Monday, May 21, 2018

NEW TAX LAW INVOLVES CHANGES TO SOME DEDUCTIONS

Confusion reigns concerning the new tax law regulations for deductions for business travel and meals, continuing education expenses, and entertainment. Under the new law, some tax deductions remain the same, some have changed, and others have been eliminated. The clearest, most concise explanation I have read about these deductions that affect virtually every dental practice is in the April issue of The McGill Advisory. A summary follows, but I urge you to access the entire article entitled "How to Get the Biggest Tax Deduction for Business Travel and Meals Under the New Law." Contact information for The McGill Advisory is at the end of this article.

Summarizing The McGill Advisory article:

100% deductible expenses:
  • Costs for business travel, lodging, and CE expenses remain 100% deductible.
  • Some meal and entertainment expenses are still 100% deductible, including (1) snacks and beverages available for patients in the office reception room and at patient-related events such as open houses, patient appreciation parties, and practice-sponsored events to educate patients about particular treatment modalities, and (2) events for the benefit of staff members, including staff parties, trips, entertainment event tickets, health club memberships, and so on.
Suggestion: Use a separate Chart of Accounts code for the 100% deductible expenses listed above to make certain full deductibility is taken and to separate these expenses from Business Meals which are still 50% deductible.

50% deductible expenses:
  • Costs for food and beverages supplied in the office for staff members are 50% deductible, including snacks, meals at staff meetings, take-out lunches to replace a missed lunch break, etc.
  • Business meals with patients and/or other health care providers and referral sources and meals while traveling away from home on business-related trips are also 50% deductible.
Deductions which have been eliminated include:
  • Entertainment for patients and/or other health care providers or referral sources, including tickets for sporting, theatrical or musical events, hunting, fishing, or sports trips, and so on.
I urge you to discuss this information with your accountant for clarification for your office. Together, you can choose expense codes to clarify the various categories of expense so that costs are properly separated as they are paid throughout the year. Doing so will avoid much confusion and many questions at tax preparation time.

For years I have advised my consulting clients to subscribe to The McGill Advisory, a comprehensive practice and personal/financial management newsletter published monthly. The article about changes in tax deductions in the April issue is an example of why I highly recommend the publication to dentists. Incidentally, I have no connection whatsoever with the McGill organization; I simply urge my clients to take advantage of the valuable information included in each monthly issue. For more information about the McGill Group, The McGill Advisory and how to subscribe, visit the group's website at mcgilladvisory.com or email questions to newsletter@mcgillhillgroup.com.

Monday, May 14, 2018

GLOBAL EPIDEMIC OF DENTAL CARIES

Since the 1960s, worldwide sugar consumption has tripled, and experts predict an even greater increase in the next generation, particularly in emerging economies. Health care providers are well aware that sugar is consistently named among the leading risk factors causing higher rates of dental caries, obesity, and diabetes. In an effort to educate the general public, alert consumers, and combat this public health problem, the World Health Organization (WHO) and the FDI World Dental Federation have cooperated since 2015. Both organizations emphasize and publicize the WHO guideline that recommends a daily intake of free sugars be limited to less than 10% of total energy intake for children and adults, that is, less than 50g (12 teaspoons) daily. Free sugars are all sugars added to foods by manufacturers, cooks, or consumers as well as sugar found naturally in honey, syrups, fruit juices and fruit juice concentrates.

If you and your staff would like to enhance the awareness of patients and others in your community about the relationship between nutrition and oral health, consider sharing the following facts with them. Besides a significant reduction in dental caries, the most prevalent non-communicable disease in the world, a diet lower in free sugars can reduce obesity and related diseases.

FACTS ABOUT SUGARS AND DENTAL CARIES

  • Dental decay is preventable, yet it is the most widespread non-communicable disease among adults and the most common childhood disease globally.
  • In the U.S., an estimated 16 million children have untreated dental caries with the resultant pain and complications listed as the main reason for school absenteeism.
  • Treatment of dental decay consumes 5%-10% of healthcare budgets in industrialized countries.
  • Sugar is a common risk factor in dental decay, and it negatively affects many other non-communicable diseases, including cardiovascular diseases, obesity, cancer, and diabetes.
  • Currently, 33 states in the U.S. have imposed taxes on sugar-sweetened beverages with the average tax rate being 5.2%.
  • Consuming free sugars more than four times daily significantly increases the risk of dental caries.
  • One 12 ounce can of sugar-sweetened beverage contains an average of 8.3 teaspoons of sugar.
  • Consumption of one can of sweetened beverage per day can cause an average 2 pounds per year weight gain.
  • People in 65 countries worldwide consume more than 100g of free sugars per person per day, over twice the recommended amount.
  • Both frequency and quantity of sugar consumption affect the worldwide dental caries epidemic.
Around the globe, individual dental practices, clinics, dental schools, and a variety of dental organizations have an excellent opportunity to educate patients and the general public about the dangers of the dental caries epidemic. One excellent reference published by the FDI World Dental Federation is entitled Sugars and Dental Caries, A practical guide to reduce sugars consumption and curb the epidemic of dental caries. For more information, contact info@fdiworlddental.org or see the WHO guidelines on sugar intake for adults and children.

Monday, May 7, 2018

A NEW CDT CODE TO ADD TO YOUR SCOPE OF SERVICE

Did you know that nearly 50% of the U.S. population has diabetes or are at high risk for developing diabetes? The CDC reports that of those at high risk, estimated at 86 million people, about 90% are unaware of their prediabetic condition.

Think about the impact dentists could have on the health of this enormous prediabetic and diabetic population if chairside glucose screening were available regularly, perhaps as part of the initial examination and every two to three years thereafter as part of a recare examination. While the ADA currently has no official policy statement concerning diabetes screenings, the Code Maintenance Committee of the ADA Code on Dental Procedures and Nomenclature approved a new CDT code in October 2017 for chairside glucose screening procedures.

DO411 Hb1Ac in-office point of service testing covers finger-stick glucose random capillary testing. Results of this chairside testing can be given to the patient’s physician for follow-up and may provide valuable treatment planning information for the dentist.

Also in 2017, the American Diabetes Association added “Screening in Dental Practices” to its written Standards of Medical Care in Diabetes. This document mentions the fact that “periodontal disease is associated with diabetes” and recognizes the usefulness of chairside screening followed by referral to primary care physicians if necessary as a means of early diagnosis and treatment of prediabetes and diabetes.

Although the ADA has not issued an official policy statement about diabetic screening in the dental office, it does offer an online CE course about oral diseases and conditions related to diabetes. For information about the course, visit ADA CE Online and access the course by title, Diabetes Mellitus and the Dental Professional.

Also, following the CDT Code Committee meeting in late 2018, watch for news of a second CDT code dealing with chairside diabetic screening. The Committee may consider requests to cover diabetic screening in the dental office using glucometers rather than the significantly more expensive HbA1c screening devices. If approved, the Committee will issue a new CDT code to cover that procedure. Experts have commented that use of the less complicated, less expensive glucometer may encourage a number of dentists to add chairside screening to their scope of services, thereby adding an important tool in early diagnosis of prediabetes or diabetes.

Monday, April 30, 2018

SEALANTS ARE OFTEN THE UNSUNG HEROES OF PREVENTION

A number of years ago, a friend in a dental office gave me an eye-catching acrostic entitled, DO SEAL OUT DECAY. She had written the piece and printed it for distribution to parents and caregivers of young patients in their practice. Written in layman’s language, the acrostic pattern caught the reader’s attention and made the information more interesting and memorable. With her permission, I invite you to use the acrostic in your own practice as a brief, convincing explanation of the efficacy of sealants to young patients’ caregivers/parents.

Decay is caused by a sticky substance called plaque that forms on tooth surfaces and interacts with sugars to produce acids that attack and damage tooth enamel.
Over and over again, repeated acid attacks break down the enamel until a cavity is formed, destroying a portion of the tooth.
Sealants are one more tool that dentists use in the fight against decay.
Even brushing cannot always clean the pits and grooves of the molars or premolars where decay most often occurs.
Aclear or shaded resin sealant can be applied to the chewing surfaces of these teeth, forming a protective barrier.
Loose bits of food and dental plaque can no longer sneak into these snug places to begin the decay process.
Optimum benefits are seen when sealants are applied to newly erupted permanent teeth.
Usually, sealants can be expected to last several years. They will be examined during regular dental check-ups to be sure they are still in place, providing protection for the chewing surfaces of teeth.
The American Dental Association (ADA) recognizes that sealants can play an important role in preventing decay. However, total prevention must still include regular dental visits, use of fluorides, daily brushing (at least 2 or 3 times daily) and flossing, and limiting sweets in amount and frequency.
Dentists, hygienists, and assistants work together to apply sealants.
Each tooth takes only a few minutes to seal.
Cost of sealants per tooth to prevent decay are less than the cost of fillings to repair decay.
Ask our staff for more information about sealants.
You will be glad you did, and your child will have one more protection against decay!

Monday, April 23, 2018

PATIENTS—ARE THEY THE STARS IN YOUR PRACTICE?

Question: How often does your dental team focus on the front-and-center importance of your patients? Without patients, there is no practice. Your patients are your raison d’etre, something every team member must believe and buy into.

Over 20 years ago, a staff member in an office with which I was consulting gave me the following description of a patient. She wrote it following a discussion we had about the proper way to value patients. Consider making this piece a sort of mantra for your team. Prepare a copy for each team member as a constant reminder of the supreme importance of patients. Read it aloud at staff meetings throughout the year.

Remember, Doctor, your team members will follow your lead. When you are determined to treat patients like the stars of your office, your staff will do likewise.

WHAT IS A PATIENT?

  • A patient is the most important individual ever in this office, either in person or otherwise.
  • A patient is not dependent on us; we are dependent on him.
  • A patient is not an interruption of our work; she is the purpose of it. We are not doing her a favor by serving her; she is doing us a favor by giving us the opportunity to do so.
  • A patient is not an outsider to our practice; he is an important part of it.
  • A patient is not a cold statistic, a name on a ledger card or a computer screen. She is a human being with feelings, emotions, biases, opinions, and prejudices like our own.
  • A patient is not someone to argue with—nobody ever won an argument with a patient.
  • A patient is a person who brings us his needs. It is our job to meet those needs with tender loving care, and to do so profitably—to the patient and to ourselves.