Cliff's Notes

The Business of Dentistry

“Cash Flow & Group Practices” / “The STA Injection System”

Cliff’s Notes for November 6, 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.



Start every day off with a smile and get it over with.

W.C. Fields


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

“Meet Dayna Johnson, The Office Manager”


In This Week’s Issue

  • What Happens to your Cash Flow When You Take a Vacation?
  • Cliff’s Virtual New York Dental Meeting 2011 – Part 1 – Attachment!
  • 2011 New York Dental Meeting Specials! – Attachment!
  • Is it a Treat or a Trick?
  • Product Review – The STA Injection System
  • Commentary for Sunday, November 6, 2011


What Happens to Your Cash Flow When Your on Vacation?………….

If you are the fuel for the revenue generating engine that runs your office, what happens when the fuel supply is temporarily interrupted? Cash flow suffers. Do you pay your staff when you’re away or do they suffer? Is your staff required to schedule their vacations around yours and what does that do for moral and productivity? These are questions that were never answered in dental school or at any seminar you ever attended.

I live in a very populated area and the public management expenses are rising at alarming rates. With the local municipalities trying to keep property taxes in check they are discussing way of utilizing “shared services”. That same concept can be incorporated with just about any small business, including dental practices, if it is structured correctly.

There could be tremendous benefits in being involved in a partnership or group practice but for it to be successful, everything, and I mean everything, must be thought out in detail and put on paper. Handshake agreements change over the years but documented agreements don’t.

The up-side of a partnership/group practice is that it can always be open and accommodate patients with more hours. Add a strong office manager, a good financial & management consultant and your desire for diagnostics and you’re in the gold. A close friend from a long time ago once told me “you can own a candy store or you can own a chain of candy stores”.

So, what is the down side of a partnership or group practice? As people get older their values and goals change. Change is very difficult to embrace especially when it is hitting you in the face every day. I have seen situations where docs that have been partners and friends for years, can’t stand being in the office at the same time. In this situation, Dr. X wanted to incorporate technology into the practice that required an investment. Dr.Y didn’t want to do it. That started 4 years of heart ache and disagreements before the practice was sold.

This can easily be avoided by running your business the way it is supposed to, by keeping it fresh. Don’t you remember all those business and economic courses you took in dental school? 

Group start-ups are expensive. The practice needs to be marketed and in most cases take insurance. Office protocol needs to be written and followed so all the docs instruct the staff in the same manner. Your key to success, aside from excellence in dentistry, is productivity. But you need the patient base and cash flow or the investment may be hefty.

Then there is the Merger. Dr. X has a practice grossing $450k with a 725 active patient count. Dr. Y has a practice in the same area grossing $525k with a 791 active patient count. Now it’s simple math. A non-cash merger would create a $1M practice with a 1500+ patient base that can now rapidly grow to $1.5M.

What is a Merger?

· A merger does not require cash.

· A merger may be accomplished tax-free for both parties.

· A merger lets the target (in effect, the seller) realize the appreciation potential of the merged entity, instead of being limited to sales proceeds.

· A merger allows the shareholders of smaller entities to own a smaller piece of a larger pie, increasing their overall net worth.

· A merger of a privately held company into a publicly held company allows the target company shareholders to receive a public company’s stock, despite the liquidity restrictions of SEC Rule 144a.

· A merger allows the acquirer to avoid many of the costly and time-consuming aspects of asset purchases, such as the assignment of leases and bulk-sales notifications.

· Of considerable importance when there are minority stockholders is the fact that upon obtaining the required number of votes in support of the merger, the transaction becomes effective and dissenting shareholders are obliged to go along.

Please feel free to contact me to discuss any ideas or concerns you may have about future or current partnership agreements.


Cliff’ Virtual NY Dental Meeting 2011 – Part 1 – Attached………….

2011 New York Dental Meeting Specials……… – Attached….

Planning for the end of the business year can be challenging. The Greater NY Dental Meeting can be overwhelming so you need a plan on what you are looking to accomplish. 

Attached is part 1 of Cliff’s Notes Virtual NY Dental Meeting 2011. There are many products that I endorse, however, it is impossible to review everything. The products and services I review are proven and reliable and receive high praise for my client base.

Also, all products are produced by quality manufacturers and their individual product lines are worth reviewing.

If you wish to discuss any particular item or need information on something not listed, please contact me.

Price will never be an issue. Cliff’s Notes pricing will compete and in most cases be lower than any authorized distributer.

If you are not a Cliff’s Notes direct subscriber (blog readers) please send your e-mail address to and I will forward the review to you as quickly as I can.


Is it a Treat or a Trick?…………………………………………………………….

I’ll bet sometimes you wonder if becoming a dentist was a treat or a trick. Well, this is one situation that digital photography or an intraoral camera won’t help. Do you think there is a “communication” issue? Maybe it’s time to look at your practice and staff protocol to find out exactly how your office’s personality affects your patient base. 

In the real world your patients don’t know if you’re a good dentists or a bad one. All they have is a perception of you and if they like you and your staff they trust you. Maybe it’s time to walk in the front door and see what your practice really looks like.

Call me, we’ll talk and figure out ways to maximize the “patient experience” at little or no cost.

2:27 Add to

“Be a Dentist” By Steve Martin


Product Review – The STA Injection System……………………………

The STA (Single Tooth Anesthesia) by Milestone Scientific is probably the most misunderstood piece of dental equipment that is available on today’s market. The problem is that it is not looked at as a practice builder. Let me explain.

Most dentists give very good injections. Patient comfort in your office is always a priority and that’s what a STA System is all about.

The patented, award-winning STA Single Tooth Anesthesia System® unit utilizes computer-controlled local anesthesia delivery to enhance the injection process for both the dentist and the patient. 

The STA Single Tooth Anesthesia System unit incorporates the ‘pressure force feedback’ elements of Milestone’s patented CompuFlo® system with DPS Dynamic Pressure Sensing® technology, and consists of a computer-controlled drive unit about the size of a cable modem  (5” L x 2”W x 5” H), and a separate single-use disposable handpiece/needle assembly. The core technology utilizes an electro-mechanical motor regulated by a central processor unit (CPU) functioning in concert with a force/pressure transducer. 

Traditional syringe techniques utilized in routine intraligamentary injections are hampered by the blind nature of the injection, the extreme pressures generated in local tissues during the procedure, and the relatively small volume of anesthesia able to be reliably delivered.  These factors have resulted in reduced duration of anesthesia, unnecessary collateral anesthesia and increased pain associated with tissue damage. 

The STA Single Tooth Anesthesia System unit takes the guesswork out of the administration of anesthetic by providing real-time visual and audible feedback via the CompuFlo system with DPS Dynamic Pressure Sensing technology.  During an injection with the STA Single Tooth Anesthesia System unit, the CompuFlo system with DPS Dynamic Pressure Sensing Technology continuously monitors the exit pressure of the anesthetic in real-time during all phases of administration.

In addition to its general use for all dental injections, the STA Single Tooth Anesthesia System unit is uniquely capable of predictably and more comfortably administering “Single Tooth Anesthesia” into the Periodontal Intraligamentary (PDL) space, something never before possible using conventional techniques. This injection results in the patient having no collateral numbness and no pain along with instant, predictable anesthesia.  The benefits of administering injections with the instrument are significant for the patient, the dentist and the business of dentistry. 

Milestone Scientific – STA System

2:08 Add to

video lang: en

Functions of the STA System

Step by step breakdown of the different functions that STA is providing, by Milestone Scientific

Milestone Scientific – STA System


Sunday, November 6, 2011 ………………………..…………………….

Well, there was no electric and once again we are reminded that all the wonderful technology that we are learning to rely on is no match for Mother Nature. Just like in business, you need to be prepared. Do you have a disaster recovery plan? Have you discussed it with your financial advisor? Do you have a way to treat patients if your office is down for more than 2 or 3 days? Maybe that’s some food for thought and if you should have any questions or concerns please feel free to contact me at any time. 

Enjoy the day and please be safe,


Cliff Marsh

Henry Schein Dental

P.O. Box 663 / 45 Rt. 46 East, Suite 605

Pine Brook, NJ 07058

Cell: 201-321-7494

Fax: 201-262-2210!/profile.php?id=1644814090

The Cliff’s Notes Channel

November 6, 2011 - Posted by | Uncategorized

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