with the - Burkhart Dental Supply

Transcription

Issue 2 | 2015
Beginning
with the
end in mind
Doctors Travis Hildebrand and Kenny Havard
of Georgetown Pediatric Dentistry & Orthodontics
CONNECTING THE DOTS
And Changing the Future
Dr. Greg Dumitru helps those in need in Morocco
Remodel + redesign = positivity
Dr. Brad Handick’s stunning office revamp in Portland, Oregon
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Imagine
Table of contents
16
Beginning with
the end in mind
SKILLFUL HANDLING. POWERFUL DRIVE.
Meet the doctors behind Georgetown
Pediatric Dentistry and Orthodontics
Introducing MIDWEST®
– The electric handpiece system
that provides a necessary balance of power and control for
all your high-speed, low-speed, and endodontic procedures
32
Remodel + redesign
= positivity
Dr. Handick's beautiful office in Portland
Practice Management
6Spring Clean your Practice
16
Doctors Hildebrand and Havard
of Georgetown Pediatric
Dentistry & Orthodontics
40
Death and Taxes: Focus on
What You Can Control
Power—lightweight brushless motor and
attachments designed for a range of applications
Control—touchscreen user interface,
small handpiece designed for easy
maneuvering, and the ability to make
a variety of adjustments on a single screen
11Thanks for asking
Answers to your practice concerns
Clinical Success
14before you do aesthetics,
you have to sell aesthetics
Selling isn't so bad when you are
helping increase self-esteem
Assistant Success
22Supply savings guarantee
Part of the Family
Giving Back
24
32
Have you scrubbed your practice
habits this spring?
Connecting the dots and
changing the future
Dr. Greg Dumitru volunteers in Morocco
Technology
30EPCS and two factor
authentication...finally!
Check out Dr. Handick's
stunning office redesign
and remodel
Basics on e-prescribing in general
Business of Dentistry
44The Rubber meets the
road with obamacare
Make sure you are in compliance!
Index of Advertisers:
For more information or to request a free demo,
call 1.800.989.8825 or visit www.dentsply.com.
NEW
© 2014 DENTSPLY Professional, Des Plaines, IL 60018
MIDWEST® is a registered trademark of DENTSPLY International and/or its subsidiaries. MID23-0914-1
A-dec....................inside Back cover
Dental Group LLC......................... 42
AKT Advisors................................ 46
Forest.............................................. 1
Brewer............................back cover
NSK.............................Inside Front Cover
Burkhart dental supply:
Practice Support Team........................ 9
Handpiece Repair Center...................13
Pelton and crane........................ 39
Dental ez........................................13
midwest........................................... 2
Planmeca...................................... 47
Scican.............................................. 5
Vatech............................................ 43
XLDent............................................ 10
CATALYST MAGAZINE // Issue 2, 2015 // 3
Serving the Dental
Profession since 1888
FROM THE
president
B
urkhart is passionate about providing exceptional
service for our clients. We aim to identify each
client’s unique needs along with their personal and
professional goals. We strive to provide helpful information,
skilled service and specific products. We earnestly
work in the best interest of others because at the end of
the day, that’s what makes our work most satisfying.
Passion is not a virtue developed overnight. Since 1888,
Burkhart has worked to make sure that every service we
provide in some way improves the career or life of the
client. Many of the services we provide help free up our
clients from smaller day-to-day tasks and allow them to
focus on their top priorities. Some of those services include:
managing inventory, controlling supply costs, and making
sure digital equipment and software work well together.
At Burkhart we realize that our clients are
both dental professionals and business
owners. It is our goal to help them be
successful at both. Catalyst is fully
dedicated to that success. The articles in
this publication vary from product use and
selection to business management topics
and provide information and guidance that
can lead to a more successful practice.
Throughout the publication are stories of
Burkhart clients who have succeeded in the
areas that are highlighted.
We hope you enjoy!
If you have a request for a topic that
you would like for us to cover in Catalyst,
please contact Mark Beagley at:
[email protected]
Catalyst Magazine is published by:
Burkhart Dental Supply
2502 South 78 th Street
Tacoma, WA 98409
p) 253.474.7761
f) 253.472.4773
Publisher
Greg Biersack
EDITOR
Mark Beagley
Designer
Sara Wisely
Advertising
Melissa Gill
All rights reserved. Reproduction of any part
of this publication without written permission
from the Publisher is strictly forbidden.
Images are not necessarily to scale.
Customer Service:
Lori Burkhart-Isbell
President
800.562.8176
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We are focused on one central goal of providing the best
client experiences. Staying focused is what makes us
efficient, knowledgeable, and current in the marketplace.
PRACTICE MANAGEMENT
PRACTICE MANAGEMENT
SPRING CLEAN
YOUR PRACTICE
by Margaret Boyce-Cooley, Director, Burkhart’s Practice Support Team
O
ne thing is certain as spring
arrives: flowers will be popping
up and many of us will have
a desire to do a little spring cleaning
and freshen things up a bit. A certainty
around our office is that calls will continue
to come in to the Practice Support
Team, many with a renewed focus on
transferring that “freshening” to systems
and productivity in their practice. If one
of the areas of your practice you’d like to
“clean up” is your volume of new patients
and/or holes in the schedule, then you’re
in good company—many of the practices
calling into our hotline have the same
concerns. In our September article, we
examined an approach to determine the
impact that individual PPOs are having on
your practice, to better plan your strategy.
Your next task was to work through the
steps we included to address openings
in the schedule. These steps should
definitely satisfy your need for spring
cleaning! The four areas we’d recommend
you freshen are:
1. Reactivating patients
2.Examining your web presence
(website/social media)
3. Developing or revisiting your
marketing plan to include referral
requests towards patients whose
employers’ have better benefit plans,
targeting specific employers (perhaps
the local school district) with better
benefit plans and local businesses
where prospective patients go to
spend discretionary income
4. Considering an in-house insurance
offering for those without dental coverage
Let’s explore the first two of these in
more detail.
Reactivating Patients
Not only will this help fill holes in the
schedule and demonstrate your follow-up
and care, it will give you truthful numbers
regarding active patients in your practice
to more accurately determine practice
needs for planning purposes.
1.Request that your front office staff
identify who is overdue and ensure
the accounts they focus on are in
good standing with the practice (work
backwards from most recently overdue
to 18 months overdue). Pull the reports
to include:
a.Outstanding treatment plans
b.Overdue hygiene appointments
c.Unaccepted treatment plans
d.Patients not seen in over a year
If the patient agrees, schedule the
appointment. If the patient declines,
send them a letter or email as a followup. (Remember: the goal is to motivate
the patient to schedule, so focus on the
benefits of coming in—not treatment.
Email or call Burkhart’s Practice Support
Team for a sample letter.) If there is no
response to the letter, follow up with
another call in two weeks. If the patient
does not respond and has been inactive
for a year or more, they’ve met the
criteria to deactivate. Be sure to do this,
or all your spring cleaning is for naught!
Ask your team to let you know about
patients that left the practice and the
reason they left. If a patient unhappily
shares that they left for another local
dentist, ask "May I let the dentist know
why?" This is a great way to discover areas
where the practice can grow or improve.
TO-DO LIST
Reactivate patients
Examining your
web presence
Revisit your
marketing plan
Consider in-house
insurance
Once the lists are ready:
2.Strategically call. The goal is to
motivate 10% of those listed to
schedule. Of those you speak to, aim
to schedule 50%. To enhance your
team’s success in “tidying up” these
overdue patients:
a.Contact the patients the way they
wish to be contacted (cell, work, etc.)
b.Try calling at a couple different
times of day (and document)
c.Only leave a message on the last call
d.Call when patients can be
scheduled within two weeks;
if the schedule won’t allow this,
don’t bother
e.Use a script! “Hello, Mr. Jones,
how are you? Dr. Smith is very
concerned that you’re overdue for
your hygiene appointment and oral
cancer-prevention screening. It’s
been more than a year since we’ve
seen you. We have an appointment
available for you on the 26th at 10
a.m. or the 28th at 2 p.m. Which
would work better for you?”
PRACTICE MANAGEMENT
Examining Your
Web Presence
It is no longer optional in dentistry’s
competitive marketplace to not have a
mobile-friendly website. Your next springcleaning chore is to examine your web
presence. Work through the checklist on the
right and grade your practice’s presence.
website review
checklist
Easy-to-follow directions and map to the practice
Office hours listed
Practice phone number displayed prominently on EACH page
Non-clinical, close-up photo of the providing dentist(s)
If you’ve given yourself a grade of
less than an A, we’d encourage you to
spruce up your web presence. Share
the “unchecked” areas with your web
developer, or reach out to our preferred
marketing partner, WEO Media, for an
assessment of your site. Bear in mind, if
you’re a Platinum account with Burkhart,
you’ll receive a discount on your website
set-up fees through WEO Media.
With focus on these areas, you should
have a renewed “fresh” approach for your
current and prospective patients! If you’d
like to consider an in-house offering for
dental coverage, please ask your Account
Manager to share our “In-House Dental
Plans—Points to Consider” overview or
give the Practice Support Team a call at
1.800.665.5323.
Mission statement including clinical philosophy of the practice
Photos or virtual tour of the practice facility, both interior and exterior
Photos that represent the current and/or targeted patient population
Patient testimonials that highlight differentiators for practice
Limited number of “before” treatment photos; more “after” photos
Limited clinical information and dental terminology
Check out some
upcoming 2015
Webinars
Please choose the hour that works best for you (webinars are 60 minutes)
Interceptive Hygiene
3-Part Series
Part 3: Friday, April 3, 2015: 7:00am PST
$189 per Office
Monday, April 6, 2015: 3:00pm or 5:00pm PST
To register, visit our website at
Video available on site
Welcome statement to new patients
Statement welcoming referrals
New patient dental/ medical/ registration forms available online
Patient reviews or links to reviews
burkhartpracticesupport.com
(click on Webinars)
$69 per Doctor
Friday, May 15, 2015: 8:00am PST
Monday, May 18, 2015: 3:00pm or 5:00pm PST
Online appointment scheduling
Are You Compliant?
HIPAA Awareness
Online patient account access
Social Media links
o Are posts recent and frequent?
o Are the posts exclusive to the practice (not “canned”)?
Search Engine results on top third of page one
/20 Grade=
A Strategic Approach
to Dealing with PPOs
%
$69 per Doctor
Friday, July 17, 2015: 8:00am PST
Monday, July 20, 2015: 3:00pm or 5:00pm PST
Managing Office
& Staff Overhead
$69 per Doctor
Friday, September 18, 2015: 8:00am PST
Monday, September 21, 2015: 3:00pm or 5:00pm PST
Overcoming the Challenge
of Failed Appointments $69
Team
The Practice Support Team at Burkhart
provides business insight and strategies to
Burkhart’s doctors and our branch teams
to help our doctors build stronger practices.
Whether it is a valuable phone call, a webinar,
or a Practice View we have the resources to
support your practice.
Registration
or contact
Dana Morano at
[email protected]
Burkhart
P l at i n u m
C l i e nt ?
Take ad
vanta
one free wgee of your
b
a quarter!inar
per Doctor
Friday, November 13, 2015: 8:00am PST
Monday, November 16, 2015: 3:00pm or 5:00pm PST
Check out
our recorded webinars
listed on our website!
www.burkhartpracticesupport.com
Team
R 12/14
Go Paperless, Mobile, Seamless at Every Point of Patient Care
PRACTICE MANAGEMENT
Thanks for
asking
Burkhart’s Practice Support Team receives calls and emails every day from offices
regarding their business questions and needs. In each issue of Catalyst, we’ll compile
some of the most frequently asked questions and share our insight with you.
Q:HOW DO I GAIN MORE
NEW PATIENTS?
As Your Practice Grows…
Your Software needs to Grow with You.
A: There isn’t a single, “magic idea”
available to gain new patients.
Ideally 70-75% of your new-patient
flow is generated from internal
referrals. The remainder will come
from outside marketing strategies.
The budget we recommend for
marketing is three to five percent
of collections depending on
your “busy-ness” level. Internal
strategies are the most successful,
cost-efficient means to gain new
patients. They start with making
sure the patient experience is
referral-worthy. Are you building
relationships that promote patient
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trust? Answering the phone by
the third ring? Greeting them by
name as they walk in? Consistently
transitioning information from the
hygienist to the doctor that engages
the patient at exams? Accurately
estimating the patient portion for
treatment diagnosed? Finally,
is your team asking patients for
referrals? Are you? Sometimes
patients simply don’t know you are
accepting new patients. If you’ve
spent the time to build a good
relationship, and a referral-worthy
experience, your patients will be
happy to refer family and friends if
you ask them to!
Kathy Edwards, RDH, Margaret
Boyce-Cooley and Dana Morano
of the Practice Support Team
Q:IS THERE A GOOD STAFF
BONUS SYSTEM?
A: An effective bonus motivates
and rewards your staff as the
practice becomes more profitable.
Structuring your bonus system
on the total staff overhead can
meet these objectives. A healthy
benchmark for staff overhead
for general dentists is 25-30
percent of collections. Select a
healthy overhead percentage and
calculate what your collections
will need to be to keep staff
overhead in the target percentage.
If you collect beyond the goal,
20 percent of the “extra” money
is shared among staff. It may be
more effective to calculate the
bonus quarterly; this ensures a
large enough bonus to make it
worthwhile and lowers payroll
costs to cut extra checks. The
bonus pool can be divided in one
of three ways: equally; based
on the number of days worked
(part-time staff will earn less than
full-time); or use a performance
review formula that rewards
higher contributors with a larger
share. You will gain consistency
by calculating a daily goal. Each
month varies in the number of
working days; multiply your daily
goal by the number of working
days each month to determine
your monthly goals.
PRACTICE MANAGEMENT
Thanks for
Q:WHAT’S A HEALTHY
ACCOUNTS RECEIVABLE
AGING?
A: We recommend your AR (Accounts
Receivable) over 90 days stay under
10 percent. Review the balance to
determine if the outstanding monies
are for barter or trade accounts,
outstanding insurance claims,
or patient balances. If it feels
challenging to keep this under ten
percent, you may need to analyze
a few systems that contribute to a
healthy (or unhealthy!) AR aging.
The doctor may need to clearly
establish and communicate
in-house finance options for the
practice. Thorough transitions from
clinical personnel to front-desk
personnel when checking patients
out needs to take place for accurate
collections. A verbal and written
review of the procedures performed
and the next steps to take will help
solidify the plan for the patient as
well as help the front desk collect
and schedule accurately. Finally, if
asking
>>continued
treatment is added chair-side, a “PIT
Stop” needs to take place: inform
the patient as to the newly added
Procedure, additional Investment
required, and additional Time
anticipated for the appointment.
This eliminates surprises for
your patients and awkward
conversations for your front desk.
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2015 DentalEZ, Inc. DentalEZ, StarDental and Columbia Dentoform are registered trademarks and NevinLabs is a trademark of DentalEZ Inc.
RAMVAC and Bulldog are registered trademarks and Osprey and OWL Touch are trademarks of RAMVAC Dental Products Inc.
©
Your
HANDPIECES
are an important part of your practice.
HANDPIECE
The Practice Support Team at Burkhart provides business insight and strategies to Burkhart’s doctors and our
branch teams to help our doctors build stronger practices. Whether it is a valuable phone call, a webinar, or a
PracticeView we have the resources to support your practice.
Call or email us today for free with your
business questions at 800.665.5323 or
[email protected]
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877.311.3856 | www.burkhartdental.com
Team
CLINICAL SUCCESS
Before You
Do Aesthetics,
You Have to Sell Aesthetics
by Rhys Spoor, DDS
Accredited Member of the American
Academy of Cosmetic Dentistry
W
hen I first graduated from
dental school, the idea of
selling my dentistry did not
seem to be a good idea and certainly
not one I thought would be necessary.
I had the naive viewpoint that since I
was a doctor all of the patients would
accept my recommendations and just do
them because, after all, I was the expert.
The reality I found was quite different.
Aesthetics was absolutely discretionarynobody dies from ugly teeth and it is
relatively expensive. Furthermore,
insurance companies put it at the bottom
of the list, exactly the opposite of where I
thought it should be. What an eye-opener.
So before you start doing significant
amounts of aesthetics in your practice,
you have to learn to sell the idea of
aesthetics to your patients. Selling is
not a bad thing, especially when the
results we can give to our patients are
enhanced self-esteem, better function,
improved health, and increased longevity
of their dentition. Obviously you need
the technical training and ultimately the
experience to deliver your peak results,
but that is just a matter of continuing
education—which we all do anyway.
The following are the steps I have found to
be helpful and effective for selling. Frame
your aesthetic treatment around you and
your team always being honest with your
patients, doing your best, and doing what
is in the patient’s best interest. Remember
that you have a great product, in the end it
makes your patients happy, and it is a winwin for everyone. You are selling a solution
to their problem.
1. Connecting
to build trust
This is the most important step and
putting forth maximum effort in the
beginning pays the highest dividends
later. It takes some time and starts with
the first contact on the phone, in person,
by email, or however that patient first
interacts with you. Introducing yourself
and your team is critical--everyone
needs to be friendly, competent, and
caring. The office environment should
be pleasant, safe, and comfortable. The
purpose, the process, and the advantages
for the patient should be clarified. Strive
to gain the patient’s agreement to the
process early on. This is not necessarily
an agreement to the ultimate treatment.
A positive relationship leads to the
necessary level of trust.
2. Asking questions to
understand
This part takes some practice, but
basically listen more than you talk and
ask questions until you are certain you
have a concise understanding and clear
picture of the problem. Listen actively: ask
questions, paraphrase for understanding,
and demonstrate empathy. Often, asking
the patient for further information and how
this makes them feel helps them open up
enough to really define the problem. This
is not difficult as it is what we all try to do
when we provide health care.
3. Defining the solution
Confirm the needs as stated by the patient.
Show the value of the solution to resolve
those needs. This is the time for stories—
including visuals of finished cases—of
how you’ve helped other patients (the idea
of the visual is to support the emotional
good feeling those other patients have,
not how the dentistry was done). Use clear
explanations in language that the patient
will understand.
4. Gaining agreement
Summarize the needs and recommend
a solution tied directly to the needs in
terms appropriate to the patient. After
presenting the solution, stop and take
time to listen again. The patient should be
doing most of the talking at this point; a
little silence is not a bad thing. Revisit the
solution and the benefits one more time
and present the fee and timing. Secure
the agreement and schedule a follow-up
or next-step appointment.
5. Overcoming objections
Objections are just unanswered questions.
If objections are present, answering the
patient's questions may require backing
up as far as Step 2 (understanding). Keep
in mind that the patient originally sought
your help to solve an aesthetic problem
and objections are extraneous. However,
this is where the process can stop--and
without focus by the whole team, will stop.
Helping patients overcome objections is
more important than any of the technical
dentistry we do, and look at the emphasis
most of us put on our technical competency.
Taking the time at the start to build the
proper relationship to the necessary level
of trust discussed in Step 1 will, typically,
greatly reduce the objections.
Dr. Rhys Spoor is a 1983 graduate of the University of Washington where he was an
Affiliate Assistant Professor in the Department of Restorative Dentistry for 10 years. He
is an Accredited Member of the American Academy of Cosmetic Dentistry, a Fellow of the
Academy of General Dentistry, the American Dental Implant Association, and the Pierre
Fauchard Society. He is also an Editorial Reviewer for the Journal of Cosmetic Dentistry. Dr.
Spoor maintains a private practice in Seattle in aesthetic, implant, and restorative dentistry.
He may be contacted at [email protected].
FEATURE: Dr. Hildebrand And Dr. Havard
Doctors Travis Hildebrand and Kenny Havard of
Georgetown Pediatric Dentistry & Orthodontics
D
octors Travis Hildebrand and Kenny Havard built their relatively new practice
on the old Chisholm Trail traditions of working hard, blazing trails, and
adjusting to population shifts. They decided to team up early in dental school,
and the partnership of Georgetown Pediatric Dentistry & Orthodontics opened in 2008
in a leased space–just one month after the doctors finished their pediatric residencies.
They almost immediately began designing a building for their growing future practice
and looking for the perfect location in a desirable area. In March 2014 they re-opened in
their own custom building in Georgetown, Texas, with twelve completed operatories and
five more plumbed and ready to go. The team also opened a satellite practice in nearby
Copperas Cove only three months after that. It has four completed operatories and room
for three more.
They have had a lot of success that has come unusually early in their careers. They attribute
it to a lot of hard work along with their philosophy of “beginning with the end in mind.”
Can you tell us a little about how your partnership started?
Havard: We became friends during our first year of college at Stephen F. Austin State
University and then continued on to dental school together at the University of Texas
Health Science Center at San Antonio. We have been friends ever since. I completed
my pediatric residency at the University of Kentucky in Lexington while Dr. Hildebrand
completed his at the University of Texas Health Science Center at San Antonio.
Hildebrand: We started building the practice in a leased space with four
operatories and room for three more while we were still in school. We finished our
residencies in July 2008, and we saw our first patients in August 2008. We were both
associating part-time in other practices early on to help pay the bills.
BY JUDI GRIFFIN
PHOTOS BY Charlotte Bell
Havard: We were pretty fortunate in the beginning. It grew faster than we planned, and
the practice took off pretty well.
FEATURE
Hildebrand: We started as the first
and only pediatric specialty practice in
town, but we also opened right as the
economy took a downturn. The aggressive
population projections that the city had on
their websites didn’t pan out. That slowed
the growth of the practice down a little bit.
We still were very fortunate and able to
support both of us within a couple of years.
We were in a five-year lease term, but we
knew that eventually we wanted to buy our
own real estate for the practice. We thought
population growth projections, it would
take a long time to be busy enough for two
full-time doctors in Georgetown, but there
were needs in other nearby towns.
and have things to iron out. When we had
one practice, it was super easy to have one
person gone. Sharing a call schedule is
another big advantage.
Havard: From 2008 to 2012, it was
The disadvantage that some people
might experience occur when the two
personalities don’t mesh. Finding the right
personality and being pretty similar on the
practice philosophy is important. Having
known each other for so long, we knew
where we stood on a personal level. We
both trained in dental school at the same
place. It was by design that we went to
separate locations for our pedo training so
we got a variety of experiences and peers
from across the country.
pretty stagnant in Georgetown. We had
always set out to have two locations. We
didn’t intend to build this office and start a
satellite at the same time. They just each
set off on their own trajectory, and they just
happened to open within a few months of
each other.
The advantages far outweighed the
disadvantages, with the big elephant in
the room being having enough patients
to support two doctors. That is where we
were fortunate to find part-time associate
positions for a while. We also had some
mentors that had been in practice for
a while that helped us make educated
decisions on things.
Havard: It is a pretty unique model
The Georgetown team members with account manager Michael Zuelke.
the sooner we got it built, the sooner it
would be done and we could start building
equity.
You also opened a satellite practice
in Copperas Cove, Texas, just three
months after your new building
opened. How did that come about?
Hildebrand: Begin with the end in
mind is what we were always taught in
dental school, and it is true in life as well.
It sounds like a negative outlook, but at
some point you want to retire. You enjoy
your job, but at some point it will be time
to move on. We knew that with the local
A lot of practices have two doctors,
but it is somewhat unique to start out
with two doctors as equal partners
just out of dental school. Please tell
us a little about that model.
Hildebrand: The benefits of having
another person with you to help with not
only the dental side–consultations and
treatment planning–but also the business
side and administration are huge. How
about being able to take a vacation and
knowing the practice is going to run
smoothly? We aren’t quite there yet, but
we are getting pretty close. With two
practices, we are still in a growth mode
to start with two partners right off the
bat. The more common scenario is one
dentist starting out on their own to grow a
practice. They then bring on an associate
that eventually buys into the practice. With
that, you usually have a pretty significant
age difference between the doctors, and
that is where you can get into differences
with treatment planning philosophies. I
liken it to when my wife and I got married
at 21 straight out of college—we were
broke and didn’t have a thing. In a way it
was easier because we both started with
zero. There was never a sense of “this
is yours, and this is mine.” It’s the same
way with Travis and me. We both started
horribly in the red with student loans and
business loans. We were just starting from
scratch. I think we have had an easier go
just because of that shared experience.
The subtle Western theme occurs throughout the practice.
Hildebrand: I would definitely
advise going into business as a
FEATURE
Janna Bona, RDH and Hillary Mersiovsky, RDA
in the custom fabricated sterilization center.
Burkhart Account Manager Michael Zuelke, Dr. Kenny Havard and Dr. Travis Hildebrand.
partnership. It is tremendously helpful
with the right person. There are so many
decisions that have to be made and
things to accomplish to build a building.
I just can’t imagine being the dentist
that is seeing all the patients in addition
to designing the office and having it
constructed. I don’t know how it would get
done. Something would have to give.
This office has a charming Western
theme that is really tastefully done.
How did you decide on it?
Hildebrand: We tried to think it
through. We wanted Mom and her threeyear-old to be comfortable, but we also
wanted the 14-year-old to be comfortable.
These little ones are growing up to be big
ones. We need to keep that in mind.
Hildebrand: As for the theme, we
wanted to have something that made
sense in Georgetown, Texas. Georgetown
has roots in the Wild West days and it is
on the Chisholm Trail. It felt like it made
sense to have a western theme.
Havard: We felt like it fit well, but we
took great steps not to overdo it. We don’t
want a 12-year-old to walk through the
door and think it’s lame–especially with
the orthodontic side growing. [They have
had a part-time orthodontist, Dr. Steve
Wood, as an associate on the team since
2012.] Most of our orthodontic patients
are adolescents and teens, but they
typically started with us as young kids.
By the time they are ready for braces, we
are right there. There’s that relationship
developed over the years, and they trust
us. We’ve likely been telling the parent
for the past five years that their child is
going to need braces. They appreciate
being told early on what they can expect.
This has given them years to prepare for
the expense of orthodontics.
Hildebrand: We think of it as old
Havard: Michael Zuelke is a
meets new–an old Georgetown theme
meets new technology. It’s also new meets
old–new kids come into the practice and
grow up to be older kids in the practice.
It’s the full transition.
consultant for us in that he is always
out there looking for products that are a
better value or on a promotion that will
save us money.
Hildebrand: I like his philosophy of
Can you tell us about the impact
that Burkhart has had on your
practices?
Hildebrand: From my standpoint,
having Account Manager Michael Zuelke
here is like having another employee on
the team. Michael has a nice system in
place for basics like ordering, but he is
also a really good resource for business
management and telling us how things
work well in other businesses. He has
been a great resource for finding solutions
to our problems. Equipment Specialist
Felix Gutierrez has been another great
resource for us.
knowing that he does better when we do
better. It’s not just that he does better if he
sells us something. For example, he takes
care of ordering our direct-only items
from other vendors. He wants us to not be
worried about that stuff. He wants us to
be taking care of our patients. He knows
that we will be more successful long-term
because he is doing these other things
for us. It is hard to quantify that. There is
a lot of value to us in the relationship and
having Michael as a resource, consultant,
and advocate for our business.
Havard: Burkhart’s service department
has bailed us out on many occasions,
and we haven’t lost any significant patient
Alyssa Vester, RDH and one of her excellent patients.
care time because of it. Our vacuum went
out at 1 p.m. one afternoon and they were
here until 10 p.m. installing a temporary
vacuum. We were up and running the first
thing in the morning. We have called at 5
p.m. when our autoclave was out, and they
will have a new one in our office before
we see our first patient the next morning.
I can’t say enough good things about
Burkhart’s service team.
this once and the sooner we got started,
the sooner it would be paid off.
Hildebrand: Our early success
really helped us be able to do something
like this. Had we not been grinding it out
hard for the first five years, there is no way
this could have happened. It took a lot of
cash and determination to make it happen.
Havard: We did do it a bit different
Tell us about your proudest
professional accomplishment?
Hildebrand: Being six years into
our careers and having this building and
our practices is something you can only
dream of happening.
Havard: We were told by many people
that this was unusual to do so early in our
careers. Our philosophy was that we were
growing out of our leased space, interest
rates were low, and we found a great
location. We knew we only wanted to do
compared to what most people do. Most
people associate for longer before they
start their own practice. We kept the end
in mind. Where do we want to be longterm? We might as well get started on that
path. Begin with the end in mind.
Supply savings guarantee:
PArt of the Family
D
r. Victor Pickett graduated from the University of Puerto Rico in 1979.
Soon after, he opened Southwest Dental in Taylorsville, Utah and has
been in the same location ever since—nearly 36 years! He sat down with
his Burkhart Account Manager, Susan Carter, and talked about the success he has
found with the Supply Savings Guarantee.
What was it that made
you want to work
with Burkhart?
What was it about the
guarantee that originally
caught your attention?
I was invited by my lab technician to
attend a 3M True Definition Digital
Scanner event at the Burkhart branch in
Salt Lake City, Utah. While in attendance
I wandered around the showroom floor
and spotted a Pelton & Crane chair. I
wasn’t familiar with Burkhart and didn’t
know they sold equipment. I had just
purchased a Pelton chair only weeks
prior and curiously asked how much it
costs. Surprisingly, it was significantly
less than what I had just spent on the
Pelton & Crane chair for my office. I was
equally impressed with the Burkhart
staff and was eager to learn more.
My Account Manager, Susan Carter,
and Branch Manager, Sam Goodrich,
invited my staff and me out to lunch to
share Burkhart’s philosophy with us.
They shared the “What a Great Supply
Rep Does” presentation with my team
and handed out gifts with a promise
to reduce my overall costs. The lunch
was a lot of fun and very informative.
My previous suppliers, Schein and
Patterson, with whom I had done business
for over 25 years, had never given my staff
anything, nor had anyone ever promised
to watch my spending and guarantee
I would spend less on supplies.
We are on track to save
over $60,000 in our
first year with Burkhart!
We have a large practice and had been
spending about $20,000 per month on
supplies. I realized that if Burkhart could
do what they were promising to do then I
would save a significant amount of money.
we saved $66,801.00 and reduced our
overhead by almost 2%. We also took
advantage of nearly $22,000.00 in free
merchandise through promotions and
coupons Susan processed for us.
What part of the SSG did
you find most valuable to
you and your practice?
How has the SSG
helped your staff be
more efficient?
I like knowing what percentage of
my production is being spent on
supplies. When we started working
with Burkhart, we discovered that our
percentage was 7.7 percent. After three
quarters on the guarantee, we are
spending nearly two percent less.
Susan has implemented a tag system
to keep track of our inventory. We very
seldom run out of products like we did
in the past. I have a very busy office
with a lot of employees. In previous
years it has been difficult to keep track
of products we were running low on.
That rarely happens now. Susan also
keeps track of our products ordered
direct with other companies.
I like that Susan shares the
numbers with my partners and me
every quarter. We have never had
accountability like that before.
How does your Burkhart
account manager help you
reach your goals
as a dentist and
business owner?
Susan continually suggests products
that save our practice money without
compromising quality. Susan is always
looking for ways we can be more efficient
without my staff or I having to ask. She
even orders non-Burkhart products for us
so my assistants can spend more time
chair-side with my patients. Spending
time on the phone ordering products
can take a lot of time. We trust Susan to
take care of all of our ordering for us.
How has the SSG helped
your business?
We just completed our first 12 months on
the Supply Saving Guarantee program.
By working with Susan and Burkhart,
In what ways does your
Burkhart account
manager help you
and your team?
There are many ways Susan and
Burkhart have helped our team. Susan
introduced us to the Burkhart service
team who we now use to take care of
our repairs at a discounted rate because
we are SSG customers. Susan keeps
us up to date on the latest products
and equipment. The whole team at
Burkhart is a pleasure to work with.
What would you say to
a doctor considering
the SSG program?
Dr. Pickett and his Burkhart Account Manager Susan Carter
You really need to give Burkhart a try.
They become part of the family, and
they’ll care about your practice as much
as you do. You’ll look forward to seeing
your rep because they will be there to
help you, not to just sell supplies.
GIVING BACK
CONNECTING THE
Dots
AND CHANGING THE
Future
When you look at a globe, you notice all the methods for marking boundaries
and giving you a sense of your relative location. One particular methodlongitude and latitude-tells you where you are at any point on Earth.
For Dr. Greg Dumitru, this sense of place was brought into sharp focus
during his first visit to Morocco. Although on opposite sides of the
globe, his hometown of Mesquite, Nevada, and Casablanca, Morocco,
share similar latitudes. Maybe that was why he was surprisingly
relaxed as his 4-wheel-drive vehicle rumbled out of the city and
toward his destination about 10 hours southeast of Casablanca.
BY ANNE BAER
PHOTOS BY DAVE AMODT
Dr. Dumitru examines a patient waiting for treatment.
GIVING BACK
GIVING BACK
One of hundreds of villages in the middle atlas mountains near Marakech.
Some people from other
regions walked for hours
to reach this outdoor
clinic, which was in a
government run school.
What was not familiar was the abject
poverty of most people he met. Although
we may think of Morocco as beautifully
austere, sheltered by the Atlas Mountains
and dotted with colorful marketplaces,
reality for most people is harsh poverty
and a severe lack of services. “There is a
layer of very wealthy citizens, but it does
not trickle down to most of the population,”
explains Dr. Dumitru. Traveling to help
was a natural extension of Dr. Dumitru’s
path. From the start of his dental career,
Dr. Dumitru has cared for impoverished
dental patients, working right out of dental
school primarily on Medicaid patients
before he opened a state-of-the-art
practice in Nevada.
One of 80 patients seen this day. Multiple unrestorable teeth were extracted, relieving pain for the patient.
But why Morocco? Simple answer:
connections. Dr. Dumitru was initially
invited by a friend he met while in Zion
National Park on vacation. Their friendship
started in the most serendipitous way.
While riding a park shuttle to a trailhead
they struck up a conversation asking,
“Where’s home for you?” Dr. Dumitru’s
curiosity grew when his friend answered,
“Morocco and Southern California.” They
ended up sharing the day hiking, and their
conversation gave birth to a dream to get
Dr. Dumitru to Morocco.
Simultaneously, Dr. Dumitru had another
connection in St. George, Utah, who was
dreaming of ways to start a clinic to serve
the Berber people. “Through my church, I
met a great group of people inspired to serve
in challenging and forgotten corners of the
world. I also felt called to encourage people
already ministering in daunting places
like Morocco, enhancing their ministry
by meeting their needs. I thought, ‘If we
don’t go, who will?’” In preparation for the
first trip, group members were required to
meet several times to explore their reasons
for going and to prepare for entering a
completely different culture. This practice has
continued with subsequent trips. “As a team
member, you really walk away from the trip
learning more about yourself. You experience
people and circumstances radically different
than in your own life. I see it as a chance to
lead the world in a positive way, shining light
in dark areas of deep need.”
The two dreams merged when Dr. Dumitru
first visited Morocco to investigate what
was needed. As he describes it, “We went
to one village where the homes were made
out of stones and mud, really like being
transported
back to
Biblical times. I was
supposed to be leading
a toothbrushing clinic,
but not one of them had a
toothbrush. They just used sticks!”
Dr. Dumitru happened to have a
small tackle box with a few dental items
in it. It came in handy that evening. As he
recalls, “First, there was a kid with a
bad tooth, then someone who had
another problem. We ended up
seeing 30 people that night. It
broke my heart. They have
nothing, and live in such
pain-both physically
and spiritually.”
GIVING BACK
GIVING BACK
Thinking
about
jumping
in?
• Ask your Burkhart Account
Manager. They offer a wealth
of information about options
for charitable activities, both at
home and abroad, plus with
available support.
• Contact your local component
dental society or state dental
organization. Their web sites
may list community events and
options for your dental team to
get started.
• Poll your dental cohorts.
Many team members have
connections to organizations or
individuals who currently offer or
need free dental services. Their
ideas may inspire new ways to
give back.
With the help of Burkhart and their mobile portable equipment,
they are able to bring high-quality dentistry to a third-world situation.
• Think beyond the passport.
Many communities welcome
volunteers who can provide
dental care. Find a niche in
your local area and get started.
The team also served in a special needs center where the children are shunned from society, and have little to no assistance from the government.
Armed with a list of basic
items, Dr. Dumitru returned to
the US and started organizing.
Now, he travels with a fully portable,
mobile dental system from I-TEC
including chair, battery, and hand
drill--all of which fit into a backpack.
Dr. Dumitru points out, “Everything
is completely mobile at this point. I
am working to establish clinics in
partnership with other service
organizations, particularly
for the handicapped and
for street women–two
groups shunned by
tribal society.” In addition to the mobile
system he takes, he has two A-dec
military-style portable units in Morocco
that he leaves with friends. Preparation
was aided by Burkhart’s service tech, Akio
Kafka, who set up the units and tested
them prior to Dr. Dumitru’s trips. Kay
Parker, his Burkhart Account Manager,
also pitched in contacting manufacturers
and securing donations of masks, gloves,
mouthwash, toothpaste, cotton rolls, and
toothbrushes. “I met one schoolteacher in
a remote village who now uses Burkhart
toothbrushes to guide children in caring
for their teeth for the very first time.”
The next logical step is creating permanent
solutions, either by building clinics or
providing mobile ones. In response to the
need yet another connection in Morocco
stepped forward, offering funding through
the United Arab Emirates Health Ministry.
As a result, Dr. Dumitru was asked to write
a $500,000 grant proposal for a mobile
dental clinic, hoping to secure it before the
end of the year.
As for the impact back home in his own
desert community, Dr. Dumitru recounts, “My
patients and the Mesquite community are into
it and can’t stop talking about it. They always
ask about my trips and when I’m going next.
There is such a need for basic oral health
education. It’s starting to make a difference.
Educating children and their caretakers
means families are now learning how to care
for their teeth. We’re changing the future and
spreading love in such a hopeless placeone tooth, one person at a time.”
What about others who want to
participate? Dr. Dumitru encourages
everyone to “do something”, whether in
their community, state, their own country
or abroad. “Give back a portion of what
you have been given. Share your gift.”
A woman waiting in line to see the doctor shows her beautiful henna design.
TECHNOLOGY
TECHNOLOGY
What does EPCS stand for?
EPCS and two factor
authentication… finally!
By Dawn Christodoulou,
XLDent President
B
efore diving into an update
on EPCS and two factor
authentication, it’s probably
prudent to review some basics
about e-Prescribing in general.
What exactly is
e-Prescribing?
e-Prescribing stands for electronic
prescribing. With e-Prescribing, dentists
can route prescriptions electronically
to a patient’s preferred pharmacy, in
addition to reviewing his/her medication
history and insurance information.
What are the advantages
of e-Prescribing?
e-Prescribing saves time, increases
efficiency, and improves safety and
security. Dentists that e-Prescribe
should be able to instantaneously route
prescriptions, check for dangerous
drug-drug and drug-allergy interactions,
and access dental-specific medication
information with the click of a button. I
say should because not all e-Prescribing
solutions are created equal, and those
features listed are the aggregate
XLDent clients can count on when
utilizing its integrated e-Prescribing
service through DoseSpot. DoseSpot is
a Surescripts™ certified e-Prescribing
platform specifically designed to
integrate with electronic health record,
electronic dental record, practice
management, and telehealth software.
What does
“dental-specific”
e-Prescribing mean?
DoseSpot has an exclusive partnership
with Lexicomp to provide dentalspecific medication information
within the e-Prescribing workflow.
Lexicomp is an industry-leading
provider of drug information and
clinical content for the healthcare
industry. This means dentists can
access crucial medication information
such as a medication’s effect on
dental use and dental treatment,
dental usual dosages, and more.
EPCS is the acronym for Electronic
Prescriptions for Controlled Substances.
Electronic prescribing was legalized
for Schedule II through V controlled
substances at the national level in 2010
by the Drug Enforcement Agency. As
with any electronic standard, adoption
and availability are typically the factors
that govern implementation. Adoption of
EPCS is largely controlled at the state
level by the state pharmacy boards. It has
taken time for legislation to be updated.
EPCS has now been adopted by 49 states.
Limited availability was due to the lack of
DEA-approved EPCS certification bodies
and the complexity of integrating two
factor authentication into e-Prescribing
systems. Under the interim final rule, the
DEA allows the use of two of the following:
something you know (a knowledge factor),
something you have (a hard token), and
something you are (biometric information).
Two factor authentication protects the
dentist from misuse of his/her credentials
from both internal and external threats;
authentication based solely on knowledge
factors is easily guessed or hacked and
used without the doctor’s knowledge. A
practitioner must undergo identity proofing
before he/she is approved to electronically
prescribe controlled substances.
Some states mandated e-Prescribing
long before EPCS systems became
readily available. Former Minnesota
Governor Tim Pawlenty, for example,
signed into law in 2008 a bill that required
electronic prescriptions and created
quality reporting rules for physicians.
Pharmacists, physicians, and others who
prescribe or dispense medication in
Minnesota were required to use electronic
systems by 2011. While many dentists
acknowledged the mandate, many were
slow to implement because they felt EPCS
was the missing link that justified such
a big change in their workflow. Based
on our observation, those that adopted
early quickly realized the invaluable
benefits a comprehensive product/service
offering like XLDent/DoseSpot afforded
them. The value is not in the actual
sending of the electronic prescription
(until recently, controlled substances
still needed to be processed on paper),
but rather the access to a patient’s
medication history and the integrated
interactions checking. Many XLDent
doctors comment that they are more
readily able to identify “drug seekers”
and feel much more “in-the-know” when
treating medically compromised patients.
Recently, two major legislative actions
have had a serious impact on dental
prescription writing. The first legislative
action was the reclassification of
hydrocodone combination products
from Schedule III controlled substances
to Schedule II controlled substances.
Prescriptions for hydrocodone
combination products, such as
Vicodin, may no longer be called in or
faxed to a pharmacy—dentists must
issue e-Prescriptions or handwritten
prescriptions on expensive, tamper-proof
paper. The second legislative action
was the passage of the I-STOP mandate
in New York State. As of March 27, 2015,
all prescriptions in the State of New
York must be sent electronically and
providers to adopt an e-Prescribing
solution capable of safely and securely
sending all prescriptions electronically.
It’s only a matter of time before more
states will pass similar legislation.
More on XLDent,
e-Prescribing and two
factor authentication
XLDent was the first Dental Practice
Management System to integrate
e-Prescribing capabilities and is now
the first PMS certified to send Electronic
Prescriptions for Controlled Substances
(EPCS). This major industry achievement
now equips XLDent dentists with the
ability to securely e-Prescribe controlled
substances in 49 states. As explained in
the associated article, EPCS requires
an additional layer of security known as
two factor authentication to protect the
integrity of each controlled-substance
prescription. The first factor is a PIN
number that each dentist will set and
the second factor is a cutting-edge
mobile application that generates a sixdigit security code every 30 seconds.
Using these two factors, dentists can
quickly send a controlled-substance
prescription. XLDent continues to be
at the forefront of dental e-Prescribing
e-Prescribing saves time,
increases efficiency, and
improves safety and security.
pharmacists can only fill prescriptions
that have been submitted electronically
via e-Prescribing. The only exception
is in the case of an emergency.
With the recent reclassification of
hydrocodone combination products and
passage of New York State’s I-STOP
mandate, it’s important for dental
and remains committed to moving
this technology forward in dentistry.
ePrescription service works with all Dental
Practice Management systems. XLDent™
is not required. Please inquire about the
non-integrated option at www.xldent.com/
esolutions/electronic-prescribing.
OFFICE DESIGN
+
REMODEL
REDESIGN
POSITIVITY
=
By Elaine Dunn | Photos By Steve Tague
W
hile attending college at Indiana
University, Brad Handick began
thinking about which direction
his career would take. He knew that he
wanted to be in healthcare, as a physician
or a dentist, and was considering whether
to enroll in dental or medical school. He
did some research and talked to doctors of
both professions. After talking with them, his
impression was that the dentists he talked
with were really happy with their chosen
profession and seemed to truly enjoy what
they were doing. He was intrigued with the
entrepreneurial aspects of small business
ownership as well so he chose dental school.
After graduating from Indiana University
School of Dentistry in 1995, Dr. Handick
practiced for three years in Indianapolis
as an associate in a busy general dentistry
practice. He was planning to buy into this
practice until he and his wife made a trip
out to Portland, Oregon, to visit his sister.
It was their first visit to the Northwest, and
they were immediately impressed with the
beauty of the region.
OFFICE DESIGN
OFFICE DESIGN
+
Before the remodel, patients
were always telling Dr. Handick
that they had driven by for
years and never known there
was a dental practice there.
After a few visits to the Portland area, Dr.
Handick started seriously considering
a total change in plans. Looking back,
it seems to him like so much could have
gone wrong with this rather impulsive
decision. But he and his wife could not be
more pleased with how it all worked out.
In 1998, he found a practice to purchase
in Garden Home from a dentist who
had been practicing at that location for
25 years. He practiced in the existing
structure for 15 years before finally
having the opportunity to purchase the
land and building. Then he thought
maybe a small remodel was in order.
Dr. Handick gives a lot of credit to his
Account Manager, Nancy Knot, who
persuaded him to think on a larger scale.
He purchased the property in 2013, about a
year before he met with the Burkhart team
to discuss plans for a remodel. His original
intention was to repaint the building , do
some landscape work and replace the
carpet. Nancy encouraged him to consider
that the timing might be right to make a
bigger investment in the practice. She
introduced Dr. Handick to the Burkhart
Equipment Specialist and together they
shared a vision of what they felt the office
could be. They shared some drawings and
floor plans as well as sketches of what the
outside could look like. It wasn’t until this
collaboration that Dr. Handick realized this
building could become so much more than
what he’d imagined.
Another key member of the team was Pat
Flora of Flora Designs. She developed
the sketches for the façade and for the
interior design. Before the remodel, people
in the community were always telling
Dr. Handick that they had driven by for
years and never known there was a dental
practice there. Pat also helped with the
new signage which really made an impact
and increased the visibility of the practice.
Dr. Handick was more personally involved
with how he wanted the layout to be on
the inside. He knew he didn’t like how the
existing operatories had only one doorway
into each operatory, which made access
cumbersome. Burkhart incorporated two
entry points into each operatory. They also
suggested he move the sterilization room
from the back of the building to the center
for a better work flow.
As part of the research process they
asked him questions such as; “Have you
ever thought about a continental delivery
system?” or “Have you ever thought about
changing the position of your computer
monitors?” Although he was somewhat
uncertain about changing his delivery
system at first, the Burkhart team arranged
for Dr. Handick to visit the A-dec facility
to see the continental delivery set up for
himself before making any decisions. As
a result, Dr. Handick decided to change
to the continental delivery system. He
said it took a couple of weeks to adapt,
+
OFFICE DESIGN
OFFICE DESIGN
The practice did not shut
down one single day during
the duration of the project
(about six months)
INTERIOR DESIGNER: PAT FLORA, FLORA DESIGN EQUIPMENT SPECIALIST: DAVE CRONAN,
BURKHART DENTAL SUPPLY CONSTRUCTION: B&K CONSTRUCTION CHAIRS: ADEC
CABINETRY: ADEC STERILIZATION/OFFICE CABINETRY: ADEC
but he knew right away this was a better
setup as he noticed important benefits
such as less back fatigue. Not only did
the new system make the workday go
more smoothly, it kept him from constantly
twisting and reaching for the hand piece
and instruments.
The existing chairs were fairly new so
they stayed, but Dr. Handick purchased all
new delivery systems, lighting, cabinetry,
new overhead lights, an A-dec sterilization
center and an ultrasonic sterilizer. Dr.
Handick credits his Account Manager,
Nancy, and the A-dec people for helping
him prioritize purchases so that he would
remain within budget. The practice is now
wired, plumbed and prepared to easily add
new equipment or technology in the future.
For the construction work, they partnered
with BnK Construction. Dr. Handick
praised the owner, Rick Shandy, and the
onsite manager, John McDowell, who
did a great job of keeping everyone on
schedule. They stayed within both budget
and timeline. In Dr. Handick’s words,
“They were fabulous.”
The practice did not shut down one single
day during the duration of the project
(about six months). The construction
crews came in and basically cut the
office in half. They would gut one side,
redo the electrical, plumbing and drywall
and install new cabinets and dental
equipment. All the while, Dr. Handick
and his team were working on the other
side of a plastic wall. It required a lot of
shuffling around of computers, front office
equipment and phone lines. Dr. Handick
and his team were always able to come in
and complete a full workday. He says of
his team during the remodel; “They were
fantastic, flexible and came at the project
with a great attitude!”
When describing the equipment
installation process, Dr. Handick told
how Dave Cronan from Burkhart really
OFFICE DESIGN
Success
REFLECT YOUR
“Pelton & Crane produces
beautiful equipment that
contributes to the aesthetics
of my practice while still
offering great functionality
for excellent dentistry.”
- Dr. Bradford Picot
+
Pictured (left to right): Vanessa Steinfeld (EFDA), Tiffany Lankford (Front Office), Dr. Brad Handick, Tonya Detlefsen (RDH), Faity Alstot (EFDA), and Michelle Turner (RDH)
Dr. Handick likes the
fact his existing patients
appreciate the changes.
spearheaded the project. He said Dave
was creative, came up with solutions, and
always found a way to make it work. He
kept things on track and understood that
by 8 a.m. all equipment needed to be up
and running.
Originally, Dr. Handick didn’t have a
vision for what the practice could be.
Now he has more pride in the facility. He
admits prior to the remodel, he was a little
self-conscious that the space wasn’t quite
what he wanted it to be, but he didn’t know
what to do about it. One day, he was with
a patient and she said, “Your old building
didn’t really look like you. Your new space
looks like you and the type of practice
you have.” Dr. Handick likes the fact his
existing patients appreciate the changes.
When considering what advice he would
give to a doctor who may be considering
a new office remodel, Dr. Handick thinks
he was perhaps too conservative and
reluctant to invest a fair amount of money
into the space. He would encourage them
to talk with their accountants, review their
cash flow and develop a realistic budget.
If the numbers add up then investing in
your practice can have immediate and
tangible benefits in terms of new patients
and overall nicer work environment. He
also recommends that while planning
the project, also consider potential
enhancements or equipment that could be
prepared for but saved for a later purchase,
thereby keeping the project within budget.
In addition to receiving positive feedback
from his existing patients, the new façade
and signage have helped to attract new
patients to the practice. This has given
Dr. Handick and his team the opportunity
to connect with new patients within the
community who may be looking for a new
dentist. The aim at Garden Home Dental
is to get to know each patient well and
earn their trust. Our goal is to provide
the best dental treatment we can in
caring and calm environment. “We are so
fortunate to have many wonderful patients
who we look forward to taking care of for
years to come.”
At Pelton & Crane, we combine design and functionality
to create innovative products that reflect your success.
We are passionate about creating clinical environments
that enhance the dental experience for practitioners and
patients - and with 115 years of experience, you can feel
comfortable knowing Pelton & Crane is a name you can trust.
Your Image Reflected.
Reflect your success with Pelton & Crane’s innovative new products
Learn more at pelton.net/newproducts
Chairs | Delivery Systems | Lights | Cabinetry | Water Treatment | www.pelton.net | 800.659.6560
064924/ rev 0 / 02.15
WEALTH MANAGEMENT
WEALTH MANAGEMENT
With SIMPLE-IRA plans and Safe Harbor 401(K) plans a
practitioner can put away a goodly amount with a reasonable
staff-participation cost. For example, a doctor age 50 or
older can contribute up to $34,600 into a Safe Harbor 401(K)
with a maximum staff cost of 4 percent of eligible pay, for
those who participate. Add a participating spouse and the
deduction grows to $58,600–with no change in staff cost.
DEATH AND TAXES:
Focus On What
You Can Control
For some dentists, adding profit-sharing over and above
the 401(K) deferral and Safe Harbor match (or contribution)
can be very effective in further reducing taxes and increase
tax-deferred savings. This makes good sense if:
by Sam Martin, MBA (Tax), CFP®, CPA
B
uilding off the Daniel Defoe
reference, Benjamin Franklin
famously said “…but in this
world nothing can be said to be certain,
except death and taxes.” This quarter,
we will take on taxes—something over
which we can exercise some control.
EVERY LITTLE BIT HELPS
If you are 40, you may not worry so much
about a few dollars leaking out here
or there, but talk to someone who is 60
and very set on transitioning into postfull-time dentistry and you may see the
urgency and prudence in proactively
saving every dollar possible. A big part
of savings is, of course, developing a
well-balanced budget—one that lets you
save at a pace that should provide you a
very comfortable retirement. Once you
have accomplished that task, you can
then look for ways to hang on to more
of what you make, through proactively
managing taxes—and not just the taxes
that are a result of owning a dental
practice, but the taxes that impact
your investment portfolio as well.
Your Practice
Smartly investing in your practice may
be the best return on your money and
typically comes with significant tax
savings through the Section 179 deduction
election and/or Bonus Depreciation
(assuming this will be restored for 2015).
Smart investing in the practice means
choosing carefully those things that
will improve practice production and
efficiency, as well as make the practice
a pleasant place to work and visit. Smart
1.You have the additional cash flow
available to fund profit-sharing
2.Your tax savings outweighs the additional
cost of funding other participants
investing
certainly
includes updating
technology and other
dental equipment,
but it may also
involve investing
in your team through
periodic and ongoing
training and development.
We generally recommend that you have
a three- to five-year plan for practice
investments. This allows you to be very
deliberate in terms of what you purchase,
when you purchase, and the ability to
schedule related training if appropriate.
Being deliberate allows you to plan
and be ready to take full advantage of
the new resource on day one. Planning
ahead also allows you to finance your
own purchases. By estimating what
you expect to spend over the next three
to five years, you can fund a savings
account on a weekly or monthly basis
at a pace that will meet your planned
needs. Get your dental CPA, equipment
manager, and technology representative
together to start mapping your plan
today. Add a dental office designer to
the team if you will have any face lift
projects for the office included in your
plan. Add any other advisors who may
be able to assist in the planning.
Regarding the latter, often a profit-sharing formula that takes
age and wages into account can provide a very efficient
result for many dentists. Younger dentists with relatively
older staff may not find this effective; however, the only way
to know that is to crunch the numbers (which is usually
provided free of charge). Have your dental CPA and pension
expert work together to find you the best plan and features.
Deducting What You Already Spend
The next most influential tax savings is having the right
retirement plan and funding it fully to the extent that tax
savings outweighs the cost of the plan. Your long-term
financial success can be greatly enhanced by using the
right retirement plan with the right features and making
sure the related investment platform is low-cost and globally
diversified. We recommend reviewing your plan annually
to see if there are better options or features available. Over
time tax law changes, your ability to fund changes, and the
ages of you and your staff change—any of these can cause
your existing plan to no longer be the best plan for you.
The government subsidizes investing in retirement plans;
both the dollars you invest for yourself as well as the
dollars you contribute on behalf of staff are tax-deductible.
Although some dentists are aggressive with their income
tax deductions, most are not. In fact, most new clients we
encounter are failing to document and deduct legitimate
expenses they already incur. These fall into categories
such as automobile deductions, meals and entertainment,
continuing education, and travel. Knowing the rules for these
deductions and keeping the appropriate documentation
could result in a few hundred to a thousand dollars kept in
your pocket each year. Even the occasional meal-including
a fine bottle of Merlot-with your spouse where you update
him or her on practice matters and plans can be 50 percent
deductible. But you must follow the documentation rules.
Spend some time with your dental CPA after tax season to
map out what potential deductions you may be missing out
on. Also develop a plan for how you will capture and store the
required documentation to sustain the deductions if audited.
Another subject to review with your dental CPA is
whether or not you are utilizing the most effective income
tax entity for your practice. Some dentists may benefit
significantly utilizing an S corporation to avoid a portion
of FICA taxes. Salary and S corporation profits must
be effectively managed to sustain this savings.
WEALTH MANAGEMENT
Your Portfolio
By now, you have no doubt heard that unnecessary “costs”
are anathema to long-term investing success. In fact, costs
are so influential that one or more studies has concluded
that if you simply picked mutual funds based on the
lowest fees—knowing nothing else about the fund—you
would out-earn the typical retail mutual fund investor.
The single largest cost in investing is federal (and state,
if applicable) income taxes. The study Ranking Mutual
Funds on an After-Tax Basis conducted by Joel Dickson
and John Shoven showed the growth of investing a
single dollar over a thirty-year period as follows:
Tax-Deferred Account
$21.89
Taxable Account
(high-income investor)
$9.87
Taxable Account
(middle-income investor)
$12.52
Taxable Account
(low-income investor)
$16.45
The high-income investor gives up 55 percent of his or her
accumulation over 30 years to income taxes. Even the lowincome investor gives up 25 percent to income taxes.
Consequently, we take tax planning for investment portfolios
very seriously. You can see from the table above that
managing investment taxes is crucial. Instead of chasing
the next hot stock or “beat the market strategy” you could
increase your long-term, after-tax return perhaps by a
percentage point or two without taking any added risk.
To be continued
Be sure to check out our next issue, when I
discuss how to tax-manage your portfolio.
Sam Martin is Director of Wealth Management Services and
Advanced Tax Planning for the Dental Group, LLC / Martin
Boyle PLLC / Dental Wealth Advisors, LLC , a CPA, practice
advisory, financial planning and Wealth Management services
group exclusively serving dentists and their practices. Sam is a
Certified Public Accountant (CPA), a Certified Financial Planner
(CFP), and holds a Masters Degree in Federal Income Taxation.
Located in Kirkland, WA— Sam can be reached at 425.216.1612
or [email protected].
There Is No Substitute For
Dental Experience and
Financial Expertise...
DentalGroup
LLC
Dental Practice Advisors
The Dentist’s CPA
(425) 216-1612
SM
SM
[email protected]
Integrated Financial Services
to Enhance Your Income and
Quality of Life
Members
www.adcpa.org
BUSINESS OF DENTISTRY
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PA
individual had coverage for one day
of the month, they are considered
covered for that month. For any
month that an individual did not have
coverage and was not exempt, that
individual is subject to penalties.
Five years ago, President
Obama signed the Patient
Protection and Affordable
Care Act (PPACA) in to
law. It was designed to
provide access to health
insurance across the full
socioeconomic spectrum
regardless of medical
history. Given this sweeping
change to our healthcare
system, the law established
a time frame during which
institutions and individuals
could adopt the new
rules and requirements.
S
tarting with the 2014 tax
filings, the proverbial rubber
met the road on compliance.
Individuals will now be required to
disclose coverage status on federal tax
returns. Since you and your employees
in your dental practice will be affected
by this mandatory reporting, you
need to know something about it.
Individual Tax Filings
Effective January 1, 2014, the PPACA
directed U.S. citizens and foreign
nationals residing in this country legally
to secure health insurance. All persons
required to file tax returns must certify
whether each household member had
health insurance coverage by month.
Each person within the household may
have had coverage and an individual's
coverage status may vary during
the course of the year. As long as an
If you or your employees did not have
coverage during the year, the minimum
penalty is $95 per person (discounted
to $47.50 for those under 18) and up to
$285 per family. Penalties increase as
a function of income with the maximum
reaching the national average premium
for a bronze plan ($2,448 per individual
per year or $12,240 for a family with
five or more members). Penalties for
2015 and 2016 will be even higher.
Starting this month, health insurance
providers may distribute statements that
document coverage for all individuals
in a household. When available, these
statements provide proof of insurance
for covered individuals and supply
information necessary to comply
with federal reporting requirements.
Three forms are available:
• IRS Form 1095-A will be issued to
individuals who procured insurance through
HealthCare.gov or a state marketplace.
• IRS Form 1095-B will be issued
by insurance carriers or large
employers who self-insure to
individuals who are covered under
employer-sponsored policies issued
by the carrier or large employer.
• IRS Form 1095-C will be issued
by large employers who sponsor
health insurance policies to all
employees covered under the policy.
The insurance exchanges are issuing
Form 1095-A in 2015. But health insurance
carriers and employers are not required
to provide this information until 2016
for the 2015 tax year, so you and your
employees may not receive formal
documentation to help prepare your 2014
returns. In such cases, you may use a
copy of your health insurance policy and
payment history as proof of insurance.
Small Employers
Dental practices with less than 50
full-time employees are not required
to provide health insurance or issue
reports on their employees’ coverage.
If your dental practice offers coverage
through a group plan, the insurance
carrier will supply this information.
If your employees procure their own
coverage, either their carrier or their
insurance exchange will attend to
reporting. However, if you self-insure,
your practice will be subject to the
same reporting requirements as large
employers (described next column).
Tax credits may be available if you
have less than 25 full-time-equivalent
(FTE) employees and you paid at least
50% of your employees’ healthcare
insurance premiums. These credits
are only available if you purchased
coverage through a Small Business Health
Options Program (SHOP) exchange.
Credits are applied as follows:
the insurance coverage they offer.
In 2016 this requirement applies to
employers with 50 or more full-time
employees. Each of their employees must
receive a Form 1095-C that reports:
• For 1-10 FTEs with wages averaging
$25,000 or less, you receive a business
credit up to 50% of premium amounts
you pay. The credit phases out up to
average employee wages of $50,000.
• The employee’s name, address, and
social security number as well as
identifying information (e.g., social
security number, date of birth) for
covered household members
• For 11-24 FTEs, the amount of credit
phases out as a function of the
number of employees and average
wage, with no credit available beyond
the $50,000 average wage cap.
• The offers of coverage made
by month, including availability
for household members
Your tax professional can help you
determine the correct amount.
Large Employers
If your dental practice consists of 50
or more full-time employees, you must
• The employer’s name, address,
employer identification number,
and contact information
• The employee's share of the
lowest cost premium by month
Tracking and reporting will likely entail
development of new information systems
and the associated administrative
procedures.
our
y
n
i
s
e
l oy e
p
m
e
r
t h is
u
y
o
b
y
d
d
e
n
t
f fec
ou a
Since y actice will be a need to k now
u
r
dental p r y repor ting, yo
o
mandat g about it.
in
someth
provide qualified health insurance
at rates that are affordable for each
employee. Coverage is treated as
affordable if the employee’s share of
the premium is less than or equal to
9.5% of the reported W-2 wages. Tax
penalties apply to organizations that
fall short of these requirements.
In January 2016 for the 2015 tax year,
employers with 100+ full-time employees
must supply detailed information about
BUSINESS OF DENTISTRY
While reporting requirements do not
go into effect until 2016, we’re working
with affected clients this calendar year
to prepare them for full compliance.
What Should You Do?
If your dental practice employs 50 or
more full-time-equivalent employees or
self-insures, contact your tax professional
as soon as possible. While you have a
one-year grace period before you face
reporting requirements, you may need time
to collect and track all of the information
for your employees and their dependents
by month. It may be difficult to pull it
all together if you wait until year-end!
If your dental practice is not subject to
reporting requirements, be prepared
to field questions from your employees,
especially if you participate in an
employer-sponsored group health plan.
They may be confused by their Form
1095—or by the absence of one!
Be prepared to direct them to the
appropriate resource—i.e., their insurance
exchange or independent insurance
carrier—to supply proof of insurance.
And of course, you might suggest that
they consult with their tax professional
regarding this year’s filings.
PLANMECA
ProMax 3D Family
®
Bob Creamer is the Director of
Dental Services at AKT CPAs
and Business Consultants, ranked
as one of the top 100 accounting
firms nationwide. He has been
working with dentists for nearly
four decades, helping practitioners
maintain efficient and profitable dental
practices. Bob knows the business of
dentistry and helps dentists understand
and apply key tax strategies to help them
keep more of what they earn to improve
their quality of life. Bob can be reached at
503.585.7774 or [email protected].
Ø5 x 8cm
ProMax 3Ds
Helping Dentists Reach Their Goals
Their Goals  Dental tax
planning
 Cost
segregation
 Practice
purchase
 Retirement
planning
 Transition
planning
 Dental practice
management
 Practice
valuations
Ø8 x 8cm
ProMax 3D
Ø16 x 9cm
ProMax 3D Plus
Ø20 x 17cm
ProMax 3D Mid
Versatile 2D/3D Imaging Technology
Patented SCARA technology, allowing limitless imaging possibilities
Offers optional ProFace 3D facial photos for advanced case presentation, operation
pre-planning, and treatment follow-up
Provides the tools to reduce radiation based on clinical need, including Planmeca’s
Ultra-low Dose Protocol, adjustable kV and mA, selectable volume sizes, and
pediatric mode for a 35% lower dose
Optional digital impression and cast model scanning available for ProMax 3D, 3D
Plus, 3D Mid, and 3D Max
Upgradable all-in-one technology
Bob Creamer, CPA Director of Dental Services www.aktadvisors.com
Ø23 x 26cm
ProMax 3D Max
Open-architecture Planmeca Romexis software included
Mac and PC compatible
To schedule a demo
please contact your Burkhart Representative
at 800.562.8176
CROWNING
moment
Night starts to fall on Dr. Greg
Dumitru and team in Morocco. The
volunteers worked late into the night
to ensure every person who waited
for hours had a chance to be treated.
Read more about their story on page 24.
Your choice again.
And again.
Thank you, Townie doctors, for consistently recognizing A-dec as the leader
across multiple categories. We are honored. Your choice is confirmation
that our solutions are making a difference for the right reason: you.
To learn more, call 1.800.547.1883 or visit a-dec.com/DentistsChoose.
Best
Patient
Chairs
(2003-2014)
©2015 A-dec Inc.
All rights reserved.
Best
Best
Best
Best
Best
Dental
Waterline
Operatory
Stools
Operatory
Cabinetry
Delivery
(2003-2014)
Lights
Systems
(2008-2014) (2003-2014)
Systems
(2003-2014)
(2003-2014)
William “Buffalo Bill” Cody
Now it’s your turn!
Discover the exclusive backpain-relieving advantages of
Brewer’s innovative Dynamic,
Split-Saddle-Seat Technology!
His production in the saddle
made him a legend…
Data shows that profit-robbing lower back
pain affects 81% of dental professionals,
which can lead to shortened work hours,
leaves of absence and shortened careers.
So what can you do to help safeguard
yourself and your team?
Optimize posture and production with
Brewer’s latest patented breakthrough!
• Unique 360º circular movement:
• Actively strengthens the core
muscles supporting the spine
• Allows natural movement while
maintaining a neutral posture
• Lessens lower back pain and
spinal muscle degeneration
• Patented split-saddle-seat design:
• Eases load on muscles by putting
weight on the “sit-bones”
• Lessens pressure on upper legs
when moving side-to-side
• Offers superior cooling comfort,
improved circulation and
reproductive health
Your production is only as good as the wellbeing of your team.
That’s why Brewer continues to lead the fight against profit-robbing
MSDs with the most innovative seating solutions available for
your entire team. Get the power to advance your health and
the health of your practice. Contact your equipment specialist
today or visit brewercompany.com.
135DSS

with the - Burkhart Dental Supply

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