Tuesday, July 15, 2014


A recent study showed almost 75% of private dental practices did not give across the board pay raises to staff members in 2013, relying instead on bonuses to reward staff.  Of those that did give raises, 72% limited increases to 2% to 3%.

There is a new 3.8% Medicare Payroll Tax on high income (above $200,000 if single; above $250,000 if married) earners’ unearned income; that is, dividends, interest, capital gains, and rental income.  However, the IRS recently reversed its position on one form of rental income, stating that rent the practice pays to the dentist-owner of the office building is not subject to the 3.8% Medicare Payroll tax.  Good news for dentists whose practice rents office space that is owned by that dentist.

As of April 8, 2014, Microsoft discontinued its technical support for Windows XP.  Windows XP antivirus software, Microsoft Security Essentials, will be updated regularly until July 14, 2015.  If you are a Windows XP user, it is time to consider transitioning to Windows 7, 8, or 8.1.  The HIPAA Security Rule requires covered practices to be aware of privacy threats and to implement security measures.  Older operating systems like Windows XP are more vulnerable to viruses, hackers, and data crashes, security risks that could expose users to liability in case of a data breach that compromises patient privacy or confidentiality.  Suggestion:  if your practice computer operates on Windows XP, contact your computer vendor as soon as possible for advice and help in updating to a newer Windows system.

The Supreme Court of the United States has agreed to hear a case in which the North Carolina Board of Dental Examiners “sought to, and did, exclude nondentist providers from the market for teeth whitening services.”  The Federal Trade Commission’s claim against the NC Board for violation of antitrust laws was upheld by the 4th Circuit Court of Appeals.  ADA general counsel, Craig Busey, stated, “This case is important because it threatens to impede the ability of all professional boards, including dental boards, to fulfill the purpose for which they were created….Boards’ actions should be protected from the federal antitrust laws under the well-recognized state action exemption.”  The SCOTUS will hear the case in its Fall 2014 session.       

Thursday, July 10, 2014


Prior to the 2008 economic crisis, the most significant changes to affect dentistry in over a decade had been: (1) increasing regulations via OSHA, HIPPA, EPA, and a number of other government regulations and monitoring agencies, and (2) changes in third party payer rules, regulations, and payment schedules. Shortly before and certainly following the 2008 economic turndown, many additional factors began to affect the dental profession.

Among these factors: passage of the Affordable Care Act; new dental care delivery models with wrangles over independent practice for hygienists, expanded duty auxiliaries, “whitening clinics”, and sealants applied by non-dentists; gigantic, multi-location practices; practices owned by management companies; PPOs and other preferred provider networks; changing payment schedules by third party payers; reduction in consumer demand for dental care; etc. We are also seeing the construction of more dental schools, among them for-profit schools; rising debt of dental students; lower income for many dentists; changes in dental benefits provided by employers; and changes in consumers’ choices of dental services.
Specifics about some of the changes:
  • The impact of the Affordable Care Act (ACA) is unclear, primarily due to the continuing number of revisions. There is also on-going confusion among insurance companies, Federal and State insurance exchanges, and consumers. Predictions are that under the ACA, payment for all healthcare services from any third party payer (private dental insurance, private-pay patients, or Medicaid) will be based on outcome or value rather than basing payments on      procedures as has been done historically. (Does that sound confusing? IT IS!!) Obviously, a successful outcome and perceived value of dental treatment are     subjective, not objective, judgments. Therefore, it remains unclear how payment schedules will be set.
  • 1990-2002—patient spending on dental care increased 3% to 4% annually. 2002-2008—flat to slight spending increases.
    2008-until now—spending flat or slightly decreased.
  • The percentage of adults without a “dental home” continues to increase, resulting in doubling the number of people who seek emergency dental care in a hospital emergency room.
  • In a 2012 survey, 42% of solo practitioners reported a “busyness” problem with open chair time that resulted in reduced production.
  • In spite of a decline in General Dentistry practice owners’ earnings for the past five years, non-owner dentists’ salaries have rebounded to the pre-2006 level which was a peak for dentists’ earnings. (Does this say that practice ownership is or may become a disadvantage? That concept flies in the face of the historically independent nature of the majority of dentists.)
  • Between 2000-2012, there was a significant decline in the demand for dental care by patients ages 21–64. However, dental spending for children and seniors (65 and over) increased during this same time period.
These and many other changes portend a new dental marketplace. All involved in the dental profession—private practitioners, administrators, educators, researchers, product and service vendors, and dental professional organizations must use all available data to plan successfully for the future. The one assurance is that the practice of dentistry will not remain as we’ve known it in the past.
The American Dental Association Health Policy Resources Center is the source of this information. For further details in the report plus many other facts about changes in the profession, go to www.ada.org. Choose the Science/Research heading and click on Health Policy Institute (formerly the Health Policy Resources Center).

Tuesday, July 8, 2014


Recently there has been much in the news about part-time employees in business and industry.  Some large companies have increased part-time positions to save the cost of having to provide health insurance to full- time employees under conditions of the Affordable Care Act.  Another topic under discussion that will affect both full-time and part-time is an increase in the minimum wage.  Many dentists too have begun to consider increasing the number of part-timers on staff for a number of other reasons.

Dentists are finding that part-time staff can be used to add to staff during busy production times and work fewer hours or not at all when production is down, thereby saving payroll costs.  Additionally, when the dentist is not seeing patients, it is understood that part-time staff will not be in the office in contrast to full-timers who expect to work a regular schedule.  Another reason, part-time work is often favored by women with children at home, thereby widening the field of potential staff members.   And part-time staff members familiar with patients and practice routine make excellent substitutes when full-time staff must be out.  Yet another reason for using some part-time staff is the cost savings from limiting or not providing fringe benefits.

One or more well trained part-time staff members may be a great boon for your practice.

Tuesday, July 1, 2014


While there are many website design and service companies, a particular one in which you might be interested is PBHS, a website and marketing services provider endorsed by the American Dental Association’s Business Resources, a wholly-owned subsidiary of the ADA.  PBHS, supporting the dental profession since 1977, custom-designs websites for dentists and provides on-going site and marketing services as well. 

An effective, attractive website design is a key to practice growth.  Further, your website must present a modern design with quality educational information about your services and procedures, a look at your office, and facts about the doctors and staff.  As fast as technology evolves, an effective website must be continuously edited, modified, and up-dated so that it invites perusal by those shopping for a new dental care provider.  In this social-media age, a dental practice must have an on-line presence that exemplifies the reputation an owner wants his or her practice to present.  Most new patients check out websites and, often, Facebook pages of a variety of practices before deciding which to call for a first examination appointment. 

Satisfied dental customers testify that PBHS-designed websites are easy to navigate, bring compliments from current patients,  and provide information to shoppers in ways that attract new patients.  For more information go to www.pbhs.com or call 1-855-WEB-4ADA (1-855-932-4232).

Tuesday, June 24, 2014


For the year 2015, 119 requests for CDT Code additions, deletions, and modifications came from practicing dentists and organizations within or servicing the profession.  The CMC (Code Maintenance Committee) was established by the ADA Council on Dental Benefit Programs to coordinate, evaluate, and accept or reject requests submitted for changes.  Twenty-one voting members of the CMC meet at ADA headquarters each year in late February or early March to address proposed changes.  The CDT set of Codes is intellectual property of the ADA, and it is the standard accepted by the federal government under HIPAA for reporting dental services on claims to third party payers.

If you have ideas for CDC Code changes to be considered in early 2015 for the year 2016 or simply want more information on the Code Maintenance Committee, visit www.ADA.org/3830.aspx.

Tuesday, June 17, 2014


Earlier this year U.S. News and World Report Ranked the top ten occupations in the U.S. using a number of factors, including work-life balance, job prospects, employment rate in that particular profession, median salary, stress level, and 10 year growth.  In order from First to Tenth, the top 10 were:

  • Software Developer
  • Computer Systems Analyst
  • Dentist
  • Nurse Practitioner
  • Pharmacist
  • Registered Nurse
  • Physical Therapist
  • Physician
  • Web Developer
  • Dental Hygienist
Dentists ranked #3 while Dental Hygienists earned the #10 place.  Dentists earned a median salary of $145,240 in 2012, the latest year’s figure available from the Bureau of Labor Statistics.  Further, the Bureau projects Dentists’ employment growth rate will be almost 16% between 2012 and 2022 with Dental Hygienists’ employment growing over 33% in that same period.  Dental Hygienists had a median salary of $70,210 in 2012 and an unemployment rate of only 2.8%.

Tuesday, June 10, 2014

CMS (Centers for Medicare and Medicaid Services) INITIATIVE FOCUSES ON CHILDREN’S ORAL HEALTH

Fall 2012 saw the launch of an oral health initiative to increase the percentage of children receiving preventive dental care and dental sealants as part of their enrollment in Medicaid or CHIP (Child Health Insurance Programs).  CMS is the federal agency that oversees Medicaid and CHIP in all states.  Low utilization of preventive services and sealants nationwide precipitated the oral health initiative.  Since the start of the push to increase utilization, states have been assembling task forces or other types of work groups to create plans to facilitate this initiative.

Dental caries is the most prevalent chronic infectious disease in children in the U.S.  This statistic is particularly puzzling when one realizes that caries in children could almost be eliminated with proper preventive care including sealants and healthy dietary choices.  The CMS initiative aims at elimination of caries in children enrolled in Medicaid and CHIP.

Some states have completed the planning process to meet the CMS initiative criteria; other states are in still in the planning process with the ultimate goal of caries elimination by improving access to preventive oral health services for children enrolled in Medicaid and CHIP.  If you are interested in how your state is addressing the CMS initiative or participating in the plans for your state, contact your state’s Department of Health and Human Services, Department of Public Health, or your state Dental Society for more information.