BULLETINOFTHESANFERNA NDOVALLEYDENTALSOCIET Y VOL

Transcription

VOL. XXXVII
NO. 3
Summer
2004
ENTAL
ENTAL
IMENSION
BULLETIN OF THE SAN FERNANDO VALLEY DENTAL SOCIETY
Visit
our
Web
Site
at
www.sfvds.org
DENTAL DIMENSIONS
published by the
San Fernando Valley
Dental Society
21201 Victory Boulevard, Suite 230
Canoga Park, California 91303
Office: (818) 884-7395
Fax: (818) 884-2341
E-mail: [email protected]
Web Site: www.sfvds.org
Executive Committee
George A. Maranon, D.D.S.
President (818) 344-0110
Kory M. Zussman, D.D.S.
Immediate Past President
(818) 907-1318
Robert G. Hale, D.D.S.
President-Elect
(818) 349-8851
Anette Masters, D.D.S.
Treasurer (818) 700-1247
Jason W. Pair, D.D.S.
Secretary (818) 349-4956
Gray G. Berg, D.D.S.
Editor (818) 790-2010
Gerald Gelfand, D.M.D.
Trustee (818) 225-8602
Joseph P. Sciarra, D.D.S.
Trustee (818) 224-2970
Delta Dental’s new approach to fee filing
Members need to know their Delta claims should have their highest office fee
for each procedure. It means the dentists will write off the difference between their
fees and Delta’s accepted fee at time of payment. This will maintain UCR at higher
level for future determinations.
Joe Sciarra, D.D.S.
In March, Delta wrote to participating dentists about modifications to Delta
Dental’s filing fee system. The mailing included a description of the modified
system, the easy steps for filing fees and how allowances will be determined.
The “questions and answers” below address common questions about the
modified system. If you have other questions, please email [email protected] or call
Professional Relations at (415) 972-8300, extension 3805. Also, please check the
“Dentists” section of our web site (www.deltadentalca.org), where you will find
answers to new questions over the next few months.
Q. When Delta switches to the new fee filing system, will any of my current
Delta fees be lowered?
A. No. All of your current Delta fees will continue to be honored.
Q. When I file new fees after the new system goes into effect, will any of my
current Delta fees be lowered?
A. No. Delta is grandfathering all of your current fees that are higher than your
region’s maximum plan allowances for those procedures. This exemption will
continue until the maximum plan allowances reach the level of these fees.
Q. How will Delta set 80th percentile fees in the new system?
A. Delta will calculate 80th percentile fees twice each year, as in the past. They
will be calculated from the fees submitted on claims by all participating dentists in
each region and specialty.
Q. What fee should I put on the claim form—the Delta allowance or my usual fee?
A. The choice is yours. You may submit either fee on your claims.
Jacqueline Bell
Executive Director
Business Manager
Member Publication
American Association
of Dental Editors
General Excellence
Award
Recipient of the
Golden Pencil
Journalism Award
International College
of Dentists
Q. Would it be useful for me to submit my usual fee on claims?
A. Yes, because Delta will calculate future allowances for your region on fees
submitted on claims by the region’s participating dentists.
On the cover:
“The Remarkable Rocks” on Kangaroo Island, Australia, are awesome, precariously balanced boulders on a smooth granite dome. (Below left) View from 1/2 mile
away. (On right) Editor Gray Berg stands inside a hole in one of The Remarkable
Rocks —note feet at bottom.
Produced by Casa Graphics, Inc., Burbank, CA
Published quarterly by the San Fernando Valley
Dental Society. The Society solicits essays, letters,
opinions, abstracts and publishes reports of the
various committees; however, all expressions of
opinion and all statements of supposed fact are
published on the authority of the writer over whose
signature they appear, and are not regarded as
expressing the view of the San Fernando Valley
Dental Society unless such statement of opinions
have been adopted by its representatives. Acceptance of advertising in no way constitutes professional approval or endorsement.
2
Summer 2004 • San Fernando Valley Dental Society
President’s Message
“Volunteer-driven organizations”
George A. Maranon, D.D.S.
President
t
hrough our California Dental Association
and San Fernando Valley Dental Society
memberships we are part of effective volunteerdriven organizations. Each member has talents to
make these organizations even more relevant.
The key to being effective is the volunteer.
As President, I am occasionally asked, why doesn’t CDA do
something about . . . ? There are legislative and regulatory issues
that must be addressed. We feel the intrusion of third party
payers and the squeeze caused by the shortage of auxiliaries. The
state government and the dental community are struggling with
Medi-Cal reimbursement as well as patient care and social
concerns of under-served segments of our population.
Volunteers are engaging these ongoing issues. As more members
participate, they become part of the solution of these and other
issues affecting dentistry.
The CDA and SFVDS are making significant changes to create
greater opportunity for members to participate. The volunteer
process is becoming more streamlined. The process is now
becoming more understanding and sensitive to the amount of
time our members have to contribute.
Using issue-specific task forces, members have the opportunity
to share their skills on shorter projects. Much of the work of
these task forces is conducted via email and conference calls to
limit the amount of time spent. For those who can devote more
time and participate more actively, there are longer term and
leadership opportunities.
Training and leadership development are also made available to
volunteers. Any member who wishes to improve their skills can
get this training. Many of these skills can be applied to your
practice and personal endeavors.
“Using issue-specific
task forces, members
have the opportunity to
share their skills on
shorter projects.”
If you would like information on how you can help, contact
SFVDS Executive Director Jackie Bell at 818-884-7396 ext. 1
or CDA screening committee coordinator Denise Gallardo at
800-736-8702, ext. 4091.
My volunteer experiences have meant a lot to me. I have grown
personally by meeting and learning from my colleagues. I have
had the opportunity to make a difference. With your help, we
can do even more. I look forward to hearing you say, “I would
like to help CDA do something about . . .”
3
Buying a dental practice
by Paul Maimone, M.B.A.
directly to buyers, (2) Practice brokers.
Practices listed with brokers are exclusive
listings and only the listing broker is
authorized to sell the listing; so contact
several. (3) Consider the practice you
work at. If it’s your type, then ask the
owner if it is for sale. If the response is
positive you can: (1) Buy in, (2) Purchase
it out right, (3) Purchase at a defined
future date, or (4) Become partners.
WHAT TO LOOK FOR
REASONS FOR
OWNERSHIP
There are three main reasons to own:
(1) Take control of your own destiny,
(2) Business ownership tax advantages
and (3) Personal satisfaction of owning a
successful business.
Once you have located a practice that fits
your criteria, look over the following
before making an offer: (1) Gross
collections/net income and the overhead,
(2) Equipment inventory and condition,
(3) Is the staff willing to stay? (4) Status
of the account receivables including
amount, age and if included in the sale,
(5) Lease status (6) Are current provider
contracts transferable? (7) Practice trends.
These and other pertinent questions need
to be addressed. If positive, write offer.
This article addresses: ownership
options, defining your ideal practice,
practice identification, what to look for,
purchase contingencies, and finally a
listing of helpful professionals.
START FROM SCRATCH
OR PURCHASE
There are two routes to own: (1) Start
from scratch or (2) Purchase. This article
addresses purchase. Before you proceed
with your practice search, first consider
and answer questions such as: (1) Where
do I want to practice? (2) What kind of
practice do I wish to own? (3) How large
an office do I want? (4) How many ops?
(5) What type of office location?
Shopping center? Professional building?
(6) Lease or own the building? (7) How
to finance?
Once defined, it is time to start your
practice search. You will find practices
for sale via: (1) “For Sale By Owners”
(FSBO’s). Sellers who sell their practice
4
PURCHASE
CONTINGENCIES
Any offer should include the following
four contingencies which will help
protect you: (1) Acceptable loan
(2) Acceptable lease (3) Due diligence book check and (4) Mutually acceptable
buy-sell agreement, covenant not to
compete and purchase price allocation.
Should one of your contingencies not be
met, you can cancel the transaction and
get your earnest deposit check back.
PROFESSIONAL HELP
There are several professional disciplines
available to the buyer, who can make the
process less risky and more manageable.
They include: dental practice brokers,
CPAs/accountants, practice consultants,
and dental attorneys.
Paul Maimone M.B.A. is a real estate
broker and is the principal and broker of
D&M Practice Sales and Leasing, a San
Fernando Valley based dental practice
brokerage. He can be reached via email at
[email protected] or
at (818) 591-1401 and would welcome
any calls for an expanded explanation of
his services.
Now available in the San Fernando Valley . . .
NewTom
NewT
om
Cone Beam
Volumetric
Scanner
As featured in the November 2003 CDA Journal.
Images similar to CT with 80% less X-ray exposure.
For imaging and referral information contact:
Daniel Halpert, Halpert Dental X-Ray, Inc.
6342 Fallbrook Avenue #102
Woodland Hills, CA 91367
Serving
your
Maxillofacial
Imaging
needs
since
1976
818-719-0055
Support our exhibitors
Dr. Ken Swartz of TDIC/
1201 with Dr. Mary A.
Ditto
Paul Maimone of D&M Practice Sales
Drs. John Neville and
Mark Leavitt with
Daniel Granados
of P & G
Eric Dye of Hayes Handpiece
with Dr. George Maranon
Maryam Khalizadeh
and David Sada
of Citibank
Lynsey Neill of Burbank Dental Labs
Joseph P. Sciarra, D.D.S., Trustee,
Debra S. Finney, D.D.S., CDA President,
Jose-Luis Ruiz, D.D.S., Program Chair
Jose-Luis Ruiz, D.D.S., Program Chair
and Ilan Rotstein, D.D.S., Speaker
M.E.N.D. representative
and Michael Yamane, D.D.S.
5
Legislative news
Political process
by James Mertzel, D.D.S.
Legislative Chairman
i
Dental Amalgam Separators — There was a bill submitted last
year to require that every dentist install an amalgam separator.
CDA continues to support the availability of amalgam fillings as
a safe and cost-effective restoration material. CDA opposes any
legal attempt by anti-amalgam proponents to restrict the use of
amalgam. CDA proposes a policy giving dentists a wider range
of options for handling amalgam waste.
urge you to get involved in the political process.
The best way to insure those issues that you are
passionate about will prevail is to meet, get to know
and to support the legislators who will advocate the
legislation that will support your causes.
Here are some of the legislation issues that the CDA
Government Relations Office is advocating on our behalf.
Most of the efforts of the State Legislature are directed toward a
budget that will attempt to cut costs. One of the original targets
was an attempt to reduce the rates by 5 percent for Denti-Cal
providers. The governor suggested a 10 percent reduction. Both
reductions have been held in abeyance due to a lawsuit instigated
by CDA and a coalition of other health providers. The lawsuit
received a favorable ruling in December 2003, thereby
postponing any attempts by the Governor to request any
reductions.
AB 539 — A bill that would allow dental students to take the
dental hygiene exam, and having passed, allow the students to
work as hygienists. The bill received final passage in the
Assembly in January, but is being held up, along with other bills,
that have potential fiscal impact.
Frivolous Lawsuits — An initiative, which will limit them,
supported by Governor Schwarzenegger is currently being
circulated for signatures for possible inclusion on the November
ballot.
A comprehensive Workers’ Comprehensive Reform Act was
passed after the Democrat dominated legislature was pressured
to act. The bill was a compromise and will not quite have the
cost-saving provisions of the proposed initiative. There are
efforts by some legislators to add further cost-cutting provisions
to Workers’ Compensation policies.
6
Dental Assisting Scope of Practice — I suggest that our
members discuss this issue with their legislators and have some
input as to what they believe dental assistants should/should not
be allowed to do, i.e. Should RDA Extended Function dental
assistants be allowed to place composite restorations?
Oral Surgeons: Scope of Practice — Under an anomaly in state
law, oral surgeons are permitted to perform complete facial
reconstructions in a hospital trauma center, but not on an elective
“CDA opposes any
legal attempt by antiamalgam proponents to
restrict the use of
amalgam.”
basis in their offices. A statute is proposed by which oral
surgeons could obtain a permit from the board to perform such
procedures on an elective basis in a surgicenter or an accredited
facility after demonstrating and documenting appropriate
education, training and experience.
Dental Licensure Exam — The deans of all five California
dental schools have expressed concern that there are inadequate
funds to provide sufficient examiners to administer the
California State Board Exam. It was proposed that applicants
could substitute the Western Regional Examination Board as an
alternative.
Celebrating members:
Elgan Stamper, president of AAOMS
Interview by Editor Gray Berg:
Elgan P. Stamper, D.D.S., is nearing the end of his term as
president of the American Association of Oral and Maxillofacial
Surgeons—an honor which occupies but two lines in a CV three
pages long. His career is filled with distinguished
accomplishments, honors, contributions and associations.
Happily he’s not near the end of that career.
Profile of Dr. Stamper
Birthplace: Los Angeles
Family: Wife Carolyn and daughters Michelle and Kristen
Education: B.A. at UCLA, D.D.S. at USC, Oral Surgery
Program at USC
Leisure activities: Year-round jogging and skiing
The following are answers to questions I posed recently over
lunch.
Q. What do you like most about your profession?
A. Oral and maxillofacial surgery—it’s always challenging in
addition to contributing to the health of the public.
Q. What is your professional goal?
A. To be the best I can be at what I do.
Q. Is there any other profession you would
choose?
A. None. I’m living a dream.
Q. Who is the person you most admire?
A. Tom Braun, Dean of the University of Pittsburgh Dental
School. He’s everything an oral surgeon should be.
Q. Who or what has been the biggest influence on your life?
A. That’s easy—my parents. What they instilled in me was to do
whatever I do to the limit of my ability.
Q. What was your best business decision?
A. Joining Drs. McMillan and Lytle 25 years ago.
Q. What was your worst business decision?
A. Next question, please.
Q. what would you want St. Peter to say when you reach the
Pearly Gates?
A. Come in—You put your family first. Congratulations!
Update from Dr. Hale
Letter from Col. Robert Hale, OMS,
SFVDS President-Elect, written from Kuwait.
(On June 1, 2004, Dr. Hale was prominently featured on CNN, the
Paula Zahn Show. Editor)
MASH is the way I described this place and, after a complete
day here, this could be the movie set. I will send pictures when I
figure how on the
Army system. My
laptop won’t
interface, but I still
need it for photo
processing.
Last night we had a
6.6 earthquake
centered 50 miles
away. No reported
injuries that we will
be seeing (yet). My
first patient will be a
40-year-old Afghani
with multiple gun shot wounds to the face (AK-47). He is on the
schedule for tomorrow.
These next few months will be interesting, but I am anxious
to get home. Bob
Additional information
from wife Sue Ellen Hale
Bob just called, and the phone line was full of static. He couldn’t
talk long, but he was able to let me know that his email
addresses are up and running, and are as follows:
[email protected]
[email protected]
How reliable and how variable these addresses are is unknown.
His address is as follows. AS PER THE ARMY—DO NOT
WRITE HIS RANK ON ANY LETTERS OR PACKAGE.
There are reasons they do not want this known.
Write to:
Robert G. Hale
Task Force 325 Medical/Section
APO AE 09354
He only had time to tell me that the hospital is a series of MASH
tents. They have room for 20 beds with an overflow tent of
another 20 beds. The hospital is located next to where he sleeps;
this is located at the end of the Air Force runway. Bob definitely
felt the 6.6 earthquake (almost like at home). There are already
some rumors that it may be early August before he is able to
come home. But with the military, things can always change.
7
CDA Board of Trustees
REPORT
by Gerald Gelfand, D.M.D. and Joseph P. Sciarra, D.D.S.
Gerald Gelfand, D.M.D. Joseph P. Sciarra, D.D.S.
t
he Board of Trustees of CDA met this last
weekend, May 22-23, 2004 in Sacramento.
The hot topic this quarter was The Code of
Ethics Update. The breakout sessions focused
on input from all parties as it related to what
our Code should say to our members and the
public we serve, what is expected of a CDA
member and how best to enforce those very
severe infractions that arise very infrequently.
The discussion was lively and to the point.
The consultants retained to help this committee have sought and
will be seeking input from all areas of our Association. If you
have something you feel very strongly about, contact CDA so
that you may be put in contact with the members working on this
project. A Code of Ethics is a dynamic, ever-changing document
that we are learning must be constantly reviewed and updated
when necessary.
The Board also looked at the legal issues still involving the
Association. Amalgam, wastewater and other areas of concern
were discussed.
The Association
leadership and
staff continue to
stay on top of
these issues and
protect the
excellent
practice of
dentistry we and
our patients all
enjoy.
“The hot topic this
quarter was
The Code of Ethics
Update.”
On the legislative front numerous bills are constantly watched.
Issues like the scope of practice for oral and maxillofacial
surgeons and for registered dental assistants are moving forward
under the Association’s watchful eye. Many of these issues
effect our practices and again our Association is there protecting
us and our patients.
8
It appears the state will NOT be lowering Denti-Cal fees this
year. We are all waiting to see how the new regulations on
Workers’ Comp. insurance may improve our premiums in that
area. We can only hope!
The Association, its subsidiary companies and the CDA
Foundation remain very strong and moving ahead with many
positive programs. Keep an eye out for articles on their
activities. Till we meet again……..
Kristy Borquez
new president
of ADAA
Kristy S. Borguez, CDA, RDAEF,
FADAA, here in Northridge has risen
through the chairs of the local Dental
Assistants Association, has been
elected Vice-President and President
at the state level and as Trustee for the
American Dental Assistants Association.
On July 10th of this year at their annual meeting, she will be
installed as President of the ADAA. A singular honor for one of
our own.
In February, 2005, Kristy will lead a Dental Assistants
Delegation to Russia under the “People-to-People” Ambassador
Program to meet with dental assistants and other dental
professionals there.
Delegates will visit clinics, hospitals and schools and hold
extensive discussions on composition of the dental team,
specialty fields, access to dental care, promotion of preventive
dentistry, the future of dentistry and relationships with other
health professionals.
Hygienists
employment referral service
Dear Doctor:
As an advantage of membership, the SFVDHS assists members
of the American Dental Hygienists’ Association with
employment referral. We will provide dental hygienists who are
members of ADHA with your information if they have informed
us that they are searching for employment.
We ask that you notify us when you need a temporary or
permanent dental hygienist. Please be aware that we have
limited human resources for temporary employment and would
have better success in assisting you for circumstances such as
maternity leave, and situations where we are not given notice of
your need at the last minute.
Please contact me when you have filled your dental hygiene
position so I can remove your name from our list. And, by all
means, feel free to contact me if you have any questions about
the service we are providing in the dental community.
Ginger A. Bradford, RDHAP, CHRM, BA
Phone or FAX: 818-708-9832
Price per participant is $4,995. from New York and includes
essentially all costs associated with the experience. Though the
program targets dental assistants, dentists and hygienists are also
invited to take part.
Program details and an application are available by calling
(887) 787-2000 or by emailing [email protected].
*******
New officers of SFVDAS
The new officers of the SFVDAS are:
President, Virginia Cardoza
Vice President, Carol Rivas
Secretary, Lydia Henry
Editor, Kristy Borquez
*******
The 257th Medical Company unit has 30 army dental assisting
soldiers out of Ft. Bragg. They are located in Baghdad.
The unit leader is ISG John Hart who accepts all packages and
correspondence for them.
ISG John Hart
257th Medical Company
LSA-ANACONDA
APO, AE 09391
AD
Rely Aid
IMG gloves
“Rely on Us for
your glove
solutions”
pick up from Fall
p.7
9
Welcome new members
Rambod R. Alirezaei,
D.D.S.
16260 Ventura Blvd., #410
Encino 91436
818-929-1464
UOP 2001
UCLA 2002
General Practitioner
Gina Dorfman, D.D.S.
18635 Soledad Cyn. Rd.,
#108
Canyon Country 91351
661-299-2525
USC 2000
Jieru Pan, D.D.S.
7864 Van Nuys Blvd.
Van Nuys 91402
818-989-2719
USC 2003
Gina Deeb, D.D.S.
4940 Van Nuys Blvd., #101
Sherman Oaks 91403
818-789-2200
USC 1988
USC 1993
Endodontist
Claudia M. Denes, D.D.S.
25856 W. Hemingway Ave.
Stevenson Ranch 91381
661-287-1523
Carol Davila Univ., Romania
1994
Rajeev S. Arhi, D.M.D.
1500 Glenoaks Blvd.
San Fernando 91340
818-898-7171
Univ. of Pennsylvania 2002
Arminita M. Martin, D.D.S.
14427 Chase St., #201
Panorama City 91402
818-895-1055
Centro Escolar Univ.
Ardeshir Taheri-Tafreshi,
D.M.D.
26324 Bouquet Cyn. Rd.
Valencia 91355
Univ. of Pennsylvania 2002
UCLA 2003
Zarin Irani, D.D.S.
USC 2003
Ylang V. Nguyen, D.D.S.
140 N. Victory Blvd., #101
Burbank 91502
Loma Linda 2000
Seongdo Kim, D.D.S.
25078 Peachland Ave., #G
Newhall 91321
661-255-0220
USC 2003
Shirvanyan Mais, D.D.S.
2040 Glenoaks Blvd., #F
San Fernando 91340
818-361-6889
USC 2002
David Varela, D.D.S.
UC San Francisco 2003
Belinda Simonian, D.D.S.
18519 Devonshire St.
Northridge 91324
818-831-9990
USC 2000
10
Hormoz Nourian, D.D.S.
20929 Ventura Blvd., #19
Woodland Hills 91364
818-716-1133
Tehran Univ. 1981
Racquel A. Macasaet,
D.M.D.
Centro Escolar Univ. 1991
Maya Reyter, D.D.S.
Moscow Russia 1968
Azita Rayet, D.D.S.
USC 2003
Charles Kimball, D.D.S.
354 E. Angeleno Ave.
Burbank 91502
818-846-2858
Univ. of Illinois 1999
Alexi D. Kossi, D.D.S.
19366 Soledad Canyon Rd.
Canyon Country 91351
661-252-8808
Loma Linda 1995
Nelly L. Montilla, D.D.S.
Univ. of the East 1986
Raffi G. Najarian, D.D.S.
17022 Devonshire St.
Northridge 91325
818-363-7469
USC 1991
Yoly M. Estrada, D.M.D.
451 S. Brand Blvd., #206
San Fernando 91340
818-838-7003
Univ. of the East 1983
Marcela Lezama, D.D.S.
Univ. Nacional Autondma
Honduras 1994
Shireen Dejbakhsh, D.M.D.
2103 Montrose Ave., #A
Montrose 91020
818-248-1718
USC 2002
Jin S. Park, D.D.S.
9700 Woodman Ave., #A-28
Arleta 91331
818-899-9999
UCLA 2000
Rancho Los Amigos 2001
Boston Univ. 2003
Orthodontist
Orna Ourshalimi, D.D.S.
USC 2003
Merle Yaneza, D.D.S.
9146-A Sepulveda Blvd.
North Hills 91343
818-830-7000
Univ. of the Philippines 1971
UCLA 1978
Silvia T. Borisson, D.D.S.
4654 East Avenue S, #A
Palmdale 93551
661-285-4001
Dental School of Medical
Academy
Sofia, Bulgaria 1978
General Meetings
2004—We’ve Returned to the Sportsmen’s Lodge
4234 Coldwater Canyon • Studio City • 818-755-5000
October 13, 2004
Infection Control,
CAL OSHA Standards – 2-1/2 hrs.
You will be provided with valuable information on the complex occupational and environmental issues affecting dentistry.
Topics include: Dental Board IC Regulation, DHS Medical
Waste Management, and Cal-OSHA BBP Standards.
California Law – 2 hrs.
Topics will include: highlights and updates of the Dental
Practice Act, renewal requirements for all licentiates, and laws
pertaining to prescriptions.
November 10, 2004
Speaker: Edward A. McLaren,
D.D.S.
Esthetics: What, When
and Where?
Topics include:
• Critical mechanical, biologic, and
esthetic requirements a material should possess that will
help better predict clinical performance;
• Differentiate among various all-ceramic systems
• New systems and innovative designs for metal-ceramics
• Polymer glasses explained
• Specific techniques that allow for proper tooth reduction
• Prototype restorations for improved esthetics
• Shade-matching
• Specific cement consideration
Community Service
The Hi Desert Children’s Dental Clinic (HDCDC) provides
dental care to children ages 3 to 17 who do not have insurance
and/or are from low-income homes.
• Sealant clinics—There have been three to date. With the help
of volunteer dentists, over 200 children have received cleanings
and sealants.
HDCDC began working with Antelope Valley Partners for
Health in 2003. Together we applied for and received a Grant in
the amount of $222,000. The monies from this grant were used
to form Save-a-Smile Program.
Dr. Gilbert Snow and staff serve as members of the Antelope
Valley Dental Coalition, which works with other local
organizations to coordinate two annual health fairs in the
Antelope Valley.
To date this program, along with the help of HDCDC, has given:
A wide variety of health services are provided including:
• 3,022 children dental screenings at local schools
• 8,000 adults and children oral health education
• Over 300 referrals for dental treatment by one of HDCDC
participating general dentists
• Dental exams and treatment
• Chiropractic
• Blood pressure/blood sugar testing
• Cholesterol testing
• HIV screening/testing
• Clinical breast exams/mammograms
11
If it’s in the Chart—it Happened
The 4 allegations & other legal matters
by Denise M. Rucci
“The comment I get most often from dentists,” Jeff Tonner
began, “is, ‘If I had only known, I would have charted that.’”
Tonner, a Phoenix attorney whose business card reads
“Defending and Educating Dentists,” recently sat down with me
for a bit of legal Q&A (special thanks to Dr. Joseph Dovgan for
help with the Qs).
Typically, how many dental cases wind up in court each year?
Dentists are more likely to experience a Board complaint. On
average, about 30 dental malpractice cases make it to litigation,
with most settling out of court. The Arizona State Board of
Dental Examiners (BODEX) processed 449 complaints in 2003.
What is the most common mistake you see when reviewing
records with clients? There are two—failure to chart diagnosis
and failure to chart clinical exams, both required by BODEX.
Often dentists aren’t quite sure how to properly chart these areas.
For the most part dental charting is learned through a mentoring
process on the job. The result is that if your mentor is great at
charting, you will be too. If not, however, you’ll keep making
the same mistakes. Because charting is often perceived as a task
that cuts into productivity, it is often overlooked. Jurors always
say that if it’s in the chart, it happened. If it is not in the chart, it
didn’t happen. Documentation is critical in protecting yourself,
your employees and your practice. Dentists must make
reasonable charting efforts and every chart should include the
oral cancer screen and review of medical history.
What are the “four blanket allegations?” They are inadequate
history and clinical, inadequate radiographs, inadequate
diagnosis and inadequate treatment planning. Of those, clinical
and diagnosis are most missed by dentists.
In your law practice, have you seen dental malpractice
insurance companies pay large settlements? Absolutely, it
happens. The areas where I’ve most seen those settlements are
failure to detect oral cancer, failure to pre-medicate, and
situations involving prescribing narcotics and lingual paresthesia
from third molar extractions. In most cases, the entries were
inadequate and the damages were usually high.
Describe one of these cases. I tried a case where failure to
detect oral cancer resulted in the patient’s death. The jury
originally awarded a $1.1 million settlement. We took it all the
way to the Arizona Supreme Court. It was reversed and then was
settled for an undisclosed amount.
How do you define “negligent referral?” Referring a patient to
a specialist whom you know or should know is incompetent. It’s
very, very rare and I don’t even lecture on it any more.
Should a dentist be subpoenaed by BODEX, what steps
should he or she take? Read the subpoena language carefully
and follow all directions precisely. For one thing, the subpoena
language, which was recently changed, reads “must receive
records within 14 days” and the dentist must be able to provide
proof those records were delivered on time. They should be sent
via any means through which delivery signatures or receipts are
provided— certified mail, hand-delivered (get a receipt) or any
carrier with a tracking mechanism and delivery signature
requirement, such as Federal Express. BODEX routinely
sanctions dentists for late records. The fine is $500 for each
infraction and they are very steadfast in that rule.
Should the dentist notify his or her insurance carrier about
being subpoenaed? Yes, but use some discretion. Insurance
companies are non-renewing dentists at a higher rate than in
the past.
What steps can our member dentists take to minimize the
risks in everyday practice? One, memorize the four blanket
allegations. Two, know the areas where insurance companies
pay out the most money. Three, identify the patient who causes
trouble or is most likely to. In cases of troublesome patients, you
have choices—terminate, refer out or chart better. Strike a
practical balance.
How can a dentist minimize risk in the case of a patient who
takes oral sedation and either drives to the appointment or
home afterward? An at-risk patient is one who is impaired. If
the dentist has prescribed an oral sedative, be sure the patient has
arranged transportation or arrange it for them. If they’ve
arranged their own transportation, document the name of the
driver. Use a form that identifies who can make dental decisions
should treatment change, and have the patient sign it.
I also wish to address how to handle a patient who shows up for
his or her appointment in an impaired state, perhaps someone
with a substance-abuse problem. Whether you treat that person
or send them home on the spot, be sure to call a taxi or other
designated driver. Don’t worry about whether the patient will be
insulted. Then take a good hard look at whether you want this
person as a patient.
Conclusion
After hearing “If only I had known…” about a zillion times from
his dentist clients, Jeff Tonner produced comprehensive resource
materials for dentists on charting and communication strategies.
Learn more by visiting www.bestdentalcharts.com or call
Tonner at (626) 266-6060.
Printed by permission of the Arizona Dental Association
12
Avoiding Identity Theft
by Cheryl Lovelace of Morgan Stanley
An Attorney’s Advice
Read this and make a copy for your files in case you need to
refer to it someday. Maybe we should all take some of his
advice!
A corporate attorney sent the following out to the employees in
his company:
The next time you order checks, have only your initials (instead
of your first name) and last name put on them. If someone takes
your checkbook, they will not know if you sign with just your
initials or your first name, but your bank will know how you
sign your checks.
When you are writing checks to pay on your credit card
accounts, DO NOT put the complete account number on the
“For” line. Instead, just put the last four numbers. The credit
card company knows the rest of the number and anyone who
might be handling your check as it passes through all the check
processing channels won’t have access to it.
Put your work phone number on your checks instead of your
home phone. If you have a P.O. Box, use that instead of your
home address. Never have your Social Security Number printed
on your checks (duh)—you can always add it if it is necessary.
But if you have it printed, anyone can get it!
Place the contents of your wallet on a photocopy machine, and
do both sides of each license, credit card, etc. You will know
what you had in your wallet and all of the account numbers and
phone numbers to call and cancel.
File a police report immediately in the jurisdiction where it was
stolen. This proves to credit providers you were diligent, and is
the first step toward an investigation (if there ever is one).
But here is what is perhaps most important—I never even
thought to do this:
Call the three national credit-reporting organizations
immediately to place a fraud alert on your name and Social
Security number. I had never heard of doing that until advised by
a bank that called to tell me an application for credit was made
over the Internet in my name.
The alert means any company that checks your credit knows
your information was stolen and they have to contact you by
phone to authorize new credit.
By the time I was advised to do this, almost two weeks after the
theft, all the damage had been done.
There are records of all the credit checks initiated by the thieves’
purchases, none of which I knew about before placing the alert.
Since then, no additional damage has been done, and the thieves
threw my wallet away this weekend (someone turned it in). It
seems to have stopped them in their tracks.
The numbers are:
Equifax: 1-800-525-6285
Experian (formerly TRW): 1-888-397-3742
Trans Union: 1-800-680-7289
Keep the photocopy in a safe place. I also carry a photocopy of
my passport when I travel either here or abroad. We have
all heard horror stories about fraud that’s committed on us
in stealing a name, address, Social Security number, credit
cards, etc.
Unfortunately, I, an attorney, have firsthand knowledge
because my wallet was stolen last month. Within a week,
the thieves ordered an expensive monthly cell phone
package, applied for a VISA credit card, had a credit line
approved to buy a Gateway computer, received a PIN
number from DMV to change my driving record
information online, and more.
But here’s some critical information to limit the damage in
case this happens to you or someone you know. We have
been told we should cancel our credit cards immediately.
But the key is having the toll-free numbers and your card
numbers handy so you know whom to call. Keep those
where you can find them easily.
13
In memory
Charles M. Strother, D.D.S.
Douglas Alexander Smith, D.D.S.
Former La Canadan, Dr. Charles M. Strother, who most recently
made his home in Indian Wells, passed away peacefully on
February 2, 2004.
On April 30, 2004, Douglas Alexander Smith, D.D.S., died at
age 75 due to kidney failure.
Born May 5, 1919, in Kiowa, Kansas, to Likens and Sallie
(Patton) Strother, he was the youngest of 10 children. Charles
moved to Hemet in 1928 and later to Glendale in 1932. He
attended Hoover High School, Glendale City College and the
University of Southern California. After graduating from USC
Dental School in 1944, he served in the Navy Dental Corps
during World War II. He married Marylou Gourley from
Pittsburgh. PA, in 1947.
Charles was in private practice of dentistry in Glendale for more
than 40 years. In his commitment to his profession, he taught at
USC for nine years, was a member of the Examining Committee
of Dental Examiners from 1972 to 1977, served as president of
the USC Dental Alumni Association in 1982, and was a
committee member and/or chairman of many different positions
with the California Dental Association and local dental
organizations. He was inducted as a Fellow of
the American College of Dentists in 1964 and
a Fellow of the International College of
Dentists in 1976.
He was also very active on local committees
and associations in La Canada Flintridge,
where he lived with his family until 1983.
After retiring from dentistry, he spent more
than 20 years as a resident of Indian Wells,
and was a member of the Indian Wells
Country Club. For 10 years Charles
volunteered as an announcer at Indian Wells
Country Club for the Bob Hope Classic Golf
Tournament.
He is survived by his devoted wife of 56
years, Marylou, his daughters Charlene
(Mark) Ebright of Long Beach, Pamela
Strother of Redondo Beach and Sandra
Baylies of Redondo Beach, granddaughters
Erin and Noelle Ebright and nephew Chuck
(Tobe) Strother of Indian Wells.
Known to friends and family as Chaud, he
was a beloved husband and father. He will be
remembered for his dedication to dentistry,
love of his alma mater, and his strength of
character.
14
A 1955 USC Dental School graduate, he spent 48 years in
private practice in the Valley with time out for a stint in the U.S.
Army Dental Corps. He served in many capacities in the San
Fernando Valley Dental Society including a term as president.
He spent 45 years as a Kiwanian with the presidency of his club
included in his resumé. Additionally, he was an active member
with Shepherd of the Hills Church and group leader of a griefsharing workshop. He was the loving father of Stephen and
Mark.
Everyone who knew him will miss his honesty, dedication and
caring nature.
News of our members
Congratulations to James Mertzel and his wife Marianne on their 48th anniversary on June 17. Jim and Marianne were married after his freshman year of dental
school and are parents of four children and grandparents of six. Jim enlisted in
the Navy following graduation and found to his disappointment that he would
spend nine months of his two-year enlistment at sea. Best laid plans, . . .
*****
Daughter Lisa has presented Alan and Lesley Stein with a little granddaughter,
Sara Eve Whiteman.
*****
Nathan Sciarra, son of Joe Sciarra, has recently graduated from the School of
Architecture at California Polytechnic Institute. Congratulations.
*****
We’re wishing Dr. Prout a rapid recovery after breaking his leg.
*****
To my friends at SFVDS,
Thank you so much for the beautiful flowers and caring note! What a
pleasant surprise! I feel very fortunate to have had a successful open heart
surgery and to be recovering so fast! All of the support from friends and family
has been overwhelming! I am truly blessed. I hope all is well with you and thanks
so much!
Love, Craig Ford
Classified
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Dental Dimensions is looking for
contributors among our members to
supply articles, guest editorials or news
of member activities. Submission of
photos suitable as a cover for future
issues is also solicited. Call Gray Berg,
editor, at (818) 790-2010
15
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16

BULLETINOFTHESANFERNA NDOVALLEYDENTALSOCIET Y VOL

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