May 2014 - New York State Dental Association

MA Y
2 01 4
Volume 27
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Issue 2
what’s inside
Humanitarian Appeal
Global Dental Relief looking for volunteers
to provide first-time dental care to children
outside of the United States . . . . . . . . . . . . . . . . 2
Score Three for NYSDA
NYSDA tallies important victories in early
days of legislative session . . . . . . . . . . . . . . . . . . 4
The More Things Change
Census figures show little has happened to
ease professional shortage areas, particularly
in urban and rural areas . . . . . . . . . . . . . . . . . . . 6
Small town America, idyllic in concept, suffers from lack of healthcare providers.
When disputes break out, peer review is credible alternative to
costly lawsuits.
Dentists Asked to Join Effort to
Resolve Provider Shortage Problem
Government-sponsored programs benefit providers and patients.
D
entists—both those currently practicing and those just starting out—
are being asked to consider signing
on to one of several governmentsponsored programs aimed at eliminating health professional shortage areas, or HPSA’s. In
all instances, participants are being offered financial
inducements, mostly in the form of educational loan
forgiveness, to practice in areas of New York State and
elsewhere in the country where the need for healthcare
providers is acute. It is hoped that the experience might
persuade these professionals to relocate to these areas
permanently.
The three programs are:
1. The New York State Primary Service Corps.
Developed to attract general and pediatric dentists
to underserved areas of New York State. Restricted
to dentists newly serving in designated areas with
qualifying student loans. The next cycle for applications begins after June.
2. The National Health Service Corps. Open to any
dentist serving in designated locations. Applicant
must have qualifying education loans and work in a
site approved by the Health Service Corps. Deadline
to apply occurs each March.
3. Federal Service. Available to most dentists, including dental students, new dentists and established
dentists looking for career change. Opportunities
include Air Force, Army Dental Corps or Navy
Dental Corps. Sign-on bonuses or loan repayment
options may be available.
Dentists are not allowed to participate in the New
York State and National Health Service Corps at the same
time. And they will be penalized if they breach their contract with either organization. More detailed information
about the government-sponsored programs follows.
New York State Primary Care Service Corps
When the
Dentist and the
Patient Disagree
NYSDA’s peer review process offers
resolution in non-confrontational
environment. Lessons from the files
of the Peer Review Committee.
Jeffrey Galler, D.D.S.
PEER REVIEW IS NYSDA’s quality assurance mechanism. It provides an impartial, confidential and
timely resolution to patient complaints about the
appropriateness of care and quality of treatment
rendered by member dentists. Two recent peer
The New York State budget has allotted $1 million in
funding that can be provided for up to 33 loan repayment
awards. Under the parameters of PCSC, participants are
obligated to serve either a two-year, full-time commitment (40 hours per week, 32 being clinical services) or a
two- to four-year, part-time commitment (at least 20
hours, 16 being clinical services). Adding additional years
to the contract is negotiable. Participants must meet scoring and awarding criteria to be reviewed competitively by
the New York State Department of Health.
review cases raise important issues for dentists to
continued on page 10
continued on page 11
consider.
The first is the importance of informing
patients of the treatment options available to them.
The second issue is both clinical and ethical: Are
there situations when it is permissible to perform
dentistry that is not “ideal?”
Lastly, when patients present in our practices, our first obligation is to perform a complete
EDITOR
Kevin J. Hanley, D.D.S.
MANAGING EDITOR
Mary Grates Stoll
ADVERTISING MANAGER
Jeanne Deguire
ART DIRECTORS
Kathryn Sikule/Ed Stevens
NYSDA OFFICERS
Joel M. Friedman, D.D.S., President
John J. Liang, D.M.D., President Elect
David J. Miller, D.D.S., Vice President
Mark J. Weinberger, D.D.S., Treasurer
Robert M. Peskin, D.D.S., Speaker of the House
Mark J. Feldman, D.M.D., Executive Director
Steven Gounardes, D.D.S., ADA Trustee
PRINTER
Fort Orange Press, Albany
The NYSDA News (ISSN 1531-684X) is published quarterly, in
February, May, October and December, by the New York State Dental
Association, Suite 602, 20 Corporate Woods Boulevard, Albany, NY
12211-2370. Subscription rates are $5 per year to members of the New
York State Dental Association; $10 per year, or $2.50 per issue, for
nonmembers. Periodicals postage paid at Albany, NY. Send address
changes to NYSDA News, Suite 602, 20 Corporate Woods Boulevard,
Albany, NY 12211-2370.
Editorial and advertising offices are at
Suite 602, 20 Corporate Woods Boulevard, Albany, NY 12211-2370.
Telephone (518) 465-0044.
Fax (518) 465-3219.
E-mail [email protected].
Web site www.nysdental.org.
Providing Relief Around the World
Global Dental Relief is a nonprofit charity devoted to providing free dental care to children.
It’s possible that GDR volunteers benefit as much from their experience as do the children they treat.
L
ast October, five dentists, one hygienist and
nine non-dental volunteers traveled to Siem
Reap, Cambodia, embarking on an adventure to bring first-time dental care to children. The group, meeting at the arrival airport, joined a 15-day humanitarian trip with Global
Dental Relief. The trip included a seven-day dental clinic
and time to see the very special country of Cambodia.
Traveling to the guesthouse, volunteers caught their
first glimpse of a country lush with tropical vegetation,
children riding bikes to school, saffron-robed monks
and a road filled to bursting with cars, motorbikes, tuktuks (motorized rickshaws) and pedestrians. The country is still recovering from a tragic past, but is clearly
filled with hope and a vibrant, friendly people.
Cambodia is the newest location for Global Dental
Relief, a nonprofit charity dedicated to providing free dental
care to children. Care is provided by teams of oral healthcare
providers and other volunteers, who deliver treatment in
dental clinics serving schools, orphanages and remote village
locations. Since 2001, GDR volunteers have brought care to
85,000 children in six countries: Nepal, India, Vietnam,
Guatemala, Kenya and, most recently, Cambodia.
The Cambodia team included two dentists from
Canada and dentists from South Carolina, New York
State, Connecticut, along with a hygienist from
California. They were joined by two spouses and other
non-dental volunteers, including an attorney, hair salon
owner, two retired teachers, a small business owner, a
pre-dental student and a young man still in high school.
These special folks devoted their vacation time to
service work. A delightful group of diverse age and background, they came with a shared purpose. When they
reached the guesthouse that first day, everyone turned in
gratefully, knowing a demanding week of work lay ahead.
The Clinic
Maria Maranga shows off award presented to NYSDA for outstanding membership effort. She is joined by, from left, Jay Skolnick, Josh Poupore, Chris
Klimecko, Joseph Gambacorta, Mark Bauman.
NYSDA Receives
ADA Award
NYSDA was recognized for two accomplishments at the
ADA annual Membership Recruitment and Retention
Conference in April in Chicago. Most significantly, the State
Association received a Membership Outreach Award for
Most Improved Active Member Retention Rate for a dental
society with more than 7,500 members.
And a point of pride was noted in the fact that NYSDA
had the most representatives of any ADA district at the conference. The NYSDA delegation included the following members:
Maria Maranga, former chair, Council on Membership
and Communications, and Second District representative to the
ADA Council on Membership; Jay Skolnick, chair, Council on
Membership and Communications; Mark Bauman, immediate
past chair, ADA Council on Membership; Joseph Gambacorta,
vice chair, Council on Membership and Communications; Josh
Poupore, assistant executive director, membership and communications; Bernard Hackett, Second District Executive
Director; Chris Klimecko, Eighth District Executive Director;
Claudia Manon-Vazquez, Suffolk County Dental Society;
Virginia Mitchell, Suffolk County Dental Society.
The first clinic day, volunteers arrived at the Hun Sen
Rolous Primary School, a village school situated some
12 miles outside Siem Reap. The clinic is set up in two
large classrooms.
The school has 900 children, ranging in age from 6
to15 years, and serves as the hub for a cluster of remote
schools serving an additional 1,700 children.
As the van rounded the corner, volunteers got their first
view of excited children, each holding a dental chart. The
children had ridden their bikes to school, often with several
children to a bike. They are dressed in blue and white uniforms, ranging from new to ragged and partially complete.
The children come to the clinic class by class. Their
visit begins with toothbrush instruction and a new brush
for each child. Then they receive a dental exam and
needed restorations or extractions. They get a cleaning as
time permits; and everyone is given a fluoride treatment.
The children exit the clinic clutching the carefully selected cartoon sticker that is the reward at the end of a visit.
Most children require two or more visits to complete their dental care, and are called back to complete
this work in the course of the clinic. Most importantly,
GDR returns to each school every two years to give
children consistent, long-term care.
While hard to conceive, dental care is simply not
available for children in many parts of the world. For
these children, a life without dental care can lead to
chronic pain, infection, sleepless nights and poor nutri-
tion. GDR’s volunteers work hard to change this, giving
children a chance to live healthier, more productive lives.
On the first clinic day, the volunteers treated 108
children from the lower classes, classes 1 and 2. As it
became clear few children were brushing their teeth, the
toothbrush instruction was ramped up, and teachers
were encouraged to partake of the information as well.
During the course of the day, most children required
treatment, including lots of primary extractions and new
molar restorations. Volunteers were touched by the children’s
sweet demeanor and trust as they climbed onto dental chairs
for exams and received high-fives as they finish.
On the second day, volunteers treated children from the
higher classes, with most patients 13 years or older. What a
difference. The clinic became solemn as volunteers saw firsthand the devastating incidence of tooth decay. Occasionally,
a child came through with healthy teeth, but the majority
had major decay or abscess in most of their teeth.
Mid-way through the week, volunteers took a welldeserved break and headed to the World Heritage site of
Angkor Thom for a day of exploration and adventure.
They returned to their hotel in the late afternoon,
revived and ready for the second half of the clinic.
As the week progressed, the clinic team became a
cohesive unit. Non-dental volunteers mastered their
new duties as chairside assistants or managing sterilization and patient records. Dentists and hygienists adapted to the field equipment and devised new ways to
manage dental cases, sharing skills and knowledge.
Teachers learned the system and worked diligently to
bring back children needing further care. For everyone,
the days were intense, vibrant and unforgettable.
Over the six days, volunteers treated 646 children,
with 452 restorations, 309 extractions, 115 cleanings
and 505 fluoride treatments. The total value of care
provided was $166,540 American.
As the final clinic day drew to a close, volunteers
said their heartfelt goodbyes to patients, teachers and
GDR’s local partner, East Meets West. Early the next
morning, the group continued on a three-day excursion
to see Cambodia’s capital city of Phnom Penh, rest and
relax and then travel home.
As they left the school for the last time, many in the
group discussed their previous experiences on other
GDR trips and hatched plans to reunite somewhere
soon for another adventure.
Other Locations
GDR provides care in six countries. Within the
Cambodia team of volunteers, many were veterans of
one or more previous GDR trips. Two, T.J. Gabriels, an
attorney from Albany, and Cynthia Gomez, a periodontist in New York City, are veterans of seven trips each.
Dr. Gomez started with GDR in Nepal, returning
three times before branching out to other GDR locations. Nepal has a special appeal, because GDR has been
based in the same local school for 12 years, and each year
the top students are assigned to work chairside during the
clinic. These students work diligently to practice English,
hone instrument and suctioning skills, and serve as a
window for volunteers into a vastly different culture.
The Nepal clinic is held in Kathmandu, a fiveminute walk to the Boudhnath Stupa, a UNESCO
World Heritage Site. Volunteers stay in a local guesthouse surrounded by vibrant Buddhist monasteries and
2
NYSDA NEWS / MAY 2014
African inhabitants include the cheetah.
Kenyan youngsters eagerly await visit by GDR volunteers.
New Yorkers Cynthia Gomez and T.J. Gabriels in Cambodian clinic.
wake daily to the sounds of chanting and colorful
processions. After each clinic, volunteers have the
option of continuing their adventure with a five-day
trek along the famous Everest trail to the spectacular
Sherpa village of Kumjung, surrounded by majestic
views of Mt. Everest and Ama Dablam.
Cambodian team members David Oberhand and
his wife, Sandy, from Stamford, CT, traveled previously
to join GDR in India. Volunteers meet for the first time
in Delhi, spending two days in the city
recovering from travels and exploring.
After two days, they journey to their
destination of Leh, Ladakh, located high on
the Tibetan Plateau and encircled by towering Himalayan peaks, 25,000 feet above.
The clinic takes place in the local Lion’s
Club building, with care provided to a blend
of Buddhist, Muslim and Hindu schoolchildren. The children are often brought in from
remote village areas of even higher elevations. Evenings and days off volunteers are
free to wander local village streets, and visit
age-old Buddhist monasteries, perched on
the highest hilltops.
A trip highlight for everyone occurs
when local children enthusiastically call
out “Jullay,” the local greeting, and
point to their teeth indicating they
know you from a visit to the clinic.
Karen Furlong, a member of the
Cambodia team from Halifax, Nova
Scotia, previously traveled with GDR to
Kenya, joining one of the 2013 inaugural trips to this country. In Kenya, volunteers work in a fully equipped, modern, eight-chair dental clinic, situated in
the hills of Karen outside of Nairobi.
The group lives and works in the gracious compound of the Kikuyu Hospital.
The patients are a major highlight in
Kenya, as the children speak fluent English.
This means they are eager to discuss the
clinic proceedings, make elaborate jokes and
discuss wide ranging topics with volunteers.
The days pass quickly in their company.
At the end of the Kenya clinic, volunteers experience a second highlight as they
head to Masai Mara Game Reserve for a
spectacular four days of rest and safari.
As the Cambodian group relives past
adventures, they look forward as well.
Several volunteers agree to meet this year in
Guatemala. They will assemble in the
atmospheric city of Antigua for a day of rest
and shopping before traveling to Panajachel.
In this bustling hub, perched next to Lake
Atitlan, the group will work for six days
bringing care to largely indigenous populations of the Mayan Highlands.
Guatemala is the shortest and nearest GDR location for travelers from the
U.S. and Canada. Lasting 10 days, volunteers can complete the trip with only a
week away from home. The misty volcanic landscape, colorful local dress and
big-eyed children make for a memorable experience.
Each GDR trip is a unique opportunity to provide
a critical service to others. As our Cambodia trip came
to a close, the group reflected on the immediacy of time
immersed in a world far from home. As Michael Pasoff,
D.D.S., said, “This involvement within another culture
is unmatched. As so many of my fellow volunteers
appreciate, this a wonderful way to spend one’s time. As
my thoughts turn homeward, life feels enriched with
new perspective and rich, enduring memories.”
To join a Global Dental Relief trip, visit www.
globaldentalrelief.org for 2014-2015 trip schedules
and itineraries. You may also call (303) 858-8857, or
email volunteer@globaldentalrelief. Join a dental
team and give the gift of health to a child. z
3
NYSDA NEWS / MAY 2014
This article was submitted by Laurie Mathews, founder and codirector of Global Dental Relief.
1st Quarter 2014 New Members
DIST
NAME
CITY
DENTAL SCHOOL
DIST
NAME
CITY
DENTAL SCHOOL
NYC
Anya Brodsky New York
New York Univ College of Dentistry
YR GRAD
2012
9th
Paul Cantelmi Middletown
Columbia Univ College of Dental Med
2010
NYC
Jennifer Castro New York
Columbia Univ College of Dental Med
2009
9th
Tina Cho Suffern
New York Univ College of Dentistry
2008
NYC
Amanda Colebeck Buffalo
Univ at Buffalo-State Univ of NY
2010
9th
Scott Fischer New City
Univ of Southern Calif School of Den
2009
NYC
Beatrice Deca New York
Boston University Sch of Grad Dent
2009
9th
Kastriot Kaci Yonkers
Univ of Tirana Albania
1996
NYC
Frank Dicicco New York
Temple Univ School of Dentistry
1996
9th
Rossarin Mitsumoto Tarrytown
Thailand-Mahidol Univ
2011
NYC
Bassel Haddad New York
Univ of Iowa College of Dentistry
2011
9th
Hai Nguyen New City
New York Univ College of Dentistry
2011
NYC
Marjan Kermanshah New York
New York Univ College of Dentistry
2004
9th
Mara Rosenberg White Plains
New York Univ College of Dentistry
2006
NYC
Michele Landolt New York
Switzerland-Der Univ Zurich
2011
9th
Callie Solomon Bronxville
New Jersey Univ of Med & Dentistry
2006
NYC
Valentina Lyssova New York
New York Univ College of Dentistry
2005
9th
Zachary Weber Mt Kisco
Tufts Univ School of Dental Medicine
2006
NYC
Natalya Modlin New York
New York Univ College of Dentistry
2002
NAS
Jay Khorsandi Rockville Centre
Northwestern Univ Dental School
2001
NYC
Melinda Quintin New York
New York Univ College of Dentistry
1999
NAS
Jacque Kohanzadeh Great Neck
Tufts Univ School of Dental Medicine
1976
NYC
Emi Shimizu New York
New York Univ College of Dentistry
2012
NAS
Dawn Weldon Garden City
New York Univ College of Dentistry
2010
2nd
Iryna Branets Brooklyn
New York Univ College of Dentistry
2005
NAS
Natsuyo Yamamoto-Trinh W Hempstead
Univ of California Sch of Dentistry
2009
2nd
Marisela Garau-Gonzalez Brooklyn
Univ of Puerto Rico Sch of Dentistry
2006
QUE
Chau Chan Flushing
Univ of Connecticut Sch of Dent Med
2008
2nd
Illya Tarasenko Brooklyn
Temple Univ School of Dentistry
2007
QUE
Keven Jackson Queens
Howard Univ College of Dentistry
1986
3rd
Narmin Girgis Albany
New York Univ College of Dentistry
2006
QUE
Hyeong Kim Rego Park
Columbia Univ College of Dental Med
2010
3rd
Carolyn Morgan W. Coxsackie
New York Univ College of Dentistry
2011
QUE
Katherine Kim Long Is City
Stony Brook Univ-State Univ of NY
2005
4th
Claire Kiehl Queensbury
Stony Brook Univ-State Univ of NY
2012
QUE
Won Sang Lee Astoria
Columbia Univ College of Dental Med
2005
4th
John O’Donnell Jr Cobleskill
Univ of Connecticut Sch of Dent Med
2010
QUE
Kacey-Ann Thompson Floral Park
Marquette Univ School of Dentistry
2010
4th
Sarupinder Singh Schnectady
Univ at Buffalo-State Univ of NY
1987
SUF
Maria Diaz Zayas Coram
Univ of Puerto Rico Sch of Dentistry
2012
5th
Reed Attisha Watertown
Univ of Louisville School of Dent
2007
SUF
Jared Funt Setauket
Stony Brook Univ-State Univ of NY
2009
5th
Gilda Jusino Liverpool
Univ of Pittsburgh Sch of Dental Med
1993
SUF
Christopher Joubert Stony Brook
Stony Brook Univ-State Univ of NY
2009
5th
Florica Miller Watertown
New York Univ College of Dentistry
1991
SUF
Krupali Thacker Selden
Univ of Illinois College of Dent
2008
5th
Honey Ojha New Hartford
New York Univ College of Dentistry
2007
BRX
Jonathan Bindiger Cedarhurst
Stony Brook Univ-State Univ of NY
2012
7th
Mohammed Baig Rochester
Israel-Hebrew Univ Hadassah
1998
BRX
Judy Chang Bronx
New York Univ College of Dentistry
1992
7th
Alessandro Geminiani Rochester
Italy-Univ Di Siena
2004
BRX
Alice Lee Bronx
New York Univ College of Dentistry
1998
7th
Ritu Shah Rochester
Univ of Pennsylvania Sch of Dent Med
2010
BRX
Robert Massimi Bronx
Stony Brook Univ-State Univ of NY
2001
8th
Ryan Sullivan Hamburg
Univ of Pittsburgh Sch of Dental Med
2012
YR GRAD
NYSDA Successful Early in Legislative Session
NYSDA scored significant early victories in the newly
enacted State Budget for 2014-2015. One critical victory was maintenance of adult dental Medicaid coverage, with no reductions in reimbursements for dental
services. That is a constant battle every budget cycle
now due to relentless pressure from local government
lobbyists to cut the costs of this program. But the governor and the Legislature have demonstrated their support
for dentistry by maintaining the best adult dental
Medicaid program in the country for New Yorkers.
Smoking Cessation
Equally important was the New York State Department
of Health announcement on March 26 that dentists
would be reimbursed under Medicaid for smoking cessation services effective April 1. After two years of NYSDA
pressing for this, the Department of Health was finally
able to come up with the total $3 million to fund this
important service for patients. While the coding and
technical reimbursement mechanisms are still being
developed, the commitment to fund smoking cessation
services by dentists has finally come to fruition.
Importantly, NYSDA has been asked to help develop
the guidelines for providing this service
Not only was this the result of continual hard work
by NYSDA, it also shows that the governor and
Department of Health honor their commitments to the
profession of dentistry and to the patients and public
that dentists serve every day. Members should stay
tuned for further details on this from the NYSDA Health
Affairs Department.
Mobile Dentistry
Another item of critical importance in the State Budget
was creation of a new mobile dental pilot program in
three counties in Western New York (Allegany,
Cattaraugus, and Chautauqua) in conjunction with the
University at Buffalo School of Dentistry. NYSDA lobbied for this program and insisted it take into account
the following concerns of dentists practicing in Western
New York: 1. minimizing any adverse effect on existing
dental practices or practices wishing to enter these
areas; 2. involving existing dental
practices in these areas with any
mobile dental program; and 3. establishing referral systems and networks
with existing dental practices in these
areas for ongoing patient care.
The program will be studied by the
UB School of Dentistry to measure its
usefulness in providing dental care to
underserved areas. It represents another in a series of NYSDA public health
efforts to combat the problem of lack of
access to dental care in rural and
underserved communities in New York
State. Solutions such as these that bring
care by dentists directly to underserved
communities make much more sense
than mid-level provider models, which
have not shown any real effectiveness
in reaching underserved areas.
NYSDA and its government affairs
team are always working on behalf of
members. These victories early in the
current legislative session demonstrate
that the State Association constantly
presses to uphold and benefit the profession wherever possible. We are looking
forward to more victories ahead. z
4
NYSDA NEWS / MAY 2014
New York Donated Dental Services Releases Annual Report
Snapshot of Statistics for First Nine Months of this Fiscal Year Compared to Previous Year and Last Fiscal Year’s Final Statistics
IN 2007, the New York State Dental Association partnered
7/1/13-3/31/14
7/1/12-3/31/13
7/1/12-6/30/13
with Dental Lifeline Network – New York in developing a
Donated Dental Services (DDS) program to help citizens
Donated Treatment Value
$657,728
$846,936
$1,223,307
with disabilities or who are elderly or medically fragile and
Donated Lab Value
$37,948
$59,195
$94,215
have no other access to dental care. New York DDS is
Patients Treated
135
191
278
similar to 40 other programs developed by Dental Lifeline
Average Value of Treatment
$4,872
$4,434
$4,400
Network that this fiscal year will collectively generate
# of Participating Dentists
633
630
632
$24.7 million in donated services through June 2014.
*# of Volunteer Labs in New York
142
206
168
Since inception, New York dentists and labs have donated
#
of
Contributing
Labs
outside
of
NY
10
6
8
over $6.5 million worth of comprehensive treatment for
Current Number of Active Patients
210
224
195
1,216 people.
The DDS program restores the oral health and often
Current # of Pending Applications
437
312
351
transforms the lives of people who would not otherwise
* Number of labs is lower in second half of 2013 due to duplicate counting in first half. We recently transitioned to new database
receive care, like 40 year-old Mr. P., who lives with his wife
that enables us to count labs more accurately.
in Brooklyn. He suffers from debilitating multiple sclerosis, which forced
him to stop working a few years ago.
And, because of several medical conditions he has taken drugs that have
contributed to the deterioration of his
oral health. He now has severe dental
problems that significantly impact his
daily life. He has problems speaking
For over 25 years, CareCredit has helped millions of
and chewing, and he was so embarpatients receive needed and desired care. CareCredit is
rassed that he had not smiled in 10
a healthcare credit card that can be used as a payment
years. Mr. P. and his wife, who also is
option for elective health expenses not covered by
disabled, rely on food stamps and
insurance or to bridge payment when desired care exceeds coverage. It is accepted at 100,000
Social Security Disability benefits and
enrolled dental practices.
odd jobs to make ends meet. They
could not afford the extensive dental
If you already accept CareCredit, contact your Practice Development Team by calling 800-859-9975, option 1, then 6.
care that he needed. Fortunately, a
team of DDS volunteers came to Mr.
If you’re ready to add CareCredit and help more patients access needed care, call 866-221-8761 to get started.
P.’s aid. Thanks to this incredibly generous team, Mr. P. received $16,312
For more information about this and other Endorsed Programs call: 800-255-2100
in free care that restored his oral
When people need treatment now,
they also need options now.
health and his smile. He shared his
appreciation for this amazing gift:
“I no longer feel like I have to hide
from people for fear they will reject my
ugly looking mouth. I had forgotten
how to smile, and had built a lifestyle
around hiding. I have remembered
something wonderful I had forgotten:
the best thing about smiling at someone
is they smile back at you. And for a
moment, you both just feel good. That’s
a joy that I had lost, and a joy you all
had given me back. Thank you all so
much.”
The New York DDS program is
truly thankful to the 633 dentists who
participate in the DDS program. Today,
437 patients are waiting for treatment.
Additional patients could be cared for,
but we are constrained by lack of funding for this important program. z
5
NYSDA NEWS / MAY 2014
Dental Establishments in New York State
Metropolitan & Micropolitan Statistical Areas
There are 213 dental care health professional shortage areas in urban and rural sections of New York State. Nevertheless, between 2007 and 2011,
except for the metropolitan area around New York City, there were limited changes in the number of dental establishments in most metropolitan and micropolitan statistical areas.
H. Barry Waldman, D.D.S., M.P.H., Ph.D.; Peter Balacky, B.S.
A SERIES OF ARTICLES in The NYSDJ reviewed developments in economics and demographics and their effects
on dental establishments in New York State.1-5 The latest
report (for 2011) on conditions before and after the last
recession at the county level indicated that “…while there
have been many changes at the county level, there does
not seem to have been dramatic changes in the overall
state numbers of dental practitioners and establishments
through the early years of the current decade.”6 (1)
But these developments are not uniform throughout
the state. A previous review in the NYSDA News
emphasized that prior to the last recession, “Upstate
(NY) areas experienced shortfalls in dental professionals.”8 A report from the Institute of Medicine
emphasized that “A severe shortage of dentists, especially those serving rural and minority groups, is
contributing to the ‘persistent and systemic’ barriers
to oral health care.”9
Health professional shortage area (HPSA) designations
are used to identify areas and population groups within
the United States that are experiencing a shortage of
health professionals. There are three categories of HPSA
designation, based on the health discipline that is experiencing a shortage. They are: 1. Primary medical; 2.
Dental; and 3. Mental health. There are 213 dental care
HPSAs in New York State, leading to a need for 217
additional dentists to achieve a population-to-dentist ratio
of 5,000 to 1 (4,000 to 1 where high
needs are indicated) in designated dental HPSAs in the state.10
Information is now available from
the Census Bureau that permits a
review of developments in dental
establishments before and after the
last recession for specific areas of
population concentration---the metropolitan and micropolitan statistical
areas of the state.
Metropolitan statistical areas contain at least one urbanized area of
50,000 or more population. Micropolitan statistical areas contain at least
one urban cluster of at least 10,000
(but less than 50,000) population.
Both metro and micro areas consist of
one or more whole counties or county
equivalents. (Note: Although information is available regarding the number
of individual dentists at the state and
county levels, similar data are not
available for the metro and micro statistical areas.)
Before and After the
Last Recession
The Business Cycle Dating Committee
of the National Bureau of Economic
Research determined that the recession
that began in December 2007 had
ended in June 2009.13 Between 2007
and 2011, there were limited changes
in the number of dental establishments
in metro and micro statistical areas
(SA) with 100 or fewer dental establishments. The major change occurred
in the New York-Northern New JerseyLong Island-NY-NJ-PA Metropolitan SA
(an increase of 290 dental establishments), representing much of the statewide increase of 162 establishments
during this period (Table 1).
The combination of changes in
the population and the number of
dental establishments produced an
increase in the population per dental
establishment in 14 of the 20 SAs for
which data are available. The largest
increase was in the Albany-TroySchenectady SA (+952 residents),
followed by the Batavia SA (+873
residents) and the Utica SA (+700
(1) An establishment is a single physical location where services are performed. It is not
necessarily identical to a company or enterprise, which may consist of one or more
establishments. In addition, one or more
practitioners may be present in an establishment. Throughout this presentation, the term
“dental establishment” refers to facilities
with employees that are subject to federal
income tax. Government agency programs
(hospitals and health department clinics) are
not included.7
6
NYSDA NEWS / MAY 2014
residents). The decreases were more modest; the largest was in the Gloversville SA (-239 residents) and the
Plattsburgh SA (-196 residents). Statewide there was
virtually no change in the number of residents per
“average” dental establishment (from 2,126 to 2,111
residents) (Table 1).
While there is no such thing as an “average” dental establishment, comparisons between averages (over
time and between locales) do provide a picture of the
evolving practice of dentistry. For example, the “average” number of employees in New York State was
determined by dividing the total number of dental
employees (51,908) by the number of dental establishments (9,237). The “average” salary was determined
by dividing the total annual state payroll figure for
dental establishment employees ($2,187,415,000) by
the total number of employees (51,908 individuals).14
Dental Establishments in 2011
There were 5.6 employees in the average dental establishment in New York State. The number of employees
in a metro and micro SA ranged from 3.8 employees in
the Malone SA, to 8.1 and 8.2 employees, respectively,
in the Corning and Elmira SAs.
The average annual salary for an employee
(including employed dentists) in dental establishments in
New York State was $42,100. The average annual salary for an employee in a metro and micro SA ranged
from $29,600 in the Olean SA to $52,900 in the
Syracuse SA.
In the past, smaller dental establishments (that is,
those with fewer than five employees) represented the
predominant arrangement for dental establishments—
for example, 62.9% in 1986. By 2011, slightly more
than half (52.2%) of New York State establishments had
fewer than five employees. In 17 of the 21 metro and
micro SAs, the proportion of the average dental establishment with fewer than five employees ranged
from18% in the Elmira SA to 45.4% in the Olean SA.
The average for the predominant New York-Northern
New Jersey-Long Island-NY-NJ-PA SA for fewer than five
employees was 54.8%.
Discussion
A review of dental establishments in New York State
metropolitan areas provides additional information
regarding the pattern for the delivery of services at a
more local level for these populated districts. Overall,
available data indicate:
l A general decrease in the availability of dental
professionals in upstate New York.
l The designation of numbers of dental care health
professional shortage areas in the state.
l Limited changes in the number of dental establishments in most metro and micro statistical areas.
l Continuing national reports of a persistent shortage
of dentists in rural area.
However, there is no specific locale information
regarding individual dentists or dental establishments in
small population or rural areas of the state. This information is necessary if the profession is to respond to the “…
severe shortage of dentists, especially those serving rural
and minority groups, (which) is contributing to the ‘persistent and systemic’ barriers to oral health care.”9 z
Dr. Waldman is distinguished
teaching professor in the
Department of General Dentistry,
Stony Brook University. Mr.
Balacky is a third-year student in
the School of Dental Medicine,
Dr. Waldman
Mr. Balacky
Stony Brook University. Queries
about this article can be sent to Dr. Waldman at [email protected].
7
NYSDA NEWS / MAY 2014
REFERENCES
1. Waldman HB. Dental establishment business activity in
New York State Counties. NYSDJ 2000;66:26-29.
2. Waldman HB. New York State dental establishments keep
getting larger. NYSDJ 2001;67:16-18.
3. Waldman HB. Stabilizing the number of NY State dental
establishments. NYSDJ 2004;70:34-36.
4. Waldman HB. Dental establishment business activity in
New York State counties at the start of millennium. NYSDJ
2006;72:42-45.
5. Waldman HB, Cannella D. Mapping dental establishments in New York State just before the recession. NYSDJ
2010;76(6):22-25.
6. Waldman HB, Segal AG. New York State after last recession: dentists and dental establishment. NYSDJ
2013;79(6):47-51.
7. Census Bureau. 2007; 2011 Metropolitan Statistical
Area Business Patterns. Web site: http:censtats.census.
gov/ Accessed Nov. 25, 2013.
8. Waldman HB. Upstate areas experience shortfall in dental
professionals. NYSDA News, 2006; 19(October): 1,2.
9. Boyles S. Millions in U.S. lack access to dentists: Study
shows geography, economics, and shortage of dentists
limit dental care Web site: http://www.webmd.com/
oral-health/news/20110713/millions-in-us-lack-accessto-dentists. Accessed Nov. 27, 2013.
10. Kaiser Family Foundation. Dental Care Health Professional
Shortage Areas (HPSAs) Web site: http://kff.org/other/
state-indicator/dental-care-health-professional-shortageareas-hpsas/#table. Accessed Nov. 27, 2013.
11. Census Bureau. Annual Estimates of the Population of
Metropolitan and Micropolitan Statistical Areas: April 1,
2000 to July 1, 2007 Web site: http://www.census.gov/
popest/data/metro/totals/2007/tables/CBSAEST2007-01.xls/ Accessed Nov. 26, 2013.
12. Census Bureau. Annual Estimates of the Population of
Metropolitan and Micropolitan Statistical Areas: April 1,
2010 to July 1, 2012 Web site: http://census.gov/
popest/data/metro/totals/2012/index.html/ Accessed
Nov. 26, 2013.
13. The Business Cycle Dating Committee of the National
Bureau of Economic Research. The recent recession. Web
site:
http://www.nber.org/cycles/sept2010.html/
Accessed April 22, 2013.
14. Census Bureau. County Business Patterns 2011. Web
site: http://censtats.censu.gov/egi-bin/cbpnaic/cbpdetl.
pl/ Accessed November 23, 2013.
TABLE 1.
Number of Dental Establishments and Population per Establishment in New York State Metropolitan and
Micropolitan Statistical Areas: 2007, 2011 7,11,12
Metropolitan & Micropolitan
Number of Dental
Population per
Statistical Area
Establishments
Dental Establishment
20072011
2007 2011
Albany, Troy, Schenectady
359
364
1,446
Amsterdam
17
17
2,8642,940
Auburn
25
24
3,2023,326
Batavia
17
14
3,4184,291
Buffalo, Cheektowaga, Niagara Falls
515
495
2,190
Corning
2124
* *
Cortland
14
14
3,5543,544
Elmira
32
33
2,7502,690
Glens Falls
47
50
2,742
Gloversville
16
15
3,4443,683
Hudson
16
15
3,8974,173
Ithaca
38
39
2,6322,604
Malone
10
10
5,0445,152
New York, Northern New Jersey,
Long Island, NY-NJ-PA**
10,171
10,461
1,849
Olean
25
22
3,2033,630
Plattsburgh
29
31
2,8352,639
Poughkeepsie, Newburg, Middletown 289
276
2,318
Rochester
441 429
2,3362,522
Seneca Falls
10
3,422
Syracuse
237 244
2,7222,714
Utica-Rome
100 98
2,3483,048
New York State
9,075
2,126
* Population catchment area changed during intervening period.
** Includes some dental establishments in New Jersey and Pennsylvania.
10
9,237
2,398
2,293
2,574
1,886
2,428
3,534
2,111
Dentists Asked to Join Effort To Resolve Provider Shortage Problem
continued from page 1
Site Requirements: The site must be located in a
part-time recipients. In total, full-time recipients can
health professional shortage area (HPSA) or be HPSAearn up to $150,000 in loan repayments and partcertified. It cannot be a for-profit, private practice. It is
time recipients can receive up to $75,000. Awards can
required to offer outpatient treatment, available to all
be received as follows:
residents in the HPSA regardless of
ability to pay. Only one recipient will
Year 1
Year 2
Year 3
Year 4
Year 5
Total
be named per site.
Full-time
$30,000 $30,000 $32,500 $32,500 $25,000 $150,000
Participant Requirements: Award Award
recipients must be U.S. citizens or Part-time
$15,000 $15,000 $16,250 $16,250 $12,500
$75,000
nationals. They must be eligible to Award
participate as a provider in Medicare,
Medicaid and Children’s Health Insurance
Programs and licensed to practice in New York State.
For more information, visit: http://www.health.
The award is only available for pediatric and general
ny.gov/funding/rfa/inactive/1205031010/
dentists.
Award Information: All awards are exempt from
National Health Service Corps
federal, state and local taxes. Each year, 50% of the
During fiscal year 2013, 4,505 awards (2,106 new
remaining balance of loans is paid, up to $30,000 a
and 2,399 continuations) were made, totaling $167.7
year for full-time recipients and $15,000 a year for
million to healthcare providers in Tier 1 HPSA locations (those scoring 14 or above). Under the parameters of NHSC, participants are obligated to serve
either a two-year full-time commitment (40 hours per
week, 32 being spent providing direct patient care)
over the course of at least four days or a two-year parttime commitment (minimum of 20 hours per week,
16 spent providing direct patient care) over the course
of at least two days. Both full-time and part-time
participants are required to work at least 45 weeks a
year.
Site Requirements: The site must be in a designated HPSA or federally qualified health center.
Unlike the Primary Care Service Corps, the National
Health Service Corps allows for service providers
from private practices to apply for loan forgiveness.
Generally, an NHSC-approved site is an outpatient
facility.
Participant Requirements: Award recipients
must be U.S. citizens—either born in the U.S. or
naturalized—or a U.S. national. Unlike the
PCSC, the award recipient does not have to be
either a pediatric or general dentist. In order to
qualify for the National Health Service Corps,
participants must have unpaid, qualifying educational loans.
Award Information: All awards are exempt from
federal, state and local taxes. The loan repayments are
distributed as follows:
2 Years Full-time
2 Years Half-time
Site with HPSA
Score of 14+
Up to $50,000
Up to $25,000
Site with HPSA
Score of 0-13
Up to $30,000
Up to $15,000
The award should be treated as a contract. When
the contract is breached, there is retribution, including repayment of unworked months, additional fees,
and interest.
For more information, visit: http://nhsc.hrsa.
gov/loanrepayment/nhscloanrepayment/index.html.
Federal Service
The military is an alternative option for loan
repayment. The Air Force, Army Dental Corps and
the Navy Dental Corps offer loan repayment, in
addition to signing bonuses, for individuals who
sign up to serve.
Air Force: The Air Force has positions for comprehensive general dentists, endodontics, general
dentists, oral and maxillofacial pathologists, oral and
maxillofacial surgeons, orthodontists, pediatric dentists, periodontists and prosthodontists.
For more information, visit: https://www.airforce.com/healthcare/dentist.
Army Dental Corps: Students in their final year of
school may apply for the Dental Office Accession
Bonus, which is a sign-on bonus paid in a lump sum at
your first duty station. As a general dentist, comprehensive dentist, prosthodontist, or oral surgeon, you can also
receive up to $50,000 to repay dental school loans as
part of the Healthcare Professional Loan Repayment
Program. Applicants must have a current, unrestricted
state dental license. Applicants may be eligible to participate in other incentive programs as well.
Is the Bull Market Over?
If so, where should you put your money? Are bonds going
to lose money? How safe are “alternative investments”?
If these questions are on your mind, you should call Altfest
Personal Wealth Management. Altfest is endorsed by NYSDA to help members get
professional investment management for their retirement funds and other savings.
Assets remain in your name in separately held trustee accounts.
Call Altfest at 888-525-8337 to get started.
For more information about this and other Endorsed Programs call: 800-255-2100
Year 1
$20,000
Year 2
$20,000
Year 3
$10,000
For more information, visit:
http://www.goarmy.com/amedd/
dentist/benefits.html.
Navy Dental Corps: The
Navy Dental Corps has open positions for graduates entering their
dental residencies, as well as practicing professionals. As a practicing professional, you can receive a
sign-on bonus of from $75,000 to
$300,000, depending upon specialty and service requirement.
Individuals must be a U.S. citizen
currently practicing in the U.S., a
graduate of an ADA-approved
dental school, between the ages of
21 and 41, and in good physical
condition with the ability to pass a
full medical examination.
For more information, visit:
http://www.navy.com/careers/
healthcare/dentist. z
10
NYSDA NEWS / MAY 2014
When the Dentist and Patient Disagree
continued from page 1
examination and inform them about our findings. But,
treating dentist’s records and the patient’s own testi-
two-unit cantilever fixed bridge with #7 as an abut-
are some dentists too aggressive in criticizing the dental
mony corroborated the fact that the patient declined
ment and #8 as a pontic, we are not permitted to do
treatment of their colleagues?
the surgical option and that the patient’s low lip line
so, even if the patient signs a multitude of forms
did, indeed, completely mask the gingival margins.
accepting full responsibility and absolving the dentist
They concluded that the patient’s complaint was
of any responsibility.
C ase #1
A general dentist practicing in upstate New York placed
unfounded, as the treatment was appropriate and
three posterior resin fillings for a 47-year-old female
performed within the standard of care. Accordingly,
placing posterior resins. As long as the patient under-
teacher who was a heavy tea drinker and bruxer. One
the patient did not receive a refund of the fees he paid
stood, in light of her bruxing and tea drinking, that the
year later, the patient relocated to a neighboring town and
to the prosthodontist for the laminates.
restorations might need replacement more often than
switched to a dentist practicing in her new community.
Her new dentist claimed that the three fillings
L essons L earned
placed by the previous dentist were unsatisfactory and
These cases illustrate important principles.
were in need of immediate replacement. The patient,
1. Inform before you perform.
consequently, filed a peer review complaint against her
It is always advisable to spend time with patients dis-
previous dentist.
cussing pros and cons,
At the peer review hearing, the original treating
advantages and disadvan-
dentist reported she had given the patient the option of
tages, benefits and detri-
utilizing different types of filling materials and had dis-
ments and associated costs
cussed the advantages and disadvantages of each. The
of appropriate treatment
patient’s chart contained brief documentation of this
alternatives.
discussion.
These informative dis-
The peer review panel of three general dentists
cussions help prevent misun-
evaluated the appropriateness of treatment and quality
derstandings. And docu-
of care rendered and determined that the fillings, while
menting the discussions in
now slightly stained and worn, were of excellent quali-
the patient’s chart helps pro-
ty. Accordingly, they found that the patient’s complaint
tect a dentist. Remember,
was unsupported by the evidence and that the treatment
informing a patient before
performed was appropriate and within the standard of
treatment is an explanation;
care. Therefore, the patient did not receive a refund of
after treatment, it sounds
the fees she paid for the treatment reviewed.
like an excuse.
C ase #2
2. Do no harm.
A prosthodontist practicing in a suburb of New York
We dentists are not permit-
City placed eight upper anterior porcelain laminates on
ted to perform treatment
his patient, a 30-year-old real estate agent. Twenty
that is clearly “wrong” even
months later, the patient presented for a routine exami-
if our patients “agree” to it.
nation and prophylaxis at a different dental office.
For example, if a patient
When this subsequent treating dentist informed the
patient that all of the laminates needed to be replaced, the patient filed a
peer review complaint against the
prosthodontist who had placed them.
According to the new dentist’s
records, the laminates were done
well and looked fine, but the gingival
heights were uneven, and the “patient
should have had periodontal surgery
to even the gum lines prior to fabrication of the porcelain laminates.”
At the peer review hearing, the
patient complained that the prosthodontist he saw originally should not
have placed the laminates without
first performing crown-lengthening
surgery to correct the gingival discrepancies. The prosthodontist reported he
had offered the patient the option of
periodontal surgery, but the patient
declined because he had a very low
lip line and the gingival margins
were not at all visible.
The peer review panel of three
prosthodontists determined that the
11
NYSDA NEWS / MAY 2014
demands that we place a
In Case #1, the dentist did not harm the patient in
other types of restorations, the patient certainly had the
right to follow the dentist’s recommendation to utilize
resin for the restorations.
continued on page 16
CLASSIFIEDS
FOR SALE
OUTSIDE ALBANY: Walk into success with this 36+ years established dental practice located just outside Albany. Approximately
2,400 square feet. 5 ops, doctor’s private office and staff lounge.
1,500 active patients waiting. Practice grosses over $450K on just
3 days/week. Real estate also available. Dentist wishes to retire.
Contact: (518) 371-0058; or email: [email protected].
YONKERS: General dental FFS practice for sale. Dental co-op on
Bronx River Road with 2 fully equipped operatories. $70K gross
on 1 day/week. Good starter practice. Email inquiries to: [email protected].
JACKSON HEIGHTS: Spacious co-op dental office and practice
for sale directly by owner. 4 fully equipped treatment rooms; fully
computerized and equipped with digital dental X-ray system.
Vibrant multicultural, multilingual neighborhood with several
schools, great shopping and close to public transportation. Renting
is also available. Contact: (800) 634-1945.
KINGSTON: General practice for sale. Retiring after 30 years.
Private; FFS; no insurance. High-quality; low volume. Emphasis
C&B, reconstruction, implant, cosmetic. 3 chairs with room for
expansion. Gross: $250K on 2-3 days, 16 hours/week. No
hygienist. Lease; beautiful space. Staff will stay on. Inquiries to:
NYSDJ Box # MY-101.
MARYLAND—BALTMORE AREA: No buyer’s fee. 3-op modern
denture center with in-house lab. Shopping center location.
Grossing $700K. Also available: retiring dentist grossing $365K
part time. Also available: 6-op satellite office in growth area. Also
available: 4 ops, grossing $750K. Free-standing. (800) 5441297; or email: [email protected].
PARAGON Practice Opportunities
“We Put the SUCCESS in SUCCESSion”
Lower Westchester: $635K/year, 4 ops, 1,400 FFS patients.
Steuben County: $400K/year, 5 ops, fully computerized and
digital.
Middle Orange County: $425K/year, 4 ops, 750 FFS
patients.
Tompkins County: $875K/year, <50% overhead, 1,800 active
patients, FFS.
FEATURED CLEMENS GROUP LISTINGS
MANHATTAN: 34th Street and 5th Avenue. Grossing $1M. Mostly
PPOs. 5 chairs; prestige building. Reasonable lease across from
Empire State Building. Limited marketing and specialty referred out.
MANHATTAN: Midtown. Grossing $300K. 2 chairs; PPOs.
Madison Avenue.
MANHATTAN—EAST HARLEM: Grossing $250K. 3 chairs;
storefront; major growth area.
CENTRAL QUEENS: High-volume location. Grossing $1.5M.
Established 30+ years. Large 15-chair facility. High visibility storefront. Multi-specialty.
FLUSHING: Grossing $673K. Almost new. 5 chairs, fully
equipped in busy shopping ground-floor location. Practice revenue
increasing 25% per year with limited owner participation. New
owner should do 7 figures first year. Absolute winner.
FOREST HILLS: Grossing $411K. Queens Boulevard; ground floor.
FFS, great staff, long-term quality patients. Ideal for merger to this
office with purchase of real estate. Never have to move again.
RIDGEWOOD QUEENS: Grossing $900K. Large, modern facility; part-time owner. Asking $600K.
JACKSON HEIGHTS, QUEENS: Grossing $1M +. Storefront;
limited chairside. Large facility. Asking $650K.
Lower Dutchess: $335K/year, 5 ops, digital X-rays and Pan.
NORTH WESTCHESTER: Grossing $437K. 3 chairs; recently
upgraded with digital Pan. Mostly PPOs and private. No marketing. Specialty referred out. Underserved high-end area.
Suffolk (Endo): $640K/year, 50 NP per month, digital and
microscope.
COLUMBIA COUNTY: Grossing $2.5M. Long-established; partnership or outright sale. Very profitable. Hidden gem if you can produce.
Nassau (Perio): $350K/year. Sale Pending.
HAMPTONS: Grossing $400K. Long-established with 4 chairs.
Unique owner building in town of Southampton. FFS.
Port Chester: $300K, 2 days/week. Ideal merger. Sale
Pending.
Capital Region: $2M, 11 ops; real estate also available. SOLD.
Putnam: $450/year, 1,500 active patients. SOLD.
Northern Westchester: $575K/year, 4 ops, 1,500 active
patients. SOLD.
Capital Region: $1.8 million/years. 8 ops. SOLD.
Visit our website www.paragon.us.com to learn more about
all of our opportunities or contact us today!
Dr. Johnathan S. Carey (Upstate NY)
Dr. Berdj & Katherine Feredjian (Downstate NY)
Phone (866) 898-1867 • Email: [email protected].
WESTERN SUFFOLK: Gross $731,227/Net $250K. 4 chairs on
Main St. corner. PPOs and insurance. Long-established; limited
marketing. Specialty referred out.
EASTERN SUFFOLK: Grossing $890K. 4 chairs; high tech; CT
scan; Cerec. Working 140 days. Turn-key with transfer and real
estate on main street location. Emphasis on implants, full-mouth
rehab and cosmetics.
MORRIS COUNTY: Grossing $400K +. PPO and private. Longestablished; conservative; Hygienist. 60% Latino community. Easily
expandable.
Contact The Clemens Group for more information at (800)3002939; or www.theclemensgroup.com
MINEOLA: Dental practice for sale in modern, 2-story professional building with elevator. 1,500 square feet. 2,000 patients; 4
treatment rooms; lunch room and private office.
Walk to train, Winthrop Hospital, shopping
and restaurants. Onsite dedicated parking
spots. Excellent opportunity. Please call (516)
692-0175;or email: [email protected].
SARATOGA COUNTY: Exceptional dental practice located in upstate New York draws patients
from many nearby communities. Established over
18 years with solid, active patient base. Grosses
over $299K on just 1.5 days/week. 1,900 square
feet; 3 ops, private office and staff lounge are
some of the amenities this practice offers. New
owner can expand hours to 5-days/week. Dentist
wishes to retire. Contact: (518) 371-0058; or
email: [email protected].
WEST HARLEM: Amazing, 5-operatory, busy
dental office for sale. Completely digital; scan
X, Panorex, ceph and many other amenities.
Gross $1.26M with great potential. Owner
relocating. 1,400 square feet. Practice has
over 6,000 active patients. Seller will stay for
transition. Inquiries to: Marius_Cismas@yahoo.
com; or call (917) 714-2537.
MARYLAND, DC, VIRGINIA SALES: No
buyer’s fees. Southern Maryland – 3 ops grossing $575K part time. High net. Near Naval
base. Eastern Shore – Near the water. Modern,
3 ops, grossing over $600K. Mostly FFS.
Olney—4 ops; retiring. PT operative practice
12
NYSDA NEWS / MAY 2014
grossing over $300K. Call Polcari Associates for more information:
(800) 544-1297; or email: [email protected].
VALLEY STREAM: Nassau County home/office for sale. Retiring.
Will be available to aid in transition, as will staff. 3 operatories,
lab/sterilization room, waiting room. Ready to work. Spacious
home has 5 bedrooms, 4 bathrooms, living room with working
fireplace, dining room, eat-in kitchen. Easy parking. Practice routinely grossed over $800K. Contact: [email protected].
MANHATTAN: Upper West Side. 135 West 70th Street. $900K.
Pristine medical office. Large, value-priced space located in prime Upper
West Side, full-service condominium. 855 square feet. Property currently
configured with generously proportioned waiting area and large room in
rear that can easily be converted into three treatment rooms. Unit has
11- to 16-foot ceilings and separate street entrance steps away from
Broadway. New renovations include Stanley electric sliding entrance
doors, central air/heat, kitchenette, new hardwood floors and designer
lighting. Low common charges and taxes make this a value investment.
Call (212) 500-2127; or email: [email protected].
SUSSEX COUNTY, NJ: Well-established 2-op practice in center
of historic town. 700 square feet; leased space. Revenue $400K
on 30 hours. Contact Donna (800) 988-5674. Visit: www.snydergroup.net. #NJ2156
NORTHERN NY: Profitable FFS practice. Close to recreation.
Recent remodeling. Easy Dental, Dexis, Soft tissue laser. Low overhead. Ideal for satellite practice. Grossing $366K. Contact: Marty.
[email protected]; or (315) 263-1313. #NY117.
SYRACUSE UNIVERISTY: Practice for sale. 2,800 square feet.
Condo for sale also. 6 ops. Busy medical building with parking
attached. Owner will stay to work 2-3 days. Contact: Donna.
[email protected]; or (315) 430-0643. #NY132.
CENTRAL NY: 30 years at location. 2,400 square feet. 4 ops;
1,000 active patients. 22-32 hours/week work schedule. Owner
retiring. Office shows well. Records only acquisition possible.
Grossing $384K. Contact: [email protected]; or
(585) 370-5301. #NY118.
QUEENS: 2,000-square-foot street-level office. 4 ops; strong
patient base. Insurance-driven practice. Fully digital with Pan.
Doctor relocating to NC and prepared to close quickly. Contact:
[email protected]; or (718) 213-9386. #NY119.
ROCKLAND COUNTY: Small, friendly Endo practice with 2 ops
in well-established professional office building. Grossing $132K.
Doctor part time, ready to retire. Contact: [email protected]; or (718) 213-9386. #NY123
BALDWINSVILLE: Reduced to $300K. Income-earning building also
available in growing community west side of Syracuse. Digital, Eaglesoft,
paperless. Highly trained staff. Doctor retiring. 4 ops. Contact: Donna.
[email protected]; or (315) 430-0643. #NY101
OSWEGO COUNTY: Huge price reduction. Make an offer.
Great satellite office. Wonderful practice outside of Syracuse. 2
ops, devoted staff, in professional building. 1,100 square feet.
Grossing $338K. Contact: [email protected]; or
(315) 430-0643. #NY100.
OSWEGO COUNTY: Beautiful, 2,500-square-foot, productive,
single-doctor practice. Doctor retiring. 5 ops, digital, up-to-date
practice management system. 2,000 active patients; experienced
staff. Gross revenue $630K. Contact: [email protected]; or (585) 370-5301. #NY113
SYRACUSE: Excellent practice. Owner-operated since 1977.
Strong, active patient base. Gross $784K/adjusted net $282K on
3.5 days. Dedicated staff in professional building 5 minutes from
downtown. Contact: [email protected]; or (315)
430-0643. #NY112
BROOKLYN: PPO practice. 6 ops. Canarsie section. Bus stop
outside office. Free parking for patients. Additional plumbed space
available next door. Accepting new patients but ready to retire.
Grossing $339K. Contact: [email protected];
or (718) 213-9386. #NY110.
SYRACUSE, EAST SIDE: Patient magnet. Attractive, 3,300-squarefoot office in newer construction. 8 ops. Grossing $944,813. 1
practitioner; 4 days/week. Dentrix, digital, paperless. Contact:
[email protected]; or (315) 430-0643. #NY120
13
NYSDA NEWS / MAY 2014
ERIE COUNTY: New construction. 1,800 square feet; great visible location near major highways. 5 ops; newly equipped with
latest technology. Dedicated staff. Grossing $687,494. Doctor
looking to retire. Contact: [email protected]; or
(585) 370-5301. #NY133.
BREWSTER NY: Desirable area. PT general practice in great
location directly on main street. Includes 4 ops, private patient
parking. Practice and real estate available. Real estate includes
two-bedroom rental apartment above practice. Excellent staff willing to continue. PPO and FFS. Grossing $310K. Contact: Mike
Apalucci (718) 213-9386; or [email protected]
#NY135
FINGER LAKES REGION: Stand-alone general practice. 26
years at location. Grossing $963K. 1,700 active patients. 2,000
square feet; 6 ops; seasoned staff; retiring doctor. Real estate for
sale. Contact: [email protected]; or (585) 3705301. #NY121
WESTCHESTER COUNTY: Endodontic practice. Established 10
years at terrific location. 2 high-end digital operatories. Room for
expansion for 1 or 2 additional. Beautiful corner office with lightfilling windows, occupying 1,440
square feet. Equipped with latest
technology. Close to major highways; ample free parking. Gross
Revenue $313K. Very reliable staff
willing to continue. An immediate
opportunity also for start-up candidates. Contact: Mike Apalucci at
(718) 213-9386; or [email protected]. #NY124.
WESTCHESTER: FFS practice in
quaint town. Doctor retiring, works
PT. Street-front condo with free parking. Higher end procedures; endo,
ortho, surgeries referred out. 30
miles outside NYC. Contact:
michael.apalucci@henr yschein.
com; or (718) 213-9386. #NY122
SUFFOLK COUNTY: Magnificently
stylish 4-operatory periodontal
office (2 equipped) in medical complex. 1,200-square-foot impeccable
office in exclusive zip code.
Paperless office includes Dentrix
with Panorex 3D capable. FFS with
some PPO. Great for solo practitioner or multiple specialties. Call Mike
Apalucci at (718) 213-9386; or
michael.apalucci@henr yschein.
com. #NY134.
CENTRAL NEW YORK: Leatherstocking Region. FFS practice with
revenue of $500K+. Fully digital. 4
ops plus additional op ready for
expansion. Contact Marty at (315)
263-1313. #NY102.
BROOKLYN—CROWN HEIGHTS:
Fully equipped office for sale or lease.
Established 52 years. Priced for quick
sale at $45K. Three operatories; lab;
busy location near public transportation. Building purchase is optional.
100% financing available. Call David
Gordon at (917) 826-9732; or email:
[email protected].
FOR RENT
M I D T O W N M A N H AT TA N :
Beautiful, new, large-windowed dental
operatories for rent. Pelton Crane equipment, massage chairs, private office,
front desk space and staff available.
Doorman; warm environment. Best
location—46th Street and Madison
Avenue. Please call (212) 371-1999;
or email: [email protected].
I n d e x To A d v e r t i s e r s
Asher, Robert . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
Banc of America . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
Blaustein & Gillen . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
Clemens Consulting . . . . . . . . . . . . . . . . . . . . . . . . . . 11
Dental Dreams . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
Epstein Practice Brokers . . . . . . . . . . . . . . . . . . . . . . . . 15
E-Vac . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
Great Expressions . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
Jacobson Goldberg & Kulb . . . . . . . . . . . . . . . . . . . . . 14
MLMIC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
MobileTek Dental Labs . . . . . . . . . . . . . . . . . . . . . . . . 11
Monore Community College . . . . . . . . . . . . . . . . . . . . 13
NSS Endorsed Services . . . . . . . . . . . . . . . . . . . . . 5 & 10
Paragon . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
Ploumis, Eric . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
RMN Consultants . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
Simone Development . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Spadaro Law Firm . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
UB Continuing Education . . . . . . . . . . . . . . . . . . . . . . . 14
MANHATTAN: 1-3 large windowed operatories facing Madison
Avenue at 49th Street. Brand new construction; high end finishes
and equipment. High floor in doorman building. Oversized front
desk and staff areas. Plumbed for nitrous. Zeiss endo microscope
and Cone Beam 3D Pan available. Office offers impressive environment for patients, you and your staff. Contact: drokon@425madison.
com; or call (212) 380-1165.
Front desk space included with rental. Separate handicap accessible
patient and staff lavatories included. Congenial environment. Only
dental specialists need apply. Reasonable rent. Must see to appreciate. Contact: [email protected]; or call (212) 685-8200.
UPPER EAST SIDE: Three-chair dental office for rent part time in
co-op medical and dental building. Two full laboratories on premises. Please call (212) 421-8238.
MIDTOWN: Beautiful, brand new operatories. Perfect 1st floor location with large cathedral windows. 2 blocks from Grand Central.
Brand new A-Dec equipment with friendly atmosphere. Minimum 2
days/week. Weekends available. Contact Ken at (917) 566-6543.
WESTCHESTER: New, modern, Southern Westchester office willing
to sublet 1-3 days/week. Close to train and Hudson River. Please
email: [email protected]; or call (914) 923-6688.
MANHATTAN—WALL STREET: Rental on top floor. State-of-theart new dental office with 2 ops. Private practice. FFS. Specialist
welcome and/or general dentist with own patient base. Please call
Marilyn at (212) 344-9317; or email: [email protected]. Visit:
www.wallstdental.com.
NASSAU COUNTY: North Shore. Chairs available for rent. Rate
negotiable dependent upon needs of dentist. Newly renovated
office space; perfect for short-term, new growth practice or winding down existing practice. Great potential for dental specialist.
Email inquiries to: [email protected].
MANHATTAN: Brand new dental operatory available FT/PT in
upscale specialty office located 2 blocks from Grand Central
Station. New equipment; CBCT available; Internet access. Elegant
office; windowed operatory; 24/7 building with M-F concierge.
MIDTOWN EAST: Spacious, fully digital 1-2 operatories with or
without staff available for GP or specialist. Private elevator and
office. Panorex and lab on premises; full- or part-time arrangement
available. Please contact: [email protected].
WHITE PLAINS: Modern, state-of-the-art operatories available in
duplex office with reception. Available FT/PT. Turn-key. Rent includes:
digital radiology with Pan; equipment; Nitrous; all disposables. Start-up
or phase down. Need a satellite or more space? Upgrade and down
size. Please call (914) 290-6545; or email: [email protected].
MERRICK, NY: 1-3 dental operatories for rent FT/PT in prime location
just off corner of Merrick Road on Merrick Avenue. Accessible by LIRR
and bus. Share large waiting room, including television and coffee
room. Private office space available. Ideal for new dentist. Current
owner full-time professor at NYUCD. Inquiries to: [email protected].
NYC-TRIBECA: Modern dental office space for sublease. 1-4 dental
operatories available part time or full time. Prefer specialist, i.e., endo,
perio, ortho, but all arrangements considered. Referrals possible for
specialist. Close to most trains (A, C, E, 1-6, R, NJ Path). Brand new
office; modern décor; 4 operatories; street visibility in high-traffic area.
New A-Dec chairs; free Internet and other amenities. Staff may be
available upon request. Email: [email protected].
STATEN ISLAND: Professional office for rent near SI Zoo. Must see.
Great location; near schools and highway. Ample space; fully plumbed.
Newly renovated, beautiful office. Please call (718) 727-7733.
POST GRADUATE
EDUCATION
LUTHERAN MEDICAL CENTER: Dental
Residency Program. ADA-CODA accredited,
two-year, hospital-based training program
prepares dental residents in diagnosis and
treatment of temporomandibular (TMD) and
orofacial disorders. Inquiries directed to
Omar F. Suarez, DMD, Director, at (718)
630-8922; or email: [email protected].
EQUIPMENT FOR SALE
EQUIPMENT FOR SALE: Selling 4 A-Dec
rear units; 4 Dental EZ chairs; 4 Pelton Crane
lights; 3 X-ray machines; 4 Gendex intraoral
cameras; VacStar dental vacuum system;
Airstar compressor. Much more; all in excellent condition. Call (212) 953-1544.
OPPORTUNITIES
WANTED
SEEKING MIDTOWN PRACTICE: Dentist
seeking to buy well-established general, cosmetic or implant practice from GP or retiring
dentist. Preferred location Midtown or Upper
East Side. Please call (917) 704-3011.
OPPORTUNITIES
AVAILABLE
MANHATTAN: Orthodontist needed for growing, high-end practice in beautiful office. Need at
least 2 years experience and great communication skills. 2 ½ days; Tuesday through Thursday.
Send resume to: [email protected].
BROOKLYN: Oral surgeon position available. Must be Board Eligible; not general
practitioner. Part time. Steady, lucrative position. Well-trained staff. Newly constructed
office in downtown Brooklyn. Contact Richard
via email: [email protected].
MANHATTAN: Retiring or losing your lease?
Join us in our modern, high-quality, fee-for-service restorative practice. Ideal for dentists
seeking exit strategy. Our experienced staff
will help you seamlessly transfer and integrate
your patients into our well-managed office.
Financial arrangements will be tailored to suit
your individual needs. Please call (212) 6971122; or email: [email protected]. We’re
looking forward to hearing from you.
14
NYSDA NEWS / MAY 2014
PEDIATRIC DENTIST: Developing pediatric dentistry residency
program has openings for 2 half-time BC/BE pediatric dentists.
Brand new, 7-chair dental facility in Williamsburg at Woodhull
Medical Center dedicated to children only. Requires patient care
in OR and ambulatory care practice, as well as resident education.
Bilingual Spanish/English preferred. Salary; 403B pension, plus
full benefit package, including malpractice, medical and dental
insurance. Facility provides pediatric dental care 7 days/week.
Email one-page resume to: [email protected].
BAYSIDE, NY: Busy Queens practice looking for an Endodontist,
Periodontist and Oral Surgeon. Prefer 2-3 years experience.
Certificate of Residency a must. Examine, diagnose and provide
treatment counseling to patients in comprehensive manner; solicit
patient feedback to improve service; direct assistants and other
auxiliary staff. Please email resume to: [email protected];
or call Lee at (718) 352-5582.
CAPITAL DISTRICT AREA: Join First Advantage New York Dental
team. Looking for full-time Dentists to join Queensbury, Latham and
Rotterdam teams. 1st Advantage Dental – New York was founded in
1978 and affiliated with American Dental Partners in 2000. In our
multiple offices serving Capital District and White Plains we believe
each practice offers quality dental care within community. Specialty
dentistry includes general restorative, oral surgery,
preventative/periodontics and endodontics. We
have Common Treatment Philosophy. 1st
Advantage Dental New York is currently working
towards AAAHC accreditation. Offering competitive salary and excellent benefit package, including 401k, health insurance and professional work
environment. To learn more, please visit: www.
amdpi.com and www.1stadvantagedental.com.
Apply today. Email resume to: sbolduc@amdpi.
com; or call (781) 213-3318.
NASSAU UNIVERSITY MEDICAL CENTER:
Oral and Maxillofacial Surgery faculty position.
With strong commitment to raising bar for
healthcare in our community, we are Level I
Trauma Center and 530-bed teaching hospital
affiliated with North Shore/LIJ Health Care
System and Stony Brook University. NUMC
treats more than 80,000 emergency patients
annually. We seek full-time BC/BE OMFS faculty position at Associate Professor or Full
Professor level with opportunity for advancement. Responsibilities involve advanced training
in Oral and Maxillofacial Surgery, including:
•
clinical supervision
•
operating room oversight
•
didactic oversight
•
research capabilities
•
participation in committee functions
•
administrative activities.
Exceptional benefits, including medical, dental,
pension and more. Apply today for chance to
be part of exciting, fast-paced dynamic facility.
Current curriculum vitae with reference information to: [email protected]. An EOE m/f/d/v.
ASSOCIATESHIPS
AVAILABLE
BRONX: Associate wanted for busy, longestablished, quality general practice located in
good area. Great opportunity with future
potential. 4 days, including Saturday. Please
call (718) 829-4646; or email resume to: [email protected].
STATEN ISLAND: General dentist wanted 2-3
days/week for busy practice. May lead to
partnership. Must be Medicaid provider.
Please respond to: [email protected]; or
call (718) 727-2555.
ORANGE COUNTY: Seeking general dentist
associate for long-term position in growing
practice near beautiful Delaware River. Willing
to mentor young dentist in remodeled facility
with well-trained staff. Applicants must have
equally good clinical/verbal skills. Come join
our team! Fax CV to: (845) 856-3000; or
email: [email protected].
15
NYSDA NEWS / MAY 2014
SYRACUSE AREA: Seeking pediatric dentist for nationally recognized
pediatric/orthodontic office. High-quality, very productive practice in
Fayetteville. Excellent partnership opportunity. Interested candidates
please forward your CV to: [email protected].
become partner. Must be team player, self-starter. State-of-the-art
facility. Loyal team. Excellent six-figure income potential for experienced practitioner. Experience a plus. Once-in-a-lifetime opportunity. Email resume to: [email protected].
NASSAU COUNTY—ROCKVILLE CENTRE: Seeking associate
to join well-established and growing general dental office. Practice
is great place to work. In need of someone enthusiastic, skilled and
ready to grow as a clinician. Must be comfortable in all phases of
general dentistry. Please email: [email protected].
NEWBURGH: Busy private general practice seeking associate leading to
future partnership or ownership. Minimum 3 years experience in general
dentistry. Please send resume to: [email protected].
SYRACUSE: Experienced dentist wanted for long-term associateship
and eventually partnership. Very busy, long-established, two-doctor
practice with one partner retiring soon. Great staff. 9-chair practice
with 3 full-time hygienists. Excellent opportunity for hard-working
individual. Please send CV to: [email protected].
MANHATTAN: Great opportunity. Seeking PT/FT periodontal
associate for future partnership in well-established, prestigious
highly regarded Midtown periodontal/implant practice. Dental
office experience essential. Send CV to: [email protected].
ROCHESTER AREA: Well-established general practice. Includes
IV sedation and implantology. Looking for long-term associate to
SYRACUSE—NORTHERN SUBURB: Associateship leading to partnership in long-established, profitable, well-managed and completely
paperless general practice. Strong hygiene recall and excellent relationship with specialists to whom we refer. Chance to grow your own practice
in pleasant, friendly community. Please forward CV or request more info
by email: [email protected]. All inquiries confidential.
ASSOCIATESHIPS WANTED
PERIODONTIST: 37 years experience in high-volume and unionoriented NYC offices seeks PT associateship with general practice
in Manhattan or Brooklyn. Excellent references. Very productive.
Call (212) 679-2472.
When the Dentist and Patient Disagree continued from page 11
In Case #2, the prosthodontist did not harm the
patient by placing the laminates without first performing
might be occasions when it is appropriate to refer the
nitely should inform the patient of the problem. For exam-
patient to peer review.
ple, if a patient presents with complaints about a poorly
crown-lengthening surgery for purely esthetic reasons.
There are many reasons why treatment can fail.
designed, ill-fitting denture and says he or she has no
Even though the result, perhaps, could have been more
Peer review committees examine patient records in
intention of returning to the dentist who made the denture,
ideal, the patient certainly had the right to decline
detail to determine whether unsuccessful treatment is the
instead of declaring, “This denture was done terribly, and
optional cosmetic surgery that would have added
result of an inappropriate diagnosis or poorly per-
we have to make a new one,” it is better to explain, “I can
expense, discomfort and time to the treatment.
formed treatment. Denigrating the treatment rendered
see how you and your dentist worked very hard to fabri-
by a colleague does not enhance one’s esteem in the
cate a denture that looks nice and fits comfortably. Now
3. Be a helpful colleague.
eyes of a patient and certainly does not enhance the
that we can see what wasn’t successful for you, we can try
It is never appropriate for a doctor to denigrate a col-
image and prestige of our profession. Moreover,
to make a new denture using a slightly different approach.”
league. Instead, there are times when it would be
patients do not think highly of dentists who act unprofes-
appropriate for a subsequent treating dentist to refer the
sionally and vociferously attack a colleague’s efforts.
patient back to the original treating dentist—and there
When we come across a dental problem, we defi-
If you were the patient, which statement would be
more likely to make you respect your dentist and the
dental profession?
Conclusion
Treating our patients as we would
wish to be treated and providing full
explanations prior to treatment is not
only ethically proper, it is also helpful
in avoiding post-treatment misunderstandings.
Further, refusing to perform dental treatment that would be harmful to
our patients is fundamental and nonnegotiable; we may, however, perform dentistry that might not be ideal,
provided our patient understands
and agrees.
Finally, treating our colleagues
as we would wish to be treated and
not denigrating treatment rendered
by others not only helps colleagues
avoid complications, it also helps
enhance our own prestige. z
Dr. Galler is chairman of the NYSDA
Council on Peer Review and Quality
Assurance. This article was written with the
assistance of Judith Shub, NYSDA Assistant
Executive Director for Health Affairs, and
Jacquie Donnelly, NYSDA Peer Review
Program Coordinator. Queries about this
article can be sent to Dr. Galler at
[email protected].
16
NYSDA NEWS / MAY 2014