Tuesday, November 18, 2014


PLEASE!  Don’t skip reading this blog, thinking, “I don’t need encouraging.” or “Nothing you say can make me feel better right now.”  Please stick with me as I share a personal story with you.

This summer, July 2014 to be precise, I had a battle with a life-threatening disease.  My surgeon and I were victorious with the help of prayers from family and friends.  During my recovery, I received many messages from well-wishers.  One card in particular begs to be shared with others.  It came from a long-term dentist/client/friend.  The message of encouragement was written as a poem, and my friend added his own words that buoyed me as I read it initially and re-read it on long difficult days.  Perhaps you or someone you know can use just such a message now:
            “A mighty wind blew night and day.  It stole the oak tree’s leaves away.  Then snapped its boughs and pulled its bark until the oak was tired and stark.  But still the oak tree held its ground while other trees fell all around.  The weary wind gave up and spoke, ‘How can you still be standing, Oak?’  The oak tree said, ‘I know that you can break each branch of mine in two, carry every leaf away, shake my limbs, and make me sway.  But I have roots stretched in the earth, growing stronger since my birth.  You’ll never touch them, for you see, they are the deepest part of me.  Until today, I wasn’t sure of just how much I could endure.  But now I’ve found, with thanks to you, I’m stronger than I ever knew.’” 

The Hallmark card listed no author.  I thank my friend who chose to encourage me at such a time, and I thank the author, whoever he or she may be.

Friday, November 14, 2014


What reputation does your practice carry in your community?  How visible is your practice to patients and potential patients in your area?  How is your practice different from other dental practices in your city?  Would you agree that branding (establishing a distinct identity for a business or organization) is not just for the “big guys” (big business), but is vitally important for a small business (your dental practice) as well?

Pew Internet Research, a respected source of opinion polls and surveys, says that 72% of Internet users look online for health information, and 93% of Americans ages 30 to 49 use the Internet.  That is a significant audience to reach.

Branding, the identity you establish for your practice, can be assured by a consistent online presence beginning with your Website.  Suggestion:  if no one on your staff has the skill or time to keep your online communications up to date, hire a reputable professional designer to coordinate your online efforts such as your Website, Blog, and Social Media postings.  Make certain your Website links to your Blog postings as well as your Social Media sites.  Conversely, create a link from your Blog and Social Media outlets to your Website.  Make certain either a knowledgeable staff member or the outsourced professional keep your Blog and Social Media sites up to date with fresh ideas and information.

The branding coordinator, whether an outsourced professional or a dental team member, should also assure your practice profile is active and accurate on Patient Review sites such as Google + and Healthgrades.com.  Further, your branding coordinator should optimize your Website’s visibility through search engines, monitoring results of patient searches, and linking your Website through all relevant-to-dentistry sites.

Make certain all references to your practice, whether print media, signage, or online, use the same name.  If your practice name differs from your own name (John H. Doe, DDS vs Doe Family Dentistry), use the practice name rather than your own in all cases of branding/marketing.  This assures that the identity of your practice is consistent across all online and offline marketing efforts.

Think of an example of big business branding---think of TARGET, the giant retailer.  The red color and the concentric-circle target make all TARGET ads distinctive and memorable whether seen online or received offline via print media.  Transfer that type of instant recognition to your practice with creative ideas generated during some brain storming sessions with your dental team.  While your own branding efforts may be more subtle that those of TARGET, you get the idea.  Go with it!

Monday, November 10, 2014


Whether developed from among current experienced staff members or newly hired to manage the practice, a Practice Administrator can be an invaluable asset in the process of strategizing, growing, and managing a busy dental office.  Besides helping with business operations of the office and the “thousand and one” details that must be handled on a daily basis, the addition of a Practice Administrator can be a tremendous stress reliever for the Dentist.  Imagine doing what you, the Dentist, trained for and enjoy while leaving the nitty-gritty details of every day practice management to your Administrator.

A Practice Administrator may be compared to the Chief Operating Officer (COO) in a corporation.  He/she helps the Dentist who is actually the Chief Executive Officer (CEO) strategize and set goals for the practice, including establishing production and collection goals; deciding marketing/branding efforts; and overseeing compliance issues for HIPAA, OSHA, and other government-imposed standards.  In addition, the Administrator can serve as the Dentist’s right hand in matters of overall operation of the office, its physical facility, its business protocols, and its personnel issues.  The Administrator can also act as liaison with the practice CPA, Attorney, and IT experts who service the computer and other electronic devices.  He or she can oversee financial activities such as writing an annual budget including realistic goals for income (collections) and expenses (overhead).  She or he can serve as the HR (Human Resource) director to coordinate interviewing, hiring, and performance appraisals for the team.  An astute Administrator will refine the practice ambiance by building teamwork, improving communication between team members, and encouraging/empowering staff to become the best they can be.
Dentists who employ a Practice Administrator attest to more enjoyment along with significantly reduced stress in their practice.  If you decide to develop such a role in your practice, remember you, as owner, retain the right of refusal/veto power over every aspect of the practice.  While a carefully chosen and well trained Practice Administrator can be a valuable addition, the Dentist must be the ultimate authority in the operation of the office.  Those offices in which I have seen a Practice Administrator function effectively are those in which the Dentist welcomes and seriously considers suggestions and initiatives from the Administrator.  The two confer frequently, thoroughly analyzing and considering ideas to improve the practice in any way.  They usually come to consensus, but if not, both understand that the dentist is the final word.       

Tuesday, November 4, 2014


The Supreme Court of the United States (SCOTUS) has agreed to hear a case that will affect not only Dentistry, but all professional associations in the country.  North Carolina Board of Dental Examiners (NCBDE) VS FTC is scheduled to be heard by SCOTUS before the end of the year.  While ostensibly about tooth whitening, the case is really about the continued ability of all professional boards to fulfill their state-appointed regulatory duties.

Brief background information:  A number of dentists in NC were concerned by the lack of standards for operation or well-trained professional providers for tooth whitening services from such places as unlicensed mall kiosks and storefront offices.  The NCBDE, charged with helping to safeguard the public’s oral health in many ways, responded by performing its regulatory duties, ordering closure of such facilities.  Complaints to the FTC resulted in a ruling that antitrust/restraint of trade laws had been violated by the NCBDE.  Next, the FTC took issue with the state of NC regulation that the agency which oversees the practice of dentistry in the state; i.e., the NCBDE, should consist primarily of practicing dentists.  (READ THAT SENTENCE AGAIN---UNDERSTAND ITS FULL IMPACT.  IF, IN FACT, DENTISTRY OR ANY OTHER PROFESSION WERE REGULATED BY PERSONS WHO HAVE NO TRAINING OR KNOWLEDGE OF THAT PROFESSION, REGULATION WOULD BE IMPOSSIBLE.  HOW RIDICULOUS!)  An appeal to the Fourth Circuit Court resulted in the decision that since members of the NCBDE are elected by practicing dentists in North Carolina, the Board is a “private actor”, and, therefore, subject to federal antitrust/restraint of trade laws.

The decisions by the FTC and the Fourth Circuit Court will lead to elimination of immunity to federal antitrust/restraint of trade laws for all state professional licensing boards.  Numerous professional boards in addition to many boards of dental organizations plus the Attorneys General in 23 states have filed “Friend of the Court” briefs in support of the NCBDE’s position that it should continue to operate under immunity from antitrust laws, just as it has in the past.

Increased media attention to the up-coming SCOTUS case means dentists all over the country should be prepared to answer patients’ questions about this matter.  In answering those questions, emphasize that this is far from a battle over tooth whitening.  It is a case in which a negative decision by SCOTUS threatens the ability of all professional boards to perform their state-appointed regulatory and licensing duties designed to hold the particular profession and its providers to standards and to protect the public without fear of antitrust/restraint of trade law suits.  Professional boards of all disciplines are most concerned, rightly so, about the outcome.

Monday, October 27, 2014


Gordon MacDonald, pastor and author for over 40 years and Pastor Emeritus of Grace Chapel in Lexington, Massachusetts, writes of ways to improve one’s life by changing two things:  (1) your Thought Processes and (2) your Expectations.  The health of both these qualities are vital to success in life.

Those who have not been taught how to think or who have allowed their mind to grow lazy often live lives according to the thoughts and opinions of others, existing by following rules, regulations, and apps with no original thought or creativity intruding on their routine.  Such individuals are in a proverbial rut---how sad.  Instead, the successful person dares to pursue new knowledge, seeks ways to stimulate the mind and grow thought processes, moves on well thought-out plans, and takes calculated risks.  Success most often follows such efforts.

The second aspect MacDonald discusses, Expectations, means raising the bar, increasing your expectations.  An old story tells of a man who went to a fortune teller to learn about his future.  She told him, “You will be poor and miserable until you’re fifty.”  “What happens then?”  he asked.  Her answer:  “By then you’ll be used to being poor, and misery will cease.”  Message from this little tale:  only by raising expectations, ridding oneself of apathy and negativism, will a person move higher up the success ladder.  Raise your expectations to experience new challenges, increased enthusiasm, renewed commitment, and higher energy levels.  Greater success will follow.

Monday, October 20, 2014


When I ask dental consulting clients that question, I typically get a puzzled look, a shoulder shrug, or a rough “guess-timate”. However, monitoring the number of active patients is to the health of your practice as important as monitoring blood pressure is to the health of a person. The effectiveness of your Recare System, key to practice growth, production, and profitability, is predicated on the number of active patients.
An active patient in General Dental Practice may be defined as one who has received treatment or hygiene care within the past 24 months, NOT including single visit emergencies. In Pediatric Dental Practice, an active patient may be defined as one seen for treatment or recare within the past 12 to 18 months, NOT including emergencies seen for a single appointment. Your computer system should have the capability of generating an active patient count upon demand, and that number should be on the monthly report you, the dentist, receive from your business staff.
If a practice has 2000 active patients, each of whom should be seen for hygiene care every six months, one can calculate:
  • 2000 active patients, each seen every 6 months = 333 recare patients/month       
  • Actual average = 160 recares/month = 48% effective system            
  • Goal = 70-80% effective Recare System            
  • 70% effective system with 2000 active patients = 233 recare appointments/month
AN EYE OPENER: Multiply the additional 73 recare patients per month given in this example by your average recare fee (with or without X-rays or other additional procedures) to calculate the additional production in a month. WOW!!!

Monday, October 13, 2014


Among countless compliance standards that are now on the “MUST DO” list for dental practices, three standards/regulations rank near the top of the list for all covered practices.  “Covered” refers to all practices that store or transmit any patient data electronically, including filing third party claims and payment information; that is, the vast majority of practices in the U.S.  Two of these regulations involve HIPAA standards and one involves standards set by the payment card industry to protect debit and credit card information.

The HIPAA standards include (1) the Risk Analysis and (2) the Security Management Process.  The Risk Analysis standard requires all covered dental practices to actively assess vulnerabilities and risks to the confidentiality of protected health information held by the practice.  The Security Management Process requires covered practices to act on that assessment of risk by implementing security measures which bring the practice to a point of compliance that reduces risks and vulnerabilities to a “reasonable level”.

Basically, these two standards mean covered practices must conduct an assessment of risk and then put measures into place to respond to perceived privacy threats.  The risk assessment should include evaluation of privacy protection when speaking with patients in the office; when corresponding with patients by telephone, email, or posted mail; when transmitting patient health data to another health care entity; and when storing patient data electronically via your office computer system and on mobile devices.

Additionally, the risk assessment must include evaluation of your computer operating system’s ability to protect against hacking attacks, viruses, and such.  It is your responsibility to keep your computer system current so that it is sufficiently supported by the vendor to avoid data loss, viruses, crashes, etc.  Reminder:  as of April 2014, Microsoft no longer offers technical support for Windows XP operating system.  Therefore, if your practice still uses Windows XP, plan immediate replacement with a new system that receives regular software updates and technical support.

The third standard has to do with payment card protection, involving measures that must be implemented to protect patients’ payment card (credit or debit) data.  These measures include protection of payment card data at the time it is given by a patient to pay for services in your office and when the data is stored and transmitted electronically by your office computer system.

For more information on the HIPAA regulations, go to:  ADA.org/8753.aspx or the Office of Civil Rights at hhs.gov/ocr/privacy.  For additional information on the Payment Card Industry Security Standards, visit:  pcisecuritystandards.org.