to start “ponying” up.

— George M. Chatalas, DDS

letters to the editor brinson, chatalas

Letters to the Editor

cover stor y dr. joel berg

DR. JOEL BERG UWSoD’s new Dean talks about the future

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cover stor y dr. joel berg

When we caught up with Dr. Joel Berg this past June, the dust was just

Cover story photos: Craig Mitchelldyer

beginning to settle on the announcement that he’d been selected as the new Dean at the University of Washington School of Dentistry (UWSoD). Berg, who was likely chosen for his mix of business and academic cred (see sidebar), as well as his ability to take a massive project from start to finish with partners both in- and outside of dentistry (he was the driving force behind the The Center for Pediatric Dentistry), will undoubtedly operate differently than Dean Somerman, whom he replaces.

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cover stor y dr. joel berg

Well-liked and congenial, we found no shortage of people willing to express enthusiasm at his selection — Eric Olendorf, Class President, UWSoD 2014, called Berg “Exceptionally energetic and dynamic in the classroom,” and said that Berg will “… usher in a new era of excellence at UWSoD.” Dr. Ashley Tercero, a former student of Dr. Berg’s says, “Dr. Berg has been a great ambassador of pediatric dentistry for Washington State. He inspired me, and many other dental students, to pursue pediatric dentistry. His work on the Yakima Residency Program enabled me to get the residency training I needed, and sparked my desire to work with a high-need population. I highly admire, respect, and appreciate Joel Berg and am thrilled to see the great things he will continue to do for pediatric dentistry and the University of Washington School of Dentistry.”

Once in place as the Dean, Berg will rely on foot soldiers in the department, saying, “I operate differently than perhaps the former Dean did — I clearly look to the team around me — operations people, the collective body of associate and assistant deans — they run the place; I’m here to help them. My job is to serve as the face of the UWSoD — to talk about what we’re doing, get support, make connections, and also reach out to alumni, graduating classes and organized dentistry.”

To that end, Berg plans to be very customer-centric, saying, “Both alumni and practitioners are our customers. They’re a proud and loyal group, and one of our biggest assets. I need three things to make the job exciting to me — a history of clinical excellence and education, a strong research infrastructure, and a loyal, proud and dedicated alumni — at the UWSoD, we have all three.” And while organized dentistry might have felt left out of the huddle lately, Berg sees outreach as one of his primary functions, along with management/operations, and lastly, the overall strategy and vision for the future of the school. In a wide-ranging conversation with Dr. Berg, he talked openly about his vision, changes he sees in the future, and his connection with WDS and others in the community.

Defining the product

If you ask Berg, he’ll tell you he was also chosen as Dean because of his bent for change — noting that while the University continues to produce excellent restorative dentists, nearly every aspect of the SoD needs attention. And while he’s clearly been knocking around ideas of how to improve the venerable institution for some time, it’s not his style, or intention, to storm the school and make sweeping changes. Before implementing any change, he’ll first hear what the other stakeholders — in this case the faculty — think, at a retreat he’s planned for December. Saying that nothing will be sacred, their first order will be to define their product and determine its specifications using sound business principles. For Berg, the product is the dentist of 2025, and he notes that what they’ve done in the past may no longer be relevant to that dentist. “It’s like having an old house with failing electrical work,” he says, “You can patch the system to keep it running, but you still end up with failing fuses when you should have something more forward thinking and modern.”

Though some might find it unorthodox when he describes dentists as a “product of a manufacturing process,” it’s a sound business model that should serve the school, and the students, well. Berg, and his crew will discuss what skill set the 2025 dentist will need, and what they’ll require to work cohesively in their communities — leaving curriculum and clinic systems out of the conversation until they’ve polished up their definition. But what if they can’t agree on specifics? “Truthfully,” Berg says, “Consensus is not always desirable or possible — but at least we’ve had a discussion, and can decide what we want to create. Then we can build a machine to make the product. This machine — as in any business — is made up of parts that form the product you want.

Dentistry is no different, really. I think in our case the machine consists of the curriculum, clinic, research and residency.”

Overhauling the clinic program

Once they have defined their product, Berg will be able to turn his attention to

the cogs of the machine. Calling the clinic system “badly in need of repair,” Berg notes that plans will include a complete assessment and recommendation for renovation of the UWSoD’s clinic systems, but not the physical facilities, which will have to come later — “We simply don’t have the money for that now,” he remarks. Calling the production system “inefficient, with a lack of clearly defined processes,” Berg stresses that the current system doesn’t teach good quality patient care. “We have to create the best possible service and experience for our customers,” he says, “Not only because we need patients who are happy, but because it teaches the students.” With serious challenges getting patients in the door, good systems and better customer service will appeal to the public, and word of mouth will help attract new customers. Recent changes in fee schedules implemented

by Interim Dean Timothy DeRouen allows patients to pay the fees they would have if adult dental Medicaid was still in effect, which should help draw adults formerly covered by the plan, but challenges remain. “They will still have to pay out of pocket,” Berg explains, “But the fees are greatly reduced, and that has helped quite a bit. But Medicaid is just one of the issues we’re facing.”

Berg also wants a massive overhaul of the way students see patients, saying, “As you know, students typically see one patient per half day, and make their own appointments. We’re teaching them to do things that are not what a dentist should be doing.

They should function like a dentist as early as possible in their training, including the management of their patients and their practices. If you ask dentists graduating from any dental school what they missed in dental school, 100 percent of them will tell you practice management — because it’s an afterthought.”

Berg would like to see a system that focuses more on the patient than the tooth and mouth, saying, “We need to think about every encounter as a patient management encounter, not as a management of the tooth encounter. It’s a very different approach, but they’ll be more efficient and

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Cover story photos: Craig Mitchelldyer

Dr. Berg stands out as a leader in his field, in the dental community, and a proven asset to the University of Washington. His well-rounded background makes him an ideal candidate to help guide the future of our great dental program. We look forward to Dr. Berg stepping into the Deanship and wait with anticipation the positive changes to come.

— Dr. Rusty Johnson

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cover stor y dr. joel berg

“Dr. Berg has been a great ambassador of pediatric dentistry for Washington State. He inspired me, and many other dental students, to pursue pediatric dentistry. His work on the Yakima Residency Program enabled me to get the residency training I needed, and sparked my desire to work with a highneed population. I highly admire, respect, and appreciate Joel Berg and am thrilled to see the great things he will continue to do for pediatric dentistry and the University of Washington School of Dentistry.”

— Dr. Ashley Tercero

cover stor y dr. joel berg

“I was privileged to have spent time with Dr. Berg at the Chicago Midwinter this past February, and then at his installation meeting as the President of AAPD in San Diego in May. Dr. Berg seems to blend the politics of dentistry with his quiet vision for great accomplishments. I couldn’t be more pleased with our school’s new directions.”

— Dr. Bryan Edgar

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Cover story photos: Craig Mitchelldyer

long as people understand that, and I can prove it to them, I think they’ll be on board with me. And while quality may be defined differently in the future, we know that dentists will always need great restorative skills. We have to be willing to change in order to produce for the future, but we will never sacrifice quality.”

Berg advocates an aggressive timeline to the changes to the clinic system once they’re defined, but is cognizant of the importance of careful planning, saying, “We need to look at what has been done so we don’t recreate something that hasn’t worked. Seattle has differences in areas like the physical facility, so we have to make a plan that works for us.” While he favors immediate implementation if possible, he’s realistic, noting that a timeline of five to ten years is probably likely. He’s amenable to options like rolling out in phases, or deferring all change until a specific year.

Regardless of the implementation plan they choose, he’s quick to say that obvious problems will be remedied whenever possible.

Facilities

The facilities issue has dogged the school of dentistry for years – Berg remembers when he first visited campus some ten years ago thinking they needed to be upgraded then. WSDA President Rod Wentworth agrees, saying, “Those of us who have spent any time around the UWSoD know that the facilities are not much different then when we were in school. It is clear that we need to see the facilities in the school upgraded to reflect the times. Dr Berg shares this concern and has the vision to make it happen.

His experience in growing The Center for Pediatric Dentistry from an idea to a world class facility will help him do the same with the dental school.”

Berg was able to make The Center for Pediatric Dentistry happen by partnering in the community to raise the necessary funds. But a new dental facility would cost hundreds of millions of dollars, at a time when state budgets are stretched thin, and questions remain about where the campus should be located.

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Berg clarifies, “There’s a discussion going on in the health sciences about a combined health sciences entity, but no decisions have been made regarding the school of dentistry’s role in it. I’m not sure if it’s better to stay on the health sciences campus or to go off – that has to be properly vetted. I can think of advantages to both – certainly there is a contiguity advantage to being there with inter-professional education, but parking is a big problem on the health sciences campus, and unless that was dramatically changed, that’s always going to be an issue.”

Development

Without aggressive fundraising, the school can’t move forward, and one of Berg’s relationships — his continuing partnership with the WDS and its Foundation — may rankle some. He’s sympathetic to the grumbling of the chorus, but realistic, saying, “WDS has been a good partner to both me and the school; without their gifts the Center might not have been built. We expanded the square footage of the school of dentistry by 16 percent by adding the facility. They became Presidential Laureates by giving a total of $10 million, half of which was for the center, but they’d already given $5 million to the SoD. But I understand the perception.” Berg asserts that they have to engage all segments of the community — corporations, alumni, other stakeholder practitioners who may have graduated from other schools, but are practicing in our area — and bring them on as supporters.

But the foundation is hardly Berg’s only resource, and new research is opening doors that were formerly closed. Case in point: Berg and Eric Seibel, a mechanical engineer at the UW, are developing a wand that can detect sub surface demineralization. That research, in turn, got engineering companies interested in funding the project. Berg sees all kinds of opportunities for similar cross-discipline funding, saying, “The fact that we’re working with other departments will broaden the scope of interest in oral health. In this case, en-

cover stor y dr. joel berg

productive. If we teach them basic management skills, how to treat customers well, and be efficient, it will increase their level of attention to the right things.” Berg insists that practice management should include conversations about the medical necessity of dental care, why what dentists do is important to overall health, not only the mouth, and why coming to scheduled appointments is important to a patient’s health. He clarifies, saying, “These issues need to be ingrained into the souls of dentists early — that doesn’t happen until later. All of these things will be developed into an overall system that we’re looking at.

We’ll try to be the role model for efficiency and productivity, while we’re teaching quality dentistry. One is not in lieu of the other, in fact, I think they make each other better.”

How far out of the box is Berg willing to look for solutions in the clinic system?

Time and again he stressed that everything was negotiable, saying, “I want everybody involved, and I’m willing to look at anything — including going back to teams, a tiered structure, a medical model, or even a system like the one I had in Iowa — in the third year you have intense training for a short period of time in all the different elements — endodontics, prosthodontics, periodontics — like a boot camp. And then, in the fourth year, you get true comprehensive care, where patients come into the clinic, and students do whatever they need — just like they would in a practice.

So, while I don’t know yet what the systems will look like in our clinics — we’ll have everybody take a good look at it, with the understanding that nothing is sacred.”

Once they’ve determined which clinic system the school will use, they can discuss changes to curriculum, but not before.

Berg explains, “Until we understand the dentist of 2025, we’re always going to be looking at our curriculum with filters that apply to practicing today, and they may not apply in the future. We might have pushback, but our mantra must be that whatever we do, we are going to produce the best quality dentist — the best product. As

Education, University of Iowa: DDS ‘83; Certificate, Pediatric Dentistry, ‘85; MS, Oral Biology, ‘85

Cover story photos: Craig Mitchelldyer

cover stor y dr. joel berg

Dr. Berg, an overview: Prior positions: Faculty: University of Pennsylvania, University of Texas.

Executive Vice President for Research and Clinical Affairs, ESPE America, Inc. Vice President for Clinical Affairs, Philips Oral Healthcare Affiliations: President, American Academy of Pediatric Dentistry Diplomate, American Board of Pediatric Dentistry Fellow, of the American College of Dentists Fellow, International College of Dentists, Board Director of the American Academy of Esthetic Dentistry

gineers value what they’ve done, and companies that support engineering entities now may see value in supporting the SoD because their technologies will be employed in dental practices. The good news is, while I can’t say who they are, there is a vast landscape of corporate opportunities available to us. There’s a lot of excitement about the school, and we have many people willing to give time and money. This is in addition, of course, to the wonderful alumni donations, upon which we will continue to depend, as a core group of support.”

Beyond that, Berg has charged associate dean of research Linda LeResche with analyzing who is in research funding and who is not —with an eye towards helping those who may have gotten stuck. “Research is a business, too,” says Berg, “The best researchers have systematic approaches, are smart, capable scientists who are self-motivated. They have a strategy that includes being published, completing experiments and because of their strategy, they’re more likely to be funded, and that brings money and prestige to the UW. It’s like anything – hard workers who deliver on their promises get funded again, so we have to see what we can do to support those people, it’s very important.” At the same time, Berg will also attend to the endowment program, explain-

ing, “If I can get another professor or two or another chair position endowed, it makes it much easier to bring in great people. It’s not just the money, it’s also the prestige — I already have my eye on areas where we need to build endowed professors and chairs, and those make a tremendous difference to what we’re able to do in research and in clinical care.”

He continues, saying, “The beauty of that is that we have a wonderful product, and amazing graduates — if you go around the world people know of the UWSoD because of the people we’ve created.

It’s exciting to be able to go out and talk to alumni who are passionate about their education — even if they’re upset about something that’s happened in the school, and some are — they’re still passionate about the university.”

That passion is one reason that Berg emphatically rejects the possibility of taking the school of dentistry private, as has happened to at least one dental school. He explains, saying, “I think that pride in the UW is an equity element, and if we were to lose that it would change who we are – like a personality change. So much of what we are is because of this culture and diversity.

Also, UW is the number one public university in research funding – more than $1

billion per year. I think we need to be more connected to that environment, not less.

These engineering developments that I’ve mentioned are about being part of the campus – these new dental schools that have started that don’t have the rich academic infrastructure, which is a really important part of who we are.”

(Not) Politics as usual

Politically, Berg is known for being aloof and dwelling outside political circles, which has likely served him well to date. Now, though, he’s been cast center stage — how will he adjust? He’s resolute: “I’m going to do my job, and my job is to train dentists, support research and residency training. I can have an opinion about a lot of things, but that’s only important to the extent that it’s about what my job is. Sometimes people look to the Dean to give an opinion on “everything dentistry.” If it relates to my position here, and what we should be doing, then of course I’ll offer an opinion.”

Berg’s plate is stacked high — but, with his proven ability to juggle many projects and court supporters from many different arenas, the School of Dentistry is in very capable hands. We welcome the changes ahead!

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nordic news liability

Are you being set up?

Are you being set up by another dentist and you don’t even know it? Or, maybe you’re the one setting up another doctor! Putting each other in a vulnerable position can be pretty easy to do if you employ another dentist, if you’ve formed a partnership with other dentists, or if you share space with other dentists. Did you know that you can be sued for vicarious liability based on the acts of another dentist in your practice, even if you’ve never even seen or treated their patient?

If any of these scenarios fit your situation or if you have a solo practice and are incorporated, let me give you some case examples to consider, that are currently in litigation (names have been changed and circumstances modified):

Case 1: Dr. One is the sole owner of 123Dentistry, LLC and also employs Dr. Two. Dr. Two’s

patient sued him and 123Dentistry, LLC, his employer. A corporate professional liability policy was never added for 123Dentistry, LLC. Consequently, Dr. One, who normally now would be responsible for the cost of the defense and any indemnity payment for 123Dentistry, LLC, is being defended under a Reservation of Rights with the understanding that if a jury finds against the corporation for negligent supervision, Dr. One will be responsible for the indemnity payment.

Case 2:

Seven doctors formed Three-Four Dentistry, LLC without purchasing a corporate professional liability policy. One of the doctors, Dr. Abcd, had a patient fatality. The attorney for the patient’s estate filed a lawsuit against Dr. Abcd and the LLC. Since there was no corporate policy, each doctor has had to open a claim against their own individual professional liability policy, even though they never saw the patient.

Case 3: Dr. Efgh and Dr. Jklm had a partnership, Five-Six Dentistry, LLC. Dr. Jklm sold his share to Dr. Efgh and then was sued by a patient. Although we did not insure Dr. Jklm, we do have coverage for Dr. Efgh and a corporate professional liability policy was in place for Five-Six Dentistry, LLC. The case is going to trial and Dr. Efgh will have to present a defense for his vicarious liability as the partner. However, because Five-Six Dentistry, LLC was added as an additional named insured for corporate professional liability coverage, Dr. Efgh will not have to bear the costs of the defense or, if there’s a verdict, any indemnity payment within the limits of the policy.

You can well imagine in Case 1 and Case 2, the doctors affected by the doctor being sued are not happy about unwittingly being pulled into the case and potentially having to bear the cost of defending the corporation or possibly being reported to the National Practitioner Data Bank if there’s a settlement. And the solution for avoiding this to begin with is so simple: • If you employ or are in partnership with other dentists, you should have a corporate professional liability policy.

• If you only share space and staff with other doctors, you should also consider a corpo- rate professional liability policy.

• If a hygienist, dental assistant or other staff member makes an error and is accused of dental malpractice, you can be sued for, among other things, negligent hiring or supervision.

• Unless you have a corporate policy in place, you may have no coverage for defense and indemnification.

• If you are a solo practitioner but are incorporated, add your corporation as an additional named insured on your individual professional liability policy. If you and your continued on page 21

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Melissa Moore-Sanchez Manager, NORDIC

“Putting each other in a vulnerable position can be pretty easy to do if you employ another dentist, if you’ve formed a partnership with other dentists, or if you share space with other dentists.”

WPHP program features effective tools for beating substance abuse

Image credit: <a href=’http://www.123rf.com/photo_3932152_pills-studio-isolated-overwhite.html’>chode / 123RF Stock Photo</a>

In a room of 100 dentists, on average, nine or more will be struggling with substance abuse, with preferred substances ranging from alcohol to prescription and street drugs. No one knows for certain, but at any one point in time, 1-3 of those 100 dentists will be dependent on their use of alcohol or drugs of abuse.

For members of the general public suffering from substance dependence, the duration and intensity of treatment that people pursue is varied, often with lackluster results. After just 12 months, the rate of relapse for alcohol dependence alone is thought to be 40-60 percent, and the relapse rates for other substances such as cocaine or opioid dependence is noticeably higher. Twenty years ago, the Washington Physicians Health Program (WPHP) was formed to help health care providers beat those odds — and they have. Nationally, physician health programs (PHPs) report a much lower relapse rate (roughly 18-20 percent over five years for all drugs of abuse) than rates for the general public.

Staying substance-free isn’t easy for anyone — while many people in the general public trying to recover from chemical dependency typically don’t go to residential treatment, that path is unusual for WPHP clients. Founded in 1986, WPHP spent the first eight years of its history learning that health care providers with substance dependence who completed residential treatment had better outcomes than those that did not.

After completing residential treatment, the health care provider is asked to enroll in a monitoring agreement with WPHP, which continues for years, allowing them to document their abstinence. While the majority of WPHP’s budget comes from a small surcharge paid by all eligible health care providers when they renew their license, it is not enough to cover all of WPHP’s operational costs. Dentists being actively monitored by the program pay monthly fees to WPHP to help cover the costs of toxicology screening and monitoring visits. The benefits far outweigh the costs, however, with majority of successful participants able to continued on page 36

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“Family members, friends and colleagues with a concern about substance abuse or psychological issues of a health care provider can start the process by calling WPHP — anyone can make a referral.”

member news fighting addiction

FIGHTING ADDICTION

member news dr. theresa cheng

“On May 25, 2004, my son, Army Specialist Rory Dunn, was on escort duty for a civil service team just outside Fallujah, when a daisy-chained IED hidden in a tree overhanging the road on which he was traveling was detonated by remote control as his Humvee passed underneath. The devastating shrapnel tore through the canvas top of the unarmored Humvee killing two soldiers and critically wounding Rory and another soldier. Rory was wearing a helmet, but the blast crushed his right cheek, forehead, and frontal skull from ear to ear; destroyed his right eye and right eye orbit completely; blew his other eye out of his head; and deafened him immediately in both ears. With no eyesight or hearing and with massive head injuries, Rory attempted to search the back of the Humvee to see if anyone else was still there, but then collapsed across one of the seats where he had been sitting. Rory was so grievously wounded that the medic, upon arriving, passed over him to assist another soldier who he thought had a better chance of survival. However, a Marine holding my son in his arms asked what he could do for Rory, as Rory was still clutching his weapon and asking about his buddies. Rory struggled against the three soldiers who tried to get him to the ground and on a stretcher. Rory finally lost consciousness as he was airlifted to a field hospital in Baghdad. His traumatic brain injuries (TBI) were so devastating that upon arrival at the hospital emergency unit, the triage doctor’s diagnosis/prognosis was that there was nothing that could be done for him. My son was set aside to die. It was his 22nd birthday.”

Excerpt from “My Son Went to War” Cynthia Lefever

Dr. Theresa Cheng:

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in Fallujah. Afterward, the Army shipped his tattered body first to Baghdad, where they literally glued him back together and placed him in a medically-induced coma, then to Germany where his parents had been flown to say goodbye, and finally to Walter Reed Army Hospital stateside. Doctors gave him no hope of recovery, and only scant hope of survival. For six weeks he lay unconscious, and when he was finally brought out of it, his world was dark and silent. “It was horrible those first few months out of the coma,” recounts his mother, Cynthia Lefever, “He couldn’t speak, hear, or see. He had to just lie in bed without knowing what was going on. Gradually, we discovered that he had slight hearing in one ear, so I would get close to him and literally shout in his ear every day ‘This is Mom. You’re in the hospital. You are safe.’ Each day I’d give him a little more information.”

Dunn’s gradual return

In time, Dunn began rudimentary communication with his mother and stepfather — for instance, by tracing a question mark in his hand and then pointing to his eyes. Lefever told him he was bandaged because his eyes needed medicine — knowing that the truth —that one eye was gone, an empty socket in its place, the oth-

er attached with glue — was more than he could handle at that point. Making matters worse, his doctors insisted that Dunn would likely live out his days in a nursing home, in a vegetative state. “I knew Rory was in there,” says Lefever, “He would wiggle his toes when he wanted a foot rub; he was trying to reach out.” One day, frustrated and desperate to prove to doctors at Walter Reed that Rory was aware, Lefever grabbed a white board and a magic marker and thrust it into Rory’s hand. “He knew it was a pen,” she says, “And I got down in his ear and shouted ‘Soldier, write your name!’” In a childish scrawl he wrote R. Dunn. Lefever finally had the proof she needed; Rory was in there. His doctors were amazed.

All told, it was a year before he would be released, only to face countless challenges — surgeries, battles with the VA over benefits — as well as some victories. A corneal

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transplant, coupled with a hard contact, has returned the vision in his left eye.

While still profoundly deaf in his left ear, a hearing aid has given him back sound in his right ear.

A Call To Action

Five years ago, when Dr. Theresa Cheng first read the horrific account of Army Specialist Rory Dunn’s injuries in The Seattle Times — and his subsequent disputes over care with the VA — she knew she had to find a way to help.

Cheng and her staff had volunteered in their community for years, helping out at Baby Corner, building houses for those in need with Habitat for Humanity, and volunteering at other community events.

And, while she saw the good in what they were doing, she and her staff had been looking for something new, and were immediately drawn to Dunn’s story. Dr.

member news dr. theresa cheng

Rory Dunn nearly died that day

member news dr. theresa cheng

Special Thanks…

The following dentists have participated in Dr. Cheng’s event over the years:

Dr. David Baird · Dr. Matthew Bagnulo · Dr. Ernie Barrett · Dr. Patricia Benca · Dr. Ray Besharti · Dr. Richard Bienenfeld · Dr. James Browning · Dr. Dean Burnett · Dr. Vidas Cemarka · Dr. Peter Chiu · Dr. Louis Cheung Dr. Mike Conway · Dr. Robert Dixey · Dr. Theron Eichenberger · Dr. Nadeem Esmail · Dr. Phil Etheredge · Dr. Robert Faine · Dr. Barry Feder Dr. Brett Fidler · Dr. Eric Fillmore · Dr. Michael Flatley · Dr. Daniel Frost Dr. Ronald Frost · Dr. Robert Ford · Dr. Ty Galvin · Dr. Dan Geare · Dr. Mark Germack · Dr. Michael Hardy · Dr. Karen Homitz · Dr. Gary Jarrett · Dr. Howard Jensen · Dr. Jeff Johnson · Dr. Eric Jorgensen · Dr. Paul Kadzik · Dr. Louis Kramp · Dr. Ann Liou · Dr. Michael Long · Dr. Tonya Loving · Dr. Bryan Maruhashi · Dr. Ann Mayeda · Dr. Patrick McCoy · Dr. Michael McDade · Dr. Kenneth McLean · Dr. Fred Melton Dr. Sasi Narra · Dr. Shane Ness · Dr. Dale Petrich · Dr. Jim Phillips Dr. Thomas Redfern · Dr. Robin Reinke · Dr. John Rossi · Dr. Randall Sobczak · Dr. Patrick Taylor · Dr. Margaret Wencel · Dr. Dennis Welch

Additionally…

Veterans who have been helped by Dr. Cheng and the others in volved in her project have been enormously grateful for the work done for them — after each of her events, they’ve written down their words of thanks. As Dr. Cheng says”They’re usually pretty quiet in the chair. Some of them, especially the Vietnam Veterans, have a difficult time expressing their thanks. But the thank-yous they’ve shared with us speak volumes, and mean the world to me, my staff, and all of the dentists who participate.”

“I need to say thank you. Life has been very complicated after combat, and I have had issues holding jobs to get any type of benefit. This is a big deal for me and my wife, thank you.”

“I really can’t express in words my sincere appreciation for the care and thoughtfulness you have extended to all of us. It’s times like this that really make me think that my time was well served when people can express their appreciation like you all have done.”

“Thank you for all your efforts to help keep a Veteran’s smile bright.”

“Thank you so much for your support of all the Veterans and their wives and families. I feel blessed and hope you know we appreciate your kindness and giving.”

“To all who have pitched in to save some folks with their teeth, thank you from the bottom of my heart. These were the most professional and courteous people I have dealt with in years. I believe my appointment may have saved my mouth. Thanks again - if more people were like you guys, the world would be a better place. Thanks so much, you have no idea how much you have helped me and my wife here today.”

“Thank you so much for your help, it is appreciated more than you know. You represent the American spirit of compassion and unity for which we served to defend. God bless.”

Cynthia Lefever, Rory Dunn & Dr. Theresa Cheng

“Dr. Cheng identified the problems in my mouth. If I hadn’t seen her, I might have lost all my teeth. She helped identify how bad things were and I was able to get the issues fixed. It had been over three years since I had been to see a dentist. When my wife retired we lost our insurance. I’ve had some issues in the dental chair, but Dr. Cheng didn’t make me take the anesthetic, which helped me because of some fear issues I have.” continued on page 25

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Planning the event

Excited by the prospect of reaching out and helping Veterans’ families, Cheng began to plan out an event — a day of free dental care for Veterans’ spouses or significant others. Timing was going to be crucial – the article had been published in September, and Cheng traditionally holds the event on the day before Thanksgiving every year. She worried there wouldn’t be enough time to pull it off.

Cheng and staff rallied and started making calls to the VA to see if they could find families in need of dental care, only to be asked why she wasn’t instead offering aid to soldiers. It was then that she learned of the byzantine regulations and criteria Veterans have to meet to receive dental care after their discharge — and that most don’t meet the criteria. She explains, saying, “It’s very complex, and I’ve tried to talk with the VA about it — but they acknowledge that the ‘service disabled’ standard is very complicated. For example, one of the people we treated he had an implant done by the VA because he had lost the tooth in combat. However, they would not do cleanings, fillings and other work because they were not directly service related.” Because of convoluted criteria, most Veterans do not qualify for dental care past the 90 days the government provides for all discharged service men and women.

Meeting Rory

Through another reporter at The Seattle Times, Cheng was able to establish contact with Dunn and his mother. “She not only wanted to extend dental services to deserving Veterans and their families,” Lefever said, “But wanted to know how to better serve Veterans both in and out of the dental chair. She wanted her staff and others to understand PTSD, its triggers, and how to deal with potential PTSD episodes/behavior in the dental office and dental chair. As a health provider, she wanted to know how to not only serve and support Veterans in her community but to help others in the dental community understand the potential special needs of Veterans who had experienced combat and returned home with PTSD, TBI (traumatic brain injury), and other disabilities.”

Lefever, who has fought ferociously for her son since his return from Fallujah, declined Cheng’s offer of dental care for herself because she had dental insurance, but accepted the offer to bring her son in for an appointment. Cheng and her staff took easily to Dunn’s outgoing personality and eventually “adopted” him into their practice, and have provided his dental care in the years since. In Dunn, and servicemen and women like him, they’d found a new way to give back to their community. But Cheng and her staff did more than provide dental care, Lefever says, “Dr. Cheng treated Rory with dignity and respect. She wanted to hear Rory’s story, and understand PTSD. She thanked him for his service to the country, and made Rory feel appreciated.” Just asking for help can be a monumental obstacle for Veterans, who often feel shunned or forgotten upon their return. Randi Jensen, director of The Soldiers Project NW, a referral service for mental health counseling for returning Veterans, agrees. Jensen says, “It is very difficult for these men and women to ask for help — they’re ashamed that they have to reach out for free services.”

Getting the word out

That first year, contacts at the VA allowed Cheng to post flyers in the VA dental clinic, which helped them nearly fill the books.

The following year, however, VA officials informed her that allowing the flyers had been a breach of protocol — that it implied an endorsement, which isn’t permitted without a long, formal process.

So, while Cheng had been warned that offering free care to Veterans would leave her inundated, she found nearly the opposite to be true, saying “It’s very difficult to get the word out – I thought I would just call the VA and they would let the Veterans know, but they don’t have a way to reach these people. I went to other community and Veteran support groups with people from Vietnam, and believe it or not, one of the biggest problems they have is reaching their audience. It was an interesting education for me — it’s harder to get the word out than you would think.”

After the first year, Cheng forged an alliance with social workers at the VA — they had patients who needed dental work, and they could help spread the word to those in need. That, along with word of mouth, has helped make the day a success for the last five years — she and her associate Dr. Sul Hong see about 30 Veterans between them on the day before Thanksgiving. And, her close relationship with the social workers means that they call on Cheng throughout the year if they find a Veteran in need. Cheng relates, “They occasionally call us with a special case during the year. One of the Vets even got an implant – Nobel donated the implant, the lab donated their work, the prosthodontist donated the dental work – it was very cool.” And while some might worry that working with Veterans could be difficult, Cheng eschews the notion, saying, There are some things to learn that are specific to Veterans who have been in combat and may be suffering from PTSD,” she says, “but they’re simple guidelines which are easy to learn and follow, and the benefits far outweigh any issues.” Cheng learned much from Dunn and his mom — that Veterans can be jumpy, you can’t just tip them back in the chair without telling them first; they’ve been trained to react quickly to surprises. Lefever adds, “It took a long time for Rory to be able to sit in a dental chair with his back to the door. They’re told never to do that, and it becomes ingrained in them.” Dr. Barry Feder agrees — he’s been an enthusiastic supporter of Cheng’s program for years. Feder, himself a Veteran, sees three or four Veterans in his office a year, noting that there is a huge need to deliver care to this disenfranchised population. Most of the dentistry he provides is standard, including cleanings, fillings and crowns. The Vets, he says, are great patients, easy to work with, and grateful for the care they receive.

Looking forward

Today, Cheng is looking to expand her program further, and she needs your help. She’s looking for additional dentists, and she’s looking for people with ties to the Veteran community to help get those in need into a chair. It’s equally important to her that the families of Veterans are looked after, too. Cheng would like to be the lead contact for Veterans and their families needing care, saying, “They can come to me and we’ll clean, screen, and set up a treatment plan, then pass some along to other dentists in the community-at-large willing to complete their care.” And, while Cheng has typically set aside the day before Thanksgiving as her personal tribute day, she sees no reason why dentists couldn’t opt to see patients any time their schedule permits. “Ultimately, I’d like to find people willing to adopt Veterans and provide ongoing care — whether it is provided free or not — but if people want to participate to a lessor extent, that’s fine, too. The idea is to find them a dental home in the community. It’s easier for the Veterans to get to their appointments, and doctors can see the Veterans in the comfort of their own office.”

If you would like to learn more about Dr. Theresa Cheng’s program, please contact her at drcheng@theresacheng.com.

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member news dr. theresa cheng

Cheng elaborates, “I was really moved by the article – he was essentially left for dead, and his mother was called out to to say goodbye to her child, only to stay with him for a year, advocating on his behalf, fighting bureaucracy, and helping nurse her son back to life from the brink of death. When I read the article, I couldn’t believe what the Veterans and their families had to go through. I assumed that Rory would have dental coverage through the VA, but I worried about his mom and her dental care — would she need our help? So initially, my goal was to provide dental care for the families of the Veterans – figuring that the Vet’s needs were provided for by the VA.”

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Dr. Jack Nugent

Dr. Jack Nugent We rely on our members and local news sources for listings posted to the in memoriam section of the WSDA News. If you know of a current or former WSDA member who has died, please email Laura Rohlman at laura@wsda.org.

WA-JUL-2012.pdf

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7/3/12

9:28 AM

Dr. Jack Nugent, longtime Aberdeen dentist, and former Husky Football player, died on Wednesday, July 18, 2012. He was 82.

Nugent was born in Centralia, Wash., Dec. 16, 1929, son of John and Nellie (Nordlund) Nugent. He grew up in Centralia and graduated from Centralia High School in 1949. During his school years, he excelled as an all-around athlete in football, basketball and track. Upon graduation, he received a football scholarship to the University of Washington, where he played halfback and fullback for the Washington Huskies. Nugent was one of the outstanding rushers at the University. At UW, he was a member of Phi Gamma Delta Fraternity, Oval Club, Tyee and Big W Club.

Following graduation, he married Aldalee Simonson of Aberdeen, Wash., in 1954. He continued his education at the UW School of Dentistry, graduating in 1958. He entered the U.S. Army as a commissioned officer, a captain in the Dental Corps at Fort Ord, Calif.

Upon completion of military service, the Nugents moved to Aberdeen where Jack established his dental practice and practiced for forty years. Nugent served as president of the Washington State Dental Association. He was a founder of Washington Dental Service, and served as its President for two years. Dr. Nugent was a founder of the UW School of Dentistry Dean’s Club and served as its president from 1984 to 1986.

He was known for his personal philanthropy and anonymous service in providing charitable dental care to many deserving people.

Nugent is survived by Lee, his wife of 58 years; two sons, Scott H. and wife Karen Nugent, Auburn, Wash.; and Jeffry A. and wife Luanne Nugent, Olympia, Wash.; three grandchildren, Katelyn, Patrick and Jacob Nugent; and one sister, Eloise Evans, Kirkland, Wash. Five sisters preceded him in death.

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corporation are named in a claim or suit, both entities are covered. Additionally, your staff is covered under your mal- practice policy providing the work they do is within the course and scope of their duties as an employee of your practice.

• If you volunteer or serve on the board of a non-profit organization, they need to have a corporate professional liability policy and a Director’s and Officer’s policy.

And make sure, if you have a second practice outside of Washington State, that you have a Workers Compensation policy. Idaho for example, requires employers to carry Workers Compensation. Any entity that hires employees, whether it’s a volunteer organization or a private practice, must have a Workers Compensation policy.

And finally: Corporate professional liability policies are inexpensive (usually factored at a small percentage of each doctor’s individual professional liability premium) and the application process is simple; corporate professional liability policies add an additional layer of coverage for vicarious liability that may not be covered under a doctor’s regular professional liability policy, and; it moves your staff’s coverage from your individual liability policy to the corporate policy. Many dentists don’t realize that they are sharing their liability limit with their staff. A corporate professional liability policy removes that concern.

Three great reasons to carry a corporate professional liability policy and no more excuses for being set up.

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nordic news continued

continued from page 13

in memoriam dr. jack nugent

in memoriam: Dr. Jack Nugent, Past President, WSDA

wdia news disability insurance

Although Disability Insurance

does not seem like a necessary expense compared to the mortgage on your home, or your electric bill, it is still crucial to have disability insurance in force and in step with your needs. Disability protects your family, and you, if the worst should happen, but if you do not have policies that cover both personal and professional expenses, and are at the needed coverage amounts, the gaps in coverage may cost you.

The best way to protect yourself, your family, and your practice, is to make sure your insurance policies have the full protection you need. Ask yourself: how much money do I need on a monthly basis to pay all my personal expenses, and for my practice to run effectively? If the amount you need is less than what you currently have in monthly benefit on your disability coverages, or if you are not covered at all, then you will want to consider increasing your existing coverage and/or obtaining other types of disability coverage.

Below are some important types of disability policies and how they protect you. Although each type provides coverage for a different aspect of your life, the benefits on each policy are triggered by you no longer being able to perform the duties of your profession. Having multiple policies at the correct coverage amounts ensure that every part of your life will be protected.

Personal Disability

Personal Disability is the most common type of disability coverage. Benefits from a Personal Disability policy are meant as personal income replacement to cover your loss of earned income if you become disabled. This coverage would be used to pay your home mortgage, water and electric bills, car payment, groceries, gas, children’s tuition: anything that your paycheck covers for your family. Without Personal Disability, all your monthly expenses would have to be paid from your savings.

Overhead Expense

Business Overhead Expense is specific to covering your business expenses if you become disabled. This coverage allows your business to continue to run while you are recovering from a disability, or in the process of selling your practice. Expenses that are covered by this policy include: rent, staff salaries, electricity, dental supplies, janitorial and maintenance work, etc. Without Overhead Expense coverage, you may not be able to keep your business running while you are recovering from a disability.

Business Loan Protection

Business Loan Protection (also called Business Reducing Term coverage), specifically covers your mortgage or equipment loan payments to the bank if you become disabled. A practice loan is thousands of dollars per month, and without Business Loan Protection, you would be paying for your loan out of your pocket.

While savings may cover the costs in one aspect of your life, it is unlikely that you would have enough funds to cover your personal and business expenses indefinitely. Washington Dentists’ Insurance Agency encourages dentists to acquire different types of disability insurance to ensure that all personal and professional expenses will be covered for the well being of themselves and their families.

If you would like to review your current Disability Insurance or get quotes for additional coverage, please contact WDIA at 1-800-282-9342 or info@wdiains.com.

wsdanene issue8,8,august august· 2012 · 2012· www.wsda.org · www.wsda.org 2 2 2· ·thth e ewsda ww s s· ·issue

DISABILITY INSURANCE

How much disability coverage do you really need?

wsdanene issue8,8,august august· 2012 · 2012· www.wsda.org · www.wsda.org· 23 · 23 thth e ewsda ww s s· ·issue

wdia news disability insurance

WDIA INSURANCE SERIES:

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August 28

October 2

Online Now

Dr. Rhonda Savage & Sesame Communications

Dr. Rhonda Savage & Sesame Communications

Bracken Killpack WSDA Director of Government Affairs

Traditional vs Digital Marketing – Which Gets You the Biggest Bang for Your Buck?

The World has Gone Digital. Are You Onboard or Have You Been Left in the Dust?

The Impact of Health Care Reform on Dentistry in Washington State

Date: Tuesday, August 28, 2012 Time: 12:00 PM - 1:00 AM PDT

Is online marketing more effective than traditional marketing? Where and how should you spend your marketing dollars?

These questions will be answered as you learn how ROI models of the online world affect your practice.

Learning objectives:

Date: Tuesday, October 2, 2012 Time: 12:00 PM - 1:00 PM PDT

Where are you in the shifting sands of dental practice marketing? How do you attract and retain new patients? Where are your prospective patients finding information about you and your practice? Is online marketing more effective than traditional marketing? Learn how to build a marketing plan to grow your practice.

• Do traditional practice operations, marketing, and patient communication modalities still have value?

Learning objectives:

• What is the business case and return on investment (ROI) associated with traditional and digital models?

• What online practice operations, marketing and patient communication platforms exist?

• Where are your prospective patients finding information about you ?

• How do you optimize practice perfor- mance in the digital age of dentistry?

• What do patients want when they visit your office?

To view the webinar go to:

http://www.wsda.org/headlines/2012/7/27/watch-wsdas-free-webinar-on-health-care-reform.html WSDA’s free webinar on Health Care Reform is now available in a recording online. The presentation was given on July 20

by WSDA Director of Government Affairs Bracken Killpack.

Please direct any questions about Health Care Reform to Bracken at bracken@wsda. org or at 800-448-3368.

No QR code scanner? Go to http://www.wsda.org/webinars/ to register for any of these webinars.

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This summer, the Department of Health (DOH) has begun a Sunrise Review of potentially expanding the scope of practice of licensed denturists to include “making, placing, constructing, altering, reproducing, or repairing all other nonorthodontic removable oral devices” and “teeth whitening using bleaching solutions of twenty percent or less.” After reviewing the proposal, WSDA determined that the proposed scope expansion added unnecessary risk to patient safety, and could confuse patients into believing that underlying medical conditions have been resolved by receiving an appliance from a denturist. Similar concerns were raised by the Dental Quality Assurance Commission. WSDA and DQAC’s written comments can be found online at www.wsda.org.

WSDA sent a voterVOICE alert to all grassroots dentists about the Sunrise Review on denturist scope expansion and encouraged them to submit public comment. More than 40 grassroots dentists submitted public comment and some of these statements can be found at www.wsda.org.

DOH is in the process of compiling a draft recommendation that will be ready for public review sometime in September.

The report is then revised and taken to the Secretary of Health for final approval before it is submitted to the Legislature.

WSDA will provide updates on this process as they develop. Please address questions and comments to Government Affairs Coordinator Mike Walsh at michael@wsda.org or 800-448-3368.

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th e wsda ne w s · issue 8, august · 2012 · www.wsda.org · 25

regulator y news denturist scope

WSDA opposes denturist scope expansion • inexpensive • disposable • non-toxic

membership news webinars

complimentary webinars for members

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• Single office or multiple locations • Computer acquisition, service and upgrades

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2 6 · th e wsda ne w s · issue 8, august · 2012 · www.wsda.org

U n i v e r s i t y

o f

W a s h i n g t o n

sChooL of Dentistry

ContinUing

D e n taL

FALL 2012

eDUCation SEPTEMBER 14

50 Oral Lesions Every Dental Practitioner Should Know About Dolphine Oda, BDS, MS Presented in Bellingham

21

CAOS! Complex Adult Oral Medicine Solutions Mark Donaldson, BSc (Pharm), RPh, PharmD, FASHP, FACHE and Jason Goodchild, DMD

22

Digital Dental Photography Jason Goodchild, DMD

OcTOBER 5

Treating, Reporting and Managing Periodontal Disease: A Dental Hygienist’s Perspective Kathy Forbes, RDH

12-14 The Art and Science of Anxiolysis and Sedation in 2013 and Beyond – Nitrous Oxide and Oral Sedation Fred Quarnstrom, DDS, FAGD, FICD, FADSA; David Donaldson, BDS, FDSRCS, MDS, FADSA, FADC; Mark Donaldson, BSc (Pharm), RPh, PharmD, FASHP, FACHE 26

Fourth Annual Washington Dental Service Annual Practice Management CDE - Morning Topic: It’s a Jungle Out There! Are You Keeping Up with the Times? Afternoon Topic: The Key Essentials of a Successful Practice Rhonda Savage, DDS

NOvEMBER 2

Medical Emergencies in the Dental Office: A Simulation Course Bart Johnson, DDS, MS

3

Worthington Lectureship Morning Topic: Clinical Applications of Advanced Digital Imaging Afternoon Topic: How Histopathology Can Aid Clinicians in Resolving Clinical Dilemmas David Hatcher DDS, MSc, MRCD and Dolphine Oda, BDS, MS

16

Medical and Dental Implications of the Most Prescribed Medications Hal Crossley, DDS, PhD This course is co-sponsored by Seattle-King County and Pierce County Dental Societies.

30

A Medicine Primer for Your Office Part 1: Pulmonary, Hematology and Cardiology Bart Johnson, DDS, MS

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.

th e wsda ne w s · issue 8, august · 2012 · www.wsda.org · 27

Professional Management Associates, Inc

FRAUD INVESTIGATIONS Feeling your numbers aren’t adding up? We can help review your records in a discrete manner. Call for a free list of items to help thwart embezzlement in your office.

Feeling overwhelmed at the end of the day and can’t find the time to review your reports? Don’t have the time you want at home? We’re able to dial into your office, review your reports, and issue a written report of our findings.* *Certain requirements apply

Crossroads, Bellevue

Five op practice for sale. Specialized type of GP practice. Great location and room to expand! Collecting 600K/year.

Linnell Isoshima Steven Kanzaki 1206 Olympic Avenue Edmonds, WA 98020 Pager: (206) 399-0242 Fax: (425) 712-1859

Comprehensive Implant Training Course in Seattle Courses offered throughout the year

“Live Surgery by participants”

“CE credit available”

This program will fulfill doctor’s desire to learn implant dentistry with practical clinical information and techniques. Emphasis is placed on anatomic considerations, treatment planning, and prosthetic techniques.

“The AIC Basic Implant Course is the best course that I’ve taken so far. The fact that I was able to place an implant on one of my own patients was the deciding factor for me. It helped me to see the confidence I knew I already had and has already made an impact on the success of my practice. I would highly recommend this course to any G.P who needs to take that next step.”

Dr. Bryan D. Wood: Alexandria, VA

HIOSSEN INC (SEATTLE OFFICE) 1375 NW Mall Street, Suite #6 Issaquah, WA 98027 Tel: 425-961-0951 Fax: 425-677-8289 www.hiossen.com Email: js@osstem.com

Seattle | Los Angeles | San Francisco | Dallas | Phoenix Indianapolis 2 8 |·Philadelphia th e wsda ne| w s · issue 8, august · 2012 · www.wsda.org Washington DC | Atlanta | New York | Chicago | Raleigh | Detroit | Little Rock

Figure 1

History of present illness:

This is a 7-year-old female who first presented to the Center for Pediatric Dentistry with a chief complaint of pain associated with cracked tooth number D. During the oral examination to find the source of the pain, it was discovered that tooth number 14 was missing while all the other three first molar teeth had erupted (Figures 1 and 2). The panoramic radiograph demonstrates an impacted tooth number 14 surrounded by a large radiolucent/ radiopaque lesion which was otherwise asymptomatic; there was no pain or paresthesia. Clinical examination of the area showed an expansion at the left maxilla overlying the lesion. The patient’s past medical history is otherwise unremarkable.

Figure 2

This “Clinical Corner” case was contributed by Dr. Libby Kutcipal Seattle Children’s Hospital and Center for Pediatric Dentistry, Seattle, Wash.

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 September 2012 entry.

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th e wsda ne w s · issue 8, august · 2012 · www.wsda.org · 29

clinical corner issue 8, august 2012

Mixed radiolucent radiopaque lesion associated with impacted tooth #14

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Call Toll Free Phone (866) 348-3800 Fax (866) 348-3809

info@mydentalbroker.com 16300 Christensen Rd. Suite 213 Seattle, WA 98188 3 0 路 th e wsda ne w s 路 issue 8, august 路 2012 路 www.wsda.org

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SEATTLE SAVE THE FACE RACE

FOR ORAL CANCER AWARENESS

SEATTLE SAVE THE FACE RACE FOR ORAL CANCER AWARENESS · OCTOBER 20, 2012 A 2.4 mile walk/run on October 20th at Seattle’s Seward Park along the shores of Lake Washington (5895 Lake Washington Blvd. S) Registration starts at 8:00 AM. / $25 for all participants.

Featured speaker: Eric Statler, a Stage IV oral cancer survivor, and Director of Strategic Partnerships for the Oral Cancer Foundation.

The team raising the most will be awarded a Veloscope oral cancer screening system valued at $3,200 donated by LED Dental!

To pre-register or sponsor a walker, visit www.savethefacerace.com or the Events page of www.oralcancer.org.

$25 PRE-REGISTRATION · T-SHIRT · GOODIE BAGS · SILENT AUCTION · FREE ORAL CANCER SCREENINGS th e wsda ne w s · issue 8, august · 2012 · www.wsda.org · 33

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Volunteers needed

The Rainier Vista Boys and Girls Clubs Dental Operatory is looking for volunteer dentists who are available for exams, cleanings and some treatment from 11:00 a.m. and 6:00 p.m. (or any portion thereof) during the week. The operatory, now in its third year, provides free dental care for children in the community who do not have access to a dentist. The Rainier Vista Boys and Girls club is located just south of Seattle. If you’re interested in volunteering, please contact Nathan Esparza, Dental Coordinator, at (206) 940-0368.

UWSoD helps WSDA add resource for patients with special needs

To help patients with special needs find dentists, the UWSoD has partnered with the Washington State Dental Association to provide a directory of Washington state dentists who care for such patients.

The directory was compiled by Clinical Research Manager Kimberly Hanson Huggins of the UW Department of Oral Medicine. It is searchable by the patient’s condition, by county, providers for adults or children, and Medicaid acceptance, and it can be viewed as a map or a list.

The Directory of Dentists that Provide Care to Patients with Developmental or Acquired Special Needs can be found online at www. wsda.org/special-needs-directory. It builds on Huggins’ earlier work in expanding dental resources for the disabled community. She teamed with Dr. Ed Truelove, former Chair of Oral Medicine at the UW, and DECOD’s Dr. Glenn Govin and Mae Chin, and Dr. Travis Nelson of UW Pediatric Dentistry, to produce a series of fact sheets on people with special needs. The fact sheets cover 14 conditions, including autism, traumatic brain injury, ADD/ADHD, cerebral palsy, Down Syndrome and more. In addition, a general caregiver fact sheet has been developed with translations into Spanish and Russian. The fact sheets have been posted on the School of Dentistry website at http://dental.washington.edu/departments/oral-medicine/special-needs-fact-sheets.html and distributed widely to other websites and organizations for health care professionals, parents/caregivers and special-needs advocates.

Moreover, a three-hour online continuing dental education course was developed based on the fact sheets. The course is free for WSDA members, $40 for others. Find the course at http://dental.washington.edu/ cde/online-courses.html and at the factsheets link above.

Dentists who would like to be included in the directory can complete the survey at: https://catalyst.uw.edu/webq/survey/ khh/136393, and their name and information will be added to the directory.

th e wsda ne w s · issue 8, august · 2012 · www.wsda.org · 35

newsflash issue 8, august 2012

newsflash

member news addiction, continued

fighting addiction, continued from page 15

keep both families and careers intact, preserving valuable members of the medical community.

How does it work?

Family members, friends and colleagues with a concern about substance abuse or psychological issues of a health care provider can start the process by calling WPHP — anyone can make a referral. Washington State law provides immunity from civil liability to all reporting sources, whether it is a fellow health care provider, a family member, or another concerned party, and WPHP safeguards the identity of the caller to the best of its ability. It’s important to note, however, that all licensed health care providers are required by law to report, “Any other individual licensed by the Department of Health who has a condition, physical or mental, that may affect their ability to practice with reasonable skill and safety.

The report involving a condition that may affect a practitioner’s ability to practice with reasonable skill and safety can be made to

WPHP and fulfill the reporting requirement of WAC 246-16-200.”* Alternatively, a concerned license-holder can also fulfill their reporting obligation by contacting DQAC about their potentially impaired colleague. However, this results in a public investigation that opens the dentist to the possibility of disciplinary action for having an illness. Per WAC 246-16-200, when such a dentist is reported instead to WPHP and complies with the WPHP’s evaluation and treatment recommendations, they can maintain their anonymity from DQAC, avoiding a public investigation.

Buhl explains, “Once a person makes a referral, WPHP does the initial investigative work to determine the details surrounding the substance abuse or a behavioral issue.

There are caveats – if there have been instances of patient harm related to some kind of impairment, one is obligated to call the licensing board. If there is any kind of abuse or larger patient harm issue, that would also have to be reported. But if it’s a worry about aberrant behavior or potential substance

abuse, individuals can direct their concerns to us first.”

If, after clinically assessing the health care provider in question, WPHP determines a formal outside evaluation is necessary, participants are “referred for a multidisciplinary evaluation at a choice of several nationallyrecognized facilities. If treatment is indicated, the practitioner is given a list of acceptable, nationally-recognized programs from which to choose.”* Following treatment, practitioners can return home to practice while being monitored by WPHP and continuing their aftercare. Individuals determined by WPHP not to be substance dependent may be endorsed by WPHP to return to work in the course of a single office visit.

The good news, of course, is that with such high success rates, dentists who enter the program have an excellent chance of continuing their dental career for many years. If you know or suspect that a colleague may have a substance abuse issue, or may be in need of psychological counseling, please call WPHP at 800-552-7236.

* Source: WPHP website

Dentists - Do you want an Expanded Function Dental Auxiliary to Increase Production?

This is your chance to fund one of your Dental Assistants to become an EFDA to enhance your prac�ce!

In just six months, Sea�le Central Community College (SCCC) can train your dental assistant to become an EFDA. EFDA’s can place and contour llings so they are highly valued in the dental office.  Fund one of your Dental Assistants to become an EFDA. For more informa�on go to: www.efdacentral.net or contact: Jolene Hartne� at 206‐934‐6922 or efda@sea�lecolleges.edu.

The EFDA Program at SCCC takes two quarters and has been customized for working dental assistants.

Graduates take the Dental Assis�ng Na�onal Board (WARE) Exam and the Western Regional Examining Board Restora�ve (WREB) Exam to receive a license to prac�ce.

3 6 · th e wsda ne w s · issue 8, august · 2012 · www.wsda.org

OPPORTUNITIES AVAILABLE

OPPORTUNITIES AVAILABLE

PART TIME GP ASSOCIATE IN ELLENSBURG — We are looking for a long-term associate in Ellensburg, Wash, to work 2.5 days Wed-Fri. We are an easy-going office where you will be allowed to treat as you see fit. Please email resume to uwdentaldoc@hotmail.com.

DENTIST NEEDED — Seeking an experienced general dentist to join established group practice approximately 32 hours per week in Vancouver, Wash. Please send CV to jennifers@wendeldental.com.

OPPORTUNITY AVAILABLE — Opportunity for dentist interested in T.M.D. / facial pain practice. Poulsbo Wa. Call (360) 9818796, tmdclinic@aol.com.

ORAL SURGEON, EASTERN WASH. — Multidisiplinary practice seeking an oral surgeon to join a great team of orthodontists and dentists. Great salary, benefits and schedule. Please call Dr. James for more information. (267) 804-3372.

GENERAL DENTIST, SUNNYSIDE, WASH. — Beautiful year old office focusing on kids. Work closely with our orthodontist to deliver superior care. Great salary, benefits and schedule. Please contact Dr. James for more information. (267) 804-3372.

FULL-TIME ASSOCIATE / PARTNER DENTIST — Compassionate. inspiring and motivating dentist desperately needed in our Everett office for future partnership.

Must be an Awesome communicator and relationship builder. CV and Resume to Christian@KoviSolutions.com.

DENTAL DIRECTOR — The Spokane District Dental Society Foundation (SDDSF), a very forward thinking, community service oriented foundation, is seeking a full time dental clinic director. This position requires an energetic individual with vision and great organizational skills. All applicants must have at least five years of clinical dentistry experience, be well versed in oral surgery as well as experienced in directing and administrating a large clinic with multi-cultural employees and patients. All applicants must be licensed dentists in good standing and eligible for licensure in Washington State. Salary and benefits will be based upon experience.

Please email CV to: Amir Ganji, D.M.D. at ganjiamir@comcast.net.

GENERAL DENTIST WANTED — At Sunrise Dental of Ellensburg and Yakima we are looking to add an exceptional dentist to our team. We are known to provide the best patient experience and dental care. We need a team player with the same vision! Candidate should have excellent chair side manner and project sunny personality! Great opportunity for the right individual. PT/ FT Must be able to work one weekend day (Saturday OR Sunday). Please email your CV to drelperin@sunrisedental.com.

ASSOCIATE DENTIST WANTED — Established dental practice in downtown Seattle is looking for an associate dentist to work 2-3 days per week, providing quality dental care to our adult patient population.

There is an opportunity for a future buyin. The applicant must have: Washington Dental license in good standing; at least two years of direct patient care experience in private practice. We have a solid team ready to support the doctor for a long-term commitment. Please send C.V./ resume to: amarashi@hotmail.com.

PEDIATRIC DENTIST WANTED — A rare opportunity for a pediatric dentist in Central Washington! We are seeking a full-time pediatric dentist to join our team.

The ideal candidate has a passion for our profession, is highly skilled and is dedicated to providing unmatched patient care.

We have a state-of-the art office and we provide conscious oral sedation, in-office general anesthesia, and patient care that is beyond expectations. If joining our fun, energetic team is intriguing to you, email your CV and resume to info@wenatcheepediatricdentistry.com.

PROSTHODONTIC ASSOCIATE OPPORTUNITY — Available in Northeast King County seeking two days/week. Surgical and implant skills required. IV sedation license preferred. Large office utilizing the latest technology. Ownership potential possible. Please email your resume to deruyter25@gmail.com.

ASSOCIATE DENTIST — needed for a growing private practice. Six+ years with a loyal patient following, a hygienist and a great team to work with, we are seeking a dynamic and driven associate to grow with us. Opportunity is what you make of it here, anything is possible. Contact our office manager via email at splendentdental@gmail.com.

ORAL SURGEON — Seattle, Wash. Gentle Dental is seeking experienced oral surgeon for our busy offices. Benefits include: Gentle Dental University, tuition reimbursement, life insurance, financial reward, malpractice insurance paid, deferred incentive compensation retirement plan, 401K plan.

Contact: Ron Brush, Manager of Doctor Recruitment, Direct: 800-836-9945 Office: (310) 765-2422, eFax: (877) 233-3542, emai: brushr@interdent.com.

th e wsda ne w s · issue 8, august · 2012 · www.wsda.org · 37

ASSOCIATESHIP — Dental associateship with potential ownership sought for well established, progressive general practice.

Great location. Modern facility. Full range of services and ages. Experience and personality preferred. Contact or CV to wallawalladentalassociate@gmail.com.

GENERAL DENTIST — Brush Prairie, Wash. Gentle Dental is seeking experienced dentists for our busy offices. Benefits include: Gentle Dental University, tuition reimbursement, life insurance, financial reward, malpractice insurance paid, Deferred incentive compensation retirement plan, 401K plan. Contact: Ron Brush, Manager of Doctor Recruitment, Direct: 800-836-9945 Office: (310) 765-2422, eFax: 877-233-3542, email: brushr@interdent.com.

GENERAL DENTIST — Puyallup and Seattle, Wash- Gentle Dental is seeking Experienced Dentists’ for our busy offices. Benefits include: Gentle Dental University, tuition reimbursement, life insurance, financial reward, malpractice insurance paid, Deferred incentive compensation retirement plan, 401K plan. Contact: Ron Brush, Manager of Doctor Recruitment, Direct: 800-836-9945 Office: (310) 765-2422, eFax: 877-233-3542 email brushr@interdent.com.

SPECIALIST OPPORTUNITY, SEATTLE New office on top of Queen Anne Hill, to be completed July, 2012. State of the art equipment. Sublease 1-2 days a week to a specialist. Great opportunity for a start-up or satellite practice with minimal investment.

Contact Dr. David Arndt at (206) 696-6772 or email Davidmarndt@comcast.net.

ASSOCIATE WANTED — Seeking FT/PT experienced General Dentist to join established family and cosmetic dental practice in Tacoma and Puyallup. Dentist must be skilled and personable and will be provided a great opportunity with high pay potential at our state of the art facility. Please fax resume to: (253) 891-1442 or e-mail to: docvan99@aol.com.

PEDIATRIC OPPORTUNITY AVAILABLE — Pediatric dentist opportunity. South King County, multiple office sites. Solid seven figure practice. Existing patient base. Part time but will eventually lead to full time. Potential to buy in. Email CV to skcpedodds@gmail.com.

classifieds issue 8, august 2012

OPPORTUNITIES AVAILABLE

PROFESSIONAL RACTICE P SPECIALISTS,

INC.

1-800-645-7590

Aaron Pershall - Randy Harrison Dental Practice Sales, Transitions and Appraisals VANCOUVER, WA – G/P collecting around $775K. Newer office with 6ops, digital x-rays, pano and laser.

EVERETT, WA – Very high profit Denturist practice collecting around $290K. Includes dental equipment.

HAZEL DELL, WA – Large G/P collecting about $1.3M. Stylish, hightech, 13-op office remodeled in 2008.

KENT, WA – G/P collecting $350K. Nicely appointed office features 4-ops, pano, and newer cabinetry.

CAMAS, WA – Large G/P collecting around $3.5M with associates.

Wonderful newer office with state of the art technology throughout!

WESTERN OREGON OMS – Excellent, high profit practice with tremendous growth potential. Great location close to a major hospital.

CENTRAL, ID – Excellent satellite opportunity! Highly Profitable G/P on just 2 days/week. Incredible lease!

Associate position available!

ANCHORAGE, AK – Very nice practice collecting about $300,000.

Bright, spacious 3-op office with pano.

ANCHORAGE, AK – Wonderful Fee-for-Service G/P collecting $2M+.

Well managed office with recent updates. Seller available for transition and work-back.

www.PracticeSales.com

Aaron@PracticeSales.com RandyH@PracticeSales.com

3 8 · th e wsda ne w s · issue 8, august · 2012 · www.wsda.org

OFFICES FOR SALE OR LEASE

OFFICES FOR SALE OR LEASE

ASSOCIATE DENTIST — Pacific Northwest. This successful applicant will possess a passion for service, exceptional interpersonal skills and the ability to successfully lead a five star dental team. The position requires 1-2 years of experience, and will start at 2-3 days a week. Applicant must have a current license in either Washington and/or Oregon. If you’d like to learn more about our opportunity, just send a cover letter and resume to jlewis@welovesmiles.com.

FOR LEASE — Newly remodeled general practice, three chair office in prime location with new sign — $150,000. Digital pano, schick digital sensor, electric handpieces, eaglesoft, all ops computerized with dual monitors, new chairs, statim, midmark autoclaves, new instruments, new carpet, paint, laminate. Approximately 1,000 charts, beautiful office! Make offer.

Email uwdental@hotmail.com or phone (360) 259-1984

FOR SALE — Spokane Valley general practice. Perfect for retiring military dentists, new dentists, or dentists looking for an opportunity for growth and return on investment. A wonderful professional lifestyle and income opportunity. Learn more at www.patientfriendlyspokanevalley.com.

Please, no brokers.

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.

DENTIST JOBS — Aspen Dental offers tremendous earning potential and a practice support model that empowers dentists.

We eliminate obstacles for dentists to own their own practice. Call: (866) 748-4261. www.AspenDentalJobs.com. EOE.

OPPORTUNITIES WANTED OFFICE SHARE WANTED — Looking for office sharing opportnity (Equipment and space) in Federal Way two days/week(Fri, Sun). I use my own instruments and supplies. Please reply to cmoonh@yahoo.com.

OFFICES FOR SALE OR LEASE GIG HARBOR — Opportunity in the beautiful Pacific Northwest. Associate needed for busy Gig Harbor office. Great staff, set your own hours. Also, other specialists needed. Call Carol at (360) 779-7219.

GREAT OPPORTUNITY! OLYMPIA, WASH — Great opportunity for GP or a specialist. A well-designed turnkey fourop practice on the street with all the equipment to start and run a practice. Low rent, great potential, low investment. Contact Dr. Yathi Lingam at (360) 528-4488 or email drlingam@olympiasmiles.com.

LYNNWOOD, NORTH SEATTLE — Dental office condo for sale or rent. Owner financing or four months free rent. 1,300 square feet. Three ops. Dr. Hertl (206) 3007060. Email nhertl@aol.com.

FOR SALE — Turn-key dental office in Olympia. 1,800 sq ft office space. Four fully equipped operatories. All equipment is is excellent condition. The office is located on a high visibility location. Eaglesoft software, completely chartless, Schick digital imaging, digital panorex, Kavo electric handpieces, Casey patient education software, Statin autoclave. State of the art equipment and beautiful setting. $175,000.

Contact me at arsmithdds@msn.com for details or (360) 480-6774.

G/P PRACTICE FOR SALE — Tri Cities Area. Fabulous location with great visibility, signage and lots of parking. Free standing dental building with six operatories.

Practice collecting over $1M per year. Tenured staff will stay with practice. Included is a CEREC machine, digital pano, and digital x-rays. Dentist and wife (business mgr.) will stay on as long as needed to ensure a smooth transition. Innovative marketing strategy that generates over 50 new patients per month. Contact: Buck Reasor, DMD — Cell: (503) 680-4366, email: info@reasorprofessionaldental.com, website: www.reasorprofessionaldental.com.

DENTAL OFFICE SPACE AVAILABLE NOW — Newly remodeled dental office in the Southcenter area, 1,350 Square Feet. Oxygen, nitrous, water, air already plumbed in so it’s ready for you to start practicing! Some dental equipment is available. Growth area, large traffic. Call Medical Centers Management (253) 508-1293.

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 you patients and staff and share the rent, utilities and supplies. Contact Rick Nicolini DDS at (206) 310-5709 or drnicolini@hotmail.com.

th e wsda ne w s · issue 8, august · 2012 · www.wsda.org · 39

PRACTICE FOR SALE — Computerized dental practice in Chehalis. Nice view.

1,400 square foot leased space. Three ops, space for four. Handicap accessible. Good growth potential. Email: smiletek@comcast.net.

SEATTLE OFFICE FOR LEASE — For specialist. Crown Hill/North of Ballard. Medical/dental complex. High traffic location.

Easy parking. 1,300 sq. ft. Four operatories, equipment negotiable. $3,200/mo triple net. Great satellite or primary office for endodontist or periodontist. Great location easy access from several surrounding key neighborhoods. Contact for details (206) 715-9302 nseattledent@gmail.com.

FOR SALE BELLEVUE — Beautiful Bellevue dental practice near Crossroads Mall.

Open and spacious with three existing operative rooms, and room to expand. Pano and Ceph machine in office. Digital x-ray system in place. Convenient location on a main street near Microsoft. For more information, please call (425) 213-6606.

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) 7151444. Email: annie@nextnw.com.

MONROE, WASH — For sale: four op dental practice generating 550k/year. Please contact (206) 909-3863.

FOR SALE (NEW)— Monroe general dental practice. Great location with significant commuter drive-by exposure. Collecting $900+ annually. Four ops, (fifth plumbed) lab, sterilization, office/consult room, business office, reception and basement storage. Digital radiography, computers in all ops. Easy reverse commute from Everett, Eastside or North Seattle. Email C/V or summary to: Sam@cpa4dds.com.

classifieds issue 8, august 2012

OPPORTUNITIES AVAILABLE

Something to Smile About For 104 years, Kitsap Bank has been the trusted financial partner for our customers and our community.

Contact us for all your practice banking needs!

• • • • •

Purchase new or expand an existing practice Finance equipment or tenant improvements Practice Buy-In Financing Real Estate Financing Business and Personal Lines of Credit

Kitsap Bank has been named a Preferred Lender by the U.S. Small Business Administration.

Kerry Keely Vice President Commercial Loan Officer 360-876-2297

Bob Banks Senior Vice President Commercial Market Manager 360-876-7800

www.kitsapbank.com • 800-283-5537

4 0 · th e wsda ne w s · issue 8, august · 2012 · www.wsda.org

EQUIPMENT WANTED

FOR LEASE, BURIEN, WASH — Brand new, 2,700 foot, 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.

EQUIPMENT WANTED — Looking for wide range 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.

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 Melissa at (425) 481-1038 or email office@gentletouchdental.com.

GUEST DENTIST — Time off, vacation, maternity leave? Temporary placement for day, week, or longer. Experienced, team and patient-oriented GP. Joe Schneider, DDS, FAGD. (206) 878-1237.

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) 715-1444 or email at annie@nextnw.com.

EQUIPMENT FOR SALE

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 — Three Instrumentarium panoramic digital x-ray machines still have 5-year warranty great condition.

Have to sell, need to buy pan ceph for my new offices. Please call (509)4757472 or email nkhurana@earthlink.net.

ADVERTISING RATES Advertising in the WSDA News is easy. Email the ad to rob@wsda.org along with the number of issues you would like it to appear in, your credit card, exp. date and the CVC code (the three-digit code from the back of most credit cards, or the four-digit code from the front of Amex cards) in the email. If you prefer not to send your credit card info over the internet, send the rest of the information and follow up with a phone call to Rob Bahnsen at (206) 973-5220 with the payment information, or the ad will not run. We do not bill for ads, and do not take classifieds over the phone.

Members - $50 for the first 30 words, $1 for each additional word Non-Members - $100 for the first 30 words, $1 for each additional word.

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.

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.

CONTINUING EDUCATION MODERATE SEDATION COURSE — Instructor: Steven Ganzberg, D.M.D., M.S. Dates: April 19-21 at UCLA, and May 15-19 at Wendel Family Dental Centre (Vancouver, WA), 2013. Cost: $11,995. A deposit of $5,000 due by February 1, 2013. Course is 80+ hours with 20 patient cases. Contact: Lori, (360) 944-3813 or loris@wendedental.com. Space is limited. AGD #218643.

th e wsda ne w s · issue 8, august · 2012 · www.wsda.org · 41

dental student prior to his Olympic success. Having made $7 million the next two years, he apparently decided he could make much more money being a corporate spokesman. Wise move! There are other dentists who have competed in the Olympics. Daniel B. Bukantz (1917–2008) was an American Olympic fencing competitor and dentist. He competed in the foil in the Olympics four consecutive times, beginning in 1948. He maintained a dental practice in Manhattan for 40 years. Erhard Keller (born in 1944), is a former speed skater from Germany. Keller, studying dentistry at the Munich University at the time, participated in the 1968 Winter Olympics in Grenoble. There, the “flying dentist” became Olympic Champion in the 500 meter, making him the first German male Olympic Champion in speed skating history. Wendy Houvenaghel is a dentist in Northern Ireland when she’s not cycling for Britain in team pursuit at the London games. She plans to return to the profession full-time once the Olympics, and her cycling career, are over.

British dentist, Dr. Tony Clough, BDS, is responsible for all dental care within the Olympic Village. He told Dr.Bicuspid.com, “We expect 800 urgent care cases, 1,000 routine follow-up cases, and several hundred screening patients. Many athletes arrive with wisdom teeth infections due to fatigue, flying, and stress. It is anticipated that we’ll perform 150 to 200 root canal therapies.” Clearly not all these world-class athletes are in the best of dental health.

And then we have swimmer/Phelps challenger Ryan Lochte and his famous American flag grill. In one of the most unhygienic displays seen on TV, he removed it from his pocket and gave it to CNN interviewer Piers Morgan. Morgan, even though he said he really didn’t understand the need for this “bling,” put it in his own mouth to model it! I was so hopeful we were done with grills with the disappearance of Flavor Flav, but apparently not. Competitive swimmers have enough erosion from chlorine, let alone starting a new grill craze.

Every day we dentists have our own Olympics: from trying to hit the “bull’s eye” of an inferior alveolar injection, to the task of trying to “sweep” the heavy rock of inertia of a patient’s lousy dental IQ in a better direction (as in curling), to being the captain of our TEAM looking for professional and financial success. There are lots of days we deserve a gold medal. But don’t start chanting “Kabaddi” waiting for the recognition. Ours is a lonely “sport,” not unlike long distance running. An occasional “thank you” or smile from a patient with a repaired number 9 is about all we can expect. Those are often enough.

parrish or perish continued

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.

SERVICES

parrish, continued from page 42

classifieds issue 8, august 2012

OFFICES FOR SALE OR LEASE

parrish or perish

Dentistry’s Olympics

Dr. Jeffrey Parrish “If everyone is thinking alike, then somebody isn’t thinking.”

— George Patton

”I did once train for an Olympic event: the Hammer Throw.

Actually it was a mallet throw. It was my gold foil mallet right after I did one foil in private practice and decided, ‘Never again!’”

As I “put pen to paper,” the Olympics in London are half over. I must admit I occasionally check what’s going on, but I never watch much of the tape-delay on the No Body Cares network. Somehow it just doesn’t interest me, and cuts into my leisurely summertime life. But to be somewhat relevant with the world, I thought I’d do a bit of research and try to “connect” with London, Usain, Gabby, Lolo, Michael, the Twittersphere, et al.

I happened upon a website that listed events that have been removed from the games since they were revived in Greece in 1896. Some of them sound much more interesting than, oh, say, synchronized swimming or watching archery or shooting. (Now I realize there is great precision in archery or shooting, but have you looked at that equipment?

There’s more there than an endodontist’s microscope; how does anyone miss a bull’s eye?)

The Olympics used to have an event called Skijoring—skiing while being pulled by horses. This sounds like an overly testosteroned teenage boy’s idea of fun…and one that probably will lead to an oral surgery visit. I see potential for business here! Wonder if it’s covered by WDS? How about the eliminated Club Swinging which involves the competitor standing erect with a club in each hand. Unlike juggling, the clubs are swung around the body and head in a variety of patterns in a complicated routine. This sounds like an eventual loss of numbers 7-10 and need for implants — more business.

Hygienists would probably love their patients to participate in the discarded game of Kabaddi in order to scale longer, without having to use the low volume suction. Here’s the official description: The game involves two teams of seven players on a field half the size of a basketball court. The teams take turns sending a “raider” across to the opposite team’s half, where the aim is to tag as many opponents as possible before returning to the home half. Tagged members are then “out” and sent off the field. The raider must hold his breath — to prove it, he must continually chant a word (“kabaddi” in the Indian form of the game, hence the name). Prophys would be quicker…but louder. I have recollections of a dental school classmate’s third extraction patient who didn’t want local anesthesia (“harmful, unnecessary medication”, etc.), and would do Lamaze to overcome the pain.

Quite a noisy afternoon in the oral surgery clinic, as I recall.

They used to have Tug of War in the early days, but I guess the name was not PC enough. I have trained for it often getting out a lower molar. Walking was once part of the track portion of the Games; I could probably compete there since it wasn’t the modern day Race Walking. And speaking of non-PC, there used to be a live pigeon shoot! PETA would be all over that even if they eventually ended up in some of London’s finest restaurants as “squab under glass”.

And to be really politically incorrect: No women competed in 1896, as it was felt that their inclusion would be “impractical, uninteresting, unaesthetic, and incorrect.” Clearly these guys had no vision for Beach Volleyball! But had we continued the ancient Olympic tradition of all participants competing nude, TV ratings would probably be much higher; look at the flap over the “wardrobe malfunction” underwater in water polo!

I did once train for an Olympic event: the Hammer Throw. Actually it was a mallet throw. It was my gold foil mallet right after I did one foil in private practice and decided, “Never again”! I did set a U.S. distance record that day—all the way to the basement of my office!

It is common lore that Mark Spitz, winner of seven gold medals in 1972, was a pre-

continued on page 41

The views expressed are those of the writer and do not necessarily reflect the opinion or official policy of the WSDA.

4 2 · th e wsda ne w s · issue 8, august · 2012 · www.wsda.org

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At NORDIC, we take things personally 4 4 · th e wsda ne w s · issue 8, august · 2012 · www.wsda.org