WSDA 18 · 20 ay ·m e6
The voice of the Washington State Dental Association
PRESCRIPTION MONITORING PROGRAM WHY YOU SHOULD UTILIZE IT SOONER RATHER THAN LATER
Also in this issue: ANTITRUST COMPLIANCE A LOOK INSIDE: ADA’S VOLPE CENTER th e wsda ne w s · issue 6, may · 2018 · www.wsda.org · 1
PREMIER BUILDERS D E N TA L FA C I L I T I E S
YOUR VISION, DELIVERED. 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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O R V I S I T U S AT B O O T H # 3 1 9 AT T H E P N D C
Dr. Ron Hsu explains the Save-A-Tooth kit to a group of school nurses in Battleground, WA as part of an effort to save avulsed teeth.
dr. miles lodmell story
endorsed company news
Cover story by Rob Bahnsen
volpe center story
dr. ron hsu story
issue 6 · may 2018
39 newsflash 42
49-53 classifieds 48
first person: dr. julie kellogg
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 Rachel McFarlane
Editorial Advisor y Board Dr. Brittany Dean Dr. John Evans Dr. Julie Kellogg Dr. Stephen Lee Dr. Joseph Vaughn
Membership Ser vices Coordinator Rachel Gunderson
Washington State Dental Association Dr. Cynthia R. Pauley, President Dr. Christopher Delecki, President-elect Dr. Nathan G. Russell, Secretary-Treasurer Dr. Bernard J. Larson, Immediate Past President Board of Directors Dr. Marissa N. Bender Dr. Dennis L. Bradshaw Dr. Chris Dorow Dr. Linda J. Edgar Dr. John Gibbons Dr. Todd R. Irwin Dr. Christine L. Kirchner Dr. Eric J. Kvinsland Dr. I. Blake McKinley Dr. Randall H. Ogata
Executive Director Bracken Killpack Assistant Executive Director Kainoa Trot ter Controller Peter Aaron
Membership and Communications Coordinator Emma Brown Bookkeeper Joline Hartman Association Of fice: (206) 448 -1914
Director of Government Affairs Mellani McAleenan
Fax: (206) 443 -9266
Director of Operations Brenda Berlin
E- mail/web: info@ wsda.org/wsda.org
Toll Free Number: (800) 448 - 3368
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 email@example.com. The WSDA News is published eight times yearly by the Washington State Dental Association. Copyright © 2018 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 eight 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: 2017: Journalism Award, Platinum Pencil, Leadership Article, Division 1, Honorable Mention; 2016: Platinum Pencil Award; 2015: Golden Pen 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 Newslet ter, Division 1, 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 6, may 2018
a day in the life
editorial dr. mar y jennings
Is a Medicare dental benefit possible?
Dr. Mary Jennings Editor, WSDA News
“Dentists have always realized the challenges and the importance of dental care for the elderly and disabled.”
Never in my wildest dreams would I have thought that Congress would seriously consider adding a true dental benefit to Medicare. It’s not that I don’t think Medicare patients need or deserve dental care. They do! But the challenge of making a decent program at a reasonable cost for 59 million people in this economy simply boggles my mind. According to the Kaiser Family Foundation (KFF), Medicare accounted for 15 percent of total federal spending in 2016. The KFF projects the program will grow from $590 billion in 2017 to more than $11 trillion in 2027. Those numbers scare me, even before adding anything new. Here is just a tiny sample of data to ponder. Medicare covers people over age 65 and younger people with permanent disabilities. Fifty percent of seniors have an income below $26,200 and less than $75,000 in savings. Older people have more serious health issues: 34 percent of beneficiaries have cognitive impairment; 30 percent have five or more chronic conditions; and 27 percent report that they are in fair to poor health. According to oralhealthamerica.org, one in five adults over 65 have untreated decay, and 46 percent do not have dental benefits. Half of Medicare beneficiaries have some degree of periodontal disease. Medicare does not cover vision, hearing, or long-term medical care. I suspect there will soon be a call for those services to be covered, as well. Dentists have always realized the challenges and the importance of dental care for the elderly and disabled populations. Physicians, et al are now among the many groups loudly advocating for Medicare dental benefits. Initially, organized dentistry was not on the dental benefit bandwagon. I cannot blame us for holding back. Our cry has always been to fix Medicaid first. It is important and meaningful to help low-income people, from both the humanitarian and budgetary standpoints. Low-income people have a much higher level of health problems than more affluent Americans. It is logical to fix Medicaid first and catch disease early with a quality program that actually works. We all know that Medicaid reimbursement rates for dentists are poor. Why would we want to participate in another government-funded program that does not understand what it takes for us to deliver care, and is seemingly unwilling to pay that cost? When the public complains loudly, politicians listen, especially when the news media and organized advocacy groups add their power. NPR, the New York Times, CNBC and other news agencies have covered the issue. Sen. Bernie Sanders (I-Vt.) and Rep. Elijah Cummings (D-Md.) introduced the Comprehensive Dental Reform Act in 2015, which includes a Medicare dental benefit. Since then there have been other bills (H.R. 3111, H.R. 508, H.R. 5396). So far there has been no traction but further bills are expected. The ADA has responded to the call in full force. We have to. We must be at the table to help drive sensible solutions. At this writing, no fewer than four ADA Councils and a significant number of staff are working hard on this. We are actively engaging with advocacy groups supportive of adding a Medicare dental benefit. We are in the very early stages of what is anticipated to be a long discussion. How would a Medicare dental benefit work? What kind of treatment would be covered? How much treatment would be covered? Those are the questions that interest me! That all depends on the level of funding our nation can support. In truth, Medicare does work quite differently than Medicaid, and the programs cannot be evenly compared. Medicare funding is much more complex than Medicaid. The KFF states that in 2016: 36 percent of Medicare was funded by payroll tax contributions; 13 percent by beneficiary premiums; and 45 percent by general government revenues. Interestingly, 11 million people are covered by both Medicaid and Medicare. continued on page 43
Dr. Mary Jennings, WSDA News editor, welcomes comments and letters from readers. Contact her at her email address: firstname.lastname@example.org. 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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Editor’s note: On May 1, legal counsel sent a letter to Premera asserting that Premera must provide its enrolled providers with 75 days’ notice before enacting any changes in scheduled fees. The letter appears below.
May 1, 2018 Brian Ancell Executive Vice President, Health Care Services Premera Blue Cross P.O. Box 327 Seattle, WA 98111-0327 Re:
Disagreement with Notice of Rate Change
Dear Mr. Ancell: On behalf of the Washington State Dental Association, we are writing to address an issue impacting its members who are party to a Participating Dental Provider Contract (the “Contract”) with Premera Blue Cross (“Premera”). The Dentists write to inform you that certain rate changes that Premera proposes to implement as of July 1, 2018 are impermissible under the Contract. On April 2, 2018, Premera notified the Dentists that it was amending the Contract to reduce compensation for specifically identified services by approximately 15 percent. According to Premera’s notice, this amendment would be effective on July 1, 2018. The Dentists do not dispute the timely notice of the particular amendments that Premera identified in the April 2 notice. However, the Dentists now have learned that Premera provided only a sample of fee cuts and that it intends to implement additional fee cuts effective on July 1 without having provided specific notice of those cuts. Any fee cuts not specifically disclosed on April 2, 2018 would be invalid under the Contract, and the Dentists strongly object to Premera’s plan. Premera is permitted to amend the Contract only upon 75 days’ written notice to the Dentists, and any amendments are subject to the approval of the Washington State Office of Insurance Commissioner. Art. IV, § I, Art III § L.8. The Contract protects the Dentists from any sharp dealing that Premera might engage in by permitting them to terminate the Contract upon 90 days’ notice. Art. IV, § K. In the event that Premera amended the Contract under Art. IV, § I in a way that is unacceptable to a Dentist, he or she could only be obligated to operate under those terms for 15 days. Premera may rely on the April 2 notice as a basis to adjust only those rates specifically identified therein. Simply stated, Premera may not issue a notice reserving a right to modify the Contract at a future date in violation of its specific Contract terms. To do so would abridge the Contract’s protections for the Dentists. The Dentists have a right to know exactly what modifications that Premera proposes and evaluate the modifications individually. If Premera wishes to implement fee cuts beyond those specifically disclosed on April 2, it must do so pursuant to the terms of the Contract. Failure to do so will be a breach of the Contract terms. The Dentists expressly reserve all rights to take appropriate action to ensure that those terms are honored. Please contact me at your earliest convenience to discuss this issue. Sincerely, Emily R. Studebaker
Board of Directors, Washington State Dental Association Toni Hood, Office of Insurance Commissioner
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member news antitrust compliance
ANTITRUST COMPLIANCE: THE DO’S AND DON’TS YOU NEED TO KNOW Editor’s note: Because antitrust law can be complex, the WSDA will soon be publishing an antitrust compliance guide for its members. In the meantime, we’ve excerpted some of the most important parts of the guide for you here.
As the voice of dentistry in Washington, the Washington State Dental Association (WSDA) provides value and useful tools to participants in the industry. Like all trade associations, WSDA activity will be closely scrutinized for antitrust violations. Since WSDA by nature is a combination of competitors, the Association and its members must ensure that their activities do not constitute an illegal restraint of trade, or even create the appearance of anticompetitive conduct. All WSDA members must be very aware of the threat of antitrust liability – at formal and informal meetings of association members; at cocktail parties, dinners, and social events; and in telephone and on-line correspondence and conversations. This is because an association is inevitably the first place government enforcers look to in investigating potential anticompetitive conduct in an industry. WSDA is a firm believer that competitive markets are the key for continuing success of its members in the industry. Federal and state antitrust provisions promote competition and prohibit certain behavior therefore WSDA expects all members to comply with applicable federal and state antitrust laws.
General antitrust do’s and don’ts
The following is provided as a general overview of topics you may feel comfortable discussing, and topics you should refrain from discussing, when meeting with competitors at trade association meetings.
What you can do • Discuss better ways to educate and provide meaningful information to the public about the dental care industry, e.g., publishing a consumer guide. • Discuss economic trends, business forecasts and materials availability generally, emphasizing that each member is free to use the information as needed in making its independent business decisions. • Discuss federal and state legislation and regulations, government payor policies, and develop and coordinate lobbying efforts and publicity campaigns. • Discuss common industry problems generally. • Discuss approaches the association might take to help solve industry problems.
Most of the antitrust violations are brought under Section 1 of the Sherman Act which prohibits any agreement, combination or conspiracy in restraint of trade. By definition, any anticompetitive agreement, express or implied, that you reach with a competitor meets the threshold test of Section 1. For example, an association would directly violate the Sherman Act if negotiating prices on behalf of members. A member of the association may also violate antitrust laws if there are not appropriate safeguards in place. There should not be personal liability for those who exercise reasonable care in the performance of their duties, showing honesty and good faith. There may be personal liability for those who participate in or knowingly approve of an antitrust violation.
• Discuss ways in which to improve the public image of the dental care industry generally or a specific segment of the industry.
Antitrust issues can arise for associations and association members in a variety of instances, including:
• Discuss strengths and weaknesses of suppliers and service vendors; develop a group purchasing cooperative.
• Price fixing through statistical reporting by the association • Price fixing through inappropriate communications between members • Group boycotts, when competitors get together and agree not to deal with a third party payor, other competitor, or vendor • Group boycotts through: · Self-regulation and codes of ethics · Standard-setting and certification · Membership requirements and access to association services and activities
• Discuss new insurance plans or products generally, for example Medicaid products, but not if, or on what terms, members should contract with such plans or products. • Discuss technological advances and ways members can better utilize them in their operations. • Discuss quality standards and outcome measures; develop best practices policies.
What you cannot/should not do Unlawful “Agreement”: • The antitrust laws prohibit agreements that unreasonably restrain trade. To be unlawful, an agreement need not be formal or binding, but may involve as little as a “knowing wink.” • The government and private plaintiffs need only show that two or more parties “knowingly participated” in a common scheme or plan. It is enough to show that concerted action was contemplated and the parties’ conduct conformed to the
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• Criminal intent can be proven by showing either: (a) that the “challenged conduct had an anticompetitive effect and was undertaken with knowledge of its probable consequences,” or (b) that “the conduct was undertaken with the purpose of producing anticompetitive effects (whether or not such effects resulted).” • Avoid creating an inference that an unlawful agreement has either been made or attempted. For example, avoid discussing proprietary business issues during breaks or at dinner.
Agreements Affecting Price: • Do not discuss a company’s current or future pricing strategies, or ways in which competitors might level the playing field, avoid unnecessary competition, or sanction a member that is perceived as overly competitive. • Do not share price or cost information, except in the context of a confidential survey conducted by the association or an independent third party from which only aggregated data are reported.
Refusal to Deal and Group Boycotts: • Do not discuss whether to deal or not to deal with any specific patient group (e.g., indigents or self-pay patients), specific payor (e.g., Delta Dental) or payor type (e.g., Exchange Products) or employer groups. • Do not discuss whether to deal or not to deal with specific suppliers or service vendors, unless limited to the operations of a group purchasing initiative.
Other antitrust issues for trade associations Lobbying: Under the Noerr-Pennington doctrine of antitrust immunity, joint action by trade associations or groups of competitors such as the WSDA to influence government policy generally does not violate the antitrust laws. This includes legislative activity, litigation in the courts, and matters before administrative bodies. “Sham” lobbying, or petitioning the government for actions to exclude competitors, is NOT permitted.
Examples of antitrust in action
Below are several examples of situations that a WSDA member may encounter as well as a brief explanation of probable antitrust
consequences. However, analysis for these situation is highly factintensive and small changes in facts can lead to different results. These examples provide just a general illustration of how antitrust laws may apply to particular situations.
Twenty WSDA members agree to increase the price of an office visit by 20 percent • This is a naked price fixing agreement that is per se illegal. It does not matter that it was only twenty dentists and WSDA has over 4,000 members since this would still be considered concerted action.
The same ten WSDA members agree to form a professional dental corporation, fully integrate their offices, and practice together for all purpose. They then agree to charge $100 for an office visit • Assuming this group does not include all or most of the dentists or members of WSDA of a particular specialty or type of practice in the area, this arrangement raises no antitrust concerns. However, the dentists must be careful not to include too large a percentage of dentists in that area within this practice or it could generate antitrust concerns.
Members of WSDA agree that they will not participate in an insurance plan unless the plan increases reimbursement rates by 20 percent • This is a group boycott to enforce a price fixing agreement and it is per se illegal.
After reviewing an insurer’s proposal, members of WSDA object to it because insurer’s claim process would be burdensome to complete and there would be too much “red tape.” Unless these problems are solved, WSDA members do not want to participate. • Communicating these concerns to the insurer on behalf of the members is completely legitimate activity. However, threatening a group boycott by the members as a means of changing the insurer’s proposal, however, would pose substantial antitrust risk. The dentists’ concerns probably could be addressed in a way that would present little antitrust risk by explaining the problem to the insurance company, perhaps even focusing on any negative impact the program might have on patient care. Regardless, legal advice should be sought.
The reader may be asking if there is any real benefit to be obtained from trade association meetings in light of the long list of items that should not be discussed. All meetings with competitors are subject to questionable conduct, but a healthy respect for the antitrust laws and the guidelines provided will minimize any antitrust risk associated with your company’s active participation in trade association activities.
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arrangement. “Agreement” has been inferred from mere attendance at meetings with competitors followed by parallel conduct inconsistent with economic self-interest.
member news dr. miles lodmell on retirement at 85
The good ol’ days: Dr. Lodmell adjusts his own crown while assistants Dee Holdeman (left) and Bonnie Lodmell look on
FOR DR. MILES LODMELL, RETIREMENT GIVES HIM MORE TIME TO DEVOTE TO FARMING AND FUN Dr. Miles Lodmell recently retired from dentistry at age 85, after practicing in Walla Walla for 62 years. His father, Anton, also a dentist, “retired” at age 82, if you can call it that. Lodmell explains, “He took some denture impressions on a Friday, and died that Sunday. I want to get in more skiing.” He’s not joking, not even a little. We had to postpone our first interview because he was off skiing in Sun Valley, Idaho for a week. Besides skiing (downhill and cross country), Lodmell rides horses, plays squash and tennis in the summer, and fly fishes, often accompanied by his wife of 36 years, Bonnie. He’s no fair-weather athlete, either. If it’s inclement, he’ll go to the YMCA and ride the elliptical. He enjoys being active and the benefits it affords him, but most of all, he says, it’s fun. And while Lodmell is retiring from dentistry, he won’t be retiring from his other “hobby,” which is farming. Since he was just a kid growing up in Walla Walla, Lodmell has loved working the land. He’ll continue to do so, harvesting some 300 acres of wheat and another 30 acres of vineyards with the assistance of Carmelo Rosales, who has been his trusted helper for decades. We reached out to Lodmell, whom we first visited on these pages eight years ago, to pick his brain about the differences between farming and dentistry, and to talk about how dentistry has changed over the years. There aren’t many people who love work enough to keep at it for 62 years, so we asked him about that, too.
Farming and dentistry: complementary “hobbies”
Lodmell’s entrée into dentistry was uncomplicated. Since his dad was a dentist, Lodmell was able to help him out in his practice. He also worked in his lab whenever he could. This gave him insight into what the field would be like, and served as something of a trial run. Additionally, there was a commercial lab next to his father’s practice where he learned how to wax up crowns, a skill he used to make additional money while in dental school at the UW. Likewise, his connection to farming was familial: an uncle was a farmer. At age 15, Lodmell worked the land alongside his cousins and learned how to drive a tractor and a combine. He loved working on the farm, but he also loved
the science of dentistry. Lodmell could have pursued either for a living, but he realized that if he became a dentist he could still work the land, but if he became a farmer, he couldn’t also be a dentist. “Being a dentist, you can schedule your own time a little bit, so if something came up on the farm I could usually get to it for an hour or two, and in the summer I took a couple of weeks off to run the wheat combine,” he said . Lodmell draws easy comparisons between dentistry and farming, saying both are very mechanical. He explains, “You have to find a way to make a restoration stay in place, and you have to design the cavity prep to hold the filling. Farming is very similar. You have equipment that you have to learn how to run and fix. There’s a lot of pride in overhauling a motor. The last 10 years I would see one to 10 patients a day, and then on Thursday or Friday, if I wasn’t scheduled, I’d go out and farm. By Monday, I’d be ready to get back in the practice. I was fortunate in farming, as I was in dentistry.” Today, Lodmell grows Dark Northern Spring wheat, used in hearty breads, and grapes including Merlot, Cabernet Sauvignon, Syrah, Semillion, and Cab Franc varietals, for some of Walla Walla’s wineries, including Lodmell Cellars, owned by his daughter.
Improvements in dentistry
We asked Lodmell what he thought was the most important change that he’d seen in dentistry over the years, and he was quick to answer. “The profession is much more respected than it was when I started, or when my dad started in 1926,” he says. “The only time people went to the dentist then was when they had a toothache.” Early dental techniques and anesthesia weren’t that good either, he says, which could have been a contributing factor in keeping patients away. “I think the main thing that I noticed over the years is that our techniques have reduced the fear and pain for the patient, and made dentistry a lot more friendly,” he says. The equipment is also better, Lodmell says, noting that chairs are more comfortable for patients and easier for dentists, too.
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member news dr. miles lodmell on retirement at 85
WORKING THROUGH HIS RETIREMENT: DR. MILES LODMELL Photos by Kimberly Fetrow
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member news dr. miles lodmell on retirement at 85
Dr. Miles Lodmell and his wife Bonnie Photos by Kimberly Fetrow
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“The lights are better and the new high-speed air rotors and electric handpieces are great. There is very little vibration to those. The cutting instruments are better, as well. The burs are pretty much the same now, but you can refine a cavity prep much better than we used to be able to,” he says. “I still use a lot of hand instruments, especially on gold foils. You have to. Basically, I think the fact that people are more relaxed when you work on them is tremendously helpful. People relax when they develop a confidence in you, and they’re a lot easier to work on, as well.” Solo dentist practices are more scarce, he notes, replaced by those with multiple associates, assistants, and hygienists. Lodmell never had a hygienist, saying, “I don’t think there is anything wrong with a hygienist, but if you do your own scaling and cleanings, it’s much easier to monitor your patients’ progress, see how they’re caring for their teeth, and check if they have more tartar. Bonnie was one of the best receptionists and chairside assistants. I had two other women who were with me for 25 years who were wonderful assistants, as well.”
Passing the torch, retaining the gold standard
While Lodmell never did cotton to composite materials the way many dentists have, he understood and accepted their value from an aesthetic standpoint. He’s the first to admit that the type of work he does best – gold foils, inlays, and crowns – has lost pace to the gleaming white composite work in favor today. He preferred working in gold and recognized that he was in the minority. He happily defends his stance. He says, “The thing that I haven’t changed is gold work. I have many patients who still have the gold work I placed years ago, even some of the gold work my dad did is still there. The teeth are worn, there’s no question that people grind and brux, and teeth will wear over a period of 50 years, but the restorations are still
sound. One of the drawbacks is aesthetics, but I perfected a hydrocolloid technique for taking impressions that is extremely accurate. You have to do your own lab work to use it. You can’t put it in a box and send it to a lab.” Lodmell also perfected a technique called pin-retained restoration, which makes restorations on the lingual almost invisible. “I like to think that I made the right decision to do this kind of work,” he says. When Lodmell started to think about retirement, it was important to him to pass the torch to a dentist who understood the value of gold work, too. He says, “Dr. Randy Pearson and I had exchanged emergency patients for a number of years, so I asked him if he could take care of my patients the way I have, and he said yes. I see the people here in town, and it’s nice to know they will have someplace to go, and Randy is a good dentist.” While retirement leaves Lodmell plenty of time for other things he loves to do, he admits he misses visiting with his patients while doing their dental work. However, he says, “It is more relaxing now to know that if someone asks me to do something or meet them at the farm, I will probably be able to.”
While he won’t cut teeth any longer, Lodmell isn’t giving up dentistry completely. He is a consultant to Pearson and other dentists, and as a Life Member of the American Academy of Restorative Dentistry, Academy of Operative Dentistry, the ADA, WSDA, International College of Dentists, Pierre Fauchard Academy, and American Academy of Gnathologic Orthopedics, he will continue to attend some of their meetings. And he will ski, or play squash, or tend his acreage, or travel with Bonnie. In short, he’ll live as varied a life in retirement as he did before. Congratulations to a life well-lived, Dr. Lodmell!
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member news dr. miles lodmell on retirement at 85
Carmello Rosales has worked with Lodmell since he was a young man. Today his son, daughter, and wife often pitch in to help, too.
cover stor y prescription monitoring program
PRESCRIPTION MONITORING PROGRAM WHY YOU SHOULD UTILIZE IT SOONER RATHER THAN LATER In 2007, the Prescription Monitoring Program (PMP) was created as a plan to improve patient care and reduce prescription drug misuse by collecting dispensing records for Schedule II, III, IV, and V drugs, and making the information available to medical providers and pharmacists as a tool in patient care. Since then, the misuse of opiates has become a national epidemic. While the PMP looks good on paper, the problem is accessing it can be a challenge, something the state is working to improve. If you frequently prescribe opioids and are in the system regularly, it can work reasonably well, but for dentists who don’t prescribe often, the experience could be rockier, with reports of up to a 30-minute process to access the site.
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cover stor y prescription monitoring program
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We’ll provide some tips and tricks that should help practitioner suse the system, but we’re issuing an advisory: The first log in could well be an exercise in frustration. Regardless, it can improve patient safety and will likely be required soon, so you might want to explore it now and establish a system for your office, rather than wait. We reached out to Dr. Rolf Christensen, Director of the Dental Urgent Care Clinic at the University of Washington School of Dentistry, Chris Baumgartner, Director of Drug Systems at the Washington State Department of Health, and Jennifer Santiago, Program Manager for the Dental Quality Assurance Commission, to talk about the benefits of the program, find out how it works and have an honest discussion about some of the program’s challenges.
Taking the PMP from should to must
“Currently, the DOH rule for chronic non-cancer pain says that providers should review the PMP. We can’t enforce ‘should,’ but it will change eventually,” says Jennifer Santiago. The Department of Health has been working on implementing legislation (HB1427) for the past year. It is described by the state as an aggregation of multiple bills that has several intended effects, primarily to implement safe opioid prescribing rules, expand access and use of PMP data, and improve access to medication-assisted treatment. Santiago says, “HB1427 requires five boards and commissions to create rules around opioid prescribing. The five boards and commissions created a task force to draft consistent rules. It’s no longer just chronic non-cancer pain, it’s opioids across the board. The Opioid Prescribing Task Force is made up of two members from each board/commission (medical, nursing, osteopath, podiatry, and dental) who worked for several months to create draft rules. The current version requires mandatory PMP checks at certain times of patient care, and it does require registration with the PMP if you prescribe opioids to patients.” Until the draft is adopted and codified, the PMP will remain a suggestion, but oral surgeons and other dentists who routinely prescribe opioids are going to have to use the PMP eventually, so the state would like to see them get on board sooner rather than later. Santiago explains, “If they start using the PMP, they’ll become more familiar with it, and it becomes easier to use. HB1427 required the boards and commissions to adopt rules by January 2019, and they have all committed to finalizing their rules by the end of October 2018. Finalizing the rules and educating practitioners and the public is the goal, it all has to play out that the boards and commissions adopt the rules and move forward.” Much of this work falls under a broader state plan – the Opioid Response Plan – to address the opioid epidemic (stopoverdose.org). Pushed forward by the executive order signed by Gov. Jay Inslee in October 2016, the plan has four goals: prevent inappropriate opioid prescribing and reduce opioid misuse and abuse; treat individuals with opioid use disorder and link them to support services, including housing; intervene in opioid overdoses to prevent death; and use data and information to detect opioid misuse/abuse, monitor morbidity and mortality, and evaluate interventions.
Identifying the blue pills
According to Chris Baumgartner, the state currently collects about 1 million records a month for controlled substances. However, he stresses that the PMP is about much more than identifying patients who suffer from opioid abuse disorder. It’s also a key component to securing basic patient safety and medication reconciliation. Baumgartner explains, “The PMP is often most beneficial to the elderly patient who shows up and says, ‘I take the blue pills,’ or the person who is unconscious in the ER. They may not have overdosed, they may not be addicted, but they may have controlled substances they take regularly that could impact how you choose to treat them. It’s also great information to use for coordinating care, which is why it is important for the dental community. I don’t know that patients always do a great job of informing their dentist or primary care provider about medications they’re getting from each other. Dentists must rely on patients to reveal the medications they’re already on prior to a procedure, and that’s not always happening. A lot of times it’s just about being better informed, providing better care, and coordinating with the other healthcare providers.” Dr. Rolf Christensen sees far more patients using opiates than a typical general practice, and is well versed in the pros and cons of the PMP. He says, “I give better care using the PMP. I know the landscape, and I especially want to know if my patients aren’t disclosing or are misrepresenting information. If they’re not disclosing, they’re either a less-reliable reporter, or there is a manipulative component. We rely on patient self-disclosure for medical information, so if they don’t disclose, I may not be aware unless I check the PMP or do a physician consult. If I telephone a physician’s office, I usually request a list of medications and their current diagnoses be faxed to our clinic.” General practitioners may argue that their experiences are unlikely to mirror those of Christensen’s in an acute care clinic. Baumgartner says that practitioners have told him about patients they would have sworn did not have an opioid abuse disorder problem, only to find out through the PMP that they did. “They didn’t have a clue that their patients were in trouble and needed help,” he says.
Early metrics on the states’ efforts to curb opioid abuse are promising, but at the same time, with so many different initiatives aimed at curbing opioid abuse, it can be hard to know which effort is having the greatest effect. Baumgartner says, “We want to be very careful not to draw lines that aren’t there, and while there is a correlation between all the things and the change, it is hard to say the exact effect of the PMP on its own. All we can say is that everything we’ve done since 2009 has resulted in a 30 to 40 percent decline in prescription-related opioid deaths. We still have about 700 opioid deaths a year because of an increase in heroin-related deaths. We’d like to think that if we can prevent someone from developing opioid abuse disorder when they’re taking prescription drugs, they’re not going to be as likely to transition to heroin later in life. That’s why the use of the PMP is so important in helping providers ensure that patients don’t get hooked on these medica-
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Getting started can be the hardest part
In recent PMP stakeholder meetings, one thing is certain: the initial onboarding process can be challenging and frustrating, even for a seasoned user like Christensen. “The initial enrollment can be pretty rough if you try to do it yourself,” he says. “It can easily take two hours. However, if you gather your information and call the Department of Health, it should take about 20 minutes. You need your license numbers, addresses, and answers to security questions, which you should write down. The security questions are good, and you won’t always remember the answers you gave. The interface can be very fussy, especially if you haven’t logged in for a month or two. You’ll have to re-authenticate, and if you have to do that, I would again recommend calling in for assistance. I’ve heard that some folks have had a problem, but to me they’ve been great and very beneficial. I’ve never had a problem with the support staff. They’re easy to get through to, as well. The area of difficulty is that there are two layers. One is the Secure Access Washington (SAW) site, which is separate from the PMP, and you have to know which one you’re looking at. To be honest with you, I think dentists should renew their licenses online because if they do, they’re accessing their SAW account. Being familiar with SAW will help facilitate smooth PMP utilization.” As an example of how easy accessing the system can be, Christensen asked us to time his PMP login. Start to finish, it took 23 seconds, including the time to get through SAW. Christensen’s praise notwithstanding, many dentists have had different experiences accessing the PMP help desk. Members shared their stories of not being able to get through at all, or waiting for 30 minutes or more to speak with someone. Additionally, when the DOH solicited feedback from users about the site, they got an earful — everything from “laborious and inconsistent” and “not user friendly and clunky,” to “I use the website and have no issues with it at present” — with negative feedback outweighing the positive. Gov. Jay Inslee admits there’s work to do, saying, “The prescription monitoring program is an important tool, and we’ve done a lot to help make it easier for you to use. Yet, we know there’s more work needed with your medical record vendors to get the PMP integrated as part of your workflow, and my administration is committed to helping make that happen.”
Barriers, tricks, and tips
Christensen says that one of the biggest impediments to widespread use of the PMP is dentists’ resistance to behavior change. Another issue hindering the PMP is that it is not a “real time” system. As one dentist pointed out in a stakeholder survey, “If a patient were to have an appointment at their MD’s office on a given
day, then they had another appointment at another medical/dental provider a little later on the same day, and then an appointment at my office at the end of the same day, the PMP will not have updated. The patient could conceivably have gotten an opioid prescription at each of these offices, and none of us would know it.” Baumgartner admits that ease of access is the state’s biggest challenge to acceptance of the PMP, but likens its use to riding a bike. The more frequently you utilize it, the easier it becomes. The state has been trying to mitigate some of the frustration by encouraging practitioners to delegate access authority to dental team members. However, under current rules, those accessing the PMP must be credentialed, meaning only licensed hygienists, EFDAs, and assistants are allowed. Christensen is amenable to changing that part of the law, saying, “I cannot delegate to students, but I want that. I would support some type of license for front office people so that they could access the system.” Both Christensen and Baumgartner say that delegates can look up patients during a two-day period, or even a week, to streamline the process. Since most practitioners have a good idea of their patient schedules for the week, this could really help. Still, there will always be changes and emergencies that occur, so being well versed in the system is important, says Baumgartner.
Coaching and counseling
We wondered, what happens when you look up patients and discover there may be a problem? It can be tricky, Baumgartner says, adding, “The thing we try to stress with providers is not to make their gut reaction to kick the patient out of their clinic, but to try and help them. We understand that sometimes you have to, and that sometimes you’re going to offer them help and they’re going to throw it back in your face. The last thing we want is for the PMP to become the source of information for ‘who do I turn away or kick out of my practice.’” Baumgartner recommends contacting their primary care provider to get to the root of the issue, yet cautions about jumping to conclusions. He says, “Do a little verification and ensure that there weren’t data entry errors. We would hate to have a patient kicked out of a clinic due to a mistake. We also really encourage practitioners to share with the other providers listed on the report. In the case of dentists, we really encourage them to identify who the primary care provider is, because that is probably the best person to have that critical conversation with the patient about the controlled substance history. Sometimes, through no fault of their own, patients have developed opioid dependency because prescribing practices were very different a few years ago.” Christensen often accesses the PMP in front of patients to share the information as he sees it, noting, “I ask open-ended questions like ‘Is there anything I should know about?’ I remind them that we check the prescription database for everyone, and that I want them to be aware. If something pops up I can say, ‘Oh! You didn’t mention that you just got 90 Percocet. I understand you shouldn’t be using your chronic meds for this acute stuff, so why don’t we do a physician consult, or maybe we should have the person who prescribes for the chronic pain prescribe for this, and we will consult
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tions on the legal side, and then turn to the illegal alternatives down the road.” Baumgartner says the state has seen significant improvements in its morbidity and mortality data related to prescription-related opioid deaths, and improvements in the number of individuals who have multiple provider episodes each month – patients who are seeing multiple providers for controlled substances every quarter.
cover stor y prescription monitoring program
“Patients come in and they really expect an opiate and can get offended if you suggest an NSAID and acetaminophen. There are arguments that occur, and many times I will supplement with an opiate, but you have to counsel them how to use the NSAID and acetaminophen because a lot of people don’t think it’s going to work, so they don’t even try.” — Dr. Rolf Christensen with him or her.’ They can watch my thinking process, and it’s an opportunity for me to counsel them.” Additionally, Christensen is actively working to change his patients’ expectations. He says, “Patients come in and they really expect an opiate, and can get offended if you suggest an NSAID and acetaminophen. There are arguments that occur, and many times I will supplement with an opiate, but you have to counsel them on how to use the NSAID and acetaminophen because a lot of people don’t think it’s going to work, so they don’t even try. That is one of my biggest frustrations. We’re developing some handouts that may help.”
Properly used, the PMP can be an effective tool in the battle against opioid abuse. Christensen says, “I like the evidence the PMP provides. I often print up the report and attach it to my dental record. Another benefit is that I can write on the prescription that I have looked at the PMP, and I know the patient is on a chronic pain contract. If the pharmacist wants to know why I’m prescribing, I can say it’s for an extraction. I get a lot fewer calls that way.”
On the horizon: EDR/EMR integration
Electronic medical record (EMR) hospital systems like EPIC, one of the most widely used systems in the country, can pull up the PMP, effectively accomplishing two goals. It meets the state’s security and privacy laws, and provides better, faster ease of access. Baumgartner calls it “the utopia scenario,” and the state is working toward integration of the PMP with electronic medical record (EMR) and, eventually, electronic dental record (EDR) systems. “We don’t have a lot of health systems involved in that yet,” Baumgartner explains. “Some dentists who work in large-care settings may already have access. Obviously, the portal improvement work group is trying to see what it can do to make improvements, but again, another part of that will require working collaboratively with groups like the dental association. We need to know how to distribute information on best practices to your members, so they can know about workarounds to make the program work more smoothly, like using delegates and creating the
ideal IT setup from a security perspective. We’ve been educating people about all of this, but it’s hard. Washington is a huge state with many providers, and trying to find avenues to disseminate hasn’t always been easy.” The state hopes to work with dental software vendors on integration in the future but nothing has happened yet. Part of the issue is that there are many different types of dental software, unlike hospitals, which tend to use one of just a few programs, like EPIC. Another issue the state is working on is interstate data sharing for border providers. For instance, if you’re a provider in Spokane, you could have patients picking up prescriptions in Coeur D’Alene or Post Falls, Idaho. The state is looking at ways to get a complete prescription history for patients. “Those are the two biggest issues from a healthcare provider perspective that we’re focusing on currently,” Baumgartner said. “Beyond that we’re looking at ways to encourage providers to make accessing the PMP a more standardized practice of their workflow because that’s something that is important, given the rule changes that are currently under consideration. It’s best to get used to the system now, while it is optional.”
Consider enrolling in the PMP now, before it becomes required. Steel yourself and go into the process knowing that onboarding can take time and be frustrating. We recommend following Christensen’s advice: enlist a trusted assistant, EFDA, or hygienist to work with you on the initial sign in, keep a record of the questions, addresses, and other information required in a safe place that you can easily access in the case of re-authentication, and call the state’s help line when you have questions. If anecdotal evidence is correct, you’ll run into problems when you don’t use the system regularly, so you might consider trying a system where you check patients in advance. If you start before the PMP is required, you may minimize your frustration with the system, and avoid the inevitable logjam of providers across the state trying to reach the help line. To that end, the state is working to get more help line staff, but in the event that doesn’t happen, you’ll want to be comfortable with the PMP before everyone comes on board!
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I’m writing to tell you about the ADA Foundation (ADAF), which works on a unique level for all of us. There has been an extensive effort during the past few years to improve the structure and function of the ADAF. Good things are happening. Outreach and collaboration with our partners in each state are a priority. Grants and scholarships play a major role in those efforts. Like many of you, I was inundated during the last quarter of 2017 with requests to give to good causes. Most are tax deductible, which means those donation receipts go into a file for use by my accountant. So many non-government organizations have charitable foundations that even the new tax bill preserved the tax deduction tradition. Americans are a giving society. It’s a good thing! I honestly don’t know what the limits of the tax deduction are, nor do I give donations based upon sending less to the IRS. There is a science to giving, or, more specifically, to entice one to give. As Vice President of Finance for the ADA Foundation, I have come to appreciate the software analytics and science of giving more than I ever dreamed possible. As I age, I seem to be giving more. But also, as I age, I am more strategic and discerning about what I give and why. The foundation world both interests and confuses me. There are so many good causes! I can’t give to them all, so how do I choose? Most of my giving these days goes to dental-related causes because I know them best and understand the need. My chosen profession has given me much, and I want to give back in ways that matter. My dental school, my state oral health foundation, my fellowship dental organizations, and the ADA Foundation are all on my short list. There are many foundations in the dental world. Most have very different missions. From a distance it seems otherwise; by title, they sound and look the same. They are not. The need is endless, the dollars too few. I have come to appreciate the distinctive purpose of the ADA Foundation compared to other dental foundations. I have witnessed the positive impacts of the ADAF Emergency Disaster Assistance Grants program for the dentists affected by the storms of late 2017 in Texas, Florida, and Puerto Rico. WSDA generously donated to dentists affected in the disaster areas in 2017. The WSDA also made sure its donation was passed through the ADAF directly to the states and areas closest to the disaster sites. For that the ADAF and the dentists who were helped are very grateful. Those kinds of charitable acts are examples of a profession standing as one in a time of need. One major problem: Need was greater than resources! I have grown to appreciate the impressive role of the scientists at the ADAF Volpe Research Center (VRC). I now realize the unique opportunity the dental profession has through the efforts of those researchers at the VRC. They are dramatically impacting the clinical practice of dentistry on behalf of the patients we are privileged to serve. There is a new and exciting energy building at the VRC labs, located at the National Institute of Standards and Technology (NIST) research campus in Gaithersburg, Maryland, located outside of Washington, D.C. The ADAF has a large grant program focused on access to care and oral health education. It also awards significant scholarships to dental students. Give Kids A Smile (GKAS) has a very successful 15-year partnership with our states and dental industry to improve the lives of children. In 2018, GKAS will help more than 300,000 underserved kids with nearly 30,000 volunteers (including 6,500 dentists) and more than $15,000,000 of care. Since the inception of GKAS, more than 5.5 million children have been helped. Earlier intervention and dental home referral and continuity of care are ongoing areas of emphasis. In summary, the ADA Foundation does not compete with, but rather enhances, the good work of the many great dental foundations and charitable dental groups in Washington. All have important missions. All deserve your consideration for contributions, expertise, and volunteer time. I hope we will all embrace the spirit of collaboration and unity for the many important works of each of our dental foundations. My charitable tax file seems to expand every year. I hope yours does, too!
Dr. Roger Kiesling Vice President of Finance ADA Foundation
“I have grown to appreciate the impressive role of the scientists at the ADAF Volpe Research Center (VRC). I now realize the unique opportunity the dental profession has through the efforts of those researchers at the VRC.”
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. roger kiesling
Support the ADA Foundation
ada news the volpe center
THE VOLPE RESEARCH CENTER: THE HIGH TECH RESOURCE YOU PROBABLY DIDN’T KNOW EXISTED
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Funding by the ADA, the ADA Foundation, grants, and you
The VRC has been supported by the ADA, the ADA Foundation, government grants, and dentists like you since the beginning and remains so today. The VRC is near and dear to Kiesling, who has served on the board since 2015. He said, “If we had not been able to get the Foundation’s house in order, we would not have been able to preserve our spot on the NIST campus. We had to ramp it back
up with a new director and new scientists at the same time we were revamping the Foundation itself.” Still, the effort to preserve the VRC is not finished. Kiesling is reaching out to dentists in Washington for their continued financial support. “In the past, Washington dentists really broke out their checkbooks,” he said with gratitude, “but we’re not in the clear yet. We’re getting more successful at getting government grants for research. We assembled an advisory group of researchers/material scientists from around the country and put together a panel of six or seven of them to advise us on the research piece at the NIST. They met with Dr. Hart, toured the campus, and made recommendations to our Foundation. Everyone is working hard to solidify the effort. It’s all good, and it’s a new day with new energy, but it’s going to take some time and, frankly, money.” Kiesling’s passion for the VRC is well-deserved. Today, the Center is engaged in some of the most fascinating, cutting-edge dental research being done anywhere. Kiesling said, “This equipment-intensive work and the amazing labs are jaw-dropping. NIST houses state of the art laboratory facilities such as the Center for Nanoscale Science and Technology (CNST). They have a dozen clean rooms that cost $5 million to $10 million each just to ensure that they’re free of any particulate matter. The tech itself is mind-blowing, and our access to the computer brainpower and all of the equipment that allows our scientists to view materials at the subatomic level is phenomenal.”
The VRC’s Mission
The facilities and equipment come with a price tag, though. “We need to make materials, tools, and devices to help clinicians provide the best care in the world,” Hart said. “It’s a little different than research at other places like the NIH and dental schools in that the main mandate is to develop things that are practical and applicable to help advance dental care. It narrows the focus. Furthermore, if you’re on this campus, you need to provide value to the NIST. We need to operate and perform research in areas that enhance their mission. We can’t just go off on our own and do what we want. With that, we’re focused on new materials, sensors, devices, and the biology related to those.” There is some really fascinating research happening there, like the work being done by Dr. Jirun Sun, who is leading the effort to make new types of dental composites using new chemistry. Dr. Sun has made composites that don’t degrade. In fact, they self-heal if they fracture. He’s improving the materials and the properties, and he’s developing them so they’ll be antimicrobial. “Traditionally, we think about materials like glass, stone, and brick, each serving its own purpose, but we’re in an age where we’re developing materials with multiple purposes and multiple functions,” said Hart. “Dr. Sun’s team is doing that.” Another important materials research project is being conducted by Dr. continued on page 21
Photo courtesy of the VRC
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The National Institute of Standards and Technology (NIST) is on a 500-acre campus in Gaithersburg, Maryland. One of the nation’s oldest physical science laboratories, it was founded by Congress in 1901 to ensure that the U.S. was as competitive in industry as its economic rivals. Its website says, “Today, the NIST measurements support the smallest of technologies to the largest and most complex of human-made creations — from nanoscale devices so tiny that tens of thousands can fit on the end of a single human hair up to earthquake-resistant skyscrapers and global communication networks.” What you may not know is that since 1928, dentistry has played a vital role on the campus, first as the ADA Research Unit, then as the Paffenbarger Research Center, and today as the Volpe Research Center (VRC). The VRC is attached to the Material Measurement Laboratory, the largest of seven labs and three extramural programs housed on the NIST campus. Though the name has changed over the years, its mission has not: to advance the oral health of the public through basic and applied research and the development of approved dental materials and treatment technologies. In case you’re wondering if the center has done something you might have heard about, consider this: The high-speed handpiece, pano X-ray, composite materials, and front surface dental mirror were all developed on the NIST campus. Today, your donations and input can help the VRC keep its place at the NIST, and we’d like to share why we think that is so important. The WSDA News sat down with Dr. Tom Hart, the Center’s Senior Director, and Dr. Roger Kiesling, former 11th District Trustee, who currently serves on the ADA Foundation’s Board of Directors as its VP of Finance, a post he has held for nearly two years. Hart held a number of positions before landing at the prestigious VRC. He was on the dental faculty in a transitional research position for the University of Illinois, clinical director in a genetics lab at the National Institutes of Health/ National Institute of Dental and Craniofacial Research (NIH/ NIDCR), and a periodontist in a large-group practice in North Carolina. “Over the years I developed grant funding and moved into more research environments running labs, and now, as a director, I’m identifying where we should put our research efforts, getting funding and developing strategic partnerships,” he explained.
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The VRC’s research on sensors aims to help dentists screen and diagnose for a diseased state. “We’re hoping to identify when you have a caries under a crown or a restoration, or developing tech so that you can detect periodontitis,” said Hart. “Additionally, we’re focusing on sensors that can detect biomolecules or chemicals that can send a signal outside the mouth to your phone, for instance, alerting you that you have been exposed to something, like bacteria or a virus.” In many ways, Hart explained, the diagnosis of dental disease is subjective. VRC researchers would like to be more objective, and include 24/7 monitoring, whether it’s on the toothbrush or on a restoration. The focus is on developing products that help dentists and the dental team do a better job of delivering care to the patient.
Finally, researchers at the VRC are looking at a number of devices, including a chip that will allow researchers to demonstrate biocompatibility. “We’re putting pulp or mucosa on a chip,” Hart said. “Instead of needing to perform animal studies or traditional lab studies, we’ll have a device that can measure responses to treatments or bacterial challenges.” Dr. Jeff Kim and his team are working on occupational exposures. In one project he’s characterized e-cigarette vapor: what’s in it; how it can change bacteria in the mouth; how it can promote caries; and how it may cause damage to a cell. In another, he’s looking at nano-particles that are generated in a dental office to see how the flow of ventilation in the office can affect nano-particulate in the air, and how using water with your handpiece can limit the amount of nano-particulate in the air that dentists and their teams are exposed to. It is practical research for the dental environment.”
Who gets the green light?
As Hart said, they look for research with cross-functional properties. Kim and Hart review technologies being developed in the scientific community with an eye for utility in the dental world. “We can set the parameters that we need,” Hart explained. “As periodontists we looked at the bone graft materials that Dr. Larry Chow had developed and realized that they could be optimized for the oral cavity. Sure, we needed to change the properties a little bit, but it could be optimized for use in dentistry because it had anti-inflammatory/anti-microbial properties that could be beneficial.” The time frame for the research varies, Hart said. “For instance, when Dr. Kim was characterizing the components of an e-liquid for e-cigarettes by gas chromatography–mass spectrometry (GCMS), he vaped it and determined what was present. It’s surprising that a large number of components are present in the vape. An experiment such as that might take a week, but the planning, design, and setup may take longer. And that’s part of a longer
experimental protocol: not just what components are generated, but how do they affect the oral cavity, what effect do they have when they coat the teeth, how do they change the existing bacteria, how do they change the function in the environment? Part of the work we do is iterative. We do an experiment, find a result, and follow where that takes us.” Unlike entities performing research, the NIST receives requests from companies with a measurement challenge. The companies work up a cooperative research and development agreement (CRADA), the NIST scientists work on the problem, and the company provides resources to hire someone, helps work on it, and helps pay for the equipment and supplies used. The NIST has some advanced equipment, like the neutron facility and a nano-fabrication facility, that most companies don’t have access to because the cost is prohibitive. “The building has certain airflow characteristics and more than 100 pieces of specialized equipment in the lab. So not only do they have the equipment, but the individuals understand how to operate it. The NIST can bring a diverse group of scientists together to figure out an issue or challenge. One of the things that the NIST is doing going forward is working to bring together new groups of people and new partnerships to tackle a common problem from some different directions. There are some research enterprises that are similar, but the NIST is unique in what it can bring to the table.”
Want to help and get involved?
There are a couple of ways you can be involved in keeping the VRC going. First, you can donate to the ADA Foundation (adafoundation.org/en/how-to-help). Please choose ADAF research to ensure that the VRC gets the donation. VRC equally welcomes research ideas for its scientists. Their mission, Hart explained, is to develop better materials, tools, and products for clinicians to render better care. And having spent many hours at the chair himself, Hart knows that dentists have many good ideas that fleetingly go through their mind while they’re working, and he’d like to access those ideas. It sounds pretty simple, but researchers at the VRC want to know what the bottlenecks are and what you need in your practice. When they hear what people need, it helps them focus, Hart said. “We’re interested in encouraging those dialogues, and hearing from people to provide better care. I can’t tell you the number of times we’ve had a discussion about an area of dentistry that came about from a clinician. It leads to fruitful interaction, and it makes us think.” Recently, a caller asked about pulmonary diseases in dentists because a group of dentists in Virginia had an increased level of lung diseases, and they were wondering if it could be occupational. The caller wondered if it had something to do with removing crowns and the particulate released into the environment, and researchers were able to tell him about some of the things that they’re working on, but they learned from the discussion, too. “Nine times out of 10, that is the case,” Hart said. “We need to hear from dentists. And wouldn’t it be great if one of your dentists told us about something they needed, and we were able to make something to solve the problem? That’s member-driven involvement at its best!” If you have an idea you would like to share, email it to Rob Bahnsen, Managing Editor of the WSDA News, at email@example.com, and he’ll forward it to Dr. Hart.
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Larry Chow’s team. “He is a brilliant scientist; he and his team made the first bone cements. Those were used by Stryker in orthopedic surgeries, so we’re trying to see if they can be adapted for use in peri-implantitis treatments. If you have an infection in the bone, these will respond to that infection as needed. So, he’s making smarter bone cements, as it were. Those are the types of materials research we’re involved in now.”
member news dr. ron hsu’s mission to save teeth
Dr. Ron Hsu first got interested in dental trauma as a resident at the University of North Carolina, Chapel Hill, where he worked on a number of cases involving young athletes. His interest never waned, and he ultimately became a member of the International Association of Dental Traumatology (IADT), a group dedicated to educating practitioners and interested parties in education, sports, industry, and appropriate governmental agencies about optimal prevention, research, and treatment service in the field of traumatic dental injuries. Hsu knows that tooth avulsions are a rarity. As the oncall pediatric dentist for Legacy Salmon Creek Pediatric Emergency Department in Clark County, Wash., he sees a handful of trauma cases and about one avulsion a year. However, he is concerned with educating school nurses, coaches, and referees about the different types of dental trauma that can happen in sports, on school playgrounds, and in scuffles during school. But so many misconceptions abound — that transporting an avulsed tooth in water or on ice is a good thing, for instance — that Hsu reached out to Clark County school administrators and pitched a plan to educate area nurses about the different types of tooth injuries, how to treat them, and how to increase the likelihood that an avulsed tooth can be saved. To date, Hsu has provided educational programming for 56 nurses serving 71,000 children in grades K though 12. He would love to reach out to coaches and referees, too, but for now, his mission to meet with as many nurses in his county as possible. For Hsu, the first line of defense is the Save-A-Tooth kit, a small sealed container full of Hanks Balanced Salt Solution, a tissue storage and transport media that can keep the root cells of up to four teeth alive beyond the typical 15 minutes. Properly used, it expands the window of opportunity for successful replantation of the tooth by up to 24 hours. Armed with a grant from Clark County Dental Society (CCDS) and a substantial discount from Henry Schein, Hsu has given a kit to every nurse and has supplied two kits to Cascade Little League for each of seven baseball field first aid kits. Because there are many other Little League athletic programs in the county, he would like to widen his distribution circle to include more sports. “Luckily,” Hsu says, “we don’t see as many injuries in football and basketball because those children routinely wear mouth guards and helmets. However, in sports like lacrosse and soccer, where kids don’t wear mouth guards, it’s more common to see injuries. A lot of softball and baseball pitchers are beginning to wear helmets to safeguard against accidents.” So far, the program has donated 62 kits at a cost of about $850. CCDS has committed $2,000 to cover two more renewals of the kits, which will cover all schools in Clark County for six years.
The high cost of avulsions
In his presentation to the nurses, Hsu first explains the differences among subluxation, extrusion, intrusion, lateral luxation, and avulsions, using actual case studies and
showing pictures of the injuries. Additionally, he covers the types of lacerations most commonly seen in these injuries and explains best practices for their treatment. Hsu points out that a tooth lost to an avulsion as a child could easily cost the patient $10,000 over his or her lifetime, depending on the restoration and re-restoration of the affected tooth. That information seemed to resonate with the nurses on the day we accompanied Hsu for his presentation in Battle Ground, a thriving community with a mix of low-income and affluent families.
There’s an app for that
Dental trauma isn’t a well-understood field, Hsu says, adding, “We’re better now than we were. A Danish oral surgeon named Dr. Jens O. Andreasen was an early pioneer in dental traumatology, and over the years he and his team were able to collect enough data from Scandinavian countries to determine what treatments work better than others, and what the prognoses are based on treatments.” Today, the IADT promotes research in dental traumatology, stimulates the development of educational curricula in managing dental injuries, and promotes public awareness of the prevention and management of dental injuries. To that end, the association recently developed a free app called ToothSOS, which is available on multiple platforms. It’s a great companion reference to the Save-A-Tooth kit, and something every referee, coach, and parent should have access to on their phone. Additionally, the IADT has posters translated into more than 20 languages available for download on its website. Visit www.iadt-dentaltrauma. org/for-patients.html.
Hsu would like to see his work replicated statewide. He’s currently compiling a list of dentists willing to see trauma patients in Clark County and hopes that other component societies will pursue their own programs locally. If you would like to join Hsu’s team, email your name, your office name, and the phone number where you would like to receive dental emergencies to firstname.lastname@example.org. Hsu will put you in touch with the right people at Henry Schein to get a comparable discount on the Save-A-Tooth kits. Local nurses, coaches and referees will welcome the information and training, and with so many children in sports programs across the state, you’re sure to have a lasting impact in your community by adopting Hsu’s model.
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member news dr. ron hsu’s mission to save teeth
PREPARING FOR THE WORST:
DR. RON HSU’S MISSION TO SAVE AVULSED TEETH
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pndc news 2018 exhibitors
Check out the exhibitors at the PNDC, June 21 & 22! 4.0 Transitions by Practice Management Associates, LLC 3DBioCAD 3M Oral Care ACTEON North America A-dec ADS Equipment IT Services Air Techniques ALCO Supplies / GloveeXpress Align Technology, Inc Aseptico Astra Practice Partners Aurum Ceramic Dental Laboratories Belmont Equipment Benco Dental Best Card, LLC Beutlich Pharmaceuticals, LLC BioHorizons Biolase Birdeye Bisco Dental Products Brasseler USA Briway Seattle/Fidalab Burkhart Dental BURST CareCredit Carestream Dental Carl Zeiss Meditec, Inc. Carr Healthcare Realty Colgate Columbia Bank Comcast Business Constantine Builders, Inc. cosmetics expo CRC Technologies Crest+Oral-B Delta Dental of Washington & Arcora Foundation Dental Accounting Pros Dental Professionals Dentech Dentsply Sirona Endodontics Dentsply Sirona Implants DesignLine Dental Systems Designs for Vision, Inc. DEXIS Digital Doc, LLC Doctor Multimedia Doral Refining Corp doTERRA Essential Oils
DSN Software, Inc. Eclipse Loupes and Products EDI Digital Technologies Elevate Oral Care Garfield Refining Company Garrison Dental Solutions GC America Inc. GlaxoSmithKline Consumer Healthcare Global Surgical Greater New York Dental Meeting Greenway & Company P.S. Guardian Dental Harris Biomedical Hawaiian Moon HD Fine Art Henry Schein Dental Henry Schein Practice Solutions Henry Schein Professional Practice Transitions Hiossen HomeStreet Bank Hu-Friedy Human Touch Impladent Ltd Infinite Trading Inc Ivoclar Vivadent, Inc. KaVo Dental KaVo Kerr Kettenbach Kulzer Lighthouse 360 LightScalpel LLC Lloyd’s Dental Lab LumaDent, Inc. McGregor & Oblad PLLC MCNA Dental Nakanishi Dental Laboratory, Inc. Neo Dental International, Inc. Neodent NORDIC NSK America O’Brien Dental Lab, Inc. Olympic Orthodontic Laboratory Omni Practice Group Opes Advisors, A Division of Flagstar Bank Orascoptic Otto Trading Inc Patterson Dental PDT, Inc./Paradise Dental Technologies Pelton & Crane
Peterson Sales Philips - Sonicare and Zoom Whitening Physicians & Dentists Credit Bureau Planmeca USA, Inc. Porter Royal Sales Prexion Inc. Pro Photo Supply Professional Sales Associates, Inc. Q-Optics & Quality Aspirators Inc Rewards Dental RGP Dental Richardson Group Rose Micro Solutions Salvin Dental Specialties, Inc Savage Success SciCan Inc. Sesame Communications Shikosha Dental Lab Sky Dental Supply Straumann Sunstar Americas Inc Surgically Clean Air Surgitel The Dental Files The Dental Group LLC The Knutzen-McVay Group Tooti enterprise inc U.S Jaclean UBS Financial Services Ultradent Products, Inc. Ultralight Optics UnitedHealthcare Valumax International VOCO America, Inc. Water Pik Inc. WDIA Weave WEO Media Willamette Dental Group Yelp Zero Gravity Skin Zimmer Biomet Dental
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The Christensen “Bottom Line” – 2018
Gordon J. Christensen, DDS, MSD, PhD Saturday, June 23, 8:30 AM-4 PM Don’t miss world-renowned dental speaker Dr. Gordon Christensen at PNDC 2018. His fast-moving, two-part “bottom line” course will cover the areas of dentistry with the most activity and change in 2018, introducing you to important new techniques and materials you can use in your office this year!
Posterior Composites That Last
Lee Ann Brady, DMD Thursday, June 21 from 2-5 PM Posterior composites are the mainstay for many practices and being able to perform them predictably and with efficiency is the goal. Learn current materials, techniques, and instrumentation to accomplish those goals.
Reducing Inflammation Through Nutrition – The Key to Perio Success
Tim Donley, DDS, MSD Thursday, June 21 from 2-5 PM Learn real-world nutritional strategies that can help your patients reduce their systemic level of inflammation. Leave with the knowledge and materials to immediately incorporate a realistic nutrition and lifestyle protocol that can improve the health of your patients, your practice, and maybe even yourself!
Everything You Need to Know About Peri-Implantitis
Dimitrios Karastathis, DDS, MSc Friday, June 22 from 1-4 PM This session is designed to cover every aspect a dental practitioner needs to know about peri-implantitis. Topics will include etiology, prevalence, anatomy of the disease, risk factors, diagnosis, treatment, and prevention.
Paradigm Shifts in Periodontal Therapy: Implementing Evolving Protocols
Kristy Menage Bernie, RDH, BS Thursday, June 21 from 2-5 PM Attend this interactive session which will review accelerated periodontal instrumentation protocols and the new gingivitis code, incorporate recommendations from the AAP Comprehensive Periodontal Therapy document, and inspire attendees to unconscious competency!
Contemporary Clinical Periodontology and Oral Implantology 2018
Jon Suzuki, DDS, PhD, MBA Thursday, June 21 from 8-11 AM Explore new trends in periodontal diagnosis and treatment planning! Concepts of pathogenesis and immunology related to periodontal diseases as well as advances in periodontal therapies will be covered.
this fast-paced and inspirational session, you will learn that what you do (or what you don’t do) at home and in the dental office can equally influence your physical health, energy, and productivity.
7 Proven Steps to Negotiating Increased Fees/Allowables with Insurance Carriers Benjamin Tuinei Friday, June 22 from 7:30-10:30 AM Learn how to successfully navigate the fee-negotiating process with dental insurance carriers! Understand the “why” behind the financial aspect of quality care, learn effective negotiating strategies, and learn the seven steps to successful negotiations with PPOs.
Pet Peeves of Dental Assistants
Tija Hunter, CDA, EFDA, CDIA, FADAA Friday, June 22 from 1-4 PM Pet Peeves: We all have them, let’s discuss how to handle them and the people that create them!
Explore the full schedule and register online by June 18 at wsda.org/pndc.
Posture Perfect: Let’s Get Your Mojo Back!
Uche Odiatu, DMD Friday, June 22 from 1-4 PM Creating a healthy workplace is important, but it’s not the only part of enjoying a pain-free career in the dental industry. In
WHAT’S ON TREND AT THE PNDC EXPLORE THE FULL SCHEDULE AND REGISTER ONLINE BY JUNE 18 AT WSDA.ORG/PNDC!
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pndc news what’s on trend at the pndc
Check out some of the top-trending courses with registered PNDC 2018 attendees. Make sure to register online at wsda.org/pndc by June 18!
We are pleased to announce... Brandon T. Johnson, D.D.S. has acquired the practice of
Richard E. Davies, D.D.S. Sequim, Washington
Corey Plaster, D.D.S. of 5th Avenue Dental, PLLC has acquired the practice of
James D. Breeden, D.D.S. Spokane, Washington Call today for a FREE MARKET VALUE ANALYSIS
We are pleased to have helped in these transitions. 800.232.3826 | www.AFTCO.net Practice Sales & Purchases Over $3.2 Billion
WSDA June 2018.indd 1
5/7/2018 9:26:57 AM
After more than 30 years of coaching Doctors, Blatchford Solutions is excited to announce a new, full-service brokerage business, Blatchford Transitions, Inc. Blatchford Transitions will offer services nationwide, helping dentists to buy and sell dental practices. We are here to help Doctors prepare for and make rewarding transitions by expanding their thinking beyond what is presently being offered by other brokerage firms.
Dr. Bill Blatchford
We look forward to working with you when it is your time to buy, sell or merge a practice. Please visit our website blatchfordtransitions.com or call us toll-free at (844) 735-7600 to discuss your transition needs. 2 6 · th e wsda ne w s · issue 6, may 2018 · www.wsda.org
Come Visit WDIA at Booth 119 at the Pacific Northwest Dental Conference! The Washington Dentists’ Insurance Agency (WDIA) is a subsidiary of WSDA, so WDIA only works with dentists, and its products and services are specifically designed to meet their needs. All revenue earned over operating costs is returned to WSDA. WDIA offers the following types of insurance for dentists and their staffs:
Business Overhead Expense (Disability): Covers the expenses for the day-to-day operations of your business; 10 percent discount for WSDA members
Buy-Sell Agreements (Disability or Life): Leaves no question as to what will happen to a deceased or disabled partner’s share of the business
Life Insurance: Provides the funds needed
NORDIC Professional Liability: Comprehensive liability coverage
to support your spouse and/or children Long-term Care: Helps you meet the cost of your care should you need assistance with daily living
NORDIC Business Owners Policy: Cov-
Group Medical Insurance: Covers one or
Personal Disability: Covers personal in-
Individual Medical Insurance: Can only
ers your practice’s property, general liability, and financial risks come protection; 10 percent discount for WSDA members
Business Loan Protection (Disability): Covers your business loan payments if you become disabled
more employees in an office; can be started at any time
be purchased during the annual open enrollment period, unless you have a qualifying event
MedAdvantage/ Medicare Supplements/ Medicare Part D Script: Cover
medical costs that are not covered by Medicare Parts A and B
Surety Bonds: Cover the money in your
office pension plan as mandated by federal requirements; an Employee Dishonesty Bond protects you from losses suffered due to theft by an employee
CyberSecurity: If patient information is
stolen from a dental office, this protection covers the cost of investigating a theft, the state and federal fines and penalties, lawsuits, and legal fees
Travel Insurance: The two types are Med-
jetAssist, a global air-medical transport program, and Travel Guard, which offers comprehensive travel packages. To learn more about the insurance coverages WDIA can offer or for an insurance review, visit www.wdiains.com, call WDIA at 206-441-6824 or 1-800-282-9342, or email email@example.com.
Becoming a managed care vendor* If you were to ask five dentists what words come to mind when they hear the phrase “Medicaid dental managed-care vendor,” we imagine the possibility that none of them would be exciting. But for The Guardian Life Insurance Company of America (Guardian)®, the prospect of being a Medicaid dental managed-care vendor for a state like Washington can be exciting. Why? Because one simple question drives us every day: How can we help? We want to help you help your patients take the best care of their teeth. To us, you are not just another access point. You are an important member of the team charged with ensuring that each Washingtonian with government dental benefits has the information, resources, and access to care needed to achieve optimal oral health. We are excited to offer help to Washington Medicaid dentists by: 1. Answering your questions and offering support through our local clinical and network teams. We offer local on-the-ground support for our dental providers, so they don’t have to call an office on the other side of the country to ask a question. • Guardian’s provider relations team, based out of Spokane, will help you understand the quickest way to file preauthoriza-
tion requests and claims using our secure online portal. • Guardian’s Washington Medicaid Dental director will answer your questions about clinical decisions and coordinate continuing education workshop on topics like special-needs dentistry and detecting and reporting family violence. 2. Giving you 150 years of experience. Guardian has been providing insurance solutions since 1860. Many of you may already have experience with us as providers in our dental insurance networks. We now seek to bring our vast insurance and administrative experience into Washington’s Medicaid community. 3. Introducing innovative dental service solutions that complement the great work Washington has been doing to improve oral health. Guardian and our wholly owned subsidiary and government programs administrative partner, Avesis, have developed innovative approaches to dental benefits management, like: • Offering bonus payments that complement, rather than compete with, your ABCD reimbursement enhancements
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• Integrating dental care with medical care in the interest of engaging the dental community in supporting the goals of Healthier Washington 4. Taking our mandate seriously. We believe our work helps give people the security they deserve for life. Dentists know that good oral health can correlate to both financial and physical security. We recognize this, too. It’s why we hold ourselves and our organization’s management of government dental benefits – the member outreach and education, the call center, the dental network, claims processing, and provider payments – to the highest standards. Helping you help your patients is what excites us. So please trust that when you need information, understanding, or expertise, we’ll be there to ask, “How can we help?” And then we will. Learn more about joining the Medicaid dental network Guardian is building in Washington by visiting www.guardiananytime.com or calling 509-468-6490. Avesis is a wholly owned subsidiary of The Guardian Life Insurance Company of America, New York, NY. #2018-58939 (exp. 4/20) *Sponsored content
pndc news sponsor companies
What insurance do you need?*
Let’s talk about how we can help your practice. HomeStreet offers banking expertise and financial solutions specifically tailored to meet the needs of your practice.
SCOTT HARVEY 206.254.7280 Scott.Harvey@homestreet.com
Visit us at the Pacific Northwest Dental Conference, booth #224
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Special to the WSDA News by Leigh Sinni Professional Practice Relationship Manager, HomeStreet Bank Member FDIC Are you looking for a new place to house your dental practice? Or are you considering the purchase of the building your office currently occupies? An Owner Occupied Commercial Real Estate loan could be your solution. This type of ownership requires that you and your business occupy 51 percent or more of the building, which can include common areas such as hallways, HVAC and shared bathrooms. If you meet these criteria, there are many benefits to Owner Occupied Commercial Real Estate loans that will reap valuable rewards for you and your practice. They include: Owning an appreciating asset. Your rent as a practice owner goes toward paying the debt on the building, instead of a third party. This reduction in debt increases your equity and your net worth. Like homes in Washington state, commercial real estate is increasing in value faster than most investments. Often, it can lower your rent payment. With leased space vacancies at an all-time low, lease rates are going for a premium. De-
pending on the purchase price of the building, a 25-year amortization and historically low interest rates may lead you to find that owning is less costly than renting. Tax Breaks. Property ownership comes with tax write-off opportunities you would not get with renting. Consult with your CPA for more information. It also increases ease in the sale of your practice. Building ownership decreases the risk of having to negotiate with a landlord to reassign or draft a new lease for your prospective buyer. It’s a great asset when it comes to your retirement and estate planning. Owning a building gives you the opportunity to collect a monthly rental income from tenants. You also have the option to sell the building and cash out that equity. It eliminates the uncertainty that comes with renting. Most commercial leases have automatic escalation clauses regardless of economic conditions. Fixed-financing options that come with ownership allow you to better budget your monthly expenses. There are several Owner Occupied CRE financing options if you are considering this type of loan. A Conventional CRE Loan is best if you
have cash to put into the loan immediately. These loans often have the lowest fees and most competitive rates. With that, they are one of the less-flexible loan products, require a minimum 20 percent down payment, and have shorter loan terms and fixed-rate periods. An SBA 504 Loan for CRE Acquisition is a great option for a buyer who is looking for longer fixed rates and terms. These loans have low rates and are a more flexible loan product that can include tenant improvements and equipment funding. They have higher fees, a 10 percent down payment requirement for most buyers, and stricter prepayment penalties than other options. A final option to consider is the SBA 7a Loan for CRE Acquisition. This loan is excellent for buyers who may not have the cash for a down payment. Although it has higher rates and fees, it is the most flexible loan product, as it can include tenant improvement, equipment financing, and working capital funding. Contact your local dental CRE loan specialist to learn more about these financing options, and find out whether you qualify for an Owner Occupied Commercial Real Estate Loan.
Is your practice ready for change?* Special to the WSDA News, by Melissa Moore Sanchez, CIC, Manager, Northwest Dentists Insurance Company The world is changing, and some of those changes eventually show up in the dental practice. Sometimes it’s a cultural change. Sometimes we obtain more medical knowledge, which gives us the tools to confidently provide appropriate care to our patients. And sometimes the decisions we make, or don’t, increase our risk of liability exposure. Join Melissa Sanchez with NORDIC as she reviews the basic principles of good risk management. She’ll also explore providing care to pregnant patients and patients with sleep disorders, and discuss the dialogue to have when working with transgender patients.
Do you know what to do when an equipment or instrument failure occurs and injures a patient? Sanchez will address that, as well. Marijuana use and the opioid epidemic are hot topics right now. She’ll discuss proper care and charting when dealing with patients who may be drug seekers or are arriving for their appointment under the influence. Is your practice ready for our changing world? Join Sanchez at the PNDC from 8 to 11 a.m. on Thursday, June 21. This session is appropriate for dentists and staff, and qualifies NORDIC-insured dentists for a 5 percent risk management credit.
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* Sponsored content
pndc news homestreet bank, nordic
Owner occupied real estate*
LOCAL DENTAL COMPU TER I.T. SUPPOR T, SINCE 2001
What makes us different? We answer our phones! Many of our clients call us in the 2-minute gaps between patients. Leaving a voicemail and waiting for a callback is not an option here! We do not use call centers or 3rd party answering services. When you call our number, one of our Seattle-based office techs will be answering the phone.
We staff our office. The technician that answers your call is not going to be driving or working at someone else’s office.
We offer same-day onsite appointments. We know the effect that a downed server, a malfunctioning operatory PC, or a broken x-ray scanner has on your practice.
We do not use contracted technicians. All of our people are employed, trained, and vested in our company and our clients.
We have vast experience in dental industry. We work with every single practice management, imaging and hardware vendors. Our techs are familiar with the particular needs, schedules, timelines, and necessities of a dental office.
Learn how we can help, contact me today
Tyson Varosyan Founder, CEO & Director of Technology 206-715-TECH (8324) www.utspro.com
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Purpose: The Citizen of the Year award exists to recognize a member dentist who has given outstanding service to a domestic and/or foreign community; to encourage others toward such activity; to reinforce values of volunteer service desirable in society; and to promote the image of dentistry.
Nominations: • Nominations can be made online: https://tinyurl.com/2018COY
Criteria for Selection: • The nominee must be a WSDA member • The award will be based on civic activities, elective and volunteer, including, but not limited to: Service organizations Youth groups Schools Non-salaried government positions Church-sponsored community services Personal commitment to community service through volunteering Service to all 501(c)(3) Foundations • Priority will be given to nominees whose service has been in Washington state
Nominations: • Nominations may be made by an individual member or a component dental society. Former nominees may be renominated. Letters of support from organizations with which the candidate has been involved are encouraged. • Nomination deadline: The first Friday in June of each year (June 1, 2018)
Selection: • Selection of the state award winner will be made by the Task Force on Recognition of the Washington State Dental Association
Presentation: • The award will be presented at the annual House of Delegates meeting September 22, 2018, Hotel Murano in Tacoma, Wash.
2018 WSDA CITIZEN OF THE YEAR AWARD
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Photos by Craig Mitchelldyer & Scott Eklund
Dr. Nhi Pham 2017 Citizen of the Year
call for nominations citizen of the year
Nominate a peer today!
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SERVING WSDA DENTISTS SINCE 1953 3 2| 2959 · th eNorthup wsda Way, ne wBellevue, s · issueWA 6,98004 may 2018 · www.wsda.org 425-822-2245 | 800-735-7231 | www.nakanishidentallab.com
Have you ever wondered how to get more involved with the WSDA or ADA? Now is your chance! We encourage members to apply as a candidate for an open state or national elected position.
2018 hod news call for nominations
Call for nominations
Nomination packet can be found here: ht tps://tinyurl.com/ WSDANomina tions2018 Candidates should be present during the WSDA House of Delegates, held September 20-22 at Hotel Murano in Tacoma, WA. All terms begin when the WSDA House of Delegates adjourns on September 22, 2018, with the exception of the ADA Delegates, whose terms begin on January 1, 2019. Please email Brenda Berlin at brenda@ wsda.org with any questions.
Term: One year as President-elect, one year as President, one year as Immediate Past President, Three years as ADA Delegate (2019, 2020, 2021) Requirements: WSDA member. Must have been a member for the preceding five consecutive years.
Board of Directors
Open Positions: 4 · Term: 3 years Requirements: WSDA member
Committee on Budget and Finance Open Positions: 1 · Term: 4 years Requirements: WSDA member
Delegate to the ADA House of Delegates
Open Positions: 3 · Term: 3 years (2019, 2020, 2021)
CALL FOR NOMINATIONS
th e wsda ne w s · issue 6, may · 2018 · www.wsda.org · 33
Photos by Rob Bahnsen
During the 2018 WSDA House of Delegates (held September 20-22 in Tacoma), the House will vote to fill the elected positions shown at right. For a complete description of any position, please email Brenda Berlin. The application period is now open for state and national elected positions with WSDA & ADA! To run for any of the open positions, please complete and return our candidate nomination packet by June 30, 2017.
wdia news disability insurance
DISABILITY INSURANCE: MAKE SURE YOU HAVE THE RIGHT COVERAGE AMOUNT
Although Disability Insurance does not seem like a necessary expense compared to the mortgage on your home or your electric bill, it is still crucial to have disability insurance in force and in step with your needs. Disability protects your family and you if the worst should happen, but if you do not have policies that cover both personal and professional expenses and are at the needed coverage amounts, the gaps in coverage may cost you. The best way to protect yourself, your family and your practice is to make sure your insurance policies have the full protection you need. Ask yourself: how much money do I need on a monthly basis to pay all my personal expenses and for my practice to run effectively? If the amount you need is less than what you currently have in monthly benefit on your disability coverage or if you are not covered at all, then you will want to consider increasing your existing coverage and/or obtaining other types of disability coverage. Included here are some important types of disability policies and how they protect you. Although each type provides coverage for a different aspect of your life, the benefits on each policy are triggered by you no longer being able to perform the duties of your profession. Having multiple policies at the correct coverage amounts ensure that every part of your life will be protected.
Personal Disability is the most common type of disability coverage. Benefits from a Personal Disability policy are meant as personal income replacement to cover your loss of earned income if you become disabled. This coverage would be used to pay your home mortgage, water and electric bills, car payment, groceries,
gas, children’s tuition: anything that your paycheck covers for your family. Without Personal Disability, all your monthly expenses would have to be paid from your savings.
Business Overhead Expense is specific to covering your business expenses if you become disabled. This coverage allows your business to continue to run while you are recovering from a disability or in the process of selling your practice. Expenses that are covered by this policy include: rent, staff salaries, electricity, dental supplies, janitorial and maintenance work, etc. Without Overhead Expense coverage, you may not be able to keep your business running while you are recovering from a disability.
Business Loan Protection
Business Loan Protection (also called Business Reducing Term coverage), specifically covers your mortgage or equipment loan payments to the bank if you become disabled. A practice loan is thousands of dollars per month and without Business Loan Protection, you would be paying for your loan out of your pocket. Although savings may cover the costs in one aspect of your life, it is unlikely that you would have enough funds to cover your personal and business expenses indefinitely. Washington Dentists’ Insurance Agency encourages dentists to acquire different types of disability insurance to ensure that all personal and professional expenses will be covered for the well being of themselves and their families. If you would like to review your current Disability Insurance or get quotes for additional coverage, please contact WDIA at 1-800282-9342 or firstname.lastname@example.org.
VISIT US AT THE PNDC: BOOTH 119
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wdia news disability insurance
The Obvious Choice for Washington Dentists
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Precious metal reclamation is the conversion of scraps collected at the dental chairside or in the dental laboratory into an identifiable financial return. The scraps themselves come in many forms, from failed crown and bridgework to extractor bags and floor sweepings. The types of metal found in most dental scraps are gold, platinum, palladium, and silver. Many dental offices have drawers or boxes full of precious scrap, but don’t know who to trust to refine it and provide the best value. There are many ways to sell your gold and other precious metals. Refiners may call at your office, look at your scrap, and tell you what it’s worth. You can also search the internet for gold buyers, or work with one of the many “pop-up” gold buyers on a neighborhood street corner. Unfortunately, many cash-for-gold transactions enrich the buyer, but shortchange the seller rather dramatically. Finding a reputable and safe way to receive excellent value for gold and other precious metals is a problem that is too familiar to dentists. Who is the person who calls on your office and wants to refine your gold? Are you being paid fair value? How would you know? One of the best ways to maximize your scrap metal return is to find a company that takes a scientific approach to valuing it. They should be able to report to you, in writing, the precise contents of the precious metals in your refining submission. Many refiners
will attempt to tell you the value simply by visual inspection. This cannot be done with any degree of accuracy. After shipping your quantity of scrap precious metal in an insured, sealed container, the refinery begins the process of reclaiming the precious metal content. The refinery should process your submission separately. Your metals are melted in a crucible, reducing the metal, porcelain, and biological tissues to a molten substance. The molten material is poured into a block form and cooled. A sample drilling is taken to forward to an independent assay office. The assayer analyzes the sample to determine the quantity of each precious metal in the core sample. Once the assay has been determined, the bar is priced on the London-based precious metals commodity market. Payment is then made to you for the value of the four precious metals at the established price. You will receive a detailed analysis report showing the total weight of the material sent, the amount of nonprecious waste, and the true weight and value of each of the precious metals.
Types of metal scrap
Gold, platinum, silver, and palladium are found in most dental alloys used in crown construction. Often included is a percentage of nonprecious alloys, including copper, which is used to bond and fuse
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the manufactured alloys. The content of precious metals can vary by several percentage points. Additional materials that constitute precious scraps include bench grindings from the technician. This is where the technician trims a crafted crown to meet the requirements of the patient. The grindings and trimmings are collected and melted in the same method described above. Dental labs typically have larger-volume material, including extractor bags and sweepings, which also contain precious metals. This type of material can only be processed by incineration. Other scrap includes platinum foil (used in copings); rugs and carpets that have been in a laboratory for a considerable amount of time; and casting flashes from the casting machine. There are many alternatives for precious metal refining. Your association has done the legwork for you and endorses D-MMEX EasyRefine for precious scrap metal refining. It uses the scientific approach described above. As an added benefit, members receive an additional 5 percent premium on the total value of the submission. Current rates are 97 percent of the value for gold, 90 percent for platinum and silver, and 85 percent for palladium. For a shipping kit, please call 800-741-3174 or order a kit online at easyrefine.com.
endorsed company news easyrefine
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For more information, please contact Dr. Ron Sherman 425.922.6700 or email@example.com
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Speaker of the House needed
The WSDA is looking for a Speaker of the House for the 2018 House of Delegates. Candidates must be a member in good standing and will be selected by the WSDA Board of Directors. The following are NOT eligible for the position: voting delegates of the WSDA House of Delegates; members of the WSDA Board; and any member running for an officer’s position or a position on the Board of Directors of WSDA. In case the Speaker is unable to fulfill the duties, the Board of Directors shall appoint a replacement Speaker of the House. To apply for the position please contact Brenda Berlin at firstname.lastname@example.org.
Paxton Memorial Funds
Following the devastating news of Dr. Mark Paxton’s unexpected death recently, members of the Spokane District Dental Society (SDDS) worked quickly to establish memorial funds in his name so that his legacy will endure in the community. SDDS Executive Director Wendy Johnson said, “Our Society will be donating $13,000 to the new Spokane Dental Residency Program in Dr. Paxton’s honor, Providence Hospital will be naming the surgical suite in his honor, and the Society is donating $7,000 to start
a scholarship in Dr. Paxton’s name that will be available to dental students (hygienists, assistants, dentists, and specialists). Additionally, a scholarship fund for Washington State University students to go on mission trips has been established in Dr. Paxton’s name. Dr. Paxton made a daily impact in our community and within our Society. It’s important to our members to honor his contributions and establish a way of giving back in his name.” Donations may be made to: The Dr. Mark Paxton Endowed Fund WSU Foundation PO Box 641925 Pullman, WA 99164 Spokane Dental Residency Program Spokane District Dental Society 23403 E Mission Ave, #104 Liberty Lake, WA 99019
WSDA member returns from annual mission to Guatemala
Dr. Gregory Plancich recently returned from his annual mission trip to Peronia, Guatemala with the nonprofit organization Open Wide Foundation. Open Wide Foun-
dation at Spear Education operates yearround and coordinates dental teams from all corners of the United States for 35 weeks out of the year. This is a journey that Plancich and his son Bryce have embarked on for the past seven years. Open Wide Foundation’s mission is to bring oral health care to underserved communities worldwide. Through its work, more than 125,000 patients have received dental treatment by 500-plus volunteers. In addition, more than 40 local dentists have been trained by the nonprofit organization, which has opened more than nine dental clinics in developing world countries. If you would like to donate or learn more about Open Wide Foundation, visit: www. openwidefoundation.org.
Submit your Credentialing Application to ProviderSource by June 1, 2018
In an effort to reduce administrative burdens for providers in Washington state, the Legislature passed Second Substitute House Bill 2335 in 2016, which requires providers to submit credentialing applications to a single credentialing database, Medversant’s ProviderSource, by June 1, 2018. continued on page 41
On average, it takes 200 hours to sell a dental practice. As a group of former dentists and experts in practice management, we have successfully guided hundreds of dentists through transitions.
Let us do the work. Get started today with a free consultation. 877-866-6053 email@example.com Practice listings: omni-pg.com Real estate listings: omni-hcre.com
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COME VISIT US AT PNDC!
newsflash issue 6, may 2018
4.0 Transitions by
Welcomes You to the 2018 PNDC!
Each dentist that stops by our booth will be entered into a drawing for a bottle of Leonetti or Quilceda Creek your choice!
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As your trusted advocate and confidant, allow my 20 years of practice valuation, transition, and banking knowledge secure a predictable transition for you.
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I have been working with dentists for over 20 years and I understand your business model. Allow me to help coordinate your optimal transition.
Practice Management Associates partners exclusively with dentists who are value driven, results oriented and relationship based. Our team has been serving dentists for over thirty years. We take a comprehensive approach, providing transition services, succession planning, leadership coaching and communication training to build healthy teams and work environments. (888) PMA-404U or (888) 762-4048 firstname.lastname@example.org • www.practicemanagementassociates.org 4 0 · th e wsda ne w s · issue 6, may 2018 · www.wsda.org
This legislation also requires health carriers to accept and manage credentialing applications from the same database. Effective June 1, 2018, health carriers must make a determination approving or denying a credentialing application submitted to the carrier no later than 90 days after receiving a complete application. Effective June 1, 2020, a health carrier’s average response to approve or deny a provider’s credentialing application may not exceed 60 days. OneHealthPort is the organization that was selected by the Office of the Insurance Commissioner to vet and select a uniform electronic process for collecting and transmitting provider-supplied data to support credentialing and other related processes. OneHealthPort chose ProviderSource, a free online data collection and verification system that allows providers to manage their provider data used for credentialing. By entering your practice data once and attesting to its accuracy, your practice will be allowed to utilize a service that: • Continuously reviews and verifies pre populated provider data available through public databases • Provides a place to enter your practice
credentialing information and upload documents to a single, secure database • Sends reminders when your practice needs to re-credential or renew mal practice insurance or licenses • Makes your data available to hospitals and health plans when they need it. As the sole source of provider credentialing information for hospitals and insurance carriers in Washington, ProviderSource will help streamline the credentialing process and improve the timeliness of information availability for hospitals and insurance carriers. What do I need to do? If you do not currently have an account with OneHealthPort, you will need to register at www.onehealthport.com/sso/ register-your-organization before setting up an account with ProviderSource. Before registering, please make sure to review the instructions on how to register for OneHealthPort at www.onehealthport.com/ sites/default/files/content-uploads/documents/HowRegisterInstructions.pdf. Once you have successfully registered,
follow the instructions in the step-by-step guide at www.onehealthport.com/sites/default/files/content-uploads/documents/PrviderSource_GettingStarted.pdf. Upon completion of the above-mentioned steps, you will be able to log in to the ProviderSource Application using your OneHealthPort subscriber ID and password. When you are ready to notify health plans of the completion or update of your credentialing information, use the Online Health Plan Notification Form. Additional Resources To make this process as easy as possible, make sure to review the resources provided by OneHealthPort: Before You Begin: www.onehealthport.com/ credentialing/you-begin Training Video & Guides: www.onehealthport.com/credentialing/training-videosguides If you have questions regarding your current OneHealthPort Subscriber ID, call 1-800-973-4797 for assistance.
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newsflash issue 6, may 2018
in memoriam issue 6, may 2018
Dr. William Bethel
Dr. William Bethel passed away peacefully on March 16, 2018 at his home, surrounded by family. He was 69. He was born on Nov. 21, 1948 in Wichita, Kansas to Robert and Audra Bethel. He moved to the Seattle area in the fifth grade and later graduated from Foster High School. He attended the University of Washington, where he found his passion for being a dentist and helping others. Bethel was highly respected by his staff and colleagues for his high-quality dentistry. He first opened his practice in August 1974 in Renton, Wash. Over the past 44 years, he considered his staff and his generations of patients as family. He was known as a loving and passionate person in his professional and personal lives. Bethel was a devoted father to Nathaniel, Nicholas, and Justin Bethel; and a caring brother to his loving sisters Leanna Janssen, Jeanne Watkins, and Babs Buchanan and his brother-in-law Larry Laughlin. He is also survived by nieces and nephews Jan Quick, Craig and David Janssen, Brad Miller, and Derek Schulte; and family friends Jim Bergstrom and Bob Catton.
Dr. Eugene Choy
Dr. Eugene Choy passed away on April 6, 2018 at the age of 79. After retirement he took great joy in volunteering at his church, Marine View Presbyterian Church, and refurbishing bikes for underprivileged families. He is survived by his wife, Young; and children Jon and Cheryl.
Dr. Thomas H. MacGeorge
Dr. Thomas Hamilton MacGeorge passed away peacefully on March 4, 2018, surrounded by his family. He was 90. He was born on March 6, 1927 in Seattle to Margaret Agnes (Marriot) and Thomas Hamilton MacGeorge. Raised in North Seattle with his brother, Jim, he went to Ronald Elementary School and attended Lincoln High School. In 1946 at Lincoln, he and his brother were members of the state championship basketball team. MacGeorge continued his education at the University of Washington, where he played football, but more importantly met his future wife, Paula. They were married on Sept. 9, 1950. MacGeorge then attended the UWSoD from 1950 to 1954. The young couple lived in Seattle until dental school graduation, when the Air Force took them to Clark Air Force Base in the Philippines. Upon returning home, MacGeorge started his dental practice in Ballard. In 1964, he specialized in orthodontics, and in 1966, began his 26-year career in orthodontics in Shoreline, Wash.
The couple raised their family of three children in North Seattle. They were longtime members of Seattle Golf Club. Golf was a common theme for the family, as were summers at Fisherman’s Alibi on Whidbey Island. MacGeorge and his wife retired to Whidbey Island in 1992. Always the engineer with an inquisitive mind, he was fond of fixing things, driving the backhoe, crabbing, keeping the soft ice cream machine full, and enjoying the island life with family and friends. He leaves a legacy that everyone close to him strives to uphold. MacGeorge is survived by his daughter Pam Lee (Jim) of Everett; sons Stephen (Lisa) of Shoreline and William (Linda) of Seattle; grandchildren Christine Cronin (Brian) and Jamie MacGeorge Lee, Andrew, Christopher, and Elle MacGeorge, and Stuart and Nancy MacGeorge; greatgrandchildren Kellen, Jack, and Anna Cronin; and brother Jim of Los Angeles. He was preceded in death by his beloved wife, Paula, on Nov. 14, 2011.
Dr. Roy S. Mar
Dr. Roy Mar passed away on March 14, 2018, surrounded by his closest loved ones. He was 90. He was born on Dec. 26, 1927 in Seattle, the eighth of 10 children. After serving in the Navy, Mar became the first Chinese American to graduate from the University of Washington Dental School. He then established his successful practice on Beacon Hill, retiring in 2013. For numerous years, Mar was active in the Seattle-King County Dental Association, holding various positions, including President. He also helped start and coach the Seattle Chinese Athletic Association’s first girls’ basketball team. Mar was well-known for his sense of humor, recipes, current events, politics, and stories. His primary joy came from spending time with his children and their growing families, whom he loved. Mar is survived by his six children, six grandchildren, one great-grandchild, and their families. Per his request, there was no service. Remembrances may be made to Medic One or Kin On.
Dr. Warren H. Marttala
Dr. Warren Harvey Marttala passed away on Jan. 15, 2018 in Pinehurst, Idaho. He was 81. He was born on Oct. 14, 1936 in Seattle, to Arvi and Neva (Waddell) Marttala. Marttala attended schools in Seattle and received a bachelor’s degree in basic medical science from the University of Washington. He received a master’s degree in
dentistry and periodontology from the Oregon University. Marttala proudly served in the U.S. Air Force as a Lieutenant Colonel, serving in dentistry for 20-plus years. He also served as a pilot and had flown fighter wing homestead ASB. He retired from the Air Force in 1998. He then opened his own practice in Bellevue, Wash. for five years. Marttala married Barbara Rodorff on March 22, 2003 in Seattle, and they moved to the Silver Valley. Marttala was a member of the American Academy of Periodontology and the Snohomish County Dental Society, and a diplomat of the American Board of Periodontology. He received many medals and awards, including the United States of America Meritorious Service Medal for outstanding service in the Air Force. He was an outstanding Boy Scout leader who received many awards. He was a member of the Church of Jesus Christ of Latter-day Saints of Pinehurst, which meant so much to him. Marttala loved and enjoyed playing classical music by memory on the piano He was also an accomplished artist who enjoyed painting and drawing. He is survived by his wife, Barbara, of Pinehurst; children Dr. Rafael Beier of Pinehurst, Jeanie Belbin of Harrison, Idaho, and David Jackson of Spokane Valley, Wash.; 10 grandchildren; and eight greatgrandchildren.
Dr. Lowell Olson
Dr. Lowell Arthur Olson passed peacefully on March 20, 2018 in Seattle. He was 95. He was born on July 14, 1922 in Menomonee, Wis. to Olaf Arthur and Ethel Marie (Larson) Olson. “Bud,” as he was affectionally known as a boy, had two younger sisters, LaRaine and Dorothy “Dode.” They had a wonderful childhood growing up on a farm on the shores of Lake Superior. As a youth, Olson started the Olson Honey Company, raising bees, pollinating nearby farms with his 50 hives, and selling honey on contract to Coca-Cola. After entering the U.S. Army at the outset of WWII, Olson reported to Fort Riley, Kan. He was selected to attend Yale University and Marquette University Dental School to ensure the Army had sufficient dentists and physicians for the war effort. He remained in the U.S. Army Reserve for 20 years, retiring as a Lieutenant Colonel. After leaving active duty, he graduated from Marquette University Dental School in Milwaukee, where he met his future wife, Carol Louise Peterson. They married in September 1948 and settled in Superior, Wis. Their children, Deborah Ann
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and Bruce Arthur, were born in Wisconsin. Following the family’s move to Seattle in 1953, daughter Susan Marie was born. They first moved to the Broadview neighborhood, and later built their dream home, which was designed by renowned architect Roland Terry. Because of his keen interest in Northwest architecture, Olson retained architect Paul Hayden Kirk to build his medical-dental building in North Seattle in 1953. Olson practiced general dentistry there for the next 35 years, until his retirement in 1988. He was an avid skier, golfer, and boater, a devoted family man, cherished friend, Mason and life-long member of Phinney Ridge Lutheran Church. Following his retirement, he built a home in Tucson, Ariz., where he was a founding member of Resurrection Lutheran Church. He enjoyed family, friends, reading, travel, golf, genealogy, and jewelry making in his retirement. Olson was revered and loved by all who knew him. He was an exemplary role model, a wise and precious soul, a renaissance man, the family patriarch, and a member of the “Greatest Generation.” He will be dearly missed by all of those who shared his life and loved him so dearly. Olson is survived by his three loving children, Deborah, Bruce (Linda), and Susan; eight devoted grandchildren; and 11 wonderful great-grandchildren. He was preceded in death by his cherished wife of 68 years, Carol on Feb. 3, 2016.
Dr. James Valentine
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In brief, Medicare is composed of four parts. Part A covers hospital, skilled nursing, and hospice care. Part B covers physicians and outpatient care (and is where dentistry would most likely come in). Part C is composed of the outsourced “Advantage” plans that many private insurance companies offer. They often use limited dental benefits as a carrot to attract enrollees to sign up for a fee. (Whether those plans provide a cost-effective dental benefit is subject to debate, depending on the plan. I suspect we need to weigh in on those carrots.) Part D is the prescription drug program. It is thought that Medicare reimburses physicians 15 to 20 percent less than most private insurance covers. This is a much higher rate than dentists get in the current Medicaid program. Will dentistry be granted the higher rate? Reimbursement and the amount of dental coverage must be designed to be a win-win for patients, dentists, taxpayers, and the government, or the program will stall like Medicaid or completely fail. We live in an era where private dental insurance companies are reducing reimbursement rates for dentists. Cash-paying patients are a big part of the payer mix that allows dentists to afford to take the lesser-paying insurance. The impact of approximately 50 million people suddenly not paying cash for their dental care could dramatically change the financial dynamics of our profession. How will this work for practices that have a higher volume of older patients? Will this adversely affect access to care for these patients? Who would have anticipated that? We are just beginning to discuss the issues and have many unanswered questions. Should the age to receive benefits be changed? Could we mandate higher premiums for wealthier senior citizens? How about a blanket raise in premiums for everyone? What about managed-care programs that give providers incentive pay for lowering program costs? It truly does boggle the mind. This is just a tiny overview of a serious and, yes, emotional issue that touches everyone in America. How responsible we are, not only for ourselves, but also for each other? How far will we dig into our pockets to plan for our aging and for those who have not or could not plan well? It speaks to how we build and share resources as a community. This is an exciting time to be a dentist, and to participate in organized dentistry. We have serious problems to solve. Please join the conversation!
Dr. James Valentine died on March 22, 2018 after a valiant fight with Multiple System Atrophy (MSA). He was 65. Valentine was born on April 12, 1952. He was blessed with good people in his life, especially Don and Patty Belknap, who took him into their home, helped him enroll at Gonzaga Prep, and sponsored him when he was baptized into the Catholic faith. A proud member of the class of 1970, he worked weekends and summers to pay his tuition at Prep and Gonzaga University. After a short three years as a Zag, he entered the Creighton University School of Dentistry on a U.S. Army Health Professions Scholarship. His time at these three Jesuit schools set him on a life-long path of service and self-sacrifice. Valentine was a decorated soldier who received the Expert Field Medical Badge and the Legion of Merit Award. He served as a field dentist, on active duty, and as a Combat Support Hospital commander in the Army Reserves. He happily gave 31 years to his country and reached the rank of Colonel. During his time in the Army,
his skills were honed in military medical centers and on foreign soil. From humanitarian efforts in Honduras, to combat support in Afghanistan, to field dentistry in Tehran during the revolution of ’78, as well as tours in Italy, Texas, and California, he treated soldiers and civilians with respect and dignity. In 1969, Valentine went on a blind date with a woman from Ferris High School, Rita O’Brien, and they married in 1973. The Prep-Ferris football rivalry of 1969’70 was a favorite topic of conversation. Together they traveled the globe, sailed the oceans blue and raised three children. They returned to Spokane, Wash. in 1990, and Valentine began his civilian career as an oral surgeon. As a founding partner in Oral Surgery Plus, he was committed to being a good boss and business partner. His compassionate care for all of his patients was surpassed by no one. Valentine was an honored dental professional and held many leadership positions in the Spokane District Dental Society and the Washington State Dental Association. In the spring of 2014, Valentine was diagnosed with MSA, a degenerative disease that eventually put him in a wheelchair and robbed him of his ability to speak. The disease didn’t keep the couple from traveling overseas and around the West in their RV, the Andiamo. Later, a wheelchair van enabled them to go on weekly outings, the last of which was the Eagle Watch Cruise on Lake Coeur d’Alene in late December. In July 2016, Valentine again was blessed with good people when he moved into the Spokane Veterans Home, where he received excellent care. He was a popular resident and patient who never lost his sense of humor or will to live. Less than a week before he passed away, he was still trying to do his exercises. Valentine loved his outings to the casino, and was an avid card player and Zag fan to his end. But more than his decorated military career and professional achievements, Valentine was a loving father and devoted husband of 44 years. He is survived by his wife, Rita; daughter Tina Pitts, her husband, Will, and their daughter Annemarie of Phoenix; son Tony, his wife, Kallee, and daughters Reese, Emersen, and Maren of Pocatello, Idaho; son Tim, his wife, Alisha, daughter Finnley, and son Jack of San Jose, Calif.; mother Pepper; sister Cindy; brother Bill; and a large extended family and network of friends. He was preceded in death by his father, Jim Sr., and sister Tammy.
in memoriam issue 6, may 2018
editorial, continued from page 4
endorsed company news sesame communications
An inside look at Google My Business
Special to the WSDA News by Tyler Carter, Product Manager at Sesame Communications What if I told you that one search engine accounted for more than 80 percent of the search engine market? You would probably focus your attention there, right? Well, according to StatCounter, Google now accounts for 86.76 percent of the search engine market share, far surpassing Bing (6.97 percent) and Yahoo (5.17 percent). Clearly, patients are using Google to find you and your practice online. This article will explore some free Google My Business (GMB) features, and explain their importance in helping you get noticed. For this purpose, we will assume your listing is verified, and you have access to it. If you don’t have access, doing a quick Google search for “adding or claiming my business listing” will turn up the results covering this process.
What is GMB?
GMB is a free tool provided by Google that allows you to manage and enhance your business listing. With GMB you can manage all of your business information, interact with patients, and understand what your patients are searching for, all in one dashboard.
First, log into your Google My Business listing. When you first log in, you may notice two listings: a doctor’s profile and/or a duplicate practice profile. It’s important to claim both listings and complete their profiles using the primary business information for name, address, and phone number. It doesn’t hurt if prospective patients land on the doctor’s profile if it’s complete and connects them to your business. After selecting the primary listing, you’ll see your dashboard, where you can update and manage your business information.
1. http://gs.statcounter.com/search-enginemarket-share/all/united-states-of-america 2. https://moz.com/local-search-rankingfactors
The first tab listed, Info, refers to your business information: name, address, and phone number. You can add other items to help attract prospective patients. According to a 2017 Moz study on local search ranking factors, business signals were the number one factor for local search results, accounting for 19 percent of search visibility. It’s important to keep your information up to date and consistent across all directories (Bing, Yelp, Facebook, Yahoo, and other directory listings). This is the foundation of your online presence.
The Insights tab gives you an idea of how patients are searching for your business, where they are viewing your information, what actions they are taking, and how often your photos are viewed. The first section of Insights details how people are finding your listing, either directly by searching your business name and/or address, or by organically discovering your listing after searching categories, products, or services. Above is a customer action chart that indicates what a patient is doing when looking at your business listing, without visiting your website. You can see this practice does really well, generating 108 calls, 124 requests for directions, and 109 website visits in just one month.
Google My Business Posts
Google is committed to providing patients with the information they need, and is continually testing new features to provide the best consumer experience possible. The recently released Google My Business Posts allows you to publish information about events, products, or services directly to your listing. Posts can link directly to any page you choose, and are a great new way of sharing information with patients. Ultimately, Google wants people to make informed decisions as efficiently as possible, displaying relevant information on the search results page. GMB is a foundational element of your marketing strategy, one of the first steps you need to take in attracting new patients to your practice, and available for you free of charge. So get started!
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ASSOCIATE WANTED — Established Bothell general practice seeking associate for Mondays-Thursdays for three weeks out of every month. Potential for purchasing in the future, after a 6 - 12 month trial period to establish compatibility and alignment of goals. Bothell is a wonderful community with good middle-class families, bike trails, restaurants, and some of the best schools in the state. Please send your resume to: email@example.com along with a cover letter introducing yourself, and we look forward to meeting you!
SEEKING ASSOCIATE DENTIST — Parttime or Full-time in Port Angeles, WA. Are you searching for an opportunity in dentistry that rises above the ho-hum of traditional private practice as well as the binding constraints of the corporation? Do you yearn for a setting that tirelessly cultivates clinical compassion and excellence alongside extraordinary teamwork and practice health? If so, we invite you to contribute your talent and passion to a leading dental organization that embodies Washington’s innovative spirit. Our aim is simple: We preserve the integrity of private practice while leveraging the power of the cooperative group. And here’s the real deal: You’ll work shoulder-to-shoulder with some of the most talented and committed dental professionals and industry leaders. The tools, technology, and clinical support are unparalleled, and practice partnership is the end-game. The field of dentistry is progressively changing, and we’re at the forefront of the positive transformation. We hope you’ll consider joining us -- or at least exploring the opportunity -- as we continue to strengthen an extraordinary culture that shines through our service to each and every patient. Please email resume to firstname.lastname@example.org.
ASSOCIATE DENTIST, SPOKANE — Spokane Pediatric Dentistry is a growing practice and expanding to Colville and Moses Lake. We have immediate openings for part-time or full-time associate dentists working in our new clinics. Opened in 2013, we are an energetic, patient-driven practice, striving to provide the highest quality dental care. Our clinics provide a comfortable, kid-friendly environment to serve our growing patient base. Our team performs comprehensive preventative and restorative dental treatments, sedations and in-office General Anesthesia. Associate position includes competitive salary and complete benefit package including, employer-paid professional liability insurance and C.E. reimbursement, health insurance and 401-K plan with match. Email Patrick@spokanpediatricdentistry.com or call 509-315-3200.
ASSOCIATE DENTIST, ROSEBURG, OR — Private practice searching for an Associate Dentist to join our professional team. We are looking for someone that has worked with patients of all ages, is proficient in performing regular checkups and complex dental procedures and is committed to the highest quality of patient care. In return, we offer great income potential, a non-competitive work environment and we will handle the marketing and new patient generating. Those who are qualified and in search of a long-term career opportunity in a cutting-edge practice are encouraged to submit a resumé today. Email your resume to email@example.com or fax to 541-440-1065. REDMOND GENERAL DENTAL PRACTICE — Looking for 2 days a week, friendly, gentle professional dentist to joined our awesome hard-working team!. Please submit your resume and cover letter to the firstname.lastname@example.org, We look forward to hearing from you! PART TIME GP ASSOCIATE IN ELLENSBURG — We are looking for a long-term associate in Ellensburg, WA to work 2.5 days Wed-Fri. We are an easy-going office where you will be allowed to treat as you see fit. Please email resume to email@example.com. DENTISTS NEEDED — Jefferson Healthcare is opening the state’s first Dental RHC! We are seeking general dentistry dentists to head up this new clinic. Competitive salary, incredible benefits, and the opportunity to be a part of an amazing organization! Apply now on our Careers website at jeffersonhealthcare.org! GENERAL DENTIST WANTED — NE Seattle general dental office interested in adding general dentist for future business partnership/long term working relationship. Please include cover letter and resume. Send to NESeattleDentist@gmail.com
ASSOCIATE NEEDED, OLYMPIA — Are you a caring & charming doctor who does beautiful quality work? We have patients who need you! A growing family and cosmetic practice in Olympia, Washington seeks associate to join our wonderful staff. Two days a week, great compensation. Two years experience. Email resume to firstname.lastname@example.org. ASSOCIATE DENTIST WANTED, ANACORTES, WA — 1-2 days per week. Our longtime associate dentist is retiring, so we are looking for a general dentist that is focused on high quality comprehensive dental care. We are a modern, mature office with an experienced staff who loves providing top notch care while having fun along the way. If you think you might be a great fit for our office, please send your resume and cover letter to the following email address: email@example.com. ASSOCIATE DENTIST WITH BUY-IN OPPORTUNITY — Experienced GP needed for our Des Moines practice. Must be proficient in all phases of dentistry. Can discuss buy in opportunity upfront or later. This position is 3 days per week Monday through Wednesday. Please email me at firstname.lastname@example.org.
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DENTISTS NEEDED — Lake Washington Institute of Technology dental clinic is seeking dentists. We have part-time positions for M/T/Th. • http://www.lwtech. edu/about/human-resources/jobs/apply/ search for dentist • Contact: Carrie.Sasynuik@lwtech.edu phone: 425-739-8157 DENTAL ASSOCIATE, REDMOND WA — Privately owned Redmond practice seeking Dental Associate with minimum 1 year working experience. This is a unique opportunity to work with the best team. You will produce! You will have a full schedule! and You you will have patients the day you start! Modern, paperless, all digital office, Performing General and advanced dentistry. Efficiently run office with great systems in place and an awesome team. You will have fun and be busy. This is a full-time (3-4 days a week). If you are interested in this position, please forward your confidential resume with a cover letter about yourself and days you are available. Thank you and we look forward to hearing from you. Email: email@example.com. DENTISTS NEEDED, STATEWIDE — We have wonderful practices throughout Washington and we are interested in bringing new doctors into the Smiles Family! Our practices are set in beautiful communities and have super fun and upbeat staff. If you are interested in joining a great team with tons of earning potential, send me, Jodie Barker, your resume via email at firstname.lastname@example.org. We will call all qualified candidates. Just a reminder: we are an equal opportunity employer!! Thank you for your interest! We look forward to speaking with you.
classifieds issue 6, may, 2018
DG Transitions LLC
5808 Lake Washington Blvd NE Suite 101
Dental Wealth Advisors LLC
Kirkland, WA 98033
We’re your Transitions Specialist,CPA,& Wealth Advisor 5 ops > Collecting $1M+
RURAL SNOHOMISH COUNTY
4/5 ops > Collecting $588K
3 ops > Collecting $583K
4 Ops > Collecting $616K
8 ops > Collecting $2.2M
Transitions Done Right
We bring all of our tools and expertise to bear to achieve your desired transition and through tax and other planning, leaving more of your hard earned value in your pocket.
The Dentist’s Advisor
For dentists and specialists who believe that planning, implementation and monitoring are crucial to long-term financial success and quality of life.
The Dentist’s Wealth Advisor
Comprehensive Financial Planning* Wealth Management Investment Management Retirement Plan—CFO Services
General Dental Practice Opportunities SEATTLE (MERGER OPPORTUNITY)
*Personal financial planning, Investment & Wealth Management Services provided by Dental Wealth Advisors, LLC a Registered Investment Advisory
Specialty Dental Practice Opportunities EASTERN WASHINGTON
Perio/Implant > Collecting > inquire
GREATER EVERETT AREA
Ortho > Collecting $629K
Pending Transitions KENT
General Practice > Collecting $415K
SOUTHEAST LAKE WASHINGTON
Pedo w/Ortho > Collecting $1.9M
General Practice > Collecting $994K
Come visit us at PNDC!
Booth #1 June 21 & 22 | Meydenbauer Center
4 6 · th e wsda ne w s · issue 6, may 2018 · www.wsda.org
Call 425-216-1612 or email@example.com us today to see how we can help you!
DG Transitions LLC
The Dental Group
Comprehensive | Professional | Tax Efficient LLC A DENTAL GROUP COMPANY
DENTIST OPPORTUNITY, CENTRAL WASHINGTON — Seeking experienced dentist for a busy, well established, successful, multi-specialty group, fee for service dental practice to work full time with part time options. Come join our professional, modern office and become a part of our wonderful team. Please send resume and direct any inquiries to firstname.lastname@example.org.
ASSOCIATE DENTIST - (Mill Creek/Snohomish/Everett) Seeking a dentist to join our great team. One day/week, possibly leading to more days in the future. Contact: email@example.com.
PROSTHODONTIST NEEDED — Hughes Dental Group (Everett, WA) is adding Prosthodontist (buy-in) to expand our One-Stop-Shop for patients. Experienced in AO4, overdentures, F/, RPD, and dental implant placement and related surgeries. Large patient base from which to diagnose and present ideal treatment. Digital radiography, CBCT. Waiting for your input to add scanner and 3D printer. Office has professional street presence, outstanding visi-bility, and high traffic count. Silverlake area of Everett. Check out website, FB presence, and then con-tact DrBob@HughesDentalGroup.com.
DENTIST NEEDED — Family Health Center, Longview WA is looking for a DDS or DMD with at least 1 yr experience. NonProfit Community Health Center. WA State DEA license. Apply to firstname.lastname@example.org. SHARED SPACE — Looking for someone who wants to cut their existing overhead by sharing my existing office space. I have a new modern office that is not being fully utilized. Ideal for startup, specialist or smaller existing practice. I have done this in the past and it has worked wonderful. Call Dr. Frank at (425) 985-8390. DENTIST — Pedodontist, FT Associate, Eagle River, Alaska. Permanent position, 4-5 day work week, immediately available for an Alaska Licensed pediatric dentist. Discovery Dental Kids is looking for a compassionate, pediatric dentist who will deliver excellent care to children of all ages from infants to teens. We provide a range of preventive and restorative services, oral sedation and GA with an onsite anesthesiologist. All in a beautifully custom designed practice located 15 miles from Anchorage and surrounded by mountain views and Eagle River. Competitive compensation. Contact Leanne 907-351-3459 for more details LOCUM TENENS — 1985 UW graduate, Washington license, 32 years GP experience. Cerec user, extensive surgical/ grafting experience in addition to typical restorative skills. Located on the Olympic Peninsula, but have a small plane so I’m close enough to anything this side of the Cascades. Contact cell/text (360) 5311762, or email@example.com. HYGIENIST WANTED — Are you a Hygienist looking to expand your skill set and join an established prosthodontic dental practice? We are looking for the right hygienist to join our team 1- 2 days a week. Experience with Dentrix and Dexis is preferred however not a must. Interested candidates please send resume. When replying, please put the words “A Team” in the subject line. firstname.lastname@example.org.
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. PEDIATRIC DENTIST ASSOCIATE POSITIONS — North of Se-attle. Part time, competitive pay, or part time to grow into full time opportunity. Modern clinic with conservative philosophy. Email NorthSeattleDentist@gmail.com ASSOCIATE DENTIST, BREMERTON-KITSAP COUNTY — Established practice in Bremerton. Kitsap Co is the best place to live outside the I-5 corridor. Come live in the best place to raise a family and work in a thriving dental practice. Permanent position available, 4-5 day work week. Experience and residency preferred. We provide full range of preventive and restorative services (implants, IV sedation, oral surgery, orthodontics, etc). Experienced providers can easily produce/ earn $200K+/year. Potential for ownership/ partnership for the right person. Contact email@example.com. TACOMA TURNKEY DENTAL OFFICE — Close to downtown Tacoma and retail shopping areas. Easy access with plenty of parking space. 2,800 sq. ft fully equipped dental office ready to operate with 5 treatment rooms, 6th plumbed, cozy reception, 2 Doctor rooms, Lab, staff lounge, 2 restrooms, storage room, laundry room. file cabinet. A digital Panoramic and 3 digital intraoral xray systems are also available for sale if interested. Great opportunity for Specialists and General Dentists. Please call for an inquiry. Call 253-230-8325 for details. Thanks. 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; firstname.lastname@example.org.
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MULTI-SPECIALTY GROUP PRACTICE OPPORTUNITIES — With more than 400,000 patients throughout our 50+ practice locations in Oregon, Washington, and Idaho, and a built-in specialty referral network to more than 30 specialists, Willamette Dental Group has been a leader in preventive and proactive dental care since 1970. What makes this multi-specialty group practice unique, and better, 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. As a member of the Willamette Dental Group team, we offer a competitive salary commensurate with experience. We are a performance based culture and offer a generous and comprehensive benefit package. Among the many amenities we offer are competitive guaranteed compensation, benefits, paid vacation, malpractice insurance, in-house CEs, and an in-house loan forgiveness program. Please contact Courtney Olson at colson@ willamettedental.com and visit www.willamettedental.com/careers to learn more! 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.
classifieds issue 6, may, 2018
clinical corner issue 6, may, 2018
CLINICAL CORNER Diffuse gingival redness and sloughing
Dr. Terry LaBell of LaBell Periodontics & Implants, Woodinville, WA
History of present illness
This is a 47-year-old male who presented with diffuse gingival redness noticed since late October 2017; initially started in the lower left canine area and progressively spread throughout the dentition (Figure 1). Patient reported the lesions were painful when eating or brushing. Upon presentation to the periodontist, there was an intense erythema on the facial of teeth #12-13, 19-25 and 28-29. The most intense redness was on #20-25 (Figure 2). The tissue bled easily with any contact and exhibited a positive Nikolsky sign. The patient’s past medical history is significant for benign atrial fibrillation and non-alcoholic fatty liver disease. He is currently on propranolol.
Test your knowledge!
Visit https://dental.washington.edu/oral-pathology/case-of-themonth/ and see if your assessment of the case is correct.
Have you been injured or are you sick/ill? We can help. The WSDA is ready to aid dentists and their spouses. Cancer, depression, substance addiction, it doesn’t matter.
Call the Disability Hotline (206) 973-5226 or email email@example.com for assistance. 4 8 · th e wsda ne w s · issue 6, may 2018 · www.wsda.org
OFFICES FOR SALE OR LEASE
SPOKANE — We are looking for a fulltime general dentist for our fast paced office. The clinic is new, beautiful and stateof-the-art. We are a family practice. We have a network of orthodontists and oral surgeons that work alongside our general dentists. We offer a great guaranteed salary and production bonuses. Position is available immediately, but we can be flexible. firstname.lastname@example.org
OPPORTUNITY WANTED — 2018 Western University of Health Sciences graduate seeks general dentistry position in Snohomish, King, and Skagit Counties. View my CV here: https://www.canva.com/ design/DACuoVq_cqc/nunviib-AOKqX1sDGuJ-NQ/view?utm_content=DACuoVq_ cqc&utm_campaign=designshare&utm_ medium=link&utm_source=sharebutton.
SALE, BOUTIQUE ISSAQUAH DENTAL OFFICE — 1,800 sq. ft. Four operatories brand new as of five years ago. One private surgical operatory brand new as of two years ago Consult room Office overlooks beautiful, serene greenbelt Located three blocks off I-90, two blocks from the Issaquah Costco/Corporate Costco, this boutique dental office is positioned to provide convenient hassle-free service to three fast growing areas—Issaquah, Sammamish and the Issaquah Highlands. Also, easily attracts patients from Renton, Mercer Island, and Bellevue. For more information, please contact Dr. Ron Sherman 425.922.6700 or email@example.com Please see page 38 for more details.
ASSOCIATE — 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 $150,000 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. Come try out the Eastern Washington, where there’s 300+ days of sunshine, beautiful landscaping, the gorgeous Columbia River and family friendly communities! Please send inquiries to firstname.lastname@example.org. OPPORTUNITY WANTED OPPORTUNITY WANTED, 2018 UW GRAD — 2018 Graduate of UWSoD seeks a general dentistry position in the King, Snohomish, or Pierce County areas. View my CV here: https://drive.google.com/file/ d /198GrZzIuVv6DQU6ttw6EDdZSoo_ oFH7t/view?usp=sharing. OPPORTUNITY WANTED — 2018 USC Pediatric Dentistry graduate seeks a pediatric dentistry position in the greater Seattle or Tacoma area. View my CV here: https://drive.google.com/file/d/1ZR CM40Znk96q7DlkOV0HgICt3mgzEeV5/ view?usp=sharing. OPPORTUNITY WANTED, WESTERN WA — 2018 UWSoD graduate seeks a general dentistry position in Western Washington. View my CV here: www.linkedin. com/in/sampada-deshpande-2692a592. OPPORTUNITY WANTED, WESTERN WA — 2017 University of Washington, NYU Medicine AEGD (expected completion July 2018) graduate seeks a general dentistry position in the greater Seattle area. View my CV here: https://drive. google.com/file/d/1NjBevZkfVR7DXM3hx oUfsSPt47UfzKuC/view?usp=sharing.
OPPORTUNITY WANTED — 2017 UWSoD graduate seeks a general dentistry position in Washington. View my CV here: https://drive.google.com/open?id=1ilkwp4 P4pc91JX6OU5u_0lX7SEYqG2bQ. OPPORTUNITY WANTED — 2018 University of the Pacific Arthur A. Dugoni School of Dentistry graduate seeks a general dentistry position in Renton or Tacoma. View my CV here: https://sites.google. com/a/u.pacific.edu/danielkamran/professional-accomplishments. OPPORTUNITY WANTED — 2018 Howard University graduate seeks a pediatric dentistry position in Vancouver or Seattle and the surrounding area. View my CV here: https://docs.google.com/document/ d /1A7XJ0yGR _crsDQGiJgxdw3nPEiHSzYTnz3xAvexGBkI/edit?usp=sharing. OPPORTUNITY WANTED — 2018 UMNSoD graduate seeks a general dentistry position in Bellevue, Sammamish or Redmond. View my CV here: https://www.visualcv.com/prgnya-sheelam. OPPORTUNITY WANTED — 2018 NYUAEGD, ICHS Bellevue graduate seeks a general dentistry position in Seattle or Eastside. View my CV here: https://sites. google.com/site/alexanderhodge/resume. BOOST PRODUCTION — Want to boost your in-house production by not referring out your patients for treatment? General dentist with over 25 years of experience in private practice with strong skills in oral surgery and endodontics available to see patients in your practice on Fridays and Saturdays.Call (360) 402-9370 or e-mail email@example.com. OFFICES FOR SALE OR LEASE ORTHODONTIC PRACTICE FOR SALE: Snohomish County — Tremendous opportunity in the heart of Snohomish County collecting $629K. 2,145 sq/ft approximate. 5 fully-equipped chairs + private exam/consult room. x-ray. Pan/Ceph. Ortho2 software w/digital charting. For more information contact: Jennifer Cosgrove at (425) 216-1612 or Jennifer@cpa4dds.com.
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GENERAL PRACTICE FOR SALE, DES MOINES — Busy main street location, six operatories with room for four more operato-ries. 2016 annual collections: $640,000 (practicing three days a week). Contact: firstname.lastname@example.org or (206) 458-3892. GENERAL PRACTICE FOR MERGER: Seattle — Strong merger opportunity centrally located in the core of Downtown Seattle w/an experienced dentist willing to workback part-time/pre-retirement! Collecting $1M+. Provides perio cleanings; cosmetic; whitening; TMJ treatment; sports guards; crown/bridge/dentures/partials. Referring out: endo; oral surgery; pano; ortho & perio surgery. Current non-renewable lease is expiring. Equipment in good condition & available (if needed): 5 fully-equipped, computerized operatories, cavitrons, lab & autoclaves w/cassettes. Digital intra-oral camera. Nitrous. Asst surgical endo, hygiene & operative instruments. For more information contact: Jennifer Cosgrove at (425) 216-1612 or Jennifer@cpa4dds.com. GENERAL PRACTICE FOR SALE: Redmond — Fantastic Eastside practice w/ tremendous upside potential. Collecting $616K. 4 fully-equipped, digital operatories. Approx 1,573 sq/ft. Dentrix. For more information contact: Jennifer Cosgrove at (425) 216-1612 or Jennifer@cpa4dds.com GENERAL PRACTICE FOR SALE: Rural Snohomish County — Outstanding family practice with great cashflow in picturesque country setting. Ideal for dr & family seeking quality of life away from city traffic. 4 fully-equipped operatories w/5th possible. Approx 1,450 sq/ft. Low overhead. Collecting $588K+ on a 3-day workweek. Opportunity to grow! For more details contact: Jennifer Cosgrove at (425) 216-1612 or Jennifer@cpa4dds.com.
classifieds issue 6, may, 2018
Delivering Solutions For Your Long-Term Financial Success By acting as your Chief Financial Officer for your practice and as a Personal Wealth Manager for your family.
DG Transitions LLC
The Dental Group
Comprehensive | Professional | Tax Efficient LLC A DENTAL GROUP COMPANY
The Dentist’s CPA
For dentists and specialists who believe that planning, implementation and monitoring are crucial to long-term financial success and quality of life.
The Dentist’s Advisor
Sam Martin MBA(tax) , CFP®, CPA
Margaret M. Boyle CPA, CVA
Nathan J. Ricks CFP®, MS
Comprehensive Financial Planning* Wealth Management Investment Management Retirement Plan—CFO Services
Call 425-216-1612 today to see how we can help you!
Now Hiring General Dentists
Oregon & Washington
Traveling General Dentist
Oregon & Washington
View all practice opportunities at willamettedental.com/careers
Visit Our Booth At Upcoming Conferences AAPD
May 24 – 27
June 7 – 9
New Orleans, LA
June 20 – 22
Courtney Olson, Regional Recruiter email@example.com Tel: 503.952.2539 Kariana Peters, DMD, Managing Dentist
5 0 · th e wsda ne w s · issue 6, may 2018 · www.wsda.org
OFFICES FOR SALE OR LEASE
OFFICES FOR SALE OR LEASE
GENERAL PRACTICE FOR SALE: Snohomish County — Charming practice in a thriving, family-based community! Collecting $583K. 1,500 sq/ft-approx. 3 fully equipped operatories. TMJ Therapy. Refers out implants, perio and ortho. For more information contact: Jennifer Cosgrove at (425) 2161612 or email Jennifer@cpa4dds.com.
SOUTH SOUND ORAL SURGERY PRACTICE — Only oral surgeon in town! Great potential. Confidential sale. Email rod@ omni-pg.com. (WD200)
NE KING COUNTY GENERAL DENTAL PRACTICE FOR SALE — Annual collections of $180,000, three operatories, busy corner lot. 1,000 sq. ft. Building for sale at $650,000. Email firstname.lastname@example.org. (WD178)
GENERAL/COSMETIC PRACTICE FOR SALE: Olympia — Beautiful, state-of-theart practice in the heart of the State’s capital! Buy-in/out option available. 8 fully-computerized operatories w/Adec chairs. Digital radiography & pano. Lasers. Nitrous. Rotary endo /elements obturation. Dexis CariVu. Intra-oral cameras. iTero. Dentrix/Dexis. 3,900 sq/ft approx. For more information contact: Jennifer Cosgrove at (425) 216-1612 or Jennifer@cpa4dds.com. NEW SOUTH SOUND ORTHO — Two practices for sale. Combined revenues of $950K. Must be sold together. Contact email@example.com. (WD202) NEW NEAR TACOMA — New startup practice. Growing quickly! Monthly collections already at $40,000/month. Great new patient numbers. Email firstname.lastname@example.org. (WD204) NEW NORTH OF SEATTLE — One of a kind, beautiful practice for sale located 30 minutes north of Seattle. Amazing view of Puget Sound from the practice operatories. Designer buildout with attention to detail. Three operatories with room for a fourth. Unlimited potential for a thriving practice. Contact rod@omni-pg. com for more info. (WD201) NEW SOUTH OF SEATTLE ORTHO — Practice for sale. Annual collections over $700K. 4 chairs. Numerous referral sources. Call Frank 877-866-6053 (WD206) NEW SW KING COUNTY ORTHO — Practice for sale. Annual collections $980,000. Large space with room to grow. 6 chairs. Large waiting room. Call Frank 877-866-6053. (WD207) NEW SEATTLE — General Dental Practice for sale. Desirable neighborhood, highly visibility. Annual collections of $1.5 million. Contact email@example.com. (WD208) NEW SW SNOHOMISH COUNTY — General Dental practice for sale. Annual collections of $300K. 4 operatories. Call Frank 877-866-6053. (WD209) SOUTH SOUND GENERAL DENTAL PRACTICE — $300,000 collections, 4 ops. Priced for fast sale! Email rod@omni-pg. com. (WD199)
NORTHGATE TURN KEY DENTAL OFFICE FOR SALE/SPACE FOR LEASE — Up to 6 operatories, reception, waiting area, restroom, lab, sterile, doctor office, staff lounge. Four operatories are fully operational with ADEC chairs, CT scanner. No patients, assets only $50,000.00. Email firstname.lastname@example.org. SEATTLE — Well established fee for service practice for sale. 2016 collections of $1,350,000. Four ops, digital x-rays. Email email@example.com. (WD191) ISLAND PRACTICE — For sale. Annual collections over $300,000. Newer buildout. Great location, tons of room for growth. Contact firstname.lastname@example.org. (WD182) LAKE CHELAN — General Dental Practice for sale. Annual collections $600,000+. Good patient base, room to grow. 4 operatories in newer, beautiful building which is also for sale. Contact email@example.com. (WD184) SOUTH SOUND ORTHO PRACTICE FOR SALE — Annual collections over $600,000. Six chair office, stand-alone building, good visibility. Some DSHS patients. Email firstname.lastname@example.org. (WD169) DES MOINES GENERAL DENTAL PRACTICE FOR SALE — Nice location, newer office. Annual collections over $600,000. Good new patient flow. Four operatories, room to grow. Call Frank - 877-866-6053. (WD171) SKAGIT COUNTY — General Dental Practice for Sale. Annual Collections over $250,000. Four operatories. Be the only dentist in town. Email frank@omni-pg. com. (WD172) WESTERN SKAGIT COUNTY — Downtown General Dental Practice located near the water. Four operatories. Annual collections approximately $400,000/year. Call Frank - 877-866-6053. (WD173) WHATCOM COUNTY — GD practice for sale. Annual collections approximately $250,000. View of Mt. Baker, busy street. Building also for sale with another space for rental income. Email rod@omni-pg. com (WD177) OLYMPIA — GD practice, building also for sale. Annual collections over $1.1 million with good cash flow to doctor. Contact email@example.com (WD176).
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NORTH SNOHOMISH COUNTY PRACTICE FOR SALE — Annual collections over $650,000. Great visibility with awesome signage. Call Frank - 877-866-6053. (WD179) EAST OF LAKE WASHINGTON PRACTICE FOR SALE — Great location just off I-90. Annual collections over $400,000. Two ops, possible room to grow. Call Frank 877-866-6053. (WD180) SOUTH SOUND — Four operatory fee for service general dental practice. Annual collections over $800,000. No PPO’s! Email firstname.lastname@example.org. (WD188) LINCOLN COUNTY — Owner is selling two separate general dental practices both within 35 miles of Spokane. Excellent cash flow for a practice of this size. Contact email@example.com. (WD189) NORTH KING COUNTY GENERAL PRACTICE FOR SALE — Annual collections almost $900,000. 5 operatories, Prime location. Low overhead, hi net practice with great cash flow. Email firstname.lastname@example.org. (WD190) OREGON DENTAL PRACTICES FOR SALE — Southern Oregon Endo, Albany building, Central Oregon GP and building for sale. Contact email@example.com for more info! BOTHELL PREMIER RETAIL SPACE AVAILABLE — 2,000 SF at North Creek Plaza. Near UW Bothell, Cascade Community College, and the Bothell Technology Corridor. Contact firstname.lastname@example.org. TUKWILA CLASS A MEDICAL/DENTAL OR OFFICE SPACE AVAILABLE — 5,000 sq. ft. on top floor and 2,500 sq. ft. on second floor. Territorial views. Two blocks from I-5 access. Next to Tukwila P&R. Ready for TI improvements. 7500-2000 sq. ft. Available $25 per sq. ft. Gross Lease. Email email@example.com. MAPLE VALLEY – FRONTIER SQUARE — A mix of office and retail uses. Currently two spaces available - 1,200 SF retail/office space and a 1,524 SF dental/medical office. Contact firstname.lastname@example.org. DENTAL OFFICE IN LYNNWOOD — Roughly 1,400 sq. ft. Plumbed for 4 ops including Nitrous and O2. Visibility from 44th Ave W. $24.00 per sq. ft. + $3.62nnn. Email email@example.com.
classifieds issue 6, may, 2018
OFFICES FOR SALE OR LEASE
classifieds issue 6, may, 2018
OFFICES FOR SALE OR LEASE
OFFICES FOR SALE OR LEASE
OFFICES FOR SALE OR LEASE
KENT — Woodmont Place Shopping Center High Visibility space available. Signage along Pacific Highway. 1,300 sq. ft. Three exam rooms, x-ray room, darkroom, lab area, executive office, kitchenette, great signage, plenty of parking. Asking $2,275.00/month - modified gross. Contact firstname.lastname@example.org.
PRACTICE FOR SALE, AUBURN — Existing DDS is ready to retire! Four ops, Selling the book of business, solid patient base. Great staff would like to stay. Collections average $700K-$900K at 3.5 days/ week. Contact email@example.com or lori. firstname.lastname@example.org.
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 email@example.com.
LYNNWOOD PLUMBED DENTAL OFFICE — Roughly 2,000 sq. ft., 5 ops including Nitrous and O2, plenty of parking, visibility from 196th. Contact steve@ omni-pg.com.
FOR SALE, SOUTH LAKE UNION — Established office 1.5 million collections. Near Space Needle, middle of Amazon. 60 new patients a month, no advertising being done. Good lease If you interested email back to firstname.lastname@example.org.
FOR SALE — Well-established (40 years) dental office for sale in stand alone building. Othello, Washington. Call (509) 9891143 for details.
MARYSVILLE DENTAL BUILDING — Two additional tax lots for sale. Well-kept 6,600+ medical building with three dental tenants in place. One smaller unit is not rented. Residential home included. Contact email@example.com. BELLEVUE MEDICAL CORRIDOR — Highland Professional Building built in 2016. Entire 2nd floor available for lease approx. 3840 sq. ft. Plumbed for 7+ operatories or medical rooms. Plenty of parking. Rent $30.00 + $6.00 NNN per sq. ft. Email firstname.lastname@example.org. GRANDRIDGE DENTAL/MEDICAL OFFICE FOR LEASE — Opportunity for a start-up or move your existing practice. Fully built out, 4 equipped operatories, reception, waiting area, lab, sterile, office, staff lounge. Contact email@example.com. MEDICAL DENTAL BUILDING FOR SALE IN NORTH SEATTLE — Currently built out as an orthodontic office. 12 parking stalls for the sole use of property. Contact firstname.lastname@example.org. PRACTICES FOR SALE COMING SOON — Snohomish County, Skagit County Perio, Grays Harbor County, Spokane, Bellevue, Downtown Seattle. Contact Rod to be notified when available – email@example.com. RESTORATIVE, IMPLANT, PERIODONTAL PRACTICE priced for IMMEDIATE SALE— Great Value at $299K. Poulsbo, WA. $600K Collections. Full Schedule of Treatment Planned Patients. (4) Ops. Digital & Nitrous Oxide. Equipped for Restorative, Implant Placement & Restoration, Periodontal Treatment. Contact: Jeff Huey at Jeffrey.c.Huey@ gmail.com or Text (206) 227-2919. GP PRACTICE MILL CREEK — Priced to sell four chairs, busy shopping center, 400k ‘15, 700k ‘16, lots of room to grow, Open Dental, low overhead, strong referral, motivated seller, email FVqualitydentalcare@gmail.com
CLE ELUM — Well established, general practice for sale, located in a fast growing area. 4 complete operatories, 1850 square feet. Option to lease or purchase building. Located 1.5 hours east of Seattle, 10 minutes from Suncadia. Contact Dr. Lorin Peterson at firstname.lastname@example.org or 509-674-1389. MODERN SOUTH LAKE UNION OFFICE — Lower Queen Anne-South Lake Union five operatory office. Well-established, modern office with collections at 1.45 million. Average 50-60 new patients a month. Great staff to help with transition. Only serious inquiries, please email me at email@example.com. FOR LEASE — High exposure commercial spaces in Sequim Professional medical/dental office spaces within 5th Avenue Medical Specialists complex. Excellent front plaza corner lot exposure in busy area of medical and dental offices in Sequim. Bring your business ideas to this great location. Water, sewer, garbage & grounds maintenance included. Tenant pays all other utilities.1229 SF @ $1600 per month-gross lease. Contact: Dollie Sparks. (360)582-7361 cell. (360)683-6880 office firstname.lastname@example.org. FOR LEASE — A dental office is available (12/1/2017) for lease. Currently, it is a dental office with three chairs set up. Total square feet is 1100 square feet. Total rent is $3300. Flexible term. Possible signage along busy 148th Avenue in Bellevue. Call (206) 498-3668 for showing. DENTAL PRACTICE FOR SALE, NORTHGATE — Well established fee for service dental practice for sale. Distress Sale $395k. $60k a month. Many services currently being referred out such as ortho, implants, wisdom teeth, molar endo and perio. 5 fully equipped operatories, lab, break room, washer and dryer and 2 private offices. Fully digital. Great staff. Possibility of office property for sale as well. Please call (206) 909-3863.
FOR SALE — New practices for sale, located in Bellevue, Burien, Tukwila, Olympia, Tacoma. Also numerous pre-existing dental spaces for lease. Call today. New office development consultants for over 35 years. Annie Miller at REMAX (206) 715-1444. SPACE FOR LEASE, WENATCHEE — Dentist moving to new location. 3,504 sq.ft + 300 sf basement. Presently 10 ops can be split-up call 509-421-4914 or email email@example.com. G/P PRACTICE FOR SALE IN NORTH KING COUNTY — Annual collections almost $900,000. Five operatories, Dexis Digital X-rays w/ two sensors. Office located in the prime location in town. Practice has been in same location since 1975. Well trained and tenured staff will assist with the transition and stay on with the practice. Seller is a Delta Premier Provider. Seller does no endo, oral surgery, or pedo. Low overhead and hi net practice with great cash flow. Contact: Buck Reasor, DMD, Reasor Professional Dental Services, firstname.lastname@example.org, (503) 680-4366. G/P PRACTICE FOR SALE IN GRAYS HARBOR COUNTY — Doctor has two practices that are 30 miles apart. One practice is the only dental office for 30 miles. Annual collections of $580,000. If you are seeking a small community to raise your family and become an active member in the community then this is a great opportunity. The main office has four fully equipped operatories. Well trained and experienced staff will assist and continue in the transition. Well-established practice that has been in the same location for 25 years. Outstanding and productive hygiene program in place. Excellent collection policy. Contact: Buck Reasor, DMD-Practice Transition Broker, Reasor Professional Dental Services. email@example.com, 503-680-4366. DENTAL PRACTICE FOR SALE — Great location in Lynnwood. 3 operatories, fully equipped, dental office. Dentist is retiring. Contact Dirk at firstname.lastname@example.org for details.
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FEE FOR SERVICE PRACTICE FOR SALE IN SEATTLE — 2016 collections of $1,350,000. Cosmetic/reconstructive in the Kois philosophy. Fee for service practice Great cash flow. Four fully equipped operatories, digital X-Rays, refers out endo and oral surgery. Well trained and experienced staff will continue and assist with the practice transition . Well established practice that has been in the same location for over 20 years. Selling Dr. will mentor purchasing Dr. for a limited time. Buck Reasor, DMD, Reasor Professional Dental Services, info@reasorprofessionaldental. com, (503) 680-4366.
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 LEASE — Downtown Redmond medical/dental office space for lease. Up to 2,800 sq ft. of space on the second floor, floor to ceiling windows on all sides. Prime location in City Center Building across the street from City Hall, Library, School, and Bus Stop. Perfect for high visibility. Building currently occupied by two GPs, an endodontist, chiropractor, and physical therapy clinic. Please email redmonddds@ gmail.com. BELLEVUE/FACTORIA — Newly renovated (incl hardwood floor & granite reception countertop, etc.) dental off for lease. 1,200 sq. ft. 3-ops (4th op can be added) in a stylish off bldg. slmliu at comcast dot net. Easy I-90/I-405 frwy access. Across street from Factoria Mall. 15’ pole sign by Factoria Blvd. AVAILABLE, SOUTHCENTER — Just available. 1200 square foot fully equipped four operatory dental space. Cerec , Panoral, four chairs, lights, nitrous, air and vacuum all available and in place. Please call Dr. Jerome Baruffi at Medical Centers Management (206) 575-1551. 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. 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. FOR SALE — General practice in beautiful Central Washington, same owner since 1979, consistent annual collections: $700,000, 60 percent OH, largely FFS, digital technology, 3,400 sq. ft., five ops, asking $546,000. Email: FredH@arizonaTransitions.com.
SERVICES INTRAORAL X-RAY SENSOR REPAIR — We specialize in repairing Kodak/Carestream, Dexis Platinum, Gendex GXS 700. Repair & save thousands over replacement cost. We also buy & sell dental sensors. www.RepairSensor.com / 919-924-8559. DENTAL EQUIPMENT FOR SALE EQUIPMENT FOR SALE — Dental office (new construc-tion/equipment in 2010) is moving and selling almost everything! Pelton & Crane teak Renaissance twelve o’clocks with Nitrous, center Islands w/ digital x-rays, sterilization center, solid surface countertops. Three Pelton grey leather chairs with back massag-ers. Pano, mechanical room. Contact Randy Blair @ email@example.com (509)-308-8068 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.
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classifieds issue 6, may, 2018
OFFICES FOR SALE OR LEASE
first person dr. julie kellogg
A journey into professional mortality
Dr. Julie Kellogg Editorial Advisory Board
“The speed of change in both technology and materials/techniques certainly poses a challenge for all of us. However, as we age, it can be harder to think in new ways.”
The views expressed are those of the writer and do not necessarily reflect the opinion or official policy of the WSDA.
We are blessed. As dentists, most of us will have the freedom to practice as long as we choose. But what is our experience with modern professional mortality? To paraphrase from the book “Being Mortal” (by Atul Gawande), are we blinding ourselves to the opportunities that exist to change our individual experience of professional aging for the better? I have had the honor of watching the long and successful dental careers of my late grandfather and my father. I enjoy practicing with my father, who continues to work nearly full time at the age of 72. I have been mentored by several colleagues who also practiced with their fathers, who worked into their 80s. And I recently had the pleasure of spending the evening with a dentist from Maryland who is in his 58th year of private practice, still works two or three days a week, and runs over 350 miles per year. How should dentists in their 60s, 70s, and 80s approach dental practice? The average American retires at age 63 and has an average retirement span of 18 years. The average American dentist retires at age 69. About 68 percent of dentists state they would like to keep working at least part time after their retirement age to stay busy and for fun. My friend and mentor Dr. Alan Rauchberg said it well: Most dentists have “no end vision,” probably in dentistry or in life. Dentists simply work until they can’t work anymore. Dr. Chris Phelps, a dentist and marketing expert, conducted an informal survey in his practice. He asked his patients why they still read the local newspaper. The most frequent answer was to read the obituaries. Living in a small and popular retirement town, even I will include the obituaries in a quick survey of the local newspaper. After 40 to 50 years of practice (depending on our age and practice demographics), we may find ourselves reading the obituaries with more frequency to see how many patients and friends we have lost. We will increasingly notice our progression of aging and limitations: decreased sensory input; difficulty performing under stress; and increased challenges to think in new pathways. We would rather believe that we might beat aging than have an honest conversation about its realities. I would advocate for the unique value of the multigenerational practice. Patients and team members love the experience that a mentoring multigenerational relationship brings. Some of our older patients may enjoy treatment with the young energetic dentist, while others prefer to see the gray-haired clinician. We can step in and help each other. A group of dental practitioners whose ages and experience span generations can provide an increased value for everyone in the practice. The speed of change in technology and materials/techniques certainly poses a challenge for all of us. However, as we age, it can be harder to think in new ways. Processes and movements that have long been automatic may still work, but they simply may not be as reliable. A desire and enthusiasm for continual learning is imperative. We also have the challenge of communication between generations. Some older dentists may be reluctant to bring in younger partners or associates. This can stem from fear of judgment for being “old school” or because the energy and time it takes to teach and mentor can be significant. Some younger dentists are sometimes a bit arrogant and dismissive of the wisdom of experience. Many existing mentorship programs are not well utilized. And different kinds of mentorship are relevant at different ages and at different stages in our careers. It’s important that we not segregate ourselves by age, but rather we choose to learn from each other. This month our magazine honors Dr. Miles Lodmell, a Walla Walla dentist who recently retired at the age of 85. Following a dental society meeting a while back, I overheard Miles describing a gold pinlay case he had done. I’ll wager that the younger dentist he was speaking with was not sure what a gold pinlay is. Miles and my father have skillfully created many beautiful gold masterpieces in their patients’ mouths over the years, just as many of us now create beautiful digital masterpieces. We should not be afraid to ask about and admire past or present techniques. Nor should we be afraid to explain and to teach. I believe that studying and teaching beauty and skill will bring beautiful masterpieces out of our own selves. My purpose in writing this is not to offer any grand solutions, but rather to open an honest discussion about the journey toward professional mortality. I challenge us to be willing to discuss what it’s like to be a creature who ages and dies. Let’s check our ego at the door and accept the changes that simply cannot be wished away. Let’s learn from the reflections on past experiences. Let’s embrace how we can achieve our best quality of life, which is freedom from disease and enough function for active engagement in the world. And as I learned from Dr. Chris Phelps, taking out an advert for your dental practice in the obituary section of the newspaper is fairly effective.
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The Obvious Choice for Washington Dentists
YOUR WDIA TEAM:
VISIT US AT THE PNDC: BOOTH 119
Matt French · Kerri Seims 206.441.6824 · 800.282.9342 www.wdiains.com A WSDA Company
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Washington State Dental Association 126 NW Canal Street Seattle, WA 98107
PRESORTED STANDARD U.S. POSTAGE PA ID SEATTLE, WA PERMIT NO. 8115
CHANGE SERVICE REQUESTED
We're not the norm… Anytime we discover exposures our doctors are facing beyond professional liability, we work to develop and offer exceptional dentist-specific products. For instance, NORDIC was one of the first northwest companies to offer dentists comprehensive cyber risk coverage. Can the big box companies say that? For more information about cyber coverage, call …… NORDIC – the Gold Standard
800-662-4075 nordicins.com firstname.lastname@example.org
Sole broker for NORDIC
VISIT US AT THE PNDC: BOOTH 218
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The WSDA News is the Official Publication of the Washington State Dental Association, representing more than 4,000 licensed dentists committ...
Published on May 22, 2018
The WSDA News is the Official Publication of the Washington State Dental Association, representing more than 4,000 licensed dentists committ...