Cliff's Notes

The Business of Dentistry

“Screening for Medical Conditions” / “Buying or Selling? Think Software!”

Cliff’s Notes for October 23, 2011

Cliff Marsh, Henry Schein ……Cell: 201-321-7494……Fax: 201-262-2210…..E-mail:


One of the reasons we do what we do, is so that we can to do what we want to do, when we want to do it. It’s a tongue twister, but working as a team and making informed decisions, will get us there.


“Conformity is the jailer of freedom and the enemy of growth.”

President John F. Kennedy


This Week’s Feature on the Cliff’s Notes Channel

 “An Introduction to E4D”


In This Week’s Issue

  • Screening for Medical Conditions – Diagnostics!
  • Buying or Selling a Dental Practice? Think Software!
  • October 28th – Marriott at Glenn Pointe, Teaneck, NJ…
  • The Greater New York Dental Meeting 2011 – Where’s The Beef?
  • Product Review – Scotchbond Universal Adhesive by 3M!
  • Commentary for Sunday, October 9, 2011


Screening for medical conditions in a dental setting…….

I’ll say it again; dentistry is the tip of the sword when it comes to preventive medicine. A dentist is a physician that specializes in the oral cavity just as a cardiologist specializes in the heart muscle. However, you have a better chance of detecting some abnormalities long before the patient sees a medical doc. Think about it! How many physicians see an apparently healthy patient more often than a dentist? Become a healthcare facility and offer your patients a medical screening, the tools are available and medical insurance may help cover expenses. It’s time to step out of the box.

The following was written by Dr. Marty Jablow.

Tuesday, October 18, 2011 at 9:57am

Greenberg, B. L., Kantor, M. L., Jiang, S. S. and Glick, M. (2011), Patients’ attitudes toward screening for 7325.2011.00280.x


Objectives: Previous studies demonstrated the efficacy of chairside medical screening by dentists to identify patients who are at increased risk for developing cardiovascular-associated events and the favorable attitude of dentists toward chairside medical screening. This study assessed patient attitudes toward chairside medical screening in a dental setting.

Methods: A self-administered questionnaire of eight five-point response scale questions was given to a convenience sample of adult patients attending an inner-city dental school clinic and two private practice settings. Wilcoxon–Mann–Whitney tests and t-tests were used to compare responses between study groups. Friedman nonparametric analysis of variance was used to compare response items within each question.

Results: Regardless of setting, the majority of respondents was willing to have a dentist conduct screening for heart disease, high blood pressure, diabetes, human immunodeficiency virus infection, and hepatitis infection (55-90 percent); discuss results immediately (79 percent and 89 percent); provide oral fluids, finger-stick blood, blood pressure measurements, and height and weight (60-94 percent); and pay up to $20 (50-67 percent). Respondents reported that their opinion of the dentist would improve regarding the dentist’s professionalism, knowledge, competence, and compassion (48-77 percent). The fact that the test was not done by a physician was ranked as the least important potential barrier. While all respondents expressed a favorable attitude toward chairside screening, the mean score was significantly lower among clinic patients across most questions/items. The priority rankings within an item were similar for both groups.

Conclusions: Acceptance by patients of chairside medical screening in a dental setting is a critical element for successful implementation of this strategy.

Note: Dr. Jablow can be contacted @ Dr. Marty Jablow.

Also, Dr. Jablow will be a featured speaker at the Henry Schein Octoberfest in Teaneck, NJ on Friday, October 28th. The 2 hour session begins promptly at 2:00 PM.


Buying or Selling a Dental Practice? Think Software!……..……………

The following article will help you understand how to buy or sell a small business (dental practice). However, if data entry is accurate, the Dentrix Practice Management Program (G4) will provide all necessary reports including active patient counts within designated date parameters. Dentrix Software can add $50k to the value of your practice. 

Most industry standard software packages will provide the information required to do “due diligence”. The most important thing to remember is to consult and retain a Dental Practice Transition Specialist. Follow your own advice and refer to the specialist because that’s what they do every day. An organized transition makes it a smooth ride for the seller and buyer. However, always remember, “When both side walk away from the table a little un-happy, it’s a good deal!”

If you have any questions or concerns about practice development, transition or preparation for transition, please feel free to contact me at any time @ 201-321-7494 or

2:51 Add to

Dentrix Practice Advisor

An Article by Stuart Auerbach, DDS

Dental practice management software has become ubiquitous. Most practices today are computerized at some level, whether they are using computers simply as an internet portal or facilitating the completely paperless office. Dental practice management software is useful on a daily basis in addition to becoming increasingly critical in the evaluation of a purchase opportunity. Here’s how.

When we are asked to value a practice we look for the reports that are available from most of the commonly used programs. Those statistics are utilized to evaluate the health of a practice and provide important information that purchasers require when they evaluate their interest in purchasing a practice.

Further, practice acquisition lenders request the same, if not additional reports, to decide whether they will finance an acquisition. As the adage says, “garbage in, garbage out” meaning the accuracy of any computer report is limited to the accuracy of the information that is entered and maintained. In valuing a practice we try to interpret and verify the reports with as much data as available.

As an example, prospective purchasers and lenders both want to know the number of active patients in the practice. But, what is the definition of an active patient? Generally, we look at the number of patients treated by the practice in the last 18 months.  This time window has been an accepted standard for years, however, practice software reports will not usually show that number anywhere. 

Most offices that still use paper charts do periodic chart audits and move patient records to storage when the patients have not been in the office for approximately 2-4 years. However, when the inactive charts are removed, the practice software is not usually updated. 

Patients need to be deactivated (set to “inactive”) in the software or they continue to be counted as “active,” erroneously, in the patient register. We often see practices with 3,000-10,000 patients on patient statistics reports but only 2,000 patient charts in the office. It is unlikely that there are more than 5,000 active patients in a general practice with two hygienists working five days per week. That ambiguity generally leads to more questions and research to ascertain the true patient census. In most cases, even 2,000 patients may be overstated and is often “too many” for a solo-practitioner.

Another report that we have seen overlooked is the accounts receivable (AR) report. If you want to know how a practice is doing financially, look at this report. How much dentistry was produced and how much money was collected? Overhead costs are actually a function of the production of the office and not the collections. A practice’s overhead may seem to be too high when compared to the collections, but evaluating its overhead relative to its actual production may reveal a significantly different perspective.

We have seen offices where the accounts receivables approach $500,000 and more. How does this happen? If the practice owner does not regularly review the status of the patient accounts and continuous errors are not corrected over time this can lead to an exponential error. Why is that a problem? At the time of the sale of the practice, the seller will be required to disclose the amount of money owed to or by the practice. 

The accounts receivable is a compilation of actual money owed to the practice by patients and insurance companies (if claims are submitted for patients) and the amount of patient credits which is the total of patient overpayments, most likely due to duplicated payments by insurance companies and patient prepayments for dentistry not yet performed. Long-standing errors are usually going to be seen in the aged collection report and probably in the over 90 or 120 days column.

If a practice does not regularly review this report a seller could find him/herself at the closing of the sale of the practice writing checks to patients to refund overpayments (credits) or transferring money to the purchasing doctor to be held for the patients to return to the office (prepayments). In either situation, it can be a real problem as sellers have had to return tens of thousands of dollars in order to sell their practices. Those using Care Credit and other prepayment sources must also realize that this “income” is actually a prepayment for services due and could cause money to be due to patients that would need to be accounted for.

Practice owners should look at the accounts receivable report and if the balance or amount of credits is excessive, they may find that the office software has not been properly closed at the end of each month or at the end of the year, for many years.  The only way to rectify that is to have the practice administrator go back and close each month individually until the software is up to date.  The seller will also need to either write off very old and/or uncollectable accounts and remove them from the practice management software or send them to a collection agency.

Whether you are contemplating selling your practice or are in the process of searching for a practice to purchase, you should consult with your transition expert to discuss the relevance of the practice reports.

If you are thinking about a practice purchase or are you 5-10 years from transitioning out? Like everything else, you need to be prepared. Please feel free to contact me at any time with any questions or concerns – 201-321-7494 or

October 28th – Marriott at Glenn Pointe………………………………..

It’s the Henry Schein “October Fest”

– A dental meeting in Teaneck, NJ – 5 Great Seminars – 50 Manufacturer Exhibits – All ADA & NY Convention Specials. Call Cliff for more details….201-321-7494 or e-mail:


The Greater New York Dental Meeting 2011……………………………..

Exhibits open on Sunday November 27th @ 9:30 AM and remain open until Wednesday November 30th, 4:30 PM. I will be at the show every day and can be reached by cell phone or at the Henry Schein Information Center.

The NY Dental Meeting is a great place to look at new technology and actively seek advice from multiple sources so that you can make an informed decision. Having a plan for your day of research will help you organize your time and better understand what’s available.

As an example, if you want to look for a digital pan, don’t go to the show with a “what’s available” mentality. Do your homework and narrow your search to 3 models that are capable of doing what you want to do. Quality and serviceability should be the key issues in your search regardless if it is for a pan or a curing light. Serviceability should be considered from the production point of view and also for anticipated down time.

A dental trade show is a great place to “touch & feel” before you buy. To help you pre-view some of the more interesting things or if you can’t make it to the show, starting on Sunday 10/30/2011 there will be an attachment to the Sunday morning Cliff’s Notes that will be a continually up-dated virtual tour of the NY Show. Every week there will be more added to it as manufacturers supply their promotions.

For more information or to schedule an appointment during the meeting, please feel free to contact me at any time @ 201-321-7494 or

Product Review – Scotchbond Universal Adhesive by 3M!……………….

Scotchbond™ Universal Adhesive is 3M’s new adhesive for both Total-Etch and Self-Etch applications. It offers one simple adhesive application technique for both direct and indirect indications and bonds to all surfaces including enamel, dentin, glass ceramic, zirconia, noble and non-precious alloys, and composites – without additional primer. The flip top vials and unit dose delivery make it easy to use.


The unique chemistry of Scotchbond Universal adhesive optimizes the ratios of the 3M ESPE proprietary Vitrebond™ copolymer, HEMA and water. This allows for rehydration of the collagen network and formation of a distinct hybrid layer whether dentin is kept moist or dry. The result is reduced technique sensitivity, consistent bonding and virtually no post-op sensitivity in both Self-Etch and Total-Etch applications.

The Scotchbond™ Universal Adhesive Guarantee is available to all new users who have purchased through Henry Schein Dental.

To be eligible for the Scotchbond™ Universal Guarantee, the individual applying the adhesive must first call 3M ESPE Customer Care at (800) 634-2249 to register and review the proper usage of the product.

The Guarantee applies to both direct and indirect restorations and all manufacturers’ instructions on the composite, compomer, cement or other dental material should be followed.

If your patient should experience post-operative sensitivity, it must be present for over two weeks, and the occlusion must be rechecked in that time frame. Should the patient present sensitivity before the restoration was placed, that procedure is ineligible for the guarantee.

Please refer to the Instructions for Use for detailed instructions and precautionary measures.

This Guarantee is applicable through one year after the date of purchase.

If post-operative sensitivity is still present after two weeks, and you have followed all manufacturers’ instructions, the sensitivity guarantee is limited to ONE (1) product return per individual SKU. 3M ESPE will replace your product with the same or other product that is equal in value at 3M ESPE’s discretion.

All other stated Warranties and Limited Liabilities apply.


Sunday, October 23, 2011 ………………………..………………………..

This kind of says it all, enjoy the day!

3:35 Add to

video lang: en

Johnny Cash – Sunday Morning Coming Down

October 23, 2011 - Posted by | Uncategorized

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