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Delta-Sierra Dental DigestDelta-Sierra Dental Digest

In this issue ...

President’s Message

Thank you

for this oppor-

tunity to serve

as the Presi-

dent of SJDS

for the coming

year. The trust

and confi-

dence you

have placed in

me is very

humbling.

Those who

have served

before me with unrelenting prowess, I sa-

lute thee. For a leader to lead with humil-

ity and dignity is the test of their uncondi-

tional service to an organization. I have

witnessed that first-hand with our past

and current leaders.

I would like to welcome the incom-

ing board members and those continuing

with their term on the board. ‘Thank you’

to the Committee Chairs, Committee

Members and all those who accepted to

serve at various volunteer positions this

coming year.

As we all are well aware,

the strength of an organiza-

tion depends on its mem-

bers. Here at SJDS, we

value the commitment of

our members and as always

will strive to increase your

Rommel Bal, DDS

President

Join Me On the Journeymember benefits and try to

create incentives for your

commitment to us.

The coming year is packed with

loads of learning opportunities and fun-

filled activities. CE classes by knowl-

edgeable speakers, family activities and

volunteer opportunities galore this coming

year.

Those of you who have thought of

but haven’t yet volunteered, come along

and join in. The professional and personal

development that is achievable through

volunteerism is remarkable and reward-

ing. Everyday as dentists, you passion-

ately help your patients beam their beauti-

ful smiles that you helped shape. By vol-

unteering some of your time, you can help

more people smile confidently and open

up more opportunities for them. Give Kids

A Smile on February 7th, and any day of

the year at St. Raphael’s Dental Clinic are

your local philanthropic arenas. We will

have a unique opportunity in October

2016 to serve our community at a tremen-

dously large scale through CDA CARES

in Stockton. I look forward to enthusiastic

participation from our valuable members.

Please come and join me on this in-

credible journey of learning, sharing and

caring.

Warm Regards,

Rommel Bal, DDS

2015 ProgramsMark Your

Calendar

2015 Programs - Continued - Page 3

General Membership Meeting

Thursday, February 19, 2015

5:30 - 9:00 PM

China Palace Restaurant5052 West Lane, Stockton, CA

2 Hrs. CE (20%)


Thursday, March 19, 2015

7 Hrs. CE (Core)

“Orthodontic Forum”Panel of Local Orthodontists

This program will be teleconferenced

for regional members at

Columbia Community College.

2:00-3:00 PM

Dr. Gary Baughman“Bread and Butter Class IIMalocclusion”

3:10- 4:20 PM

Dr. Chris Parker“Temporary

Anchoring Devices”

6:15-7:20 PM

Dr. Andrew Trosien“Airway Management in

Orthodontics”

4:30-5:40 PM

Dr. Cameron Wheeler“MultidisciplinaryApproach toEsthetics”

7:20-8:30 PM

Dr. Lyndon Low“Invisalign”

8:30-9:30 PM

Dr. Mike PanzerPanel & Q/A Moderator

2:00 - 9:00 PM5:40-6:15 PM - Social/Dinner

Stockton Hilton2323 Grand Canal Blvd., Stockton, CA


Thursday, April 16, 2015

5:30 - 9:00 PM

Manteca Transit Center252 Magnolia Ave., Manteca, CA

2.5 Hrs. CE (Core)

This talk is aimed at general dentists, special-

ists, dental hygienists, and assistants. It will discuss

the management of medical emergencies from both a

medical and a social point of view and will also dis-

cuss the five instances in which prompt treatment can

actually save a life. These are cardiac arrest, status

asthmaticus, status epilepticus, hypoglycemia, and

acute anaphylaxis. We will also discuss the use of

automatic external defibrillators.


Thursday, May 28, 2015

Extended Program

2:00 - 9:00 PM

7 Hrs. CE (Core)

Wine & Roses Hotel2505 W. Turner Rd., Lodi

(More program details will be published

in the March-April newsletter.)

2015 Programs - Continued - Page 5

Regional General

Membership Teleconferenced

Meetings

2015 Board of Directors

OFFICERS

Dr. Rommel Bal ......................... President

Dr. Maria Stefan ............... President-Elect

Dr. Pankaj Patel ........................ Treasurer

Dr. John Reed ............................ Secretary

Dr. Tom Bianchi ............... Immediate Past

President

BOARD OF DIRECTORS

CDA Trustee:Dr. John Hall

Dr. Mircea Mitu

Dr. David Neal

Dr. Chris Parker

Dr. Lita Rodriquez

Dr. Bruce Toy

Deadline to Submit Articlesfor the Next Issue - 3/6/15

EDITORIAL BOARD -

SJDS Board of Directors

EDITORIAL STAFF

Lyndon Low, DDS, EditorKathy White, Managing Editor

Colleen Lee, Executive Director

Laura Lomba, Secretary

Delta-Sierra

Dental Digest

Published by theSan Joaquin Dental Society

7849 N. Pershing Ave.

Stockton, CA 95207

Phone (209) 951-1311

FAX (209) 951-1321

Website: www.sjds.orge-mail: [email protected]

Dr. Charles Feldman

Dr. Jim Grabow

Dr. Kate Lomen

Dr. Jennifer Low

Dr. Lyndon Low

Dr. Michael Moreno

A Warm Welcometo Our New SJDSMembers

Richard Edwards, DDSEndodontics

2007, UCLA

2014, VA Med - Long Beach

3427 Deer Park Dr., Suite A

Stockton, CA 95219

209-478-2252

Melissa Shotell, DMDOrthodontics

2008, Nova SE Univ - FL

2014, Loma Linda Univ.

13955 Mono Way, Suite B

Sonora, CA 95270

209-532-2288

In Memory Of

Wesley “Wes” H.

Chalmers, D.D.S.

Feb. 14, 1931 – Jan. 3, 2015

It is with great

sadness that we

announce the

death of Wesley

Chalmers. Wes

died on January

3rd, 2015 at the

age of 83 from

complications of dementia. He

was born and raised in Stockton,

CA and was a graduate of U.C.

Berkeley and UOP School of

Dentistry. Wes practiced dentistry

for over 50 years and was very ac-

tive in the Rotary Club of Stock-

ton. He served on the SJDS

Board of Directors where he also

served as Secretary and Treasurer.

He is survived by his wife of 51

years, Barbara Chalmers, sister

Margaret Rore, children Kathleen

Berns, Maureen Chalmers and

Gordon Chalmers; and three

grandchildren, CJ Chalmers,

Helen Berns, and Madeline Berns.

tainly over the ADA News or JADA.

While those are fine publications that

contain much needed information and

education, it seems that the more local the

news, the more interest I have in taking

the time to read the articles.

My goal as Editor is to continue to

provide informative and enriching mate-

rial that is relevant to you, our members.

We will continue to publish educational

articles that provide both clinical and

practice management value, writings that

will make good use of your precious time.

We will also feature more in depth pro-

files of our diverse membership so that

we may become better connected as a

group and appreciate our contributions as

both dentists and socially conscious com-

munity members. Another reason I ac-

cepted the position was because I was as-

sured that Kathy White would be continu-

ing on as Managing Editor, a job that she

has continued to excel at since retiring as

Executive Director in 2006. We are truly

fortunate to continue to have someone

with her dedication and knowledge of or-

ganized dentistry to provide expertise in

our publication.

In addition, and for

those who know me well, I

will stir the pot. I hope to

provide material that will

engage our members in

civil and meaningful dis-

cussion because that’s

part of what editors do.

Editors editorialize.

They express their opinions and make

comments rather than just report the

news. I may not be as far left or extreme

right as some of my predecessors, but I

can stir it up with the best of them. So as

I liked to say when I was teaching my

three kids to drive as teenagers, “Get in,

sit down, and buckle up, it’s going to be a

fun and wild ride!”

Editorial

Lyndon S. Low, DDS, MS

It is with

great pride

that I enter

into the posi-

tion of Edi-

tor of your

Delta Sierra

Dental Di-

gest. This

award win-

ning news-

letter has a

tremendous

history of

editors in-

cluding out-

standing dentists and writers such as:

Raynor Harmeson, Corwin Jones, Doug

Martin, Dale Stocking, Ken Takeda,

David Gifford, Phil Abeldt, Randy

Mallett, Doug Fong, Ron Brown, Nicolas

Veaco, and the immediate past editor, Jay

Hislop. It is my mission to carry on the

tradition of providing informative, enter-

taining, and enlightening material to our

membership. I would like to take this op-

portunity to publicly thank Jay Hislop for

serving as an excellent editor for the past

two years. His writings were thought pro-

voking and often were not without contro-

versy. Whether you agreed or disagreed

with Dr. Hislop’s positions, I can honestly

say I enjoyed the discussions. Thank you

again for your service.

Since being approached by Brad

Louie to undertake the position of Editor,

I have been asked by many people, includ-

ing myself, why I would take on this task.

I recall vividly when I served as President

of SJDS, how I fervently loathed writing

the President’s message each month as at

that time we were publishing nine issues a

year. Well, things are different now. It’s

been thirteen years since I served as Presi-

dent and we publish only six newsletters a

year! My perspective has changed as I’ve

matured in practice and in life and I think

I can still contribute. What I have noticed

is that when I have limited time and have

several dental mailings on my desk, the

publication that I’m most likely to pick up

is my Delta Sierra Dental Digest. For me

it’s always the SJDS newsletter over the

CDA Journal or CDA Update and cer-

Buckle Up!

2015 Programs-- Continued from Page 3

“Endodontics”Rick Wittenauer, DDS

Speaker

2.5 Hrs CE (Core)

5:30-9:00 PM

University Plaza Hotel110 W. Fremont St., Stockton

Staff Appreciation Night

“You Can Run but YouCan’t Hide! Conflict

Resolution andCommunication Skills

to Keep Your Teamon Track”

Mary O’Neill, MA, MFT

Speaker

2 Hrs CE (20%)

5:30-9:00 PM

Hutchins Street Square125 S. Hutchins St., Lodi

“California Dental PracticeAct/Infection Control”

Nancy Dewhirst, Speaker

4 Hrs CE (Core)

4:00-9:00 PM

Stockton Golf & Country Club3800 Country Club Blvd., Stockton

Online renewal is open now.

Renewal deadline is

January 2, 2015.Anyone that participated in the

EDP program in 2014 that did NOT

opt into auto renewal for 2015 has un-

til December 8, 2014 to enroll online

or mail in a new EDP form.

Below are the renewal payment

options available to you:

Online:www.cda.org/renew

Electronics Dues Payment:All eligible members can enroll

in EDP by completing a new EDP

form or online at www.cda.org/renew

(to enroll online, log in to your

cda.org account, follow the renewal

steps and when you are asked to “pay

dues in full” or “enroll in monthly

payments” select “enroll in monthly

payments”) which must be completed

by Monday, December 8, 2015.

Changes can be made by contacting

CDA membership. Once enrolled in

the EDP program you will automati-

cally be auto enrolled each year mov-

ing forward.

Final deadline for dues

is March 31, 2015.

Mail:Complete and return the bottom

portion of your renewal statement

with your dues payment.

Phone:Call 1.800.CDA.SMILE to speak

with a member service representative

and renew via credit card.

If you have questions regarding

your 2015 renewal, please feel free to

contact the dental society at

209.951.1318 or CDA at 1.800.

CDA.SMILE (1.800.232.7645).

Membership

Renewal Made

Easy

CHICAGO, January 15, 2015 — An up-

dated ADA clinical practice guideline, last

evaluated in 2012, finds that in general,

for patients with prosthetic joint implants,

the use of prophylactic antibiotics, or an-

tibiotics administered to prevent the risk

of infection, are not recommended prior

to dental procedures to prevent prosthetic

joint infection (PJIs). The guidance, in-

cluded in the January issue of The Journal

of the American Dental Association

(JADA), was created by a panel of ex-

perts tasked by the ADA Council on Sci-

entific Affairs.

“The panel found that the current

best evidence failed to demonstrate an as-

sociation between dental procedures and

prosthetic joint infection,” said Dr. Tho-

mas Hart, Chair of the ADA Council on

Scientific Affairs. “However, this guide-

line should be integrated with profes-

sional judgment and used along with other

available, patient-specific data, needs and

preferences to determine an evidence-

based approach to care.”

Dentists should note that there does

not appear to be a conflict between the

updated ADA prosthetic joint infection

Updated Guideline Indicates

Preventative Antibiotic Use Not

Recommended Prior to Dental

Treatment for Most Patients with

Prosthetic Joints

Journal of the American Dental Association Features Guidance

practice guideline and a recent Lancet

publication on infective endocarditis.

“Prosthetic joint infection and infective

endocarditis are different disorders,” said

Dr. Thomas Sollecito, who is one of nine

members of the panel. “They have differ-

ent risk factors. The microorganisms in-

volved in PJIs are often from different

ecosystems than the oral cavity whereas

those in infective endocarditis can be from

the mouth.”

This recommendation clarifies find-

ings in the 2012 guidelines entitled, “Pre-

vention of Orthopaedic Implant Infection

in Patients Undergoing Dental Procedures:

Evidence-based Guideline and Evidence

Report,” which a 2012 panel of American

Academy of Orthopaedic Surgeons and

ADA authors co-developed.

The full recommendation, entitled, “The

Use of Prophylactic Antibiotics Prior to

Dental Procedures in Patients with Pros-

thetic Joints: Evidence-Based Clinical

Practice Guideline for Dental Practitio-

ners,” can be accessed in the January 2015

print edition of JADA and the JADA

website at http://jada.ada.org/article/

S0002-8177%2814%2900019-1/fulltext.

This month’s featured member profile is

Masood Cajee. Masood was born and

raised in South Africa and moved to the

U.S. thirty years ago with his family. He

received his high school, college and den-

tal training all in Oklahoma where his fa-

ther held a faculty position in Anesthesi-

ology at University of Oklahoma. After

graduating from the University of Okla-

homa, School of Dentistry in 2000,

Masood associated for a while before un-

dertaking a health policy fellowship and a

Masters in Public Health at Harvard. He

has been practicing general dentistry in

Manteca since 2008. His desire to be

closer to family drove him to California to

continue his professional career. He then

started a practice from scratch, undertak-

ing no loans, as he had saved in order to

pursue his dream. Dr. Cajee was very

gracious to sit down over breakfast re-

cently to share his story and views of den-

tistry.

What is unique about your prac-tice?

We have built the practice on bread

and butter dentistry, prevention and emer-

gency care, with convenient hours and fo-

cusing on a great patient experience. The

joy of being a dentist is the chance to

Member Profile

Masood Cajee, DDS, MPH

Interviewed by Dr. Lyndon Low

build long term relationships with patients

and families. We’re successful when we

do that.

We also have a mobile dental ser-

vice, 1 to 2 days per month. My assistant

and I pack up my Prius with mobile gear

and serve homebound patients in nursing

homes and private homes in Stockton,

Manteca, and Modesto. I used to work

full time in nursing home dentistry. It’s an

ergonomic nightmare for your neck and

back, but it’s very rewarding – not finan-

cially, but professionally. I work with a

lot of dementia and stroke patients. I

spend a lot of time educating patients

about their oral health and general health

and nutrition.

Why do you belong to organizeddentistry and what value to youplace on membership?

A mentor once told me, “It is very

important that you join whatever guild or

association exists to advance yourself and

your profession.” We are lucky in the

U.S. to be as organized as we are in den-

tistry. Dentistry is America’s last great

cottage industry. Everything that is great

about the profession in the U.S. is attribut-

able to the fact that organized dentistry

has always been strong. It provides life-

long learning and a community of fellow

dentists, some of which are fighting for us

daily in Sacramento and Washington, DC.

What are your tips for maintaining asuccessful practice?

1. You need a solid team – you’re only

as good as your team. Dentistry is a

team sport and in the best practices,

even patients are members of the

team.

2. You need great labs and suppliers.

You don’t need headaches with labs

and tools.

3. You need to learn every day – to im-

prove the business, the clinical sys-

tems, and yourself!

4. Surround yourself with successful

mentors.

5. Join organized dentistry.

What are you involved in outside ofdentistry?

I have served on the board of the

Library and Literacy Foundation for San

Joaquin County for six years. I am in-

volved with Strong Libraries = Strong

Communities for over one year. These or-

ganizations seek to ensure that we have

the best public library systems possible.

In Stockton, many of our pressing prob-

lems – and challenges in dental practice –

can be traced to lower incomes and edu-

cation levels compared to California and

national averages. Income and education

determine the health profile of a commu-

nity. Stockton spends about $15 per resi-

dent on libraries when other cities spend

$25-35 per resident. This allows all citi-

zens to have a place to get educated and

help in filling out job applications, re-

sumes, and with homework and tutoring.

A high performing public library system

has the potential to catalyze the rising tide

that lifts all boats – making us healthier,

wealthier, and wiser.

My top five things I could not livewithout in private practice are:

1. Hi-magnification Designs for Vision

Loupes and LED headlight.

2. J. Morita Root ZX II apex locator

3. Digital radiography with the

Planmeca Promax

4. Fusion Curing light.

5. Vibraject buzzing accessory for com-

fort when giving local anesthetic.

The end of the year is a good time

for dental practices to evaluate how they

did over the last year and prepare for next

year. As part of CDA’s Practice Advising,

which is an in-office consulting service

designed to provide dentists guidance on

reaching their individual business goals, a

dentist can receive an in-office visit from

an advisor.

The advisor will help the practice

get an idea of its production in the past

and how it may need to adjust things mov-

ing forward.

“We want to come in with you, sit

down and go over several aspects of your

finances, ordering, expenses and more to

help you understand where your practice

is doing well and where it can improve so

that 2015 is better than 2014,” said CDA

Practice Advisor Shaun Pryor.

One of the key tools used during this

in-office meeting is a spreadsheet that

helps a dentist add up their total annual

sales and show the percent of total sales

contributed by several categories. Dentists

must first understand what the cost of

goods sold means, according to Pryor.

‘Cost of goods sold’ are expenses di-

rectly related to producing or buying your

products or services. For example, pur-

chases of inventory or raw materials, as

well as the wages (and payroll taxes) of

employees directly involved in producing

your products/services, are included in

‘cost of goods sold,’” Pryor said.

These expenses usually go up and

down along with the volume of production

or sales.

“Study your records to determine

‘cost of goods sold’ for each sales cat-

egory. Control of ‘cost of sold’ is key for

most businesses, so approach this part of

your forecast with great care,” Pryor said.

Pryor and the other CDA advisors

who visit practices for the end-of-the-year

appointments will help dentists analyze

each category of product/service to deter-

mine how much it costs for labor, for ma-

terials, for packing, for shipping, for sales

commissions, etc.

Operating expenses, which are nec-

essary expenses but are not directly re-

Analyzing End-of-Year

Practice Production

lated to making or buying a practice’s

products/services, also will be analyzed.

Rent, utilities, telephone, interest and the

salaries (and payroll taxes) of office and

management employees are examples.

“Most operating expenses remain

reasonably fixed regardless of changes in

sales volume. Some, like utilities, may

vary with the time of year. Your projec-

tions should reflect these fluctuations,”

Pryor said.

CDA advisors will use this data and

the total operating expenses and gross

profit to determine the practice’s net

profit. They also will compare the average

cost factors with other dental offices of

the same size in similar communities.

“It is unlikely that your expenses

will be exactly in line with industry aver-

ages, but this can be helpful in areas in

which expenses may be out of line,” Pryor

said.

The member-only Practice Advising

helps dentists develop a vision statement

and a customized action plan for their

business and also gives them an opportu-

nity to enhance their skills through quar-

terly workshops on everything from lead-

ership and treatment planning to financial

policy and case presentation. The

program’s three areas of focus are practice

management, regulatory compliance and

employment. For a monthly fee, dentists

will receive six in-office visits per year,

five off-site workshops and a monthly

one-hour scheduled call with a CDA Prac-

tice advisor.

For more information, visit cda.org/

practiceadvising.

While CDA Practice Advising is focused on

helping our members develop and improve

their business practices, patient care must al-

ways be a primary focus. Any business change

that we recommend will not affect the treat-

ment that patients receive from their dentist.

Patients should receive care and a treatment

plan that meets their dental needs regardless

of payer source. Remember, all patients

should be treated fairly, consistently, and ethi-

cally, as more fully described in the Patient

Bill of Rights.

SJDS Condo Expansion Fund Drive

Thanks to the following SJDS members for their pledges:

A pledge form is enclosed

with this newsletter.

Thank you! We are so close to achieving

our $60,000 goal for the condo expan-

sion project! There is only $10,750 left

to meet our goal! Thank you to those

members who have newly contributed. If

you haven’t had the opportunity to help

with this project, please consider doing

so now by sending in your donation.

There’s just a little bit more, so please

help! If you are ever in the neighborhood,

stop by and see the new office. You’ll be

impressed with what was done! There is a

pledge form included in this newsletter.

Photo: Courtesy of Olson Construction, Inc.

Dental students in California

will soon officially be able to graduate

with a “portfolio” model exam process

over the course of their final year in

dental school.

In November, the Dental Board

of California finalized the regulatory

process of approval for the portfolio

examination model and California’s

dental schools can now begin the

implementation process (it is not a re-

quirement for the schools, however).

This is the first licensure-by-portfolio-

exam program in the nation.

The portfolio examination al-

lows candidates to build a portfolio of

completed clinical experiences and

clinical competency examinations in

six subject areas over the normal

course of clinical training. Both clinical

experiences and clinical competency

examinations are performed on patients

of record within the normal course of

treatment. The primary difference be-

tween clinical experiences and clinical

competency examinations is that the

clinical competency examinations are

performed independently, without fac-

ulty intervention.

“This is going to improve the

education of California’s dental stu-

dents and is something that CDA and

the dental students themselves have

fought for over several years,” said

CDA President Walt Weber, DDS.

CDA and ADA policy supports

the elimination of the one-time “live

patient” clinical licensure exam and

California’s dental students have been

quite active in California’s process.

Students hosted licensure forums at

CDA Presents The Art and Science of

Dentistry in Anaheim and San Fran-

cisco in 2007, bringing together leaders

from the Dental Board of California,

CDA and selected dental school deans

to discuss the future of licensure. In

2009, Assemblywoman Mary Hayashi

Licensure by Portfolio

Set to Be Implemented

(D-Hayward), introduced CDA-spon-

sored bill AB 1524, calling for the re-

placement of the California clinical

examination with a “portfolio” model

exam process that would take place

over the course of students’ clinical

training in dental school. In 2010,

Gov. Arnold Schwarzenegger signed

the bill into law, and up until this past

November, it had been in the develop-

ment phase.

The Dental Board of California

has included licensure by portfolio in

its recent Sunset Review Report. In the

report, the board lays out the require-

ments for students to participate in the

examination, including that students

must be in good academic standing

and have no pending ethical issues at

the time of the portfolio examination.

Additionally, students must be signed

off by the dean of their respective

schools to participate in the exam.

The report goes on to state,

“Portfolio assessment can provide a

powerful approach to assessing a

range of curriculum outcomes not eas-

ily assessed by other methods and pro-

vides a more in-depth picture of stu-

dent competence than the snapshot ob-

tained in a traditional examination.”

A concern that has been raised

about the portfolio examination is that,

as the first of its kind in the nation, li-

censure reciprocity with other states

must still be resolved. The dental

board hopes that as the examination

proves itself a model for other states,

licensure portability will follow.

“CDA has been at the table

throughout the portfolio development

process by the Dental Board of Cali-

fornia and we plan to continue to pro-

vide direct input as the program is

implemented,” Weber said.

For more information on licen-

sure, visit the dental board’s website,

dbc.ca.gov.

Continued - Page 12

dents so tuition-sparing strategies are

critical. Educational programs that ignore

attracting strong students, maintaining

high value and relevance, and preserving

a sustainable financial model are vulner-

able ... no different from a private prac-

tice in these ways. Our goal in relocating

these programs is to maintain dental hy-

giene programmatic educational strength

and viability.

Since graduating our

first Dental Hygiene

Class in 2005, the pro-

gram has graduated 225

practicing hygienists.

Forty-one (41) of these

grads harkened from sur-

rounding communities

(Stockton, Lodi, Tracy,

Manteca etc.). Since

opening our doors to pa-

tient care in 2003,

Pacific’s AEGD and

Dental Hygiene pro-

grams have collaborated

with many community

agencies to improve oral

health.

Among these partnerships:

First 5 of San Joaquin

Head Start

Jene Wah Health Fair

San Joaquin Children’s Dental

Disease Prevention Program

Special Olympics

St. Raphael’s Dental Clinic

M o s t

of you un-

derstand that

University of

the Pacific’s

A d v a n c e d

E d u c a t i o n

in General

D e n t i s t r y

( A E G D )

program is

in the pro-

cess of

c los ing i t s

Stockton site

and consolidating its residency program to

our Union City clinic. Our baccalaureate

Dental Hygiene program will transition to

the dental school’s San Francisco campus

in 2017. Having worked with SJDS to es-

tablish the dental hygiene program in

2001, these changes are bittersweet for

me. These were very tough decisions and I

hope to share some of the contributing fac-

tors that went into making them.

Concerning our dental hygiene pro-

gram, applications have softened some-

what in the last several years, paralleling

the softening employment market for the

profession. Future employment trends ap-

pear positive and, by moving the program

to San Francisco, we believe we can

strengthen both the Dental Hygiene and

DDS programs. Students will provide co-

therapy, improving comprehensive patient

care and becoming more practice ready,

through working together. Foundational

courses and faculty can be shared to

achieve economies of scale and to provide

students from both programs an opportu-

nity to learn together. Administrative sup-

port for the program can be customized to

include improved candidate recruiting and

admissions processes. By taking advantage

of the school’s new San Francisco site,

clinic capacity can be utilized more eco-

nomically.

In addition to educating future prac-

titioners, private, non-profit institutions

such as the University, and each program

within them, must work diligently to be

self-sustaining. Red ink is borne by stu-

Pacific Residency and Dental Hygiene Transitionby Cindy Lyon, DDS

Su Salud

Valley Mountain Regional Center

Kaiser Permanente Community

Grant Programs

San Joaquin County Hospital

Dental Clinic

SJDS Give Kids a Smile

Dignity Health grant supporting

direct patient services (2014)

Dignity Health Partnership grant

with YMCA & Community Medical

Center (2015) to provide oral health

education and preventive care to af-

ter school programs in SJ County.

We are grateful for the opportunity

to have served and contributed to the

community in significant ways. Thank

you, SJDS, for the chance to work with

members in many of these special ven-

tures.

We understand that the School of

Pharmacy and Health Sciences will as-

sume the clinic and classroom space once

the dental hygiene program fully moves to

San Francisco in summer 2017. We are

working with Lester Low to donate clinic

equipment to St. Raphael’s Dental Clinic.

Mobile equipment acquired will be do-

nated to newly grant funded programs

and/or other San Joaquin County initia-

tives.

We look forward to continuing to

grow outstanding dental hygienists and

residents who will provide care and serve

communities throughout California. My

personal appreciation to you for your un-

derstanding and continued partnership as

we work together to shape new practitio-

ners and the environment in which they’ll

practice. Special thanks for all you do for

Pacific.

It can be particularly disconcerting

to receive a certified letter from CDA’s

Council on Peer Review or Judicial Coun-

cil. You may have an uneasy feeling as

you sit down to open the letter. Thoughts

of, “What did I do?” turn quickly to,

“What do I do now?” You sit down, take a

deep breath, and open the letter, then scan

it to determine what they want. You may

even wonder what would happen if you

don’t do anything.

As you consider your options, you

know that you cannot ignore an unpleas-

ant situation and hope it goes away. Per-

haps your competence is being questioned

by someone who is seeking justice. You

may feel your integrity is at stake as you

determine whether or not to respond. You

want to act ethically, so you turn to the

CDA Code of Ethics for guidance.

Taking the Ethical Path

In Challenging TimesRobert D. Stevenson, DDS, Member, CDA Judicial Council

When you signed your membership appli-

cation, and each year when you pay your

dues, you agree to abide by the CDA and

ADA codes of ethics, including comply-

ing with the requests of duly constituted

committees and councils. What does that

mean? A duly constituted committee or

council is a committee or council that has

been legitimately established by the gov-

Section 3 of the CDA Code of

Ethics states, “A dentist has the

obligation to comply with the rea-

sonable requests of a duly con-

stituted committee, council or

other body of the component so-

ciety or of this association neces-

sary or convenient to enable

such a body to perform its func-

tions and to abide by the deci-

sions of such body.”

erning body (CDA or your local compo-

nent), with members elected or appointed

in accordance with the organization’s by-

laws. Occasionally, these committees and

councils will request information to help

them in their mandated roles.

The CDA Judicial Council is the

only body that has the right to discipline

our members for violations of our Code of

Ethics. When a member does not comply

with the request of any of CDA’s councils

or committees, the matter may be referred

to the Judicial Council, where our Investi-

gative Panel reviews the case and, if war-

ranted, makes recommendations for disci-

pline, and establishes the conditions for

once again becoming a member in good

standing. The Judicial Council may seek

the penalties of expulsion, suspension, or

censure, or may offer the option of set-

tling the matter, often through probation-

ary membership.

Focus on your professionalism if

you receive that letter. In the Ethical Prin-

ciples section of the CDA Code of Ethics,

we read that “self-governance is a hall-

mark of a profession and dentistry will

thrive as long as its members are commit-

ted to actively support and promote the

profession and its service to the public.”

Through peer review and ethics reviews,

CDA members demonstrate the ability to

be self-governing; and through compli-

ance with duly constituted committees

and councils, we demonstrate our commit-

ment to the profession.

As a member of CDA, you have

committed to take these requests seri-

ously. Ignoring them may have serious

consequences. For further information,

contact your local Ethics Committee.

- Continued from Page 10

Melissa D. Shotell, DMD, MS re-

cently joined the SJDS and has estab-

lished her orthodontic practice in Sonora.

S h e

earned her

DMD at Nova

Southeastern

Unive r s i ty.

The rea f t e r,

she completed

a General

Practice Resi-

dency at Ohio

State Univer-

sity and a

Masters De-

gree in Orth-

odontics at

Loma Linda University.

She was kind enough to answer a

few questions for us, so that you can get

to know her:

Why did you choose to practice in San

Joaquin county?

After spending my childhood sum-

mers in a rural part of Oklahoma visiting

my grandparents, I grew to enjoy the

small town atmosphere and slower pace

of life. As a native of Southern Califor-

nia, my family vacationed in Northern

California and I fell in love with the beau-

tiful atmosphere of the Central California

foothills.

As a student, I lived throughout the

country to study at several universities.

At the end of my Orthodontics residency,

my husband and I were looking for a

place to truly call home. We visited the

Sonora area and had to stay. I look for-

ward to working with other dentists

within Central California to treat the

needs of the community!

Professional interests?

As an Orthodontic resident, my re-

search focused on the use of three dimen-

sional imaging and looking at the effect

of functional appliances on the TMJ com-

plex. My training at Loma Linda Univer-

sity had an emphasis on the utilization of

CBCT imaging for diagnosis and treat-

ment planning for the individual needs of

the patient. My professional interests fo-

cus on the utilization of technology and

three dimensional imaging to focus on di-

Meet Our New SJDS Memberagnosis of individual patients and design-

ing treatment that is most effective for the

patients’ individual treatment needs.

Favorite part of your career?

Being able to interact with patients

and parents to provide education that en-

hances their understanding of their indi-

vidual treatment needs.

I feel a strong commitment to com-

munity involvement and promoting educa-

tion. I recently spoke at Columbia Com-

munity College to give a seminar on “Ca-

reers in Dentistry,” and participated as a

scientist at the Tuolumne County Dinner

with a Scientist event. I became a dentist

after attending a field-trip in pre-school to

a dental office. My experience on my

field-trip in elementary school has in-

spired me to share my love of education

and healthcare with the community.

I also love to be able to offer and

provide unique Orthodontic services for

clinicians and patients throughout Central

California. I strive for excellence and

work extremely hard to be able to provide

specialty services for my community.

Outside interests?

Cooking, skiing, scuba diving, trav-

eling, and spending time with my two

Shih-Tsu puppies, Pumpkin and Flower!

Member Get a Member

Recruit a new member, get $200

A Hearty Thanksto Our

St. Raphael’sDental ClinicVolunteers

Our thanks to the following mem-

ber volunteers who gave of their

time and talents in December

2014 and January 2015 at St.

Raphael’s Dental Clinic:

You can’t change the world in four

hours, but volunteering 4 hours

per month or every other month

at St. Raphael’s Dental Clinic is a

start. Call Mary Ann at the clinic

to sign up (467-0703). For ques-

tions call Dr. Lester Low (474-

3333).

The effective date for employers to

begin providing mandatory sick leave to

all employees is July 1, 2015, or on the

first day of employment for new employ-

ees – whichever is later.

CDA Practice Support is still moni-

toring developments and interpretations of

the California Paid Sick Leave Law (AB

1522). The most notable information of

late is that employers must comply with

displaying the required poster for employ-

ees by Jan. 1, 2015. Dentists can find the

poster here:

http://www.dir.ca.gov/DLSE/Publications/

Paid_Sick_Days_Poster_Template_(11_2014).pdf.

In addition:

The law applies to all employers, re-

gardless of staff size.

All exempt and nonexempt part-time,

full-time and temporary employees

who have worked in California for 30

or more days are eligible.

Part-time and temporary employees

who work more than 30 days per year

are eligible.

The employer can limit an employee

from accruing or using the leave for

the first 90 days of employment.

The employer can limit employees to

using no more than three days a year

(24 hours).

An employer who chooses to provide

leave on an accrual basis, no less than

one hour for every 30 hours worked,

can limit the amount of paid sick leave

to 24 hours/three days each year and

can cap the total accrual banked by an

employee to 48 hours/six days. Keep

in mind that both regular and overtime

hours are counted toward the employ-

ees’ accrual rate.

If the employer already has a policy in

place that provides for paid sick leave

equal to or greater than the state re-

quirement, there is no requirement to

provide additional paid sick days.

CDA recommends adding additional

language to a practice’s employee

manual that indicates that the policy

adheres to the state requirements.

The employer must provide the em-

ployee with a written notice indicating

the amount of sick time available to

the employee at each pay period.

Records of an employee’s hours

should be kept for a minimum of three

years.

If an employee should leave the prac-

tice, sick leave does not need to be

paid out unless the employer’s policy

combines the sick leave and vacation

into a paid time off (PTO) policy.

Noncompliance can result in fines and

state penalties.

The labor commissioner has also re-

leased a new Wage and Employment No-

tice 2810.5 (required since 2012) contain-

ing the information related to the right to

accrue and use paid sick leave. The no-

tice can be found here:

http://www.dir.ca.gov/DLSE/Publications/

L C _ 2 8 1 0 . 5 _ N o t i c e _ ( R e v i s e d -

11_2014).pdf.

Dentists Must Post Sick Leave

Law Poster by Jan. 1, 2015

CDA reminds dentists in San Fran-

cisco that they must comply with both the

new state law regarding employee sick

leave as well as the local sick leave ordi-

nance, (at least in those areas where it is

more generous).

Accrual for San Francisco employ-

ees is one hour of paid sick leave for ev-

ery 30 hours worked. For employers that

have fewer than 10 persons working for

them, there is a cap of 40 hours of ac-

crued paid sick leave per employee. For

employees of other employers, there is a

cap of 72 hours of accrued sick leave.

More information is available at the Of-

fice of Labor Standards Enforcement

website, sfgsa.org. Other local ordinances

could be adopted with stricter require-

ments, in which case employers would

have to comply with the strictest require-

ment, whether that is state or local law.

As additional information becomes

available, CDA will continue to provide

updated information in the Update and on

cda.org.

For more information, contact CDA

Practice Support at 800.232.7645.

www.projectsandsolutions.com

There are many advertising options

for dental practices to use as a way to

keep current patients and bring new pa-

tients in. One way dentists can do this is

through a patient loyalty program where

patients earn “points” in exchange for gift

cards or other rewards for keeping ap-

pointments, brushing and flossing regu-

larly, etc. Dentists participating in such a

program must make sure they are staying

within the guidelines of the law and CDA

ethical standards, however.

The CDA Judicial Council reminds

dentists that problems arise in a patient

loyalty program when points are earned

and prizes are given for patient referrals.

Under the California Business and Pro-

fessions Code Section 650, dentists cannot

offer or accept anything of value as com-

pensation or inducement for the referral of

a patient.

“When you offer loyalty programs

to your patients, or work with a company

that helps you with your marketing and

runs a program like this for you, you

should know that it is OK to offer prizes

for things such as good brushing habits or

making all of their appointments on time.

But when you include a third party into

the equation that is benefitting financially

for referrals, it goes against Section 650

and you could be in violation,” said Alma

Clark, DDS, chair of the CDA Judicial

Council.

In a 2013 legal opinion, the Legal

Division of the California State Depart-

ment of Consumer Affairs (DCA) deter-

mined that “fee splitting” was not in the

best interest of the patient (mainly as it re-

lates to “social couponing services”). Fee

splitting occurs when a third party (indi-

vidual or company) is compensated for

helping bring in a new patient.

“While there are many reasons the

DCA is against this practice, the main rea-

son is that you want a patient to go to a

dentist because they provide the best care,

not because it was part of an incentive,”

Clark said.

A violation is punishable upon a

first conviction by imprisonment in a

county jail for not more than one year, or

Use Caution with Patient Referral, Loyalty Programs

Ethics

by imprisonment pursuant to subdivision

(h) of Section 1170 of the Penal Code, or

by a fine not exceeding $50,000, or by

both imprisonment and fine. A second or

subsequent conviction is punishable by

imprisonment pursuant to subdivision (h)

of Section 1170 of the Penal Code, or by

imprisonment and a fine of $50,000.

Social couponing companies typi-

cally provide a dentist the option to send

out daily deals to bring new patients in the

door. Dentists must make sure they are

abiding by Business and Professions Code

Section 650 here as well and not offering

anything of value as compensation or in-

ducement for a specific referral of pa-

tients.

“In other words, if you are using a

social couponing website as part of your

marketing, you cannot give the company a

percentage of the profit gained from that

particular daily deal because that would

be considered fee splitting,” Clark said.

Dentists can still use social

couponing companies if they are paying a

flat rate (either monthly or yearly) and are

not paying per individual referral. The

prohibition against fee splitting is not ap-

plicable to marketing via group advertis-

ing or referral services that do not base

their fees on the number of referrals or

amount of professional fees paid by the

patient to the dentist.

With the loyalty programs and so-

cial couponing issues discussed above,

dentists should be aware that, similar to

the prohibition in Section 650, CDA Code

of Ethics Section 11 and the related Advi-

sory Opinion 11.A.1. also prohibit split-

fees in advertising and marketing services.

‘Daily deal’ websiterecommendations

Dentists interested in advertising

free cleanings, whitenings, etc. to patients

should be mindful of California Code of

Regulations Section 1051, which covers

advertising discounts and truth in advertis-

ing details. CDA recommends that dentists

using “daily deal” websites make sure the

ads are not false or misleading in any ma-

terial respect (see Section 6 of the CDA

Code of Ethics). The ad should contain all

of the information patients would need to

properly evaluate the deal and make an in-

formed choice about the provider and the

service.

From a legal standpoint, members

should watch for several red flags, includ-

ing:

Ads must not be intended or likely to

create false or unjustified expecta-

tions of favorable results.

Ads may not make a scientific claim

that cannot be substantiated by reli-

able, peer-reviewed, published scien-

tific studies.

Dentists may not offer gifts, discounts

or anything of value as compensation

or inducement for patient referrals

(but it is acceptable to provide some-

thing to the actual new patient).

Dentists may not advertise that they

will perform any procedure “pain-

lessly.”

Claims of professional superiority are

not lawful.

Price advertisements must be accurate

and precise, without the use of

phrases such as “as low as,” “and up,”

or similar words or phrases.

Ads relating to fees must fully dis-

close all services customarily in-

cluded as part of the advertised ser-

vice, as well as any additional ser-

vices not part of the procedure but for

which the patient will be charged, to-

gether with the fees for such services.

An advertisement of a discount must:

1. List the dollar amount of the

non-discounted fee for the ser-

vice;

Continued - Page 16

2. List either the dollar amount of

the discount fee or the percent-

age of the discount for the spe-

cific service;

3. Inform the public of the length

of time, if any, the discount will

be honored (i.e. expiration

date);

4. List verifiable fees pursuant to

Section 651 of the Code (See

the two bullets above.); and

5. Identify specific groups who

qualify for the discount or any

other terms and conditions or

restrictions for qualifying for

the discount.

For more information, review the

CDA Code of Ethics http://www.cda.org/

about-cda/cda-code-of-ethics.

- Continued from Page 15

Use Caution with Patient

Referral, Loyalty Programs

33rd Annual SJDS Leadership Conference

Back Row (L-R): Drs. Michael Moreno, Jennifer Low, Lyndon Low, Brad Louie, David Neal, Lita

Rodriquez and Jim Grabow; Front Row (L-R) John Reed, John Hall, Tom Bianchi, Rommel Bal,

Maria Stefan and Bruce Toy.

Risk Management

If a little rest and recreation is on

your schedule, The Dentists Insurance

Company wishes you bon voyage and of-

fers a reminder to make “reasonably care-

ful” arrangements for emergency patient

care while you are out of the office.

TDIC recommends lining up emer-

gency coverage with one or more of your

colleagues, notifying patients at least one

month before vacation

and providing information

about the dentists who

will provide care in your

absence. Inform patients

of the colleagues’ emer-

gency contact information

on your website and via a

sign in your waiting room.

If you are closing for va-

cation, leave a message on

your telephone with emer-

gency contact informa-

tion. If you use an answer-

ing service, leave specific

directions for the operator

to collect information

from the patient, including full name, date

last seen, complaint and telephone num-

ber. Meet with colleagues in advance to

discuss verification of patients of record

and provide a referral list of specialists

you routinely use to ensure continuity of

care.

“There are circumstances, such as

vacation, where dentists should have a

policy or protocol regarding emergency or

similar after-hours care,” said John Sillis,

a Northern California attorney specializ-

ing in professional liability. The key is

whether the dentist is being “reasonably

careful” to make sure patients are taken

care of while he or she is out of the office.

Sillis said the phrase “reasonably

careful” is in the definition of standard of

care. A dentist can be negligent if he or

she fails to use the level of skill, knowl-

edge and care in diagnosis and treatment

that other reasonably careful dentists

would use in the same or similar circum-

stances.

Make ‘Reasonably Careful’ Plans, Then VacationBy TDIC Risk Management Staff

“‘Reasonably careful’ is frequently

defined as whether the dentist’s action or

omission caused the patient injury,” Sillis

added. “Develop a protocol to protect

yourself and your patients while you are

on vacation.”

In addition to arranging for emer-

gency patient care, schedule someone to

check your mail for urgent or time-sensi-

tive letters from patients, the Dental Board

or an attorney.

Another option for vacation cover-

age is to hire a dentist to work in your

practice while you are gone. If considering

this option, TDIC recommends verifying

the active license and insurance of the

covering dentist. Make sure this dentist

follows your protocol for charting entries

and has the skill level you expect of some-

one who is going to treat your patients.

Carve out the time to discuss practice phi-

losophies such as the dentist’s availability

to respond directly to patient concerns in

the event of an emergency procedure, such

as an extraction or root canal therapy.

Again, provide a referral list of specialists.

Meet with staff to plan for a smooth tran-

sition for the covering dentist and leave

your contact information.

Vacation checklist:

If closing your practice for vacation:

Arrange for emergency coverage

with one or more colleagues.

Notify patients one month in advance

of vacation and provide emergency

contact information.

Leave emergency

contact information on

your website and

answering machine.

Develop a protocol

for verification of patients

of record.

Provide a referral list

of specialists.

Schedule a daily mail

check for urgent or time-

sensitive matters.

If your office is open and another

dentist is covering for you:

Verify an active license and insurance

of the covering dentist.

Ensure the covering dentist’s docu-

mentation and skill level meets your

expectations.

Discuss practice philosophies regard-

ing emergency care and availability.

Meet with staff to plan for a smooth

transition.

Leave your contact information.

Questions? Call TDIC’s Risk Manage-

ment Advice Line at 800.733.0634.

The Dental PPA ... A Better WayThe Mission of the Dental PPA is to provide quality dental care for a reasonable reimbursement, to provide

our patients with the freedom to choose their own practitioner, and to accomplish these objectives at a cost

savings to the employer whenever possible.

The Dental PPA was formed by a

group of private practice dentists who

joined together in 1995 in order to pro-

vide the best care for the lowest pos-

sible cost for individual patients, as

well as employees and their employers.

Our organization has created a network

of over 1500 dentists up and down the

central valley representing every spe-

cialty.

Our participating dentists accept

the PPA benefits that provide coverage

based on each individual dentist’s fees

that are submitted to The PPA and up-

dated annually. The Dental PPA be-

lieves that our dentists’ fees represent a

fair and reasonable compensation for

our services while maintaining the pa-

tients freedom to choose their dentist.

The Dental PPA’s vision of our

profession’s future is the continued

provision of high quality, full service

care at a fair and reasonable reimburse-

ment. But providing high quality care,

while maintaining competitive pricing

is a challenge—a big challenge—in

today’s environment.

It has been our intention to imple-

ment a program that will allow us to es-

tablish a market position so that when

competing dental insurance carriers in

California drop their reimbursement

rates, The Dental PPA will be in place

with market position and a very viable,

excellent alternative. Unfortunately, the

time we have dreaded regarding de-

creased reimbursement rates is starting

to take place as of 1/1/2015. The state of

California PERS (Public Employee Re-

tirement System) has contracted with the

largest dental carrier in California for a

PPO plan that reimburses dentists at

60% of UCR. The insurance max for

participating dentists is $2000/year and

only $1000/year for non-participating

dentists. Considering that most general

dentists have overhead expenses of

70%, a decrease in reimbursement of

20% may not even cover their overhead

expenses. Dentists are being forced to

make a very important fork in the road

decision: either to maintain a tradi-

tional, quality, personal care type of

practice, or to develop into a quantity,

“production line” type of practice.

The Dental PPA, by offering a self-

insured plan to employers at a 10-20%

cost savings, is providing the solution

that dentists, employers, and employ-

ees are looking for in today’s difficult

economic market. We at The Dental

PPA are seeking quality brokers who

are willing to give their employer cli-

ents this choice of a self-funded plan

administered by a local third party ad-

ministrator with a 10-20% cost savings.

If you know of a broker or employer

who might be interested, please call

Kelli at 1-866-241-6646, or email her

at: [email protected]. Your

continued help and support are ur-

gently needed.

Life After Dentistry?Call Jay - cell 209-406-6314, ore-mail [email protected] is LIFE AFTER DENTISTRY!

Jay M. Hislop, DDS, Esq.

Attorney at Law

Legislative Update

Practice Management

Currently, the cost of acquiring one

new patient is estimated to be $282, while

the estimated cost of retaining a patient is

$57. Patient retention is one of the biggest

concerns in owning and marketing a prac-

tice, and given these estimates, it’s easy to

understand why.

A practice acquiring 30 new patients

per year is spending an average of $8,460

to do so, while a practice focused on

building patient loyalty is only spending

about $1,710 to retain their current cli-

ents. And, as you may have already

learned, one of the biggest busts in mar-

keting your practice is running a “new pa-

tient special,” as it never guarantees to

keep a new patient coming back.

The following ideas are intended to

help you retain patients beyond their first

visit:

Make a Great First Impression – De-

spite the common belief that a patient’s

first impression is formed in your practice,

their in-office visit may not actually be

their first point of contact. When research-

ing providers, many patients look at your

website, social media profiles, mailers,

and networking groups to formulate their

first impression, so be sure you are repre-

senting yourself well across all channels,

not just in your office.

Host a Patient Appreciation Event –Select one day each month or every other

month as your Patient Appreciation Day.

On this day, verbally thank each patient

you see, and let them know how much you

value their patronage. You could even

present them with a small gift, such as a

$5 or $10 gift card, depending on your

budget. Each patient is not only likely to

feel valued, but is also likely to recom-

mend your services to their friends and

family. Also, you can randomize the day

each month to avoid patients catching on

and scheduling their appointments accord-

ing to your appreciation schedule.

Use Social Media to Interact withYour Patients – It’s no secret that

people like doing business with friendly

9 Ideas for Increasing Patient Loyalty

and familiar faces. Interact with your pa-

tients on social media by congratulating

their achievements and encouraging their

endeavors. You can use your practice

Facebook page or Twitter account to an-

nounce your patients’ achievements and

share their successes with all of your fol-

lowers. Just be sure you get their permis-

sion before featuring them on your page.

Remember, you don’t always have to pro-

mote your services to build patient loy-

alty; you just have to show you genuinely

care about your patients.

Make Your Patients Feel ImportantYear-Round – In order to make your pa-

tients feel like they’re part of your family,

you have to treat them like family, even

when they aren’t in your physical pres-

ence. Send patients birthday cards and an-

niversary cards celebrating their patronage

to your practice. Include a handwritten

note with a meaningful message.

Make New Patients Feel Welcomed– Following a patient’s first visit with a

thank you card is a great form of customer

service. Making new patients feel impor-

tant and appreciated even after just one

visit will make them more inclined to re-

turn. If your patients are tech-savvy, con-

sider sending a thank you email, in which

you can include a link to your social net-

works and details about key differentiators

in your services.

NEVER Be Late for a New PatientAppointment – If you have a patient

who is visiting for the first or even second

time, be sure you are punctual. Nothing is

more likely to turn a new patient away

than having a delayed appointment. When

you know you have a new patient sched-

uled, do your best to stay ahead of the

clock and avoid excessive waiting room

times.

Offer a Complimentary Service toYour Loyal Patients – If you know a

patient has a big upcoming event, such as

a wedding or prom, and they’ve been your

patient for years, offer them a complimen-

tary service such as professional teeth

whitening. This unexpected gesture will

thrill patients and make them likely to re-

fer your services to others.

Communicate Clearly – In a recent

study, 93% of patients said a clear expla-

nation of required services was a major

factor in whether they would return to the

dentist or not. When you have a first-time

patient, they often don’t understand which

recommended services are necessary and

which are just suggestions. Additionally,

33% of patients think their dentist tries to

sell them unnecessary services, so be sure

you aren’t miscommunicating with your

patients, as it’s likely to scare them away.

Establish and Advertise a PatientRewards Program – People love good

deals, especially when the deals are

backed by excellent service. Try imple-

menting a patient rewards program where

patients who remain loyal over a set

amount of years can earn free services,

such as teeth whitening or deep cleanings.

Giving patients an incentive will encour-

age them to stay loyal to your practice.

While the cost benefit of investing in

recalling current patients is evident, there

are other benefits as well, namely an in-

crease in new patient referrals. Studies in-

dicate happy, loyal patients are more

likely to recommend your services among

their individual networks, providing you

with valuable word of mouth marketing

that generates new patients without any

added expense.

In addition to these ideas, you can

find more helpful practice marketing tips

on our blog, within the Practice Marketing

category.

This article was contributed by Lance

McCollough, founder and CEO of

ProSites, a website design and Internet

marketing company, specializing in den-

tal-practice marketing. ProSites is a CDA

Endorsed Program. For more informa-

tion, please call 888.327.5212 or visit

cda.org/endorsendprograms.

Brett L. Tholborn, CPA

Before adjour-

ning for 2014,

Congress passed

the Tax Increase

Preven-tion Act of

2014, which is

basically a retro-

active extension of

temporary tax

rules. What does

this mean for you?

If you have been

wondering what federal breaks are, once

again, available for your 2014 individual

and business income tax returns, here is

an overview of some of the most utilized

provisions. The Bill was signed by the

President less than two weeks before

2014 ended, and has already expired. It is

only applicable to the 2014 tax year, with

its provisions terminating on December

31, 2014. This legislation is important

and affects income tax returns which are

being prepared right now. These

deductions and credits will not be

renewed for tax year 2015 unless the new

Congress takes the matter up again.

Following are specific items included

in the Act which affect a significant

number of taxpayers:

Bonus depreciation. You can

expense 50% of the cost of new

property you acquired and placed in

service during 2014.

Section 179. The immediate

expensing limit for new and used

property purchased and placed in

service during 2014 is $500,000. Your

total Section 179 deduction is limited

when you purchase $2 million or more

of assets during the year.

Qualified improvements. You can

use a 15-year straight-line depreciation

method for improvements to leased

buildings, restaurant property, and the

interior of retail establishments.

Commercial building energy-

efficient improvements. If you made

improvements to your commercial

building that helped reduce utility

costs, you can claim a deduction of up

to $1.80 per square foot.

Residential energy-efficient im-

provements. Did you buy qualifying

storm windows or doors for your home

during 2014? The credit of 10% of the

cost of improvements is back, up to a

lifetime limit of $500.

Charitable contributions from IRAs.

When you are age 70-1/2 or older, you

could make a 2014 tax-free

distribution to a charity from your

IRA. Of course, by the time you read

this, it will be too late to take a 2014

distribution.

State and local sales tax deduction.

If you itemize, you can claim a 2014

deduction for these taxes instead of

deducting state and local income taxes.

Qualified tuition expenses. The law

reinstated the above-the-line deduction

of up to $4,000 for expenses you paid

in 2014 for higher education for

yourself and/or other family members.

Teacher classroom expenses. If you

are a teacher and you paid out-of-

pocket for books and certain other

materials for use in your classroom,

you can claim an above-the-line

deduction of up to $250 for 2014.

We see more and more households

with nannies and caregivers these days. If

you have a household employee, the

nanny tax rules apply to you. Essentially,

a household employee is somebody that

does work in or around your home and is

considered an employee. An independent

contractor (such as yard maintenance,

housecleaners, and the like who have their

own equipment and supplies, control how

the work is done, and perform similar

services for other homeowners) is not your

employee and does not fall under the

nanny tax rules. However, if you have a

homeworker such as a health aide,

private nurse, or caretaker and you

control their wages, hours, and working

conditions, they could be considered an

employee and could subject you to the

nanny tax. The employee/contractor

relationship is sometimes difficult to

determine, so do not hesitate to seek

professional assistance to determine the

status of your homeworker.

If you determine that you do have a

household employee, and you paid them

$1,900 or more in wages in 2014, both

you and the employee are required to pay

Social Security and Medicare taxes (plus

any applicable state employee taxes).

Also, make sure that you are in

compliance with state minimum wage

laws, worker’s compensation rules, and

that your employee can legally work in

the United States.

If tax withholding is required, you

can either do it yourself or engage the

services of a professional payroll

processor. You can use a simplified

method to pay the taxes (IRS Schedule

H) and file with your individual income

tax return, but you will still have to deal

with state taxes and Forms W-2 in an

appropriate manner.

Finally, do not overlook that wages

paid to your household employee can

sometimes be used as the basis for a tax

credit on your individual income tax

return for the child and dependent care

credit.

Brett L. Tholborn, CPA

Brett L. Tholborn is a managing partner at

Tholborn, Ostrowski & Crane, LLP. These

Accountants and Consultants are located at

4525 Quail Lakes Drive, Suite B, Stockton,

CA 95207. If you have any questions or com-

ments, please call Brett at 209-474-3375 or e-

mail him at [email protected].

Extenders Bill Plus Household Employees

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SJDS Activity Calendar

Our SJDS Mission ...

The mission of the San Joaquin

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CEREC AC Blue cam and MCSL mill-

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Space to Share: Hyung G. Kim, DDS,

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Space to share available: Alfonso

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Associate wanted: Call Noe Mora

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Exciting opportunity for a dentist tojoin our amazing team in our private

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leading to full time. Send resume, in-

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