north texas dentistry convention issue volume 2 issue 7

VOLUME 2 | ISSUE 7

Smiles in the SpotlightLife After TraumaSloan Hildebrand, DDS, MS

ProfileRobert ZimbroNational Target Mailing/DentistryPostcards.com

Community NewsPerot Museum of Nature and Science Delivers

North Texas

Dentistrya business and lifestyle magazine for north texas dentists

The Bestof BothWorldsMarshall V. Johnson, DDS, MS& Elizabeth D. Jaynes, DDS, MS

convention issue

See dozens of patient, doctor and team member videos at DRSdoctor.comTo learn more, call 866-250-5657

INNOVATIVE“An innovative diagnostic and treatment technology is now available for dental practices that enable an objective diagnosis of muscle and force dysfunction, as well as pain management through physical rehabilitation of the musculoskeletal physiology, software and therapeutic protocols that have been well developed and tested to provide predictable results through straightforward, conservative care.” - Shane Sykes, DMD, November DentalTown

WAITING LIST OF NEW PATIENTS“We’ve experienced professional growth, and I’ve expanded my practice in previously unimaginable ways, all by assessing and treating dental force related conditions and their symptoms. The clinic is � ourishing, and within recent weeks, we’ve had 100 patients wait for TruDenta treatment schedule... TruDenta taps into a new market of clients directly bene� ting from your services, which helps ensure increased revenue during economically unstable times.” - Robert Harrell, DDS, November Dental Tribune

EXCEPTIONAL CARE“Using the TruDenta system, dentists can provide exceptional care by delivering an objective, visually engaging diagnosis and o� ering scienti� cally proven, systematic and predictable treatments for patients su� ering with the symptoms of dentomandibular sensorimotor dysfunction.” - Ronald Ritsco, DMD, MS, PA, FACE, October 2012 Inside Dentistry

See dozens of patient, doctor and team member videos at

“An innovative diagnostic and treatment technology is now available for dental practices that enable an objective diagnosis of muscle and force dysfunction, as well as pain management through physical rehabilitation of the musculoskeletal physiology, software and therapeutic protocols that have been well developed and tested to provide predictable results through straightforward, conservative care.”- Shane Sykes, DMD, November DentalTown

“Using the TruDenta system, dentists can provide exceptional care by delivering an objective, visually engaging diagnosis and o� ering scienti� cally proven, systematic and predictable treatments for patients su� ering with the symptoms of dentomandibular sensorimotor dysfunction.” MS, PA, FACE, October 2012 Inside Dentistry

100% ROI“I � rmly believe I will see well over 100% ROI within the � rst year. The system works because the patients can see tangible results from the very � rst appointment. The pro� tability is limited only to the amount of e� ort put in by the dentist and team.” - Jodi Danna, DDS, September 2012 The Progressive Dentist

Dental Headache CareThe Fastest Growing Niche in Dentistry

Life Changing Dentistry

Dentists can now predictably treat dental force related pain and dysfunction in the head, neck, face and jaw. Booth #1225

www.northtexasdentistry.com | NORTH TEXAS DENTISTRY 3

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North Texas

Dentistry

BAYLOR COLLEGE OF DENTISTRYAddressing the Trend in Turnkey CareBCD launches post-graduate surgical implant training program

SWDC BOOTH LISTINGCheck out the NTD advertisersChart your course at the convention and don’t miss a thing!

PROFILERobert ZimbroNational Target Mailing/DentistryPostcards.com

MONEY MATTERSCliff Hangers They make for good movies – but not good portfolio decisions

SMILES IN THE SPOTLIGHTDr. Sloan HildebrandLife After Trauma

PRACTICE MANAGEMENTFinancing Success Strategies for the Modern Dental PracticeMake your toughest conversations with patients a win-win

PRACTICE TRANSITIONA Deer in the HeadlightsDon’t panic – take the chaos out of the crisis

PRACTICE MARKETINGProtect Your RepPatient reviews can make or break your dental practice

LEGAL NEWSAre You Obstructing Justice Without Realizing It?Tips to avoid actions that could be construed as criminal

WINE CELLARVirtual Wineries, Real Good WinesThe role of the négociant in getting great wine to your glass

COMMUNITY NEWSThe Perot Museum of Nature and Science Delivers180,000 square feet inspiring minds through nature and science

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8 ON THE COVER: Dr. Elizabeth D. Jaynes and Dr. Marshall V. Johnson

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ON THE COVER

The Best of Both WorldsDr. Marshall V. Johnson and Dr. Elizabeth D. Jaynes

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NORTH TEXAS DENTISTRY | www.northtexasdentistry.com4

Happy New Year to All!

As 2013 begins, North Texas Dentistry isexcited to present the Convention Issue forthe Southwest Dental Conference. We lookforward to continuing to bring our readersthe latest news and information of interest tothe North Texas dental community. I hope tosee many of you at the Southwest DentalConference, January 17-19, at the DallasConvention Center. Please stop by to sayhello and tell us about your practice or busi-ness. North Texas Dentistry will be inbooth #1327.

I believe 2013 will be another fascinating yearfor readers of North Texas Dentistry.During the coming year we plan to expandour cover features to spotlight several dentalindustry professionals in addition to leadingdental professionals.

For this issue’s cover story, North TexasDentistry features the periodontal practiceof Dr. Marshall Johnson and Dr. ElizabethJaynes. Dr. Jaynes is an active member of theDallas County Dental Society and holds lead-ership positions with the Southwest DentalConference, making this feature even moretimely. I worked with Drs. Johnson & Jaynesseveral years ago and their practice continuesto have an outstanding team utilizing the lat-est in equipment & technology.

This issue is packed with lots of great editori-als and information. Smiles in theSpotlight features a case by Dr. SloanHildebrand that details the restoration of asmile following a traumatic injury. LegalNews offers tips to avoid obstructing justiceand Money Matters offers suggestions forportfolio management in these uncertainfinancial times. The Dallas Arts District has anew addition which has received ravereviews, The Perot Museum of Nature andScience. North Texas Dentistry is pleasedto share information on what the museumoffers along with some fabulous photos. It iswell worth a visit in the New Year!

Don’t miss the Southwest Dental ConferenceSpecial Booth Listing (pages 6 & 7) for theNorth Texas Dentistry advertisers whoare exhibiting at the conference. Plan to stopby their booths to see the products and serv-ices they offer and let them know you appre-ciate their support of this publication.

Keep smiling and I hope to see you at the2013 Southwest Dental Conference!

LuLu Stavinoha, RDHPublisher

from the publisher

Although every effort is made to ensure the accuracy of editorial material published in North TexasDentistry, articles may contain statements, opinions,and other information subject to interpretation. Accordingly, the publisher, editors and authors and theirrespective employees are not responsible or liable forinaccurate or misleading data, opinion or other informa-tion in material supplied by contributing authors. Copyright 2012. All rights reserved. Reproduction inpart or in whole without written permission is prohibited.

Advertise in North Texas DentistryFor more information on advertising in North Texas Dentistry, call LuLu Stavinoha at (214) 629-7110 oremail [email protected]. Send written correspondence to: North Texas Dentistry P.O. Box 12623 Dallas, TX 75225

North Texas

Dentistry

Ray BryantPHOTOGRAPHY

Tina CaullerWRITING / DESIGN

Publisher | LuLu StavinohaPhotographer | Ray Bryant, Bryant StudiosContributing Writers | Tina Cauller, Kim Clarke,Carolyn Cox, Marc Fowler, Dru Halverson, John O. Hetzel, Dr. Sloan Hildebrand, Cathy Jameson,Dr. Richard V. Lyschik, Sarah Q. Wirskye

Remember to “Like” us on Facebook at: http://www.facebook.com/NorthTexasDentistry


Just four months into the new postgraduate surgical implanttraining program at Baylor College of Dentistry, coordinator Dr. William Nagy is enthusiastic about its progress.

“There’s no other program like it in the country,” says Nagy,professor in restorative sciences and director of the prostho-dontic graduate program. “It’s working very well so far.”

Funded by a $100,000 five-year grant from dental device man-ufacturer Biomet 3i, the initiative serves graduate residents inthe areas of prosthodontics and advanced general dentistry.This puts prosthodontic residents ahead of the curve in meetinga new education standard of the Commission on DentalAccreditation: Effective 2014, prosthodontic graduates mustplace implants.

“There is a big emphasis on prosthodontists placing implantsas part of a turnkey effort involving both surgery and restorativecare,” Nagy says. “Previously prosthodontic residents placedfive to 10 implants in the three-year program; these were placedin the oral surgery clinic with the assistance of oral surgery fac-ulty and residents.

“While our residents participated in treatment planning andassisted the surgeon during placement of all their patients’implants, most implant surgery was done by periodontic resi-dents and oral surgery residents and faculty. Implant placementalready is an integral part of those graduate programs.”

Dr. Josh Chapa, a periodontist, was hired as a clinical assistantprofessor July 1 to supervise the residents in the program anddesign the course curriculum. Faculty members from theDepartment of Oral & Maxillofacial Surgery presented a 14-ses-sion course this summer for prosthodontic and AEGD residents.

“The summer didactic class encompassed the basic surgicaltechniques, and Dr. Triplett has given lectures this fall pertain-ing to treatment planning for implants,” Chapa says. “Previousimplant instruction was not geared to single-unit cases likethese residents would see in everyday practice. The informationthey receive now can be applied in the future whether or notthey do the actual surgeries.”

As for securing patients, Nagy reports no difficulty identifyingimplant candidates from the existing pool. “I’d say 75 percentof the AEGD and prosthodontic patients have implant require-ments,” he says. “Once the program is going full steam, we esti-mate residents will place five to 10 implants per year.”

A new dedicated surgical operatory within the sixth-floor AEGDclinic is ideal for the program’s needs. Cabinetry to hold neces-sary equipment was purchased with grant funds, and a part-time dental assistant will soon join the staff. Biomet 3i alsoprovided $46,000 of products and supplies such as the surgicalhandpieces, titanium implants and other surgical components,and graft materials used during implant placement. The firstsurgery took place in early October.

“I provide clinical oversight, stand right next to the student andtalk them through the procedure,” Chapa says. “In addition, Ihave started doing case discussions on Fridays with the AEGDresidents.

Likewise, I go to the prosthodontic residents and discuss caseswith the patient in the dental chair. We talk about things likewhether the patient has adequate tissue, if they require bonegrafting, and other things a surgeon would look for. We reviewtreatment options with patients, because there is more than oneway to approach a case.”

Carolyn Cox is publications manager at Texas A&M Health Science CenterBaylor College of Dentistry, where she has been employed for 23 years.A 1986 journalism graduate of Texas Christian University, she resides inLewisville, Texas.

Founded in 1905, Baylor College of Dentistry in Dallas is a college of the TexasA&M Health Science Center. TAMHSC-BCD is a nationally recognized center fororal health sciences education, research, specialized patient care and continuingdental education. The TAMHSC serves the state as a distributed, statewide healthscience center that is present in communities throughout Texas.

By Carolyn Cox

Addressing the trend in

turnkeycareSurgical implant training isn’t just for periodontic and oral surgery residents anymore

AFTCOWouldn’t it be nice if you had an advisor guiding you toincreased profitability, productivity and stress control?

Jameson Management, an Oklahoma-based firm specializingin personalized practice management, marketing and clinicalcoaching for dentists, can lead you towards this goal.

AFTCO is the oldest and largest national dental transition network with over 150 programs customized

to meet your needs. AFTCO is truly the nation’s leader in dental practice sales, with 1.5 billion dollars of practices sold to date.

Structures and Interiors is a commercial generalcontractor specializing in dental office construction

offering design-build services including new buildingconstruction, interior finish out, office improvements andrenovations.

For more than 40 years, Pacific Continental Bank hasbeen providing individually tailored financing solutions to

dentists. At Pacific Continental, we strive to understand theneeds of dental practices with a personalized level of service thatis unique to each client. Our bankers strive to help dentalpractices and practice owners reach their financial goals byoperating efficiently and making the most of opportunities.

Burkhart Dental has served dental professionals for 125 years. It provides supplies, equipment, office design,

practice management consultation, equipment repair andmaintenance, and software. Important to its associates areintegrity, knowledge and client success.

Beaird Harris & Co. is a Certified Public Accounting firm providing tax, accounting and business consulting

services. Beaird Harris Wealth Management, Inc. is anindependent fee-only wealth management firm providingsophisticated financial planning and investment advisory services.

Pact-One As an industry leader, our unique blend oftechnological expertise represents decades of combined

experience exclusively mastering dental networking, 3D imaging and internet technology to enhance the operationalmanagement of your practice. Pact-One provides a local presencewith live client service representatives waiting to assist you whenyou call.

Reliable Dental Laboratory is a full service laboratory thatprides itself on being able to meet all your fixed, removable

and dental implant needs. Working together with our cliniciansto provide smiles for our dental community is truly our passion.

J. Houser Construction is a full-service constructioncompany, providing quality construction management for site

development, new construction, interior finish-out, remodelingand design-build projects. We have a strong design teamconsisting of site developers, architects, engineers and interiordesigners that lend to creating a very functional and appealingdental office.

Healthcare Professional Funding (HPFC) is a leadingprovider of financing programs designed specifically for

licensed healthcare professionals. We offer programs designedto grow your practice. We’ll maintain a focus on structuring programs tomaximize the value of your asset every step of the way. You take careof your patients. We’ll take care of your financing.

North Texas Dentistry Advertisers2013 Southwest Dental Conference Booth Listing

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Dental Auxiliary Service has been serving the Dallasdental community since 1979 and has been a leader inemployment placement for dental personnel. Dental

Auxiliary Service is a full service staffing agency that takesresponsibility for paying temporary personnel, minimizing IRS andTWC unemployment issues for its clients.

RT Edwards & Associates, P.C. is primarily anadvisory firm that also provides tax and accounting

services to those in the dental industry. In addition, the firmoffers compre-hensive, individually tailored, fee-only financialplanning, retirement guidance and investment services to itsclients.

Midco Dental is a family owned company with branchesin Irving, TX and Oklahoma City, OK. We offer

merchandise, service, equipment and office drawing.

Bullseye Media is a McKinney, Texas based full-servicemarketing agency that provides turnkey programs for

dentists & dental specialists who want to leverage theinternet to get high value dental patients.

Med+Tech Construction is a general contractorwhich specializes in design, construction and renovation

of dental offices across Alabama, Georgia, Florida,Louisiana, Oklahoma, Tennessee, Texas and Washington.

struction

Wallace Specialty Insurance Group A single source foryour insurance needs. We work exclusively for dentists and

specialize in malpractice, office, liability, disability, health, life,data breach and EPLI.

LegacyTexas Bank is an independent family-owned bankthat has served North Texas for 50 years. Hundreds of

dentists and physicians trust our team of specialty bankers tomeet their professional and personal financial needs.

TDA Financial Services Insurance Program works withTDA members and their staff in providing life, health, disabil-

ity income, employee benefits, long term care and malpracticeinsurance. Bob Michaels, CLU has been an Associate with them forover nine years.

TruDenta is a complete system of technology and trainingwhich enables dentists to help the estimated 80 million

Americans suffering from dentomandibular sensorimotordysfunction. Symptoms resolved include chronic headache,migraine, tinnitus, TMJ/D and other pains of the head, neck faceand jaw. TruDenta is now in use in dental practices in 47 states.

At National Target Mailing / Dentistry Postcards.Com, we create marketing solutions specifically designed to meet

the specific needs of dentists and have created and executedeffective, customized marketing strategies and materials forhundreds of dental practices all over the country.

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In a metropolitan area, a patient typically has access to thelatest advances in dental care. In a small town, patients arelikely to know their dentist personally and enjoy a warm,

friendly relationship. Patients choose the practice of Dr. MarshallJohnson and Dr. Elizabeth Jaynes because they have the best ofboth worlds – a caring, personal relationship with dental profes-sionals who offer state-of-the-art periodontal care.

Dr. Johnson opened a periodontal practice in Plano 23 yearsago, after graduating from Baylor College of Dentistry and earn-ing his M.S.D. at the University of Missouri in Kansas City. In1997, his colleague, Dr. Elizabeth Jaynes joined the practice.Dr. Jaynes graduated from the University of Tennessee andearned her M.S.D. at Baylor College of Dentistry where she didmany advanced cases in cosmetic grafting, oral medicine, anddental implants with some of the best clinicians in these fields.After completing a three-year residency, she practiced inRichardson for two years. She has now been in practice for 17years and has extensive experience in dental implantology.

Drs. Johnson and Jaynes share an unwavering commitment to

excellent patient care, and bring complementary interests andstrengths to the patients in their practice. Drs. Jaynes andJohnson provide conventional periodontics, including regener-ative therapy, guided tissue regeneration, osseous grafts, as wellas cosmetic periodontics including aesthetic crown lengthening,soft tissue grafts/root coverage procedures, ridge and sinus aug-mentations and dental implants.

Dr. Jaynes is married to a pediatric dentist, and she and Dr. Johnson share a passion for treating orthodontic patientswho are referred by their pediatric dentist or orthodontist forcanine uncovering, treatment of tooth impaction, microscrewsfor secure orthodontic anchorage, soft tissue grafting andfrenectomies.

Patient comfort is a priority in this thoughtfully designed office.Patients enjoy the homelike environment of the reception area,where they can relax with a bottle of water or cup of coffee.During procedures, patients can snuggle under a cozy blanket,and listen to satellite music to fit almost anyone’s musical taste.For optimal patient relaxation and comfort, the options of oral

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Drs. Johnson and Jaynes have complementary interests and strengths, and share an intense commitment to excellent patient care. They are among a selectfew periodontists who have gone on to achieve the status of Diplomate in Periodontics, a certification of the American Board of Periodontology.

The Best of Both WorldsA unique blend of technologyand personal careMarshall V. Johnson, DDS, MS AND Elizabeth D. Jaynes, DDS, MS

cover feature

by Tina Cauller


sedation and nitrous oxide sedation are available, and an anes-thesiologist, when necessary, provides intravenous sedation.

In keeping with their commitment to providing the best possi-ble care for each patient, Drs. Jaynes and Johnson continuallylearn about and evaluate the latest materials, products, tech-niques, and procedures. New technologies are incorporated intothe practice once they have been proven to enhance patientcare.

Over the past decade, technological advances have made dentalimplants a highly predictable and reliably successful option fortooth replacement. Drs. Johnson and Jaynes are well versed inthe complexities of dental implants and have accumulated manyhours of experience and continuing education. As Dr. Johnsonexplains, “The single factor that has most transformed dentalimplantology is experience – we now know that long-term suc-cess depends on restorative-driven implant placement.”

In the early years, dental implants were placed wherever a sitewas available. Because the placement was not driven by therestorative goal, the longevity of these early implants was some-times less than ideal. “Now, we work closely with the referringdentist to determine the exact result we want to achieve, andwith Cone Beam CT imaging, we can plan and guide the place-ment of implants with great precision based on the desiredresult,” notes Dr. Jaynes.

“Being able to accurately visualize the implant area is a criticalpart of the equation,” notes Dr. Johnson, “but if the bone qualityor quantity in the target area is not sufficient to support thereplacement tooth, we have exciting new methods of preparingthe site to support the implant. Properly prepared bone allowsus to be sure the replacement tooth is securely anchored inexactly the right position so it can function correctly. Patientswho would not have been candidates for dental implants cannow be successfully treated and expect excellent results, bothin terms of esthetics and longevity.”

Besides affecting the long-term success of treatment, subopti-mal placement of dental implants can cause irreversible damageto vital anatomical structures, including perforation of the boneor nerve damage. Drs. Jaynes and Johnson use Anatomage soft-ware to design computer-generated surgical guides to ensure

From the front office to the clinical assistants and hygienists to the doctors,each member of the team demonstrates a genuine commitment to patientcare.


Drs. Johnson and Jaynes rely on sophisticated Dentrix management soft-ware to access patient scheduling and information and to improve efficiencyand communication between the front desk and their seven operatories.


that vital structures are protected during treatment. This tech-nology also allows the implant to be placed further into thebone, which achieves a more natural-looking result and pre-serves bone and soft tissue.

Dr. Jaynes describes an arsenal of new products that provideimproved treatment options for patients. “Alloderm graftingenables us to treat recession without harvesting tissue from adonor site in the palate, which greatly improves patient comfortand healing time. We also use human growth factors to helpregenerate bone. Specialized products like Periosciences antiox-idant dental gel help to facilitate post-operative healing.”

In this unique practice, multidisciplinary teamwork is impor-tant at every touchpoint in the process of providing care. “Weacknowledge the intelligence of our patients and encouragethem to be involved in planning their treatment, because theirparticipation is an important component of success,” notes Dr. Johnson. “The restorative dentist is another key player in the team effort that underlies a successful result.Communication is key, so information is tailored to the needsof the restorative dentist, and can be provided either in writingor electronically, depending on the dentist’s preference. Weinclude the restorative dentist at every stage, starting with theinitial consultation, which we follow with a detailed case analy-sis and recommendation for treatment.”

Often, Drs. Johnson and Jaynes meet with the restorative den-tist to plan treatment using three-dimensional models, andcoordinate comprehensive care between themselves and thereferring office. After treatment is completed, a thoroughdescription of the procedure is provided. At follow up,

During a preoperative consultation, the doctors take time to explore theirpatient’s goals, explain their choices, the risks and benefits of each option,and help them define reasonable expectations.

Drs. Johnson and Jaynes provide conventional periodontics, including regenerative therapy, guided tissue regeneration, osseous and soft tissue grafts, aswell as cosmetic periodontics including aesthetic crown lengthening, and dental implants. For optimal patient relaxation and comfort, the options of oral seda-tion and nitrous oxide sedation are readily available, and intravenous sedation is provided by an anesthesiologist when necessary.

Drs. Jaynes and Johnson reinforce the recommendations of therestorative dentist and set up an alternating cleaning schedulebetween the two offices.

The staff is an essential part of the team and is integral to cre-ating a positive experience for each patient. From the frontoffice to the hygienists to the doctors, each member of the teamdemonstrates a genuine commitment to patient care.

Drs. Johnson and Jaynes rely on sophisticated Dentrix manage-ment software to access patient scheduling and information andto improve efficiency and communication between the frontdesk and their seven operatories.

Twice a year, Drs. Jaynes and Johnson offer convenient contin-uing education instruction in hygiene, as well as clinical presen-tations for dentist colleagues in cosmetic periodonticprocedures and implants. They also host a mini-conventionvendor show at Gleneagles Country Club. This event hasbecome a popular opportunity to socialize and explore newproducts and services.

Dr. Johnson and Dr. Jaynes provide pediatric periodontal care,as well as care for adults and seniors. Dr. Jaynes observes thatpatients generally have three main concerns. “Most patients ask

about their outcome, how much discomfort they can expect toexperience during and after treatment, and how they willfinance their care. We make sure they are fully informed priorto treatment so there are no surprises. We take time to exploretheir goals, explain the procedures that are planned, and reviewthe likelihood of success. We explain their choices and the risksof each option, and help them define reasonable expectations.Before their treatment, they understand what to expect in termsof recovery, discomfort, and any post-operative medicationsthat may be required. They also receive complete informationabout fees and financing options, and our friendly staff helpsthem maximize their insurance benefits. We find that beingwell-informed helps put patients at ease.”

The office of Drs. Johnson and Jaynes is located at 5800 CoitRoad Suite 300 in Plano in the Lone Star Crossing Building, justnorth of Parker Road on Coit. Additionally, Dr. Jaynes offersexpert care in her satellite office at 9191 Kyser Way in Friscotwo days a week. For more information or to make an appoint-ment, call (972) 964-8833 or visit www.jjperio.com. n

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A talented and experienced hygiene department is important for a successful periodontal practice. Drs. Johnson and Jaynes are proud of their team of hygienists who have been with the practice collectively for 42 years. Pictured from left: Kim, Amy, Ann and Karen.


Elizabeth D. Jaynes, DDS,MS has been honored by herprofessional peers to be namednumerous times in D Magazineas one of the “Best Periodontistsin Dallas”. She was named“Young Dentist of the Year” ear-lier in her career by the DallasCounty Dental Society, and nowserves on the Board of theDallas County Dental Society.She is very involved in theSouthwest Dental Conference,

where she can be found running the host and information boothor registration. Dr. Jaynes is actively involved in numerous pro-fessional organizations. She is a member of the National CharityLeague, and is an associate member of 4th District DentalSociety. Dr. Jaynes has taught in the Collin County HygieneSchool, and takes more than 50 hours of continuing educationeach year in cosmetic procedures and implant dentistry. Dr. Jaynes is among the select few periodontists who have goneon to achieve the status of Diplomate in Periodontics, a certifi-cation of the American Board of Periodontology. Dr. Jaynes ismarried to a pediatric dentist and they have a teenage daughter.

Marshall V. Johnson, DDS,MS is a firm believer that a trueprofessional must remain state-of the-art and takes over 50hours of continuing educationeach year in implant dentistry,bone regeneration and cosmeticprocedures. He was featured in D Magazine as one of the “BestPeriodontists in Dallas”.

Dr. Johnson is a dedicated andinvolved community member.

He has served on the staff at Medical Center of Plano, the Boardof Directors of Leadership Plano, and is a past chair of the Boardof Managers for the Plano YMCA. He is now on the Board ofDirectors for PISD Education Foundation and Plano YouthLeadership. He is currently a member of the Plano Rotary Club.Dr. Johnson is among the select few periodontists who havegone on to achieve the status of Diplomate in Periodontics, a cer-tification of the American Board of Periodontology. Dr. Johnsonhas been married for 25 years and he and his wife have threeboys, Ryan, Kyle and Travis.

The periodontal practice of Johnson & Jaynes is located in the Lone StarCrossing Building at 5800 Coit Road Suite 300 in Plano. www.jjperio.com

1 1 4:25 PM

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Robert ZimbroNational Target Mailing & DentistryPostcards.com1507 Capital Avenue, Suite 103Plano, TX 75074(972) 424-5979Robert@nationaltargetmailing.comwww.nationaltargetmailing.comwww.dentistrypostcards.com

Q. Our practice has potential – if onlythose potential patients out thereknew more about it. How do dentistsfind expert help with marketing?

Robert: At National Target Mailing, we cre-ate marketing solutions specifically designedto meet the needs of dentists, and have cre-ated and executed effective, customized mar-keting strategies and materials for hundredsof dental practices all over the country. Aboutsix years ago, we started specializing in mar-keting for dental professionals and today,thanks to referrals from our satisfied clients,dental marketing now constitutes about 90%of our business.

Thanks to that remarkable success, we aremore than just a printing service or a bulkmail shop. We know the dental industry andunderstand the subtle but critical distinctionsbetween different types of dental practices.Whether a practice is based primarily on serv-ing families, cosmetic patients, or Medicaidpatients, we can implement a plan to createinternal marketing, external marketing andinternet marketing campaigns that speakdirectly to potential patients.

For some practices, growth is a long-termgoal, for others there is a genuine need to seeappreciable growth quickly. Starting up a newpractice can be challenging and demands asolid marketing plan to ensure that growthhappens rapidly enough to sustain the busi-ness. A practice that has experienced a short-term downturn may need to boost productivityin order to be profitable. Or, a practice mayneed to increase patients to bring on an asso-ciate or prepare to sell the practice.Regardless of the specific situation, we canaddress your needs with a customized plan.

Q. We have been hesitant to getinvolved with a marketing group.Dentistry is such a unique field, howcould a marketing company possiblyunderstand the profession, much less thegoals of our unique practice?

Robert: We have private practice dentalclients with a single office and large dentalpractices with multiple locations. Througheffective marketing, many of our clients havereached their goals to expand their practice.One client who has worked with us for nineyears has grown from a single office to sevenoffices, another from a single location to 27locations.

There is a saying, “A goal without a plan isjust a wish.” We’ll explore your professionalgoals, and help you outline a plan to getthere. For a new practice, we match theirgoals with an appropriately aggressive mar-keting campaign. We view our role as a part-ner in growing your business.

We offer a flexible, dynamic and responsiveplan that can adapt easily to accommodatethe changing needs of the practice. Whethera client chooses a one-time campaign or amonthly campaign, we never lock them intoa rigid plan. If business slows down, we makesure the marketing can respond immediatelyand, if the office gets too busy, we can adjustthe schedule accordingly.

Q. How can we make sure our market-ing budget is used wisely?

Robert: We advise dentists to ask questionsand become informed when setting out tochoose a partner in creating a marketingplan. Too many firms will get a client in thedoor for a low price and then break thebudget with add-ons, or lock clients in to along-term contract that is carved in stone.Make sure that you are comparing apples toapples when you comparison shop for mar-keting support.

Our clients enjoy a working relationship witha single team member who provides expert,personal service. Rather than blanketinghouseholds with unwanted junk mail createdfrom generic online templates and wastingmarketing dollars in the hopes of reaching afew interested individuals, we design custommaterials and mailing plans that preciselymatch the profile of the target audience.

The dental profession is impacted by regula-tions, laws and conventions that are con-stantly changing and evolving. Our familiaritywith those requirements helps you avoidcostly or marketing pitfalls and common mis-takes. We help our dental clients establishconsistent branding across websites andprinted materials. Our approach ensuresthat every dollar of your marketing budgetachieves maximum return.

Robert Zimbro has been in marketing for 14 years,and founded National Target Mailing 12 years ago.He recently founded www.DentistryPostcards.comto help dentists easily create mailers that reachclients with high-impact print promotions that getmeasurable results.

National Target Mailing has experienced tremen-dous growth for three years in a row, and is per-fectly positioned to help dental clients achievetheir own goals. With its new 5,200 square footmanufacturing center located in Plano, and state-of-the-art mailing software and addressing equip-ment that saves time and eliminate productionheadaches, National Target Mailing is ready toserve dentists more efficiently and cost-effectivelythan ever before.

For more information, call (972) 424-5979 orvisit www.nationaltargetmailing.com andwww.dentistrypostcards.com.

National Target Mailing/DentistryPostcards.comRobert Zimbro

&AQ

If you are like most Americans, you probably do not havea lot of confidence in the fairytale ending with a GrandBargain prior to year end. Fortunately there is still plentyyou can do, regardless of what legislation Congress doesor does not pass.

Watch your fees. There are going to be a lot ofinvestment managers trading positions with each otheras they try and guess what is in store for our country inthe near term. Unfortunately, the only known outcomeof those trades will be the costs associated with perform-ing them. It is imperative that investors do not get toocaught up in trying to guess market direction and losesight of the overhead associated with all that trading.Generally speaking, you can figure on trading fees ofaround 1% of the turnover percentage inside mutualfunds. These expenses are in addition to the manage-ment fees and any marketing costs (12b-1, load, etc.).

Diversify. With our growing debt, many are losingfaith in the dollar and running to gold. There are far bet-ter places to invest your hard earned money if you areconcerned about the dollar falling. There is a global mar-ket of companies in multiple countries all trying to betterthemselves. Why not invest in them since they are tryingto turn your money into more money? Gold has no ambi-tion and therefore no expected return. Its return isentirely speculative and therefore much riskier than anasset offering a yield (bond), or increased earnings(stock). By holding a well-diversified portfolio of com-panies from all over the world, you are investing in cap-italism and greatly reducing the risk of currency issues.

Remember Taxes. It is almost a foregone conclu-sion that high income earners are in store for highertaxes in the near term. That increases the need to watchwhere you hold certain assets to make sure you keepthe majority of your gains. For example, hold bonds inyour tax-deferred accounts and stocks in taxable orRoth accounts. Also, consider moving to tax efficientshare classes of funds you already hold. Many should

CLIFF HANGERS Make for Good Movies… Not for Good Portfolio Decisions

“Everything will be fine… just don’t look down!” These arethe words often used to console those dangerouslyperched on the side of a mountain, building, or any otherelevated location crumbling below them. We can almost allpicture some instance of this particular cliché playing itselfout in our mind’s eye. In the movies, our hero always savesthe day, but will that be the case if we are teetering on theedge of a fiscal cliff?

by John O. Hetzel, CFA, CFP®, AIFA®

money matters


look at municipal bonds as their tax-freeinterest becomes more attractive tohigher income earners.

In the end, we have no idea what our herowill look like and when he or she will showup. Fortunately, it does not really mattersince there are plenty of things we can doto better position ourselves right now.Just remember to keep your attentionfocused on what you can control anddon’t look down! n

Beaird Harris Wealth Management, Inc. is an inde-pendent fee-only wealth management firm locatedin Dallas, Texas. Beaird Harris provides objective,fee-only advice to financially established individu-als and families, trust funds, retirement plans andnon-profit organizations; with a particular emphasisin the healthcare industries. Beaird Harris is dedi-cated to helping clients maximize their assets, re-duce financial stress and realize their personal andfinancial goals.

Please remember that past performance may not be indicative offuture results. Different types of investments involve varyingdegrees of risk, and there can be no assurance that the futureperformance of any specific investment, investment strategy, orproduct (including the investments and/or investment strategiesrecommended or undertaken by Beaird Harris WealthManagement, Inc.), or any non-investment related content, madereference to directly or indirectly in this newsletter will be prof-itable, equal any corresponding indicated historical performancelevel(s), be suitable for your portfolio or individual situation, orprove successful. Due to various factors, including changing mar-ket conditions and/or applicable laws, the content may no longerbe reflective of current opinions or positions. Moreover, youshould not assume that any discussion or information containedin this article serves as the receipt of, or as a substitute for, per-sonalized investment advice from Beaird Harris WealthManagement, Inc. To the extent that a reader has any questionsregarding the applicability of any specific issue discussed aboveto his/her individual situation, he/she is encouraged to consultwith the professional advisor of his/her choosing. Beaird HarrisWealth Management, Inc. is neither a law firm nor a certified pub-lic accounting firm and no portion of the article content should beconstrued as legal or accounting advice. A copy of the BeairdHarris Wealth Management, Inc.’s current written disclosure state-ment discussing our advisory services and fees is available forreview upon request.

John O. Hetzel, CFA, CFP®, AIFA®

Beaird Harris Wealth Management, Inc.(972) 503-1040 [email protected]

[email protected]“We specialize in customer satisfaction.. ”

www.jhouserconstruction.com817.988.7842

PO Box 325 Canton, TX 75103


Call 1-800-232-3826 today for a free practice appraisal, a $2,500 value!

AFTCO is the oldest and largest dental practice transition consulting firm in the United States. AFTCO assists dentists with associateships, purchasing and selling of practices, and retirement plans. We are there to serve you through all stages of your career.

David M. Chei, D.M.D. (UMDNJ 1999)

has acquired the practice of

Richard L. Brown, D.D.S. - Dallas, Texas

(Baylor College of Dentistry 1971)

Paul R. Searby, D.D.S.(UT Houston 1984)

has acquired the practice of

John W. Scott, D.D.S. - Waco, Texas

(UT Houston 1984)

AFTCO is pleased to have represented all

parties in these transactions.

Helping dentists buy & sell practices for over 40 years.

WWW.AFTCO.NET

Come visit us at the Southwest Dental

Conference in Booth 314!

creating compelling professional images thatspeak for your practice

214.369.1850817.966.2631www.Bryant [email protected]

PHOTOGRAPHY WITH A

FOCUSON DENTISTRY

SMILESin theSPOTLIGHTLEADERS IN NORTH TEXAS DENTISTRYCREATING UNFORGETTABLE SMILES

Life After TraumaPeggy, one of the first patients I encountered whenentering into my father’s restorative practice, was kickedin the face by a horse at the age of 5 and the damageto her right maxilla was extensive. She lost her primaryteeth in this quadrant as well as her budding permanentteeth #4-7. Peggy had no other option than to wear avariety of removable partial dentures for the next twodecades. In time, a long-span provisional fixed partialdenture was fabricated with a metal substructure,processed acrylic and a rigid precision attachment onthe distal of #8, which aided in ease of removal duringthe preplanned future grafting and implants stage of herrehabilitation.

TreatmentWhen implants became a reality for Peggy, Dr. RonStukalin elevated the schneiderian membrane and re-stored the quantity of bone sufficient to place StraumannRP implants in sites #4, 5, 6. Post integration, I fabri-cated screw retained provisionals with a mesial can-tilevered pontic in site #7. This allowed for soft tissuedevelopment and to visualize the 3-7mm vertical boneand soft tissue defects present from the ideal gingivalzenith. Her low lip line and small buccal corridor aidedin the planning of the needed custom gingival coloredceramic.

Laboratory ExpertiseI sought out Gilbert Young of GNS Studio, Inc. to joinour team for the laboratory expertise in developingPeggy’s final prostheses. Cast custom abutments werefabricated and torqued to 35Ncm to support cement re-tained crowns and a mesial cantilevered pontic in site#7. Custom gingival colored porcelain was fired ontothe cervical contours and embrasures of the crowns inthe esthetic zone. Ducera, hydrothermal-1 phase lowfusing ceramic, was the material chosen as this ce-ramic minimizes porosities near the tissue interface al-lowing for superior cleansability. Ducera has only amatrix phase (no crystalline phase) thus requiring lessfiring cycles producing less overall distortion. A hy-droxyl ion is added to the matrix phase creating anionic exchange furthering the intraoral compatibilitywith the saliva and surrounding tissues. These proper-ties were imperative when considering esthetic mar-ginal integrity and cleansability at the gingival ceramicinterfaces of #6, the mesial pontic #7 and the distaloverhang #8.

2. Custom abutments on Straumann RP implants and prepared teethfor metal ceramic crowns.

1. Implants placed in grafted bone. Long span provisional with metalsubstructure, processed acrylic and rigid precision attachment.


ResultsUpon delivery of the final crowns, Peggy was thrilled andhas been extra diligent with her homecare due to theseareas of overhanging porcelain. Over the past four years,her tissue has adapted extremely well and although weknow this treatment is far from perfect, we know it is farfrom where she started with that accident at age five. Wenever lost sight of trying to “Keep it Simple” and “Keep theEnd in Mind”.

4. Intraoral metal ceramic crowns, custom gingival color and marginalintegrity of Ducera ceramic.

Sloan W. Hildebrand, D.D.S., M.S.

Graduate of Baylor College of Dentistry, Prosthodontics Masters Certificate, M.S., 2005 Graduate of University of Texas Dental School, D.D.S., 2000

Sloan Hildebrand, DDS, MS currently practices prostho-dontics in Dallas, Texas. Dr. Hildebrand bases his practiceon the principles passed down through his father’s legacyin regards to unwavering dedication and excellence be-stowed upon each and every patient with no compromisein work ethic, integrity and service. Dr. Hildebrand has apassion for serving those that are seemingly less fortu-nate around the earth, specifically the geographically andfinancially isolated villages throughout Africa, South Amer-ica and Southeast Asia.


6. Follow up four years post insertion of custom crowns.

3. Metal ceramic crowns with custom Ducera gingival-colored ceramic, GNS Studio, Inc.

5. Peggy's smile, 65 years after her horse-related accident (scar onchin still visible).

In life and upon entering into my prostheticcareer, my father, Dr. David Hildebrand,taught me to try to ‘Keep it Simple’.

www.drsloanhildebrand.com

“


Communicating with your patients about their financialresponsibility and about the options you have available forpayment may be one of the most challenging conversa-

tions you will have with a patient. If you have done a beautifulpresentation, and the patient wants to proceed but indicates thatthey are not going to do so, more than likely, the reason may bethe cost.

Even if the doctor or treatment coordinator gets the go ahead fromthe patient, don’t be too confident. The closing on the clinicalaspects of the treatment is the pre-close. The final close comeswhen the patient agrees to the financial responsibility and sched-ules that first appointment.

ESTABLISHING FINANCIAL OPTIONS

For patients who need financial assistance, whether for a smallcase or a major multi-thousand-dollar case, there are ways forthem to access financial assistance. However, the dentist does nothave to provide the money, only the financing vehicle.

For many years now, I have had the privilege of studying withbanking and financing experts and with the people who first orig-inated the concept of patient financing in our industry. It has beenexciting to see how this concept has evolved over the years. As den-tistry has evolved, so has the patient-financing concept. However,there is still only a small segment of the dental profession that isinvolved with patient financing, and then once a practice becomesinvolved, the use of the program is limited.

Consider this goal for your practice: to make the financing of yourdentistry affordable for the vast majority of your patients withoutdoing the banking yourself. Get out of the banking business, andstay out.

FINANCIAL OPTIONS

Consider the following financial strategies. These are the strategiesthat we, as advisors, have integrated into over 2500 practicesthroughout the U.S. and other countries around the world. Thesestrategies work to help more people accept your dentistry and keepyou out of the banking business. Not only can your productionincrease significantly, but also your profit margin will do the samething. Consider the following financial options:

n Five percent accounting reduction for payment in full beforetreatment begins. (Do this for cases over a designated amount, tobe determined by each individual practice.)

n Payment by the appointment. (Take the total investment,divide it by the expected number of appointments, and collectthose equal amounts per appointment.)

n Bank Cards.

n Healthcare financing programs including revolving paymentplans and extended payment programs.

The first option gives the people who can afford to make full pay-ment an incentive to do just that. You will be dollars ahead to getthe money in the bank before treatment begins. Any time you haveto wait on the money, you begin to lose. The value of the dollardecreases, the chances of the person not completing treatment areincreased, the possibility of a person not paying as arranged canbe an issue, and the costs of carrying accounts on your own booksare prohibitive. In addition, any scheduling coordinator will tellyou that if a patient pays for their treatment in advance, they willshow up for their appointments. Therefore, do not carry accountson your own books. You are not a bank, nor are you trained asbankers or loan officers. Stick to what you do best — dentistry.

practice management

Financing Success Strategies for the Modern Dental Practice

By Cathy Jameson and Dru Halverson, RDH

The second option, payment by theappointment, is done in a specific way sothat the patient’s financial responsibility toyou is complete by the time that the treat-ment is complete. The option payment bythe appointment is for cash, check orbankcard.

Bankcards are terrific. Do not be con-cerned about the service fee you will payfor the use of these financing vehicles.Again, you will be dollars ahead to get pay-ment and not be responsible for state-ments or collections. The dollars you willsave by not running a credit businesswithin your practice will far outweigh anyservice fees you will pay.

Market bankcards to your patients as apayment option. Believe it or not, peoplestill do not think of using their bankcardsfor payment of dental services. However,the bankcards are marketing heavily toconsumers, encouraging them to considerthis option. You can do the same thingright in your practice. Use newsletters,special mailings and verbal skills duringfinancial presentations to get your patientsused to handling their payments with abankcard.

For any long term or extended payments,those patients who want the treatment butneed to make monthly payments andspread those payments out over severalmonths, use a healthcare financing pro-gram. These programs have the financialwherewithal to loan your patients themonies necessary to receive treatment.

By carefully developing an excellent finan-cial system in your practice and by learn-ing how to maximize the options, you takethe lid off your practice productivity. Byoffering the recommended options, den-tists win because they get to do the kind ofdentistry they have been so carefullytaught to do. Their production goes up sig-nificantly when they proactively promoteconvenient financing.

Patients win because they don’t have toput off needed or desired care if they can’tcome up with large amounts of money atone time. That’s what I call win-win. n

Cathy Jameson founded Jameson Management,Inc., an international dental practice managementand marketing firm through which Dru Halversonhas advised countless clients over the last twodecades. She recently released her third book,entitled “Success Strategies for the ModernDental Practice”. Learn more about Cathy atwww.JamesonManagement.com and plan toattend the March 8, 2013 half-day course Cathywill present at the Waterford Marriott in OklahomaCity. Call (877) 369-5558.

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PROFITMAX SM

Our production is up 41%! -Dr. B., Dallas, TX

Exclusive Resources Proven to Drive Revenue and Reduce Overhead

ProfitMaX changes the playing field for independent dentists and small group practices in the battle against corporate dentistry.

Grow Revenue· Increase New Patient Flow· Boost Hygiene Production· Improve Case Acceptance· Establish Win-Win Financial Arrangements· Expand Low-Risk Patient Financing Options· Maximize Revenue Through Fee Optimization· Drive Daily Success With Effective Morning Huddles

· Reduce Lab Costs Without Compromising Quality· Drive Down Supply Costs· Optimize Staff Productivity· Decrease Bad Debt· Enhance Patient Service· Measure and Monitor Performance

· Estate Planning· Wealth Accumulation and Exit Strategy Planning· Financial Analysis· Accounting Analysis· Practice Loan Analysis

Reduce Overhead

Gain Financial Freedom

A nominal up-front fee and monthly service fee ensure lasting profits – the savings alone exceed the fees!

CALL NOW to Learn More! “We saved 44% on our first supply order!” - Dr. D., Dallas, TX

TWICE THE DIFFERENCE

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O ne of our clients called me this past September with abig problem. After experiencing a strong and steadilyincreasing new patient flow for quite some time, his

new patient flow suddenly slowed down… way down. He wasunderstandably concerned and needed some help. So, my teamdug in to do some research. What could possibly cause potentialnew patients to suddenly decide not to choose him when look-ing for a dentist? We spent hours on the case and came upempty handed. We could find no reasonable cause of his dra-matically decreased patient flow. We were very perplexed so wedug even deeper and finally, we found the culprit. In July, a dis-gruntled patient left a negative review of her experience withthe dentist on a prominent review website. And what do youknow… that was exactly when his new patient flow began todecrease. The case was solved and we came to one very strongconclusion. Dentists can’t afford to ignore online patientreviews. Why? Because people read them.

Everybody Googles

Consider this scenario: You are on a business trip in an unfa-miliar city. You are taking some colleagues to dinner, so youneed a great restaurant choice. You ask around, get a few refer-rals from the hotel staff, but more than likely, you probablydon’t stop there. You do what every other consumer is doing…you head to your smartphone/laptop/tablet and Google therestaurant choices before you decide on your final pick. So, youdo a quick search and see that both have websites with greatphotos of their food and are easily accessible from your hotel.The only visible difference between them is one has a negativereview from a disgruntled diner and the other doesn’t. Whichrestaurant do you choose? If you’re being honest with yourself,you will take your colleagues to the restaurant that doesn’t havea negative review.

This is the way that consumers choose today. They ask aroundand then they Google. So, if most people go through this muchtrouble for one meal, do you think they will do the same whenchoosing a dentist for themselves or their family? Absolutely.

Bad Reviews Can Cost You Good Referrals

Our client was in shock that just one dissatisfied patient couldimpact his practice in such a big way. But he shouldn’t be.Consider these statistics:

One negative review on a social media website can costa business 30 new customers. (Convergys, March2012)

84% of Americans say online customer reviewshave an influence on their decision to purchase aproduct or service. (Opinion Research Corporation,April 2009)

The Real Cost (in Actual Dollars) of One Negative Review

Procedure Average Dollars Lost (CDT Code) Cost (30 patients)

Abutment Crown (D6740) $1,297 $38,910

Veneer (D2962) $1,620 $48,600

Dental implant (D6010) $2,297 $68,910

Coronectomy (D7251) $611 $18,330

practice marketing

Protect Your RepHow patient reviews can make or break a dental practice

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by Marc FowlerWhat is ProfitMaX?For the first time ever, ProfitMaX provides independent

dentists with world-class resources and services that

are proven to drive revenue higher and overhead lower.

With ProfitMaX, you can now compete head-to-head

with corporate dentistry while preserving

your independence.

PROFITMAX SM

Our production is up 41%! -Dr. B., Dallas, TX

Exclusive Resources Proven to Drive Revenue and Reduce Overhead

ProfitMaX changes the playing field for independent dentists and small group practices in the battle against corporate dentistry.

Grow Revenue· Increase New Patient Flow· Boost Hygiene Production· Improve Case Acceptance· Establish Win-Win Financial Arrangements· Expand Low-Risk Patient Financing Options· Maximize Revenue Through Fee Optimization· Drive Daily Success With Effective Morning Huddles

· Reduce Lab Costs Without Compromising Quality· Drive Down Supply Costs· Optimize Staff Productivity· Decrease Bad Debt· Enhance Patient Service· Measure and Monitor Performance

· Estate Planning· Wealth Accumulation and Exit Strategy Planning· Financial Analysis· Accounting Analysis· Practice Loan Analysis

Reduce Overhead

Gain Financial Freedom

A nominal up-front fee and monthly service fee ensure lasting profits – the savings alone exceed the fees!

CALL NOW to Learn More! “We saved 44% on our first supply order!” - Dr. D., Dallas, TX

TWICE THE DIFFERENCE

www.nexusprofitmax.com

dentists with w

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Today’s customers are conditioned to read reviews before theydecide to buy. In other words, your potential patients want toknow what others have to say about you before they book a firstappointment.

If they read just one negative review, they will likely move onto the next dentist. What’s more is these patients have no pointof reference when it comes to the validity of a negative review,they simply have no other choice than to believe what they readon reputable review and recommendations websites like Yelpor CitySearch.

By now you might be thinking, “But most of my patients arereferrals from current patients or other doctors”. That’s great,however, a recent HubSpot survey found that 51% of customersfind user-generated content (or online customer reviews) moreimportant than the opinions of their friends and family. Thebottom line?Whether a potential patient found you through areferral, directory listing or a billboard ad, they are still probablygoing to Google you before they make an appointment.

Protect Your Rep

Leaving your online reputation defenseless is much like leavingthe front door to your practice unlocked…it’s just not somethingyou can afford to do. You’ve worked hard to create a thrivingdental practice, so why leave your success to chance.

We believe that a great offense is the best defense. A solid rep-utation management plan is the foundation to any great mar-keting campaign because without it, any online or offlinemarketing initiative you invest in will be ineffective if negativeonline reviews are undermining it.

So what can you do? Here are a few simple steps to “protect yourrep”:

Check yourself out. Google yourself and your prac-tice name. Is what you see positive or negative?Getting a good feel for your online presence is the firstthing you should do.

Take control. Focus on controlling as much of thecontent on the first two pages of a Google search aspossible. There are definite steps you can take to try topush any negative information down in search rank-ings. How? By creating positive content throughmicrosites, blog posts, press releases, videos and mak-ing sure you have claimed, accurate profiles on all theprominent local listing directories and social mediawebsites.

Think positive. Ask your best patients for positiveonline reviews. Make it easy for them and have yourstaff remind your patients to give positive reviewsimmediately after an appointment. You can do this asthey are checking out at the front desk.

Turn lemons into lemonade. If you get a negativereview, address it! Many businesses ignore negativereviews, so you will set yourself apart by even address-ing the issue. In some instances, you can turn a dissat-isfied customer into a brand advocate for yourpractice!

Our team at BullseyeMedia just released our latest eBook on thesubject, “The Definitive Guide to Online ReputationManagement for Dental Practices”. If you want some instantstrategies and specific recommendations on how to proactivelyprotect your online integrity, you can download it for free atwww.DDSReputationDefender.com.

Many dentists may not have the time or the staff to consistentlymonitor their online reputation. Part of what we do is to act asour client’s personal security team…always there to protect and-defend their online integrity. We think Reputation Managementis so important, that we’ve been working hard on creating agreat offense for our clients. Here is how we can help:

Provide 24/7 reputation monitoring so that anytime aclient’s name or practice is mentioned anywhere onthe web, we’re notified. We then work with the clientproactively address any negative reviews.

Customized software monitors the web to identifyinaccurate directory listings (incorrect name, address,phone, practice description and hours)

A turnkey patient reviews accelerator program toassist clients with collecting and leveraging positivereviews.

We have developed and tested a multi-step processesto capture more real estate on the first two pages ofGoogle, so when a client’s name is searched, positivecontent comes up first.

Don’t leave your hard-earned reputation to chance. Implementa proactive approach to protecting your online reputation andtake control of your online identity to ensure that prospectivepatients like what they see when they Google you. n

Marc Fowler is President of Bullseye Media, LLC, aMcKinney, Texas based full-service digital marketingagency that specializes in turnkey programs for den-tists who want to leverage the internet to get high valuedental patients; including Website Optimization, Pay-Per-Click Online Advertising, Website Design, MobileWebsites, Social Media and Reputation Management.You can contact Bullseye Media at 214-491-6166,

[email protected] or by visiting OnlineDentalMarketing.com.

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There is an old Chinese proverb, “May you live in interestingtimes” and unfortunately for many dentists today, these timesare certainly more interesting than what anyone ever wanted.With high unemployment, most dentists today are seeing a sub-stantial drop in patient revenues. Combine that patient revenuedecline with a high fixed overhead, and you have all the makingsof a financial crisis almost unheard of in this field of healthcare.

We are all too familiar with the analogy of the “deer in the head-lights”. When a crisis arises it creates uncertainty, which oftenleads to confusion and then panic, and ultimately chaos. Inter-estingly enough, there are solutions for most financial prob-lems, solutions in which, if pursued in the early stages ofdevelopment, can prevent those problems from becoming a cri-sis. However, solutions require decisions, and decisions can bedifficult to make when you are in a maelstrom. So, rather thanstepping back and approaching a solution logically and early on,many dentists will react like “deer in the headlights” by choosingnot to make critical preventive decisions, as the proverbialeighteen wheeler of life bears down on them.

As the saying goes, “How do you eat an elephant?... one spoonfulat a time”. When you step back and think about it, most prob-lems can be broken down into manageable increments (orspoonfuls if you may). Most financial problems arise not froman excess of money, but the lack of sufficient funds to pay over-head and make a profit. There is only so much overhead that canbe cut in the average dental practice. Sure, supplies and lab feeswill drop as production drops, and you could always lay off somestaff, but there is a point where you’ve done all the cutting pos-sible and patient revenues continue to drop, so what do you do?

Well, if patient revenues are down, then doing whatever is nec-essary to increase patient revenues is what makes the mostsense. Cutting overhead will not increase patient revenues. Bor-rowed money is not a fix, if anything, it will make your financialfuture even more difficult. If the economy takes a long time forrecovery, and now you’ve increased your debt, then you’ve in-creased the need for more money in the future. Borrowingmoney and/or skipping tax payments is not an answer to anyfinancial crisis.

You increase patient revenues by increasing your patient base.If people put off dentistry during a recession, then you need toincrease the size of your patient base. More patients mean morerevenue. Advertising during hard times is not going to increaseyour patient base because there are not a lot of people lookingfor a new dentist during hard times. However, patients whocontinue to see a dentist and get their dental care during a fi-nancial crisis are the type of patient you are looking for to addto your existing practice. Buying and merging an existing prac-tice allows for economy of scale (two practices in one locationcuts overhead by a huge percentage) increases the size of yourpatient base, and adds more patient revenues. Problem solved.

When the going gets tough, the tough get going. The time to actis before your problem becomes a crisis, not after, if at all pos-sible. You might be a candidate to sell and merge, or one to buyand merge, depending on your particular situation. But this isthe time to consider practice mergers and/or consolidationswhich provides economy of scale and increased revenues. Nomatter how bad you might think things are, there is a solutionthat is right for you. Don’t get caught in the headlights; improveyour practice revenues. n

Richard V. Lyschik, DDS, FAGD is one ofAFTCO’s leading innovative Senior Analysts whohas helped over 2,900 dentists in associating,buying, expanding, or merging and guided older,disabled and/or “burned out” dentists to sell theirpractices. Dr. Lyschik’s clients have seen the con-siderable benefits of incentive programs, pensionfunding plans and increased productivity throughhis guidance. There is no substitute for experi-ence in this business. Who better could you

choose to talk to about your future transition plans than a seasoned fellow dentist,a recognized premier transition expert, and AFTCO Analyst of the Year Awardwinner? Check out the impressive AFTCO website at www.AFTCO.net, then callfor a free appraisal and a no-obligation consultation with Dr. Lyschik at your officeor the AFTCO office in Dallas, TX at (214) 893-0410 or 1-800-232-3826.

A DEER IN THE

HEADLIGHTSby Richard V. Lyschik, DDS, FAGD


practice transitions

The crime of obstruction of justice refers to interfering withthe work of police, investigators, regulatory agencies, pros-ecutors, or other government officials. Obstruction can

generally be grouped into the following three categories: (1) state-ments and actions toward the government; (2) statements andactions toward third parties; and (3) deleting, altering or failing toproduce documents. In addition to a term of imprisonment,obstruction can increase a defendant’s sentence under § 3C1.1 ofthe Federal Sentencing Guidelines.1

Obstruction allegations often arise in health care investigations.These are usually easier for the government to prove rather thanexplaining complex healthcare fraud schemes to the jury.Obstructive behavior also makes it easier for the government toestablish the defendant’s state of mind. Obstructive behavior, par-ticularly relating to documents, also makes it easier for the govern-ment to execute a search warrant, which makes it more difficultand more costly for a provider to defend themselves in an investi-gation. Martha Stewart’s trial is a great example of the force of theobstruction statutes. She was criminally convicted of obstructionfor covering up actions that had only civil insider trading conse-quences and a criminal charge of securities fraud that was dis-missed as a matter of law.

The federal obstruction law is located at 18 USC §1501, et. seq.2

This article will discuss some of the provisions more commonlyused in healthcare fraud cases. It does not focus on what we wouldall view as obstruction – for example, bribing a juror – but rathermore obscure obstructive conduct. For example, an innocent mis-

statement, adding or removing helpful information in documentsor inadvertently failing to produce a responsive document maybe viewed as obstruction by the government. This article also con-tains tips to avoid actions the government may construe asobstruction.

THE LAW

The primary federal obstruction statutes used in healthcare fraudcases are 18 USC §§ 1503, 1512, 1516,3 1518 and 1519.

The Omnibus Clause - § 1503

Section 1503, titled “Influencing or Injuring Officer or Juror,” con-tains the Omnibus Obstruction Clause. The penalty for violatingthis statute, absent a killing or attempted killing, is a fine and upto 10 years imprisonment.

The Omnibus Clause states that a person who “corruptly or bythreats of force, or by threatening letter or communication, influ-ences, obstructs, or impedes, or endeavors to influence, obstruct,or impede the due administration of justice” is guilty of obstructionof justice. Federal courts have read this clause expansively to pro-scribe any conduct that interferes with a judicial process. To obtaina conviction under §1503, the government must prove that therewas a pending federal judicial proceeding, the defendant knew ofthat proceeding, and the defendant had corrupt intent to interfereor attempted to interfere with the proceeding. Cases under this pro-vision include the concealment, alteration or destruction of docu-ments, and the encouraging or rendering of false testimony. Actualobstruction is not an element, however.

ARE YOU OBSTRUCTING

JUSTICEWITHOUT REALIZING IT?

by Sarah Q. Wirskye

legal news


General Witness Tampering Clauseand Documents - § 1512

While certain provisions in §1512 addresswitness tampering, subsection (c) providesfor a fine and up to 20 years of imprison-ment when an individual “corruptly (1)alters, destroys, mutilates, or conceals arecord or document, or other object orattempts to do so, with the intent to impairthe objects integrity or availability for usein an official proceeding; or (2) otherwiseobstructs, influences, or impedes any offi-

cial proceeding, or attempts to do so.”This provision is used in documentobstruction cases.

Obstruction of Investigations ofHealth Care Offenses - § 1518

In 1996, as a part of HIPAA, congress addeda new criminal statute which provides“[w]hoever willfully prevents, obstructs,misleads, delays or attempts to prevent,obstruct, mislead, or delay the communica-tion of information or records relating to a

violation of a federal health care offense toa criminal investigator shall be fined underthis title or imprisoned not more than fiveyears, or both.”

Anticipatory Obstruction of Justice- § 1519

Section 1519, titled “Destruction, Alterationor Falsification of Records in FederalInvestigations and Bankruptcy,” waspassed under the Sarbanes-Oxley Act. Thisprovision provides that “[w]hoever know-ingly alters, destroys, mutilates, conceals,covers up, falsifies, or makes a false entryin any record, document, or tangible objectwith the intent to impede, obstruct, orinfluence the investigation or properadministration of any matter within thejurisdiction of any department or agency ofthe United States…, or in relation to or con-templation of any such matter or case, shallbe fined under this title, imprisoned notmore than 20 years, or both.”

This provision was highly controversialwhen enacted because it removes certainkey proof burdens. Significantly, the gov-ernment does not have to prove which spe-cific “pending proceeding” the accusedattempted to obstruct. Prosecutors charg-ing violations of § 1519 must however, stillestablish the following: (1) the accusedknowingly directed the obstructive act toaffect an issue or matter within the juris-diction of any United States department oragency; and (2) the accused acted at least“in relation to” or “in contemplation” ofsuch issue or matter.

HELPFUL HINTS

There are three primary areas in whichhealthcare providers potentially violate theobstruction statutes. The following dis-cusses those types of actions I have per-sonally seen in my cases and includesthings that a provider can do to avoid apotential violation.

Government Interviews of theProvider

When speaking to a governmentemployee, it is important that a provideris prepared and knows their facts. While

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an intentional or blatant lie to an investigator is likely an easyobstruction case for the government to prove (if the other ele-ments of the statute are satisfied), even an innocent misstatementmay be construed as obstruction of justice. There was a case inwhich a healthcare provider represented he had only once orderedfrom a pharmaceutical supplier who was under investigation. Infact, he had ordered from that supplier twice, but this was severalyears prior to his questioning and he had merely forgotten.Throughout the investigation, the government agent took theposition that the healthcare provider had obstructed justice basedupon this innocent misstatement.

Government Interviews of Third Parties

Under no circumstances should a healthcare provider instruct awitness not to talk to the government nor suggest what to say.This sometimes occurs when a healthcare provider is under inves-tigation, and he or she tells the employees not to talk about certaintopics or not to talk to the government. I have seen cases in whichthe instruction to not speak to the government may be for the“protection of the employee” so the employee does not become“scared.” Again, these actions were characterized as obstructionby the government.

Ideally, a provider should not discuss the investigation with any-one. Counsel who practice in this area can have a short conversa-tion with the employees and provide them with the ground rules.Alternatively, all a healthcare provider should say to their employ-ees regarding being interviewed by a government investigator isthat if they talk to the government, they should tell the truth.

Documents

Destroying, altering, or not producing responsive documents couldalso lead to an obstruction charge. Destroying, failing to produce,or altering incriminating information in documents is a fairly easyobstruction case for the government to prove if the other elementsof the statute are satisfied. However, merely “cleaning up the files”before production may be construed as obstruction of justice. Youshould never do this. In the event that any additional notes mustbe made (which I do not recommend), those notes should be datedwith the present date so that it is clear this information was addedafter the document request. Finally, something as simple as delet-ing an email may also be construed as obstruction. You should havecounsel advise you regarding a document preservation procedureif you receive a request for documents from the government.

Overall, if you are under administrative, civil and certainly a crim-inal investigation, it is helpful to have counsel to guide you throughthe process of interacting with the government and potential wit-nesses so there are no allegations of obstruction. n

1 Defendants in the federal system see upward departures for obstruction under§ 3C 1.1 more often than any other upward departure.

2 State statutes somewhat similar to the federal obstruction law are found inChapters 36, 37 and 39 of the Texas Penal Code. These statutes are rarely usedin white collar prosecutions and, therefore, are not discussed in this article.

3 This statute is titled Obstruction of a Federal Audit and criminalizes“endeavor[ing] to influence, obstruct, or impede a Federal auditor in the perform-ance of official duties relating to a person, entity, or program receiving in excessof $100,000, directly or indirectly, from the United States in any one year period...”This provision is generally inapplicable in the dental and orthodontic context.

Ms. Sarah Wirskye has represented numer-ous individuals and entities in civil and crim-inal disputes with federal and stategovernments and private insurers. She iscurrently representing several healthcareproviders, including dentists and orthodon-tists, in inquiries by both the state and fed-eral authorities.

For more information contact Ms. Wirskye at [email protected] or call (214) 749-2483.

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Despite marketing hype depicting the wine industry asromantic, refined and prosperous, growing grapes andmaking wine is hard work. Even more difficult, appar-

ently, is selling wine. The old joke about “how to make a smallfortune in the wine business is to start with a large one” is notvery humorous to those in the business – it happens quite often.The usual vagaries that come with being a farmer combine withpressures from the economy, competition and shifting con-sumer tastes to create a roller coaster environment within whichto make a profit. When sales are strong and the industry makesmoney, grape farmers and wineries expand their operations,only to find themselves with excess grapes and winemakingcapacity when the next downturn arrives. Coming to the rescueto help span that gap between the wineries, growers and the

marketplace are négociants – merchants who buy, bottle andsell wine under their own label. They don’t own a vineyard or awinery, but a number of them have built strong brands withgood quality wines.

Négociants have been a part of the French wine industry forhundreds of years, but they’ve played a big role in the domesticwine scene only within the last couple of decades. Big vineyardexpansions in the 90’s flooded the market with product anddrove prices down. Growers found themselves with largeamounts of grapes leftover after their usual contracts werefilled. Independent wine makers, taking advantage of qualitywine grapes at bargain prices, found space at wineries or customcrush facilities where they could crush, ferment, age and bottletheir wine.

by Kim Clarke

wine cellar


Virtual Wineries, Real Good Wines

One of the more visible and prolific ofthese California “wineries” is CastleRock. Started in 1994, the companybuys grapes from approximately 40growers and makes wine at facilities in Napa Valley, Sonoma County,Willamette Valley in Oregon andWashington’s Columbia Valley. With astaff of 11 and virtually no overhead, theyfocus on producing good wines at rea-sonable prices. All the wines are madeunder the guidance of their experiencedwinemaker, August Briggs (who alsomakes wines under his own label) andthey have several expert growers whospend time in the vineyards to make surethe raw materials measure up. CastleRock offers more than 10 Pinot Noirsfrom some of the best West Coast appel-lations. From some of these same appel-lations they also make Syrah, Cabernet,Zinfandel, Merlot, Chardonnay, PinotGrigio, Riesling and Sauvignon Blanc –more than a half-million cases in total.With a price tag of less than $10, a CastleRock wine always delivers more than youmight expect.

Cameron Hughes is an Americannegociant whose eponymous companymakes, imports and distributes premiumwine. Started more than 10 years ago inSan Francisco, the company’s wines cannow be found in grocery chains, big boxstores like Costco and Sam’s as well as inthe broad market. Their Lot Series beganin 2004 with help from Costco, whereCameron Hughes acted more as a bro-ker, procuring and blending the wine toCostco’s approval. Once approved,Costco issued a purchase order thatenabled Cameron Hughes to obtainfinancing to purchase the wine and bot-tle it – about 1800 cases. In 2007 thecompany began buying grapes and mak-ing their own wines. In 2012 theycrushed 5,000 tons of grapes (about300,000 cases) and purchased bulk wineof about the same amount. From theoriginal Lot 1 made exclusively forCostco, Cameron Hughes is now at Lot404 and counting. With wines from allover the world at a number of different

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price points, the company offers some-thing for everyone and usually succeedsin making the consumer happy.

Taking advantage of a down economy in2009 and lackluster sales of wine sellingfor $20 or more, Ninety Plus Cellarsembarked on a plan to help highly ratedwineries get rid of their excess inventorywithout eroding the value of their brand.As partners, the winery would bottle thewine and put a 90+ Cellars label on it. Inreturn, they would be paid promptly andreceive complete anonymity. The com-pany’s goal is to “seek out, bottle anddeliver fine wine that costs you lessmoney.” Teasing the consumer with adescription of the wine and its “SourcePrice”, the Boston-based company hasalso managed to secure wines from allparts of the world while keeping thescores high and the price low.

A common theme among these négo-ciants is value – good quality for a fairprice. A bargain, so to speak. While anoversupply of grapes and excessiveamounts of good wine has helped thisformula succeed, the landscape may bechanging. According to a June, 2012Wall Street Journal article, prices forgrapes and bulk wine are surging as sup-plies are failing to keep pace withexpanding consumption. The cost ofCalifornia Cabernet red grapes has dou-bled in the last year with other wine vari-etal grapes following suit. The recessionput a damper on new vineyard plantingsand several strong harvests, such as theone in 2009, further delayed planting.Grapevines have also been pulled up infavor of planting nut trees and vegeta-bles, as prices of those have also doubled.

While the full effects of the price squeezehave yet to be felt, it’s obvious that négo-ciants may have a more difficult timeproducing the bargains that they have inthe past. Get them while you can! n

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Want to race a T-rex, experience a simulated earthquake, fly like abird or program a robot? Stirring up buzz from around the globe, thePerot Museum of Nature and Science has welcomed thousandsof visitors since its December 1 debut, inspiring people of all ages toexplore the many exciting worlds of science offered within the stun-ning 180,000-square-foot museum.

Located on a 4.7-acre site north of downtown Dallas, the PerotMuseum is named in honor of Margot and Ross Perot, the result of a$50 million gift made by their five adult children — Ross Perot, Jr.;Nancy Perot Mulford; Suzanne Perot McGee; Carolyn Perot Rathjen;and Katherine Perot Reeves.

The building was designed by 2005 Pritzker Architecture PrizeLaureate Thom Mayne and his California firm, Morphosis Architects.

The overall building mass was conceived as a large cube floating overthe site’s landscaped plinth (or base). The landscape architecture,which reflects Texas’s indigenous ecosystems and demonstrates a liv-ing system that will evolve naturally over time, was created by Dallas-based Talley Associates.

Because its mission is to “inspire minds through nature and science,”the Perot Museum fully embraces both the natural world and themanmade world, focusing on earth and space sciences, life and nat-ural sciences, chemistry, physical sciences and engineering.

The 180,000-square-foot museum features five floors of public spacewith 11 permanent exhibit halls, including a children’s museum com-plete with outdoor play space/courtyard, and a state-of-the-art halldesigned to host world-class traveling exhibitions. Other highlights

PEROT MUSEUM OF NATURE AND SCIENCEDELIVERS


Photo by Jason Janik

Discovering Life Hall

with 180,000 square feet of inspirationfor science education

include an expansive glass-enclosed lobbyand adjacent rooftop deck; a multi-media3D cinema with seating for 298; a flexible-space auditorium; a Café; and a MuseumShop.

The Perot Museum expects to attain threeenvironmental designations – LEEDCertification from the U.S. Green BuildingCouncil; Green Globes Certification from theGreen Building Initiative, (separate from theGreen Building Council), which focuses on awide range of sustainable issues includingoperations; and the Sustainable SitesInitiative, which emphasizes landscape andsite design.

The $185-million fundraising goal – whichprovided for the site acquisition, exhibitionplanning and design, construction of thenew building, education programs and anendowment – was achieved November 2011,more than a year before the Museum’sscheduled opening.

The Perot Museum is open year roundMonday through Saturday from 10 a.m. to 5p.m. and Sunday from noon to 5 p.m. Pleasecheck the website for special holidays,extended hours and unexpected closings.

General admission is $15 for adults (18-64),$12 for students (12-17) and seniors (65+),and $10 for children (2-11). Admission to thetheater is $5 (for 30-minute shows) and $8(for 60-minute shows). For members, gen-eral admission is free and theater admissionis $5 (for 30-minute shows) and $6 (for 60-minute shows). Parking is available underWoodall Rodgers Freeway across from theMuseum for $6 when paid onsite, $4 whenpre-paid online, and $3 for museum mem-bers (when paid onsite or online).

One of the best ways to take advantage of thePerot Museum is through membership.Charter Membership (personal and gift) is$45 for students, $65 for individuals, $80for dual memberships, $100 for Family,$160 for Family Plus, and $200 for FamilyPlus Platinum. Patron level membershipsalso are available for $250 and up. Fordetails, call (214) 756-5751 or go to perotmu-seum.org.

The Perot Museum is located at 2201 N.Field Street in Dallas. For more informa-tion and to purchase tickets or member-ships, visit perotmuseum.org or call(214) 428-5555. n

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north texas dentistry convention issue volume 2 issue 7

Documents

force dysfunction

dental practices

trudenta system

dental force related

predictable results

patients su ering

objective diagnosis

engaging diagnosis