February 2011 Nugget

February 2011

Is ThIs DenTIsT real?Inside:AB 2637 — Changes to allowable RDA DutiesPLUS: Call to Leadership — Are you ready to serve?

member forumMarch 18, 2011


Build Your own EmploYEE HandBookPresented by: Mari Bradford (CEA)

Topics will includE:• BenefitsandRisksofanEmployeeHandbook

• PoliciesRequiredbyStateandFederalLaw

• RecommendedPolicies• WhatNOTtoputinaHandbook

8:30am–1:30pm • 4 ceu (20%)SDDS Office

THE numBErs of Your pracTicE: THE good, THE Bad, avoiding THE uglYPresented by: John Urrutia, CPA(Mann, Urrutia, Nelson, CPAs)

Topics will includE:• Thebeststructureforyourbusiness• Redflagswhensomeoneelseis“handling”yournumbers

• Howyourpracticeandyourpersonallifeworktogether

• WhatyourCPAshouldbedoing• Therighttimeforinvesting:expanding,building,partnering

6:30pm–8:30pm • no cEuSacraMentO hiltOn — arDen WeSt

continuing educationMarch 4, 2011

rpds — sTill a good opTion in THE agE of implanTs

Presented by: Alan Carr, DMD, MS

coursE oBjEcTivEs:• UniquedifferencesbetweenRPDsandotherprostheticoptions

• WhyreportsofperiodontaldiseaseinRPDwearersexist,andwhetherthereisatruecausalnaturetotherelationship

• Keyclinical/patientfeaturesthatputpatientsatriskfordissatisfactionwhenprovidedwithRPDs

8:30am–1:30pm • 5 ceu (core)hyatt regency SacraMentO

don’t miss these upcoming events!

general meetingMarch 8, 2011

BEnign & malignanT Tumors of THE nEck & skinPresented by: Barbara Burrall, MD

coursE oBjEcTivEs:• Recognizenormalvariantcutaneousstructures,arangeofbenigncutaneoustumorsandarangeofcutaneousmalignanttumors,includingmelanomaandnon-melanomacancers

• Performageneralheadandneckskincancerscreening

6:00pm–9:00pm • 2 ceu, coreSacraMentO hiltOn — arDen WeSt

SPoUSe NIght!

5ce, core

4ce, 20%

November 2007 | 3www.sdds.org

THE NUGGETFebruary 2011

Volume 57, Number 2

Table oF ConTenTs

February 2011 | 3

The NuggeT IS A foUR-tIme INteRNAtIoNAL CoLLege of DeNtIStS JoURNALISm AwARD wINNeR:

GoldeN PeN (HoNorable meNtioN, 2007)Article or series of articles of interest to the profession

outstaNdiNG CoVer (2007)Remarkable cover

oVerall Newsletter (2007)Exceptional publication overall

PlatiNum PeNCil (2010)Outstanding use of graphics

feAtUReS7 Testimony by Guy E. Acheson, DDS at DBC Meeting

Guy E. Acheson, DDS, MAGD, FACD, FPFA

8 The Tip of the Spear Guy E. Acheson, DDS, MAGD, FACD, FPFA

SPeCIALS10 Don’t Just Sit There… Learn!

Robert C. Harris, CAE (The NonProfit Center)

15 What is Privileged Communication? Yasica Corum (Risk Management Analyst, TDIC)

32 It’s the Law: When All Goes to Hell in the Handbasket Petra von Helmburg, DDS, JD (Reprinted with permission from Chicago Dental Society)

RegULARS4 President’s Message5 From the Editor’s Desk6 Cathy’s Corner13 Foundation Update14–15 Being Social15 Our Condolences16 YOU: The Dentist… the Business Owner19 Board Report22 YOU: The Dentist… the Employer23 Announcements24–25 Committee Corner25 Committee Meeting Schedule26–27 Vendor Members27 Vendor Member Spotlights28 We’re Blowing Your Horn!30 Advertiser Index30 Link of the Month30–31 Membership Update34 Event Highlights35 Classified Ads36 SDDS Calendar of Events

* featured on cover

4 | The Nugget Sacramento District Dental Society

First 5, City Councils, Board of Supervisors and the water district board members.

Other members have visited public officials to lobby on various health care issues. The hearings, planning and lobbying take a great amount of time from their practices and their family.

Our Dental Society’s charitable arm, Sacramento District Dental Foundation, has existed since 1969. We continue to provide dental care and community education through SDDF. We started our annual Smiles for Kids day in 1991. In addition to free dental care for kids up to 18 years old on the Smiles for Kids day, kids with extensive needs are scheduled to individual offices for follow up care. Our member orthodontists each take in one new patient per year pro bono. Last year, we provided over one million dollars in free dental care in the five counties covered by SDDS. In 2010, we started Smiles for Big Kids — a program for parents of kids who participate in Smiles for Kids, as well as the elderly and others.

Since 2008, our members have acted as advisors to The Effort’s Community Health Center in planning and establishing Federally Qualified Health Center Dental Clinics (FQHCs). It is a joy to see that with the support of Sacramento Children’s Dental Task Force and First 5 Sacramento, two clinics have opened in 2010 and three more will be coming in these next two years.

Members of the Sacramento District Dental Society have a long history of community service. According to Dr. Kent Daft, our resident historian, in 1911, Sacramento City School Board established a dental clinic. Members of SDDS worked in that dental clinic until its closure in 1929. During the Depression, members used the dental equipment from the school clinic to form a new dental clinic to serve children, which they staffed on a rotating basis until its closure in 1955.

In the early 1970s, Sacramento’s C Street Dental Clinic was organized with the help and support of SDDS. Some of our members volunteered there and some worked as paid staff. Sadly, that clinic was closed in 2009 and was relocated to a new location with limited services. We still have members working there.

20 years ago, Dr. Steve Cavagnolo and other members started the dental clinic for Davis CommuniCare Health Centers and we have continued our support there.

Since the 1990’s, our members have participated in Donated Dental Services, providing free complete dental services for underserved mentally and physically challenged patients and geriatric patients.

Some SDDS members have actively joined forces with medical and public health organizations in pursuing water fluoridation of our community, working tirelessly with

PresIDenT’sMessage

CommUNIty SeRvICeIn 2009, our members founded an in-school dental clinic in Sacramento School District, staffed by volunteer dentists. They provide free dental care for underserved high school students.

In 2010, a few members have partnered with the Gathering Inn, planning a free dental clinic in Placer County. This year, SDDS kicks off the “1st Tooth or 1st Birthday” campaign, bringing awareness to the public, the medical community and our dental community on the importance of children visiting dentists by the time they are one year old.

We have members who volunteered for the Coalition of Concerned Medical Professionals, providing free dental care for underserved adults. We have members who provide dental screenings for various community health fairs. Some have volunteered for the school career days. There are many members who provide pro bono services in their offices to patients in need.

These are our silent heroes. They are not noticed by the news media. They are not recognized by the legislators and special interest organizations. They do this out of their love for humanity. They have made a difference in our community.

I am proud and humbled to have these heroes as my fellow members. Don’t let the special interest groups say that, as a profession, we do not care for our community. They can talk their talk, but we have actions to prove that we walk the walk.

by Wai M. Chan, DDS

RAM iS CoMing! Sacramento, CA (Cal expo) April 1–4, 2011oakland, CA April 9–12, 2011

www.ramusa.org

remote area medical (ram) is holding two 4-day clinics in our area in 2011. they are in need of volunteers to help provide free services to children and adults.

DentAl VolunteeRS neeDeD:dentists/oms (65)rdHs (20)das (65)

to pre-volunteer for these expeditions, please call ram/Calaoms: (916) 772-8197

www.sdds.org February 2011 | 5

The lead story of AGD IMPACT, August 2010 was about mid-level providers. Did that cover photo of the dejected dentist staring at his empty dental chair (shown below) get your attention? Another way to introduce the topic would be to ask the question, “Should you encourage your children to pursue dentistry as a career?”

One of the most troubling trends in dental politics is the issue of creating mid-level providers. This agenda is being pushed by national foundations that refuse to engage with dental organizations and push for change through legislation, bypassing the regulating ability of state dental boards. Mid-level providers are their vision of solving the crisis of dental caries in children that they feel is due to limited access to dental care.

My personal view is that this effort addresses the problem of early childhood caries in exactly the wrong way. The mid-level provider agenda emphasizes the surgical model of treating disease when the effort should be on prevention. It is as if the proper response to cardiovascular disease and heart attacks should be to build more hospitals and increase surgical capacity by creating a surgical nurse practitioner. Lifestyle choices,

FroM TheeDITor’s DeskIs General DentistryDeAD?

dietary habits, poor oral hygiene practices and cultural attitudes are the genesis of tooth decay. In my view, 90% of prevention of dental caries is behavior modification.

Interestingly, most of the behavioral changes needed to prevent dental caries would also help prevent obesity, diabetes and cardiovascular disease. Four of the most costly diseases in America are fundamentally the result of poor lifestyle choices and are all best addressed by education. Why is it that Americans demand technological and surgical repairs for diseases that are essentially preventable? This is the most expensive and least effective approach to disease a society can take.

California has all the elements needed to solve the caries problem. We have more than enough dentists. Our dentist to population ratio is 1:1250 compared to 1:1639 for the entire United States. We have a workforce category that can allow a dentist to be more than twice as productive in providing restorative care through the RDAEF. We have specialists in preventive care and education that have the authority to practice independently in underserved areas and in public health care settings, the RDHAP. What we are missing is the organization and funding to put these existing workforce categories to effective use. It takes money to hire people to do the work that they are already authorized and trained to do. A new workforce position of mid-level provider will only drain more money and time in developing educational programs and there still will not be money to pay for the services of these new personnel. It takes political will and courage to push a prevention agenda in a society that screams, “Don’t tell me how to live!”

Two programs in California that seem to be shining lights in developing and implementing real solutions to the children’s caries problems are Project Headstart with their case management model and First Five Sacramento. Both emphasize establishing

by guy e. Acheson, DDS(Pictured)

Jim Mcnerney, DDSassociate editor

a Dental Home for children before age 12 months and both stress education of the family in preventing dental caries.

Wouldn’t it be wonderful if, when the Pew and Kellogg Trusts begin lobbying for mid-

level provider legislation in California, they were met by legislators who pushed back by telling them that we are solving the problem very well with existing workforce models?

Dr Guy Acheson received his DDS degree from the University of the Pacific in 1979 and subsequently completed an Air Force general practice residency. He has practiced in Sacramento for over 30 years with a focus on conscious sedation and hospital dentistry. He is a California Dental Board Evaluator for in-office IV conscious sedation. He has earned both Fellowship and Mastership in the Academy of General Dentistry, the former requiring 500 hours of continuing education courses, the latter an additional 600 hours, 400 of which must be hands-on. He is retired from the Air Force Reserve Dental Corps with the rank of full colonel, a founding member of the Sacramento-Sierra component of the California AGD, and currently serves on the Board of CAGD as vice-president. With two grown daughters, he fills the void flying sailplanes, having completed flights of 500km and more than 5 hours duration, as well as the Symon’s High Altitude Award for climbs above 32,000ft. He currently pilots a Rolladen-Schneider LS-8. Additionally, having foot-climbed 32 of California’s 58 counties’ high points (including Mt Whitney and White Mt), his goal is to stand on the highest in all 58.

Why is it that Americans demand technological and surgical repairs for diseases that are

essentially preventable?

August 2010 issue of AGD Impact


President — Wai Chan, DDSImmediate Past President — Terrence Jones, DDS

President Elect — Victor Hawkins, DDSTreasurer — Gary Ackerman, DDSSecretary — Kelly Giannetti, DDS

Editor — James Musser, DDSExecutive Director — Cathy Levering

Dan Haberman, DDS, MSCarl Hillendahl, DDS

Jennifer Goss, DDSKenneth Moore, DDS

Craig Johnson, DDSViren Patel, DDS

Wallace Bellamy, DMDBrian Royse, DDS

Kim Wallace, DDS

Kevin Keating, DDS, MSDonald Rollofson, DMD

CE: Jonathan Szymanowski, DMD, MMScCPR: Margaret Delmore, MD, DDS

Dental Health: Dean Ahmad, DDSEthics: Volki Felahy, DDS

Foundation: Robert Daby, DDSLeadership Development: Terrence Jones, DDS

Legislative: Mike Payne, DDS, MSD / Gabrielle Rasi, DDSMembership: Lisa Laptalo, DDS

Peer Review: Bryan Judd, DDS / Brett Peterson, DDS

Dental Careers Workgroup: Robin Berrin, DDS Beverly Kodama, DDS

Budget & Finance Advisory: Gary Ackerman, DDSBylaws Advisory: Adrian Carrington, DDS

Fluoridation Advisory: Kim Wallace, DDSForensics Advisory: George Gould, DDS / Mark Porco, DDS

Strategic Planning Advisory: Victor Hawkins, DDS/ Gary Ackerman, DDS

Golf Tournament: Damon Szymanowski, DMDSacPAC: Donald Rollofson, DMD

SDDF Gala Fundraiser: Wes Yee, DDSSmiles for Kids: Donald Rollofson, DMD

CaThy’sCornerSfK, SfBK, RAm, etc…February marks the beginning of our “volunteer” season… and do we have the opportunities!

By the time you receive this issue of the Nugget, our Smiles for Kids (SFK) Day will be over — our member dentists and staffs will have seen and treated about 1000 kids. About 500 volunteers will have participated on SFK Day.

Smiles for Kids “Adopt a Kid” is beginning this month — offering continued care to “finish the work” that was done on SFK Day. Another 400 doctors participate with SFK Adopt-a-kid, including specialists.

Next month, we will be doing the SFK Orthodontic screening — and another 70 kids will receive orthodontic treatment, beginning this summer. 70 orthodontists volunteer for this.

Smiles for Big Kids (SFBK), developed especially for the parents of SFK and the elderly, shoots off from this point. Another 300 dentists participate in that.

The point I make here, humbly, is that … well… WOW! I am deeply grateful to be part of an organization that can do all that we do. And we can’t do it without our members’ stepping up and saying… “I’ll help.”

Thank you!

And, there is another volunteer opportunity coming up — RAM (Remote Area Medical) is coming to Sacramento (held at Cal Expo) on April 1–4th. This project is headed up by our friends at CALAOMS (the Oral Surgeons Association of California) and it is a great undertaking. (In addition to the Sacramento area event, they will then pack up and move the project to Oakland the next five days.) RAM will provide dental care, vision services (including glasses), mammograms and diabetes testing.

Volunteers are needed for set up the two days before, and 80-100 dentists (including specialists) are needed for every day. Hygienists and assistants are also needed, as well as general volunteers to do intake, triage and running. Since the event is on a Friday, Saturday, Sunday and Monday, we hope that the volunteers will have scheduling opportunities to volunteer for one or more days.

This event was held in LA the last two years, and more than 7000 people stood in line for treatment. It is anticipated that in Sacramento and Oakland, large numbers will again attend. If you can attend and help, the flyer to sign up is inserted in this issue of the NUGGET.

Again, thank you!

Happy February!

SACRAMento DiStRiCt DentAl SoCietyAmador • El Dorado • Placer • Sacramento • Yolo

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EXECUTIVE COMMITTEE

Leadership

BOard Of dIrECTOrs

TrUsTEEs

COMMITTEEssTandIng

ad hOC adVIsOryTask fOrCEsWOrkgrOUps

spECIal EVEnTs OThEr

Advertising rates and information are sent upon request. Acceptance of advertising in the Nugget in no way constitutes approval or endorsement by Sacramento District Dental Society

of products or services advertised. SDDS reserves the right to reject any advertisement.

The Nugget is an opinion and discussion magazine for SDDS membership. Opinions expressed by authors are their own, and not necessarily those of SDDS or the Nugget Editorial Board. SDDS reserves the right to edit all contributions

for clarity and length, as well as reject any material submitted.

The Nugget is published monthly (except bimonthly in June/July and Aug/Sept) by the SDDS, 915 28th Street, Sacramento, CA 95816 (916) 446-1211. Subscriptions are free to SDDS members, $50 per year for CDA/ADA members and $125 per year for non-

members for postage and handling. Third class postage paid at Sacramento, CA.

Postmaster: Send address changes to SDDS, 915 28th Street, Sacramento, CA 95816.

EDITORS EMERITuS: William Parker, DMD, MS, PhD • Bevan Richardson, DDS

sdds sTaffCathy leveringExecutive Director

della yee Program Manager/ Executive Assistant

Melissa Orth Publications Coordinator

lisa Murphy Member Liaison/ Peer Review Coordinator

Erin CastleberryMember Liaison/ Smiles for Kids Coordinator

Nugget EdITOrIal BOardJames Musser, dds

Editor

Paul Binon, DDS, MSDDonna Galante, DMD

Alexander Malick, DMDJames McNerney, DMDChristy Rollofson, DDS

Oladimeji Sorunke, BDSAsh Vasanthan, DDS, MS

Sacramento District Dental Society

by Cathy B. leveringsdds executive director


My name is Dr. Guy Acheson. I am a general dentist who is in private practice in Rancho Cordova, California. I am the current Treasurer of the California Academy of General Dentistry. Although I am a Board Member of the California Academy of General Dentistry, I am speaking today as an individual.

There are several areas regarding AB 2637 that I would like to speak to today. I would first like to speak about my concerns regarding the supervision of RDAs as stated in AB 2637. Then, I have several concerns regarding the RDAEF program, specifically with regards to how they are educated and graduated from the training programs as well as regarding some of their new duties. Let me be clear that I am a supporter of expanded duty dental auxiliaries. My practice has employed an RDAEF from the beginning of the program and she continues to be a valued member of my staff.

My first concern is the change in level of supervision required for RDA duties. As I understand it, AB 2637 allows the supervising dentist to decide what level of supervision is needed for each duty performed by an RDA, where the previous law allowed the Dental Board to specify the level of supervision required for each specific duty. This troubles me because of the risks of supervising dentists abusing this authority which could put the public safety at risk. I will use just two examples.

First is the duty of Denture Adjustments. On the surface this seems like a very safe duty to give general supervision to, but my experiences as a general dentist over the last 33 years makes this a much more involved duty than just adjusting the plastic parts of a denture. To begin with, there are many different philosophies on how a denture should be fabricated with regards to coverage of soft tissue, variable loading of tissues, extension of borders and flanges, as well as widely divergent occlusal designs. If the RDA does not recognize the design with which the denture was fabricated, a simple grinding away of some plastic could significantly alter

TestimonyBy gUy e. ACheSoN, DDS At DBC meetINg

the function of the denture in a very negative way. I believe a dentist needs to inspect the denture and specify what adjustments are to be made based upon the dentist’s recognition and understanding of these design issues.

I also ask; can an RDA recognize and distinguish a sore spot or gingival irritation that is from a mal-adjusted occlusal situation, versus a denture flange overextension, versus residual ridge remodeling, versus a primary or secondary infection, versus significant oral pathology such as oral cancer? In my career I have had two cases of oral cancer that have presented as a denture sore spot. I feel all denture adjustments require an examination by a dentist who is trained to recognize all these issues.

My second example regards the duty of fabricating and placing temporary restorations. I can imagine a large pediatric or adolescent restorative case where multiple deciduous and permanent teeth could be prepared for stainless steel crowns. The dentist could declare these stainless steel crowns to be temporary restorations, turn the case over to an RDA, consider this to be a duty requiring only general supervision and the dentist leaves the building to have lunch while the RDA places multiple stainless steel crowns. With the prospect of these restorations being in place for years, not the typical three to four weeks that a temporary crown is in place while a definitive crown is fabricated, the potential for injury to the patient because of poor marginal adaption, improper occlusion, inadequate cementation, overextension or residual subgingival cement is significant. A requirement for the supervising dentist to be present during the completion of these duties reduces the risk of abuse. Perhaps stainless steel crowns need to be singled out as being different that other temporary restorations.

I now want to address some concerns I have regarding RDAEFs and the duties of placing and finishing direct restorations. The educational standards in AB 2637 make

by guy e. Acheson, DDS

distinctions between didactic education, and laboratory exercises, and go on to say that clinical experience is to be satisfied by practice on typodonts mounted in mannequin heads. No actual clinical experience on a human patient is required. I have taken hundreds of hours of dental education on typodonts

mounted in mannequin heads and can state that they do not adequately duplicate issues of pain control, tissue management, hemorrhage control, maintaining a dry field, airway management, and problems of limited access due to anatomic variations or patient behavior. In addition, the procedures of bonded restorations are highly technique sensitive. The multiple steps involved with maintaining a dry field, etching of dentin and enamel, judging whether the etching step was adequate, how much to dry tooth structure or bonding components, the proper placement of composite restorative materials, and judging the adequacy of the final restoration just cannot be duplicated on plastic teeth.

Dental schools recognize this and have extensive requirements for practice on human patients before considering a student to be competent. University of the Pacific School of Dentistry has a minimum of 130 restored surfaces to be completed on human patients before clinical competency is even considered. These 130 restored surfaces are only the absolute minimum standard for human clinical experiences and many would agree that this is barely adequate to assure basic competence and assuring public safety. I simple cannot conceive of considering any practitioner to be competent in a procedure when they have not be instructed, practiced, and demonstrated their skills in actual clinical situations.

My overarching concern is for public safety.

continued on page 20


as well as fitting and cementing endodontic master cones and accessory points using lateral condensation.

Take a moment to think about this. Read the previous paragraph again and let it sink in.

In the practice of restorative dentistry, which is the very core of most general dentist’s practices, the dentist is needed to complete an examination, develop a treatment plan and come to an agreement with the patient as to what treatment will be provided. After

2010 was a very important year for Dentistry in California. Two of the most significant events in our profession have taken place that have the potential to dramatically change the dental workforce model we are all used to. Whether they are viewed as opportunities or attacks will depend on your view of what it means to be a dentist and what dentistry’s future should be in California. The troubling fact is that most California dentists don’t have a clue of what I am going to write about. One has to do with changes that are already the law in California and the other suggests one possible future for dentistry in California. The second item represents the very pointy tip of the spear that powerful lobby groups have thrown in our direction to force their model to solve the problem of early childhood caries in the United States.

The first item concerns changes made in the duties and scope of practice of dental auxiliaries in what is known as AB2637. AB2637 is sweeping legislation that dramatically changed the organization, training and oversight of dental auxiliaries. Developed over five years with significant effort by CDA, it was passed in 2009 and became law in 2010. It created two new dental assistant categories; Orthodontic Assistant and Dental Sedation Assistant. It gives Registered Dental Assistants (RDA) the new duty of adjusting dentures extraorally. It changed the way RDAs are managed in that previously, the level of supervision for each duty by the supervising dentist was specified by the Dental Board of California. With AB2637 this changed to allow the supervising dentist to determine whether general supervision or direct supervision is indicated for each duty performed by an RDA.

The most far reaching effect of AB2637 is expanding the duties of the Registered Dental Assistant in Expanded Functions (RDAEF) to include placing direct restorations of all materials (amalgam, bonded composite, glass ionomer), the fitting, adjusting and final cementation of indirect restorations,

The Tipof the SPeAR

that a hygienist can provide local anesthesia (this was previously allowed). The dentist will prepare the teeth for composites, amalgams and crowns. Then, under the new law, the case is turned over to the RDAEF. The RDAEF will etch, prime, bond, matrix, place, cure, and finish composite restorations, as well as matrix, place, condense and carve amalgam restorations. The RDAEF will complete placement of retraction cord, obtain master

by guy e. Acheson, DDS

continued on page 29



• Askgoodquestions.Dososilentlytoyourself,orwritethemdownas they occur to you so you can ask at the appropriate moment. Question to learn, not to show off in front of colleagues.

• Takegoodnotes.You’lllosegreatideasbeforeyoueverhavea chance to try them if 1) you dash them off illegibly, 2) you never bother to read them when you get back to your office, or 3) you didn’t take any. Write notes as if you’ve been asked to read them at your next staff meeting. You probably won’t do that, but do share the “idea-gems” you learn with at least one other person.

• Beopentonewseedsofwisdom.Bykeepinganopenmind,you may hear something that can change your approach to a project or motivate you to expand your interests. But if you don’t hear the information you want most during the session, stay a minute or two afterward and ask the speaker if you can talk or exchange e-mails later on.

• Don’tstoplearningjustbecauseyou’reinthehallwaysortradeshow aisles. Not everything is taught from the podium. Keep your notebook in hand and ask questions of the people you meet outside the formal sessions. If exhibitors are present, the information they provide and their handouts might give you new ideas and facts.

• Contactthemeeting’ssponsors.Theyhaveadecidedpurposefor participating in the conference. Recognize the sponsors, thank them, find out what’s new with them and what they might be able to do to help you.

• Finally,applynewconceptsandinformationnotjusttoyourjob but also to your personal life. If you let it, what you learn can add value to many areas of life beyond the office.

Reprinted with permission from Robert C. Harris, CAE; chairman of the Nonprofit Center in Tallahassee, Florida. www.nonprofitcenter.com

It’s true of so many things, but especially seminars and conferences: You get out of them what you put into them. To encourage attendees to make the most of your association’s educational opportunities, share these 13 tips to maximize the benefits of attendance. (You’ll probably even profit from the suggestions yourself.)

• Beforeyoueversitdownattheconference,determinewhatyou want to learn. Prepare by picking the right sessions for you, reading speaker bios, and anticipating some of the content and what you hope to find out.

•Findthebestseat.Arriveearlysoyoucanfindaspotyou’recomfortable in. To avoid distractions, sit near the front. If the handouts are on the table when you arrive early, scan them for content so you’ll be better able to follow the presentation.

• Sit next to someone you don’t know. Stay apart from thepeople with whom you came. Make new friends. Look for a potential mentor, customer, or contact. During the breaks, make a point of meeting at least one new person.

• Turn off distractions. Put away your calendar, Blackberry,newspaper, and trade journals so you can really focus on the presentation. Don’t worry about anyone else; concentrate on becoming the best you can be for yourself.

• Listenwiththe intenttoreally learnandimproveyourself.Pay attention specifically for one or two good ideas from every session. The best way is to take notes and be quiet. At the end of the day you may have a dozen new facts, resources, and inspirations. Sometimes you have to hear the entire presentation before you understand the original concepts. Don’t cut off the thought or start critiquing too soon.

• Don’tbeaknow-it-all.Whenyouhearafamiliarfact,don’ttell yourself, “I already knew that.” Rather, ask yourself, “How good am I at that?” Self-evaluation is one of the keys to self-improvement. Pick out what will work for you and concentrate on applying the new and relevant information.

• Turn down your sensitivity meter. You’re attending to getinformation, not to be offended by a remark or word. Don’t expect everything to be politically correct. Don’t criticize the presenters; instead, help them make dynamic presentations by listening and nodding your head when you agree or by asking good questions.

Don’t Just Sit There…LeARN! by Robert C. Harris, CAe

The NonProfit Center

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CALIfoRNIA voLUNteeRS NeeDeD!

dentists/oms (65)rdHs (20)das (65)

if you are not available to volunteer, please consider making a donation to the ram Ca expeditions

the California association of oral and maxillofacial surgeons (Calaoms) is the host coordinator for this expedition. Please help us support these clinics by volunteering for a day, or multiple days at either or both venues. we need mds, rNs, dds/dmds, omss, rdHs, das, ophths, ods, opticians, op techs, and general volunteers. To volunteer, find up to date information, or to donate, go to www.ramCaliforniaVolunteers.org.

RAM iS CoMing!Sacramento, CA (Cal expo) April 1–4, 2011

oakland, CA April 9–12, 2011

For more information on services, or to donate

medical services, donate food, or to make

a contribution, call:

Pamela CongdonCalaoms executive director,

ram Host Coordinator

(916) 783-1332(800) 500-1332

[email protected]

remote area medical (ram) is holding two 4-day clinics in our area in 2011.they are in need of volunteers to help provide free services to children and adults.

www.RAMCaliforniaVolunteers.org • www.RAMusa.org


saCraMenTo DIsTrICT DenTal soCIeTy FounDaTIon A chAritAble 501-c3 orgAnizAtion

A few woRDS fRom the PRez

$25,000California Endowment

$25,000Mercy Catholic Healthcare West

$10,000California Dental Association

Welcome,2011 fOUndaTIOn BOard!Robert Daby, DDSPresident

Matthew Campbell, Jr., DDSVice President

Robert Gillis, DMD, MSDTreasurer

Kelly Giannetti, DMD, MS Secretary

Board members:Adrian Carrington, DDSKevin Keating, DDS, MS Terry Jones, DDSGordon Harris, DDSVictor Hawkins, DDSDennis Peterson, DDS Wesley Yee, DDSGayle Peterson (Associate Member)Damon Szymanowski, DMD (Golf Chair)

On behalf of all the needy kids and adults treated by SDDF over the years, I want to express their sincere appreciation for restoring their smiles and improving their dental health. Not only do you “fix” teeth, you often change lives. As incoming President of SDDF, I marvel at the huge strides that SDDF has made. Initially formed to administer a small orthodontic fund which treated one patient a year, SDDF has now performed about $10 million of charitable dental treatment. Smiles for Kids has been so successful that it has become a model for the nation.

It seems to me that SDDF is currently at a crossroads in its history. We can rest on our laurels and slowly lose our effectiveness, or we can renew our commitments, reenergize, and catapult ourselves to successes never imagined by our predecessors. I choose success and humbly ask every SDDS dentist for their help. First, please become SDDF dues paying members either by checking SDDF on your dues statement or responding to dues notices

sent in SDDS mailings. Take the opportunity to meet the kids in your community by volunteering for dental screenings, Smiles for Kids, or by adopting several kids who need our help but have huge barriers to dental care. If you have adults in your practice who have fallen on hard times, apply for a general dentistry grant from SDDF. If you are a specialist, call the SDDS office to offer your expertise in treating the indigent. Volunteer for RAM on April 1–4 as Cathy details in her article. Last, please attend the SDDF Gala on October 1, 2011 and bid generously.

When you donate your money to SDDF, you get immense satisfaction if you watch your dollars at work. If you join us in the trenches to screen or treat patients one on one, you will be paid handsomely. You will receive little or no money, of course, but you will be paid. Patients and families will offer their sincere thanks, but, in addition, you will receive a feeling that I cannot fully describe a feeling of deep fulfillment and satisfaction. When legislators ask you what you have done to improve access to dental care, point to the Sacramento District Dental Foundation and explain the commitment of our volunteers. Then as your legislator: “What have you done?”

by Robert Daby, DDS2011 Foundation President

n

EW!

sfk receives large grants

for 2011!

ocT 12011Save the Date!


If you were to make a list of up-and-coming business trends, social media strategies would probably be near the top. However, thousands of companies are rushing headlong into the profile-creating, news-tweeting, blog-posting frenzy...only to find that their valiant efforts are not getting the results they had hoped. If you’re looking for fans, followers, and friends to build a Social Nation around your business, don’t panic, says Barry Libert, author of Social Nation: How to Harness the Power of Social Media to Attract Customers, Motivate Employees, and Grow Your Business.

“When it comes to building a successful social network for your company, you need to understand that there’s a lot of prep work to be done, “Libert explains.” You can’t just set up a Facebook profile for your company, tweet once or twice a day and expect public interest in your company to shoot through the roof.” Think about it this way: if you were in charge of your company’s booth at a trade show or conference, you wouldn’t just slap your company’s logo onto a piece of poster board, place your business cards on the table and hope for the best, would you? Of course not.

“If you want to become a meaningful part of social conversations and interactions,” explains Libert, “you’ve got to know who your target ‘fan base’ is, where they spend their time online, and what sorts of content and programming is valuable and relevant to them, and will foster their continued interest and participation. You also need to make sure you have the wherewithal to commit to growing and sustaining your Social Nation, and you’ve got to make sure that you have buy-in from within your company. And that’s just for starters.”

Libert is eager to share the top 10 social media pitfalls he’s seen organizations fall victim to in the past.

Running a Social nation like a traditional business.

If you want to run a social company, you first need to understand that almost everything you do is a two-way street. That is to say, you’re not going to prosper if your products and services are designed solely by folks on the inside. You need to embrace the perspectives and contributions of your employees, as well as those of customers and partners.

underinvesting in social initiatives and abandoning them too soon.

Understand that a Social Nation is organic. Early on, you’ll need to invest a good deal of time, thought, and money in attracting fans and followers — and your efforts will need to be sustained. Only after you’ve built a firm foundation will your social network begin to sustain itself through participant contribution and recommendation. Successful strategies include posting quality content that people want to consume, letting customers tell their stories and post their grievances, and then responding to their criticisms. Also, make sure that prospects are able to learn about your business through customer and employee testimonials. Lastly, remember that using multiple approaches — for example, a blog, Facebook profile, and interactive website — will reach more people.

Neglecting to find ways to encourage and inspire your Social Nation’s followers and fans.

Realize that your fans and followers are essentially volunteering their time and energy to serve as developers, sounding boards, and advertisements for your company. So for goodness’ sake, respect what they have to say and take their input to heart!

Relying on a “build-it-and-they-will-come” mentality.

You need to purposefully reach out to potential community members and make it worth their while to accept your invitation.

“Rolling out a community and just expecting people to join as friends or followers is a flawed philosophy,” confirms Libert. “Marketing 101 principles still apply. That means you need compelling incentives to have people join your community. You also

need an aggressive programming strategy, one that includes defining your key audiences and targeting them through all available channels, to ensure that they know that you want to build a relationship with them.”

Delaying the process of going social.

Contrary to what you may wish, your company doesn’t have the luxury of waiting until it is “convenient” to go social. Why? Well, you have competitors, right? And if you don’t start gathering loyal followers and fans now, there’s a good chance that some other company will woo them first. One of the best strategies for going social as quickly and effectively as possible is to designate employees and subject matter experts to act as community success managers focused on fostering community growth and member satisfaction. Separate from your sales and support teams, these community leaders should have the ability to advise members of the community on how to best participate with the company and with each other. If you do things well, you’ll find that they’ll generally serve as internal and external advocates for others in your organization — be it employees, partners or customers.

Underestimating the power of a Social nation.

If you believe that social networking is just a window dressing that your company “needs” (but not really), then think again. Social media and community collaboration bring many benefits, including brand-building, customer loyalty and retention,

BEiNgsocial

neW featUre!Engagesocialmediamarketingtoestablishbranding,buildyourpracticeandprotectyourreputation

top 10 Social Media PitfallsReprinted with permission from California Employers Association (SDDS Vendor Member)

Your company doesn’t have the luxury of waiting until it is “convenient” to go social.

OUr CONdOlENCEs

MARie AliCe KoCHMarie Alice Koch, wife for 60 years of SDDS Past President Dr. George Koch, passed away peacefully on January 5, 2011. Marie graduated from UCSF Nursing School before she and Dr. Koch moved to Carmichael in 1955. They remained there for 50 years. Photo taken at SDDS Holiday Party, Dec 2010


cost reductions, improved productivity and revenue growth.

neglecting employees, partners, investors or customers when building your Social nation.

Set up a focus group of employees to serve as community leaders who will shepherd your company into the social networking world, but don’t put all of the power in their hands. Social Nations are organic organizations, so the more people who are empowered to influence yours, the better. “You’ll find that leaders will emerge from your community population — whether they are employees, partners, customers or prospects, “promises Libert.

Relying on traditional approaches when designing your Social Nation.

A decade ago, you probably would have been horrified at the thought of releasing ideas and products into the hands of your customers before they were as complete as you could get them. With social networking, that approach is now becoming obsolete.

Developing your own social software and analytic solutions.

You wouldn’t dream of placing “remodeling the office” or “handling legal issues” in the Do-It-Yourself category, would you? Not too many would. Instead, you’d hire someone skilled in those areas. Do yourself a favor and use the same strategy when it comes to building your own Social Nation.

Getting caught without partners to help you succeed.

Make sure that you truly treat your community members as partners, not just as fans or numbers. Yes, integrating into the social web (Facebook, Twitter and other social networks) is key to your company’s future success, but being connected to the social web is only a part of what you need to do. Shifting your business strategically, culturally and operationally are key components to the equation.

“We are on the cusp of a new business era,” concludes Libert. “Building a new Social Nation isn’t just about a paradigm shift in technology. It also requires a business and cultural shift in how your company is organized and run. Now is the time for leaders and their organizations to find a way to connect to individuals — be they coworkers, investors, customers, or partners — on personal and social levels. Do all of this with an appropriate amount of forethought and planning, and you’ll succeed in creating enduring social and emotional value for your organization.”

Privileged communication is the exchange of information between two individuals, which is confidential due to the nature of the relationship, such as a doctor-patient relationship.

Doctor-patient confidentiality begins when a patient seeks the advice, care, and/or treatment of a dentist. This applies to dental consultations as well. Patients seeking dental treatment or advice should not fear that their dental concerns, medical conditions or personal information will be disclosed to others. The expectation is for dentists to hold that personal health information in confidence and use it exclusively for the benefit of the patient.

Maintaining confidentiality covers not only what a patient may reveal to the dentist, but also what a dentist may independently conclude or form an opinion about, based on an examination or assessment of the patient. Confidentiality covers all of the dental record (including radiographs, lab reports, and billing) as well as all communications between the dentist and patient. It includes communication between the patient and dental staff and phone conversations between dental staff and

third-party payers. The duty to preserve privacy even continues after a patient is no longer part of the practice.

Divulging health information is a privilege belonging to the patient, not the dentist. Only the patient may waive that privilege. In general, dentists should not release health information to a third party without getting a release signed by the patient. A common exception occurs when two dentists are treating the same patient and they consult each other regarding treatment. To obtain a sample “Release of Patient Records” form, visit the Risk Management section of the TDIC website at www.thedentists.com.

Medical issues warranting special confidentiality include mental health information, drug and alcohol abuse records, and HIV test results. Do not release this information unless you have express written permission from the patient or the patient’s legal representative allowing you to do so.

If you have questions regarding the information presented in this article or you need to discuss another Risk Management issue affecting your practice, please call the TDIC Risk Management Advice Line at 800.733.0634.

What isPRIvILegeD CommUNICAtIoN?by yasica Corum (Risk management Analyst, tDIC)


yOU arE a dEnTIsT. You’ve been to school, taken your Boards and settled into practice. End of story?

not quite. Are you up to speed on tax laws, potential deductions and other important business issues?

In this monthly column, we will offer information pertinent to you, the dentist as the business owner.

look for Package Deals. Get an estimate on the cost of consolidating your home phone, Internet access and long distance, cell phone plans with one provider. Do the same insurance; look for a carrier who will reward you for bundling your car, life and home insurance policies with them. Do the math to make sure you’re getting a good deal in exchange for your loyalty.

Check your credit. Under the Fair Credit Reporting Act, you are entitled to one free credit report from each of the three nationwide credit reporting companies — Experian, Equifax and TransUnion—every 12 months. Use their online tools to keep an eye on your credit score and report any errors.

Seek help. A qualified financial advisor can help you create or update a personalized financial plan that includes reviewing your insurance policies, banking relationships investments, loans and budget to help you find everyday savings that could prove valuable.

Violetta Sit Terpeluk, CFP®, MBA, CFPC® is licensed/registered to do business with U.S. residents only in the states of CA and WA.

Brokerage, investment and financial advisory services are made available through Ameriprise Financial Services, Inc. Member FINRA and SIPC. Some products and services may not be available in all jurisdictions or to all clients.

Ameriprise Financial does not provide tax or legal advice. Consult your tax advisor or attorney.

© 2010 Ameriprise Financial, Inc. All rights reserved. File #110669

Violetta offers complimentary initial consultations to SDDS members and is available to speak to study clubs. Please contact her at (916) 787-9988 ext.2 or [email protected].

It’s the start of a new year and we all know what that means: time to make some resolutions. We’ll confidently pronounce our vow to shape up, eat right, save more money and cut out the excesses so we can be a better version of ourselves in 2011. Alas, best intentions aside, we’re all prone to the “resolution slide”—that gradual decline in dedication which creeps in as the year wears on. (For evidence, compare traffic levels at the gym on January 2 and February 2).

Fortunately, from a financial perspective, there are easy steps you can make to help get your house in order. These require little time commitment, so no excuses.

Stop Paying AtM Fees. Withdrawing from an ATM outside of your bank’s network commonly results in a fee of a few dollars. If your own bank tacks on a surcharge for going out of network (many do) you could be looking at an overall cost of four dollars or more per transaction. If you make two such transactions per week, you’re shelling out $416 over the course of a year just to retrieve your own money. A better option is to work with a national bank that has a large network conveniently located ATMs or with local bank or credit union that has formed alliances to grant you no-charge ATM usage.

Don’t overpay your taxes. That rebate check you got from the IRS last spring was like free money, right? Wrong. It’s actually reflective of the fact that you overpaid your taxes throughout the year, in essence giving the government an interest-free loan. Don’t make the same mistake again. Work with a qualified tax professional to adjust your withholdings so you receive only a small refund on your taxes. That way, throughout the year, you can put your money to better use through investments that offer compounding and greater returns over time.

Five Financial ResolutionsfoR the New yeARby Violetta Sit terpeluk, CFP®, MBA, CRPC®

financial Advisor, Ameriprise financial (SDDS vendor member)

youthe Dentist, the business owner


THE numBErs of Your pracTicE: THE good, THE Bad, avoiding THE uglYPresented by:John Urrutia, CPA (Mann, Urrutia, Nelson, CPAs)

Topics will includE:•interpretingyourbusinessnumbers•Redflagswhensomeoneelseis“handling”yournumbers•Thebeststructureforyourbusiness•Balancingpracticeandpersonallife•WhatyourCPAshouldbedoingforyou•Costcontrolforoptimumprofitability•Therighttimeforinvesting:expanding,building,partnering

6:30pm–8:30pm • no cEuSacraMentO hiltOn — arDen WeSt


Personalized attention. Customized banking services. And the strength of a solid financial partner.When it comes to managing your money, switch to the bank that’s been a part of Sacramento and the California landscape forwell over a century. In fact, Union Bank has been helping Californians succeed for nearly 150 years. We’re deeply invested in thelocal communities we serve. And with our proven history of sound financial policies, we’re ready to put our strength to workfor you. Isn’t it time you switched to a bank that puts your best interests first?

Switch to a strongerbanking relationship.

©2010 Union Bank, N.A. Visit us at unionbank.com

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TDIC_Daby_SacDS_TOPRINT.pdf 1 12/1/10 3:13 PM


The first Board meeting of the year was called to order by President Wai Chan. Dr. Chan introduced and welcomed new Board members Drs. Jennifer Goss and Wallace Bellamy.

RAM

Representatives from CALOAMS Dr. Steve Leighty (SDDS Affiliate member) and Ms. Pam Congdon addressed the Board and answered questions about the upcoming RAM (Remote Access Medical) event being held at Cal Expo on April 1, 2, 3, and 4th. They encouraged SDDS’ participation. Approximately 80 dentists are needed each day, as well as auxiliary staff. Board members asked for clarification and plans. Organizers need to raise $200,000 for the Sacramento event, to pay mostly for supplies and food for the volunteers. It is anticipated that 700 volunteers per day will be working. If anyone has any contacts, they are encouraged to help.

tReASuReR’S RePoRt

Dr. Ackerman reported that we are not closed out for 2010, but the projections for the fiscal year end look like we will end with a small surplus, funding our reserves and enabling a donation to the SDDS Foundation.

eXeCutiVe DiReCtoR’S RePoRt

Cathy Levering reviewed the bylaws, obligations and policies regarding serving on the Board. She also reported on the following:

• Committee placement — All committees are fully staffed and meetings are scheduled throughout the end of the year.

• 1stToothor1stBirthdayCampaign—this campaign begins in full force in January. All SDDS member dentists have been educated and notified via numerous modes (i.e. emails, faxes, Nugget articles) this past fall. The next step is outreach to the medical community, to the pediatricians, OB-GYNs, and GPs. The message is that it is important to teach parents that children should make their first visit to the dentist at age 1 or by the 1st tooth. Demonstrations of the knee-to-knee exam will be made at the general meetings, as well as continued education to the membership. The message is important; it is our intention that the dental community is consistent with the message. This doesn’t mean that every dentist needs to treat kids at age 1; certainly they can refer to pediatric specialists or others who are comfortable seeing younger patients. What is important is that the education to the parents begins at age 1. Our hope is that this message will prevent tooth decay usually not identified until age 3 or more. SDDS is working with First 5 on this, and the Dental Health Committee is working to deliver education to those doctors who would like more information.

JANUARy 4, 2011unFiniSHeD BuSineSS

• Task force — Premedication /prophylaxis issue – Dr. Kevin Keating reported on his task force recommendations. It was M/C to accept the Task Force report as presented. Drs. Musser and Keating will dedicate the March issue of the Nugget to this topic.

• RAM—Dr. Don Rollofson reported that he attended the RAM organizational meeting at CALAOMS (see above).

• YoloCountyFluoridationefforts— Dr. Kim Wallace reported that Woodland and Davis are securing surface water rights that may facilitate future fluoridation options. The committee, headed by Yolo County First 5 staff, has met in November and will meet again in January.

neW BuSineSS

• Nominating(LDC)CommitteeNominations– Dr. Terry Jones presented nominations for the nominating/LDC committee. It was M/C to approve the following members to serve with Dr. Jones (chair) on the 2011 Committee: Drs. Wai Chan, Vic Hawkins, Matt Campbell, Bob Daby, Wallace Bellamy, Jennifer Goss, Kristy Whiteman, Herlin Dyal.

ADJouRnMent

The meeting was adjourned at 8:40pm. The next meeting will be on March 1, 2011 at 6:00pm. Dr. Kerry Carney, CDA Executive Committee and Journal Editor, will be a special guest.

the next meeting will be on March 1, 2011 at 6:00pm.

boarD rePorT


Even more challenging to me is the notion that all of these clinical duties can be taught to the RDAEF students by instructors who could have no actual clinical experience in these procedures. As I understand the requirements for instructors in these programs, they can be limited to only fellow RDAEFs who have at least two years of teaching experience. There is no requirement for actual clinical experience. I do not feel that expertise in treating plastic teeth, in plastic mouths, with plastic soft tissues transfers well to treating actual human beings. The instructors must have significant clinical experience with all procedures that they teach and I feel a dentist is needed to provide the depth of knowledge and experience required of many of these duties.

My next concern is the new duty of endodontic obturation by RDAEFs, specifically the sizing, fitting and cementing of endodontic master cones and accessory points. It specifies doing this using the technique of lateral condensation. In general, I concur with the comments already submitted by the California Association of Endodontists. Endodontic obturation is a very difficult clinical skill for dentists. Indeed, so difficult that a great number of dentists choose not to do any endodontic procedures. The consequences of poor technique can be grave and a short list would include extrusions of gutta percha, overfills, underfills, as well as perforations and cracked roots from the improper use of spreaders and condensers. There is also such a great range of endodontic obturation techniques that defining exactly what is the technique of lateral condensation and what constitutes fitting and cementing a master cone is up to debate. Just one example would be a technique of warm gutta percha obturation that involves fitting and cementing a master cone as well as placement

of accessory points with a spreader. However, heat is used to plasticize the gutta percha so that it is even more possible to allow the now softened gutta percha to be extruded out the apex as well as the possibility to cause thermal damage to the tooth, periodontal ligament and surrounding bone. Yet, that is within the definition of lateral condensation. Here again is a duty that is very complex, the students have very limited laboratory experience, NO clinical experience, and could conceivably be taught by fellow RDAEFs with absolutely no clinical experience.

To wrap this up… my overarching concern is for public safety. AB 2637 is especially problematic because by statute it impedes the Dental Board’s ability to assure public safety by certifying licensees are competent to perform authorized duties when they have not been educated in a manner or tested in an environment that can actually demonstrate any level of clinical competence.

An addition, it leaves the onus of assuring competency and public safety to the hiring dentist. How will the hiring dentist be assured of competency when the new licensee has had no human clinical experience? The dentist is forced to test the competency and safety of the new licensee by allowing them to practice on patients. Shouldn’t patients know that these auxiliaries have had no prior actual human experience? Should there be an informed consent before allowing treatment by these new licensees?

I think the Dental Board has a duty to assure the safety of the public. This statute puts public safety at risk by virtue of requiring no actual clinical practice and testing, and by allowing instruction by instructors who conceivably have no actual human experience. The Dental Board has a duty to correct this

lack of assuring safety of the public. As I see it, the statute must be changed such that it is assured that licensees are trained to clinical competence and that the you, Dental Board, can assess, test and confirm the competence of these new practitioners.

Until this statute is changed, the Dental Board must use regulations to specify the training and testing necessary to assure public safety.

testimony…continued from page 7

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yOU arE a dEnTIsT. You’ve been to school, taken your Boards and settled into practice. End of story?

not quite. Employee evaluations, hiring and firing, labor laws and personnel files are an important part of being an employer. Are you up on the changes that happen nearly EVERY January 1st?

In this monthly column, we will offer information pertinent to you, the dentist as the employer.

youWage & Hour . . . . . . . . . . . . . . . 70Handbooks/Policies/ID Theft . . 42Leave Laws . . . . . . . . . . . . . . . . . 29Termination . . . . . . . . . . . . . . . . 28Hiring. . . . . . . . . . . . . . . . . . . . . . 23Discipline Issues . . . . . . . . . . . . . 20uI Claim/LC notice . . . . . . . . . . . 16Health Benefits. . . . . . . . . . . . . . 10Other . . . . . . . . . . . . . . . . . . . . . . 10Vacation/PTO . . . . . . . . . . . . . . . . 8Poster/Records/Forms . . . . . . . . . 5Surveys . . . . . . . . . . . . . . . . . . . . . 8Training . . . . . . . . . . . . . . . . . . . . . 6Work Comp . . . . . . . . . . . . . . . . . . 5Investigation. . . . . . . . . . . . . . . . . 1Drugs/Alcohol. . . . . . . . . . . . . . . . 0Alternative Work Week . . . . . . . . 020

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Mar

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Do You Have an Extra $80,000to gIve to the StAte of CA?From Mari Bradford (California employers Association)

the Dentist, the employer

Any time an employee is not compensated according to the wage and hour laws of California, they can file a complaint with the State. Not only will you have to pay them their past due wages, but the State will add on some extra interest and penalty fees as an added bonus.

Wage and hour laws have become increasingly complicated in California over the past few years and who knows what the future will hold with a new administration coming in to office. How can you protect yourself? By contacting the SDDS Human Resource Hotline whenever you have questions about your office personnel practices and also by joining us for one of our upcoming HR Audio Conferences. Audio Conferences are scheduled throughout the year. In one short hour, you can receive a wealth of information to help you stay compliant with the confusing world of California Labor Law and stay out of the Labor Commissioners hearing room! The Hotline can be reached Monday through Friday from 8:00am to 5:00pm at 1 (800) 399-5331.

That is the potential check you could write to the Labor Commissioner if you are currently paying your hygienist as an salaried/exempt employee and they are not receiving overtime, meals, rest breaks, etc. and they file a complaint with the Labor Commissioner’s office. Sound outrageous? It is! It’s a crazy amount of money you may have to pay, but if you are not paying your dental staff on an hourly basis, ensuring they take their required breaks and receive overtime for working more than eight hours in a day, you are playing a risky game.

Employees can now claim up to three years of lost wages when they file a complaint with the Labor Commissioner. What is considered a ‘lost wage?’ If you have your employees work an extra half hour without paying them, but ‘let them leave early another day,’ your employees have lost wages. If your employees start the work day at 8:00am and you do not have them start their lunch break until 1:30pm, you have broken the law regarding meal periods and you will owe your employee an extra hour of pay – for every meal break that has not commenced before the completion of the fifth hour of work.

WhaT Can ThE hr hOTlInE dO fOr yOU? Provide you with answers to your questions regarding breaks, meal periods, performance problems, attendance issues and so much more! Simply call (800) 399-5331 and talk to a live person about any HR issues that you are currently dealing with and they will help you out!

WhaT arE ThE TOp hr IssUEs dEnTIsTs arE faCIng TOday? Hygienists — do you pay them on a hourly basis vs. a salary (hint — you should be paying them hourly), how does an office schedule break times when you are trying to schedule patients and make money, what to do when an employee constantly calls in sick with the Monday Flu?

Why shOUld I Call? Get advice on an employee who is driving you crazy. Get a second opinion on what you have been doing for years, that you think “is the right way but are not quite sure”.

WhO has CallEd? The HR Hotline has take over 500 calls from SDDS dentists in the past two years - so don’t worry, you aren’t alone in your HR challenges. Call today!

35

30

25

Jan

number of Calls

Feb

Mar

Apr

May

June

July

Aug

Sept

Oct

nov

Dec

Monthly

Average

20

15

10

5

hr hotLine MonthLy CaLL totaLs

= 2007 = 2008 = 2009 = 2010


Announcements:dentists urged to discontinue use of products

The FDA advises dentists to discontinue the use of dental products manufactured by the Rite-Dent Manufacturing Corporation. The move comes after federal marshals raided the company’s facility in Hialeah, Florida.

The FDA is also advising health practitioners to discontinue the use of alcohol prep pads, alcohol swabs and alcohol swabsticks supplied by the Triad Group following a voluntary recall.

More info: www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm237894.htm

dentists exempt from red flags rule

CDA is pleased to announce that dentists will be exempt from the Federal Trade Commission’s Red Flags Rule that goes into effect Jan. 1, 2011.

President Obama signed into law the Red Flag Program Clarification Act of 2010, which clarifies and narrows the definition of a “creditor” and thereby excludes dentists and other small businesses.

Under the Red Flags law, creditors and financial institutions must implement written identity theft detection and monitoring programs, designed to help business and organizations detect and respond to patterns, practices or specific activities that could indicate identity theft.

The ADA has estimated the nationwide savings in implementation and compliance costs associated with this exemption to be $72 million for dental offices alone.

More info: www.govtrack.us/congress/bill.xpd?bill=s111-3987

dentist Volunteers needed — raM California

Remote Area Medical (RAM) is holding two 4-day clinics in our area in 2011. They are in need of volunteers to help provide free services to children and adults.

sacramento OaklandApril 1–4, 2011 April 9–12, 2011If you are not available to volunteer, please consider making a donation to the RAM CA Expeditions

The California Association of Oral and Maxillofacial Surgeons (CALAOMS) is the host coordinator for this expedition. Please help us support these clinics by volunteering for a day, or multiple days at either or both venues. We need MDs, RNs, DDS/DMDs, OMSs, RDHs, DAs, Ophths, ODs, Opticians, Op Techs, and general volunteers.

More info & to volunteer: www.RAMCaliforniaVolunteers.org

3rd annual Cda foundation dental Motorcycle ride

ken sanford, dds Memorial ride: $400 per rider includes CE, reception, barbecue and Dentists Motorcycle Ride Group Membership.

March 24–27, 2011Death Valley National Park • $400/riderSpeaker: Tom Lenhardt, DMD (Dental anesthesiologist & CDA Trustee)

More info: Ron Mead, DDS ([email protected])

CsUs pre-dental Wine Tasting Event

Proceeds to benefit “Project Backpack,” which provides backpacks with dental and school supplies to children at Smiles for Kids Day.

april 8, 2011

More info: www.csus.edu/org/predental/

“Targeting smiles” sporting Clays TournamentTo benefit California Dental Association Foundation

May 21, 2011Rio Vista, CA • Price TBAMore info: CDA Foundation (916-554-5951 • www.cdafoundation.org)

fluoridation allowable level adjusted by the Epa

The California Dental Association continues to support community water fluoridation and the recommendation by the Department of Health and Human Services to recalibrate the ratio of fluoride to water in community water systems. Currently, the recommended optimal range is 0.7 to 1.2 parts per million. The new recommended level is 0.7 ppm.

Because water is now one of several sources of fluoride, along with toothpaste and mouth rinses, the new recommended lower levels of fluoride will still provide an effective level to reduce the incidence of tooth decay, while minimizing the rate of fluorosis in the general population. Dental fluorosis in the United States appears mostly as cosmetic, barely visible white spots or markings on the tooth’s enamel.

The EPA recently announced that it will review its current maximum allowable level of fluoride in water — 4 parts per million (2 ppm in California) — but the announcement does not question the safety of optimal water fluoridation.

Fluoride remains a proven safe and effective way to prevent dental disease and is recognized by the Centers for Disease Control and Prevention as one of 10 great public health achievements of the 20th century. Currently, almost 75 percent of the U.S. population and 58 percent of Californians (21.5 million) receive fluoridated water, up from 27 percent of Californians in 2002.

More info: www.ada.org/fluoride.aspx.

1-800-399-5331

CALL THE sdds hr hOTlInE WITH ALL YOuR BuRnInG quESTIOnS!


SDDS NomINAtIoNS ARe oPeNA candidate for any office in the Society must be an active or life member in good standing.

DiReCtoRS:

(Sacramento — Yolo — Placer — Amador/El Dorado) — Four (4) Positions Open (2 year term, 2012–2013) on the SDDS Board of Directors

Subject to the provisions and limitation of the California Nonprofit Mutual Benefit Corporation Law and any other applicable laws, and subject to any limitations, of the Articles of Incorporation or Bylaws regarding actions that require approval of the Members, the Corporation’s activities and affairs shall be managed, and all corporate powers shall be exercised, by or under the direction of the Board of Directors. The Board of Directors shall meet as often as is necessary to conduct the business affairs of the Society (currently five times per year). A majority of Members shall constitute a quorum of the Board of Directors for the transaction of business.

tRuStee to tHe CDA BoARD oF tRuSteeS:

One (1) Positions open (3 year term)

Trustees shall serve as members of the managing/fiduciary body of CDA, vested with the authority to conduct the business of the association within the policies established by the CDA House of Delegates. A Trustee serves as a voting member, develops policies, procedures and regulations for the operation of CDA and monitors and sets policy relative to the finances of the association.

DelegAteS to 2011–12 CDA HouSe oF DelegAteS (HoD):

Four (4) Positions open (2 year term)

The Delegates to the CDA shall represent the Society in the House of Delegates of the CDA. In the absence or inability of a Delegate to serve, a regularly elected Alternate Delegate shall act as a Delegate. In the absence of the necessary number of Delegates, the President of the Society will make such temporary Alternate Delegate appointments as needed. The Delegates and Alternate Delegates shall meet each year prior to the annual meeting of the CDA at the call of the President. The Society may instruct the Delegates concerning its policies, and the Delegates are to make every effort to carry out the Society’s instructions.

CDA CounCil PoSitionS:

If you are interested, contact CDA or SDDS for information — CDA is always looking for Council members.

DeADLINe: FeBRuARy 28, 2011

lOOkIng fOr yOUr 2011 dIrECTOry?

Don’t worry, you haven’t missed it!

Last year, the print date for the SDDS Membership Directory was adjusted from January to May. This coincides more closely with the membership dues schedule and annual program calendar, and will therefore be a more accurate resource for SDDS members.

You can expect to receive your copy of the 2011 Directory during the month of June.


YOu ASKED FOR THIS!

Nugget Survey 2009

Every association depends on the willingness of its members to volunteer. SDDS has been so successful because so many of you have done just that. With your support, SDDS has made great strides in fulfilling its mission: to serve our members and enhance the oral health of the community. Unfortunately, that mission is never completely accomplished; we always will demand new voices that help us understand our members’ concerns and our community’s needs.

Those of us at SDDS who have already been given the honor to serve in leadership positions are keenly aware of the selfless time and energy that so many of our colleagues devote to making our Society so special. Along the way, their participation has not only enhanced our prestige but also enriched the social fabric that binds us together. In other words, they are the leaders we hope will heed this call to action.

On the adjoining page we have provided a list of positions our society is looking to fill. The duties and responsibilities are also specified. Please take a few moments to consider applying for these positions or nominating someone you feel is particularly qualified. In the next few months we will be considering applicants for these positions and we would welcome your input. Those individuals we select will be going to the Board of Directors for approval in April or May so please respond promptly.

Be bold and seize the day!

CoMMITTee CornerLeadership Development Committee:A CALL to LeADeRShIP by terrence W. Jones, DDS

leadership development Committee Chair

Board of DirectorsSDDS • 6:00pmMar 1 • May 3 • Sept 6 • Nov 1

Ce CommitteeSDDS • 6:00pmMar 22 • May 24 • Sept 20 • Nov 29

CPR CommitteeSDDS • 6:30pmFuture meetings tba

Dental Health CommitteeSDDS • 6:30pmFeb 7 • Mar 21 • May 16 Sept 12 • Nov 14

ethics CommitteeSDDS • 6:30pmApr 27 • Sept 28 • Nov 16

Foundation (SDDF)SDDS • 6:00pmApr 5 • Sept 12 • Nov 17

2011 SDDS CoMMittee MeetingS:

5400 Park Dr., Rocklin, CA

Medical Building Available For Sale

$99 Per Sq. Ft. 4,592 Sq. Ft. Great Street Visibility 1 Block from Rocklin HS Beautiful Window Line/Greenbelt

Gordon Stevenson Senior Vice President Healthcare Real Estate Specialist TRI Commercial 2250 Douglas Blvd., Suite 200 Roseville, CA 95661 916.677.8150 Tel [email protected]

Helping Those That Help Others

(30 Years Real Estate Exp.)

Committee meetings, CE courses and more available 24/7 on the SDDS website.Visit www.sdds.org and click the “Calendar” button.

golf CommitteeSDDS • 6:00pmFuture meetings tba

leadership Dev. CommitteeSDDS • 6:00pmFeb 10 • Mar 7 • Mar 29

Mass Disaster / Forensics CommitteeLocation TBA • 6:30pm2011 meetings tba

Membership CommitteeSDDS • 6:00pmMar 15 • May 17 • Sept 21 • Nov 15

nugget editorial CommitteeSDDS • 6:15pmMay 17 • Sept 27

SacPAC CommitteeSDDS • 6:00pm2011 meetings tba


deNtal SupplieSDESCO Dental Equipment

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4095 Del Mar Ave. #13Rocklin, CA 95677

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FiNaNcial ServiceSFechter & Company

CraigFechter,CPA

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KimParker,ExecutiveVPMariBradford,HRHotlineManager

800.399.5331www.employers.org2004since

deNtal SupplieSPatterson Dental

JamesRyan800.736.4688

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MagaziNeSacramento Magazine

BeckiBell,MarketingDirector

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LaurenHerman•209.969.6468KevinMcKittrick•916.765.9101

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practice MaNageMeNt & coNSultiNgStraine Consulting

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coNStructioNAndrews Construction, Inc.

ToddAndrews

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coNStructioNBlue Northern Builders

MarcDavis•MorganDavis•LyndaDoyle

916.772.4192www.bluenorthernbuilders.com2007

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Medical gaSeSAnalgesic Services

gearyguy,VPSteveShupe,VP

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Credit Union

gordongerwig,BusinessServicesManager

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preciouS Metal reFiNiNgStar Refining

JimRyan,SalesConsultant800.333.9990www.starrefining.com2009

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tecHNologyTekfix Team

garrettgatewood,President877.291.1099

www.tekfixteam.net2011

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coNStructioNOlson Construction, Inc.

DavidOlson

209.366.2486www.olsonconstructioninc.com2004

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StaFFiNg ServiceSResource Staffing Group

KathyOlson

916.960.2668www.resourcestaff.com

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FiNaNcial ServiceSAmeriprise Financial

ViolettaSitTerpeluk,CFP®,MBA,CRPC®

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deNtal SupplieSHenry Schein Dental

NicoleDeuser,RegionalManager916.626.3002

www.henryschein.com

FiNaNcial ServiceS20/20 Financial Advisers

LeonardSimpson,RFC®,AiF®

916.989.3295

www.2020fa.com2009since

FiNaNcial ServiceSMann, Urrutia, Nelson, CPAs

JohnUrrutia,CPA,PartnerChrisMann,CPA,Partner

916.774-4208www.muncpas.com2010since

HoMe/auto/liFe iNSuraNceLiberty Mutual

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Job placeMeNt perMaNeNt & teMporary

dentassist

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FiNaNcial ServiceSEagle West Group, Inc.

ChrisNunn

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deNtal SupplieSSupply Doc, Inc.

AminAmirkhizi,CEO

877.311.7373www.supplydoc.com2010

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FiNaNcial ServiceSBanc of America

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Want to know more? Contact your Practice Specialist today at 1.800.491.3623. Mention Priority Code ADDPH10A. Or visit us online at www.bankofamerica.com/practicesolutions.

*All programs subject to credit approval and loan amounts are subject to creditworthiness. Some restrictions may apply. Loans greater than $250,000 may be eligible for a 20-year term. **Banc of America Practice Solutions may prohibit use of an account to pay off or pay down another Bank of America account. � Bank of America and Banc of America Practice Solutions are trademarks of Bank of America Corporation. Banc of America Practice Solutions is a subsidiary of Bank of America Corporation. © 2010 Bank of America Corporation

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DENNIS NELSONCPA, APC

PLANNING & CONSULTING ASSOCIATES


traNSitioN brokerWestern Practice Sales

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legal ServiceSWood & Delgado

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a Cpa practice for dental practices: At dennis nelson, Cpa, apC, we provide tax, accounting and bookkeeping services to a large number of Dental Practices and have been for over 24 years. Our level of familiarity specific to Dental Practices ensures that your accounting needs will be met with skill and a high level of knowledge.

fixed rates or a la Carte: For the Dental practice that wants to know the cost up-front for accounting and tax services, we offer special, fixed-rates specifically for Dentists. We also appreciate how important flexibility is to our clients — not every dentist wants to just turn everything over to their CPA. Some of the individual services we provide include:

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Whatever your choice of services, you can be assured of prompt, reliable and accurate services.

annual financial survey results: In addition, our Annual Financial Survey of Sacramento-area Dental practices provides valuable insight into the region and how regional Dentists have been performing over time. Contact us for a complimentary copy today.

dennis nelson, Cpa6611 Folsom-Auburn Road, Suite C • Folsom, CA 95630Main Number (916) 988-8583 • Toll Free 800-464-8583 • Fax 916-988-8801www.cpa4dentists.net

DENNIS NELSONCPA, APC

PLANNING & CONSULTING ASSOCIATES

neWTHiSyEAR!

neWTHiSyEAR!

We’re bloWIng your horn!

CoNgRAtULAtIoNS to...Have some news you’d like to share with the Society? Please send your information (via email, fax or mail) to SDDS for publication in the Nugget!


Drs. Nicky Hakimi and the SDDS Membership Committee, for their successful “Fun Times” Ski Trip to SugarBowl! (photo at right)

Dr. Lora Foster Rode and her husband, Jim, who are expecting their first child in June 2011!

Dr. Dale Thompson, for his 17-year-old grandson Danny’s involvement with NASA! Danny’s experiment, which he dreamed up with a team of eight students during an internship at Institute for Systems Biology, was accepted to be launched into space on the last mission of Space Shuttle Endeavor this coming April.

Dr. Kevin McCurry, for the sale of his practice and his family’s move to beautiful Wyoming. Dr. McCurry, we’ll miss you and Cheri, but you sure do look happy there! (photo at right)

Dr. Ike Rahimi for dancing the night away! When he’s not practicing dentistry, Dr. Rahimi teaches Zumba on the side. Alright, Dr. Rahimi — let’s see those hips!

Dr. John Cutter, for his new position with an affiliate of the Center for Disease Control; he is one of the two dentists responsible for the oral assessment units of 15 research centers across the United States.

Dr. Lisa Laptalo, on opening her new practice, Dentistry for Children, in Sacramento!

JasonCaluzaCA Lic. #0D97803

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Pro e n en s s. I ’sallwe o.

Sacramento-7.5x4.875.pdf 1 3/9/10 9:47 AM

Dr. McCurry (left) enjoys the snow of Wyoming, while Dr. Hakimi and friends (right) hit the slopes at SugarBowl.


impressions, fabricate and place temporary restorations and later will fit, cement, and adjust the occlusion of the final restorations. All this is done under the direct supervision of the dentist. The capacity of a single dentist to provide restorative dental treatment is almost doubled if you assume the dentist is treating another patient while the RDAEF is working.

Now this is really powerful stuff. There are people and groups arguing that the reason for so much untreated dental disease in California is due to a lack of providers. That what is needed to solve the dental caries epidemic in California is to create a new dental provider, a non-dentist, who will expand the capacity of the dental industry to drill and fill our way out of this dental disease problem. Yet, here is a mechanism that exists today to essentially double the capacity of each general dentist in providing restorative dental care. But wait! It gets even better since a dentist is allowed to supervise up to (three) RDAEFs the capacity of a general dentist can almost be tripled!

Let’s do some math. The dentist to population ratio on average in the United States is 1:1639. In California it is about 1:1250 so we already have many more drills available that the national average. (These numbers are an average of what is available from the American Dental Association, the California Dental Association and the Dental Board of California.) Now assume that just 20% of the dentists incorporate just one RDAEF in their practice and utilize that staff person fully. Now the dentist (Drill) to population ratio goes to 1:1042. Think about this. Using our existing dental practice laws we can easily achieve a higher dentist to population ratio than any state and have it all done under the direct supervision of a dentist.

The second significant Dental Workforce event happened with the approval of a pilot program to test the feasibility of new workforce models. California is one of only a handful of states that has a department with the express mission of allowing trial runs of job duties that currently are not allowed under California law. It is known as the Office of Statewide Health Planning and Development (OSHPD “osh pod”). A test of new job duties is known as a Health Workforce Pilot Project. The dental workforce demonstration project I am writing about is known as Health Workforce Pilot Project #172 (HWPP 172). HWPP 172 is the continuation of a teledentistry project run out of Arthur A. Dugoni, School of Dentistry by Dr. Paul Glassman. His pilot project demonstrates the feasibility of supervising remotely sited dental auxiliaries via computer linkage and would temporarily allow two new dental duties: allowing dental auxiliaries to take radiographs on new patients without the prior order of a dentist and, allowing dental auxiliaries to excavate caries and place a temporary glass ionomer restoration. These duties would be tested over one year by having RDAs, RDHs and RDHAPs work in nursing homes, public health facilities and schools as remote dental teams that communicate with a “collaborating dentist” via web technology. There would be no dentist on site. This is heady stuff. When it comes to the prospect of Midlevel Providers, this is the tip of the spear.

This project also gets down to what many people feel is the very definition of a dentist… a dental surgeon. The removal of human tissue. This is not an RDAEF working under the direct supervision of a dentist removing dental caries. These are RDHs and RDAs removing dental caries via remote supervision. No local anesthesia. No dentist on site for backup. These patients then have a glass ionomer

restoration placed as a temporary restoration to stabilize the patient until they can obtain definitive treatment by a dentist.

Now I am sure that I am the only dentist who has had patients who are dumbfounded when told that the reason they have a painful swelling in their jaw is that they did not complete the endodontic treatment they were advised to have after having had a pulpectomy three years earlier and were told that that procedure was only temporary (and is documented in the chart). So in the situation presented by HWPP 172 there should be no confusion on the part of the patients or the parents of the patients that even though they did have a filling today, that it is only a temporary and they still need to see a real dentist for treatment. In the end it will still come down to money. The temporary was free via a public health project, but there is no money for the definitive treatment. Even if there is money for the definitive treatment, should the public be paying twice to treat a single problem?

I am not trying to be an obstructionist in looking at alternative methods to solve the problem of dental caries in America. After looking at all the approaches to solving the problem of dental caries the best answer still seems to be that prevention is the best choice, and if you need treatment that you get appropriate treatment by a fully competent practitioner the first time. And what I mean by a fully competent practitioner is one that can handle virtually any outcome of starting a procedure. A two-tiered or three-tiered dental treatment model just doesn’t seem fair to the patients and certainly doesn’t seem to be cost effective.

Ladies and gentlemen, these issues are the tip of the spear.

The current laws regarding dental auxiliary utilization can be found on the DBC website at: http://www.dbc.ca.gov/formspubs/pub_statutes20090101.pdf

You can contact me at: [email protected] or (916) 214-6663.

The Academy of General Dentistry is an organization by and for General Dentists only. For it to work, we must know how you feel on everything to do with you practicing dentistry. This is one issue that the CAGD Board feels has significant impact on our practice of general dentistry and we want to hear from you.

the tip of the Spearcontinued from page 8

CHECKTHEWEB!www.sdds.org

ADveRtISeR iNdexDentAl SuPPlieS, equiPMent, RePAiRAccurate Handpiece Repair . . . . . . . . . . . . . . . . . . . . . . . . 29DESCO Dental Equipment . . . . . . . . . . . . . . . . . . . . . . . 26Henry Schein Dental. . . . . . . . . . . . . . . . . . . . . . . . . . 24, 26Patterson Dental Supply, Inc. . . . . . . . . . . . . . . . . . . . . . . 26Procter & Gamble Distributing Co. . . . . . . . . . . . . . . . . . 26RelyAid . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26Supply Doc, Inc. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17, 26

FinAnCiAl & inSuRAnCe SeRViCeS20/20 Financial Advisors of Sacramento, Inc. . . . . . . . . 9, 26Ameriprise Financial . . . . . . . . . . . . . . . . . . . . . . . . . . 26, 33Banc of America Practice Solutions . . . . . . . . . . . . . . . . . . 26Dennis Nelson, CPA . . . . . . . . . . . . . . . . . . . . . . . . . . 26, 27Eagle West Group, Inc. . . . . . . . . . . . . . . . . . . . . . . . . . . . 26Fechter & Company, CPAs . . . . . . . . . . . . . . . . . . . . 26, 34First U.S. Community Credit Union. . . . . . . . . . . . . . . . . 26Liberty Mutual Insurance . . . . . . . . . . . . . . . . . . . . . . . . . 26Mann, Urrutia & Nelson, CPAs . . . . . . . . . . . . . . . . . 21, 26Principal Financial Group . . . . . . . . . . . . . . . . . . . . . . . . . 26TDIC & TDIC Insurance Services . . . . . . . . . . . . . . . 18, 28U.S. Bank . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11Union Bank . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17, 27

HuMAn ReSouRCeSCalifornia Employers Association (CEA) . . . . . . . . . . . . . . . 26

legAl SeRViCeSWood & Delgado . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27

MeDiCAl gAS SeRViCeSAnalgesic Services, Inc. . . . . . . . . . . . . . . . . . . . . . . . . . . . 26

oFFiCe DeSign & ConStRuCtionAndrews Construction . . . . . . . . . . . . . . . . . . . . . . . . 11, 26Blue Northern Builders, Inc. . . . . . . . . . . . . . . . . . . . . . 9, 26Henry Schein Dental. . . . . . . . . . . . . . . . . . . . . . . . . . 24, 26Olson Construction, Inc. . . . . . . . . . . . . . . . . . . . . . . . . . 26

PRACtiCe SAleS, leASe, MAnAgeMent AnD/oR ConSultingDBC Consulting. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20Henry Schein Dental. . . . . . . . . . . . . . . . . . . . . . . . . . 24, 26JoAnne Tanner, MBA. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21Straine Consulting. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26TRI Commercial Real Estate (Gordon Stevenson) . . . . . . . . 25Western Practice Sales . . . . . . . . . . . . . . . . . . . . . . . . . 27, 33

PuBliCAtionSSacramento Magazine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .26,

StAFFing SeRViCeSdentassist. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26Resource Staffing Group. . . . . . . . . . . . . . . . . . . . . . . . . 21, 26

teCHnologyAthena Global Media (AGM1). . . . . . . . . . . . . . . . . . . . . . . 19Tekfix . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26, 27

WASte MAnAgeMent SeRViCeSAbsolute Securred Shredding . . . . . . . . . . . . . . . . . . . . . . . . 33Star Refining. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26


2010 membersHiP RePoRt

New memBeRS:New members: 39New dual members: 1New aFFiliate members: 2New studeNt members: 4New traNsFers: 26

totAL New memBeRS: 72

memBeRS LoSt:traNsFerred out: 13droPPed For NoN-PaymeNt: 36reiNstated: 7 •Net: 29deCeased: 11aPPliCatioNs witHdrawN: 0resiGNed membersHiP: 12droPPed (otHer reasoNs): 6studeNt to aCtiVe: 4totAL LoSt: 75

liNk Of THE mONTHContinue your volunteer spirit with the RAM event — coming

to Sacramento (Cal expo).

sign up to help at:

www.RAMCaliforniaVolunteers.org

stumbled upon a great link?email it to [email protected], to submit

it as a possible link of the month!

April 1–4, 2011


neW MeMbersweLCometo SDDS’s new members, transfers and applicants.

CliP out this handy New member uPdate and insert it into your direCtory under the “New members” tab.

February 2011

imPortaNt NUmBeRS:

SDDS (doctor’s line) . . . . . . . (916) 446-1227

ADA . . . . . . . . . . . . . . . . . . (800) 621-8099

CDA . . . . . . . . . . . . . . . . . . (800) 736-8702

CDA Contact Center . . (866) CDA-MEMBER (866-232-6362)

CDA Practice Resource Ctr . . cdacompass.com

TDIC Insurance Solutions . . (800) 733-0633

Denti-Cal Referral . . . . . . . . (800) 322-6384

Central Valley Well Being Committee . . . . . (559) 359-5631

totAL aCtiVe memBeRS: 1,312totAL retired memBeRS: 198totAL dual memBeRS: 2totAL aFFiliate memBeRS: 12

totAL studeNt/ ProVisioNal memBeRS: 2

totAL CurreNt APPLICANtS: 9totAL dHP memBeRS: 36

totAL New memBeRS For 2011: 3

totAL membersHiP (as oF 1/19/11): 1,571

KeeP usUPDAteD!Moving? Opening another office?Offering new services?Share your information with the Society!

We can only refer you if we know where you are; and we rely on having your current information on file to keep you informed of valuable member events! Give us a call at (916) 446-1227.

The more accurate information we have, the better we can serve you!

Ricardo Andrade, DDSGeneral Practitioner9833 Horn Rd, Ste ASacramento, CA 95827(916) 368-2500Dr. Ricardo Andrade graduated from the UCSF School of Dentistry in 2005 with his DDS. His general practice is located Sacramento where he practices with his wife and fellow SDDS new member, Dr. Denisse Montalvo. Drs. Andrade and Montalvo live in El Dorado Hills.

Denisse Montalvo, DDSGeneral Practitioner9833 Horn Rd, Ste ASacramento, CA 95827(916) 368-2500Dr. Denisse Montalvo graduated from the UCSF School of Dentistry in 2007 with her DDS. Her general practice is located in Sacramento where she practices with her husband and fellow SDDS new member, Dr. Ricardo Andrade. Drs. Andrade and Montalvo live in El Dorado Hills.

Shibani Sehgal, DMDGeneral PractitionerPending Office Address Dr. Shibani Sehgal graduated from the University of Pennsylvania School of Dentistry in 2010 with her DMD. She is currently seeking employment in the greater Sacramento area and lives in Sacramento.

Gregory Senter, DDSGeneral Practitioner87 Scripps Dr, Ste 102Sacramento, CA 95825(916) 565-1300Dr. Gregory Senter graduated from the UOP Arthur A. Dugoni School of Dentistry in 1980 with his DDS. His general practice is located in Sacramento and he lives in Carmichael with his wife, Alisha.

Jonathan Vongschanphen, DDSGeneral Practitioner2161 Sunset Blvd, Ste 300Rocklin, CA 95765(916) 772-2838Dr. Jonathan Vongschanphen graduated from Loma Linda University in 2001 with his DDS. His general practice is located in Rocklin and he lives in Roseville.

New traNsFer memBeRS:Satbir Kahlon, DMDTransferred from Santa Clara County Dental SocietyGeneral Practitioner140 Folsom RdRoseville, CA 95678(916) 784-2129Dr. Satbir Kahlon graduated from the Tufts College Dental School in 2002 with her DMD. She is currently practicing in Roseville after recently purchasing the practice of fellow SDDS member, Dr. Kevin McCurry.

Jooyoung Oh, DDSTransferred from San Joaquin Dental SocietyGeneral Practitioner15 W Main StIone, CA 95640(209) 274-2600Dr. Jooyoung Oh graduated from Loma Linda University in 2005 with her DDS. She is currently practicing in Ione and lives in Elk Grove.

Samuel Oglesby, DDSTransferred from Tri-County Dental SocietyEndodontist4001 Hwy 104Ione, CA 95640(209) 274-4911Dr. Samuel Oglesby graduated from UCSF School of Dentistry in 1974 with his DDS and later completed his specialty certification in Endodontics at the Herman Ostrow School of Dentistry of USC in 1980. He is currently practicing in Ione and lives in Garden Grove.

New studeNt memBeR:Jesse MantonUniversity of the Pacific, 2014

Navneet Sahota UOP Arthur A. Dugoni School of Dentistry, 2011

New aPPliCaNts:Israel Armijo, DMDAnnie Barnes, DDSStephen Barnes, DDSGrant Irwin, DDS — weLCome BACK!William Koett, Jr., DDS — weLCome BACK!Mignon Mapanao, DMDFeroz Nawabi, DDSKenneth Silva, DDSKirk Youngman, DMD

welCome baCk!

welCome baCk!

2011 nEW MEMBER DInnERaprIl 6, 20116pm • Old Spaghetti Factory


What went wrong? How should the case have been handled? What can be done at this stage?

Dr. Brown is an experienced orthodontist and the technical phase of his treatment is not at issue. The problems of the case are associated with the evaluation and handling of the patient. We do not work in a vacuum; we treat people with all their attitudes, expectations and foibles.

In this case, the first misstep occurred, when Dr. Brown relied on the patient’s assurances that he would do “whatever it took to make the orthodontic treatment a success,” when the evidence did not support the patient’s assertions. Dr. Brown and the patient’s general dentist should have insisted on a stable oral environment and signs of the patient’s commitment to the treatment, before embarking on the orthodontic regimen. However, we all know how convincing patients can be, when they try to talk us into a treatment option which we know to be fraught with problems.

Communication between Dr. Brown and the general dentist was only sporadic, was not documented in the chart or supported by a letter exchange. To an attorney reviewing the records, there is nothing to indicate that there was any communication between the providers.

Proper treatment records require a paper trail documenting everything we do for our patients. Such details assist the patient in his or her future care as well as the dentist in the defense of his diagnosis and treatment of the patient. Both orthodontist and general dentist should have alerted each other regarding the patient’s deteriorating oral condition and his uncooperativeness with the treatment.

Frequently, a dentist is unsure about his obligations to continue treatment of a patient. Can he bow out at all and if so, when? The doctor-patient relationship is no more sacrosanct than a marriage, which can end in divorce. Hence, if done properly, a dentist can — and as we see in the above case — should discontinue treatment. When Dr. Brown realized that the patient was uncooperative, continually broke appointments and did not maintain his oral

A few days ago, I received a call from an orthodontist client, who was frustrated and anxious about the way a case had turned out and wanted advice on how to handle the situation: A patient was threatening to file a malpractice as well as a license complaint against him. What had gone wrong?

I have changed some facts and background information to protect his privacy, but the legally important details have been kept intact in order to give you an overview of the situation and provide guidelines in the prevention and handling of such cases.

According to Dr. Brown (not his real name), the patient had periodontal problems and lacked hygiene care, but was anxious to “get his teeth straightened.” Discussions ensued between the orthodontist, the general dentist and the patient regarding the patient’s oral care and his periodontal condition. The patient insisted that he was going to mend his ways and would do whatever it took to make the orthodontic treatment a success.

Dr. Brown went ahead with the placement of the brackets and the scheduling of successive appointments. Subsequent treatment notes indicate Dr. Brown’s dissatisfaction with the patient’s oral hygiene and missed appointments. The situation deteriorated over the next 18 months. The periodontal condition worsened, carious lesions began to show up, and the patient began to experience pain and discomfort. Dr. Brown had not seen the patient for four months, when he received a request from the patient that copies of his records were to be sent to another orthodontist, call him Dr. Black. The patient was obviously dissatisfied with his treatment.

Dr. Black was appalled at what he saw: uncontrolled periodontal problems, carious lesions, broken brackets, etc. He indicated to the patient that the prior orthodontist had done a less than stellar job bordering on malpractice. The patient wrote a letter to Dr. Brown threatening legal action and asking for a refund of the monies paid for the unsuccessful and sub-par treatment.

It’s the Law:wheN ALL goeS to heLL IN A hANDBASKet

hygiene regimen, he should have removed the brackets and terminated treatment.

Obviously, such actions should not come as a total surprise to the patient. In fact, the dentist’s right to discontinue treatment in case of a lack of follow-through by the patient with treatment-related recommendations should be stated in the consent form the patient signs before treatment begins, and it should be explained to the patient in subsequent certified mailings. Again, it is important to establish the paper trail, to reiterate the reasons for the discontinuance of treatment and to impress upon the patient that this is necessary because of his own failure to live up to his end of the deal.

Finally, I would like to briefly address the behavior of Dr. Black, the subsequent provider. Before any of us passes judgment on a colleague because of problems we see in the mouths of new patients, it behooves us to pick up the phone and call the colleague to discuss the case.

While in this case the action might not have prevented the patient from blaming Dr. Brown and threatening legal action against him, a phone conversation with Dr. Brown might have given Dr. Black an indication of what to expect from his new patient and would have alerted him to possible problems down the road.

Experience shows that an uncooperative patient does not always turn into a compliant one over night or after a change to a new provider.

As far as Dr. Brown is concerned, he is in a difficult situation because certain warning signs were missed and his treatment records were incomplete. At this time, this case is unresolved. But it serves as a lesson to all doctors and teaches us to avoid making similar mistakes in our practices.

Reprinted with permission from Chicago Dental Society. The above article does not constitute legal advice but is for educational purposes only. In order to obtain legal advice, a personal consultation with an attorney is required. The views expressed in this column are those of the writer and not necessarily the opinions of SDDS.

by Petra von Heimburg, DDS, JD


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lInk TO yOUr praCTICE WEBsITE On WWW.sdds.Org!

SDDS Members only: $300 for one year (renew for $100/year)

See www.sdds.org/MembersOnline.htm for more information.


evenT hIghlIghTsJANUARy geNeRAL memBeRShIP meetINgJanuary 11, 2011 — Hygiene Night

1: Drs. Jason Matsushino (left) and John Fuiks (right) arrive with their staff. 2: Drs. William Sloan and Elizabeth Johnson catch up after the holidays. 3: Dr. Richard Silva stops for a photo with his staff members, Sherry and Edwina. 4: Karen Roth, Dr. Sean Roth and Jessica McVey enjoy the social hour. 5: Dr. Wai Chan calls to order his first General Meeting as SDDS President. 6: Dr. Carl Hillendahl (center) with his staff. 7: Dr. Cindy Weideman presents the Helen Andrus Award to Debra Payne (First 5 Sacramento), for her dedication to children’s dental health in the community. 8: Dr. Wai Chan presents the Western Career College Hygiene Award to Amanda Spear. 9: Dr. Mitch Goodis demonstrates the “knee-to-knee” technique for infant exams. 10: What will he think of next? Dr. Jonathan Szymanowski gets the crowd excited for MidWinter 2011 — Under the Boardwalk.

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Selling your practice? Need an associate? Have office space to lease? Place a classified ad in the Nugget and see the results! sdds member dentists get one complimentary, professionally related classified ad per year (30 word maximum; additional words are billed at $.50 per word). Rates for non-members are $45 for the first 30 words and $.60 per word after that. Add color to your ad for just $10! For more information on placing a classified ad, please call the SDDS office (916) 446-1227. Deadlines are the first of the month before the issue in which you’d like to run.

SDDS memBeR DeNtIStS CAN PLACe CLASSIfIeD

ADS foR fRee!


dentists serving dentists — Western Practice sales invites you to visit our website, westernpracticesales.com to view all of our practices for sale and to see why we are the broker of choice throughout northern California. (800) 641-4179. 03-09

great loCation on madison ave in CarmiChael — 40 years established. no mediCal, no capitation. dr. retiring. great, loyal patients and staff — will stay. (916) 966-8567 [email protected]. 12-10

Stop the Screaming! In-office sedation services by MD anesthesiologist • Pedo/Adults • Medi-Cal Provider • 20 years experience • Call (800) 853-4819 or [email protected]. 05-07

loCum tenens — i am an experienced dentist, uoP graduate and i will temporarily maintain and grow your practice if you are ill / maternity leave or on extended vacation. (530) 644-3438. 04-10

loCum tenens — loma linda grad, 1980. temporary dentist for emergencies, vacations and maternity leaves. (530) 823-0502. 02-11

#1 DentIst PArtner / AssoCIAte: experienced gd seeking a long-term, mutually beneficial plan. to discuss possibilities or reserve a meeting, please contact Gayle: (916) 784-6982 or [email protected]. temporarily, available for vacations, maternity leave or illness. 02-11

New CLASSIfIeD SeCtIoNS!Vacation homes • Misc items for sale • Home rentals / sales • Tickets

Contact SDDS at (916) 446-1227 for more information.

3‘-8”

S.V.

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2O -6O

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4O -6

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2‘-6“

lite

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Vacation Trade

3‘-8”

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2‘-6“

2O -6O

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3O -5O

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lite

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Sporting Event Trade

YOu ASKED FOR THIS!

Nugget Survey 2009

greater saCramento area multi-sPeCialty offiCe looking for an associate pediatric dentist and orthodontist 2–4 days/week. Ideal candidate is a skilled team player looking for long-term commitment. fax resume to (916) 817-4376. 11-10

for sAle: AssIstAnt ChAIrs — Pelton chair with bone cloth, adjustable foot rings. Purchased 2002. $150.00. marcus with bone cloth, adjustable foot rings. Purchased 1995. $100.00. 12-10

SDDS HR hotline:1-800-399-5331

HAVe An uPCoMing PReSentAtion?the SDDS LCD projector is available for rent!

three days — $100members only pleaseCall SDDS at (916) 446-1227 for more information or to place a reservation.

design your oWn dental suite offering generous tenant improvements for this 800 sq ft office space. rent negotiation is available. the suite is in a three story mid-town dental complex. (916) 448-5702. 11-10

DreAM offICe shell — nICest / newest In saCramento! Build / design 2,000 sf to suit. near watt / el Camino, close to shopping. Great for new / existing practice, general / specialty. Call Dr. favero (916) 487-9100. 02-C1

free rent — fully equipped, 4 ops, dentrix software, arden area, great for starting new practice. former location of 35 year practice. Contact douglas yee (916) 801-1707. 11-10

oPeratory sPaCe to share with orthodontist or endodontist in general dental office on J street and 51st street. Contact Dr. steven Brazis at (916) 731-5151 to discuss details if interested. 02-11

suite for lease — in Midtown sacramento at 30th & P. ideal for perio, endo or oral surgery. improvements + allowance for modification. signage, high visibility, on-site parking and freeway access. in the midst of sutter’s medical campus expansion. (916) 473-8810. lic. 01227233. 02-11

sDDs CalenDar oF evenTs15 Golf Committee 6:00pm / SDDS Office

Membership Committee 6:00pm / SDDS Office

16 SDDF Broadway Series 9–5 8:00pm / Sac Community Center

18 Member Forum Build Your Own Employee Handbook Mari Bradford (CEA) SDDS Office 915 28th Street, Sacramento 8:30am–12:30pm

21 Dental Health Committee 6:30pm / SDDS Office

24 Member Forum The Numbers of Your Practice:

The Good, the Bad, Avoiding the Ugly John Urrutia, CPA

(Mann, Urrutia, Nelson, CPAs) Sacramento Hilton — Arden West 2200 Harvard Street, Sacramento 6:30pm–8:30pm

March 8, 2011:Benign & Malignant Tumors

of the neck & Skin

Earn

2CE UnITs!

MARCH GEnERAL MEMBERSHIP MEETInG: spOUsE nIghT

6pm: Social & Table Clinics7pm: Dinner & Program

Sacramento Hilton, Arden West (2200 Harvard Street, Sac)

Presented by:Barbara Burrall, Md

COuRSE OBJECTIVES:• Recognize normal variant cutaneous structures• Recognize a range of benign cutaneous tumors• Recognize a range of cutaneous malignant tumors, including melanoma and non-melanoma cancers• Perform a general head and neck skin cancer screening

YOu ASKED FOR THIS!Nugget Survey 2009

PRSRT STD

US POSTAGE

PAID

PERMIT NO. 557

SACRAMENTO, CA

915 28th StreetSacramento, CA 95816916.446.1211www.sdds.org

ADDRESS SERVICE REQUESTED

for more calendar info, visitwww.sdds.org

3–

SAVE THE DATE FOR THE 32nd annUal MIdWInTEr COnVEnTIOnTOnS OF CE & A GREAT TIME! YOu WOn’T WAnT TO MISS IT! fEBrUary 9–10, 2012

4 Continuing Education Removable Partial Dentures:

Clinical Considerations Alan Carr, DMD, MS Hyatt Regency Sacramento 1209 L Street, Sacramento 6:30pm–8:30pm

7 Leadership Development Committee 6:00pm / SDDS Office

7 CE Committee 6:00pm / SDDS Office

8 General Membership Meeting Benign & Malignant Tumors

of the Neck & Skin Barbara Burrall, MD SpouseNight Sacramento Hilton — Arden West 2200 Harvard Street, Sacramento 6:00pm Social 7:00pm Dinner & Program

10 Dental Health Sub-Committee 6:30pm / SDDS Office

UNDER THE BOARDWALKE E

SDDS PRESENTS THE 31ST ANNUAL MIDWINTER CONVENTION & EXPO

fEbrUary4 31st Annual

MidWinter Convention & Expo Sacramento Convention Center

7 Dental Health Committee 6:30pm / SDDS Office

10 Leadership Development Committee 6:00pm / SDDS Office

11 Executive Committee Meeting 7:00am / Del Paso Country Club

21 President’s Day SDDS office closed

marCH1 Board of Directors Meeting 6:00pm / SDDS Office

Documents

February 2011 Nugget