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West Michigan District Dental Society 2010 Spring Bulletin
Citation preview
Bulletin
SPRING ISSUE 2010VOL. 42, NO. 4
WEST MICHIGAN DISTRICT DENTAL SOCIETY | SPRING ISSUE 2010 1
Contents
President’s Message ..................................................................................................... 2
Editor’s Thoughts ........................................................................................................ 3
The Role of the Valuation Analyst in the Dental Profession .................................... 4
Annual Session At-A-Glance ....................................................................................... 8
New Members .............................................................................................................. 9
Legislative Breakfast .....................................................................................................10
2010 Tuition Grant Recipients ....................................................................................14
Trustee Report by Dr. Brian Cilla ...............................................................................16
Trustee Report by Dr. Norm Palm .............................................................................18
Classified Ads ...............................................................................................................22
Advertiser Index ...........................................................................................................23
Editor James Papp
Associate Editors Seth Vruggink Jeff Smith Aric Smith Larrisa Bishop Sheryl Jenicke
Advertising Editor Elaine Fleming Executive Secretary WMDDS 511-F Waters Building Grand Rapids, MI 49503 (616) 234-5605 [email protected]
West Michigan District Dental Society Executive Board 2009-2010 President Douglas Klein President-Elect Seth Vruggink Vice President Larissa Bishop Secretary-Treasurer Ryan Lebster Editor James Papp Immediate Past President
Doug Killian
Directors Tyler Wolf Christopher Morgan Samuel BanderArea Representatives
Kent County David Armbrecht Ionia-Montcalm
Kathleen Ellsworth
County Mecosta County Margaret Gingrich Ottawa County Thomas Phares
MDA IV District Norman Palm Trustees Brian Cilla
Big Rapids Dental Study Club Officers, 2009-2010President Erick Perroud Vice President Christa SternSecretary Christa SternTreasurer Erick Perroud
Holland-Zeeland Dental Society Officers, 2009-2010President Meredith Smedley Treasurer Robert Ankerman Secretary Immediate Past President
Ionia-Montcalm Dental Study Club Officers, 2008-2009President Chris Morgan Treasurer Kirkwood Faber
Kent County Dental Society Officers, 2009-2010President Brant Erbentraut Vice President David Armbrecht Secretary Lathe MillerTreasurer
West Michigan Dental Foundation OfficersPresident Donald Vander Linde Vice President Matthew Gietzen Secretary Devin Norman Treasurer Carl Kruyswyk
The Bulletin of the West Michigan Dental Society is published six times a year (the directory issue, fall issue, holiday issue, winter issue, spring issue, and summer issue). The opinions expressed in The Bulletin are not necessarily the opinions of the West Michigan District Dental Society.
Contributions to The Bulletin are welcome and should be addressed to The Bulletin Editor, 4880 Cascade Road SE, Ste. B, Grand Rapids, MI 49546. Requests for purchase of advertising space should be directed to the Advertising Editor, Elaine Fleming, (616) 234-5605. The deadline is the 1st of the month prior to publication.
© 2009-2010 West Michigan District Dental Society Bulletin
Mission StatementThe Bulletin is the newsletter of the WMDDS and its mission is to inform the membership of
upcoming and recent events, state & local issues related to dentistry, and as a forum for its officers,
representatives, and members to discuss appropriate topics of interest to the membership.
Communication & Advertising PolicyThe Bulletin will publish submitted articles from members and others that relate to the practice of
dentistry, small business, social, or political issues affecting dentists, or other subjects of interest to
the membership. All published items are subject to space restrictions and the community standards
of the WMDDS. The editors reserve the right to reject any article or advertisement deemed
inappropriate and to edit submissions as they see fit.
Submission & Publication Policy: Articles and advertisements must be submitted no later
than the 1st of the month preceding publication date. The Bulletin has six publications: the
directory issue, fall issue, holiday issue, winter issue, spring issue, and summer issue. Direct
submissions or correspondences to:
Dr. James C. Papp • 4880 Cascade Road SE, Suite B • Grand Rapids, MI 49546
Phone: 616.940.9872 FAX 616.940.2854 • Email: [email protected]
Include “Newsletter” in the subject line
About the cover
Photos courtesy of Elaine Fleming, Executive Secretary, WMDDS.
appy Spring! I just love this time of year… spring
break, March Madness, and the beginning of base-
ball, golf, and boating season. However, this spring
brings some melancholy with it; it’s hard to believe my term as
your WMDDS president is coming to a close. Time flies when
you’re having fun! All sarcasm aside, I have truly enjoyed and
will cherish this experience. I must confess, however, there is
one part of this position I will not miss – writing the President’s
Message! As I stated in my very first message, it was shaping
up to be an interesting year with several hot-button issues looming
around dentistry. In that respect it certainly didn’t disappoint.
On the federal level, the repeal of the McCarran-Ferguson
Act’s exemption of health insurance companies from federal
antitrust laws (H.R. 3596) got off to a good start. The U.S.
House of Representatives voted overwhelmingly in favor of
the repeal. From here the bill moves on to the Senate… stay
tuned. For more information, visit the ADA website,
www.ada.org/2388.aspx.
Here in Michigan, there are currently four bills before the
House (H.B. 5839-5842) seeking to make it illegal for insurance
companies to set fees for services they do not cover. Grass
roots member involvement is crucial to the success of our leg-
islative campaign. Please visit www.stopinsurancebullying.com
to request a “Stop Insurance Bullying Communications Kit”
for MDA members. This kit will provide you with talking
points, valuable background information, and through the
website you can directly contact local legislators to ask for
their support in our legislative campaign.
Improving access to dental services for the underprivileged
remains a very complex philosophical, financial, and political
problem. The current political sentiment is that all Americans
are entitled to dental care, but the current economy has left
state and federal government unable to pay for it. In several
states, potential solutions to this problem are being inves-
tigated and in some cases implemented: a cheaper delivery
model (mid-level provider) and increased revenue (dental
service tax). Rest assured that the MDA, through its Special
Committee on Access to Care (chaired by our own Dr. Norm
Palm) is working diligently to stay in front of this complex
issue. This will certainly not be the last you hear about access
to dental care.
I am very proud of the work that was done this year by
the Executive Committee of the WMDDS Board and the
WMDDS Board itself. Many of the housekeeping projects that
were started last year have come to fruition and we have an
energetic and motivated group of volunteer leaders. Having
an “organized organization” and motivated leaders are obvi-
ously very important, but I’d be remiss not to acknowledge
all the hard work done by our Executive Secretary, Elaine
Fleming. Thank you, Elaine, for keeping all the moving parts
moving together.
As I said previously, I am thankful for and humbled by
the opportunity to serve as your President. I am proud to be
a member of the West Michigan District Dental Society and
will cherish the time I’ve spent serving it. Thank you for the
opportunity. Have a great summer!
WEST MICHIGAN DISTRICT DENTAL SOCIETY | SPRING ISSUE 20102
P R E S I D E N T ’ S M E S S A G E
WMDDS Has Productive YearBy Dr. Douglas R. Klein, WMDDS President
H
WEST MICHIGAN DISTRICT DENTAL SOCIETY | SPRING ISSUE 2010 3
rom a professional perspective, there are probably one
or several people in your life experiences that have
influenced your decision/drive to be a dentist. For me,
Drs. Fred Duiven, Ted Williams, Leo Kupp, Jeff Johnston,
and Fred Smith helped shape my vision to pursue dentistry
and consequently periodontics. From each person, I retained
valuable pearls of information and experiences that facilitated
my thoughts that, “this was the direction for me to follow.”
Some influences were simply a pleasant experience at the den-
tal office as a child. Others a bit more challenging – involving
writing a thesis, a research grant, or defending treatment cases.
Looking back, some of these were tall tasks (and it kind of
makes me exhausted just thinking about it) but priceless none
the less. Priceless experiences that help shape us as professionals
and how we conduct ourselves in a professional environment.
Experiences that continue each and every day – listening,
learning, interacting with your peers in a respectful sort of
way. I hold in high regard the interaction I have with my fellow
dentists and co-workers. Continuing to learn each day how to
be a better professional in both the clinical and social setting.
I am always taken back by the thought that dental school and
specialty training were, although very important, only a frac-
tion of what I am as a professional today. I hold in high regard
the people I am surrounded by in the dental community at all
levels and continue to learn from them each day. The West
Michigan District Dental Society, as well as our state and
national associations, provide ample opportunity to better
ourselves as professionals. Not only from just a technical
standpoint to better ourselves as clinicians, but also to provide
opportunity to interact and learn from each other’s experi-
Lifelong ExperiencesBy Dr. James C. Papp, WMDDS Editor
E D I T O R ’ S T H O U G H T S
ences. These organizations also provide us with a sense of
community, a voice, a stand, and information on vital issues
that may affect our dental community as a whole. With the
current issues at hand such as insurance bullying and alterna-
tive providers to name a couple, now it is more important
than ever to interact, listen to their experiences, and arm
ourselves for the good of our dental community. Embrace life
experiences to better yourself and our profession, ignore them
and risk compromising yourself and how someone else shapes
our dental community.
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WEST MICHIGAN DISTRICT DENTAL SOCIETY | SPRING ISSUE 20104
General Valuation ApproachesThe subject of dental transi-
tions has exploded in recent
years. Literally hundreds of arti-
cles have been written on this
topic.1,2,3 One of the most sig-
nificant aspects of any transition
is determining the fair market
value of a practice. Numerous
approaches can and have been employed to establish a rea-
sonable valuation for a practice. In fact, it may be safe to
assume that until recently most transactions involving the
sale of a dental practice occur without the benefit of a valua-
tion conducted professionally by an independent third party.
“What the market will bear” was and may be the standard
attitude concerning sale prices for practices.
Currently the profession is experiencing an upsurge in the
number of businesses that offer valuations as part of a transi-
tion service.4,5,6,7,8 Some companies are combining resources
to offer this service cooperatively.9,10,11 Suffice it to say, there
is more than one way to transfer ownership of a dental
practice and central to all of this is to place a price tag on a
dental practice.
One of the most dependable methods in determining the
value of a practice prior to its sale, transfer, or transition of
ownership to a new dentist is to have a professional conduct
a valuation. Many companies (referenced above) do just that.
Others do not. Determining the most appropriate valua-
tion method for all parties should be the overriding goal of
any due diligence process. Arriving at the most appropriate
value of a dental practice is safest way to assure a smooth
sale, transfer, or practice transition. The confidence that both
selling and purchasing dentists gain from a professionally
determined practice value cannot be understated. A Certified
Public Accountant with demonstrable experience using gen-
eral valuation approaches is a start. Finding one that has a
suitable understanding of the ins and outs of a dental practice
is a different challenge. In general, all CPAs are expected to
understand the three basic approaches used in the valuation
exercise. Those approaches are:
• Income-based
• Asset-based
• Market-based
Reputable CPAs with valuation experience will incorporate
all three when rendering an opinion on a valuation. Each
approach involves a complex set of methods that must be
employed when determining the value for a business. The
income-based approach, for example, requires the valua-
tion analyst to include the capitalization of benefits method
and the discounted future benefits method which include
but are not limited to the intangible assets, terminal values,
capitalization rates, capital structure, forecast and projection
assumptions, goodwill, and much, much more. Valuation
analysts with specialized knowledge in dentistry will perform
these calculations and many more for their dental clients.
Dentistry comes with its own set of modifiers that should be
taken into consideration if an accurate valuation is desired.
Making it fair for both the buyer and seller is in everyone’s
best interest. A “win-win” situation should serve as a mutual
and commendable goal which will provide the cornerstone
for any transition.
Valuation Components Related to a Dental Practice Numerous factors specific to dentistry affect the value of a
dental practice. The purpose of this article is to draw attention
to those aspects that may help the selling dentist, the purchas-
ing dentist, and the valuation analyst understand those factors
that are unique to buying and selling a dental practice. It is
not meant to serve as an all-inclusive, exhaustive treatise on
the considerable amount of time and effort that take place in a
transition nor is it intended to explain any of the legal ramifi-
cations of entering into and completing a purchase agreement
and practice transition; however, the reader should be able to
begin the process of understanding how a proper valuation of
a dental practice is conducted.
Valuation components specific to dental practices may have
substantial influences upon a valuation analyst’s appraisal of
a dental practice. The description and explanation of compo-
nents exclusive to the dental profession are provided by the
author for informational purposes only. Valuation analysts
cannot and will not deviate from the American Institute of
Certified Public Accountants (AICPA) valuation standards.
Moreover, the author presupposes that valuation analysts
The Role of the Valuation Analyst in the Dental ProfessionSubmitted by Reggie Vander Veen, DDS
P R A C T I C E M A N A G E M E N T
WEST MICHIGAN DISTRICT DENTAL SOCIETY | SPRING ISSUE 2010 5
P R A C T I C E M A N A G E M E N T
utilizing this information are familiar with the Statement
on Standards for Valuation Services (SSVS)12 issued by the
AICPA Consulting Services Executive Committee or its most
recent version of that statement. Dentists can expect any
respectable valuation analyst to adhere to these standards
when determining the value of a dental practice. Moreover,
a valuation analyst can also be expected to apply valuation
approaches and methods to information obtained from tran-
sition components specific to dentistry. The specific dental
transition components beyond those found in typical busi-
ness valuations used for transactions for total acquisitions
and/or partner and shareholder buy-ins/buyouts include but
are not limited to:
• Determination of active patient population
• Management of recare (or recall) patient base
• Fee schedule analysis
• Facility assessment
This list does not attempt to consider the compliance-
oriented engagements that occur in a practice transition such
as income tax compliance, corporation conversions, purchase
price allocation, and other matters, nor does the list reflect the
comprehensive aspects of applying valuation theory and prin-
ciples in the valuation analyst’s performance of due diligence
in determining a practice’s valuation. Those elements specific
to an individual purchase agreement and practice transition
are left up to the valuation analyst for their proper execution
and detailed explanation and the attorneys responsible for
executing the related documents.
The scope of this article is not intended to address when a
valuation should be determined; however, relationships have
been tarnished and even broken if careful consideration isn’t
given to the timing of when a valuation is to be determined
for a practice. Common sense leads reasonable minds to the
conclusion that any a practice valuation that is determined
long after the arrival of an associate would be skewed in favor
of the selling or owner dentist. An associate that works many
months or even years in a practice in such a scenario would,
in fact, be increasing the value of a practice by the increase
in the gross production and net revenues simply by his or
her presence in the practice. Suffice it to say, practice own-
ers may wish to include a clause to remedy such undesirable
consequence in an employee agreement prior to bringing an
associate into the practice if a delay in the valuation of the
practice goes beyond six months to a year. Many new dentists
understand the need for such language in an employee agree-
ment and may even demand it. The old “timing is everything”
axiom makes sense in this instance.
Determination of Active Patient PopulationPlenty of articles have been written on how an active patient
population should be determined.13,14,15,16 Consultants have
varying views on what the number of active patients may
mean to a practice’s bottom line. The valuation analyst must
take into consideration these differences of opinion in the
profession. Buyers and sellers would be advised to explore
all the methods that are used to determine an active patient
figure. Many software applications have a proprietary feature
built into their programs to come up with a number and, as
expected, definitions vary. For the purposes of the valuation
analyst, a raw yet demonstrable number may be all that is
necessary in arriving at a valuation for any given practice.
In any event, the easier it is for a practice to identify, con-
trol, and retain its active patient base, the less difficult it is for
the valuation analyst to determine the health of a practice – a
valuable piece of information that may need to be used in
appraising a dental practice. Dentists fundamentally depend
upon this number for deciding whether or not an office can
sustain an associate during a transition and support the owner
dentist as a “senior associate” after the sale of the practice
is executed; however, valuation analysts use this number
to objectively appraise the health of a practice as an intan-
gible asset which may ultimately affect the value. A practice’s
patient base, in contrast, is a tangible asset – invariably the
largest asset listed in a valuation – and in most cases will make
up the lion’s share of a practice’s goodwill, if not all of it. After
all, the whole point in purchasing a practice is to obtain the
selling dentist’s patient base, therefore the importance placed
upon it cannot be understated. The obvious conclusion from
this is to make sure that care and concern is exercised when
ascertaining the number of active patients in a practice.
Management of Recare (or Recall) Patient BaseThe significance being placed on a practice’s recare program
is debatable as it relates to valuations of practices. The impor-
WEST MICHIGAN DISTRICT DENTAL SOCIETY | SPRING ISSUE 20106
tance to the health of a dental practice, however, does not
appear to be debatable.17,18,19 Practices that understand the
need to cultivate the process of keeping their patients active
have strong recare programs in place. Figures vary amongst
the members of the consulting crowd, but a case can be made
to conclude that good practices reappoint 80 to 85% of an
active patient base, better ones 85 to 90%, and the best ones
even more.20,21,22 The number of patients active in a recare
program directly correlates with a dental practice’s ability to
bring on an associate.
If an adequate patient base is available and the recare pro-
gram is performing poorly, an underdeveloped asset exists. If
the owner dentist is amenable to requests to activate measures
reverse such a downward trend, this may positively affect the
practice’s valuation. Obviously, the facility’s capacity to handle
the anticipated increase in patient flow needs to be addressed
and its overall effect on the practice’s value. This serves as
another example of the need for the valuation analyst’s famil-
iarity with the intricacies of a dental practice.
Fee Schedule Analysis A sometimes overlooked aspect of the value of a practice to
the purchaser is the strength of its fee schedule. You would
expect a corresponding drop in value for a practice that has
a weak schedule of fees and dependence upon capitated fees
or other forms of fixed reimbursement levels. The purchasing
dentist should not overlook this important aspect in evaluat-
ing the worth of a dental practice nor should the competent
valuation professional. Valuation analysts have at their dis-
posal numerous sources for securing fee schedule analyses of
dental practices.23,24,25 The impact of the existing fee schedule
on the valuation of a practice should never be viewed as a
trivial component of a practice’s value.
Facility AssessmentAs stated above, a dental transition depends upon a large mix
of factors available to the valuation analyst when determin-
ing the value of a dental practice, not the least of which is
the physical plant in which dental services are delivered. The
valuation analyst must understand that mere square footage
does not address the complexity of arriving at an accurate
valuation figure for a dental office. The proper balance of
operatory space, business space, and support space should
have a direct relationship upon the final figure.
From strictly a facilities standpoint, offices with a small
footprint usually consider expanding office hours to com-
pensate for the addition of an associate. Needless to say,
offices faced with this dilemma have to weigh the increased
gross production and net revenue against the strain on staff
and potential loss of goodwill and reduction of one-on-one
mentoring that will undoubtedly ensue. Therefore, it may
be wise for the valuation analyst to take this aspect of facili-
ties capacity into consideration and for the owner dentist to
acknowledge the effect that this may have on practice value.
Many offices considering transitions are painfully aware of
this consequence and address it in distinctive ways. Others
have unused or adaptable space that can readily adjust to the
addition of an associate; however, those practices with under-
utilized space have to accept the negative implication that
this unquestionably has on a valuation. Larger, underutilized
facilities bring their own set of complexities to the equation.
The precise valuation analyst understands the difference and
considers this appropriately in the calculation.
ConclusionIt is incumbent upon the prudent dental practitioner to set up
strategies well in advance of the sale of a dental practice: when
to exit practice, what it is worth, what the retirement needs
are, and how a sale will maximize one’s pension planning.
Although the dependence upon the sale price of a practice as
a major part of a dentist’s retirement package varies widely
from case to case, every dentist considering a transition from
active practice must not ignore the importance of finding
the right professionals to assist in this life-changing event.
Moreover, the role of the valuation analyst in determining fair
market value for dental practices cannot be overemphasized.
Purchasing dentists should never take for granted the business
repercussions associated with the valuation process. Securing
a fair and sound figure is of paramount concern. Never
assume that “60% of last year’s gross” should ever serve as
being “close enough.” Seeking out the services of a true valu-
ation specialist protects everyone’s investment. Practitioners
and future practitioners should seek out this indispensable
service as locally and logically as possible. No one loses when
it’s done right.
P R A C T I C E M A N A G E M E N T
WEST MICHIGAN DISTRICT DENTAL SOCIETY | SPRING ISSUE 2010 7
Bibliography14 Professional Transition Strategies, http://www.professionaltransition.
com/Dental-Practice-services.htm
15 Dental Practice Report, Thomas L. Snyder, DMD, MBA “Patients Lists” – Best Practices Section, http://www.professionaltransition.com/Dental-Practice-services.htm
16 “The Most Important Number – The Active Patient Count,” http://www.henryschein.com/us-en/images/dental/ActivePatientCount.pdf
17 Dentistry.com, http://www.dentistry.com/articles/Increasing_Your_Recall_Rate_Through_Your_Dental_Hygienist.aspx
18 Dental Success, http://dentalsuccess.biz/index2.php?option=com_content&do_pdf=1&id=48
19 The Profitable Dentist: “Coaching,” http://www.newdentalforum.com/index.php/coaching.html
20 AnnetteLinder.com & Capital Assoc., http://www.annettelinder.com/articles.htm
21 “The Perfect Recall System” – presentation by Fran Martini, RDH of Lighthouse PMG, http://c1-preview.prosites.com/70102/wy/docs/The%20Perfect%20Recall%20System.pdf
22 The Journal of Practical Hygiene, July/August 2001, http://www.mmcpub.com/pdf/2001jph/200104jph_pdf/01jphv10n4p53.pdf
23 Proveer, http://www.dentistfee.com/
24 Tracker Enterprises, http://www.trackerenterprises.com/index.php?option=com_content&task=view&id=74&Itemid=71
25 Renaissance Services & Systems, LLC, http://www.rss-llc.com/r_fees.php
Bibliography11 Dentaltown, http://www.towniecentral.com/Dentaltown/SearchResults.
aspx?q=dental%20%20transitions
12 American Dental Association publications, http://gsa.ada.org/search?q=dental+transitions&site=ADAorg_Collection&client=ADAorg_FrontEnd&proxystylesheet=ADAorg_FrontEnd&output=xml_no_dtd&proxyreload=1&btnG.x=0&btnG.y=0&btnG=Search
13 PennWell Dental Group, http://www.dentaleconomics.com/search/results.html?keywords=practice+transitions&collection=de
14 AFTCO Transition Consultants, http://www.aftco.net/
15 Paragon Dental Practice Transitions, http://www.paragon.us.com/
16 Henry Schein, http://www.henryschein.com/us-en/dental/services/PPTaboutus.aspx
17 Mercer Advisors, http://www.merceradvisors.com/services/transitions.php
18 Practice Transitions Partners, http://www.practicetransitions.com/
19 Professional Practices Consultants, Inc., http://www.practicesales.com/dental/default.asp
10 Transdent, http://www.transdent.com/ (Patterson Dental and Mercer Advisors)
11 ADS Brokers, http://67.199.84.244/Public/adsbrokers.aspx
12 AICPA SSVS #1, June 2007, http://fvs.aicpa.org/NR/rdonlyres/672E1DD4-2304-47CA-8F34-8C5AA64CB008/0/SSVS_Full_Version.pdf issued by the AICPA Consulting Services Executive Committee
13 Dentalcompare, http://www.dentalcompare.com/featuredarticle.asp?articleid=78
P R A C T I C E M A N A G E M E N T
WEST MICHIGAN DISTRICT DENTAL SOCIETY | SPRING ISSUE 20108
M D A N E W S
Annual Session At-a-Glance
Dr. Chris Smiley at the Candidate’s Forum.
Dr. John Vander Kolk was presented with the MDA Public Service Award. Dr. Norm Palm, MDA Secretary.
Dr. Colette Smiley gives nominations speech for Dr. Chris Smiley, candidate for MDA Journal Editor.
WEST MICHIGAN DISTRICT DENTAL SOCIETY | SPRING ISSUE 2010 9
N E W M E M B E R P R O F I L E
Drs. Ryan & Jolanta WilsonDr. Ryan Wilson obtained his
undergraduate education from
Alma College earning a Bachelor
of Science degree with Biology
major. Dr. Jolanta Wilson com-
pleted three years of under-
graduate studies in Chemical
Engineering at the University of
Michigan College of Engineering. The two met in dental
school and completed their dental education and training
at University of Detroit Mercy School of Dentistry. Ryan
graduated in 2003 and Jolanta in 2004. The couple
married one week after Jolanta graduated. In 2006, Ryan and
Jolanta purchased the Rockford practice of Dr. Lisa Sostecke.
Dr. Sostecke continues to practice with the Wilson team.
On any given day you may find Ryan road biking, keeping
bees, brewing craft beer, or perfecting his shot at the local
sportsman’s club. Jolanta is an avid painter and gardener,
even growing hops to supply their home brewery. Recently,
Jolanta has made a commitment to add running to her sched-
ule and will compete in her first road race this summer. The
couple has two loving “children,” Bella, a toy poodle, and
Ko-Ko, a standard poodle.
The Wilsons are members of local, state and national den-
tal societies and continue to further their education with the
goal of providing state-of-the-art care their patients deserve.
Drs. Ryan and Jolanta Wilson enjoy working together, with
their exceptional staff, and enjoy the community in which
they live.
WEST MICHIGAN DISTRICT DENTAL SOCIETY | SPRING ISSUE 201010
L E G I S L A T I V E B R E A K F A S T
n Friday, April 23rd, the West Michigan District
Dental Society held a legislative breakfast at GVSU’s
Eberhard Center. Thanks to all the legislators and
dentists who attended. There was some very good discussion
around the tables about the Michigan Dental Association’s
legislative action to stop dental insurance plans from
setting maximum fees for non-covered dental services. If
you haven’t requested your Stop Insurance Bullying
Communications Action Kit for MDA Members, go to
www.stopinsurancebullying.com.
Lawmakers attending: Rep. Dave Agema, Rep. Justin
Amash, Sen. Bill Hardiman, Rep. Dave Hildenbrand, Sen.
Mark Jansen, Sen. Wayne Kuipers, Rep. Arlan Meekhof, Rep.
Roy Schmidt and candidate for state representative, Rusty
Richter. Also in attendance were staffers Lindsey Koorndyk,
Janis DeVree, and Kerry Van Laan.
Attending from the Michigan Dental Association: Mr.
Drew Eason, Mr. Bill Sullivan, and Mrs. Caroline Ruddell.
WMDDS members attending: Drs. Richard Baldridge,
Eugene Bonofiglo, Aaron Boucher, Mark Brieden, James
Brennan, Todd Brower, Brian Cilla, Steven Dater, Jason
Dew, Bradley Dykstra, James Hur, Douglas Klein, Ryan
Lebster, Erik Lee, Debra Peters, William Rocker, Michael
Smith, Donald Vander Linde, Seth Vruggink, Tyler Wolf, and
Peter Zwier.
More new from the WMDDS Legislative CommitteeDr. Steve Dater is the new committee chair. If you have any
legislative questions or concerns, please contact him at
616.866.0869 or by email at [email protected]. He
also recommends you sign up for ADA Legislative Alerts
by going to http://capwiz.com/dental/mlm/signup/.
O
WMDDS Hosts Legislators
Dr. Douglas Klein, WMDDS president.
Representative Dave Hildenbrand.
Representative Roy Schmidt and Representative Arlan Meekhof.
WEST MICHIGAN DISTRICT DENTAL SOCIETY | SPRING ISSUE 2010 11
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WEST MICHIGAN DISTRICT DENTAL SOCIETY | SPRING ISSUE 201014
was the master at multi-tasking in Dr. Branyan’s practice. Dr.
Branyan added that “he (Ezequiel) has the strongest work
ethic I have ever seen in a young man of his age.” When Zeke
does graduate in 2011 as an RDH, he will definitely be an asset
to any lucky dental practice.
Kristine McCallion – Grand Rapids Community College Dental Hygiene ProgramKristine has worked for Steve
Dater, DDS, in Rockford for the
last 4½ years as a dental treat-
ment coordinator. She has a lot
of knowledge from her years of
private practice experience, both
in front office and assisting areas. Her goal is to work for a
general dentist in the Grand Rapids area upon graduation
as an RDH in 2011. Her personality, attitude, and love of
the dental profession won over the committee in her per-
sonal interview. Kristine will be a definite asset to a lucky
dental practice.
Nicole Weemhoff, Grand Rapids Community College Dental Assisting Program
Nicole was voted c lass
President in her dental assisting
program because of her willing-
ness to be involved. She relates
well to everyone and feels this is
an important asset in the work-
a-day world. She has thoroughly enjoyed her participation
in the lab and clinical areas and has had perfect attendance
throughout her dental assisting program. She will receive her
Associates degree in Dental Assistance in June 2010. She says
“a nice and healthy smile can go a long way in contributing
to the success of everyone who obtains one.” Her major goal
and desire is to put a smile on everyone’s face by cosmetically
helping to make their smile the nicest it can be so they will feel
good about themselves. To Nicole “making others happy and
pleased with the results of her service is a goal in itself.”
W M D F N E W S
Announcing 2010 Tuition Grant RecipientsSubmitted by Rosemary Jeruzal, Chairperson, WMDF Tuition Grant Committee
h Requests for Grant applications received.h Grant applications received and reviewed by Tuition
Grant Committee.h Personal interviews held with each applicant.h WMDF Tuition Grant Committee makes final decision
on Grant Recipients.
The following exceptional students are named the recipients of the 2010 West Michigan Dental Foundation Tuition Grants:
Stephen Mancewicz, University of Michigan School of DentistrySteve’s plan upon graduation in 2011 from dental school is to return to Grand Rapids and practice with his father, Gary Mancewicz, DDS. Since taking on certain leadership responsi-bilities while in dental school, he
plans to pursue leadership roles once in organized dentistry and in his community. He says that “coming from the city that began the greatest advancement in Dental Public Health with the fluoridation of city water, I grew up learning about the importance of oral health and preventative care.” His goal is “to continue to educate the public about how to maintain good oral hygiene and work with fellow colleagues to provide care to underserved communities.” With a student of Steve’s caliber, the future of organized dentistry in West Michigan looks strong.
Ezequiel Rios, Grand Rapids Community College Dental Hygiene Program“Zeke” has worked in the dental
setting since he was 18 years of
age. He has loved the experiences
he has gained through his work
in a private practice in Muskegon
and at Clinica Santa Maria in
Grand Rapids. A letter of recommendation received from Dr.
Carl Branyan stated that “I cannot possibly say enough good
about this completely outstanding young man.” He always
showed foresight, anticipation, and attention to detail, and
3
3
3
3
WEST MICHIGAN DISTRICT DENTAL SOCIETY | SPRING ISSUE 2010 15
Leah Waterman, Grand Rapids Community College Dental Assisting ProgramLeah impressed the committee
with her desire to give back to
her local community by helping
to serve their dental healthcare
needs. She has worked every day
she can to continue her school-
ing, a work ethic taught to her by her mom. Her ultimate
goal would be to continue her education in a dental hygiene
program. Leah’s attitude toward life and giving to others
will serve as an inspiration to the West Michigan Dental
Community.
W M D F N E W S
Whenever I saw someone with an obvious handicap, I
would think, “There but for the grace of God, go I. Thank
you, Lord, and bless that person.” That is, until February
20 this year, when I fractured my right wrist. I was a spec-
tator at a basketball game at the Basketball Courthouse
on 84th Street, sitting in the only three-riser bleacher
seating behind the backboard. Just before halftime, one
of the players threw a ball from midcourt, but missed the
backboard totally. The ball headed straight for my head.
My reflex action was to put out my right hand to prevent
a face plant. The ball hit my hand so hard it bent my hand
back and fractured the radius wrist bone. Welcome to the
world of the handicapped!
I never realized how cumbersome a cast can be, espe-
cially when it covers half of your hand and arm, or when
the use of your dominant hand is limited to holding
nothing heavier than a cup of coffee or water. Brushing
and flossing my teeth, eating, dressing myself, doing my
makeup and hair, cooking and cleaning, typing on the
computer, starting the car (ignition and gear shift are on
the right side), grocery shopping, babysitting my grand-
children, and holding dental hygiene instruments have
all become major challenges. The cast is off and I am in
a brace now and doing physical therapy to relieve the
“frozen wrist.” It’s a process. But it has also given me time
to think about all those other “handicapped-impaired-
disabled people” who have permanent injuries (e.g. war
veterans, work-related injuries, and those with arthritis
and other debilitating diseases and injuries, etc.) as well as
those with birth defects and anything else that limits one’s
agility and mobility.
As dental professionals, how do you view your patients
who are handicapped? What is your “Office Plan of
Action” to assist your impaired patients with their oral
health needs? What would you do if you were disabled?
This has been a tough “life lesson” for me, and it’s not
over yet. But it has given me a whole new appreciation
for those people with impairments who have to deal with
theirs every day in every way. Bless us all, Lord.
Life Lesson #1: Handicapped-Impaired-DisabledBy JoAnne Hodder, RDH BS
WEST MICHIGAN DISTRICT DENTAL SOCIETY | SPRING ISSUE 201016
T R U S T E E R E P O R T
Spring 2010 By Dr. Brian Cilla, MDA Trustee
his year, the MDA annual session was held at a new
venue, the Rock Financial Showplace, in Novi. The
attendance was excellent, with over 5,000 dentists
and staff turning out for this event. Given the state of the
Michigan economy, everyone was pleasantly surprised to see
that these numbers surpassed the previous Detroit session.
The vendors were very impressed by the facility and staff. This
group expressed sentiments which overwhelmingly supported
return to the same location in three years. Dental attendees
expressed similar opinions and as a consequence, the MDA
will be looking to return to Novi in 2013. The MDA annual
session rotation will return the meeting to Grand Rapids next
year and it will be our turn to host this event.
Once again, West Michigan and Muskegon District Dental
Societies were well represented by our delegates and alternates.
This group needs to be congratulated. Everyone on the delega-
tion has volunteered their time and effort to insure that we are
well represented for the issues that have potential impact on
our profession. It is important to note that our representatives
are not shy and have a knack for asking the right questions at
the right time. We, as a district dental society, encourage par-
ticipation and are always looking for individuals to sign on to
the delegation. No experience required, just be ready, willing,
and able to serve.
I would like to report on the most pertinent resolutions
and actions taken at the 2010 HOD:
• The HOD passed an extension of the building dues assess-
ment (up to $160/year) for three more years. It is anticipated
that this will provide for a five-year payoff of the mortgage
on the new MDA Headquarters.
• Approval was given for ongoing MDA lobbying activity in
order to achieve support for passage of “I’m Sorry” legisla-
T
tion. This is a common sense approach to resolving poten-
tial patient-related issues that will be strongly opposed by
the legal profession.
• The most discussed topic at this HOD pertained to whether
or not the MDA should be involved with funding issues
related to public oral health programs. Ultimately, the
HOD passed a resolution that allows our MDA speaker,
Dr. Deb Peters, to appoint a committee for the purpose of
investigating the feasibility of new revenue sources dedi-
cated to funding Michigan Public Oral Health programs.
This committee will report back to the 2011 HOD or in a
special session called for this purpose.
• The HOD adopted a resolution, which advocates that the
State of Michigan needs to have an Oral Health Program
that is supervised by a state dental officer. This position
would be held by a licensed dentist and allow for positive
interaction with the Michigan Department of Community
Health (MDCH) in determining public dental needs, pro-
vide pertinent oral health care advice, supervise regulated
dental procedures, and act as a guardian of a state compre-
hensive oral health plan.
• It has become apparent over time that there are significant
deficiencies with the legislative act that allows for the oper-
ation of mobile dental clinics. As a consequence, the HOD
has resolved that the MDA should seek specific changes
to statutory public health code regulations. This process
would be done in collaboration with the MDCH and the
State Board of Dentistry. The most pertinent issues requir-
ing change revolve around the concepts of comprehensive
dentistry, establishment of a dental home, informed con-
sent, and post-treatment information. These are serious
issues, which hopefully can be resolved with active MDA
input and participation.
• Certain medical technologies, such as a dental CAT scan,
require a Certificate of Need prior to their use in a clinical
setting. The HOD has requested that the MDA Board of
Trustees investigate the feasibility of appointing a dentist
to the Certificate of Need Commission in order to advance
the interest of dentistry for these FDA-approved devices.
• The HOD has resolved that the MDA should endorse the
candidacy of Dr. Jane Grover for State Representative. Jane
is seeking election in the Jackson area. She has experience
WEST MICHIGAN DISTRICT DENTAL SOCIETY | SPRING ISSUE 2010 17
T R U S T E E R E P O R T
in private practice and with public health dentistry.
Interestingly, there has never been a dentist elected to any
state office. The general consensus is that Dr. Grover will
provide a reasoned voice for issues that might have impact
on the dental profession.
• Dr. Chris Smiley was in a contested election for MDA
editor. The campaigns were conducted in a collegial and
professional manner. Both candidates had impressive cre-
dentials and the necessary attributes for continuation of
the fine traditions of our past Journal editors. In the end,
the HOD elected Dr. Virginia Merchant as the new MDA
Journal editor. I believe that Virginia (as Chris would have
been) is certainly up to the task of keeping our Journal
relevant and informative.
• Dr. Norm Palm announced his candidacy for MDA vice-
president. Talk about a glutton for punishment. The
amount of time and effort required for his work on the
Special Committee on Access to Care would have killed a
mere mortal. Norm has demonstrated that he is as tena-
cious as a pit bull and is unafraid of addressing difficult or
challenging issues. We can be thankful for his willingness
to continue on with service to the MDA.
• Dr. Deb Peters announced her candidacy for MDA speaker.
Deb possesses an exemplary knowledge of parliamentary
procedures and has a proven ability to run an efficient
meeting. Those of us that attended the HOD are certainly
appreciative of her ability to keep us on task.
Bill Sullivan will be our new MDA director of Legislative
and Insurance Affairs. He is taking the reigns from Caroline
Ruddell, who has retired in order to be a stay-at-home mother.
You will find that Bill is eminently well qualified for this
position and that his strong legislative experience will be a
necessary asset to the MDA. He will be taking a lead role in
our opposition to Delta Dental and the policy of setting fees
for non-covered services (NCS).
The MDA has been very active with the “Stop Insurance
bullying” campaign. In March, a legislative reception was held
in Lansing. Dentists from across the state were in attendance
to meet and greet legislators. There have been fundraisers for
representatives friendly to our cause. Locally, WMDDS had a
well-attended legislative breakfast. These events are important
mechanisms for demonstrating our concern over this issue. It
is apparent, from the sentiments that I am hearing from our
colleagues, that Delta Dental executives might as well have
poked a hornet’s nest with a sharp stick. If they wanted to see
where the line is drawn in the sand, then I believe that they
have accomplished that objective.
Nationally, there are twenty-seven states that have intro-
duced bills to overturn Delta NCS policies. New York already
had existing laws that prevent insurers from offering induce-
ments, such as fee reductions for NCS, to purchasers of insur-
ance policies. At the end of April, twelve states had passed, or
were finalizing, laws that prohibit this absurd policy. It is of
interest to note that support is bipartisan and overwhelmingly
in support of our position (1816 yes vs. 93 no).
Our efforts at the local level are absolutely required in
order to counteract the influence of Delta Dental in Michigan.
This dental insurance company is not without influence. They
have begun to paint a picture that Delta is a white knight
riding in to do battle with greedy and uncaring dentists. As
a consequence, conversation with your local state representa-
tive and/or senator is strongly encouraged. The bill sponsors
have indicated that a personal letter will have more impact
than e-mail. Please take the time to send some of your statio-
nery to Lansing.
As always, I will try to keep everyone informed about MDA
activities. Do not hesitate to call or write ([email protected]) if
you have any questions, concerns or commentary. I hope that
everyone has a good summer!
WEST MICHIGAN DISTRICT DENTAL SOCIETY | SPRING ISSUE 201018
grant for the training of the Alaska DHAT in a two-year cur-
riculum with didactic instruction through the University of
Washington MEDEX in the first year and clinical training
under supervision in Alaska in the second year of training. A
comprehensive two-year evaluation of the DHAT’s effective-
ness in Alaska will begin soon, with the ADA having a seat
on the evaluation panel. The Indian Health Service sought
approval to expand DHAT deployment to the lower forty-
eight states in late 2009 with mixed results. Only Minnesota
will have DHATs available for serving native Americans as
that state sanctioned the development of this provider model
in legislation passed earlier in 2009.
How are DHATs in Alaska and Minnesota similar? How do they differ?The Alaska DHAT really works in a collaborative manner
with a supervising dentist. After completing training, the
Alaska DHAT initial worksite is supervised. The supervising
dentist makes an assessment of the skill set of the DHAT and
issues standing orders of allowable duties. Thereafter, the
supervision is remote. The scope of treatment includes diag-
nosis, restorations, prophylaxis, extractions, pulpotomies,
and crowns for primary teeth. The Alaska DHAT has tribal
certification and is not state sanctioned.
The Minnesota DHAT has two levels of training and, right
now, two differing curriculum tracks. This has caused some
confusion, but what you need to know is that Minnesota will
have two types of DHATs – a basic and an advanced. The scope
of the Minnesota DHATs will include irreversible procedures
and surgical treatment and is similar to the Alaska model.
The duties list includes interim therapeutic restorations,
local anesthesia, restorative care, pulpotomies, pulp capping,
primary extractions, and prescription writing. Supposedly,
the Minnesota DHAT will provide care in FQHC’s, assisted
living centers, military or VA facilities, and other sites where
at least 50% of the population is enrolled in a public program
or has an income less than 200% of the federal poverty level.
However, at this time the regulatory oversight and supervi-
sion of the Minnesota DHATs has not been settled and is in
transition. The crucial decisions of whether the DHAT will
have a CODA approved curriculum, oversight by the Board
of Dentistry, and direct or general supervision have yet to be
T R U S T E E R E P O R T
What You Should Know About Alternative ProvidersBy Dr. Norm Palm, MDA Trustee
ember dentists have been hearing more about alternative providers recently. What is behind this move for a new
dental provider?New providers are being proposed as a solution to the access
to care problem, particularly to improve access to under-
served children. Proponents of an alternative provider cite a
lack of capacity of the existing dental delivery system to treat
the large number of people in the U.S. that do not have ready
access to dental care. In addition, a declining ratio of dentist
to population, an increasing age of the dentist workforce, and
the lack of participation by most dentists in the Medicaid sys-
tem are stated reasons to create another provider in dentistry.
Are there any alternative dental providers currently in the United States?The first alternative provider was the Dental Health Aide
Therapist in Alaska. The Alaska DHAT is sponsored by the
Alaska Native Tribal Health Consortium and has had sov-
ereign control of the project. They will train and deploy this
dental provider in remote areas of Alaska to provide basic oral
health care with collaborative supervision by a dentist. The
design is to train from the community and to return to the
community to serve. Although the Alaska Dental Association
and the ADA provided a dentist workforce and support to
serve these rural native Alaskans, the ANTHC required a
culturally-sensitive dental provider, not an outsider. The
ANTHC saw the Community Health Worker as a model to
which dental services could be added, spawning the DHAT.
The W. K. Kellogg Foundation has provided a four-year
M
WEST MICHIGAN DISTRICT DENTAL SOCIETY | SPRING ISSUE 2010 19
made. While the design was created to direct treatment to
those most in need, enough latitude exists in deployment to
question whether the intended increase in the capacity of the
delivery system will actually be seen where the greatest disparity
in access to care exists.
What has happened with the ADA-sponsored provider, the Community Dental Health Coordinator?The rural and native American pilot programs are under-
way in Oklahoma and are supervised by UCLA School of
Dentistry. The inner city program, however, was delayed and
will be starting soon in Philadelphia under the auspices of the
School of Dentistry at Temple University. Like the DHAT,
the CDHC will be an individual who is drawn from the com-
munity to be served. The curriculum is 18 months long and
will have a clinical scope of preventive care such as fluoride
application, sealants, prophylaxis and very limited scaling,
placement of interim therapeutic restorations, plus screening
and diagnostic data collection. The scope excludes irreversible
treatment. The CDHC will be a community health worker
who will play a primary role as a demand aggregator and
patient navigator, demonstrating skills in cultural competency,
community networking, and barriers to care resolution. I
think it is fair to say that the lack of vigorous support from
well intentioned but misinformed dentists for the CDHC has
affected the momentum behind this model. There is existing
ADA policy in effect since 2004 which declares that the ADA
is opposed to non-dentists making diagnoses, developing
treatment plans, or performing irreversible procedures. The
2009 ADA House directed the Council on Dental Practice
to review this policy statement and report its findings to the
2010 House.
Am I correct in thinking that the DHAT is the model with the most proponents?Right now the DHAT movement has the most velocity.
Recently, the American Association of Public Health Dentists
announced their intent to develop a DHAT curriculum in
cooperation with the Kellogg Foundation. There are other
models as well such as the Advanced Dental Hygiene
Practioner, supported by the American Dental Hygienist
Association and the Pediatric Therapist in Maine. The ADHP
T R U S T E E R E P O R T
was proposed in 2004 and has the broadest scope of practice
with only a collaborative supervisory role for the dentist. The
educational requirement is six years, nearly that of a dentist.
No pilots for the ADHP are in progress. In Colorado, where
independent hygiene practice has been in place for ten years,
there has been no measurable improvement in access for the
underserved. The Maine Pediatric Therapist is sponsored by
the Maine Dental Association as an alternative to an ADHP
proposal in that state.
This seems confusing. Why the differing models?Each state is seeing varying components to their access work-
force issue, and models for alternative providers are being
developed to address local needs while accommodating the
political culture in these states. Additionally, non-dentist
stakeholders are vying for influence in the outcome of this
proposed reordering of the dental workforce. What we can be
sure of is the legislative and regulatory process in each state
will guarantee inevitable variation from state to state in any
alternative provider that is produced and sanctioned.
What is the political environment on the alternative provider issue right now?Again, variation from state to state is the norm. States such as
Maine, Connecticut, Washington, and New Mexico have been
coping with alternative provider proposals for some time.
In these states, dentists are making decisions that we in
Michigan have not had to face. Legislatures across the country
are responsible for a chronic underfunding of dental Medicaid
programs. The result has been an increasing disparity in den-
tal care for poor children on Medicaid compared to children
covered by private insurance in this country. This underfund-
ing is attributable to an actual increase in the caries rate in
poor children aged 2 to 5 in the last decade and a concentra-
tion of 80% of dental caries in 25% of children in the United
States. However, the fact that state Medicaid programs for
dental care are typically inadequately and inconsistently
funded is being masked by the development of the alternative
provider movement as a solution to the access problem. These
alternative provider models have political appeal as they
appear to be flashy solutions with low costs and are modeled
after community health workers, physician assistants, and
WEST MICHIGAN DISTRICT DENTAL SOCIETY | SPRING ISSUE 201020
nurse practioners in medicine. However, these newer work-
force members in medicine do not provide surgical treatment
with remote supervision as is proposed with some of the new
dental alternative providers.
In the states facing alternative providers, did their legislatures force the issue upon dentistry?In a number of states, dentists found it important to enter
into an intensive process of engagement with legislators and
proponents of alternative provider solutions. This action was
necessary in order to achieve the best outcome with legisla-
tion, and prevent actions that they did not necessarily want
to happen. Minnesota had a protracted two-year fight on
alternative provider proposals. It was an exhaustive process
for the Minnesota Dental Association. The Minnesota experi-
ence could be repeated. Legislators state that poor access to
dental care is one of their most frequently heard health care
complaints. While Democrats have been more traditionally
attuned to access issues, many Republicans embrace these
issues with an eye toward cost containment in one of each
state’s biggest line items, health care costs. Many legislators
are legitimately concerned and view the foundations as an
independent voice on the issue. The entrance of the Kellogg
Foundation and the Pew Charitable Trust into the access to
care issue has accelerated these new alternative provider pro-
posals. Workforce creation is voiced by them as a more mea-
surable metric in which to gauge success on access improve-
ment. Also to be expected will be the entrance of the dental
education establishment into the foray with opinion and a
desire to protect turf.
How did these foundations get into this issue? What can we expect from them?They became involved by identifying the need for better oral
health care for poor children, proposing solutions, and fund-
ing pilot programs. The two most vocal foundations have been
the Pew Charitable Trust with its Children’s Dental Campaign
and the Kellogg Foundation, which has been involved with
the DHAT movement since its inception in Alaska. Both of
these foundations are seeking to call attention to poor chil-
dren’s inadequate access to dental care and mean to affect
social change to correct the access problem. They describe the
problem as ripe for reform, and these foundations are giving
poor children a voice when they historically have had none.
Kellogg has become very aggressive in its position and has
marked five states that it wishes to start DHAT pilot programs
in the next year: Vermont, New Mexico, Kansas, Washington,
and Ohio. They intend to be community based and partnered
with an in-state, non-profit agency that will help Kellogg
move public opinion on access issues for dental care. Pew ini-
tiated its campaign in October of 2009. Pew states that, unlike
so many other of America’s health care problems, the chal-
lenge of assuring children’s dental health and access to care
is one that can be overcome. There are a variety of solutions,
Pew states, that can be achieved at relatively little cost; and
the return on investment for children and taxpayers would
be significant. Pew supports state efforts to expand the exist-
ing dental health care team with new providers. Proposals
for new workforce models, Pew reasons, should be based on
research and evidence from both domestic and international
sources. Pew also agrees that Medicaid dental programs are
chronically underfunded with most states way below the cost
of providing the service.
What is the public’s perception on access to dental care?National surveys show that the public is comfortable with
medical mid-level providers, as such providers have been in
the medical workforce for many years. The public states they
want lower costs for dental care and greater access. They have
less well formed opinions on what constitutes quality and
safety in care. They are distrustful of institutions and prefer to
form their own opinions. The public also indicates that they
are overwhelmed by information on topics in health care.
What are the ethical issues for the profession on this issue?In Michigan, we are very proud of the success of Healthy Kids
Dental, which is the Delta Dental administered Medicaid
program for children in 61 of Michigan’s 83 counties. The
program is successful by most any metric used to assess
a publicly-funded health care program. However, despite
tireless efforts on the MDA’s part, we have not seen HKD
expanded to all Michigan counties. Of concern is the fact that
T R U S T E E R E P O R T
WEST MICHIGAN DISTRICT DENTAL SOCIETY | SPRING ISSUE 2010 21
only about 31% of children on Medicaid reside in a HKD
county. Yet, these counties not served by HKD are the ones
where the greatest disparities exist. These are the counties that
have the highest minority populations and where it is known
that 64% of Latino children and 65% of African American
children under age six come from a poor family. These are
also the poor minority children that we know have the greatest
concentration of dental caries. This should cause all dentists
in Michigan concern. Lastly, with respect to the development
of an alternative provider, reserving a lower standard of care
for children who are disadvantaged at no fault of their own
creates a separate and unequal level of care for these children
that is undeserved. Such a distinct two-tiered standard of care
has not been sanctioned in the health care delivery system in
the United States until now.
What is the MDA doing about access and the alternative provider issue?The MDA Board formed a Task Force on Access to Care in
late 2007. The Task Force reported to the Board of Trustees
in June 2008. In that report, the Task Force defined several
mission directives that the MDA must pursue on the access
issue:
• MDA must become an authority on access-to-care in
Michigan via research and sound collection of data.
• MDA must demonstrate that it is the credible and authori-
tative leader on access-to-care in Michigan and remain a
credible leader.
• MDA must develop educational opportunities that focus
its members, the public, and policy makers on the nature
of the access-to-care issue in Michigan.
• MDA must open more collaborative pathways with stake-
holders and communities of interest to improve access-to-
care and advocacy efforts.
In response to these directives, the MDA Board formed a
Special Committee on Access to Care (SpCAC) to formulate
specific measures to improve assess. This MDA Board com-
mittee began meeting in October 2008. This SpCAC is work-
ing on the goals of expansion of Healthy Kids Dental state-
wide, support of the Michigan Department of Community
Health’s oral health plan for Michigan, administrative reform
in the Medicaid program, the creation of a dental home for
all children, as well as calling attention to the increasing prob-
lem of early childhood caries and its later affects in school
aged children. In addition, the MDA has embarked on a
project to develop a public policy statement on oral health-
care in Michigan, including not only member dentists but
other stakeholders and parties who have an interest in the
oral health of Michigan residents. The report of the Michigan
Access to Oral Health Care Work Group is anticipated in
June of this year. Broadly based recommendations are antici-
pated from the Work Group, and new partners with common
interests are being identified. It is hoped that the MDA can
nurture these new relationships further. Some of the work of
the SpCAC is reflected in four resolutions that will be before
the MDA House this April. The SpCAC is alarmed that the
access issue is suddenly being overcome by proposals that the
development of an alternative provider will solve the access
problem.
What can I do as a member dentist about the alternative provider issue?Don’t be antagonized about the issue. Try not to react emo-
tionally to what you see and hear. Try to think about the
potential ramifications for dentistry if part of our scope of
practice is given to another lesser trained provider. Realize,
too, that we have no timeline and we don’t know the out-
come on this issue. Don’t be ambivalent: another dental
provider of the designs being considered will affect all dentists
in Michigan no matter where you are at in your practice life
and where in Michigan you practice. Rather, be assertive on
the issue by staying informed on developments in access and
workforce. Come to understand that we may be faced with
difficult decisions in the next several years.
T R U S T E E R E P O R T
WEST MICHIGAN DISTRICT DENTAL SOCIETY | SPRING ISSUE 201022
Space for Lease – Holland (great north side neighborhood location). Previous tenant was a family practice dentist. High visibility sign available. Building interior is ready for equip-ment installation. Three ops and small lab. Owner is willing to adapt build-ing to needs. Call 616.245.9098 or 800.669.0717.
SE Grand Rapids – Opportunity for a younger dentist to begin transition to their own practice. Recently remod-eled office in an excellent location. Gradually meet the patients and earn extra money as existing dentist takes additional time off over the next three to five years. If interested, email [email protected].
Office Space for Lease – Great loca-tion! 2426 Burton St. SE, 915 sq. ft., 3 operatories, lab, private office, reception, business office, base-ment. Contact Dr. Sam Bander at 616.949.5980 or email at [email protected]
Storage Space for Lease – Safe, secure, 24/7 access. Ideal for records, models, or just stuff you need to store. Located in the basement at 1151 East Paris Ave. Contact Dr. Sam Bander at 616.949.5980 or [email protected] for more information.
Dental Practice For Sale – Jenison, Michigan. Established and growing dental practice on major Jenison traffic route. Great income potential. Call for details 616.245.2767 or cell 616.485.1348.
Established Dentist with an Existing Office in Grand Rapids Wants to Buy – in or partner with another dentist. Open to all options. Please contact P.O. Box 141661, Grand Rapids, MI, 49514-1661.
Dental Practices Wanted to Buy – Two dentists separately looking for a practice to buy in the Grand Rapids area. Contact Greg McGlaun of Proveer at 616.425.5523 or [email protected].
Dental Office Suite/Three Opera tories for Lease – Desirable SE Grand Rapids location. Some shared space (recep-tion room, lab, etc.) with two other general dentists. Great opportunity for general, specialty, or start-up. Excellent terms. Call 616.949.8990.
Grandville: 2000+ sq. ft. office space available for lease in exclusive profes-sional office building. Other tenants include endodontist, family dentist, pediatric dentist, oral surgeon and orthodontist. Building partnership buy-in also possible as investment. Call 616.531.6377 or 616.531.1260.
RDH/RDA – Dental professional with over 5 years experience seeking full-time, part-time or subbing opportuni-ties where I will be able to utilize my professional experience with patients. Please contact me at 616.262.8719.
Opening a Satellite Office. Looking for a good used panoramic x-ray and some other used equipment (in good shape). Please email: [email protected] or call my office at 616.774.9402 or cell phone 616.307.2213 (leave message).
$190,000 Medical/Dental Office Building for Sale – Just south of 28th St. off Eastern Ave. in Grand Rapids. 2,345 sq. ft. For more information call Tyler DeGraaf at NAI West Michigan 616.242.1118.
Dental Office for Lease – Sparta, MI. 2,000 sq ft., includes two x-ray machines, vacuum extraction, cabin-etry, laboratory. $1,350 plus utilities. Traffic flow/14,000 daily. 616.874.4192.
C L A S S I F I E D A D S
The classified ad rate is $10.00 up to and including 30 words; additional words 15¢ each. Space permitting, WMDDS members may place ads free of charge as a membership service. Ads should be submitted in writing and sent with payment to Elaine Fleming, WMDDS, 511-F Waters Building, Grand Rapids, MI 49503. Telephone numbers and hyphenations count as two words, abbrevia-tions count as one word. Ads received after the first of the month prior to publication may appear in the following issue.
Spielmaker Accounting, Inc. – Specializing in medical practice accounting. Providing all aspects of accounting, payroll, and tax services. Licensed. Over 20 years of practice experience. References available. 616.885.0432.
Kentwood, Muskegon, Fowlerville – We have three practices for sale. These opportunities are excellent starters and satellite offices. Kentwood and Fowlerville have buildings also for purchase. Starting gross of $470,000 to $600,000. Financing and working cap-ital available. Contact Dr. Jim David, Henry Schein PPT Sales at 586.530.0800 or [email protected].
Half of Building (2,424 Square Feet) for Lease. Other half is a full-service dental laboratory. Two year old build-ing, excellent for a dental practice. Great location in Kentwood on the corner of Breton and 32nd Street. If interested please call 447.0190.
RediDental Emergency Dental Care is now accepting applications from den-tists. This is a perfect opportunity to “moonlight” to bring in extra money. Schedule not full? Consolidate your office hours and work a few with us for guaranteed pay. We have morning, evening, and weekend hours available. Email resumé to [email protected].
CPR/AED Training – your site. Two year certification. Medical professional with 18 years of training experience. Heartsine AED’s for sale. Penny Loosenort RRT www.healingheartscpr.com or call 616.485.4669.
Office Condo for Sale – Income pro-ducing! 3769SF new medical tenant on 5-year lease, 5351SF available to occupy. High traffic corner. Norton Shores. Call 616.776.0100.
WEST MICHIGAN DISTRICT DENTAL SOCIETY | SPRING ISSUE 2010 23
C L A S S I F I E D A D S
RDH – 19 years Hygiene experience, professional demeanor with excellent chair side manner seeking part-time or substitute opportunities, flexible, proven individual/team player, strong references. Kathy 616.682.1967.
Gorgeous Brand New 9120SF Class A Grand Rapids, Michigan area – General practice with average revenues of $600,000. Great family community convenient to Grand Rapids. Fully paperless office with complete digital, computerized system in four fully equipped operatories. Contact Phil Stark, Peak Transitions 888.477.7325 or visit www.peakdental.com.
Practice Wanted – Experienced general dentists wish to grow existing practice through buy-out or merger. Greater Grand Rapids. All options considered. Contact [email protected].
Grand Rapids, Michigan area – General practice for sale, average rev-enues of $600,000. Great family com-munity convenient to Grand Rapids. Fully paperless office with complete digital, computerized system in four fully equipped operatories. Phil Stark, Peak Transitions 888.477.7325 or visit www.peakdental.com.
Dental Office for Lease – Rockford, MI. 1,000 sq ft, includes some dental equipment and furnishings. $675/mo., plus utilities. Traffic flow/10,000 daily. 616.874.5300.
Tired of your IRA losing money? Is your IRA insured? Invest in an insured, secured, diversified real estate note package paying income each and every month. 20% return on full purchase. Investment is $500,000. Partials considered for a 15% return. Current owner has other business opportunity. Call now. TPS Holdings, 616.299.5778.
Charlevoix County – Well estab-lished, solo general practice for sale in Northwest Lower Michigan between Charlevoix and Petoskey. Averaging $357,000 the last three years on a part time schedule. Great potential to grow practice or add satellite office. Possible associateship with option to buy. Three equipped operatories, real estate with lake views available as well. Ken Smith Peak Transitions (888)477-7325 or peakdental.com
Non-Profit Organization seeking gently used dental chair for program serving autistic children. Contact Deb Frost at 616.726.1914 or email [email protected].
Our very busy, well established family/ esthetic practice has an opening for a full-time associate dentist. Great buy-in opportunity. Facility located in a small town near the lakeshore. Has 6+ operatories and long term devoted staff members. This is an excellent opportunity to benefit from the advantages of a group practice, learn from us and have management input. Contact Wendy at 616.218.8159 for more information.
Associate Position Wanted – General dentist looking for a position in a private practice as an associate in the Grand Rapids and surrounding areas. Open to all options (buy-in, partner-ship). Please call 616.307.2472 or email [email protected].
SE Grand Rapids/Cascade – Office suite available on 28th Street. Up to 3,000 sq. ft., remodel to suit, adjoin-ing new office of established general dentist, perfect for a specialist. Lease or purchase option. Contact Randy Chambers, DDS at 616.974.9947, or Eric Trierweiler with Prime Development at 616.957.4733.
Orthodontist Needed in Northern Kent County/Sparta – Two unequipped operatories ready in new, 2-dentist, 10-operatory, general dentistry building with room to expand to multi-chair practice. Ideal for satellite or start-up practice. Great referral base with six general dentists in Sparta and many more in just a 5-6 mile radius. See facility at www.spartadentistry.com. Email [email protected] or call 616.887.7389. We are open to all scenerios of space sharing and partnerships.
The Bulletin wishes to thank our valued advertisers who support organized dentistry by helping to defray the cost of printing and mailing.
Advertising in the Bulletin is seen by over 90% of the dentists in the West Michigan District. This includes five of the fastest growing counties in the state: Kent, Ottawa, Ionia, Montcalm and Mecosta.
For information on advertising rates, call Elaine Fleming, WMDDS Executive Secretary at 234-5605. Target your Market – advertise in the Bulletin!
Davis Dental Laboratory ............... inside front cover
Founders Bank & Trust ......................9
Henry Schein ............inside back cover
Hungerford, Aldrin, Nichols & Carter, PC ............................................7
MDA IFG ...........................................13
Professional Solutions ............................................11
ProNational .......................................24
TechTrust ..........................................12
Weston Financial ................................3
A D V E R T I S E R I N D E X
WEST MICHIGAN DISTRICT DENTAL SOCIETY | SPRIING ISSUE 201024
ProAssurance understands your desire for more control, less uncertainty, and preservation of your hard-earned professional identity.
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The qualities you value most in a protection partner are easily within reach.
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“Why is this the best fi t for my practice?
Professional Liability Insurance & Risk Management ServicesProAssurance Group is rated A (Excellent) by A.M. Best.
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Building
eht htiw spihsnoitaleR suoiraV •
Professionals in the Process &
Creating Your Team
• Contractors
• Architect
• Engineer
• Dental Suite Designer
• Developer
• Realtors
• Lenders
• Property Manager
• Site Selection
• Demographics
• Site Plan Approval Process
eht gnipoleveD •
Project Cost
• Determining Rent
• Project Feasibility
• Financing the Project
• Accumulation of Wealth
• Design Considerations
• LEED & Green Considerations
• Value Engineering
• Retro Fitting Existing Space
The Course begins with fielding
topics from the attendees regarding
their goals and objectives for
attending the Course and creating a
working list of topics, in addition to
the above, that the Instructors will
make sure are covered.
The Course concludes with a review
of the goals and objectives and a
Question & Answer session. After
the Course there will be networking
over cocktails.
Developing your ownProfessional Building
Course attendees will gain a thorough understanding of the process of developing their own professional building as well as understand the economic benefits derived from it.
“If you don’t have time to do it right, when will you have time to do it over?”
–John Wooden
Learning Objectives Include
For more information, please contact Rob Hulick at 616-454-1223. Registration begins at 8:15am the day of the course.
JUNE 18TH · 9AM–5PM
• Determining the Size of the Building
• Various Relationships with the Professionals in the Process & Creating Your Team
• Contractors
• Architect
• Engineer
• Dental Suite Designer
• Developer
• Realtors
• Lenders
• Property Manager
• Site Selection
• Demographics
• Site Plan Approval Process
• Developing the Project Cost
• Determining Rent
• Project Feasibility
• Financing the Project
• Accumulation of Wealth
• Design Considerations
• LEED & Green Considerations
• Value Engineering
• Retro Fitting Existing Space
The Course begins with fielding
topics from the attendees regarding
their goals and objectives for
attending the Course and creating
a working list of topics, in addition
to the above, that the Instructors
will make sure are covered.
The Course concludes with a review
of the goals and objectives and a
Question & Answer session. After
the Course there will be networking
over cocktails.
Developing your ownProfessional Building
Course attendees will gain a thorough understanding of the process of developing their own professional building as well as understand the economic benefits derived from it.
“If you don’t have time to do it right, when will you have time to do it over?”
–John Wooden
Learning Objectives Include
To register, please call The Prosperity Partners at 616-285-4991 or email [email protected].
JUNE 18TH · 8:30AM–5:30PM
Supported by
Presented by
The Prosperity Partners
Hilton Garden Inn27355 Cabaret DriveNovi, MI 48377
Cost is $195 ✷✷6CECredits6CE
Credits
WEST MICHIGAN DENTAL SOCIETY
511-F Waters Building
Grand Rapids, MI 49503
PRSRT STDUS POSTAGE
PAIDGRAND RAPIDS, MI
PERMIT # 657
MARK YOUR CALENDAR
West Michigan Dental FoundationAnnual Golf Outing
Friday June 4, 2010 Returning to
beautiful Egypt Valley Country Club
WATCh FOR MORE INFORMATION AbOUT ThIS EVENT!
Mission Statement: An organization dedicated to the improvement of oral health through the financial support of
education and service programs to address the needs identified by the dental profession and the communities it serves
in Kent, Ottawa, Ionia, Mecosta and Montcalm counties.