Bridge July 2015_Bridge JuneQK4

Volume 69 • Number 2 • Spring 2015 • San Francisco Dental Society
Organized 1869
2015
SAN FRANCISCO DENTAL SOCIETY
OFFICERS AND
BOARD OF DIRECTORS
2015 Executive Committee
President
Dennis Song, DDS, MD
President-Elect
Joseph Gabany, DMD, MSD
Immediate Past-President
Paul Weller, DDS, MS
Secretary
Vlad V. Shuster, DMD
Treasurer
Carlos Nogueiro, DDS
CDA Trustees
Irene Hilton, DDS, MPH
Gail Duffala, DDS
Executive Director
Deborah A. Elam, MS CAE
SFDS MOVERS AND SHAKERS
San Francisco Endodontist, Educator Honored
by American Association of Endodontists
Stephen Cohen, D.D.S., M.A., received the
Ralph F. Sommer Award, at the AAE’s recent
annual meeting in Seattle, Wash. The award is
given to the principal author of a publication of
specific significance to the science and art of
endodontology. Dr. Cohen is the senior co-editor
and author of Pathways of the Pulp, the definitive
textbook for endodontics. The 10th edition of the
textbook, published in 2010, was renamed Cohen’s Pathways of the Pulp. Dr. Cohen is
also a co-editor of A Clinical Guide to Clinical Traumatology and has authored or coauthored more than 40 journal articles and book chapters.
Dr. Cohen is pictured above with AAE Honors and Awards Committee Chairman
Dr. Shepard Goldstein, left, and Immediate Past President Dr. Robert Roda, right.
THE BRIDGE Interim Editor
Craig S. Yarborough, DDS
Directors
Carolyn L. Brown, DDS
Earl Capuli, DDS
Wayne Del Carlo, DDS
David Ehsan, DDS, MD
Courtney Fitzpatrick, DDS
Thomas A. Jacobs, DDS
William Lee, DDS
Curtis D. Raff, DDS
Sima Salimi, DDS
Clint K. Taura, DDS
Russell H. Taylor, DMD
SFDS Team
SFDS Member, Dr. Kat Vo, Runs the Boston
Marathon
Dr. Kat Vo, running in a water soaked poncho,
completed this year’s Boston Marathon on April 20,
2015. Dr. Vo reported that it was a challenging day
for a 26.2 run, but the cold, wind and rain made crossing the finish line even more worthwhile. Though
hoping for a 4 hour finish, Kat was thrilled to carry
her water-filled shoes across that famous FINISH line
at a personal record time of 4:06:37. Way to go Dr. Vo!
Alfonso Estera, Jr. – Membership Administrator
Lisa McNichol – Administrative &
Advertising Assistant
2015 Committee Chairs & Vice Chairs
Community Dental Health Jeff Jang, DDS & Allen Wong, DDS,
Ethics - Mark Wiesen, DDS
Executive - Dennis Song, DDS, MD
Finance - Carlos Nogueiro, DDS
Governance - Vlad V. Shuster, DMD
Legislative - Claudia Masouredis, DDS MPH
Membership/New Dentist Terry Im, DDS, MS & Earl Capuli, DDS
Peer Review - Michael Ramsay, DDS
Poster Contest - Dennis D. Shinbori, DDS
& Stafford Duhn, DDS
Professional Development
Matthew Young, DDS
Well-Being - Bruce Hiura, DDS
(Confidential assistance to professionals,
spouse and staff for drug and alcohol abuse,
call (415) 776-5855)
San Francisco Dental Society • Page 2
Dr. Harvey Brody Appointed to UC Board of
Regents
Congratulations to SFDS Member Dr. Harvey Brody on
his recent appointment to the Board of Regents of the
University of California. This is the first time a dentist
has served on the Board of Regents, which oversee the
operation of the 10 campus University of California
system. Dr. Brody is a San Francisco native and former
executive member of the UCSF Alumni Association
Board of Directors. His many awards include the UCSF
School of Dentistry and Mount Zion Outstanding
Teacher awards and the UCSF School of Dentistry
Alumni Association Medal of Honor. He has served as a health policy advisor to U.S.
Senator Dianne Feinstein, U.S. Assistant Secretary of Health Philip Lee, and the UC
Office of the President.
PRESIDENT’S MESSAGE
Dennis Song, DDS, MD
Progress Report
nbelievable! We are just about
half way through the year and we
are busy!
U
All our volunteer leaders and SFDS team
are working hard at all levels and we
have never been busier. After our retreat,
our Board of Directors confirmed our
strategic plan and moved to provide
even more events and services for your
benefit. Not only is this great for our
Society, but also for the oral health care
of our San Franciscans.
We are developing further relationships
as we look to the future of our Society in
the midst of our changing environment.
Our colleagues in the San Francisco
Medical Society (SFMS) have encountered many of the same issues that we
are facing today. Executive Director
Deborah Elam, Dr. Claudia
Masouredis and I had the pleasure of
meeting with Dr. Roger Eng, SFMS
President, Dr. Richard Podolin, SFMS
President-Elect, SFMS Executive
Director Mary Lou Licwinko, and
SFMS Associate Executive Director
Jessica Kuo recently to rekindle our previous relationship lost many years ago.
Much of the legislative activities including soda tax, sugar, tobacco, and vaccines are parallel to our goals for the oral
healthcare of San Franciscans. This also
opens opportunities to educate our colleagues in medicine on the importance
of oral health care and its impact on
general health.
In tandem, we are refocusing and
redefining our Legislative Committee
chaired by Dr. Claudia Masouredis to
create another direction in our Society
and align ourselves with the future
needs of oral health care and your needs
as a dentist practicing in this city.
Although many of our dentists do not
live in the city, the legislative actions
have a direct impact on your practice
and on your patients. Therefore, knowl-
edge of our elected leaders and changes
in regulations are important to our practices at a local level. Presently, the
Legislative Committee and our Political
Action Committee work together to
assist in these efforts. We are looking
toward optimizing these endeavors to
provide you with an even better reach for
your voice.
Our Membership and New Dentist
Committees chaired by Drs. Earl Capuli
and Terry Im have been working hard
with their volunteers to bring you the
best in member benefits and ways to
connect with you. We have several new
members on the committees. Drs. Russ
Taylor, Clint Taura, Monica Chmiel,
Linda Kuo, Erin Shah, and Sanjini
Sathri-Rajaputrage, a postgrad consultant to the committee, who are devoting
their valuable time to expand our reach
to you, including through social media
outlets, to disseminate information and
plans for future events.
Our Community Dental Health
Committee’s Poster Contest Awards
Ceremony was a success with over 150
parents and students attending. I had the
pleasure of working with Lisa McNichol
and Executive Director Deborah Elam,
SFUSD Nurse Cathy Fuller, and Drs.
Dennis Shinbori, Stafford Duhn,
Sandy Shih, and Jeff Jang in judging
hundreds of entries to our annual contest. We were also fortunate to have
Assemblyman David Chiu join us for
this great community event, the Annual
Poster Contest Awards Ceremony. The
smiles on the faces of the children of our
city, as well as their parents, were priceless
and I commend the Community Dental
Health Committee, chaired by Dr. Jeff
Jang, for assisting Drs. Shinbori and
Duhn in continuing this wonderful
event now in its 40th year!
Our Finance Committee under the direction of SFDS Treasurer Dr. Carlos
Noguiero has been working diligently to
keep our expenses under control.
However, membership dues are only part
of the equation and for the last three
years, we have not had cost of living
increases in our dues. We need more
sponsors for our meetings and events so
if you have any patients or acquaintances
that know of companies that might be
happy to sponsor a table at one of our
events, please send this information to
info@sfds.org or call (415) 928-7337. It
does NOT have to be dental related and
they will have a captive audience of dentists, many of whom could be great
future customers for them.
Additionally, we have our Table of Five
Lunches, inviting you to join us for
lunch in your neighborhood for a casual
“get to know” you and your practice. We
know how busy you are and we want to
hear what concerns you have as a practitioner or even as a resident or business
owner in San Francisco. Random dentists will be invited. If you receive an invitation that presents a schedule conflict,
contact Alfonso Estera, Jr. (membership@sfds.org); we may be able to schedule an alternate date or you may be able
to join a lunch in a different neighborhood. And remember, lunch is on us!
Otherwise, I hope to see you at our
next event! Keep connected with us via
Facebook and Twitter and put our
events on your office calendar so you
remember to sign up and come. We also
need more volunteers for our committees – 78 of your colleagues are serving
on our committees and we still need
more. Please contact the SFDS office
(415) 928-7337, info@sfds.org, or visit
the website at www.sfds.org Members
Only section, Leadership Tab, to learn
how you can get involved and make
a difference! ❖
San Francisco Dental Society • Page 3
EDITORIAL
Craig Yarborough, DDS, Editor
Options for the Future
n May, I gave a presentation to the
Sacramento District Dental Society
on the future of dentistry. It was
essentially laying out the 27-page
Diringer Report, Critical Trends Affecting
the Future of Dentistry: Assessing the
Shifting Landscape, an environmental
scan of emerging trends in dentistry
that was prepared for the American
Dental Association in 2013. Diringer
and Associates noted 12 trends in four
areas – People, Providers, Payments
and Policies – that ultimately affects
the fifth area, Practice Implications.
The report is a must read and can easily be found online by Googling
“Diringer, ADA, 2013”.
I
In conclusion to the presentation, I
proffered 3 options for the participants
in their future – remain Traditional,
Corporate and Adapt. The Corporate
option was simplest and the least complicated. Apply for a job, sell them your
practice or buy in. For the most part,
Corporate will make most of the business decisions for you.
Many of you, especially in the last
decade of your careers, will opt for a
Traditional approach. Practice management guru Roger Levin recommends you will have to build value
through “personal attention, strong
customer service, extensive experience,
community involvement and uniqueness.” His six bullets of advice revolve
around 1) Activate inactive patients, 2)
Innovative customer service, 3) Solicit
new patient referrals, 4) Improve collection systems, 5) Maximize insurance
benefits and 6) Sharpen case presentation skills. You know how to do most
of these already but to stay in the traditional, cottage industry single practi-
tioner office, you will need to “sharpen
your saw” in these areas. Under innovative customer service, you are going
to have to figure out what market segment you want to reach and find the
innovative approaches to continue to
attract this group.
The third option – Adapt - will take a
lot of work, diligence and information.
The over-arching practice model will
be a patient-centered practice. Think open 7 days a week, two shifts per day,
open at 6:00 am, close at 9:00 pm. This
results in 14 shifts, nearly perfect for
three individuals who want to work
five days a week (one four and a half).
You will actually increase your life balance with this approach by not having
to see all emergencies the days you are
out of the office. Patients will have
access to you five days a week and your
office at almost all hours of need.
Large fixed costs like rent/mortgage,
technology, tenant improvements,
property tax, maintenance, etc. will be
split three ways. Variable costs like
supplies can be exposed to economies
of scale, the inverse relationship
between quantity and per-unit cost.
Control of both fixed and variable
costs are the typical advantages to
Corporate dentistry. You may not be
able to beat them at this game, but
you can join in the advantages.
The first major hurdle will be finding
a few partners with the same practice
philosophy. I would recommend starting your own corporation, formally
adopting the same vision, mission, values and goals. In a demographically
favorable environment (read not the
Bay Area), you may be able to start the
practice from scratch. In the Bay Area,
you may have to consolidate three
practices into one office. Additionally,
you may want to consider locating
near specialty offices to be able to refer
patients in the same building or across
the street. Again, think patient-centered. Can your patients receive all
facets of dental care either in the same
building or neighborhood? Another
option that is being explored in many
practices is “itinerant specialists”,
bringing the specialist into the GP
office, taking advantage of economies
of scope, average cost of production
decreases as a result of increasing the
number of different products. This is
not as easy as it sounds and patient
follow-up has to be considered an
obstacle that must be overcome for the
patients’ welfare.
The patient bases are changing, also.
Patients over age of 65 are going to be
plenty, have restorative, periodontal
and cosmetic needs, no insurance and
will pay out-of-pocket. Providing payment options will be a must - think
Care Credit, Comprehensive Finance,
etc. Are your cosmetic care skills top
notch? Children under 19 will be the
most covered by public and private
insurance. A lot of coverage will be
below your fees, at least at your current
volume. Can you use RDAEF’s to help
increase your number of patients,
again taking advantage of economies
of scale? Are your pediatric skills up to
speed; is your office children friendly?
California is one of the leading destination states for immigrants from
Mexico, Latin America and Asia.
Patients prefer offices and dentists
that speak their languages. Do you or
continued to page 7
San Francisco Dental Society • Page 4
EXECUTIVE PERSPECTIVE
Deborah Elam, MS, CAE, Executive Director
What’s in it for you?
hen talking to new dentists,
SFDS leaders and staff are often
asked to articulate the “What’s
in it for me?”—the ROI (return on investment) provided by organized dentistry
(SFDS, CDA, ADA). The SFDS and CDA,
together, provide a tremendous return to
all dentists in California, members and
non-members alike. For example…
W
As dentists, you are well aware of the
mounting state and local legislation
shaping how dentistry is and will be
practiced. CDA’s Cal-D-Pac, SFDS PAC,
and the SFDS Legislative Committee
work to educate dentists about state legislation and provide a grass roots political base for political advocacy at the
state level. The Society’s Legislative
Committee works on your behalf to educate local government officials regarding
dental and business issues affecting San
Francisco’s dentists and plans on hosting future breakfast meetings with SF
Supervisors. Stay tuned. Additionally,
the SFDS and CDA are urging the state
to increase Denti-Cal rates for the top 10
children’s services to the national average and to reverse the 10% cut for all
other children and adult dental services.
CDA is also supporting SB 2432 and
AB366 this year, which would make significant progress towards fully funding
the Medi-Cal program. And, of course,
there was the success of defeating last
year’s MICRA reform ballot measure
Proposition 46! A united voice can
have a tremendous impact.
Through the CDA/SFDS Peer Review
and Ethics Systems, the Society provides
a dispute resolution process for patients
and dentists. Both systems continue to
provide the opportunity for dentists and
patients to air and resolve grievances in a
non-adversarial way that has resulted in
tremendous savings of time and money
to dentists and patients alike.
Throughout the year, the SFDS provides
education and training programs to
assist dentists and their dental teams in
the practice of dentistry, programs that
include Infection Control Compliance,
CPR Training, and California Dental
Practice Act, to name a few. In addition,
CDA’s spring and fall sessions provide a
full range of programs, including the
Smart Dentist Series at CDA Presents SF
in August 2015.
“...the Society
provides the
San Francisco
community a dental
referral service 24/7.”
A deeply valued resource for members
is our newsletter The Bridge, published
4 times a year and our Bridging the Gap
e-updates. The Bridge provides timely
topics written by SFDS member dentists including your interim Editor,
Dr. Craig Yarborough and SFDS
President, Dr. Dennis Song as well as
yours truly. Each issue holds a plethora
of information about upcoming programs, community service projects, risk
management and practice management
tips, and regulatory initiatives that may
affect some aspect of your practice. As
important, many member dentists have
come to rely on the SFDS website’s
classified section, at www.sfds.org, for
staffing needs. Our website is undergoing several enhancements, so keep
watching…we’re moving forward.
As important, the Society provides the
San Francisco community a dental referral service 24/7. SFDS team members
handle over 300 calls a month in addition to the calls managed through our
referral line. Callers receive the names of
member dentists who meet the criteria
of the caller. This is a widely used service
that is provided free to the San
Francisco community. If you want
patient referrals, be sure to let us know
by calling 415/928-7337.
The future of organized dentistry rests
with our younger dentists who have told
us that they want practice management
programs and the opportunity to interact socially with other young dentists.
The new dentist committee, under the
guidance of Drs. Terry Im and Earl
Capuli, is designed to do just that. And
the SFDS Social Hour, organized by the
membership committee, provides opportunities for dentists, new and established, to meet and socialize with their
colleagues in a relaxed, fun, setting.
The SFDS continues to work with the
Department of Public Health, providing
dental screenings to over 3000 of San
Francisco’s Public School
Kindergarteners. Together, we are working to identify need and to increase access
for dental services for San Francisco’s
children. As well, the SFDS participates in
Project Homeless Connect, is part of the
continued to page 7
San Francisco Dental Society • Page 5
RM MATTERS
By TDIC Risk Management Staff
Precise Documentation Is an Advantage in Veneer Cases
isk management articles and seminars often look at problematic
cases where things go wrong during dental treatment, but let’s turn the
tables and see what happens when a case
goes right.
R
The following case involves the placement of dental veneers, a procedure that
generates numerous questions, according to risk management analysts at The
Dentists Insurance Company. TDIC
reports regular calls to its Advice Line
about veneer-related situations, and
numbers show that veneer cases are sent
to claims more frequently than cases
involving other dental issues. In a recent
two-month timeframe, Advice Line calls
revealed 10 of 12 veneer-related calls
ended up in the claims department.
“Veneer cases can be difficult,” said a
senior risk management analyst with
TDIC. “There is not one easy answer.”
Risk management analysts are clear,
however, that dialing the Advice Line
does not mean your call is automatically
sent to claims. Based on the facts of the
call, the analyst may determine the case
is beyond risk management and refer the
caller to the claims department.
Some veneer cases have a more positive
outlook than others. Here’s an example:
Last October, a Northern California dentist placed five anterior veneers on a 29year old patient. The dentist discussed
the procedure with the patient, and she
signed an informed consent form. The
dentist also charted the discussion and
procedure and took photos, including a
final photo of the smiling patient with
the new veneers in place. The patient
even gave a “thumbs up” in the photo.
The dentist was surprised when the
patient called a month later and
San Francisco Dental Society • Page 6
demanded a refund. She said another
dentist had to “fix” the veneers. The dentist called TDIC’s Advice Line to discuss
options about the best way to proceed.
The risk management analyst asked the
dentist about documentation surrounding the case. He had appropriate chart
documentation, photos and the informed
consent form. He said he took time to
explain the procedure, including tooth
preparation, and noted the conversation
in the dental record. This documentation
gave the dentist an advantage because he
felt the veneers were clinically sound, and
he had the evidence to back it up.
The TDIC analyst recommended the dentist tell the patient he was willing to
investigate further. The dentist should
then ask the patient for permission to
speak with the new dentist who fixed the
veneers, so he could learn what was
allegedly wrong. In this case, the burden
is on the patient to prove there is a complication with the veneers, and the dentist is poised for a favorable outcome
thanks to good clinical work and recordkeeping. Unfortunately, not all cases go
this way.
“Some would say we preach documentation,” said a TDIC risk management analyst. “Yet, in too many cases we find the
documentation is spotty or incomplete.
What we see is a lack of signed informed
consent forms for invasive procedures
such as veneers and no documented
patient esthetic approval prior to the permanent cementation of veneers.”
Dentists have told analysts that patients
often assume if they do not like the
veneers, then the veneers can just be
removed with no consideration of tooth
coverage. The issue is whether the doctor
was clear during the informed consent
discussion that the tooth preparation is
irreversible and veneers cannot simply be
taken off.
Informed consent discussions about
veneers include essential information
about tooth preparation, potential consequences and possible alternatives. If
orthodontics or periodontal surgery is
recommended but the patient chooses
veneers instead, be clear verbally and in
writing about the risks, benefits and
alternatives to veneers.
Equally as important are questions
about what the patient expects from the
treatment. Patients may bring pictures of
celebrities they admire. Often the patient
is looking at the overall appearance in
the photo rather than just the teeth.
Other times the patient is seeking a more
youthful appearance. As a prominent
dental attorney advises, “There needs to
be a meeting of the minds about the
patient’s expectations and the limitations of dentistry. Communicate what
you can accomplish compared to what
the patient expects, and make sure the
patient hears you.”
Document the conversation and include
the patient’s comments and questions.
Keep consistent records throughout the
treatment including progress notes, findings, patient and clinician concerns, and
photographs. Claims professionals
emphasize the importance of the dental
record for continuity of care and keeping
the facts straight. Without consistent
and thorough recordkeeping, it is difficult to remember everything for every
patient, especially relating to treatment
that may have happened several months
or even years ago.
Additionally, risk management experts
always advise dentists to pay attention to
continued to page 7
RM Matter - Precise Documentation Is an Advantage in Veneer Cases continued from page 6
any intuition they may have about a
patient. This is especially true during an
informed consent discussion about
veneers. The desire for cosmetic procedures may be tied in with complex emotions, and the patient may be seeking a
cure-all or miracle that even superior
dental work cannot deliver. You are not
obligated to take on every case that
comes your way. As one well-known
esthetic dentist put it, “In one instance,
my best cosmetic case was one that I
never started.”
Key Recommendations
EDITORIAL
Options for the Future
EXECUTIVE
PERSPECTIVE
continued from page 4
What’s in it for you?
To boost the success of veneer cases,
TDIC strongly recommends the
following:
•
•
Communicate clearly with the patient
about the irreversible aspect of porcelain veneers. Discuss tooth preparation, potential consequences and
alternatives.
Ask the patient to sign an informed
consent form. Informed consent
forms are available at thedentists.com.
•
•
•
Chart the informed consent discussion, treatment plan and progress
notes in sufficient detail.
Photograph the procedure from start
to finish.
Prior to cementation of veneers, ask
the patient to sign an esthetic approval
form. Esthetic approval forms are available at thedentists.com. ❖
TDIC’s Risk Management Advice Line can be
reached at 800.733.0634.
continued from page 5
your team members have the ability to
speak Spanish, Chinese, etc.? Perhaps
consider language qualifications with
your next hires.
San Francisco Children’s Oral Health
Collaborative, and we continue with our
Annual Children’s Poster Contest, 40
years old this year.
Around the corner with the implementation of the Affordable Care Act and
introduction of Electronic Health
Records (EHR) will be requirements for
more exchange of patient information
and collaboration with other health
disciplines. Insurance companies will
demand accountability while measuring your effectiveness (cost and treatment) and outcomes. This means the
need for data collection through technology like EHR will be the standard of
care. Caries Measurement by Risk
Assessment (CAMBRA) seems tailormade to prove to insurance companies
you are doing your best to prevent the
need for restorative and periodontal
care, lowering the overall cost of care.
This year we’ve launched additional initiatives: SFDS Job Fair in August—stay
tuned; SFDS Facebook Advertising
“Visit an SFDS Dentist”; SFDS Table of
5 Lunches—lunch is on us, all we ask is
that if you receive an invitation, you
come and share your thoughts; SFDS
Video Campaign—responding to newer
members; SFDS Oktoberfest in
September to raise funds for a new
homeless denture project; Small Group
CE meetings for up to 30 at the SFDS.
All of these initiatives are the result of
feedback and survey responses from you
our members. If you would like to volunteer to assist us in launching one or
more of these endeavors, give us a ring.
These are exciting times in our profession. In 1862, Abraham Lincoln may
have been speaking about our future
with his quote “The dogmas of the
quiet past are inadequate to the stormy
present.” When faced with oncoming
waves, rather than succumb to them,
grab your surfboards and ride them. ❖
Organized dentistry and your Society are
alive and well. But, your participation &
membership are keys to maintaining the
type of organization that dentistry needs
to fight for and to support you and your
patients… Next time someone asks you,
“What will I get for my money?” don’t
miss a beat. Start by reminding them of
the resources available to all members...
their ROI, return on investment!!!
And on a more personal note, longtime SFDS team member Lisa
McNichol is making a career move,
accepting a new and challenging position with UCSF. We wish her every success. She will be missed. ❖
San Francisco Dental Society • Page 7
NEW DENTIST SEMINAR
Tax Planning and Strategies for Recently Graduated Dentists
On February 24, 2015, Jerry Cizek of Morling & Company provided an educational seminar for new dentists and dental students
about tax planning strategies, and ways recent laws are affecting dentists. Jerry provided practical tax tips, focusing on what
kinds of tax deductions are best for dentists, the Alternative Minimum Tax, and audit risks. ❖
APRIL 2
SOCIAL HOUR
Southern Pacific Brewing
San Francisco Dental Society • Page 8
TRUSTEE REPORT
By Irene Hilton, DDS, MPH and Gail Duffala, DDS
he California Dental Association
Board of Trustees (BOT) met on
March 14-15, 2015 following the
CDA Leadership conference in Irvine,
CA. San Francisco Dental Society members in attendance included trustees
Irene Hilton, DDS, MPH, and Gail
Duffala, DDS, CDA, secretary Natasha
Lee, DDS and speaker Craig
Yarborough, DDS.
T
Let’s take a moment to remind ourselves
that 2014 was a very successful year for
CDA. Some highlights of the accomplishments on behalf of members:
•
•
•
•
•
•
•
Providing leadership to maintain
MICRA protections, Prop 46 in the
2014 election
Continuing Delta Dental litigation
that has delayed potential reimbursement rate reductions, saving CDA
dentists more than $100 million
Co-sponsoring AB 1962 (Skinner)
which requires dental plans to have
the same Medical Loss Ratio (premium protection) transparency that is
required under ACA for health plans
Assessing new direct member service
opportunities resulting in the formation of The Dentists Service Company
(TDSC), CDA’s new subsidiary
Adding practice management services to the Practice Support Center
Successfully advocating for two new
positions in the state Department of
Public Health (a dental director and
an epidemiologist) with ongoing,
rather than one-time, funding
Sponsoring a national conference on
Dental-Medical collaboration and
inter-professional education
•
•
CAL-D-PAC support of Dr. Jim
Wood’s successful state assembly
campaign
•
Support for the successful ADA presidential campaign of Dr. Carol
Summerhays
The board met in closed session to
review and approve the 2014 evaluation
of CDA’s Executive Director, Peter
DuBois, and to hear updates on the
U.S. Supreme Court decision regarding
the North Carolina dental board, and
the continuing Delta Dental litigation.
The board voted to continue funding
the litigation against Delta Dental.
The board received and discussed a
progress report on the development of
TDSC, reviewed proposed strategies for
implementing the new CDA strategic
plan that was approved at the 2014
House of Delegates, approved the 2015
Management by Objectives of the CDA
Executive Director, Peter Dubois and
approved “Connect Now”, a new membership promotion offer.
We also viewed a video of Dr. Jim
Wood speaking during recent
Sacramento legislative hearings discussing access to dental care for children in the Denti-Cal program. It cannot be stressed how important and
meaningful it is to have dentists serving
in the California legislature, to provide
the viewpoint of oral health care
providers.
Expenditures approved at this meeting
were:
•
•
•
$75,000 annual Californians Allied
for Patient Protection (CAPP) dues.
CAPP is the coalition created to preserve the Medical Injury
Compensation Reform Act of 1975
(MICRA), California’s landmark
medical malpractice law
$25,000 contribution to the Center
for Oral Health, previously known as
the Dental Health Foundation, an
organization now focused on
research and becoming a respected
resource for oral health information
$200,000 to conduct a member relationship survey and program assessment (previously the Mind of the
Dentist survey). The new survey will
give an understanding of the types of
programs and services that are of
most interest to members, identify
gaps in program offerings and
increase understanding of members
expectations about how programs
are delivered, all in the context of
CDA’s new strategic plan
Up to $36,000 to develop the business plan, including scope of the
project, requirements, cost, time and
resources needed for implementing
Aptify association management software at the component level. Aptify
has now been fully implemented at
the CDA state association level.
If you have any questions about any of
these actions or items, please feel free to
contact your CDA Trustees, Drs. Hilton
and Duffala or CDA Secretary, Dr.
Natasha Lee, via e-mail or telephone. ❖
San Francisco Dental Society • Page 9
GETTING TO KNOW AN SFDS
COMMUNITY VOLUNTEER
Name: Kenneth Ng
Dental School and Graduation Year: UCSF1995
Describe your present practice:
Private practice with my wife and classmate,
Susan Tran, DDS since 1997.
Volunteer faculty at UCSF since 1995 and
part time faculty since 2000.
What is the organization that you work with?:
SFUSD kindergarten dental screening
Therefore, San Francisco public schools have a special place in my
heart. In addition, while a student at UCSF, one course involved
going to certain SF public elementary schools to provide dental
education to the children. I recalled having had a great experience.
By volunteering for the dental screenings, I am able to lend a hand
to the SFDS as well as providing an important service to children of
the San Francisco public school system.
How do you feel about volunteerism, in general?:
I feel that volunteerism is an easy way to give back to the community
or to any other organization. It takes very little effort. The only
requirement is time commitment.
How long have you been working with this volunteer organization?:
Even that is very flexible. The overall positive feeling one gets from
volunteering is the best reward.
Since 1999 but had a hiatus from 2002-2008. Started back up again
since 2009.
What would you tell other SFDS dentists about volunteering with your
organization?:
How did you get involved?:
The kindergarten screening is one of many ways to help out with the
SFDS. The schedule is very flexible and generally can be customized
to one’s work schedule. Very little effort is needed. We are doing
exactly what we are trained to do. Seeing the children smiling and
thanking you at the end is the ultimate return.
Basically from a mailed informational flyer from SFDS about the
new program in collaboration with SFUSD.
There are many worthy organizations. Why did you select this one for
your volunteer time? What is your specific involvement?:
I was born in Hong Kong and immigrated to the US (San Francisco)
when I was seven years old. I am the product of the San Francisco
Unified School District.
To volunteer for the SFDS Kindergarten School Screening
project, contact info@sfds.org or call (415) 928-7337. ❖
A STANDING OVATION…
TO WELCOME OUR NEWEST SFDS MEMBERS:
Ardavan Fateh, DDS; Periodontics;
UCSF 2010; Harvard 2013; Office
Address Pending
Barbara Jean B. Betita, DMD; GP;
Centro Escolar 1985; 212 Sutter St, Fl 5
Bernadette A. Fa, DDS; GP; UOP 2006;
Faculty at UOP Dugoni, 155 Fifth St
Maxine M. Fotadar, DDS; GP;
Howard University 2012;
2920 Sonoma Blvd, Vallejo
Brittany L. Gonzales, DDS; GP;
UOP 2014; Office Address Pending
Aneil P. Kamboj, DDS; Pediatric
Dentistry; UOP 2009; St. Barnabas
Hospital 2012; Office Address Pending
San Francisco Dental Society • Page 10
Katina A. Landon, DDS; GP; UCSF 2014;
Office Address Pending
Ramina Sarmicanic, DDS; GP; UCSF
2014; Office Address Pending
Quynh-Mi Le, DDS; GP; UOP 2014;
AEGD Lutheran Medical Center 2015
Talia M. Shackelford, DDS; GP; UCSF
2014; Office Address Pending
Brandon B. Malan, DDS; GP;
UCSF 2014; AEGD Lutheran
Medical Center 2015
Kim Tran, DDS; GP; UOP 2014; Office
Address Pending
Sophia N. Morghem, DMD; GP;
UNLV 2013; Office Address Pending
Christine I. Peters, DMD; Univ
Heidelberg 1991; Univ Zurich 2001;
Endodontics Faculty at UOP Dugoni,
155 Fifth St
Hui Jue Wu, DMD; GP; Pittsburg 2013;
Office Address Pending
Stanley Y. Xiao, DDS; GP; China Med
College 1989; 296 21st Ave
SFDS DOES CDA CARES SACRAMENTO & PROJECT
HOMELESS CONNECT SF
A huge shout-out of thanks to all of our CDA Cares and Project Homeless
Connect Volunteers! A few photo highlights from both spring events
San Francisco Dental Society • Page 11
40th Annual
San Francisco Children’s Dental Poster Contest
promotes dental health and education through numerous
programs and volunteer efforts, including those of the SFDS
Dental Health Committee. If you are interested in working on
one of the Dental Health Committee’s many programs, please
give us a call.
This year’s judges included: Dr. Dennis Song, Dr. Jeffrey Jang,
Dr. Sandy Shih, Dr. Kat Vo, SFUSD Nurse Ms. Cathi Fuller,
SFDS Executive Director Deborah Elam, MS, CAE, and Ms.
Lisa McNichol, SFDS Poster Contest Coordinator.
Last but not least, we would like to acknowledge and thank
our donors for their generous support that provides crucial
funding and prizes, ensuring the continuation of this timehonored contest.
“Brush and Floss out Monster Mouth,” the theme of this
year’s poster contest, inspired wonderful artistic creations
from San Francisco’s public and private Kindergarten through
5th grade students. With an estimated 1500 entries, 60 winners were chosen and presented with awards at a ceremony
held on Friday, April 24, 2015 at the Arthur A. Dugoni School
of Dentistry. Associate Dean Dr. Craig Yarborough welcomed the budding artists to the school.
Dr. Dennis Shinbori welcomed Assembly Member David Chiu
and the many winning artists and their families to this year’s
40th Awards. Assembly Member Chiu, who has a dentist in
his extended family, encouraged everyone to floss and brush
regularly. In addition to presenting the first place winner, 3rd
grader Clarise Wu of Spring Valley Science School, with a 1
year family membership to the California Academy of
Sciences, $50 cash and a Sunstar/Butler gift bag,
Assemblyman Chiu presented Clarise with a Certificate of
Recognition from the California State Legislature. Clarise’s
teacher, Mrs. Chan, and principal, Ms. Kwong, each received
recognition and prizes, too.
Clarise’s fellow winners were presented with prizes by SFDS
President, Dr. Dennis Song, Dr. Jeff Jang, Chair of
Community Dental Health Committee, Ms. Deborah Elam,
SFDS Executive Director, and Dr. Sandy Shih, member of the
Community Dental Health Committee. It is a family affair,
with brothers, sisters, mothers, fathers, grandparents, friends,
all participating and sharing in the awards. You can see these
winning posters on display at the Main Public Library during
the summer.
Poster Contest co-chairs, Drs. Dennis Shinbori and Stafford
Duhn, deliver plenty of smiles every February during National
Children’s Dental Health Month, hosting this contest to raise
awareness about the importance of oral health through artistic means of inspiration. The San Francisco Dental Society
San Francisco Dental Society • Page 12
Pacific Dugoni School of Dentistry
Mitchell and Mitchell Insurance Agency
Northern California Practice Sales
San Francisco Public Library
Sunstar Americas, Inc, Manufacturer of Butler
TDIC/TDIC Insurance Solutions
San Francisco Dental Society • Page 13
San Francisco Dental Society • Page 14
Alternative Workweek Hours May Start 30 Days After Announcement
e regularly receive calls regarding how to provide references
for employee’s that member
dentists have terminated, wondering what
information is safe to provide.
CalChamber’s Dana Leisinger has written
about this and we are reprinting the following, which may be of help to members:
W
Providing references can be a tricky
area, and many employers will provide
only dates of hire and position held,
fearing that if they provide negative
information about a former employee,
they will be subject to a lawsuit for
defamation, even if the statements are
accurate. Before limiting your responses, however, there are issues to consider.
Eligible for Rehire
For example, Civil Code Section 47(c) protects employers who respond to the question, “Is this person eligible for rehire?”
The section states: “This subdivision
authorizes a current or former employer, or the employer’s agent, to answer
whether or not the employer would
rehire a current or former employee.”
If a former employer states the person
is not eligible for rehire, that response
alone says a great deal.
Negligent Referral
A problem also can occur with a “negligent referral.” This occurs in a number
of ways, but the most frequent challenging situation is when an employee leaves
after an extremely negative situation—for
example, theft, harassment or violence.
When prospective employers call in for references and the prior employer does not
reveal any information at all, there can be
consequences down the road if the individual continues in the negative behavior.
One case involved an employee who
engaged in extremely bizarre behavior,
ending in his termination. A neutral
referral was provided to a subsequent
employer, who also terminated him.
That termination, however, was followed
by the individual shooting several people
who were involved in the termination.
A case such as described above is
extreme to say the least; however, it
demonstrates the care employers must
exercise in this area. There may be a
moral responsibility to report extreme
behavior, particularly if it relates to the
job the former employee is seeking.
The bare minimum of information
may not be wise. Nor is it advisable to
provide a glowing recommendation on
an employee, leaving out negative information that should be disclosed. This is
yet another form of negligent referral.
Establish Guidelines
It is best to establish guidelines on how
all references will be handled to avoid
awkwardness and confusion:
•
•
Draft specific policies. Following
those policies will help when those
reference calls come in.
All requests for references should be
directed to a specific individual(s).
• Verify the caller’s identity. For example,
call the company back and ascertain the
caller’s status.
•
•
Establish whether requests must be
in writing or may be verbal.
Decide exactly what information you
will provide. For example, dates of
employment, position held, rates of
pay and eligibility for rehire. ❖
Dana Leisinger serves as a CalChamber HR
adviser and holds a J.D. from the McGeorge
School of Law, University of the Pacific.
᭑ In Memory ᭑
Our condolences to family and colleagues…
Dr. William Y. Castillo (1970-2015) - Member 2010-2015
An active member and general dentist, Dr. William Y. Castillo graduated from the Universidad Nacional Autónoma de
Honduras, Class of 1996. Dr. Gomez practiced at 556 Battery St. ❖
San Francisco Dental Society • Page 15
FEBRUARY CRAB FEED – FUN & GAMES WITH THE SFDS
At St. Mary’s Cathedral, over crab and pasta, SFDS members, their staff, and family bonded and enjoyed themselves in a night
filled with amusements and music. While DJ Marc provided music to dance the night away, the real hit of the evening was a
photo booth, complete with props to make each photo both amusing and fun.
Special thanks to the students at Dugoni School of Dentistry for presenting their posters as a part of our Student Poster
Competition - Basil Al Shaikhly, Holly Yuen, Rachael Prokes, Jesse Han, Tarun Padmani, Niki Ghaderi, Steven Speaker, and
Hennasea Tokumura. We also would like to thank our Sponsors: Carestream Dental, SoFi, and TDIC Insurance Solutions.
For more pictures, visit our Facebook page.
San
San Francisco
Francisco Dental
Dental Society
Society •• Page
Page 14
16
FEBRUARY CRAB FEED – FUN & GAMES WITH THE SFDS
San Francisco Dental Society • Page 17
COMMUNITY CORNER –
YOUR COMMUNITY NEEDS YOU!
Program/
Agency
What is it?
Date/Time/Loc.
Contact
K School Screening
Partnership with SFDPH &
SFUSD to screen
kindergarteners
Morning/Afternoon 2-3 hours
SF Public Elementary Schools
SFDS
info@sfds.org
415-928-7337
Project
Homeless
Connect
Partnership with SFDPH to
provide dental care to homeless
individuals and families
Half or full day
Bill Graham Civic Center/
Southeast Health Center
SFDS
info@sfds.org
415-928-7337
Everyday
Connect
Seeking dental services for
those who are at risk of becoming
homeless, currently homeless or
recently transitioned into
permanent housing
Ongoing.
Project Homeless Connect
25 Van Ness Ave
Ste 340
SF, CA 94102
Helpline 1-855-588-7968;
Everyday Connect staff
will respond to voicemail
messages or email staff at
edc@projecthomelessconnect.com
Salvation Army
Harbor House
Arranges for program clients to
receive care in dentists’ offices.
Dentist determines number of
clients and services
Ongoing. Dentist’s office
Jaime Smith
Volunteer Coordinator
415-503-2720
Ongoing.
140 Turk Street
Contact Staff
415-441-1628 for
volunteering and to pick
up or drop off equipment
at SFCI Health and
Wellness Center
SF City Impact (SFCI) General Dentist Needed
arrange Health &
Thursdays 9 AM -2 PM, to
Wellness Center
Screen/Treat. Also seeking
donations of small dental
equipment, dental instruments
& oral surgery instruments
San Francisco Dental Society • Page 18
You are not a
policy number.
And at The Dentists Insurance Company, we won’t treat you like one because
we are not like other insurance companies. We were started by, and only
protect, dentists. A singular focus that leads to an unparalleled knowledge
of your profession and how to best protect you. It also means that TDIC
is in your corner, because with us, you’re never a policy number.
You are a dentist.
Endorsed by the
San Francisco
Dental Society
®
Protecting dentists. It’s all we do.
800.733.0633 | tdicsolutions.com | CA Insurance Lic. #0652783
San Francisco Dental Society • Page 19
ON YOUR BEHALF
By Claudia Masouredis, DDS, MPH, Chair Legislative Committee
Grassroots Advocacy
aws passed by the Legislature,
both State and Federal, have a
direct impact on your life.
L
Understanding the process by which
those laws are passed, and knowing how
you as a citizen can have a legislative
influence, is imperative in today’s world.
The San Francisco Dental Society’s
Legislative Committee and the SFDS
Political Action Committee are dedicated to fostering involvement of member
dentists in understanding and being
aware of the legislative process and the
laws and regulatory actions that will
impact dentists and small business owners. The Legislative Committee makes
yearly visits to legislators in Sacramento
to meet with representatives from San
Francisco to discuss issues affecting San
Francisco dentists. The committee also
highlights topical issues in The Bridge.
Efforts at the state level by CDA and
CalDPAC are financed through your
CDA membership dues. In 2014 and
2015, CDA and CalDPAC successfully
supported candidates and key pieces of
legislation to the benefit of members.
Bills supporting efforts to fight tobacco
use have passed initial committee hearings, attempts by the California Dental
Hygienist’s Association to lessen oversight of RDHAPs have been successfully
amended and AB 1962, mandating more
dental insurance accountability, is now
law. AB 1962 requires that a minimum
of 80% dental insurance premium dollars be spent on patient care, not on
profit or administrative costs.
Advocacy, in particular, grassroots advocacy, can be a means to shaping public
policy. Dentists can have a direct effect
on legislators when they organize
around issues that affect them and for
which they are seen as experts, such as
dental health. A legislator will respond
to issues based on how they may affect
their district, how the issue pertains to
good public policy, and who cares, supports or opposes the issue.
Know who your key state legislators are
and what issues they support or oppose.
San Francisco is in Senatorial District 11
with Senator Mark Leno (D) as representative. We are also Assembly District 17
with David Chui (D) as representative.
Use ‘VOTE-SMART’ online to check
what issues your legislative representatives support.
Know the issues and who supports or
opposes them – ignorance is only a
means of allowing others to make
decisions that dentists should be making. Volunteer for the SFDS Legislative
Committee and join San-Fran-DPAC.
There is power in numbers, legislators
in Sacramento will listen to a
formidable group. ❖
San Francisco Dental Society • Page 20
Published by the
San Francisco Dental Society
2143 Lombard Street, San Francisco, CA 94123
415.928.7337 • Fax 415.928.5297
Email: exec@sfds.org
Layout/Design - SowleWork • Printing - Sundance Press
Advertising rates and information sent upon request. Acceptance of advertising in The Bridge in no way constitutes approval or endorsement by the San
Francisco Dental Society of products or services advertised. The SFDS reserves the right to reject any advertisement. Opinions expressed by authors are
their own, and not necessarily those of the SFDS or The Bridge editorial board. The SFDS reserves the right to edit all contributions for clarity and length,
as well as reject any material submitted. The Bridge is published bi-monthly by the SFDS, 2143 Lombard Street, San Francisco, CA 94123, 415.928.7337.
Subscriptions are $40 per year for SFDS/$45 per issue for non-members.
䉷 2015, San Francisco Dental Society. All rights reserved.
Deadline for October 2015 publication is: September 1, 2015
San Francisco Dental Society • Page 21
Simplified Equilibration for the General Practitioner
(cont. on next page)
Before beginning restorative work on a new patient, do you routinely evaluate whether that patient would benefit
from an occlusion equilibration? Most practitioners do not. Why?
One reason is that the traditional method of equilibration, mounted models, and transferring those corrections to
the patients is time consuming and expensive.
However, the primary source of hesitation due to the confusion over occlusion is that we are unsure of our goals.
One popular objective is to have CR equal to CO, while another is to reduce occlusal stress by altering the dentition
in lateral excursions.
Occlusion, dentistry’s most important subject, is incoherent. Contemporary texts on occlusion provide valuable
information about all the components of the masticatory system, but fail to provide a logical connection between
the design of teeth, the most ideal way they are supposed to touch each other and disorders of TMJ.
Restorative dentistry takes place on two distinct levels; complex and maintenance. Complex restorations or reconstructions are very expensive which limits treatment to the affluent.
Maintenance dentistry however, is the way that 99 percent of the restorative work is being accomplished throughout the world. Unfortunately there are no guidelines, it’s a copy what you see technique.
The majority of patients have very little work done each year and that work is done incrementally. So the question
is: how exactly should increments of restorative work be accomplished so that a high standard of dental health is
achieved and maintained?
This equilibration workshop will look with a critical eye at the way the subject of occlusion is being presented
today which will include:
• How the stomatognathic system is supposed to work ideally
• The role that the design of dentition plays in ideal function
• How to identify the signs of dysfunction when the system goes awry and what to do about it
• All the reasons the subject of occlusion is incoherent
• How to design incremental work in order to minimize oral facial pain and TMD
• How to treat and prevent TMD
• Guard design
• Simplified, no down side, equilibrations in 30 minute appointments.
These one day workshops will be limited to:
• Three dentists at a time, who will be equilibrated and fitted with a guard.
• Tuition: $2400
• Time: first Fridays of most months
• CE Credits
San Francisco Dental Society • Page 22
Simplified Equilibration for the General Practitioner
(cont.)
Testimonial
“I am a Canadian dentist who has been practicing for 18 years. I have always understood the importance of occlusion,
but with all the different philosophies that currently exist, I have found the subject to be controversial and confusing.
Nevertheless, I have a strong desire to incorporate occlusal equilibration into my practice. I took a course offered by
prosthodontist with over 50 years of clinical experience. It was a good experience but I was discouraged by the fact that
the technique was just not practical for a general dentist. It was by chance and good fortune that I came across one of
Dr. McCoy’s publications online. I was intrigued by his views on occlusion and his methods of equilibration. I contacted him right away and he was kind enough to offer me information over the phone. I realized that to really learn
the technique, I would have to see him in person. I met him at his office where he took the time to explain the theory
behind his method. He then performed an occlusal equilibration on my dentition. I noticed a difference immediately;
my bite felt more balanced than before. This is even after I had previously had my bite adjusted elsewhere by the indirect technique (mounted study casts in centric relation, trail equilibration on casts, removing interferences one by one
until centric relation is co-incident with maximum intercuspation).
I use what I learned from Dr. McCoy in practice every day. His technique is applicable to individual restorations as well
as full equilibrations. Occlusion is less of a mystery to me now and I certainly do not fear making adjustments to teeth
as needed. Of the full equilibrations that I performed, my patients have reported that their bite feels better than before,
that they have stopped clenching and that they no longer have headaches.
I am very grateful to Dr. McCoy for sharing his clinical expertise. If you are a general dentist, seeing him will help you
tremendously in making occlusal adjustments with ease and confidence.”
F Haji, D.D.S
Toronto, ON
Gene McCoy DDS is an honored fellow of the American Academy of Implant Dentistry and a member of the
American Equilibration society. He has published and lectured internationally and is a frequent visiting lecturer at
Peking University School of Stomatology in Beijing, China.
You may contact him at: genemccoydds@sbcglobal.net or 415-621-5471, his office is located at 1390 Market St, Suite
226, San Francisco, Ca 94102.
San Francisco Dental Society • Page 23
2143 Lombard St., San Francisco, CA 94123