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Growing the Practice

Part 1: Taking the leap to practice ownership? These ADA resources can help

Let me start off by saying that opening my own practice from scratch was one of the scariest moments in my life thus far. I knew I had a good portion of dental knowledge amassed over the last few years, but what did I know about running a business? I could sit down and talk to patients about decay and occlusal wear; however, could I sit down and talk to a team about the goals of the practice and how to achieve them? What about how much my fees would be for my services, and what insurances I should take? How would I go about preparing my office for HIPAA and OSHA protocols?

Dr. Sinclair

Dr. Sinclair

Many of these questions I later found out could be answered through various departments and locations through the ADA’s resources. In this article, I will be discussing several of those resources that can be huge assets when you decide to make the leap into practice ownership.

ADA Benefit Plan Analyzer 

Shortly after setting up my own practice, I was contacted by one of the local representatives of a dental benefit plan. They wanted to know which carriers I would be in network with and also inquired about participating with them.

Since I was just starting out my own practice without any patients, I knew that participating with insurance plans would provide me with an influx of patients. However, I wondered what it would cost me down the road. Just as a refresher, if I became a contracted provider with this insurance company, I would be held to their fee schedule and would only be allowed to charge a patient what they had deemed an appropriate fee. For example, let’s say if normally I were to charge $1,200 for a crown but the insurance company only allowed a charge of $800 for their patients; then I would be looking at a loss of $400 in profit without even picking up the hand-piece. Looking on the opposite spectrum I also had to consider that by becoming a participating provider I may have an increase in 25 new patients a month as opposed to 5 without participation.

This arises the question of how do you know when it makes sense financially to participate with an insurance company? Well, good news, the ADA has developed a benefit plan analyzer that gives you information to see if participation with a certain insurance company makes sense for your office. The program will actually sync with your current system and give you a rating from one to 100—100 being in the best interest and financially speaking for the dentist to participate with the plan. There is nothing worse than starting a practice participating with 10 or 15 insurance plans only to be busy but not productive. It can be a very tough road to recovery from there, which is why I recommend you take a look at this program to help you make those decisions from both a capacity and financial perspective.

This blog post, reprinted with minimal edits and permission, originally appeared in the Virginia Dental Association journal. Dr. Cappy Sinclair is a New Dentist Now guest blogger and a 2009 graduate of Virginia Commonwealth University. Dr. Sinclair currently serves on the Board of Trustees at the Academy of Cosmetic Dentistry, as member of 3M’s Council for Innovative Dentistry, and as an ambassador for the Dawson Academy. He started his own practice Coastal Cosmetic Dentistry 3 years ago from the ground up and is more than happy to share his success and failures with fellow new dentists. He is a member of the American Dental Association and the Virginia Dental Association. To contact Dr. Sinclair, email him csinclair@smilevabeach.com.

2015 ADA/Kellogg executive management program registration opens

New dentists and office management staff seeking to enhance their business experience and acumen with enhanced management skills and business principles can register by July 1 for the 2015 session of ADA/Kellogg Executive Management Program.

KelloggIn its 11th year, the executive-level program, organized in collaboration by the ADA and Northwestern University Kellogg School of Management, consists of specially designed curriculum for dentists to learn more about business management from one of the nation’s top-ranked management schools.

“Dental school and my orthodontic residency taught me the clinical skills I needed and I learned the necessities of running a practice over time, but I always felt like I was missing the business fundamentals that would that allow my practice to thrive,” said Dr. Spencer Pope, a 2014 graduate of the program and who has been in practice for 16 years.

“Unfortunately, you don’t know what you don’t know, and dentists tend to lack the business fundamentals that almost all other sectors of the economy utilize on a daily basis,” he added. “This program helps to level the curve and provide you with a knowledge base to go forward.”

Based on the core curriculum of incoming Kellogg Master of Business Administration students, the program addresses business strategy, organizational leadership, marketing, finance, accounting, economics, business analytics and operations. Kellogg professors teach all courses.

The 12.5-day program is held at Northwestern University’s Chicago campus, near the ADA headquarters. The 2015 sessions are set for Sept. 18-21, Oct. 23-26 and Nov. 13-17.

Registration fees are $16,750 for ADA members and $17,750 for nonmembers. Fee includes tuition, course materials and most meals. Tuition does not include travel and lodging. ADA members receive discounts on select Chicago hotels. Registrations are accepted on a first-come, first-served basis.

To register, visit ADA.org/Kellogg or contact Connie Paslaski at the ADA toll-free number at ext. 3541, or email ADAKEMP@ada.org.

Data aids new dentists in deciding where to practice

Wouldn’t it be nice if simply putting a wet fi nger in the wind were enough to fi gure out where to open a new dental practice — or where to fi nd work at an existing one?

Dr. Partha Mukherji of Forth Worth, Texas (middle), launched a private practice in 2012. Here he participates in a table breakout session at the 2012 ADA Evidence-Based Dentistry Champions Conference in Chicago.

Dr. Partha Mukherji of Forth Worth, Texas (middle), launched a private practice in 2012. Here he participates in a table breakout session at the 2012 ADA Evidence-Based Dentistry Champions Conference in Chicago.

Knowing which direction to take when making such important career decisions takes more data than that, of course. Thankfully, brave souls have paved the well-worn path to opening a new practice or deciding where to seek a position. Some have left a trail in the form of advice for new dentists.

Dr. Partha Mukherji of Fort Worth, Texas, for instance, has a few trail tips to share on figuring out where to open a practice. He graduated from Baylor College of Dentistry in 2001 and from the University of Texas School of Dentistry in Houston in 2002, where he completed a one-year postgraduate general practice residency in hospital dentistry focusing on the treatment of medically and physically compromised patients. Then he went to work as an associate.

“After practicing 11 years as an associate in private and corporate settings, I felt confident that I could do dentistry on my own,” he said. “Still, I wasn’t too confident on the business aspects of dentistry. In hindsight, I probably should’ve established my own office sooner. But, hindsight is 20/20.”

Foresight, with data, can also be 20/20. Before deciding where to hang a shingle and open for business, Dr. Mukherji consulted professionals. One of the first things he did was call on a reputable dental practice real estate agency. He made his choice of business location largely based on their assessment of the area. They helped Dr. Mukherji review such variables as demographics and the saturation of dentists in the area.

But Dr. Mukherji also calculated his decision based on certain personal preferences. “I lived in the area, was active in the area and wanted to practice in that area,” he said. He also asked friends, colleagues, specialists and dental vendors for their input. “I found that to be valuable, too,” he said.

Dr. Mukherji advises tapping ADA resources, such as statistical reports. The ADA also refers member dentists to data sources to explore when assessing where to practice. A few suggested resources:

US Census Bureau — Factfinder: Provides population information on household income, education, and many other demographics. Start by entering a city or zip code under the “Community Facts” heading in the left column.

2013 Color-coded zip codes, median household income: Provides a color-coded overview of zip codes ranked by income and education level. Clicking on the map will bring up additional details about the zip code’s income and education level. To locate the map, search the newspaper website for “super zips.”

Wells Fargo Practice Finance: Provides statistical information, including population variables for both residential and employed populations; socio-economic indicators including economics, education and housing; and number of existing practices in designated area.

Why new dentists need a legal entity

So you’ve decided to open your own dental practice. Now that you’ve told your family, friends, and dental school buddies, it dawns on you…you don’t actually know how to open a practice.

Rich McIver

Rich McIver

In this blog we’re going to walk you through some of the basic requirements needed to open a practice, and provide you practical steps that you can take to get your practice off the ground.

The first step to starting a dental practice is a pretty mundane one: legally forming a company entity. A legal entity is simply a company that is recognized and registered with your state. Your legal entity can be a Corporation, a Limited Liability Company, a Partnership, or any other business type that your state recognizes. It is distinguished from running your business via a sole proprietorship, or other arrangement which is not registered or recognized by your state.

Why do Dentists Need an Entity?

The short answer is you don’t. There’s no law requiring that you run your practice via an entity, you can run it as a sole proprietorship (which in plain English means, “in your own name”). However, here are some pretty good reasons why you’ll want to have an entity:

  • Legal Protection

The biggest reason to form a dental business entity is that it means that your business is separate, legally speaking, from you. That’s useful because if you get sued personally, which could happen for a variety of reasons—such as a guest slipped and fell at your house, you default on your home mortgage, or you get sued for medical malpractice—then the assets of your business aren’t subject to the lawsuit. That is to say, if the lawsuit against you is successful, they won’t be able to take your business. Same thing applies if your business is sued. If the lawsuit is successful, they won’t be able to seize your personal assets. In effect, it creates two separate pots, and a successful lawsuit can only raid one of those pots if you’ve used an entity.

  • Accounting Transparency

A second reason to form an entity is accounting transparency. By having your business run as a separate entity you’ll have separate bank accounts, separate accounting, a separate line on your tax return to report the earnings, etc. That accounting separation is necessary if you’re ever going to try to bring in a business partner, sell a business, or even just properly calculate your taxes. Can you do these things with a sole proprietorship? Technically yes, but it’ll be such a mess trying to disentangle your personal expenses from your business expenses that nobody, whether it be a partner, a buyer, or the IRS is going to believe your calculations and thus your valuation or tax liability will be worse than it otherwise would be.

  • Business Credit Separated from Personal Credit

Another reason you want to create a separate legal entity is that you can start to develop business credit that is separate from your personal credit. In plain English, the loans you take out in the business’ name, whether for equipment, a building, etc. will go on your business’ credit report, and not your own. That’s a good thing for two reasons: first, if either your business or your personal credit isn’t squeaky clean you’ll have fewer problems; second, you can generally borrow more money in total if they’re separated, which as a new dentist trying to start a practice and likely carrying a mortgage, that’s a good thing.

In sum, it’s not legally required, but it’s a good idea to form a separate entity to run your dental practice in.

In the next article, we’ll cover what type of entity you should form, what elections to make, how to actually do it, and how much it will cost you.

For information on ADA legal resources, click here.

Rich McIver is a New Dentist Now guest blogger. He graduated from the University of Notre Dame in 2005 and obtained his law degree at the University of Chicago Law School in 2008. After graduating law school, Rich founded and managed three tech startups that were each acquired through private equity, private sales and a merger, respectively. In 2010, he founded and managed a Houston-based plaintiffs law firm which he sold via a buyout in 2014. In 2013, he and his wife, Holly McIver, an ADA member dentist, founded Kingwood Orthodontics, where he continues to manage back-office operations. His current project is running Merchant Negotiators, a Web startup based in Houston. Rich provides practical actionable advice for new dentists based on his experience starting and building successful businesses.

The purpose of this article is to promote awareness of legal and other issues that may affect dentists and dental practices, and is not intended to provide either legal or professional advice. Dentists are urged to consult directly with a properly qualified professional or with an attorney admitted to practice in their jurisdiction for appropriate legal or professional advice.

New Dentist Conference Joins ADA 2015 – America’s Dental Meeting

The ADA is pleased to announce that for the first time, the New Dentist Conference will be held at the ADA annual meeting from November 5-10 in Washington, D.C.

New Dentist Conference 2015Features of the New Dentist Conference include:

  • Shark Tank co-star Daymond John as keynote speaker.
  • Exclusive, interactive educational offerings.
  • High-level networking opportunities with leadership and peers.
  • New Dentist reception and lounge.
  • Significantly reduced hotel rates.
  • A chance to give back at the ADA Mission of Mercy.
  • We encourage you to share this information with any dentists who have been out of school for ten years or less as this is an experience they won’t want to miss.

Registration for the New Dentist Conference at ADA 2015 opens May 13 — a full week earlier than general registration! For more information, visit ADA.org/NDC.

ADA offers resources for new dentists, dental students

Recognizing that dental students and new dentists have different needs, the ADA offers a plethora of services, resources and benefits to help them succeed in their professional and personal lives.

“As dentist, we are professionals, and the ADA is our professional organization,” said Dr. Chris Hasty, vice-chair of the ADA New Dentist Committee. “I see the ADA as the lighthouse of dentistry, guiding our profession to a safe and ethical future, and steering us away from the dangers of outside entities.  As new dentists, we have our whole career ahead of us, and the ADA is here to help and see us prosper.”

Dental students and new dentists receive benefits all other members get, including travel benefits, health and wellness information, continuing education programs and access to care initiatives. However, certain ADA products and services are tailored to their needs.

Financial planning

CalculatorAdjusted for inflation, the average dental school debt for the class of 2000 was $118,515. For the class of 2013, it was $215,145, according to the annual ADEA Survey of Dental School Seniors. Now add in the cost of starting a practice, and it can get overwhelming.

The ADA provides dental students and new dentists with resources to help them stay on track for a bright financial future.

Provided by Wells Fargo Practice Finance, and developed with dentists in mind, the Center for Professional Success provides business planning calculators, including a debt load calculator, which can help new dentists and dental students determine how much they can responsibly afford to borrow for personal and business use. Other calculators available are the loan payment calculator, which estimates monthly loan payment. The loan term calculator helps dentists see how much faster they can pay off an existing loan by adding an additional fixed amount to their monthly payments.

For students seeking financial assistance, the ADA Foundation has a scholarship program for those pursuing careers in dentistry, dental hygiene, dental assisting and dental laboratory technology. The number of ADA Foundation scholarships awarded is dependent upon available annual funds. To learn more about the ADA Foundation scholarships, visit adafoundation.org/en/how-to-apply/education. The ADA also provides information on various federally funded scholarships.

In addition, the ADA provides information on dental student loan repayment programs and resources, including federal and state programs, that offer student loan repayment assistance, often in exchange for services in a health care shortage area. To learn more, visit ADA.org/student or request more information from studentaffairs@ada.org.

Understanding licensure

Understanding LicensureDental licensure marks the transition between dental school and dental practice. The ADA provides a free guide called Understanding Licensure, a resource to help guide dental students through the licensure experience.

The guide takes new dentists through the application process, preparing for the clinical exam, notification and appeals, licensure by credentials, etc.

To view the Understanding Licensure guide, click here.

Finding a job

The ADA CareerCenter is the official online job board of the ADA, a resource for searching dental career opportunities or recruiting dental professionals.

The resource allows professionals to search or post job opportunities for dentists, oral surgeons, orthodontists and other qualified professionals who specialize in dentistry. Visit the ADA CareerCenter.

Staying up-to-date

The ADA can also help new dentists and dental students stay current on the latest dentistry news as well as scientific findings and studies.

The Journal of the American Dental Association and the ADA News are free to members. These publications are available on ADA.org/publications, along with the ADA Dental Product Guide, the ADA Catalog and ADA E-Communications, which include the ADA Morning Huddle, a daily bulletin of the latest news complied exclusively for ADA members.

New Dentist NewsIn addition, new dentists and dental students receive the ADA New Dentist News, a quarterly publication distributed as an insert in the ADA News as a member resource. To read the latest ADA New Dentist News, click here.

In 2013, the ADA New Dentist Committee launched New Dentist Now, a blog where new dentists can keep up with their colleagues, stay fresh on issues in dentistry and find out about events.

For scientific findings and studies, new dentist and dental student members can access full-text articles online with instant access to over 280 journals through the ADA Library & Archives website. About 95 percent are strictly dental journals. The other 5 percent have medical-dental crossover. This includes in-house access to the New England Journal of Medicine articles going all the way back to 1812. To access the ADA Library & Archives online, click here.

Leadership and Advocacy

Comprising 17 members representing each of the ADA’s regional districts, the New Dentist Committee is a national committee of the ADA Board of Trustees. Its mission: To serve as the voice of the new dentist within the ADA. The committee advises the Board on member benefits and the member experience from a new dentist perspective, as well as, on policy affecting new dentists, among other things. Committee members also provide insight on the issues and needs of new dentists through their liaison roles on the other 11 ADA agencies.

The New Dentist Network engages new dentists, develops leaders and contributes to and influences resources that add member value. It has over 800 contacts and is comprised of new dentist committees and volunteers, ASDA leaders and society staff at all levels of the ADA.

In addition, the New Dentist Committee oversees and actively participates in the Success Dental Student Programs conducted in dental schools around the country. The Success Dental Student Programs provide the next generation of dentists with ethical and practice management information and valuable ADA resources for the transition from dental school to dental practice.

“As a new dentist it is important to be a member of the ADA because we are the future of Dentistry,” said Dr. Michael LeBlanc, New Dentist Committee chair. “In order to help set policy we must have a voice. No better place than the ADA to help set policy and the success of dentistry now and in the future.”

To get involved or for more information, call your state or local dental society, or contact the ADA New Dentist Committee office at newdentist@ada.org or 1-312-440-2386.

Win a free registration for an ADA Executive Program in Dental Practice Management class

Want a chance to win a free class in the ADA Executive Program in Dental Practice Management? If you are an ADA member, click here to enter.

Clinical and Business

In an effort to provide the best in ongoing education for dentists, the American Dental Association’s Center for Professional Success  recruited dental management experts to introduce applications specific to running a dental practice, which are complemented by ADA-selected foundational business skills delivered by Notre Dame’s graduate-level faculty. The end result is a six course, dental practice management certificate program offered 100% online. The ADA Executive Program in Dental Practice Management takes on the tough practice management challenges today’s dentists must master. This includes reducing costs, enhancing marketing strategies, and practicing amid increased regulation.

These six online courses help dentists navigate the business side of dentistry:

  • Legal and ethical issues in dental practice.
  • Negotiation and conflict management.
  • Understanding leadership.
  • Business strategy and systems.
  • Dental team management.
  • Financial management.

For each course completed, verification of potential continuing education credits will be issued.

One winner will be named each month.

To enter the giveaway, click here.

Visit PMcertificate.Success.ADA.org or call 1.855.598.6559 to learn more about the program.

Remodeling your practice

Grand Rapids, Mich. — When Dr. Andrea Toth bought an existing practice in October, she knew she needed to remodel.

Dr. Toth

Dr. Toth

Soiled carpets. Furniture from the ’70s. Wallpaper falling apart. White walls no longer white. Bathroom floors appeared moldy.

“The equipment needed updating,” Dr. Toth said. “The dental X-rays and countertops were green. The chairs and upholstery were ripped. It all needed to be cleaned up and modernized.”

Three months later, she got her wish. New equipment. New dark wooden floors. Modern furniture. Clean new granite countertops.

“It’s given me a completely different feeling when I come in to work,” Dr. Toth said. “The best part is that my staff and my patients love it.”

Dr. Toth spoke with ADA New Dentist Now blog to share some advice and suggestions, based on her experience, for making a remodeling experience as smooth as possible.

With financing, be patient

The biggest obstacle Dr. Toth said she faced in the process was the issue of finance.

“I was trying to get a loan from a bank, but it was taking so long,” she said, adding that when she finally heard back regarding the loan, the bank wanted to hold the practice as collateral.

“My husband and I just decided to pay for it,” she said. Even then, with the holidays and the search for contractors, the construction and remodeling couldn’t start until Jan. 10 — finishing a week later.

For those who can’t afford it and need a loan, be patient.

“I would advise that you have a realistic idea of how long this this will take,” she said. “Give yourself enough time and plan ahead. Realize that you can’t have it all in an instant.”

Lobby (Before)

Lobby (Before)

Lobby (After)

Lobby (After)

Find the right people

Another process that took time was the search for a contractor to be tasked with the construction — replacing the floors, painting the walls, removing the wall paper, etc.

The dentist that Dr. Toth had bought the practice from had been in the space for over 30 years. When she came to acquire it, she didn’t have the layout of the of the facility.

“I didn’t know what were in the walls,” she said. Contractors asked where and how the plumbing was set up; where the electrical wires were.

“My guess was just as good as theirs,” she said. “So some contractors didn’t want to work with me.”

In addition, some companies would send someone to visit the practice, then never submit a bid as promised. Then there were contractors who would submit bids that excluded costs on certain work — which made their bids appear low.

In the end, Dr. Toth found a local contractor, Copper Rock Construction from Grand Rapids.

“They were very upfront with me on the costs,” she said, adding that they were more affordable compared to the other bids. “They said that if they go over budget, it won’t be over 15 percent. They were sincere, with good prices and did good work.”

Dr. Toth also went with Dental Equipment and Repair, of Kalamazoo, Michigan, to remove and reinstall all dental-related items such as cabinets, dental chairs and dental equipment.

“I was very happy with the results,” she said.

Utilize the Internet and friends

When it came to decorating the space, Dr. Toth said, Dental Equipment offered to furnish the space.

However, after conducting simple Google searches, she found pieces that were much more affordable, including artwork, mirrors and furniture.

It was through looking at photos online of other dental practices that she was inspired and decided to get dark wooden floors.

“The rest sort of fell into place,” she said. “I met with neighbors and friends to give me some input on what they thought. And I considered what they said in my decisions.”

Operatory (Before)

Operatory (Before)

Operatory (After)

Operatory (After)

Oversee the operation

Once you’ve hired the right people, don’t disappear.

Dr. Toth said she made sure she was available to coordinate schedules. For example, Copper Rock Construction couldn’t paint until Dental Equipment finished installing a certain equipment or cabinet.

“I would come over and make sure everything was going as planned,” she said.

In addition, her front desk staff worked during remodeling week to answer phone calls from patients.

“If anything needed my attention,” she said. “I instructed them to call me.”

For more information or tips on remodeling your practice, visit the ADA Center for Professional Success website here.

10 steps to starting a Head Start program in your office

Head Start began as a summer program in 1965 and serves the nation’s most vulnerable children. It focuses on school readiness with inclusion of medical, dental, nutrition and mental health.

Action for Dental HealthAction for Dental Health has created a basic 10-step process to launching your own Head Start program in your dental office.

In essence, the 10 steps are:

  • Step 1: Call the local Community Action Agency and speak with the director about oral exam federal compliance opportunities.
  • Step 2: Discuss with local officials (county commissioners) what percentage of their Head Start children have received dental exams and what more can be done.
  • Step 3: Arrange appropriate follow-up care for those children identified with dental needs.
  • Step 4: Present in-services on early childhood decay to local pediatricians/family medicine staff and promote the need for caries risk assessment, anticipatory guidance and referrals to establish a dental home.
  • Step 5: Become a registered state dental Medicaid provider.
  • Step 6: Meet with community leaders from United Way, local foundations or faith-based communities to discuss health needs/support for young children to access dental exams.
  • Step 7: Discuss opportunities to partner with local business community in holding events aimed at Head Start children receiving dental screening services and oral health education.
  • Step 8: Utilize local dental society meetings to coordinate Head Start screenings and follow-up care.
  • Step 9: Evaluate the success of the program.
  • Step 10: Visit the Women, Infant, Children Department (WIC) in the local health department or county offices and determine need for children under age 5 to have dental exams.

To read more on the 10 steps to starting a Head Start program in your office, click here. For more information, contact Dr. Jane Gover, director of the ADA Council on Access, Prevention and Interprofessional Relations at groverj@ada.org. For more information on Action for Dental Health, visit ADA.org/action.

Editors’ Pick: Favorite New Dentist Now blog posts of 2014

It’s been an eventful 2014 for New Dentist Now as it continues to feature resources for new dentists and dental students, along with news and insight on the dental profession and beyond.

Just in case you missed them, here’s a look back to some of our favorite and most popular blog posts of the year.