WSDA News Issue 4 · March 2017

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news

The voice of the Washington State Dental Association

WORKING THE SYSTEM FOR THESE WASHINGTON DENTISTS, THE PRISON SYSTEM FITS THE BILL

Also in this issue: th e wsda ne w s · issue 4, march · 2017 · www.wsda.org · 1

LEGISLATIVE UPDATE DENTAL ACTION DAY REVIEW

“Our experience working with Constantine Builders was with utmost respect and professionalism. Their team presented us a beautiful office in a timely fashion.

We couldn’t be more pleased.” — Dr. Adrian and Janet Pawlowski, Bell Harbour Dental and PerioInnovations C O N S TA N T I N E B U I L D E R S . C O M

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Dr. Ramesh Rao (left) and Dr. Jay Jensen in front of the Walla Walla State Penitentiary

WSDA news Cover story by Rob Bahnsen Cover photos by Kimberly Teske Fetrow Dental Action Day photos by Craig Mitchelldyer DAD reception photos by Scott Eklund /Red Box Pictures

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editorial

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guest editorial

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dental action day news

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legislative news

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cover story

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pndc news

26-29

member news

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ce news

33

nordic news

issue 4 · march, 2017

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regulatory news

36-37

give kids a smile

39

endorsed company content

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clinical corner

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volunteer news

43, 45, 47, 49

classifieds

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in memoriam

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first person: dr. john evans

Like us on Facebook: www.facebook.com/WashingtonStateDentalAssociation WSDA News Editor Dr. Mar y Jennings

Dr. Ashley L. Ulmer Dr. Amy M. Winston

Continuing Education and Events Coordinator Sarah Quigley

Editorial Advisor y Board Dr. Brittany Dean Dr. John Evans Dr. Julie Kellogg Dr. Stephen Lee Dr. Joseph Vaughn

WSDA Staff:

Membership Ser vices Coordinator Rachel Gunderson

Washington State Dental Association Dr. Bernard J. Larson, President Dr. Cynthia R. Pauley, President-elect Dr. Nathan G. Russell, Secretary-Treasurer Dr. Bryan C. Edgar, Immediate Past President Board of Directors Dr. Theodore M. Baer Dr. Marissa N. Bender Dr. Dennis L. Bradshaw Dr. Christopher R. Delecki Dr. Linda J. Edgar Dr. Todd R. Irwin Dr. Christine L. Kirchner Dr. Eric J. Kvinsland Dr. Randall H. Ogata Dr. James W. Reid

Executive Director Bracken Killpack Assistant Executive Director Kainoa Trot ter Controller Peter Aaron Director of Government Affairs Mellani McAleenan Director of Operations Brenda Berlin

Membership and Communications Coordinator Emma Brown Bookkeeper Joline Hartman Administration and Financial Coordinator Tom Harshbarger Association Of fice: (206) 448 -1914 Fax: (206) 443 -9266 Toll Free Number: (800) 448 - 3368 E- mail/web: info@ wsda.org/wsda.org

Ar t Director/Managing Editor Robert Bahnsen Director of Continuing Education and Events Emily Rademacher, CMP Government Affairs Associate Emily Lovell

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

The WSDA N ews is pub lishe d 8 time s ye arl y by t he Washington State Dental Association. Copyright © 2017 by the Washington State Dental Association, all rights reser ved. No part of this publication may be reproduced without permission of the editor. Statements of fact or opinion are the responsibility of the authors alone and do not express the opinions of the WSDA, unless the Association has adopted such statements or opinions.

Subscription price is $65 plus sales tax per year for 8 issues of the News. Foreign rate is $97.92 per year. Advertising is published as a service to readers; the editor reserves the right to accept, reject, discontinue or edit any advertising offered for publication. Publication of advertising materials is not an endorsement, qualification, approval or guarantee of either the advertiser or product. Communications intended for publication, business matters and advertising should be sent to the WSDA Office, 126 NW Canal Street, Seattle, Wash.

98107. ISSN 1064-0835

Member Publication American Association of Dental Editors.

Winner: 2016: Platinum Pencil Award, 2015: Platinum Pencil Award Honorable Mention, 2014: ADA Golden Apple Award for Outstanding Achievement in the Promotion of Diversit y and Inclusion, 2013: Journalism Award, Platinum Pencil, 2012: Journalism Award, Best Newsletter, Division 1, 2012: Platinum Pencil Award Honorable Mention (2), 2008: Best Newsletter, Division 1, 2007 Platinum Pen Award, 2006 Honorable Mention, 2005 Platinum Pencil Award, 2005 Publication Award; International College of Dentists

table of contents issue 4, march 2017

a day in the life

editorial dr. jennifer king

Put dental patients above corporate profits

Editor’s note: A version of this editorial ran in the Yakima Herald-Republic on January 30, 2017

Dr. Jennifer King

“Based on my 18 years of practice, the best care results when decisions are made solely by patients and their dentist.”

Debate in Olympia regarding the operation of corporate dental chains might seem to matter only to those directly involved, and have little impact on the public in Yakima.

That’s not the case. The outcome will have a dramatic impact on the quality of care received by dental patients here and across the state.

Corporate chains, or Dental Service Organizations (DSOs), operate in Washington under names like Aspen Dental, Modern Dental, Bright Now, and Gentle Dental. But they do so in a gray area outside of the oversight of the state regulators.

As a practicing dentist, this worries me. Not because corporate chains represent new competition, and not because there’s anything inherently wrong with a dentist contracting for administrative support. As dentists, we should be open to models that deliver better patient care.

But that’s not the case with DSOs. Based on my 18 years of practice, the best care results when decisions are made solely by patients and their dentist. Interference in the doctorpatient relationship by third-party for-profit corporations can lead to inferior care or overtreatment, or both, and should not be allowed.

Because of my concerns about corporate clinics, I’ve spent time reviewing legal actions taken in other states. What I’ve learned is that, left unchecked, non-dentist corporate managers routinely: hire, supervise, and evaluate licensed dentists; choose equipment and materials that directly impact care; review and challenge treatment plans; and develop unrealistic production schedules that treat patients like widgets in a factory. DSO employment contracts often include incentives that have nothing to do with patient needs or the quality of care provided, and everything to do with revenue generation and profit maximization.

I’ve also heard enough from former patients and dentists who have worked in these offices to confirm that these things are already happening in our state.

My conclusions are confirmed by government studies at both the federal and state levels. In 2015, a report by Washington’s Dental Quality Assurance Commission raised concerns about non-dentists gaining influence over issues related to dental treatment and adversely impacting patient care.

A June 2013 U.S. Senate report concurred that “profits are being placed ahead of patient care” in these offices.

Fortunately, there is an a proposal that would provide strong protections for patients. A bill supported by me and my professional colleagues within the Washington State Dental Association would confirm dentists’ rights to contract with third parties for support services, but expressly prohibit DSOs from interfering with a licensed dentist’s independent judgement on patient care.

It would prohibit corporations from compensating dentists based on volume, revenue generation, or referrals to affiliated specialists — arrangements currently used to exert control over their decisions. It also would establish clear authority for the state to oversee these operations and whistle-blower protections for anyone reporting violations. It’s a responsible approach to protect the public.

I’d never allow one of my patients to endure unnecessary pain or expense. The same protections should be extended to any patient seeing any dentist in the state. That means requiring corporate chains to put patient care ahead of profits.

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

The views expressed in all WSDA publications are those of the individual authors and do not necessarily reflect the official positions or policies of the WSDA.

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For decades, the Northwest Dentists Insurance Company (NORDIC) has been the preeminent provider of professional liability and business owners insurance to dentists throughout Washington and Idaho. For the last 10 years, NORDIC has been owned jointly by MODA Health (with 75 percent equity), and WSDA (with 25 percent equity). For many years, Washington Dentists’ Insurance Agency (WDIA), which is wholly owned by the WSDA, has been the exclusive broker of NORDIC products in Washington.

Effective Feb. 28, 2017, NORDIC became wholly owned by TDIC (The Dentists Insurance Company), a subsidiary of the California Dental Association. WDIA will continue to serve as the exclusive broker of NORDIC in Washington, and NORDIC is now a company endorsed by the WSDA. The NORDIC Board of Directors will also continue to have representation from Washington and Idaho dentists.

This sale will have no impact on NORDIC policyholders. All existing policies will remain the same. NORDIC’s experienced staff and its Oregon- and Washington-based management team will continue providing the service you have come to expect from the company.

WDIA’s relationship with NORDIC will also continue forward. As the exclusive broker of NORDIC in Washington, the WDIA team will continue to be available to sell NORDIC products and answer questions about the appropriate level of coverage needed for your specific situation. WSDA’s endorsement of NORDIC demonstrates our continued commitment to professional liability and business owners’ protection exclusively tailored to the dental profession.

Last April, we informed you that MODA Health had agreed in terms to sell its 75 percent equity stake in NORDIC to TDIC. Since that time, WSDA has been evaluating its future relationship with NORDIC and TDIC. After considerable internal deliberation and several meetings with TDIC leadership, the Board of Directors decided to sell WSDA’s 25 percent equity stake in NORDIC for the same price offered to MODA Health for its equity.

WSDA purchased its NORDIC equity for $2.1 million and has sold this equity, 10 years later, for approximately $4.5 million.

The Board of Directors has already started evaluating options of what to do with the proceeds of the sale of our NORDIC equity. Over the course of the last decade, WSDA has made a concerted effort to invest in assets that provide the Association with sustainable non-dues revenue, in order to keep membership dues stable. The Board of Directors fully intends to honor the original intent of our NORDIC investment by investing the proceeds of this sale into a forward-thinking investment for the benefit of the Association and its members. The process for determining this long-term investment has begun, and we will provide you with updates in the months ahead.

TDIC has committed to maintaining dentist leadership from the Pacific Northwest in NORDIC. I am pleased to report that Drs. Princy Rekhi and Doug Walsh will both serve on the NORDIC Board of Directors, and that Bracken Killpack, our Executive Director, will also attend NORDIC Board meetings. Additionally, Dr. Walsh has also accepted a position on the TDIC Board of Directors. WSDA leaders will continue to participate in the NORDIC decision-making process at the highest levels.

TDIC is not new to the dental professional liability market. Currently, TDIC provides coverage to more than 19,000 dentists in Alaska, Arizona, California, Hawaii, Illinois, Minnesota, Nevada, New Jersey, North Dakota, and Pennsylvania. TDIC has developed strong partnerships with state dental associations, and has brokerage relationships similar to the existing relationship between WDIA and NORDIC in several of those states. We will work to build such a partnership in the years ahead.

WSDA and WDIA are committed to working with NORDIC and TDIC to ensure a smooth transition for all NORDIC policyholders. The Association’s relationship with NORDIC has been mutually beneficial, while providing the gold standard of care to Washington’s dentists. We are committed to maintaining this same extraordinary commitment to service within the new arrangement.

Should you have any questions, please do not hesitate to call the WSDA at 800-4483368 or email bracken@wsda.org.

Dr. Bernard J. Larson President, WSDA

“Effective Feb. 28, 2017, NORDIC became wholly owned by TDIC (The Dentists Insurance Company), a subsidiary of the California Dental Association. WDIA will continue to serve as the exclusive broker of NORDIC in Washington, and NORDIC is now a company endorsed by the WSDA.”

The views expressed in all WSDA publications are those of the individual authors and do not necessarily reflect the official positions or policies of the WSDA.

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guest editorial dr. bernard j. larson

The future of NORDIC in Washington

dental action day in pictures

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dental action day in pictures On Wednesday, February 1, more than 200 dentists and students from the University of Washington School of Dentistry converged on the state capital to meet with legislators from around the state, not only as dentists and students, but as concerned constituents.A special thanks to Representative Michelle Caldier for providing a warm welcome to all participants in the tent before the start of the day!

With so many important pieces of legislation in the works this year, there was much to talk about: from midlevels; to DSOs; and more. WSDA staff worked diligently to schedule meetings throughout the day, and although legislators were often busy in session, they proved willing to conduct impromptu meetings in hallways and corridors whenever possible. By moving the event from Friday to Wednesday, WSDA staff were able to schedule more face time with the lawmakers themselves, as opposed to their Legislative Aides.

The night prior to DAD, WSDA held a reception for dentists and legislators to meet in a more relaxed setting and talk about the issues. About 80 people came, and got to know their lawmakers a little better — it was a truly successful event!

Dental Action Day photos by Craig Mitchelldyer DAD reception photos by Scott Eklund/Red Box Pictures

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dental action day in pictures

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dental action day in pictures

Photos, opposite page, clockwise from top left: Rep John Lovick, D-44, Dr. Austin Baruffi, Rep Tom Dent, R-13 (in the hat) talks with Rep. Paul Graves, R-5, Sen Steve Conway, D-29 meets with constituent dentists during Dental Action Day (DAD), Dr. Amy Cook at the reception. This page clockwise from top: Attendees make their way to a meeting during DAD, Dean Berg meets with students and colleagues in the hall between meetings, Dr. James Hutchinson shares a laugh, two WSDA members make their way to a meeting, WSDA members meet with Rep Jeff Holy, R-6.

dental action day in pictures

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dental action day in pictures

Photos, opposite page, clockwise from top left: The Clark County contingent preps for a meeting, Dr. Jeff Schur at the reception, Big smiles from the reception, constituent dentists hold an impromptu meeting in the hall with Rep Jay Rodne, R-5, Sen Jan Angel, R-26. Photos this page, clockwise from top: A large Seattle-King County group meets with a lawmaker, the annual UWSoD shot.

legislative news 2017 legislative updtae

2017 LEGISLATIVE UPDATE AN UPDATE ON LEGISLATION IMPORTANT TO DENTISTRY

The 2017 regular legislative session began on Jan. 9 and will run for 105 days. Because this is a long session, the first major deadline, the house of origin committee cutoff, did not occur until six weeks in. As of Feb. 17, all policy bills must have passed out of their original committee or they are “dead” for the remainder of the session. While six weeks feels like plenty of time, the pace at the Capitol has been frenetic because there is no shortage of big issues for the legislators to tackle. Issues like the impending Supreme Court-issued deadline for K-12 education funding overshadow all others, and have created an air of disquiet among a legislature that is almost equally divided between Republicans and Democrats. With the Democrats holding a two-vote majority in the House of Representatives, and the Majority Coalition Caucus (Republicans plus one Democrat) holding on by one vote in the Senate, compromise will be necessary for any controversial bill to pass both chambers. Here are some of the issues WSDA is working on this session.

Protecting patient safety

Some companies, known as dental support organizations (DSOs), provide administrative support services to dental practices, but experience in Washington and other states has shown that those services sometimes cross the line into the corporate practice of dentistry, with non-dentists calling the shots on patient care.

WSDA supports choice in how dentists manage their practices, as long as proper patient safeguards are in place. Dental care decisions should be left to a patient and his or her dentist’s independent judgment.

That’s why WSDA supported Senate Bill 5322 and House Bill 1598, but opposed Senate Bill 5158 and House Bill 1389. All four bills were heard in their respective policy committees, and legislators directed the WSDA and DSOs to negotiate a compromise solution. WSDA honored the legislators’ requests, engaged in discussions with the DSO representatives, and found a compromise that will allow dentists to utilize the services of dental support organizations subject to the limits of important patient safety pro-

tocols and oversight by the Department of Health. To read more about this important issue, please visit wsda.org/blog.

Defending against midlevel providers

Four bills related to midlevel providers were introduced this session. House Bill 1364 and Senate Bill 5224 would create a new licensed health profession called “dental therapists.” These dental therapists would only need about three years of post-secondary school education, but would be allowed to do almost everything a dentist (with eight-plus years of education) is authorized to do, including drilling and extracting teeth. WSDA-member dentists testified in opposition to both bills, and WSDA is working to keep these bills from passing. WSDA remains opposed to licensing dental therapists in Washington.

House Bill 1414 and Senate Bill 5079 provide state authorization for the practice of dental health aide therapists on tribal members on tribal reservations in Washington State. After great deliberation and discussion with tribal leaders, the WSDA Board of Directors decided to take a neutral position on these bills. This decision was based solely on the recognition that tribes are sovereign nations with the innate right to govern themselves. Senate Bill 5079 passed the Senate unanimously, and House Bill 1414 passed the House with an 80-18 vote. House Republican floor leader JT Wilcox noted at the time that a “yes” vote on the bill did not necessarily indicate support for the creation of a general midlevel provider, but was a vote in recognition of tribal sovereignty. Senate Bill 5079 is already on its way to the governor to be signed into law, having passed the House by the same 80-18 vote.

Medicaid and insurance

WSDA supports ensuring patients have the same protections when accessing dental care as when accessing medical care, and supports eliminating the unfair insurance practices of some dental insurance companies. House Bill 1316, as amended by the House Health Care and Wellness Committee, will require carriers to

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Opioids

The overuse and abuse of opioids have become a crisis nationwide, and Washington’s legislature is reviewing a number of bills related to opiates. House Bill 1339 would have limited a dentist to prescribing only a three-day supply of an opioid drug for a patient’s first-time outpatient use. Because there are valid reasons why a patient may need more than three days’ coverage, WSDA opposed this legislation, and member dentists testified in opposition at the bill hearing. This legislation has since been amended to a less-restrictive form, but would require continuing education and rulemaking by the Dental Quality Assurance Commission.

Residency expansion

Dental residents are a superior alternative to dental therapists.

WSDA is supporting capital budget requests to help fund facilities and infrastructure needed to expand dental residency programs.

Providence Health & Services is looking to expand in Spokane and Olympia.

Gov. Jay Inslee’s proposed capital budget includes a grant program that could provide funds for some of these programs, but the funding is not enough to cover all of them. WSDA will continue to support the inclusion of funds in the capital budget, which is also subject to constraints due to the K-12 funding deadlines.

RIDE Program expansion

WSDA also supports the UW School of Dentistry’s $1.96 million request for infrastructure and personnel to expand the capacity and footprint of the Regional Initiatives in Dental Education (RIDE) program, which trains providers in rural and underserved areas.

Dental labs

The Washington State Dental Laboratory Association is proposing legislation to address supply chain accountability through dental laboratory registration and disclosure. WSDA believes House Bill 1782 will enhance patient health and safety, and that a state-maintained registry will assure dentists that their dental laboratory is compliant and operating under high standards.

Conclusion

The 2017 legislative session is more than one-third completed.

Decisions regarding what bills will survive has begun in earnest, and with each passing cutoff, the number of active bills will continue to decrease. WSDA is working hard to ensure the issues that matter to organized dentistry remain in the forefront of the legislators’ minds.

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legislative news 2017 legislative update

maintain a utilization review program description and written criteria based on the prevention of dental disease and chronic disease implications. It will prohibit a carrier from retrospectively denying coverage for care that had prior authorization, and it will prohibit carriers from subjecting providers to additional oversight based on the provider filing an appeal or grievance on behalf of a patient. It also requires the Office of the Insurance Commissioner to convene a workgroup to examine current practices related to explanations of benefits. Rep. Michelle Caldier, the only dentist in the Legislature, prime sponsored this bill, as well as House Bill 1314, which would create safeguards to ensure fair and transparent Medicaid audit processes. WSDA fully supports her efforts on both bills.

Following a budget provision last year that required the Health Care Authority to report on how the administration of dental Medicaid could be contracted to an outside company, administrative service organizations, such as Delta Dental, and managed-care organizations, such as Dentaquest and MCNA, are trying to convince the Legislature that their model is the best option. WSDA believes that the Legislature should conduct a comprehensive review of the Medicaid dental benefit and reimbursement rates, before deciding if or how the administration of the program should be contracted out. Because this decision will impact the state budget, discussions will not be limited to the standard deadlines.

cover stor y working the stystem

The first thing you notice when visiting a prison is that officials take things very seriously. Like, where you park while shooting pictures outside the compound. “If you park on the side of the road, they might want to shoot first and ask questions later, but they’ll definitely be out to see who we are,” quipped Shari Hall, the Public Information Officer (PIO) working with us on a photo shoot at the Washington State Penitentiary (WSP) in Walla Walla, Wash. We were at the maximum-security facility to take pictures of Dr. Ramesh Rao and Dr. Jay Jensen, two dentists who practice there. (The day before we had been at Coyote Ridge Corrections Center in Connell, Wash., to take pictures of Dr. Cassidy Blount). As Hall predicted, within about a minute of disembarking from our cars and starting to set up the shot, we were joined by two vehicles with corrections officers (CO) wanting to know our business on the property. Hall shooed the officers away with a laugh and a flash of her badge, but her point was taken: Our every move was being watched.

Cover photos by Kimberly Teske Fetrow · This page: Dr. Cassidy Blount at Coyote Ridge Correctional Center

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cover stor y working the stystem

WORKING THE SYSTEM FOR THESE WASHINGTON DENTISTS, THE PRISON SYSTEM FITS THE BILL

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cover stor y working the system

Photos, clockwise from top left: Dr. Cassidy Blount, razor wire surrounds the property, Dr. Ramesh Rao of the Washington State Penitentiary has a laugh, instruments are counted several times daily to ensure none are missing, a guard’s belt and keys.

Cover photos by Kimberly Teske Fetrow

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The finer points of handcuffing and throat punches

For Blount, Rao, and Jensen, it’s an oft-repeated scene, and even though they’re all fairly new to prison dentistry (two years, one year, and six months, respectively), they say they’re used to the rules and know they’re designed to make them safe. Over in Connell, Blount notes that he always has a CO nearby, and he and his staff were well-trained in all aspects of prison safety through its six-week Core training program. Rao explains, “We learned the finer points of handcuffing and throat punches. I never thought I would be learning how to apply handcuffs. It’s actually fairly technical. We learned how to talk to inmates, how to avoid being compromised. They definitely have fine-tuned manipulation skills.”

Rao says that for dentists working in the system, compromising situations are less likely than for the officers. “I might see inmates for a 30-minute appointment, and then not see them again for three weeks, but the officers see them every day,” he says. Dentists, however, are still taught how to search cells in the event of a unit or hospital takeover, and how to defend themselves. “Believe it or not, I was a little scared during Core to come back here because they showed us some disturbing videos,” says Rao. “The rules don’t always apply, so you learn to expect the unexpected. Other than that, I’ve never really had any concern for my safety. We have three clinics, and one is a little more at risk, but for the most part I feel safe. You think about it, but you don’t want to be on high alert all the time. It would just be too exhausting. If something does come up, I know I won’t be flopping around trying to figure out how to put handcuffs on.”

Dr. Ramesh Rao · Walla Walla State Penitentiary

Rao is a friendly guy with a quick laugh and an easy smile who graduated from Newport High School in Bellevue, Wash., and then to the UW, where he earned a degree in chemistry. He took a little time off and went to the UWSoD, graduating in 2002.

He never dreamed of becoming a prison dentist (“saying you’re a prison dentist is a lot like saying you raise unicorns for a living,” he jokes), but he has never taken the road more traveled, either.

Right out of the gate, he signed with Dental Professionals, a local company, doing locum tenens work. Soon after, he took a position with the South Seattle Public Health Clinic, which was primarily a pediatric clinic. It was good work, but he wanted to get back to working on adults, so he left after 18 months and started working with a denturist, doing lots of oral surgery, restorative crown and bridge, and prepping folks for their dentures. Not long after, owners decided to sell the practice and they approached Rao, but it wasn’t the right fit.

About the same time, he heard about an opening at Fircrest School in Shoreline, Wash., a residential habilitation center (RHC) with 200 residents with developmental disabilities. The facility has been around for a long time, and has had its ups and downs.

Rao started there in 2007, and it took a little while for him to get used to the patients because only about 5 percent were verbal.

Because of the population of the facility, he was doing a lot of sedation. “I did what I could do,” he explains, “but there was certainly no crown and bridge, no fancy dentistry, just amalgam in the posterior, and a lot of extractions. But the patients grow on you, you get into a rhythm, and one year goes by, then two.” Before he knew it, nearly nine years had passed, and it was time to move on. “It was a good experience for hospital or institutional dentistry,” he says. “I just decided that those patients were only getting faster, stronger, and quicker, and I wasn’t sure how much longer I wanted to be chasing them around to try and do dentistry on them.”

Becoming a prison dentist

Soon after, he started looking around for other opportunities and heard about an opening at the state penitentiary in Walla Walla. He was intrigued. “It was attractive because the move was lateral from DSHS to DOC, so I would accrue my retirement in the same fashion, and I had the same vacation, as well,” says Rao. “I didn’t have much going on in Seattle anyway, and I had never lived in eastern Washington, or a town the size of Walla Walla. It was an interesting time to move here because the wine industry had put it on the map.” Rao, a bachelor, is fairly light on his feet and didn’t have to pull up stakes for a whole family to move there.

His mother still lives in Seattle, but his brothers have moved out of state. “I thought I would give it a year to see how it goes, and so far, so good. I like what we do, and the services we provide.

“There’s certainly a lot of dentistry to be done. The work is similar to what I was doing at Fircrest, but here, my patients understand my instructions, which makes work much easier” he says.

Still, there is the long walk through tall fences topped with rings of razor wire, a daily reminder that this isn’t a private practice somewhere, but he and Jensen never wanted that, anyway. “It’s not for everybody. There are no bells and whistles, no coffee in the waiting room, but I enjoy it,” says Rao. “We have three dentists on board. The one who has been here the longest came from private practice. I think he enjoys it and has a good grasp of the system, how it operates, and the machinery behind it. Dr. Jensen is a lot like me. We never really had the inclination to go into private practice. When you buy a practice, there are a lot of big numbers, and you have to start talking with bankers, accountants, and lawyers. It can be intimidating. There’s definitely a niche for folks who like the clinical side of dentistry, but aren’t as interested in owning and operating a small business. There’s a lot less risk. I arrive at 7, leave at 3:30, arrive home at 3:37. It’s nice like that. I like the interaction with the departments. In private practice you’re on your own little planet of your staff and you.” He continues, “You know, when I’m on vacation, I’m on vacation….and I’m getting paid. Sometimes when private practitioners go on vacation, it’s a double whammy because they’re spending money, and they’re not earning money.”

At Walla Walla, Jensen and Rao deal with the full spectrum of inmate populations. Rao explains, “It’s a different place, I must say. You’re dealing with a population and a workplace that a lot of people don’t see, and that isn’t open to the public. It takes a little getting used to, but that’s the only thing I can really think of. These guys are serving anywhere from one year to life, and we have a death row/supermax level, too. So we have guys who stole a couple of cars, and more notorious criminals like Gary Ridgeway (the Green River Killer). I try not to think about it too much. We can look up what they’ve done to land here, but I think that’s sort

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cover stor y working the system

About an hour before, as we were getting ready to meet the subjects for our shoot, we’d surrendered everything the prison doesn’t allow — weapons (not that we had any) phones, and any electronic devices. Our photographer had to carefully account for every piece of equipment she had told the prison she would bring along, both before and after the shoot. Then we had to go through metal detectors before we were allowed to make the long trek into the facility. And while most of us have grudgingly gone through weapon searches such as this at the airport, how many of us can say that we do this every day, twice a day, as we make our way to and from the office?

cover stor y working the system

Photos, clockwise from top left: Dr. Jay Jensen of the Washington State Penitentiary at the front gate of the facility, a shot through the razor wire, Dr. Blount shows the long walk to the facility, locks at the facility - bars are a thing of the past at modern prisons.

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Dr. Cassidy Blount · Coyote Ridge Correctional Center

Dr. Cassidy Blount set his sights on becoming a prison dentist.

Actually, he wanted to be a prison counselor first, and was in the process of becoming one when he got accepted into dental school at the Loma Linda University School of Dentistry. And while dental school may seem like a leap from prison counselor, his dad was a general dentist who practiced for 27 years, and his brother is an oral surgeon, so dentistry was very familiar to him. Blount always knew he wanted to work with the disenfranchised - with low-income patients, the homeless, and what he calls “the forgotten population.” Loma Linda afforded him the chance to work on many people in need, and he took it upon himself to do mission work in Nicaragua for two summers through his church, performing extractions and getting people out of pain. This is a guy who was determined to put his money where his mouth was, and right out of dental school, he started working in the prison system.

The appeal of the prison system

We wondered, what did Blount’s father think of him becoming a prison dentist? “He was on board with it, and always thought it was a good idea. He knew it was a good, stable job. Moreover, he knew how much I liked doing oral surgery, even though I never wanted to be an oral surgeon like my brother. I didn’t really want to go to school for another four to six years. I was 31 when I graduated, and I wanted to settle down and start a family. In the prison setting I can do all the oral surgeries I want to, so it’s a good fit.”

There are also tremendous advantages for new graduates working in the system. “We have the loan repayment program, and it’s very stable work. I don’t have to worry about production, and I don’t have to sell anything to anybody. If I’m slow one day, I’m not worried that I’m going to lose money. I can do what I think the patient needs and what is right without having to worry about my pocketbook,” Blount says. “I don’t have to worry about employees in terms of providing enough work for them, either. Additionally, I know there will always be a high need here. I get to help people out of pain every day. If you like doing oral surgery, it’s a pretty stress-free job. It’s challenging work sometimes. I even get to do flaps and remove bone when I have a tooth that just doesn’t want to come out.” As Blount says, “If you want to do cosmetic procedures or crown and bridge all day, this isn’t for you.”

The patient population

At Coyote Ridge, a minimum-to-medium-security prison, Blount sees a lot of meth mouth and neglect. Patients tell him their parents never taught them about oral health, or how to brush.

“Some of the panos I see here, I can’t imagine that general dentists ever see,” he says, “I see two or three pathologies a month, including cysts and drug-related issues that general dentists rarely see. Even my brother says that is a high number.” But Blount isn’t working solo. He has a capable staff of four assistants and a hygienist, and will soon be joined by another dentist and hygienist.

He says, “I believe in hygiene. We have a lot of untreated gum disease in here, and we try and manage that as best we can, but sometimes that feels like a losing battle because the patients aren’t doing their part or the disease is too severe.”

Blount also has an incredible medical support system in place,

should other concerns arise. He says, “I have to be really on top of patients’ systemic health, too. What helps is that our medical staff is really great here. I can look back and see what nursing has been doing with the patient. Sometimes the patients don’t know what medications they’re on, and I can flip their chart to medical and get that information immediately. I have PAs I can refer to if I think there’s something going wrong medically.” Case in point: Blount recently had a patient who wasn’t healing well from his extractions, and he wondered if the patient was diabetic. “I referred him over to medical and sure enough he was. His blood sugar was out of control, and that’s why he wasn’t healing well,” says Blount.

“I feel like I have more medical support here than I would otherwise, nurses, PAs, and physicians who are here and available to me if I need them.”

Scope of practice

Like Rao and Jensen, Blount’s scope of practice is primarily fillings, extractions and dentures, but because of the type of prison he’s working in, there are additional options if the inmate wants to pay. “If they want crown and bridge work, they have to pay for it on their own, and they have to go see an outside specialist.

There are offender-paid health plans, and they are allowed to see outside specialists if they want and can afford it, but if they are in high security at another facility, it may not be an option,” says Blount. “Also, I’ll do some anterior endo if the tooth is restorable with a filling.” To get in the queue, inmates “send a kite,” which is a message to the staff. What they say in the kite determines how quickly they’re seen. If they’re in pain, they’re typically seen right away, but if they just want a cleaning, that will take longer. Blount tries to educate every patient he sees, knowing that for many, this is their first time with a dentist, but it doesn’t always stick. “Every patient I see gets a treatment plan and a conversation about oral hygiene. I have shown the hygienists what I want patients to know about brushing and flossing, and that unless the patients follow the plan, the work we do is pointless because it will fail,” he says. “We go over oral hygiene constantly. Sometimes it works, and sometimes it doesn’t. That’s just how it goes.”

Dr. Jay Jensen · Walla Walla State Penitentiary

Jensen is another one who came to dentistry late in the game.

He was enlisted in the Army and working as an X-ray tech when he and a buddy decided they could do what “those yahoos in the ER were doing.” Together, they set out to attend medical school.

Although his friend changed his mind, Jensen kept after it, even after he got out of the Army. Then one day he ran into a friend who suggested dentistry. Jensen shadowed him and the rest, as they say, is history. Soon after, Jensen went back into the Army and enrolled in the Health Profession Scholarship Program (HPSP), which pays off four years of dental school in exchange for service.

He retired from the Army debt free. He served five years at Fort Riley and Fort Hood, and while he enjoyed the service, it wasn’t a stable life for his family, so he looked into the National Guard.

Fortunately, the state prison system is very supportive of National Guard service. “The state gives me an additional 21 days of paid leave a year for my training. When I go to do my two weeks in the summer, I get paid by the state and the National Guard,” says Jensen. “I’m hoping to go to Thailand with the Guard to do some mission work, education, and some emergency dentistry. They do a trip to Thailand almost every year.”

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of irrelevant, and I try to treat everyone the same. It’s just more straightforward to stick to the tooth.”

IS IT TIME FOR AN INSURANCE REVIEW? USE THIS CHECKLIST As your practice grows, your earnings increase. or your family gains new members, your insurance needs increase, as well. Many dentists forget to keep their insurance coverage in step with their life and business changes, which can leave them in a difficult financial situation if an accident occurs.

Washington Dentists’ Insurance Agency recommends that all dentists review their insurance coverage at least once each year to determine if what they have meets their present and future needs.

Things we’ll cover in your annual review include: • Have you added to your family?

• Are you purchasing or selling a practice?

• Was there any change in your marital status or dependents (children, parents, or other relatives) during the year?

• Should you update your will?

• Have you inherited considerable funds or gifts?

• Do you feel you have adequate life insurance for your practice and family?

• Do you feel you have adequate personal disability insurance to replace your earnings due to sickness or accident?

• Do you feel you have adequate long-term care insurance for yourself, your parents, or other family members?

If you would like to review your current insurance needs, please contact the Washington Dentists’ Insurance Agency at 800-282-9342 or wdia@wsda.org Visit wdiains.com today!

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Jensen grew up in Port Orchard, Wash., and went to dental school at the University of Kansas City, but his family had never been to Washington State. “My wife and daughter came to Walla Walla ahead of me from Kansas and they fell in love with it. We have a joke that there is nowhere you need to go that is more than seven minutes’ travel time away. I live 3 miles from the prison, but it is a world away. Our practice schedule is 7 a.m. to 3:30 p.m., and there is little movement after 2:30 p.m., so our last hour is just paperwork. We usually get a half hour for lunch, maybe a little longer. We handle our emergencies during the day. There are no night calls, and no weekend work, ever.”

However, the work can be grueling, and right out of a dental school classroom, says Jensen. “We can pretty much do anything on the surgical side, as long as we feel comfortable and have the training to back it up. We see proportionally more people with drug-related issues, which can make us a little more jaded. We have patients who come in and say, ‘Yeah, my teeth are bad because I did meth for years, and I just didn’t care.’ The thing that surprises me is how honest they are, and how textbook the damage is,” he says. “They have teeth that look like black apple cores, just the way the pictures look in the textbooks. I thought I was going to be doing a lot of difficult extractions, and I do, but they’re difficult because there is nothing to grab hold of. The majority of the time we’re extracting rotted-out teeth.”

At Walla Walla, the population of 2,500 patients is spread over three campuses. Maximum-security prisoners have one chair and limited facilities, but Jensen says his work there is primarily limited to getting patients out of pain. Another clinic is for close-custody and medium- security prisoners, and has two operatories. That clinic, Jensen explains, is for prisoners with mental issues and those under protection, which also means that movement within the clinic is very restricted. The third, the one we were allowed to see, is a six-op modern facility. Jensen, Rao, and the third dentist working in the facility have a hygienist and four assistants who rotate through the three facilities with them.

Prison service is very different from the Army. Jensen says he performed more extractions in the first two weeks at the prison than he had in the previous two years of Army service. “In the Army we tried to save teeth as often as we could. We called it ‘herodontics,’ and we ended up trying to save a lot of teeth that didn’t necessarily deserve saving, but we had the facilities,” he says. “We had CADCAM units, same-day crowns, and we’d go to extreme measures to save teeth. Here we don’t have those things.

I probably do 15 to 20 extractions a week, on average.” The pace of the practice was another adjustment for Jensen, who says, “I’ve actually had to slow down a lot and be more patient here because our prison has all five levels in it. Because we have a high gang population here, their movements are restricted. WSP is the end of the line for many of our guys. When other prisons in the state can’t handle an inmate, they end up here, so we end up with a lot of guys who can’t get along with anybody, anywhere. Some inmates in the facility have ‘fight on sight’ orders, meaning that if they don’t fight a rival gang member when they see him, their own gang will beat them up. Because of that, we can only see six or seven patients a day, and maybe an emergency. That’s about it.”

Oral health education

be frustrating work. Although the state does allow prisoners to receive cleanings every two years, prison dentists don’t see their patients regularly, and there is no oral health education in the system. When you factor in that, for many of the inmates, this is the first time they have ever been to the dentist, and they are not generally cognizant of basic oral health practices, providers face a steep learning curve. Jensen says. “We talk with them oneon-one a little bit when they’re in the chair, but there is nothing out in the prison. Some of them have never been to the dentist and have no idea how to floss. They have access to floss, it’s the only thing we can give them when they leave, but they have to buy their own toothbrush and toothpaste from the general store.

We have to rely on them to want to take care of their own teeth, and to know how to take care of their own teeth. Oral health is a huge concern for us, but in this prison setting we’re such a small cog that we really have to remind ourselves of our role. Sometimes safety precautions preclude educational opportunities. We definitely shoot for more education opportunities, but it is hard to make that happen in this setting.”

A great opportunity

All three prison dentists we interviewed say they love their work. “They’re new,” joked Hall, as we were finishing up the shoot.

“It doesn’t mean that all of them will change their perspective, but some will.” None feel unsafe at work, saying that having COs present and the proper training went a long way toward alleviating fear. And, as Jensen points out, “When we’re at the max clinic with the life guys who have nothing to lose, they’re cuffed at the wrist and ankles the whole time. For the rest of the guys, most of them are just really working to try to make their life better when they get out, and they don’t want any trouble. They’ve been clean for the majority of the time they’ve been here, and they see that their life isn’t that great.”

The dentists also said the pay and benefits together added up to a satisfactory package that works for them. Rao explains, “The pay is pretty close to what a lot of my peers are making, when you look at the whole package. You obviously can make more money in the private sector, but if you want to work Monday through Friday and live a comfortable life without the stresses of running a private practice, it’s a potential option for dentists.” The loan repayment plan is generous: $25,000 a year for a three-year commitment.

Once the three years are up, the dentist can reapply, work off an additional $75,000, and be close to debt free in six years.

Additionally, all three dentists agree that the retirement and healthcare plans are optimal. All said the other dental staff at the prisons are equally satisfied with their work, and they often celebrate milestones together, just as they would in any other dental practice. Are there downsides? Sure. Jensen and Blount wish they could treat their own family like dentists in private practices, and say being vigilant all the time takes some getting used to. For instance, how many dentists in private practice have to count instruments several times a day, and how many dentists, hygienists, and assistants have to be mindful of their position in an operatory at all times?

Still, these three dentists are proud to work in the prison system, and now that we’ve taken a look inside their world, we can understand why.

Educating prisoners about the fundamentals of oral health can

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Practicing in Walla Walla

pndc news courses the pndc committee won’t miss

2017 PACIFIC NORTHWEST DENTAL CONFERENCE COURSES THE PNDC COMMITTEE WON’T MISS

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Each year, the Committee on PNDC scouts dental conferences across the country to find the most relevant and interesting speakers for the Pacific Northwest Dental Conference. It can be tricky work, as scouts typically only stay for 25 to 30 minutes of a lecture, gauging a speaker’s worthiness by attendance, course content, lecture delivery, and the number of attendees remaining at the end.

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pndc news courses the pndc committee won’t miss

All work and no play makes for a dull conference — Come to the PNDC where you’ll learn and laugh at the same time!

pndc news courses the pndc committee won’t miss

Fortunately, PNDC committee members will often recommend

speakers whom they’ve heard at study clubs and at other conferences or meetings, where they’ve attended the full lecture. For this two-part series, we reached out to committee members Dr. Joseph Luchini, Dr. Chris Lee, and Midge Carstensen, RDH, to find out which PNDC speakers they’re excited about this year, and why.

Dr. Joseph Luchini · An established dentist’s perspective

Dr. Joseph Luchini chose three speakers for this story: Karen Baker, MS, who will speak about “Advances in Dental Pharmacology”; Dr. Frank Milnar, whose lecture is titled “The Illusion of Esthetics With Composite”; and Dr. Gregory Folse, who will discuss “Difficult Denture Patients: Real-World Solutions.” Luchini says, “I have seen Ms. Baker in Spokane two times. Her lecture will focus on the way medications affect the mouth, and she’ll make it very dental-specific.” Baker’s intended audience will be dentists and hygienists, says Luchini, who likes the way she covers the gamut of products. “She’ll cover topics like high blood pressure medications and how they can affect the mouth, but she’ll also talk about everyday products such as mouthwashes and toothpaste,” he says.

“She’s very knowledgeable and a wonderful lecturer, and I’ve always been able to use content from her lecture right away.”

When we asked Luchini why he thought a lecture on difficult denture patients was pertinent in today’s image-obsessed society, he was quick to respond, saying, “Dr. Folse’s lecture is pertinent because not everyone can afford implants. Dentures are still needed in the community, and it’s important to be proficient at it, even though a lot of the work is done by denturists.” As he pointed out, denturists cannot touch teeth, and if a dentist can work from start to finish with patients who need dentures, they may be more

satisfied with the outcome. “I may charge more upfront for a set of dentures, but I put a lot of time and effort into a patient. And while a denturist may be able to fabricate a set of dentures more quickly and economically, it’s a la carte after that. They charge for any adjustments and changes, and that can add up quickly. As a dentist fabricating a set of dentures, all that work is included.” As for the value of this course for young dentists, Luchini says, “Young dentists can absolutely benefit from this because you never know who is going to walk into your office. Not everyone can afford an implant, and your patient may only be able to afford a denture. It is better to be willing and comfortable to offer the service to the patient. It’s a time-consuming process, but Dr. Folse can show us ways to make it less so.”

Luchini is really excited about Milnar’s esthetics lecture because, as he says, “Anterior composites are something we all need to do, and we all want to do better. Anyone can fill a hole, take a color out of our little box and stick it in, and have it look pretty close to the natural color of our patient’s teeth, but the real goal is to make that restoration disappear. The best work simply can’t be seen. We can give patients back something they have lost, and it’s much more economical than a veneer or a crown. There’s some really phenomenal work being done out there, and Dr. Milnar can show you techniques to deliver outstanding results.”

Dr. Chris Lee · Through a young dentist’s eyes

Dr. Chris Lee has been practicing dentistry for a little more than four years, and we were keen to discern what he is most interested in this year. The needs of recent grads are much different than those of someone who has been practicing for decades, he says, adding, “I have school loans. I own my practice now, but I have been an associate, so I understand the pressures that young den-

RECOMMENDED LECTURES Full schedule at wsda.org/pndc-schedule/ Thursday, June 15

8:00-11:30 a.m. · Advances in Dental Pharmacology: How to Maximize Success While Limiting Risk in Everyday Practice - Part 1 · Karen Baker, MS · 3.5 CE Credits · Free with conference badge 1:30-5:00 p.m. · Advances in Dental Pharmacology: How to Maximize Success While Limiting Risk in Everyday Practice - Part 2 Karen Baker, MS · 3.5 CE Credits · Free with conference badge

Link to both courses: http://www.wsda.org/pndc-schedule/?trum baEmbed=view%3Dobject%26objectid%3D990808

8:00-11:00 a.m. · Difficult Denture Patients: Real World Solutions Gregory Folse, DDS · 3 CE Credits · Free with conference badge Link: http://www.wsda.org/pndc-schedule/?trumbaEmbed=view %3Devent%26eventid%3D121909724

8:00-11:00 a.m. · New & More Efficient Ways to Perform Difficult Extractions Karl Koerner, DDS, MS · 3 CE Credits · Free with conference badge

8:00-11:00 a.m. · Simplifying Posterior Composite Restorations: Bulk Fill Flowables and Bioactive Materials Robert Lowe, DDS · 3 CE Credits · Free with conference badge

Link: http://www.wsda.org/pndc-schedule/?trumbaEmbed=view %3Devent%26eventid%3D121909732

Friday, June 16

7:30-10:30 a.m. · The Illusion of Natural Esthetics Frank Milnar, DDS, AACD · 3 CE Credits · Free with conference badge

Link: http://www.wsda.org/pndc-schedule/?trumbaEmbed=view %3Devent%26eventid%3D121909764

8:00-11:00 a.m. · Staging Comprehensive Treatment John Nosti, DMD, FAGD, FACE · 3 CE Credits · Free with conference badge

Link: http://www.wsda.org/pndc-schedule/?trumbaEmbed=view %3Devent%26eventid%3D121909782

Link: http://www.wsda.org/pndc-schedule/?trumbaEmbed=view %3Devent%26eventid%3D121909727

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NEW DENTIST EXPERIENCE Recent graduates can attend for as little as $150 Recent dental school grads (2011-2016 classes) who are WSDA members can purchase a Conference Badge for just $150.* We know starting a career in dentistry can be financially straining, so we want to do all we can to provide an opportunity for you to earn great CE at a very affordable price.

Recent Grad Reception Friday, June 17 from 4:00-6:00 p.m.

Location: TBD The PNDC isn’t just about the CE – there are great chances to socialize, too! Dentists 0-5 years out of dental school or residency are invited to enjoy complimentary drinks and appetizers with friends and colleagues at this event, held exclusively for recent graduates.

Reserve your ticket during the online registration process. *Early Bird price shown.

patients as well, by teaching us how to clearly explain how a treatment plan will benefit patients and help them stay healthy.”

Midge Carstensen, RDH · A voice for hygienists

Midge Carstensen is a hygienist who serves on the Committee on PNDC to help choose the best educators for dental staff attendees, and we’re happy to have her on board. She’s thrilled to recommend Kathy Bassett, RDH, and her lecture “Complimentary and Alternative Local Anesthesia.” Carstensen says, “Do you want to improve your local anesthetic skills? Who doesn’t! Kathy Bassett is a master in technique, and she’s an amazing clinician to learn from. You’ll leave knowing that on Monday morning you can immediately apply these skills with confidence. She’s an amazing lecturer.” Carstensen also recommends Dr. Timothy Hempton’s lecture called “Implant Therapy and the RDH.” She says, “Learning from Dr. Hempton is a privilege for all dental professionals, especially hygienists. He is a periodontist and a clinical professor at Tufts University School of Dental Medicine, and was a close colleague of Esther Wilkins for many years before her passing last December. Dr. Hempton works with hygienists on better understanding the overall management of dental implant therapy maintenance. He will be discussing anatomical concerns, surgical failures, and the role biofilms play in complications.”

Register today!

Not signed up for the 2017 PNDC? Be sure you get the Early Bird rate by registering before April 28. WSDA Member dentists save $100 by registering early, and staff members save $60. Visit wsda. org/pndc and register today!

2017 PACIFIC NORTHWEST DENTAL CONFERENCE Conference: June 15-17 | Exhibits: June 15-16 Bellevue, WA Register here: wsda.org/pndc pndc@wsda.org · (800) 448-3368 PRICING Purchase a Conference Badge and have your pick from 75 lectures. Early Bird prices shown.

WSDA Members: $150-$250 Team Members $140-175 Non-ADA Members: $1,800 COMMITTEE ON PNDC Dr. Carrie York, Chair Dr. C.R. Anderegg, Jr. Dr. Chris Lee Dr. John Lo Dr. Joseph Luchini Dr. Kevin Suzuki Midge Carstensen, RDH

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pndc news courses the pndc committee won’t miss

tists are living with. I bring the perspective of a young dentist to the committee. I see through the eyes of my peers.”

Lee knows that his colleagues have many different resources for CE. “The PNDC is about convenience and good education. You can get nearly all the CE you need in one place, in one weekend.

Between the cost, the convenience, and the quality of the lectures that are available, it’s a great deal,” he says. “Also, dentistry can get lonely, and it’s nice to be a part of organized dentistry and attend a conference with peers and colleagues who are going through the same thing.”

Lee is most interested in these lectures: Dr. Karl Koerner’s “New & More Efficient Ways to Perform Difficult Extractions”; Dr. Rob Lowe, “ Simplifying Posterior Composites”; and Dr. John Nosti’s “Staging Comprehensive Treatment.” He calls Lowe’s lecture “bread and butter,” explaining, “It’s easy to think there isn’t more to learn, so we only practice and improve the techniques we learned in dental school. Since a majority of our time is spent doing posterior composites, learning new and better techniques can minimize a lot of stress, and save a lot of time.” Lee scouted Koerner and Lowe at the Yankee dental conference last January, saying, “They’re both great speakers, and I like their subject matter immensely. It’s not just good content and educational, but their delivery really caught the audience’s attention.” As for Nosti’s lecture, Lee notes that coursework on practice management topics like effective treatment planning often play second fiddle to clinical studies in dental school. He explains, “John Nosti’s lecture on treatment planning is something that every dentist needs. As we get out of dental school and learn more skills, we add more types of dentistry to our practice, which makes presenting treatment plans more complex. This lecture not only benefits dentists, but

member news ser ving nationally

ADA SERVICE: FROM SCIENCE TO ACCESS MEET WSDA MEMBERS WHO HOLD NATIONAL POSTS IN THIS SERIES

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Dr. Mark Koday

At the American Dental Association (ADA), there are 10 councils whose work is to define what the Association does for its members in areas such as advocacy, education, and ethics. Most councils are composed of one member from each of the 17 trustee districts of the Association. All must be active, life, or retired members of the Association in good standing.

Most councils meet twice a year, either at the ADA headquarters in Chicago or the Washington, D.C., office.

The Board of Trustees oversees the Advisory Committee on Annual Meetings, and is charged with conducting the annual meetings of the ADA. The American Dental Political Action Committee is a voluntary nonprofit unincorporated committee of dentists and others. The commissions of the Association are: the Commission for Continuing Education Provider Recognition; the Commission on Dental Accreditation; and the Joint Commission on National Dental Examinations. The Committee on the New Dentist, a standing committee of the ADA Board of Trustees, is charged with providing the Board with expertise on issues affecting new dentists. This committee is also composed of one member from each of the 17 ADA trustee districts.

Single-state districts (such as California) have representation on every council. But in multistate districts, like ours, states take turns providing members for the councils and commissions. Currently, Washington represents District 11 in council positions at the ADA. Nearly all councils and commissions have four-year terms, and are comprised of state and district representatives, along with representatives from the ADA and the Committee on the New Dentist. In addition to twice yearly, two-day meetings, council members are expected to serve on at least one subcommittee, whose business is typically conducted by conference call and email.

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member news tser ving nationally

Dr. Rebecca Slayton

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Dr. Mark Koday · Council on Advocacy for Access and Prevention

Dr. Mark Koday is well known in Washington and Oregon because of his unflagging service to the underserved community through his work at the Yakima Valley Farm Workers Clinic, but he’d never held a national post before joining this council. Koday had his first taste of the political scene when he served on the Dental Quality Assurance Committee (DQAC) in 2001, which, he says, changed his perspective on what it is to be a professional.

He explains, “When I was just here at the clinic, all of the issues were local, so I didn’t get a chance to see what professional organizations like the WSDA and the ADA were all about. At DQAC, I was able to talk with Bracken Killpack, Executive Director of the WSDA, get to know the people at the state dental association, and learn how the work of the association is really critical, and how much they help state dentists.” Koday also marvels at the services offered by the ADA, something he never realized until he began to serve. “What is interesting is that I’m learning more and more about what the ADA does, and the depth of the different activities they are involved in,” he says. “For instance, the work the ADA is doing on behalf of new dentists is amazing. I wish I had them when I was a young dentist. I have the feeling that many ADA members have no idea what the organization does for them and for the profession.”

In his role at CAAP, Koday finds much of what the council focuses its efforts on mirrors the advocacy work he has done at the local and state levels, including advocating for fluoridation and increased Medicaid reimbursement across the country, promoting school based oral health programs and health literacy, and medical/dental migration issues, particularly diabetes, geriatrics, and pregnancy. Koday explains, “It’s better for patients to connect medical and oral health, and in the long run is should be better for the practices, as well. If you can connect dentists with private sector physicians, you can generate more referrals, which is good for business and good for health.” Additionally, one of the duties of council members is to promote the goals and benefits of CAAP at the local level. “We take ideas developed by CAAP, like the Community Dental Health Coordinator (CDHC), and get them out to the state. Council members Drs. Steve Geiermann and Jay Grover got a lot of frequent flier miles because of their work across the country promoting the CDHC program, and that’s just one of the many things they do.”

For his part, Koday has three of his hygienists being trained as CDHCs to work in his organization’s Washington and Oregon practices, and he and Glover have asked a number of schools to add the CDHC training to their programs. Koday sees the position as vital to the system, explaining, “In Yakima County, 67.3 percent of Medicaid children have gotten access to dental care, so private and public health dentists are all doing their job. We have one of the highest Medicaid-use rates in the country. It’s so good that any parent with a child in Yakima County who wants access to dental care can get it. The problem is that 30 percent of the patients have never seen a dentist once, and those are the ones a CDHC can go after and bring into the system. Medical can’t do without case management, but dental has been expected to thrive without it for all of these years, and I think that’s what the CDHCs will change. Additionally, they will help reduce missed appointments. Duties will include motivational interviewing, how to promote health, how to work with various agencies, and how to set up referral systems.”

When the CDHC position first rolled out, Koday wasn’t convinced it would amount to much, especially when one of his hygienists asked to take the training. “The next time I saw her, I couldn’t believe how excited she was about the education she was

getting in the CDHC class. She’s finding it useful for patients in the clinic when she’s promoting oral health,” says Koday. “You get some of the material in dental school and hygiene school, but not to the degree that you get in these courses. They’re pretty intense.”

He’s a firm believer in the program now.

In addition to his work on CAAP, Koday is the chair of the medical committee, but that group has yet to meet, and he will serve as CAAP’s representative on National Quality Dental Alliance, the group that develops dental metrics. When asked if he would consider another national post following his service on CAAP, Koday says, “This will probably be it for me. By the time I am done, I will be ready to retire, but I couldn’t think of a better way to end my career. It is really fulfilling!”

Dr. Rebecca Slayton · Council on Scientific Affairs

Dr. Rebecca Slayton is the Energizer bunny of national service and work. She’s currently serving the last year of a four-year term on the Council on Scientific Affairs, and is also the chair of the American Academy of Pediatric Dentistry’s (AAPD) Scientific Program Committee. She previously served on the AAPD’s Council on Scientific Affairs, and was on the Examination Committee of the American Board of Pediatric Dentistry, and a site visitor for the Commission on Dental Accreditation (CODA). Slayton had all of these responsibilities while working in academia. She was the Chair of the Pediatric Dentistry department at the UWSoD, served as the Director of the Dental Department at Seattle Children’s Hospital, and was the associate dean for graduate studies at the UWSoD. Slayton explains, “I do better when I’m busy. You know what they say, if you want to get something done, find someone who’s busy, because busy people know how to balance things.” Currently semiretired, Slayton is the Director of the Dental Department at Seattle Children’s Hospital, where she works with our editor, Dr. Mary Jennings.

Slayton is passionate about the work of the council and calls it one of the most important councils of the ADA, because its goal is to stay up-to-date on scientific findings, working with evidencebased science to define clinical guidelines for the dental profession.

She explains, “One of the things I appreciate about being on the council is that nearly every specialty is represented. Since most of my career has been spent focused on pediatric dentistry, service on the council broadens my horizons by allowing me to interact with prosthodontists, periodontists, and endodontists, who all have different views on things. It helps me to see the bigger picture. But then it’s good for pediatric dentists to be on the committee, too, because we can remind people that children are not just little adults, they function differently.” Slayton serves on two of the council’s subcommittees. One handles the ADA Seal of Approval program, and the other is tasked with focusing on cariology and creating guidelines related to caries management, which she chairs.

Slayton values the work of the subcommittees because they have been highly effective. She says, “If there is a topic that comes up that people have a question about, like oil pulling or something else that has been in the news, individuals on the CSA can work with staff at the ADA to gather information about the topic, and publish their findings in the ADA magazine and elsewhere. Additionally, we’ve been helping the ADA update their web content.

Nothing ever moves as fast as we would like, but I feel like the work the councils are doing is effective, and we have a strong voice in the ADA. We’re not window dressing. The ADA values science, and the voice of the people on the committee.”

Beyond that, Slayton has gained a newfound respect for the work of the ADA, saying, “Serving helped me develop an appreciation for what the ADA does. My council is only a small potion of what it does. I’ve always believed it was important to be a member of the ADA because it represents out profession, but I never really knew about all the things the organization did, and this has given me a little more insight into at least this part of it. Working with other specialists who are dedicated to the profession and good science to support the profession is really enjoyable.”

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member news tser ving nationally

The WSDA News recently spoke to two WSDA members who are serving national posts: Dr. Mark Koday, who serves on the Council on Advocacy for Access and Prevention (CAAP); and Dr. Rebecca Slayton, who serves on the Council on Scientific Affairs (CSA).

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ACROSS THE STATE Want to be included in this listing? Send your component society or study group listing to Managing Editor Rob Bahnsen at rob@wsda.org.

Mount Baker District Dental Society March 14 Dr. Jacob Burry Modern Endodontic Techniques Max Dale’s, Mt Vernon

April 11 Matt Babick · Fraud Prevention BG&CC

May 9 TBA

Pierce County Dental Society Upcoming Meetings

Register Online At: www.pcdentists.org All General Membership Meetings: 2 CE Credits, Cost: $41.00 (meal included)

March 21, 2017 Brad McPhee

March GMM Tacoma Country & Golf Club

April 18 Dr. Steve Hannon

April GMM/ Installation of New Officers Tacoma Country & Golf Club

April 28 Lois Banta, Staff Appreciation and Casino Party

Emerald Queen Convention Center 1425 E. 27th St., Tacoma, WA 98421 253-274-9722

Seattle-King County Dental Society April 25

Annual Officer Installation and Member Recognition event Dr. Bernard Larson · Dr. Sherwin Shinn Location: Salty’s on Alki, 1936 Harbor Avenue SW, Seattle, WA 98126 (206) 937-1600 Sponsored by: WDIA

May 12 Management of The Fearful Dental Patient; Drugs, Death and Dentistry featuring Dr. Stanley F. Malamed, DDS The Fearful Dental Patient - a.m. Session

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Drugs, Death and Dentistry - p.m. Session Bellevue Westin Hotel, 600 Bellevue Way NE, Bellevue, WA 98004 (425) 638-1000 Sponsored by: Washington AGD, SKCDS and UW SOD

Snohomish County Dental Society

Contact the SCDS office for more details or to register for any meeting. All SCDS General Membership meetings are held at the Mill Creek Country Club starting at 6 p.m. with a Social Hour, followed by dinner at 6:45 p.m. and a one hour CE program. at 7:30 p.m.

March 15 Dr. Dolphine Oda · Oral Pathology, TBA SCDS General Meeting Mill Creek Country Club

April 19 Dr. Rhonda Savage · Dealing with Difficult People

SCDS General Meeting Mill Creek Country Club Joint meeting with Snohomish Co. Dental Hygiene Society Dentists and staff welcome to attend.

April 28 BLS for Healthcare Providers & First Aid Courses Presented by I Know CPR

I Know CPR, Everett Advance Registration Required.

Contact the SCDS office.

May 17

SCDS General Meeting

WSDA President, Dr. BJ Larson · WSDA Update & Current Issues

Washington State Dental Association June 15-17

Pacific Northwest Dental Conference

Three days · Up to 24 CE Credits Visit wsda.org/pndc

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Spring is approaching, and that almost always conjures up thoughts about new beginnings, and tackling projects or new goals. With winter and the holidays behind us, we’re back into our normal work routine. There are dental society meetings to plan for and conferences to attend.

Maybe you’re hiring new staff, or considering adding more equipment to the practice. Wherever you stand, there are always a couple of things to keep in mind when thinking about your practice.

First, how current is your Business Owners Policy? When was the last time you did an equipment inventory, and do your policy content limits accurately reflect what it would cost to replace your equipment if you had a loss? I can’t tell you how common it is to find that a dentist is woefully underinsured for office coverage. For example, we find that, on average, it costs roughly $90,000 to replace an operatory, including plumbing, electrical, and equipment. You should also factor in phone systems, computers, hand tools, office buildouts, art, furniture, supplies, and books.

If you’re unsure about your coverage, ask

your insurance representative to review your policy with you. Updating your policy is a simple process, and you get peace of mind of knowing you’re prepared, just in case.

If you’re hiring new staff, how up to date is your operations manual? Adding new staff also means making sure you’ve done additional HIPAA training. To be HIPAA compliant, annual staff training is required. It must be done more frequently if you’ve hired new staff, the laws change, or your practice protocols change. For all trainings, make sure you document the topic discussed, the date, and who was present.

And speaking of HIPAA, the Office for Civil Rights has made it perfectly clear that it is stepping up its efforts to conduct more random practice audits. If you haven’t started assessing and addressing practice vulnerabilities, I encourage you to start today. NORDIC offers its customers a free HIPAA Compliance Packet, which includes current forms and a step-by-step process for making your practice HIPAA compliant. For more information, please contact

Melissa Moore Sanchez Manager, Sales and Marketing NORDIC

Melissa Sanchez at Melissa.Sanchez@nordicins.com.

Besides offering patient care, a dental practice includes business decisions that should be reviewed from time to time, and modified, when appropriate. Take advantage of the business relationships you already have. Partner with them when you need another perspective and don’t particularly want to reinvent the wheel. Your malpractice carrier should be one of those resources because you already have enough on your to-do list.

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nordic news spring is here — what’s on your to-do list?

What’s on your spring to-do list?

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give kids a smile snohomish county toothapalooza!

Snohomish County Toothapalooza!

Each year the Snohomish County Dental Society spends the month of February holding events for kids and distributing dental health goody bags with toothpaste, brush, and floss.

This year, SCDS distributed 3,000 goody bags, and hosted the popular “Toothapalooza” event with the Imagine Children’s Museum in Everett, WA. on February 17. One thousand people attended the event and SCDS members did screenings on 400 kids! Congrats SCDS, on this enduring favorite event!

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On February 3, 2017, Dr. Judson Werner’s office partnered with the Boys and Girls Club of Bellevue to host the 13th annual Give Kids a Smile Day. Dr. Werner & his staff of volunteers donated their time and $4,900 worth of dental care to help 14 kids get free dental exams, cleanings, fluoride, and fillings. Good work!

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give kids a smile dr. judson werner

Give Kids A Smile · Dr. Judson Werner

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PROTECTING YOUR PRACTICE ONLINE

Special to the WSDA News

by Tyler Carter, Product Manager, Sesame Communications

Introduction

Today’s patients are educated, tech savvy, and expect a certain level of privacy to be maintained when browsing the web. According to the Privacy Rights Clearinghouse, the healthcare industry experienced a 272 percent increase in data breaches from 2015 to 2016.1 So how can you instill a level of trust online equal to what your patients experience while in your office? Start with SSL certificates. SSL certificates cost anywhere from $50 to more than $600, depending on the level of certificate. At Sesame, we use Let’s Encrypt, which is supported by Google. Dentists need an SSL certificate to strengthen security, build trust with their patients, and boost their SEO rankings. Members who purchase a website through Sesame receive a complimentary SSL certificate.

What is SSL?

SSL, or Secure Sockets Layer, is a secure protocol that encrypts data between a client and server to help ensure the integrity and confidentiality of the shared data. SSL is an industry standard that is deployed on millions of websites. SSL keeps data shared between the client and server encrypted, and requires decryption of the data before the information can be read. Typically, the data transferred between the client and server is in plain text using Hypertext Transfer Protocol (HTTP), which allows for “bad actors” (malicious users) to eavesdrop on the session and potentially steal personal information. When an SSL certificate is installed, all connections to the website occur on Hypertext Transfer Protocol Secure (HTTPS), protecting the data transmitted and preventing bad actors from malicious activity.

How SSL works

Think of when patients visit your practice. The first thing they need to do is identify themselves by presenting their ID. Your staff member views the ID, verifies it is the correct patient, hands back the ID, and begins communicating about treatment. The same process occurs online. The browser used by your patient asks the server to identify itself. The server then provides the browser with a copy

of its SSL certificate, which the browser validates. Once this verification process is complete, communication between the two parties is encrypted, and a secure connection is established over HTTPS.

Why use SSL?

SSL provides your website with a professional look and improves the performance of your website by taking advantage of next-generation technology. Adding an SSL certificate to your practice website will: • Strengthen security: SSL provides a secure, encrypted connection between your practice website and your patients.

• Boost SEO: Sites with a valid SSL certificate rank higher in Google search results.2 • Enhance trust: A green lock icon provides a visual indicator in the URL bar that visitors will see and feel confident in while navigating your website.

SSL provides a secure, encrypted connection to your practice website, provides a boost to your SEO rankings, and assures your patients that their personal data is safe. As threats continue to rise, and patients continue to demand a higher level of security for their personal information, SSL will become even more critical for your practice website. Contact your hosting provider or Sesame today to find out more about what an SSL certificate can do for your practice.

1. http://searchengineland.com/google-starts-giving-ranking-boost-securehttpsssl-sites-199446 2.https://www.privacyrights.org/data-breaches?title=&org_ type%5B%5D=258&taxonomy_vocabulary_11_ tid%5B%5D=2257&taxonomy_vocabulary_11_tid%5B%5D=2122

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SSL AND YOU:

clinical corner issue 4, march 2017

CLINICAL CORNER Left mandible, lingual-exophytic radiopaque lesion Contributed by

Drs. Srinivasa R. Chandra and Randy Eggert of Harborview Medical Center, and Redmond Oral and Maxillofacial Surgery.

History of present illness

This is a 28-year-old Caucasian male who presented with an exophytic lingual plate expansion in the left posterior mandible (Figure 1). The panoramic radiograph demonstrates a well-defined exophytic radiopaque lesion protruding into the floor of mouth and measuring approximately 4 X 2 cm. The lesion had grown gradually since the patient was 13 to 16 years of age, and has not been accompanied by pain or bleeding. The associated teeth are vital. The lesion was surgically removed, and recurred within a year (Figure 2). The patient denied any past history of trauma to the area.

Figure 1

Test your knowledge!

Visit https://dental.washington.edu/oral-pathology/case-of-themonth/ and see if your assessment of the case is correct.

Figure 2

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L to R: Diane Meyer, Dr. Bob Meyer, Dr. Roger Lutz, Kari Hall, Dr. Steve Albright, author Paula Cipolla

Special to the WSDA News by Paula Cipolla My knuckles gripped and tightened the rain poncho hood knotted under my chin in an effort to block the insistent rain against my face. My husband, Steve, edged up against me for support (his or mine, I wasn’t sure). Bobbing, thrashing up and down, we inched forward in our modest outboard, the storm like a whip battering some rebellious insurgency inside its realm. With us on this adventure were Dr. Bob Meyer, Colorado Dental Society’s Executive Director, his wife and dental assistant, Diane, and our photojournalist, Kari Rene Hall. One thing was for sure: This wasn’t the Fiji I had expected.

How we happened to be in the midst of this tumultuous cyclonelashed weather began with a rather impulsive decision about six weeks earlier. Our story was reminding me more of Hemingway’s “The Old Man and The Sea,” and less of those idyllic postcards of sunshine rising over Fijian bures (traditional straw huts) in sapphire-blue waters.

After a rain-lashed workweek, we departed the remote island of Rabi (pronounced Rambi), part of the Fijian chain, but whose inhabitants are not Fijian. Theirs is an interesting history, which begins on Ocean Island in the Pacific Ocean, 1,300 miles away, just west of the Gilberts. Phosphate discovery and its subsequent mining by the British forced the 1,000 Banaban-Gilbertese to agree to a relocation plan to this distanced island of Rabi on Dec. 15, 1945. Environmentally and climatically different, adjusting here was a hardship. It was and remains far removed from modern, technology-driven society. By invitation only, it appears that’s how the residents wish it to continue. Life here is extraordinarily basic.

For decades Steve, a dentist, and I have provided dental care

around the globe,, mostly in Guatemala. In non-Spanish-speaking situations, I am his designated dental assistant. Each trip is an escapade, an opportunity to enlighten myself about other cultures, while, at the same time, act as an unofficial goodwill ambassador from the United States.

The timing of this trip, intentionally coinciding with Rabi’s 71st commemorative celebration of the arrival of its ancestors, was the idea of our group leader, Roger Lutz, the local coordinator for the nonprofit Jabez Humanitarian Foundation.

Despite the weather throwing a wrench into our plans, we managed to provide care to 100 patients that week, performing extractions, fillings and/or combinations thereof. In exchange, our cultural experiences were numerous. We learned about the kava plant’s medicinal and ceremonial significance, and drank the root mixture from a bowl carved from a coconut husk. Another local offered me a swig of sweet sappy syrup extracted from a palm tree via an elaborately roped contraption he had concocted around its branches.

The locals arranged a special ceremony in our honor on our last day. Crowned with floral headdresses, we were entertained by exuberant dancers and lulled by musicians singing nostalgically of their homeland. We were humbled by this expressive gift.

The jovial “bula” (hello) was ever present during our stay, and our dental project allowed us a glimpse into everyday life in a place we could never have imagined.

And, if the tempestuous tidewater sucked at us during our departure, perhaps it wasn’t akin to Homer’s Sirens in “The Odyssey,” intending to bring us to a watery grave, but rather, a kavainduced Banaban plea for us to relax and stay awhile.

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volunteer news volunteering in rain-swept fiji

Dr. Steve Albright and Paula Cipolla in Fiji

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OPPORTUNITIES AVAILABLE

OPPORTUNITIES AVAILABLE

DENTIST NEEDED — Growing general dental offices are seeking caring, competent dentist with great people skills to join our team at greater Seattle area.

Excellent opportunity for potential partnership.

Please email resume to mydental88@gmail.com.

DENTIST NEEDED WITH PARTNERSHIP OPPORTUNITY — Busy practice in tri-cities is looking for a FT general dentist. Must be comfortable performing all aspects of general dentistry. 2.5 million annual production. Very competitive compensation with buying/partnership opportunities.

Email chencsee@gmail.com

DENTIST NEEDED — Great general dentist opportunity, close to downtown Seattle, new state of the art clinic. Experienced support staff including restorative hygienist. Group practice with oral surgeon and orthodontist co-treating. $150,0000 minimum guarantee or 30% and opportunity to earn well above $200k. Full benefits. Mix of children and adult patients. Must be friendly, team oriented, motivated, and have a good chair-side manner. Please email jbabka@applesmiles.com for more information.

DENTIST NEEDED — Potential ownership in Eastern Washington. FT associate position available to start immediately. Fast growing family practice in Kennewick. Very competitive pay with daily minimum guaranteed. kennewickdentistassociate@ gmail.com DENTIST NEEDED — Seeking skilled dental associate with 2+ years experience. 3-4 days/week for a general practice. Offices in Lynnwood / North Seattle. Must be able to work on Saturdays. Please send resumes to dentaladsml@gmail.com.

PROMINENT DENTAL PRACTICE — Spokane Washington looking for full time associate. Enthusiastic, hard working dentist desired. Seeking an ideal candidate that is highly skilled, dedicated to providing unmatched patient care and desiring a long term commitment to the practice. Applicants can expect to perform all aspects of dentistry including: root canal therapy, crown and bridge, oral surgery, general restorative and much more. Great pay and benefit. Ownership options available.

Please send resume: employment@sleepdentistryspokane.com visit: sleepdentistryspokane.com.

ISSAQUAH ASSOCIATE — Associate position available to start immediately working Tuesdays with hours 7-5, and 2 Saturdays a month 8-2. More days available in future. Doctor will be working in a family practice with the ability to practice as one desires and is capable of. OS, Endo, Perio, Pros, Rest patients/ cases to work with. Send resume to dr.howey@hotmail.com.

MULTI-SPECIALTY GROUP PRACTICE OPPORTUNITIES — At Willamette Dental Group, we believe that health is preventing disease, not just treating it.

When you work at Willamette Dental Group, the organization’s progressive approach frees you to do what matters to you – and to your patients. What makes this multi-specialty group practice unique is a commitment to proactively facilitating the best possible health outcomes. We currently have openings in Oregon and Washington for General Dentists, Endodontists, Oral Surgeons, Pediatric Dentists, and Locum Tenens Dentists, and offer competitive guaranteed compensation, benefits, paid vacation, malpractice insurance, inhouse CEs, and an in-house loan forgiveness program.

Please send your resume to Kelly Musick (kmusick@ willamettedental.com) and visit www.willamettedental.com/careers to learn more!

DENTIST NEEDED — Part-time dentist for national claim Review Company. Work from your home or office. Must have clean active Washington dentist license. Seeking dedicated individual, please submit resume PRDentalLLC@gmail.com or fax 212-471-9973.

GENERAL DENTIST, SUNNYSIDE — Full time position. Work beside specialists. Offering a great schedule, great compensation and guarantee. Great opportunity to expand skill set as you work or a perfect opportunity for an experienced dentist to utilize a wide range of skills. For more information, please contact Jolene Babka at jbabka@applesmiles.com.

GENERAL DENTIST ASSOCIATE POSITION — Option to buy. Existing DDS with is looking to be retired within the next year or sooner. This private practice (30+ year patient base) is open Mon-Thurs (Mon-Wed 8-5, and Thurs 9-3). Prefers someone with at least five years of experience. Part time to start, (3 days) building into full time. Substantial patient base! Salary DOQ. Email: lori.leonarddds@outlook.com.

LOCUM TENENS — Family dental practice, in the heart of Ballard, seeking a temporary dentist to cover my maternity leave, April 17th-August 31st.

Please send CV to jenniferohsiedds@live.com

SPOKANE — Seeking full-time general dentist, able to work a varied shift schedule including weekends; must be able to do all aspects of general dentistry including molar endodontics and 3rd molar/surgical extractions; able to adapt to new systems and paradigms; great opportunity to grow and learn; 1-5 years experience preferable. Unlimited income potential! Send resume to Dr. Bradley J. Harken; bradharken@hotmail.com.

ASSOCIATE OPPORTUNITY, YAKIMA — We have a great associate opportunity for a new graduate or a long term home for a seasoned dentist looking to be compensated well with less of the headaches and stress. Group practice composed of general dentists, orthodontists, and oral surgeons. For new grads it’s the perfect opportunity to learn your craft by working side by side with generalists and specialists while being paid very well. Base salary of $150,000 for new grads plus bonuses. Base salary of $175,000 plus bonuses for experienced dentists. Opportunities to earn much more with our full schedules! Both positions have the opportunity to earn well above $200,000. Full benefits package. State of the art clinics and equipment. Mix of children and adult dentistry. Mix of State and private insurance. Full time opportunity available. Moving expense reimbursement offered.

Please send inquiries to jbabka@applesmiles.com.

DENTISTS NEEDED — Dental Professionals is recruiting dentists for temporary and permanent positions throughout western Washington – Vancouver to Bellingham and the Olympic Peninsula.

No fee to you and you pick the days and geographic locations that you are available to work. This is a great opportunity to earn supplemental income or find a permanent position. If interested please call Bob at (206) 767-4851.

PART TIME ENDODONTIST — Looking for a parttime Endodontist to work a day or two day a month.

Nice modern office located in Bothell Area. Please respond with resume to bellevuedentists@gmail.com.

PERIODONTIST NEEDED — Large private group practice in brand new state of the art building looking for part time periodontist in Silverdale, WA. Digital office with CBCT. Thriving practice in need of a specialist to come in 2-4 days per month. Please send CV to silverdaledental@hotmail.com.

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FULL-TIME ASSOCIATE IN BELLEVUE — We are looking for full time associate in Bellevue to work 4+ days a week . We are a top office in our area. Beautiful modern office with state of the art technology. Fantastic patients and team. Fully digital. Must be highly skilled and experienced.

Ready to learn and be a part of the team. Outstanding earning potential. Please email resume to bellevuedentists@gmail.com.

DENTIST NEEDED — Join our mission driven team of ten dentists and well trained support staff in providing quality, comprehensive general and restorative dental care to our patients. 4/10 hour workdays provide a good life work balance and the opportunity to enjoy the areas recreational activities with your family. Comprehensive benefits, sign on bonus, Employer match 401(k), relocation, generous paid leave and CDE. HPSA score 23. Potential for loan repayment. Start date: September 2016. For more information contact : Colleen Hazel, PHR, HR Generalist / 509.764.6105/chazel@mlchc.org. Or visit our website at www.mlchc.org to apply online.

DENTIST NEEDED — Yakima Neighborhood Health Services (YNHS), a Community Health Center in Central Washington State, is looking for a full time dentist to serve low income and underserved individuals and families in a new dental clinic in Granger, WA. Provide full scope preventive and restorative care all ages, six months to elderly. YNHS is an eligible site for National Health Service Corp and Washington State Health Professional loan repayment programs. YNHS also has a special focus to serve the homeless of Yakima County. Dental providers work alongside committed HCH staff to care for high needs homeless individuals. Full time for providers is 40 hours per week. YNHS offers a competitive compensation package, inclusive of malpractice coverage, paid leave, CME, retirement / life / disability. See our website at www.ynhs.org for the breadth in our services and diversity in our staff. We are looking for individuals who share a sense of compassion for the underserved, and passion for quality.

GENERAL DENTIST, TRI CITIES — Great associate opportunity for a new graduate or a long term home for a seasoned dentist looking to be compensated well with less of the headaches and stress.

Group practice composed of general dentists, orthodontists, and oral surgeons. For new grads it’s the perfect opportunity to learn your craft by working side by side with generalists and specialists while being paid very well. Base salary of $150,000 for new grads plus bonuses. Base salary of $175,000 plus bonuses for experienced dentists.

Full benefits package and moving allowance. State of the art clinics and equipment. Mix of children and adult dentistry. Mix of state and private insurance. Position available in coveted Pasco, Washington facility this Spring. Please send inquiries to jbabka@applesmiles.com.

classifieds issue 4, march 2017

OPPORTUNITIES AVAILABLE

Membership

Make sure to renew your WSDA membership for 2017!

The January 1 deadline to renew your membership by mail or fax has now passed. You may still renew your membership by credit card quickly and easily online at wsdasource.org or by calling us directly at (206) 448-1914.

Please note that if you have recently retired or plan to retire before March 31, 2017, you must contact Rachal Gunderson at (206) 973-5210 or at rachal@wsda.org to update your membership status.

Please contact Rachal Gunderson to request waivers for both disability and financial hardship, or to inquire about reduced dues if you are an active life member making less than 50 percent of your income from dentistry.

Contact Rachal Gunderson at (206) 973-5210 or at rachal@wsda.org with any questions regarding your annual membership dues.

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GENERAL DENTIST REQUESTED, MAPLE VALLEY — Our multi-doctor, family practice is looking for an outgoing, professional doctor skilled in all aspects of dentistry to join our team. Our beautiful, modern office has been providing excellent dental care to our ever growing community for over 10 years. We offer a generous compensation package along with the opportunity to work with an established, efficient and personable team.

Please email your resume to wendyloconnell@yahoo.com or you may fax it to 425-413-8599.

DENTIST OPPORTUNITY IN WESTERN 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.

GENERAL DENTIST, SPOKANE — We have a great associate opportunity for a new graduate or a long term home for a seasoned dentist looking to be compensated well with less of the headaches and stress. Group practice composed of general dentists, orthodontists, and oral surgeons. For new grads it’s the perfect opportunity to learn your craft by working side by side with generalists and specialists while being paid very well. Base salary of up to $150,000 for new grads plus bonuses.

Base salary of $175,000 plus bonuses for experienced dentists. Opportunies to earn much more with our full schedules! Full benefits package and moving allowance. State of the art clinics and equipment. Mix of children and adult dentistry.

Mix of State and private insurance. Full time and part time opportunities available. Moving expense reimbursement offered. Please send inquiries to jbabka@applesmiles.com.

GENERAL DENTAL PRACTICE — Central WAHighly Visible, well-established Ellensburg practice for sale. Over 25 years of a great reputation and goodwill. The office is located in a single occupancy building on a prominent intersection with long term lease options. There is an amazing team that is committed to a successful transition.

Collections averaging $80K/month, low overhead, productive hygiene department and excellent systems. The owner does not practice; an owner/practitioner would have solid upside potential. Great opportunity to retain specialty procedures in the practice. Seven treatment rooms, pano, digital x-rays, and intraoral cameras and Dentrix. Only Qualified buyers please. Contact Susan at 509962-2755 or MVDC@fairpoint.net.

OPPORTUNITIES WANTED POSITION WANTED — Successful practitioner/owner for almost 30 years. Currently seeking non-ownership dentist position. Part or full time. Willing to learn/adapt to established office protocol. drive.google.com/ file/d/0BxyJ9WnvqXMSOXB3azVhWXBHVGc/ view?ths=true.

OPPORTUNITIES WANTED

OFFICES FOR SALE OR LEASE

PART TIME POSITION WANTED —Dentist with advanced training, based in Lynwood area, seeking part-time employment, 1-2 days a week.

Willing to make a reasonable commute. Flexible on days, Saturdays are an option. Please contact dentalcare855@gmail.com.

FOR LEASE — 2500 SF brand new retail space ideal for oral ortho/Oral surgeon, hard corner with traffic lights in Mill Creek. Retail is part of a new housing project with over 350 apartments. High growth area. General dentist and pedodontist moving in soon. Inquiries@ parmpal32@hotmail. com or call 425-442-9798.

OPPORTUNITY WANTED — University of Washington RIDE graduate looking for a part time associate position in the Seattle area. View my CV here: https://docs.google.com/document/d/1Lo34mcSje oNOakGekjmGrqQFXHlbP-GIfU3zT9t5Glg/pub.

OPPORTUNITY WANTED — 2016 University of Illinois Chicago, College of Dentistry graduate looking for a general dentist position in the Seattle area. View my CV here: http://drive.google.com/op en?id=0B6blGvDOSE36NTFOckdwY2lDME0.

ASSOCIATESHIP — Seeking Associateship in Whatcom County-Graduated from Tufts University School of Dental Medicine, 2016. View my CV here: drive.google.com/file/ d/0BxLG0RUgFDpnUlNNamNqdF9vbDg/view.

OPPORTUNITY WANTED — 2016 USC graduate looking for an Endodontist position in Endodontic office or GP office. View my CV here: docs.google. com/document/d/1363Zn09JEFt8Jfxw1AlTfDpfU GZKBgBR0VgMMDaMuFs/edit?usp=sharing.

OPPORTUNITY WANTED — 2016 Roseman University Of Health Sciences graduate looking for a general dentist position in Washington. View my CV here: http://drive.google.com/file/d/0B4KsU4tgzcZRnRselIzWHVyMm8/view?usp=sharing.

OPPORTUNITY WANTED — 2017 University of Pittsburgh School of Dental Medicine graduate looking for a general dentist position within 30 miles of Seattle. View my CV here: https://www.scribd.com/document/339699684/ Resume-Smriti-Madrecha?secret_ password=lSKuVegqZIA6bMM6os3G OFFICES FOR SALE OR LEASE FOR SALE OR SUBLEASE — Attractive, fully equipped, modern five operatory dental office in UW/Laurelhurst area. Exceptionally well-designed, and maintained – 1900+ sf office with separate consultation op, sterilization room, private office for two DDS, handicap bathroom, full laboratory for technicians, and staff room. Attractive 3rd floor location provides excellent natural lighting in every operatory. Sale includes all dental and office equipment (dental chairs, lights, units, handpieces, instruments, x-ray equipment, office furniture and built-in cabinetry throughout, plus everything else that makes this office “Truly Turnkey”. Office appraised above $250,000; listing for $210,000 and open to all offers. Excellent value for relocation of established DDS or starter office for new grad. Email rleemfp@gmail.com for photos and additional information or call/text 206 949 2958.

GENERAL DENTIST OFFICE FOR SALE DOWNTOWN SEATTLE — Premier 30 years established, 10 Operatories, 4 hygienists. Cerec, CBCT, ITero, Solea, Microscope, Digital, Paperless. Bright modern office in heart of the city. Wonderful experienced staff. Strong Implant and Surgical component. Premier Invisalign Provider. In-office lab. Will transition if desired. Please contact: k1100rs@icloud.com.

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GENERAL PRACTICE FOR SALE, South King County — Large, profitable multi-disciplinary practice. Digital radiography,I-V sedation, separate digital pan/lateral ceph, CBCT, CEREC. Approximately 5,000 sq/feet. For more information contact: Jennifer Paine: (425) 216-1612 or Jennifer@ cpa4dds.com GENERAL PRACTICE FOR SALE, Renton — Lovely, nice-and-bright general dental practice in Renton. Near Valley Medical Center with great visibility from high volume traffic areas. four operatories. Approximately 1,255 sq/feet. Collecting $801K. For more information contact: Jennifer Paine at (425) 216-1612 or email Jennifer@ cpa4dds.com GENERAL PRACTICE FOR SALE, South of Seattle/Burien — Well-established practice located in charming, renaissance-area of Burien. Collecting $389K. 1,298 sq/ft. approximately. Four fully-equipped operatories. DSN, digital radiography, nitrous. For more information contact: Jennifer Paine at (425) 216-1612 or email Jennifer@ cpa4dds.com GENERAL PRACTICE FOR SALE, Snohomish County — Outstanding Snohomish County general practice collecting $900K. Referring out ortho; oral surgery; advanced perio and most endo.

Three operatories w/stereo headphones-room for expansion. Digital panoramic machine, intra-oral photography, computerized injection machine, air-abrasion, nitrous. Building available for lease or sale-by-owner. For more information please contact: Jennifer Paine at (425) 216-1612 or email Jennifer@cpa4dds.com GENERAL DENTAL PRACTICE FOR SALE, Shoreline/Seattle — Profitable 3-dr-day/week opportunity. Maintain 3-day schedule or expand to full-time. Add strategic marketing program to increase new patient flow. Collecting $463k.

Three fully-equipped operatories w/x-ray (4th op possible with remodel). Approximately 1,080 sq/ ft. Building available for lease or sale-by-owner.

Digital radiography, nitrous, rotary endo, lab/sterilization room. For more information contact: Jennifer Paine at (425) 216-1612 or email Jennifer@ cpa4dds.com GENERAL PRACTICE FOR SALE, South Snohomish County — Fantastic visibility within close proximity to aerospace giant. Collecting $625K. Three fully-equipped operatories. Lab. 1,000 sq/ ft (approximate). For more information please contact: Jennifer Paine at (425) 216-1612 or email Jennifer@cpa4dds.com FOR SALE: So. ARIZONA “Scale up or scale down.”

Rural setting, gross average collection $381K (last three years). Schedule 10 days/month. Zero insurance claims, two ops. with one more plumbed.

General dentistry, two staff members, hygienist.

Patient base mostly seniors Check: tubacdental@ yahoo.com Inquire: waanabe@hotmail.com Investment: $180K.

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OPPORTUNITIES AVAILABLE

first person dr. john evans in memoriam magee, webber

first person, continued from page 50

and they require different approaches.

What does not change is the patient’s need to express his or her loss and frustration.

“Why did this happen to me?” is always the main question. This is soon followed by “What can we do about this?”

Answering these questions takes time, a quiet space, repetition, and patience. Be prepared and do your homework. Know the facts and schedule adequate time. Permanent loss of normal function in a part of the body as frequently used as the mouth and the dentition is a big loss.

Regarding the legalities involved, I try to avoid giving legal advice. I make it clear that the law is not my area of expertise.

Nonetheless, expect to be asked if mistakes

were made. This is a difficult question to answer much of the time. Occasionally, it is not, and being honest with patients is the correct course. You can see what I mean when I say these are difficult conversations.

Hospitals appoint teams of professionals who practice the skills necessary to disclose professional errors with compassion and honesty. We must not hurt our patients further by hiding behind professional jargon and half-truths. We are ethically obliged to disclose our professional errors, as well as those of others, to patients. We are also obliged to do it well. It is, at this point in the evolution of our profession, a necessary part of professional practice.

in memoriam Dr. Dail W. Magee

Dr. Dail W. Magee passed away on March 22, 2015, in Vancouver, Wash. He was born in Michigan, and spent his childhood in Florida and New Mexico. Magee enlisted in the Army during the Korean War, and served as an X-ray technician. He met the love of his life, Marlene Hansen, in Angwin, Calif., in 1950. They married in March of 1956.

Magee attended Pacific Union College, and graduated from Pasadena City College in 1959 and from the Loma Linda University School of Dentistry in 1963. He began practicing dentistry in Provo, Utah, and Blythe, Calif.

The family settled in Moab, Utah, in 1964. Magee was active in the Seventh-day Adventist Church, serving as an elder, deacon, and teacher. The family spent many happy weekends Jeeping, camping, and taking photographs of the scenic Four Corners area. Several of Magee’s photos were used in publications, and others were sold.

Magee was the president of the Carbon County Dental Association from 1973-76.

Magee earned his private pilot license with single-engine and commercial ratings. This allowed him to fly to Monument Valley to provide free dental services on the Navajo reservation.

Magee enjoyed amateur (ham) radio, talking and listening to people around the world. His vehicle always bristled with a collection of antennae, and buzzed with information from the scanner and radio.

He practiced in Moab until 1992, when he was forced to retire due to Parkinson’s disease. The Magees moved to Ocean Shores, Wash. After grandchildren arrived, they moved to Redmond, Ore., to be part of their lives. Magee volunteered with Air Life Medical Service. Subsequent moves

included Idaho Falls, Idaho, and Olympia and Battle Ground, Wash. His grandchildren recall that he was present for every important event in their lives.

Magee was a determined, intelligent, and principled man. His family will miss his gentleness, humor, and compassion. He was most proud of his family. He leaves a legacy of his children and grandchildren, and a life devoted to servicing his God and those around him.

Magee is survived by his wife of 59 years, Marlene; son Dail Jr. (Chelle Downey-Magee); daughter Karen Mallory (Marlin); and grandchildren Jaymeson and Alecksana Mallory.

Dr. Charles E. Webber

Charles Eric “Chuck” Webber died on Jan. 10, 2017 at a memory center in Gig Harbor, Wash. He was born in Seattle on Sept. 16, 1936 to Mildred and Albert Webber. He was a graduate of Roosevelt High School.

Webber graduated from the University of Washington School of Dentistry. He served as president of the Seattle-King County Dental Association, and president of the Seattle Crown and Bridge Study Club. He was chairman of the Peer Review Committee for many years, and was honored with a SeattleKing County Dental Society service award in appreciation of his service to the community and the dental profession. He was a fellow of the International College of Dentists, and a Fellow of Pierre Fauchard Academy.

Webber was a stubborn Swede with a great sense of humor. He enjoyed skiing and sailing with his family and friends.

Webber is survived by his wife of 55 years, Dede; sons Jeffery (Stacey) of Gig Harbor and Kairo of San Diego; and daughter Laura (Justin).

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OFFICES FOR SALE OR LEASE

OFFICES FOR SALE OR LEASE

GENERAL PRACTICE FOR SALE, Eastside/North — State-of-the-art office located in a prime medical-dental area of the Eastside. 3 fully-equipped operatories with room for one additional. 1,685 sq/ft (approximate). Collecting 516K. Nitrous, digital X-rays, Soft-tissue laser, intra-oral camera.

Treatment includes: adult prophylaxis; pediatric; root-planing; periodontal maintenance; composite/metal-free fillings; crowns/bridges; veneers; dental implants; root canals; mouthguards; bite balancing. For more information please contact: Jennifer Paine at (425) 216-1612 or email Jennifer@cpa4dds.com

G/P PRACTICE FOR SALE IN LINCOLN COUNTY — Annual collections over $430,000. Four operatories, doctor works three days per week.

Practice is located within 35 miles of Spokane.

Practice has been in same location since mid-60’s.

Doctor owns the building and will sell it now or in the future. Well-trained staff will assist with the transition and will stay with the practice after the transition. Well-established practice with an excellent collection policy in place. Excellent cash flow for a practice of this size. Please contact Buck Reasor, DMD, cell: 503-680-4366, Fax: 888317-7231, email :info@ reasorprofessionaldental. com, www.reasorprofessionaldental.com. PO Box 14276, Portland, OR 97293.

WHATCOM COUNTY — General dental practice for sale – Located in busy shopping complex and growing area. Annual collections over $500,000.

Four equipped operatories, lots of opportunity for growth. Contact Rod Johnston @rod@omni-pg.com.

PEDIATRIC PRACTICE FOR SALE or BUY-IN, N. Central WA — A once in a lifetime opportunity: premier Central Washington Pediatric practice available for either full sale or 50 percent buyin. Referring out oral surgery, orthodontics, and third-molar Extractions. Doctor owned building available for sale or lease. Great opportunity w/ flexible transition terms. For more information contact: Jennifer Paine at (425) 216-1612 or email: Jennifer@cpa4dds.com.

FOR LEASE — Beautiful first floor office in a three story professional building. Has been the location for an Oral and Maxillofacial surgeon for nearly 30 years. Two surgical and three exam rooms with lots of parking. Post op room and private door to drive up. One block from Medical center and hospital. Park like setting with private gardens and floor to ceiling windows. Owner of the building is a General Dentist who is an owner occupant. Also an endodontist, orthodontist and other general dentists in the building. There is a need for another Oral surgeon in the valley! Owner will make the lease attractive. Call for more details and a showing. (509) 670-7593.

FOR SALE — Bellevue Ideal for a specialist or a general dentist start-up. Beautiful turn-key dental space for sale in Bellevue, top quality construction, DanNix design. Located on the growing Bel-Red corridor close to Microsoft, 520, new multi-family development, and the new REI corporate headquarters. Fully equipped with three operatories, all ADEC, Pano, plumbed nitrous, and separate storage space with compressor. The lease term is excellent and structured simply with base monthly rent. There is no triple NNN pass through for expenses. Please contact financial@belmoddental. com for more details.

FOR SALE — General practice in Battle Ground WA. Three fully equipped operatories, busy main street location. Contact Vicki at (360) 521-8057 or lyledkelstrom@gmail.com.

MERGER THROUGH SALE — A small practice downtown Seattle ($415,000 revenue in 2016) with no in-network insurance contracts. Entirely fee for service and we help them bill their insurance. We need to relocate and are looking for a merger through sale to another practice to work back part-time. This may mean signing insurance contracts. Call (206) 915-1234.

NEW LISTING - Top of the line dental office for lease with high-quality finishes. Very convenient location right off of I-405 in Bellevue. The dental office is 1,242 SF with four operatories. Plenty of parking stalls for patients and staff, ADA access.

Email Steve Kikikis steve@omni-pg.com.

G/P PRACTICE FOR SALE, FEDERAL WAY — Annual revenues over $740,000. Annual revenues have increased each year over the last three years.

This practice generates a lot of cash flow. Four fully equipped operatories plus plumbed for one more.

Digital X-rays and a new computer system. Well established practice that has been located in the same location for the last 12 years. The building is located on Pacific Hwy S. which is one of busiest thoroughfares in Federal Way. Building has great visibility and signage directly on the Pacific Hwy. Contact: Buck Reasor, DMD, bucjbucxkReasor Professional Dental Services, info@reasorprofessionaldental.com 503-680-4366.

FOR SALE OR LEASE — Spokane dental office.

Nearly turn-key opportunity with major equipment in all 5 identical operatories. Building is located in the prime center location of a beautifully landscaped and maintained dental/medical office complex. On street visibility and signage exposure with ample free parking. The main floor is 2,450 sq ft with an identical footprint in the daylight lower level. Has full telecom services including CAT-5 computer networking. For information contact: Gary Kuster, Dowers Commercial Real Estate (509) 869-8100.

FOR LEASE — Built out dental space available for lease downtown Redmond Washington. Some equipment in place. Flexible terms. Up to six operatories, business office, and personal office. Contact Dr. Rod Robinson at (425) 822-6279.

FOR LEASE – Maple Valley Dental office for lease. start-up or move your existing practice. Fully built out with five operatories, Plenty of parking in plaza. Approximately 1,524 sq. ft. with favorable lease terms. Email Steve Kikikis steve@omni-pg.com.

SUBLEASE — Established general practice in Northgate performing general, surgical/non-surgical endo, Implants, and cosmetic dentistry seeking competent and well-rounded dentist to share the office space consisting of four ops, small lab, all digital system, Digital Pano, 3M True Def scanner.

I currently only utilize two chairs and am willing to sublease the other chairs and office space. email to precisiondentalofseattle@gmail.com.

FOR LEASE — Highly visible Lynnwood Dental office for lease. Plumbed for four operatories, including nitrous and O2. 1,400 sq.ft. $24 per sq.ft and $3.62 NNN. email Steve Kikikis steve@omni-pg.com.

FOR SALE —Investment opportunity in Maple Valley for sale. Mix of office and retail uses Asking price is 1.4 million for this visible building on .95 acres is 6,400 sq.ft. Contact Steve Kikikis at steve@omni-pg.com.

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FOR SALE, Price reduced - South Sound perio practice and real estate available for sale. Collections over $1.5 million. Great referrals and low overhead. Building is also for sale. Call Rod at Omni 206-979-2660 or rod@omni-pg.com.

FOR SALE, Grays Harbor - Fee for service general dental practice for sale. Annual collections over $200,000, four operatories, lots of parking on busy street. Contact Rod Johnston of Omni Practice Group at 206-979-2660 or e-mail rod@omni-pg.com.

FOR SALE, West Olympic Peninsula — General dental practice for sale. Annual collections over $800,000 on three days per week. Doctor and hygiene booked several weeks out. Only dentist in town. Building also for sale. Contact Rod Johnston of Omni Practice Group at rod@omni-pg.com.

OUTDOOR LIFESTYLE — For sale with general dental practice. Work three days/wk with little competition, enjoy the outdoors the other four days/week. Annual collections over $400k without trying. Low overhead. Contact Jim Vander Mey at jim@omni-pg.com NEW LISTING, BELLEVUE — – Dental office space up to 3,204 sq. ft. Plumbed for seven operatories. Great parking and signage. Close to Microsoft, Group Health and other eastside businesses.

Contact Steve at steve@omni-pg.com EDMONDS — Plumbed office space for lease in Edmonds. Three ops expandable to 4 or 5. Located on high traffic street going into Edmonds. Great visibility and signage. Contact Steve at steve@ omni-pg.com.

NEW LISTING - Fully equipped dental office for sale in Arlington. Three operatories, dental chairs, and sterilization, equipment included in purchase.

No patients included. Approx. 950 sq. ft plus storage room. Asking $180,000. Email Steve Kikikis steve@omni-pg.com NEW LISTING, NORTH WHATCOM COUNTY — General dental practice for sale. Annual collections of $400,000. Located next to Starbucks on busy street. Newer equipment, pano, etc., Beautiful city on the Canadian border. E-mail rod@ omni-pg.com NEW PEDIATRIC PRACTICE LISTINGS — – One located in the South Sound, the second pediatric practice is located north of Seattle. Contact rod@ omni-pg.com for details.

BELLINGHAM — Lease turnkey dental suite. Formerly successful pediatric and orthodontic Class-A office space. Save $200,000+ construction costs.

Ample parking. Interstate-5 access. High-traffic/visibility location. Customization available. Lincoln Professional Center: 360-739-1421 adengst@gmail.com.

BELLEVUE/FACTORIA general dentistry/specialist office for lease. 1,249 sq. ft. 3-ops. (Or, 2,100 sq. ft. for ? ops) Winner location. Easy I-90/I-405 frwy access. Across the street from Factoria Mall.

15’ pole sign by Factoria Blvd. available. T.I. required for conversion. Landlord will contribute to concession (206) 915-2263 Mark.

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OFFICES FOR SALE OR LEASE

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OFFICES FOR SALE OR LEASE

EQUIPMENT FOR SALE

BELLEVUE — General practice for sale in Lake Hills neighborhood. 20+ years. Great location with good street visibility. Three chairs with room for four, approx. 1,500 sq. ft. , fully digitized, Dentrix, Invisalign, mostly adult restorative and families. Ave. 600k+ annual production, staff wlling to stay, doctor will work through transition. Please reply to: Piega@delaneytransitions/ (425) 890-8271.

DOWNTOWN SEATTLE – Space sharing, sale, partnership, or merger. Looking for a dentist with an existing practice to share our office space or to merge with a dentist nearby. This is not an associate position. Restorative practice with in-house C&B and denture processing lab, and technician.

Large five chair office, small three days/week dental practice. Space sharing, partnership, or merger.

Your office or mine. (206-310-5709) drnicolini@ hotmail.com.

FOR SALE — Decay Detection Canary System $6,200- Includes: console, hand-piece, protective shield, netbook, secondary holder, Canary Software, disposable tips and plastic sleeves, Calibration Block, transformer, cables, touchscreen stylus, Dell mini Laptop. Admin@uptowndentalgigharbor.com http://www.thecanarysystem.com/ about.php

FOR LEASE, OLYMPIA — Ideal location on Martin Way near St. Peter Hospital, 2,000+ sq. ft. Five ops including chairs, panex and more. Perfect for startup/ satellite office, future purchase possible. Contact Don at uncledgh@aol.com.

FOR SALE — Modern general dental practice for sale in downtown Bellevue. One to two year association with sale price to be determined at today’s value plus one half of earned equity at the time of transition. Six chair office built out in 2008.

Chartless, digital pano and xrays. Email: office@ dentistryinbellevue.com.

YAKIMA/SUNNYSIDE — We have a great associate opportunity for a new graduate or a long term home for a seasoned dentist looking to be compensated well with less of the headaches and stress. Group practice composed of general dentists, orthodontists, and oral surgeons. For new grads it’s the perfect opportunity to learn your craft by working side by side with generalists and specialists while being paid very well. Base salary starting at $165,000 plus bonuses. Full benefits package and moving allowance. State of the art clinics and equipment. Mix of children and adult dentistry. Mix of State and private insurance. Position available in Yakima/Sunnyside, Washington. Come try out the East side of the state where there’s 300+ days of sunshine, beautiful landscaping, the gorgeous Columbia River and family friendly communities! Please send inquiries to jbabka@applesmiles.com.

NEXT/ANNIE MILLER & ASSOCIATES — Providing consulting services to the dental community for the past 35 years. New practice start-ups, practice transitions, sales and valuations. Dental space planning and architecture; real estate leasing and acquisitions, employment benefits; staffing resources and training; financing. Call today for your free consultation…we can’t mint money for you, but we can sure save what you have now! Annie Miller (206) 715-1444. Email: annie@nextnw.com.

FOR SALE — Tukwila. Newly upgraded dental practice in Tukwila for sale. $725,500.00. Six ops with the latest in imaging upgrades, new computers, software and hand pieces. One of the last feefor-service practices left. Seller will pay for new floor covering throughout, leave the security deposit for the new buyer on the lease assessment and help with the transition. Call today for a tour.

Annie Miller, (206)-715-1444.

AVAILABLE, SOUTHCENTER — Just available.

1200 square foot fully equipped 4 operatory dental space. Cerec , Panoral, 4 chairs, lights, nitrous, air and vacuum all available and in place. Please call Dr. Jerome Baruffi at Medical Centers Management (206) 575-1551.

FOR LEASE — Quality professional office Space for lease in the heart of the Renton Highlands in the Highlands Professional Plaza medical dental building. Excellent place for an oral surgeon and/ or endodontist to open a satellite office or start up practice. Currently there are two GP dentists, a pedodontist, an orthodontist and a large physical therapy clinic. This building has a proven track record of successful businesses because of its location and quality. The building sits across the street from Bartells, QFC, and Starbucks. There are six elementary schools and four high schools within two miles. Get close to where the people live and enjoy fast practice growth. Call (206) 595-9100.

FOR IMMEDIATE OCCUPANCY — A fully plumbed dental office. 1,350 sq ft , three operatories, air, water, vacuum, nitrous oxide and oxygen, private office, lab, staff lounge, separate staff entrance. This office has exceptional exposure to the Southcenter Mall traffic. Please call Dr. Jerome Baruffi at Medical Centers Management (206) 575-1551.

SERVICES HAVE SEDATION, WILL TRAVEL! — Make fearful patients comfortable with IV Conscious Sedation. I am set up to come to your office and sedate your patients so that you can perform needed treatments the patients avoid due to fear. I have over 19 years experience providing safe IV Conscious Sedation. Serving Washington and Oregon. Richard Garay, DDS. (360) 281-0204, garaydds@gmail.com.

FOR SALE — Rayscan 3D CBCT machine (Rayscan Alpha – EXPERT3D) Owned our previous machine for seven years. Purchased this one new for $65K, as it had similar capabilities. Later realized we want to upgrade for more features. Less than one year old, low shot count, still under parts warranty. (360) 692-0300 (Silverdale, WA).

DENTAL EQUIPMENT FROM REMODEL — Rolling chairs, valves, compression gauges, tools, towel and glove dispensers, computer, grinding equipment, pluming parts, loads of cabinets with formica interiors. Make offer. Chris 206 595-5791 EQUIPMENT FOR SALE FOR SALE: Gently used 2yr-old Digital Pano (Instrumentarium OP30)- $17k This unit has the Extra-Oral Bitewing program as well as TMJ Projection. The images are brilliant and easy to diagnose from. Buyer responsible for cost of moving, installing and insurance for the move. admin@ UptownDentalGigHarbor.com.

FOR SALE OR LEASE — Dental building, 1,800 sq ft, four dental operatories, plus hygiene space.

Includes 1,800 sq ft basement used for orthodontic care and storage. Growing area with agriculture and data centers. Centrally located in Washington State. Deb Adams, Windermere RE/Central Basin, LLC, 509-750-1384, dadams@windermere.com.

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FOR SALE — Mobile Dental Office Equipment For Sale — AMC-20 Aseptico dental unit with fiber optic handpieces, curing light and scaler. Schick Digital Radiography with handheld Nomad X-ray gun. A-Dec dental chair and Stat-Im sterilizer.

Two dental carts full of dental supplies and instruments for a turn-key mobile practice, all contained in a 2013 Chevrolet Cargo Van. Email michelle@ michellecaldier.com for more information.

INTRAORAL X-RAY SENSOR REPAIR — We specialize in repairing Kodak/Carestream, Dexis, Gendex and Schick CDR sensors. Repair and save thousands over replacement cost. We purchase old/broken sensors. www.RepairSensor.com / (919) 924-8559.

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.

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.

CLASSIFIED ADS IN THE WSDA NEWS Visit wsda.org/news/classifieds/ to place your ad and select the issues you would like your ad to run in. Follow up your submission with a phone call to Rob at (206) 9735220 to submit your credit card information (sorry, no check payments), and your ad will be placed.

Sell your practice or fill a position quickly?

Don’t worry, you’re only charged for the ads that run. We’re flexible, and the process is painless and cost effective.

Pricing is as follows: Members: $50 for the first 30 words, $1 per word for each word over 30.

Non-members: $100 for the first 30 words, $1 per word for each word over 30.

classifieds issue 4, march 2017

OFFICES FOR SALE OR LEASE

first person dr. john evans

Talking to patients about compromised outcomes of dental treatment

Dr. John Evans Editorial Advisory Board

“Not long ago I had the good fortune of enrolling in a workshop focused on the process of disclosing professional errors to patients and their families. It turns out that there is a significant and growing literature on this topic.”

Whether we are disclosing our own errors or informing patients about the mistakes of others, honest conversations about the unfavorable outcomes of dental care are difficult for everyone involved. Let’s be honest, the perfect dental procedure is hard to achieve. But striving for perfection in our practices is very common, indeed.

At times, given the limitations some patients present with, a truly excellent result is simply not possible. We must settle for the best we can do in any given situation. This implies that there is a threshold below which less-than-perfect treatment outcomes need not be discussed. This is, in my view, context-sensitive and a case-by-case decision.

Uncomfortable conversations with patients about the quality of the dental care they have received are inevitable. They are part of a professional practice. Further, well-respected practitioners who have built reputations for professional skill and honesty over the years are especially aware of this obligation. Think about how often we are asked, directly or indirectly, to comment on another practitioner’s work. Being asked for a second - or third - opinion is always an interesting, and frequently unwelcome, process. Trusted professionals are trusted for very good reasons.

Back in the day, we were told never to admit that we had made a mistake, or that a colleague had made a mistake. The belief was that to do so would likely cause the patient to hire an attorney, and a malpractice suit would ensue. True or not, taking this position placed dentists in a no-win situation. We had to choose between lying to patients about the quality of treatment they received, or remaining neutral and giving them as little information as possible. The goal was to defuse the complaint before legal action was taken.

The first alternative was unethical, and the second was, at the very least, awkward for the dentist and the patient. Then and today, patients just seemed to know when we were being less than honest with them.

Not long ago I had the good fortune of enrolling in a workshop focused on the process of disclosing professional errors to patients and their families. It turns out that there is significant and growing literature on this topic. Our professional obligations include telling our patients the truth about the care they have received, and doing it well. Communicating difficult information to patients is a skill. It can be learned, and must be done with compassion, grace, and humility.

There is an important ethical principal at play here. We are obliged to be honest with our patients. The professional, peer-reviewed literature addressing this process goes back to 2000 and the publication of To Err is Human, a sentinel report by the Institute of Medicine. Since then, research has been done and numerous studies published addressing professional errors in medicine and in the nation’s hospitals. Many of the recommendations and best practices coming out of this literature have direct application for dentistry. There have been some surprising conclusions.

Disclosing professional errors to patients does not seem to result in more malpractice suits. Patients are hurt and angry, of course. But they will still be injured and even angrier if their complaints go unheard, especially if they suspect a cover-up.

Patients want to hear a sincere apology from the practitioner involved. “I am so sorry this happened to you“ is a sentiment that may go a long way toward defusing a difficult situation, and, perhaps, preventing legal action.

Finally, apologies to patients must be done well. Whether you are apologizing for your own mistakes, or informing patients about the mistakes of others, this involves several steps that should be carefully planned. We must gather all the facts, define alternatives to correct the error, and choose the right time and place to have the conversation. Doing this chairside in the middle of a busy day is probably not the best choice.

Patients referred to me for evaluation of unfavorable outcomes fall into two categories.

They either have a complication that was avoidable, or a complication that was not avoidable. In the first instance, a professional error was involved. In the second, the outcome is simply unfortunate, and no mistakes were made. Both are difficult for patients to accept, continued on page 46

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

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THE OBVIOUS CHOICE

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Washington State Dental Association 126 NW Canal Street Seattle, WA 98107

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