Cliff's Notes

The Business of Dentistry

The 4 D’s of a Business Exit Strategy!

Cliff’s Notes for February 1, 2010

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

“In this business, by the time you realize you’re in trouble, it’s too late to save yourself”
Bill Gates

In This Week’s Issue
• Defense Wins Games – The 4 D’s of a Business Exit Strategy!
• Webinar February 9th May be the single most important thing you can do for your future!
• Kavo Introduces an LED Up-Grade for existing Multiflex users.
• Henry Schein Outlet Store Specials

Defense Wins Games – The 4 D’s of a Business Exit Plan………………………………………..
The following article was taken from “ Small Business Information by Brent Dees.” Please remember, consult with a professional transition expert before signing on the dotted line. As always, I am available if you have any questions or concerns.
“Begin with the end in mind,” says Stephen Covey in his book, “The Seven Habits of Successful Living.” Those who have created a successful business know it does not happen without planning, hard work, and a little luck. Yet most have no exit plan for leaving their business. The truth is that most business relationships do not have happy endings. To have a successful business, you must plan for all four D’s of a business exit strategy. The idea that your business will provide you with income after you are no longer there may not be a reality. You have to depend on yourself. Take the time to look at the four D’s of a business exit strategy: death, disability, divorce, and departing. To have a successful business, you must plan for all four D’s.
The Four D’s of a Business Exit
Death: The issue of the death of a small business owner should be considered during the start-up of a business. Unfortunately, during the creation of many buy/sell agreements the issue of death is only addressed at the urging of a life insurance agent. At the meeting, you arbitrarily decide how much insurance you can afford and how much your company is worth, when in fact you do not know.
Disability: Death is not as likely to end the business relationship as disability. Small business survival will often take prescient over paying a disabled partner. If the person is important to the business, the financial strain impacts the business and the family who depends on the income.
Divorce: You can imagine the torn feelings if a disability occurs, but what if the partners cannot get along? How do we split a partnership without financially ruining each other? It may be complicated by many personalities, some may not even be a part of the dispute, yet may be affected financially.
Departure: You may all be happy working together, but your partner or you may decide to leave for another opportunity or simply to take life easier. Who is going to do the work? What is owed the leaving partner? Where is the money coming from? All important considerations for your business exit strategy.
A Fair Buy/Sell Agreement
For the small business owner, each one of the four D’s has special demands on: family, income, taxes, and transfer of control of assets. An agreement, commonly called buy/sell agreements, can be used to handle the four D’s. The concern of the family or income can conflict with the business. The business exists as a separate entity. Reduce conflict by developing mutual fair agreements and the desired level of income.
Creating a Business Exit Strategy
Once you understand the four D’s, include the following actions in the creation of your business exit strategy:
• consider incorporating your small business to legally recognize yourself and your business as separate entities
• find a method of determining the value of the corporation that can be done at least annually and will qualify under IRS standards
• develop an employee benefit plan that will assist with the departure of each partner in case of death, disability, or retirement
• plan for who retains company ownership and who gets paid off
The great American dream is to: build a business of your own; bring it to life; and make it successful. How you plan your small business exit strategy will determine your financial success. Just as building a successful business takes planning, hard work, and a little luck, so does leaving it.

Webinar February 9th………………………………………………….

Subject: HS Professional Practice Transitions Webinar: “Successful Exit Strategies”

All Dental Professionals

HS Professional Practice Transitions Webinar ~ “Successful Exit Strategies”

Tuesday, February 9, 2010 at 9:00 PM Eastern (1 Hour Session)

Webinar Registration Below


Kavo’s LED Up-Grade for existing Muliflex Owners……………
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• There is no downtime—clinicians can independently exchange the LED in their practice
• The LED lasts longer than halogen bulbs
• Extends the life of the couplers

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February 1, 2010 Posted by | 1 | Leave a comment

Time Quality Management

Cliff’s Notes for January 24, 2010

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

“The world is changing very fast. Big will not beat small anymore. It will be the fast beating the slow.”
Rupert Murdoch

In This Issue
• Just-In-Time Inventory & Time Quality Management Require an Employee Education!
• The BFC Syringe can add value!
• Implant Scalers, require a new tray set-up!
• Navigate Henry Schein’s World of Dental!

Just-In-Time Inventory & Time Quality Management Require Employee Training…………….
The following summary was copied from
In today’s manufacturing society, one of the most popular ideas that are circulating in the manufacturing industry is the idea of just-in-time manufacturing. There have been various journals, magazines, newspapers, and other published documents that illustrate the actual efforts of companies to develop and implement just-in-time processes. This document will define just-in-time manufacturing; the methods organizations take in implementing the just-in-time process, and the results of this implementation.
With this in mind, just-in-time manufacturing is the idea that companies should have manufacturing and purchasing strategies that reduce the time between the beginning of the manufacturing process and shipment to the customer. However, the actual development and implementation of these strategies are of difficult tasks (APCIc 1-6)
One significant idea about just-in-time manufacturing is throughput time. This is the time between the start of the manufacturing process and the end, where the product is ready to be shipped. Five key elements are involved in throughput time. The first element is processing time, or the time actually spent working on the product. Next is inspection time and moving time.
According to recent studies, just-in-time systems have helped keep inventories of American companies down. Ratios of inventory-to-sales have been declining for the past four years. However, due to the economy growing very slowly, finished goods inventories have increased over the past year.10
These basic ideas are not unique to Just in Time Manufacturing; however, they are essential in training employees about the just-in-time philosophy. Most companies have realized that the philosophy is an important component in the idea, development, and implementation of total quality management. TQM is similar to JIT in regards to goals, however, it hunt for as few errors as possible between each stage of production. Just-in-time philosophy is a tool that top-level managers use to implement total quality management (Ontario 1-4).
There are numerous companies that attempt to implement this type of philosophy successfully, and the steps that they follow are as followed. The first step to implementing TQM/JIT manufacturing is to train the top management then form a top-level team. The responsibilities of the team will include deciding upon an organizational structure and developing a plan to implement TQM/JIT within their organization. This plan to implement the strategy should include the organizational goals in regards to production and methods of how employees will be implemented with in this plan. The employee area must also include methods in regards to motivation and discipline. After all of this information is obtained and formed, then a plan ought to be used to begin the overall philosophy.
Just-in-time systems are being implemented in most companies, though some more than others. Those companies that acknowledge just-in-time philosophies and implement them fully as part of a complete total quality management system are quickly becoming players in the world market. Those companies that do not implement total quality management with an emphasis on just-in-time systems may be left behind as we go into the twenty-first century.

BFC Syringe Can Add Value…………………………………………………………………………………….
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The lightweight, pre-loadable design of Better Faster Cheaper (BFC) Syringes offers tremendous advantages over the standard automix gun technique. Start using BFC Syringes and:
• Stop trying to maneuver and control bulky mixing guns.
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• Stop wasting expensive material left over inside large mixing tips.
• Stop cross-contaminating entire impression material cartridges.
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Implant-Prophy+ Kit #1 most recommended by Hygienists; Graphite-Free Re-Sharpenable, just like a steel instrument. Autoclavable, multiple cycles up to 190C (375F) Standard geometries; Gracey 5/6, 11/12, 13/14, Columbia 13/14 universal. A specially designed sharpening stone is included in the kit. These scalers will not scratch any abutment system! Registered as an FDA Class 3 device.
Item #107-1132………………$99.99 (note: all discount programs will be applied)

Navigate Henry Schein – Quick Connect Menu Guide “One Call For Everything Dental”…………………
The size and resources that Henry Schein offers is extensive and can be confusing. If you can’t reach me on my cell (201-321-7494), the listing below may help.

Cliff Marsh
Henry Schein Dental
P.O. Box 663, 45 Rt. 46 East, Suite 605
Pine Brook, NJ 07058
tel. 201-321-7494

January 24, 2010 Posted by | 1 | Leave a comment

Employee Theft, Embezzlement & Fraud

Protecting Yourself from Employee Theft, Embezzlement, and Fraud

As a practice owner (also known as a “business owner”), a dentist will face a multitude of business related tasks, issues and challenges. However, the rewards far exceed the drawbacks to business ownership. But there will be challenges.

One of these potential challenges a dental practice owner faces is possible employee theft. Depending on the source checked, estimates for the number of dentists who will experience theft at least once during their dental career range from thirty-five to fifty percent (35-50%). Estimates of dollar loss range from $100 to $500,000+. This loss due to employee dishonesty may take the form of out-right theft, fraud, or embezzlement.

The good news: with certain minimal protective measures, the majority of this theft is preventable. The key is to understand where the potential exists for theft to occur and implementing the necessary strategies to prevent this loss.

Meet the Thieves
First on our list is “Jane the Eraser” (her name has been changed to protect the guilty). Jane simply withheld any cash payments that were made for services and then erased the patient’s account information after posting the payment (and giving the patient a receipt), thereby removing any record of the payment from the system.

How was she caught? She Quit! During the first couple weeks after her departure, the doctor noticed that although there was no significant increase in production, there was a definite increase in receipts. Upon further investigation, the doctor discovered that the computer records for several patients seen during Jane’s last week of employment no longer existed.

Estimated loss- $50,000+ over a three year period. The doctor recovered $25,000 from his office insurance plan. Jane got three years probation and was ordered to pay $10,000 restitution.

Recently we were contacted by a dentist who reported an even better technique. To cover her tracks his employee, who had worked with the office’s software system for four years, simply ignored the five warnings given by the computer before erasing the entire software system. The back-ups were also mysteriously “corrupted”.

Meet “Doris the Duplicator”. When hired, Doris had successfully lobbied against computerization, convincing the doctor that it was not as efficient as the old manual pegboard system. In turn, Doris kept a duplicate set of patient ledgers. Payments and receipts were recorded on the duplicate ledgers while charges were posted on the real ledgers.

Over a period of eighteen months Doris stole an estimated $40,000. She was caught when the doctor became suspicious and carefully personally tracked daily financial activity for a couple of days. Doris was not prosecuted and accepted a job with a different local dental office.

Mary the Master
Mary was one of the best we have ever seen. She was involved in 1)skimming, taking cash and not posting it, 2)layering, a technique involving the taking checks and withholding for posting later, and 3)had an excessive need for petty cash, going through about $100 per week. Mary also set up a second business checking account in the dentists’ name (she was the only authorized signer) and subsequently diverted the office credit card deposits to that account.
Mary paid all office bills, using erasable ink and thereby allowing for the checks to be made out to her personally and then changing them back to legitimate venders after they cleared the bank. The deposit slips never matched the bank deposits actually made and subsequently the checking account could never be balanced with the ledger.

But Mary’s most effective technique was to turn off the statement generator for most patient’s accounts. And this eventually led to her getting caught. The two doctors noted that while each year their taxable income had increased over the prior year, according to the computer, their accounts receivable had spiraled out of control and was showing a balance of $500,000+.

Feeling there may have been an error in how information was being entered into the computer, they called in a software specialist who discovered the statement generator problem. After resetting the statement generator, the computer promptly spit out 3000+ statements. These statements were mailed and the phone lines to the office began to melt as patient after patient called in to complain that this balance had been paid. Who handled all the calls and comforted the patients? Mary the Office Manager, of course, who promised to post credits to clear up the balances.

How was she caught? At one of the many extravagant parties thrown by Mary, another employee, while retrieving her coat from a closet, saw shoeboxes full of checks made out to the doctors. But not before, over a five-year period, Mary had embezzled $400,000. Apparently Mary had some “dirt” on one of the partners, so Mary was never prosecuted and nothing was recovered. Subsequently, the partnership was dissolved.

Before going any further, we need to define the different terms used to describe loss by “staff dishonesty.” Theft is simple defined as “the taking of another’s property.” This is also referred to as “the five fingered discount.”

Embezzlement is the theft of an employer’s property while in the embezzler’s trust. It is also defined as a misappropriation or conversion of entrusted money, property, etc. to the personal use of the employee.

Fraud is the intentional deception that causes another to give up his/her money, property, etc. The easiest to understand method of fraud is to submit a claim to an insurance company for work that was never completed. There have been multiple instances wherein the employee submitted these fraudulent claims, unknown to the employer. This provided funds that in combination with other methods of embezzlement allowed the employee to divert the payments to the employee’s personal use.

Understanding the Thief
Why do dental staff steal? There are different reasons for different individuals. For some it is the need for money. For others, feeling they have not been treated fairly, it is revenge. For many, feeling they are not compensated enough in light of how much the doctor “earns”, jealousy plays a major role. And for some, just like gamblers who continue to “lose” but continue to bet, it is the “excitement.”

Many staff that steal share certain characteristics. Many have life-styles beyond their means. Excessive debt and constant money problems accompany many. Many are also the victims of excessive family problems. These problems come from children, spouses or significant others, and “ex” spouses/significant others. Many have excessive habits including alcohol, drugs, and gambling.

What does an employee who is likely to steal from you look like? They are intelligent and knowledgeable in office procedures. They are personable and friendly. They are tireless, willing to put uncompensated over-time and rarely take their allotted vacation time. Basically, the perfect employee, except for a tiny character flaw-they are dishonest!

Signs Theft May be Occurring
The most common sign that theft by embezzlement may be occurring is patient complaints regarding their accounts. The problem with relying on this sign to deter theft is that most of time the person who handles the complaint is also the person doing the stealing. However, patient complaints that come to the attention of another staff person or the doctor must be carefully and fully investigated.

Petty cash should be used only for emergencies. Subsequently, constant requests for petty cash reimbursements should be closely monitored. Even outright theft of the petty cash in a multiple staff office is difficult to track.

Review of end-of-day reports may also show signs of a problem. Excess patient account write-offs or adjustments are a warning sign. So are “inactivated” patient accounts.
Increases in accounts receivables with no off-setting increase in overall office production is reason for concern. While this may indicate financial policies are not being followed, the problem may also be due to employee theft.

Missing documents-invoices, insurance claim forms, explanation-of-benefits (EOB) forms, patient checks, practice checks, checking account records, patient clinical records, patient account records, etc. are definite signs of a problem. So is sloppy filing and record keeping on the part of a staff person.

The practice checking account also holds potential signs of a problem. Unusual deposit patterns and deposits that frequently do not add up to the total posted by the bank are one sign. The inability to balance the checking account is another. Missing sequential checks are a third. Unfortunately, because of the quality of today’s copy machines, counterfeit or duplicate checks can also be an issue, which will lead to an inability to balance the checking account.

Methods of Theft
One of the best methods of avoiding theft is to understand how employees steal. Taking petty cash for the petty cash drawer and taking and not depositing patient cash payments are easy to understand. But today’s thieves and embezzlers are much more sophisticated.

We have all seen movies regarding what happens to individuals who are caught skimming from the “mob” or other unscrupulous individuals. The usual outcome is cement overshoes. Skimming is taking cash or checks before they are entered into the company books.
A sophisticated method of skimming includes a concept called “layering”. It is one of the most difficult methods to track and discover. In this theft, the first payment of the day is not recorded. As additional payments come in, the next payment is posted to the account that was skipped. This means the account that payment was supposed to be posted to has now been skipped. During the course of the day, this process continues including skipping a couple more patient’s payments. At the end of the day, the remaining skipped patients are simply deleted or adjusted.

If any payments were made in cash, these are easy to steal. If payments were personal checks or even insurance checks, they are frequently deposited either directly into the employees account (most banks do not pay any attention to the payee on the check, as long as cash is not requested) or, in some instances, the employee opens a second “Employer Named” checking account with only themselves as authorized signers of the checks. We have even seen instances wherein credit card payments are routed to this “personal account”.

Games with the practice’s checking account are endless. If a trusted employee is given control of a checking account, it is an invitation to disaster. Even if only the doctor can sign the check, use of erasable ink that can be changed after the check is signed and changed back when the bank statement arrives has frequently been used.

Duplicate payments wherein the original check has supposedly voided is one method. Some employees, authorized to actually sign checks (another invitation for a problem), have actually stolen checks, written them out for seemingly legitimate purposes, deposited them into their own account, and subsequently acquired the employer’s money.
Thefts involving the purchase of supplies provides another category of theft. Over-payments and double payments result in refunds. The refund subsequently disappears. A similar method involves the legitimate purchase, paid for by office funds, and then subsequently returned for a cash refund.

With today’s desktop publishing capabilities, developing a fictitious supply company is easy. Fictitious invoices are generated and the payments are deposited into the fictious company’s checking account. Guess who the account signer is?

Payroll theft is another means of stealing from the employer. Misrepresentation of the hours worked by an hourly employee is easy to understand. But this is just the start. Office managers have been caught miscalculating staff bonuses, with themselves the beneficiary of the error. Office managers have also been caught falsifying their own compensation rate. One doctor who used a payroll service discovered that his office manager had given herself a $2,000 a month salary increase. This had gone on for the prior eighteen months.

At the time she gave herself the raise, she also designated that all monies were to be split between federal and state income taxes withheld. The net payroll amount did not change, so nothing alerted the doctor at the time. And the doctor did not notice the change in the withholding deposits because the doctor himself took different amounts each month and was used to significant fluctuations in the tax deposits. The doctor never checked the accountant prepared W-2’s, so he did not catch it here either. And the employee, while she had to be patient, got huge income tax refunds.

Finally, there are the games played relative to patient accounts. Hiding patient payments that have not been recorded is easy if the patient’s statement generator has been turned off. Account adjustments are another way of hiding payments made but not recorded.

Some employees have hidden their theft by posting treatment for fees that were less than the doctor requested and the patient subsequently paid. In some instances, treatment was recorded with no fee at all. The patient paid in full, but the charges and payment was never posted (the treatment was posted, just no fee). Giving patients credits instead of posting charges is another means of hiding payments made but not posted.

Preventing Theft
Whether theft takes the form of fraud, embezzlement, or outright theft, theft by an employee shares three steps. For theft to occur, all three components of the theft triangle must be intact. The first is “Motive”. The employee needs a reason to steal. The reasons are as varied as there are individuals.

Next, they need the “Opportunity”. In a dental office, they need unimpeded access to the funds they are attempting to steal with minimal or no restraints, checks or accountability.

Finally, they need to be able to “Rationalize” their behavior. They need to justify in their mind that what they are doing is acceptable. They need to quiet their conscience.

The key to preventing theft is to break the triangle by attacking the only area under the control of the dentist. Steps must be taken to remove the “Opportunity”. Controlling access to those areas providing the “Oppor-tunity” to steal must be done to avoid theft.

Theft control begins by controlling how money is handled. Ever notice how when you go to the grocery store and pay by check, the cash register cannot be opened or a receipt given until the check has been inserted into the register where it is stamped for “Deposit Only”. All checks must be immediately stamped “Deposit Only” upon receipt. This means when the patient hands it to the staff person, or an envelope is opened containing a check.

Over-the-counter cash must be posted with receipt given before patient leaves. If a receipt cannot be issued for some mechanical reason, the doctor must be immediately notified (before the patient leaves, to ascertain how to handle the situation). Bank deposits must be made daily, even if only one payment has been made and recorded all day.

Splitting Money Handling Duties
Who handles money is as important as how it is handled. Preferably, two individuals should handle different aspects of the day’s receipts. The first clerical assistant should open mail-in payments, make a copy of any checks and/or EOBs, and make the deposit.

The second administrative assistant should post payments and prepare and audit the computer generated deposit slip. Any discrepancies must be immediately reported to the doctor. This individual, who has minimal money handling responsibilities should post adjustments/credits.

What happens if only one person is available. Someone other than this person must count and do the deposit. Deposit slips must be compared to computer generated deposit slip by doctor daily. Other possible people to do the deposit: the list includes the doctor, the doctor’s spouse, or a chairside. Some offices have required all monies put in a bank bag and had the bank do the counting and make out the deposit slip. This amount is then compared with the computer generated deposit slip.

Doctor/Accountant Responsibilities
The doctor must also do some of the money handling duties. He/she must authorize any account adjustments and check the adjustment report daily. They must authorize and check refund requests. They must sign and mail all checks if a staff person makes out the checks for vendors. Once the check has been signed, it should not be put back into the control of a staff person.

The doctor or his/her accountant must open and balance the bank statement. This means bank statements should be mailed to the doctor’s residence or directly to the accountant.

Either the accountant or a Payroll Service should prepare payroll. If a payroll service is used, it is the doctor or accountant’s responsibility to call the information into the payroll service.

Other Preventative Areas
Each office should use a time-clock and any manual entries must be initialed by the doctor. If the staff knows the doctor is monitoring the hours worked, they will be hard pressed to abuse/report extra hours.

Petty cash should be counted and balanced daily. The amount of receipts plus cash on hand should equal the same balance every day. The outside of the envelope containing the petty cash should be used to monitor the daily balance. Each day, the date, the receipt total, the cash total, and the sum of receipts and cash should be listed along with the initials of the person reconciling the petty cash.

When the age of computerization came to dentistry, one of the selling points was that computers would make it more difficult to embezzle. Nothing could be further from the truth. Whether computer related, computer enabled, or computer camouflaged, the use of computers has made embezzlement easier than ever unless the proper safeguards are instituted.
First on the list of preventing theft by computer is a thorough understanding by the doctor of the security features built into the office’s software. This information must be carefully reviewed with the software vendor’s support team to ascertain that access to various features of the system is correctly restricted.

No system should allow the “Deletion” or “Erasing” of accounts or charges by staff. More importantly, no system should allow deletion/disabling of the entire system (I have received two calls in the past two weeks reporting this office disabling event by a staff person suspected of theft).

The statement generator should never be turned off. Any patient having an outstanding balance must receive a statement. Patients who have paid their bill, think they have no balance, and do not receive a bill, are the easiest to have their payments “mis-appropriated”. Any patient complaints relative to payments and balances must be carefully investigated.

Computer reports are designed to assist in avoiding theft problems. But to work, someone (i.e., the doctor) must review them. These will only take a few minutes to review, but this must be done.

Adjustment, refund, and write-off reports should be read by the Doctor daily. Posting reports should be scanned by the Doctor daily. The doctor can quickly spot incorrect charges posted for procedures they have just performed.

The accounts receivable (A/R) aging report should be checked monthly. In addition, this A/R report should be discussed monthly with the financial coordinator. The financial coordinator should be prepared to respond to each account over 90 days old with why, what has been done, and when payment is expected. In addition to demonstrating that the doctor is monitoring things, which in and of itself will deter theft, this also greatly assists in making certain collection procedures are being followed, thereby keeping accounts receivable under control.

Dealing with Embezzlement
Dealing with embezzlement, fraud, and theft involves four steps. “Discovery” is the first step. The longer the period, the greater the loss and the bolder the thief becomes. It is the doctor’s responsibility to diligently observe what is going on in his/her office relative to the handling of money.

If theft is suspected or discovered, the next step is “Investigation”. Before making any accusations, the doctor must make certain that the evidence supports the alleged crime. This means reviewing entries, reports, patient account records, etc. to gather the hard evidence necessary to confront the thief.

“Prosecution” is the next step. This is sometimes harder for the doctor than the realization that their trust has been betrayed. But it is a necessary step. If not, the theft will continue, either from you or another doctor. This means calling the police.

Reasons Doctors Do Not Prosecute
Why do some doctors elect to forgo “Prosecution?” There are several reasons. Topping the list is the fear of a “slander suit.” Avoiding this allegation is the purpose of the “Investigation” stage. If you have the evidence, you are not guilty of, nor can you be accused of, “slander”. Involving the police once you are certain you have become a victim will aid in protection against these false allegations.

Many doctors fear to prosecute because of fear of the IRS. After all, they have unreported income. Herein lies a “Catch 22”. If one fails to report and prosecute the theft, the IRS takes the position that income has been fraudulently under-reported and they get very ugly about it. If one reports the loss to the authorities, the IRS views this as proof that a loss by theft has occurred and therefore the under-reported income is offset by the theft loss and no charges by the IRS will be levied.

Last on the list of reasons theft is not reported is the “Fear of Blackmail.” Some of the doctors suffering losses from theft are themselves involved in insurance fraud, unreported income, and/or income tax evasion. They know the offending staff member is aware of this and out of fear of retaliation, they elect to terminate the employee but not prosecute.

The last of the four steps of dealing with employee theft is “Recovery.” Total recovery is usually not possible. Even if successfully prosecuted involving a judgment requiring repayment, most staff members involved in theft no longer have the money nor do they possess the ability to repay, even if spread over a life-time. Actual judgments issued such as $50 per month until the amount embezzled has been repaid would require one hundred years of monthly payments to recover a $60,000 loss (that does not even include interest).
The best chance of partial recovery comes from the office insurance policy. Many policies contain a provision allowing for a flat repayment in the event of employee theft. Limits of $10,000 to $25,000 are common. The policy will pay the actual amount of loss or the policy limit, whichever is less. However, most policies require the reporting of the loss to police and prosecution if advised by the local district attorney (a guilty verdict is not required, just an attempt at prosecution).

Most theft, fraud, and embezzlement is avoidable if minimal safeguards are instituted. However, the doctor must take an active role. Those doctors who blindly trust their employees are the easiest targets and suffer the greatest losses.

Many new dentists who acquire their dental practice by purchasing an existing practice face the same problem relative to implementing safeguards that older dentists in practice for many years face. How to implement new procedures without creating the impression that the dentist does not trust the staff?

This one is the easiest answer. Blame it on your accountant. Tell your staff that your accountant has recommended certain changes be made in how things are done because the recommended changes represent better compliance with GAAP (Generally Accepted Accounting Principles). In this manner, these changes will barely be questioned, except perhaps for a staff person who is guilty of theft.

January 17, 2010 Posted by | 1 | 1 Comment

The E4D Hands-On Experience

Cliff’s Notes Special Invitation

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

“Experience E4D CadCam Dentistry”
Hands-On Session / February 19, 2010, 45 Rt. 46 East, Pine Brook, NJ. 10:00 AM – 3:00 PM

You can’t understand what E4D can do for your practice until you experience it 1st hand. This special hands-on session will be presented on Friday, February 19, 2010. Bring with you an impression, a poured stone model & an opposing bite. At the end of the session, you will leave with a metal free crown that is ready for insertion. Please follow the instruction below so that we can have the correct shade blocks to mill your crown.

For reservations and information, please contact me directly @ 201-321-7494
or call:
Joe Egan @ 201-978-2323
John Mayer @ 201-572-3053

Hope to see you on the February 19th. It’s a chance to see where dentistry is today and decide if this technology will work for you!

Cliff Marsh
Henry Schein Dental
P.O. Box 663, 45 Rt. 46 East, Suite 605
Pine Brook, NJ 07058
tel. 201-321-7494

January 16, 2010 Posted by | 1 | Leave a comment

Inventory Control, Your Business Can be a Power House

Cliff’s Notes for January 10, 2010

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

“A genuine leader is not a searcher for consensus but a molder of consensus”
Martin Luther King, Jr.

In This Week’s Issue
* Defense Wins Games, Part II – The Advantage of Inventory Control Software!
*Defense Wins Games, Part III – Your Business is a Power House!
* GC America gains “Kosher Status”!
* Teens Without Teeth, A DPR Web Exclusive!

The Advantage of Inventory Control Software…………………………………………
Every day the world is moving faster. Keeping pace with new state & federal regulations as well as rising costs of just doing business is devouring our most precious resource, time. We need to spend more hours today to generate the same revenue as we did in the past let alone increase it. We need to devote those hours to line items that increase production and retained earnings.

The cost of inventory (fluid, sustained or capital) for an organization based in production, such as a dental office, is negligible compared to the cost of managing it. Now I’ll explain that statement. According to an ADA survey of their membership on business expenses, dental supplies average 6.2% of gross production. That leaves 93.8% of operational expenses on a P&L statement that need to be addressed. Employee costs alone are approximately 30.3%. Now, in the real world, a 20% savings on dental supplies will change your P&L by 3/10 of 1%. However, if you have a $500k practice, you will still need to manage $75k in sustained inventory. Over the past couple of years, I have seen my clients, that instituted inventory software control, increase inventory turns, increase cash flow and realize more retained earnings. Retained earnings, that’s the bottom line, ask your financial advisor about the virtues.

What exactly will inventory control software do?
1 No more guess work with product numbers or sizes.
2 Product usage levels. See the last 3 dates a product was ordered as well as quantities.
3 Category expenses. See the exact amounts of products used for each category and the expenses (i.e. X-ray, infection control, cosmetic, etc.).
4 Monthly detailed expense reports to help form budgets.
5 Access to all national manufacturer free goods promotions and rebates.
6 Notification of all product promotions exclusive to your organization.
7 Proof of Purchase print-outs that eliminate the need of finding invoices for free goods.
8 Automatic coordination of quarterly purchases to obtain all free goods and rebates.
9 Direct access to warehouse inventory.
10 Next day delivery & 99.5% fill rates.
11 Instant UPS tracking of shipments.
12 Access to all invoice and credit reprints.
13 Less staff time spent on non-revenue generating responsibilities.
14 Control of supply expenses.

How much time does your staff spend shopping for prices? How much do you pay your staff? How much $$ are you really saving? Is their time more valuable doing something else like dealing with patients or scheduling? Your staff’s time is your investment, what’s the ROI?

Inventory control software is free and easy to use. It is a stand-alone program that does not affect any other software programs and offers its own on-line encrypted warehouse connections.

Your Business is a Power House!………………………………………………………………………..
It doesn’t matter how big your organization is or the clientele you service, if you focus your business relationships, your practice will run smoother and you will reduce your expenses as they relate to production. Here is a simple analogy, you can use light to illuminate a room or you can concentrate it and create a laser.

Years ago when I had a small company, we were looking for a new banking relationship. There is always a little intimidation when asking for money and we were no different until a trusted advisor laughed and called us a little power house. We had a clean operation that wanted to grow and needed solid business relationships along with experienced professional consultation to help us steer the ship. There wasn’t one bank that didn’t want to talk to us and show us their value in helping us “do business”. Doing business, or in your case is seeing patients and takes a lot of time. All of your business relationship need to respect that and earn their value by helping you maximize your production time.

If you are planning on practicing dentistry for more than 5 years, you will need a relationship with organizations that can provide all the resources you need when you need them. Start by looking at what your business requires on a day by day basis. Look at clinical, front desk, management, legal, financial, etc. Then select some companies to interview. Offer to focus your business with one source and in return, they need to show you what additional services and values they can offer.

The lowest price should not be the main criteria. Price shopping is a consumer mentality. Value shopping is a business mentality. As an example, we had wanted to add an addition to some commercial property. It was a 3600 sq ft cinderblock warehouse extension. We had plans drawn, got city approval and began interviewing contractors. The contractor we chose was the 2nd most expensive, $60k above the lowest, but we had a good gut feeling about a quality effort backed by some great recommendations. The work was done to specs and the contractor handled all of the issues. We were able to keep business flowing with nothing more than a few little speed bumps. We focused our business and the value of the service we got in return could not be measured. We invested in a relationship and the ROI was off the charts.

MI Paste by GC America Gains “Kosher Status”………………………………………

TEL: 718-258-5596 FAX: 718-252-8418
Rabbi Jehoseph Ralbag Rabbi Aryeh Ralbag
This is to state that the following products produced by GC CORPORATION located in Japan are under our Rabbinical Supervision and are KOSHERCHALAVI (Dairy) לאוכלי אבקת חלב נוכרי . Our Rabbinical Supervision visits the plant on a regular basis and has checked that all the ingredients are Kosher.
The following products are Kosher-chalavi:
שמות המוצרים:
Tooth Mousse
MI paste
Tooth Mousse Plus
MI Paste Plus
A D may be placed on the above items.
This certificate is valid until30/09/2010 We hereby affix our signature today 30/09/2009 in Brooklyn, New York,
Rabbi Aryeh Ralbag, Rabbinical Coordinator

Teens Without Teeth, A DPR Web Exclusive………………………………………………
December 30, 2009 |
web exclusive
Teens without teeth
A genetic condition prevents permanent teeth from forming. Hear from one woman living with the condition and what you can do to help.

By Lauren Bryant, Associate Web Editor

Mackensey Carter
Both mother and daughter suffer from the same symptoms. Their upper right and left laterals never grew in after their baby teeth fell out. “We’ve been told that this is a genetic condition,” said Mackensey Carter, a Georgetown student who learned of her condition at an early age.
“I discovered that I had this condition when I was very young because right when I lost all my baby teeth and my permanent teeth were coming in, I noticed that nothing was growing in the spots by my two front teeth,” she said. “I was already planning on having orthodontic work done and x-rays confirmed my condition.”
Studying the gene pool
Although information on this condition can be difficult to find, Drs. Rena D’Souza and Sylvia Frazier-Bowers from the University of Texas Dental branch at Houston, have been conducting a study about this genetic condition. According to the study, congenitally missing teeth can occur in two variations: hypodontia and oligodontia. Hypodontia is characterized by the absence of six or fewer permanent teeth, while oligodontia is characterized by the absence of more than six permanent teeth.
The researchers’ efforts revealed that a mutation in the PAX9 gene was responsible for a rare form of oligodontia, missing molars, in a Houston family. Finding more genes responsible for congenitally missing teeth may unravel the genetic code for all teeth, and it may potentially provide for genetic screening and new forms of treatment for individuals with this condition1.
Treatment options
For Carter, treatment options came from the orthodontist who discovered the missing bone and congenitally missing teeth during x-rays.
“The options he gave me for the future were either implants or a complete upper bridge,” Carter said. “ He explained that implants were the better option because they are more permanent and more cosmetically attractive.”
Carter’s orthodontist also recommended she wear braces to fix her bite and straighten her teeth before processes were put in place to repair the gaps and missing teeth in her bite.
“He recommended that I look into implants around the age of 18 because by that time my teeth would not be shifting as much,” she said.
Because Carter did not have any bone to support an implant structure for her upper right and left laterals, her orthodontist started by moving the two teeth on the other side of the missing teeth over so bone could grow in the gap where implants would eventually be placed.
After a few months, the teeth were moved back to their normal position and two prosthetic teeth were constructed and fastened onto her braces so the gaps would not be noticeable. After the braces were removed, the doctor constructed a retainer with prosthetic teeth to create the illusion that she was not missing any teeth.
Unfortunately for Carter, the orthodontic work that had been done to form bone for implant placement had not created bone with enough depth to withstand a fixed implant.
“This meant I would have to have bone grafting done, which is what my orthodontist was hoping to avoid,” Carter said. “So last summer I had bone grafting done so I will hopefully be able to get implants in the beginning of the upcoming summer.”
Advice for others
Getting multiple opinions about treatment options is the No. 1 piece of advice Carter has for other patients with her condition.
“Also make sure you speak to your dentist, oral surgeon or orthodontist about any worries or concerns you might have about your treatment plan so they can be addressed early,” she said.
Flexibility also is important, Carter said. It’s uncertain how teeth will respond to treatment. Patients must be willing to accept successful treatment along with failed treatment and remember each body reacts differently.
To dentists or other doctors who may be treating someone with this condition, Carter says to listen to that patient’s concerns about treatment.
“For me, it was important that my oral surgeon was very understanding about my situation and how it could be embarrassing or uncomfortable,” Carter said. “For all dental professionals, care about your patients’ emotional and physical well-being because dental procedures can sometimes be uncomfortable and worrisome to patients.”

Cliff Marsh
Henry Schein Dental
P.O. Box 663, 45 Rt. 46 East, Suite 605
Pine Brook, NJ 07058
tel. 201-321-7494

January 10, 2010 Posted by | 1 | Leave a comment

Defensive Business Strategy

Cliff’s Notes for January 3, 2010

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

“In a time of universal deceit, telling the truth is a revolutionary act.”
George Orwell

In This Issue
* Defense Wins Games, Offence Sells Tickets!
* ARUBA Software Advisory.
* Did Snap-On-Smile Get a Bad Rap?
* A Blog-Radio Event! Hey Marketing Genius!

Defense Wins Games, Offense Sells Tickets!………………………………………………..
For the last 10 months I’ve been talking about marketing & advertizing. I guess you would consider that the offensive side of the game plan and we do have a plan, don’t we. It is true that the best defense is a strong offense, but as the great Vince Lombardi once said, defense wins games. If by this time you haven’t engaged in a coordinated marketing campaign, you left thousands of dollars on the table, just over the last several months, and there is nothing more I can say to get you started except, call me! So, let’s start focusing, again, on defensive strategies.

To understand the concept of offense and defense you need to recognize that all business, in one aspect, do the same thing. They buy and sell goods and services. Henry Schein buys and sells goods and services (widgets) and so do you. We do it very well and enjoy sharing our knowledge and experiences with our clients. After all, we both service the same end user. Why try to re-invent the wheel? We understand that our success directly depends on yours.

The “sale” strategy is the offensive game plan, and when executed correctly, it can generate quite a bit of revenue. The defensive game plan, when coordinated correctly, will maximize the “retained earnings”. The concept is not rocket science, however, it does take time to discuss, plan and implement and I do suggest that you consult with professionals before attempting it on your own.

If you want to increase your future retained earnings, you need to start today. There has not been one dental office that I ever walked into that didn’t have thousands of dollars a year leaking out the holes. Most of the offices with the biggest leaks are the ones that worry about paying $1.20 instead of $0.99 for a gross of matrix bands. Now don’t get me wrong, cost is a major factor in a defensive strategy considering the defense includes supplies, rent, utilities, employees, accounting, insurance and any other expense that you incur that is necessary for you to deliver your goods or services. If the defense is strong, the offence has more time ($$) to do its thing, generate new revenue.

Inventory control affects about 15% of your annual P&L (profit & loss statement). That is based on an expense overhead of 65.6% (ADA survey). This year that percentage may increase a little do to the economy, but your inventory liability will or should remain at about 15% of your gross. Before we can control inventory, we need to define it.

Main Entry: 1in•ven•to•ry
Pronunciation: \ˈin-vən-ˌtȯr-ē\
Function: noun
Inflected Form(s): plural in•ven•to•ries
Etymology: Middle English inventarie, inventorie, from Anglo-French inventaire, inventorie, from Latin inventarium, from inventum thing found, topic, neuter of inventus
Date: 15th century
1: a / an itemized list of current assets: as (1): a catalog of the property of an individual or estate (2) : a list of goods on hand b : a survey of natural resources c : a list of traits, preferences, attitudes, interests, or abilities used to evaluate personal characteristics or skills
3: the quantity of goods or materials on hand: STOCK
4: the act or process of taking an inventory

To simplify it, your inventory is everything you own. However, for the purpose of this commentary, we’ll confine it to the 15% of gross production. The percentage is broken out (according to ADA surveys) as 7.2% for lab (fluid inventory), 6.2% for dental supplies (sustained inventory) and 2% for office supplies (sustained inventory). We’ll discuss the other 50% of the office expenses as we move through 2010.

Fluid inventory is the most profitable. Example: you can get paid for a PFM before the bill is due to the lab. Great cash flow, quick inventory turn. Sustained inventory is the day by day “widgets” you need to conduct business. This is what needs to be focused on to maximize its value.

When implementing an inventory control program, you have to concern your self with “carrying costs”. It is the hidden expense. An old friend once told me “don’t fall in love with your inventory”. Every day, everything you own costs you money. For consumable product to produce the greatest ROI (inventory is an investment) it needs to turn over rapidly. This is called “inventory turns”. All business strive to have an average12 inventory turns per fiscal year. Due to the usage levels all product won’t be used up that quickly but remember, we looking at an average and (12) is a goal. If you can average 6 turns, you have good control for a small business.

Carrying costs can be as high as 1% per month. A product sitting on your shelf for 30 days past it payment due date is costing you money. It doesn’t matter if its carbide burs or copy paper, you paid for it, and your money is in someone else’s bank account. At the end of January, the 10% you saved is now down to 9% and let’s not forget that the saving is considered taxable income on your P&L. Example: you purchase $500.00 worth of product (it doesn’t matter if it is copy paper or burs) that will last you 3 months. You saved 10% ($50.00). After 90 days, the cost of the deal would be realized at about $510.00 due to carrying costs and your tax liability on the deal will be about $15.00 (You saved $50.00 from your expenses and that shows as taxable profit). In the end, the 10% deal turned into a 5% deal, not taking into account the time it took to shop and make the purchase. You invested $500.00 for 90 days to save $25.00 or better yet, $8.33 / month, or $0.41 / day. Also, we did not take into account the time it took to facilitate the purchase or the accounting expenses involved. This is not how to make money! Ask your “dental” accountant.

Automation will give you the tools to move towards a “Just-In-Time” inventory. There is a reason Wall Mart embraced the concept. You are running a business. You’ve been to all the lectures about selling dentistry and generating revenue. How you address those suggestions is your decision and part of your standard of care, however, controlling your defensive expenses (inventory, work flow, liabilities & staff) is the common thread that all business has. Unfortunately, most dental offices don’t take advantage of the experts because it may require a change in thinking or worst, some money. I say, if it works don’t fix it, however, never stop trying to make it better! By the way, most dental offices don’t even know it’s broken and if they do, they don’t know how to fix it or are embarrassed to ask. There is no shame in asking. That’s why God created specialists.

If you have a $500k practice, your inventory exposure is about $75,000.00 per year. Who guides that investment, your assistant, hygienist, office manager or you? Do you have checks & balances? Is your inventory showing up on E-Bay? Have you discussed inventory exposure with your accountant and insurance adviser? Inventory control software is available from Henry Schein at no cost. Lunch & learn sessions are available to discuss concepts and provide training. I conduct those sessions personally.

The bottom line of any defensive program is cash flow and retained earnings. As a side note, inventory control software will also manage the required MSD Sheets and Chemical Inventory Lists that are required by O.S.H.A.

Aruba Inventory Control Software – User Advisory………………………………………..
Those offices using ARUBA Software should run the following reports to help facilitate a 2010 budget.
1. 2009 free goods Proof of Purchase report.
2. 2009 monthly detail purchase report.
3. 2009 category expense report.
If you have difficulty in printing any of the reports available, please contact me at any time.

Note: All manufacturer 2010 Q1 national promotions will be available on ARUBA, for viewing, by January 15, 2010.

Did Snap-On-Smile Get a Bad Rap?………………………………………………………………………..
I have been hearing some complaints about Snap-On-Smile. After researching some of the issues, it appears that most failures are with cases that are not ideal candidates for the prosthetic. Snap-On-Smile can be an excellent alternative to expensive cosmetics and can serve as temps for prolonged cases. The key words are “can be”. You need to be case selective. The following video may help better understand when the appliance can be most successful. For more information, please feel free to contact me directly, at any time.

For Immediate Release a Blog-Radio Event…………………………………………………
Jackie Doyle, Managing Partner of High Performance Dental, to be featured as Guest on Verasoni’s Web Radio Show, “Hey Marketing Genius”.

Little Falls, New Jersey. December 30, 2009. Jackie Doyle, of High Performance Dental will be featured as a guest on the popular web talk radio show, “Hey Marketing Genius” on Monday January 11, at 11:00am.

Ms. Doyle and host Abe Kasbo, CEO of Verasoni Worldwide, will discuss effective internal and external dental marketing. The discussion will focus on marketing strategies that will help dentists help promote and grow their practices effectively.

“This is a radically different business environment for dentists, and those dentists who recognize and capitalize on the new realities are inevitably going to do better,” said Abe Kasbo CEO of Verasoni Worldwide. “My discussion with Jackie Doyle will deliver meaningful strategies to our listeners to help them grow their practice,” continued Mr. Kasbo.

“Hey Marketing Genius” is hosted by Abe Kasbo CEO of Verasoni Worldwide. Verasoni Worldwide, along with its medical and dental group, Cambridge MedCom, is a fiercely independent Marketing and Public Relations Firm. The radio show delivers and discusses real world marketing communications strategies to help practices of all sizes thrive.

To tune into the show visit or call in to 347-539-5243 on Mondays at 11:00 AM.

To learn more about Verasoni Worldwide visit

Sunday, January 3, 2010………………………………………………………………………
Enjoy the day, tomorrow morning the starting gun will be fired for the race through 2010. It will be a good year to grow. The best time to grow a business is when the economy is down. It forces us out of our comfort zones and we begin, once again, to focus and be creative. As always, I am available at any time to address any of your questions or concerns.

Cliff Marsh
Henry Schein Dental
P.O. Box 663, 45 Rt. 46 East, Suite 605
Pine Brook, NJ 07058
tel. 201-321-7494

January 3, 2010 Posted by | 1 | Leave a comment

2 Inspirational Stories to end 2009

Cliff’s Notes for December 27, 2009

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

“Please forgive me, my eyes have grown tiered and week in the service of my country”
George Washington

In This Issue
Two Stories to end 2009, we’ll get back to the dental world next week.

Leadership & Respect
As I get older, inspirational stories mean more. I guess it’s because of the numerous victories and failures we all endure over the years. The victories are sweet but the failures make us stronger. A few of you know that one of my greatest heroes is George Washington. He lead by example and lived what he believed. He was an exceptional human being. The following short story is one of my favorites. The actual facts may have changed over the years; however, the basis of the story is true.

After the victory over England the Continental Congress needed to build a new government. Being very short on funds, it became apparent that they could not pay the army. The troops became disgruntled and a number of the officers wanted to take troops to Philadelphia to demand their pay or remove the congress and take control over the new union. The officers arrange to meet and discuss the plan. Washington heard of the gathering and walked into the room during the conversations. The room fell silent as Washington entered and spoke. He said, “Gentlemen, for 7 hard years many of our brothers have died fighting a war for our freedom and independence from tyranny. We did this to remove a tyrant, not to create a new one”. Washington then took out his pocket watch and not being able to see the hands clearly, removed a pair of spectacles from his pocket and put them on. The officers in the room were stunned. Washington had never allowed them to ever see any of his frailties or weaknesses. As he returned the spectacles to his pocket, he looked at the gathering of true patriots and said “Please forgive me, my eyes have grown tiered and week in the service of my country”. As Washington left the room, there was silence. Inspired by his pure courage and dedication as well as the respect and loyalty he commanded, the group dropped their plans and disbanded.

The Home Run
Just the other day I was watching ESPN’s Greatest Sports Moments of the Decade. I coached my kid’s sports for years. Most recently my daughter’s softball team so this story got to me. Everyone should hear this story. Compete hard, play to win, but if you give it everything you’ve got and today, your opponent comes out on top, respect their victory. ESPN showed the actual game film and coincidently, my oldest brother who lives in Maryland just sent me a link to a very short film created around the story. It’s called “The Home Run”. I hope you enjoy it and pass it on. The story is true; you can see the real film on ESPN. By the way, the girl was a senior; it was her last at bat in her last game. She never hit a home run.

If we do not have a chance to speak in the next few days, please have a safe and happy New Year!!


Cliff Marsh
Henry Schein Dental
P.O. Box 663, 45 Rt. 46 East, Suite 605
Pine Brook, NJ 07058
tel. 201-321-7494

December 27, 2009 Posted by | 1 | Leave a comment

Cliff’s Notes 2009 Holiday Message

Cliff’s Notes for December 24, 2009

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

“May God bless and keep you always, may your wishes all come true, may you always do for others and let others do for you.
May you build a latter to the stars and climb on every rung and may you stay forever young.
May you grow up to be riotous, may you grow up to be true, may you always see the truth and the light surrounding you.
May you always be courageous, stand upright and be strong and may you stay forever young.
May your hands always be busy, may your feet always be swift and may you have a firm foundation when the winds are changing shifts.
May your heart always be joyful and may your songs always be sung and may you stay forever young”.
Bob Dylan

Please allow me to take this time to thank you for all of your confidence and support throughout the past year. I look forward to working with you on the challenges we all face in 2010. We are now walking through a tough storm, but when we get through it, and we will, it will be sunny and warm on the other side.

Warmest wishes from my family to yours,


p.s. Please excuse the video. It was done at 4:00 in the afternoon on the last day of the New York Dental Meeting on the convention floor. It was just too easy! Imagine sending messages like this to your patient base? Next year.
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December 24, 2009 Posted by | 1 | Leave a comment

Direction According to Webster, Bone Grafting Materials

Cliff’s Notes for December 20, 2009

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

“A smart man speaks and a wise man listens”
Jimmie Hendrix

In This Issue
* Direction, According to Webster.
* Bone Grafting Material Up-Date.
* Learn Implants! Hands-on Education Center Opens in Clifton!

Direction! According to Webster…………………………………………………………………………….
Direction, according to Webster (for those of you of tender years, Webster defines the words in the English language), can be defined as; A general course along which something has a tendency to develop; “I couldn’t follow the direction of his thoughts”; “his ideals determined the direction of his career”; “they proposed a new direction for the firm”. Now ask yourself if you have a definite direction for your business and your career? A Football Quarter Back (American Football) gets possession of the ball on his own 20 yard line. He needs to see the goal line 80 yards away and formulate a plan on getting there or he doesn’t score.

It doesn’t matter how old you are or how long you’ll be practicing, your practice is one of your greatest assets. It can be a major part of your future financial independence. Unfortunately, most dentists leave 50% of there potential equity on the table because they didn’t have a plan. A dental practice that has annual collections of $1M would have an equity value of about $500k. If formulated correctly, the equity value realized could be $1.5-$2M. I’ll bet you just said B-S_ _ T. Well, just like a “dental accountant” can show you how to transfer tax liabilities into healthy revenue generating investments, a dental business consultant can help formulate a plan to move forward. A good friend of mine is an accountant and a member of the American Academy of Dental CPA’s. One of his lecture topics is “The 10 Biggest Mistakes a Dentist Makes”, Number 1 is waiting too long.

Let me ask a question; Are you a “for profit” organization? Unless I missed something along the way, most of us get up and go to work for 2 reasons, fortune & glory with fortune being high on the daily agenda. Increasing revenue on a daily basis is what we strive for. Everything we do is defined as ROI (return on investment). Why don’t we consider investing in the engine that drives our entire lives? Maybe we don’t because most of us think like general consumers. It’s time to think outside the box.

Last week I read a transcript of an interview with an industrial psychiatrist. The topic was technology and how it affects our behaviors and thought process. On-line marketing (the type I promote) actually puts us in a box. If you surf the internet looking at all the things that interest you, cyberspace knows. You will be bombarded with advertisements covering your range of interests and that will not you leave any time to explore what you don’t know about. That’s why we need to consult with professionals that have different interest and thought patterns. You need to stimulate your creativity with the things you don’t think about.

Implementing a business investment strategy is critical to long term financial success. It doesn’t really matter to me what impression material or composite you use. You’ll use what works the best for you. However, if I can help you do more dentistry and realize the financial rewards, you are going to need more supplies and if you need more supplies, you can get better prices. Wouldn’t it be wonderful if your biggest problem is how to legally reduce your tax liability because you made too much money? Then again, most of us are “smart men”, aren’t we?

As always, I am available at any time if you should have any questions or concerns.

Bone Grafting Material Up-date………………………………………………………………
I have been receiving a lot of requests for information on bone grafting materials. Below are links to the more popular brands.

1. Ossix Plus Resorbable Collagen Membrane. Distributed by OraPharma and sold through Henry Schein.

2. Healos Bone Graft Substitute. Manufactured by DePuySpine, a Johnson & Johnson Company, and distributed by OraPharma. Sold through Henry Schein

3. Ace Surgical has an assortment of materials, all available through Henry Schein.

4. Foundation, a collagen base bone filling augmentation material is distributed by J. Morita and available through Henry Schein

Hands-On Implant Training Center Opens in Clifton, NJ…………………………………..
Atlantic Dental Implant Seminars has opened a hands-on training center in Clifton, NJ. The center offers sessions on all levels of implantology. Implants 101 is a 2 days session and surgery can be preformed on site. ADIS has also opened a training center in Jamaica. The 7 day course is supported by the Ministry of Jamaica and the Linkow Institute. All accommodations are First Class. For more information, please follow the link.

Cliff Marsh
Henry Schein Dental
P.O. Box 663, 45 Rt. 46 East, Suite 605
Pine Brook, NJ 07058
tel. 201-321-7494

December 20, 2009 Posted by | 1 | Leave a comment

Arestin Through CVS Pharmacies, Implants 101, Radiation Monitoring

Cliff’s Notes for December 13, 2009

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

“So, you just want to be normal? You’re 21 years old and you have $50M in the bank. If you don’t like the publicity or the pressure, give the money back.”
Arnold Palmer to Tiger Woods just prior to Tiger winning his first PGA title.

In This Issue
* Arestin through CVS Pharmacies
* Implants 101
* Emergency Office Repairs
* Radiation Monitoring

Arestin through CVS Pharmacies……………………………………………………………
Let’s say that you have a patient that has perio issues in multiple sites. Arestin would be the answer, however the patients insurance won’t cover it or worst, they don’t have dental insurance. You can now utilize the patient’s medical prescription plan to obtain Arestin and all it would cost the patient is their co-pay. Here’s how it works.

Using the patient’s medical information, you fill out a short form and fax it to OraPharma. This process takes about 5 minutes. You then schedule the patient (min. 7-10 days out) OraPharma then transfers the information to CVS Pharmacies. CVS will contact the patient, process the co-pay and contact your office to confirm the appointment. This part of the process takes about 1 day. CVS will then ship the product to you 2 days prior to the patient’s appointment. There is no cost to you and the Arestin has been paid for in full. You would now charge the patient only for the administration of the medication. That could be $10.00/site.

For more information, please feel free to contact me at any time or you can speak directly to the OraPharma Account Manager in your area.

Implants 101……………………………………………………………………………………
If you want to learn about implants, consider looking into this organization. In New Jersey, there is a hands-on class room and surgery can be preformed at the same facility with instructors chairside. There is no affiliation with any one brand of implant so technique is the focus. The course is 2 days and the first session is scheduled for January 29th & 30th.

The 7 night hands-on session in Jamaica is not to be missed. Outside of a modern facility that is maintained by the Jamaican Ministry of Health, the package includes: Hands-on implant session, 7 night luxury resort hotel accommodations, entertainment, tips and more for 2 adults and a child for around $5500.00 plus 35 CE hours.

For more information, log onto

Emergency Office Repairs…………………………………………………………………….
Small emergencies arise all the time. Most of the time it doesn’t take a rocket scientist to figure out the problem. Little water leaks, air leaks, holes in tunings, if you can see it, you can fix it. DCI International supplies parts for just about any piece of equipment on the market. They have an emergency repair kit (#8071) that contains just about everything you would need to handle any small repair. The kit sells for $50.00 and pays for it’s self the first time you use it. Henry Schein stocks most DCI parts and recognizes the part numbers.

The following link will take you to the DCI Catalog in PDF Format. You will find it in the “service parts” section on page #3 (part #8071).

Radiation Monitoring………………………………………………………………………….
Radiation in dentistry is not a major hazard as long as we respect it. With new technology, the patient is exposed to no more radiation than if they were standing next to a big screen TV. Although the energy level of big screen is much lower than a dental x-ray, it is potent within several inches, a dental x-ray will disperse after 6 feet. That’s what we need to look at.

Would you allow your child to sit inches from the TV? Well, your staff are moving through the office continuously and in our part of the country, it is easy to pass within 6 feet of an x-ray. Here comes OSHA, don’t you just hate that acronym? I usually get requests for Dosimeter Badges when a staff member finds out that they are pregnant. Question, how pregnant are you? Answer, 10 weeks! Problem, what about the 2 ½ months prior? I call it a liability.

In business, every now and then you need to assume a defensive posture. Any staff member that is of child bearing age needs to have a monitored x-ray dosimeter badge. Please contact me if you require more information or log on to: or

Monday, December 14, 2009………………………………………………………………….
Please forgive the delay in this week’s Cliff’s Notes. The computer hardware Gods were a little mischievous over the weekend. Have a wonderful week.

Cliff Marsh
Henry Schein Dental
P.O. Box 663, 45 Rt. 46 East, Suite 605
Pine Brook, NJ 07058
tel. 201-321-7494

December 14, 2009 Posted by | 1 | Leave a comment