New Faces and Practice Management

Once again, it's time to congratulate the graduating endodontic residents and welcome the incoming class! We also have some new faces on the AAE Resident and New Practitioner Committee: Drs. Cameron M. Howard, Steven L. Richardson, Farid B. Shaikh and Craig B. Thiessen. Our AAE Board of Directors liaison is Dr. Kenneth P. Sunshine, who practices in New London, Conn. You can learn more about our newest committee members by reading the profiles we've included in this issue.

New residents are focused on education, but it is never too early to begin thinking about the business. No matter where your career takes you, solid management skills will contribute to your success. A recent survey of the graduate endodontic programs revealed that most provide some kind of practice management information to their residents, and program directors were anxious to include more opportunities and resources. We invited speakers who have presented on practice management at AAE annual sessions to share some tips with you in this issue of The Paper Point. We hope that you enjoy their articles.

One of our committee projects is to develop a database of business experts who provide services that may be valuable to us as residents or new practitioners. We would love to hear how your program prepares residents to manage a practice or to know what topics you would like to learn more about. Do you have the opportunity to visit and observe practicing endodontists in the community? Does your program invite speakers to lecture about practice management? Contact us at residents@aae.org. The more we hear from you, the better we will be able to serve your needs.

If you are interested in becoming more involved with residents across the country or are looking to learn more about the AAE, consider becoming your program's Resident Representative. The committee is very resident-friendly. You will be paired with the RNP member assigned to your program, and can direct any questions, concerns or information that you want to share about events and activities to this liaison. This is a great way to provide your ideas to the committee and get feedback in return. If you are interested in becoming a resident liaison, please notify your program director now! We are looking for one representative from each endodontic residency program.

Lastly, the seventh annual APICES was just held this past weekend, July 23 – 25, in Chapel Hill, N.C., at the University of North Carolina. One of our new committee members, Dr. Richardson, and his fellow residents put together a terrific program for everyone. The RNP Committee members were there too.

We are always looking for feedback or information to share with our colleagues. If you have questions or submissions for The Paper Point, please contact our AAE staff by e-mailing residents@aae.org, or by calling 800/872-3636 (North America) or 312/266-7255 (International).

Warm Regards,

Kimberly A.D. Lindquist, D.D.S.
Chair, Resident and New Practitioner Committee

Good Practitioners Manage, Great Practitioners Lead
Submitted by Joel C. Small, D.D.S., M.B.A.

Leadership is one of the most misunderstood and misapplied concepts in the dental profession. Because most of us have no formal training, we tend to see leadership in terms of deeds of epic proportions being performed by larger-than-life heroes. Nothing could be further from the truth. Leaders are people like you and me, and at its core, leadership evolves from our ability to define our values and align those values with what we do.

Defining our values is a personal endeavor that requires thought and introspection. Although the limitations of this article do not permit a lengthy discussion of this process, I recommend that you read an excellent book on this topic: A Hidden Wholeness: The Journey Toward an Undivided Life, by Parker J. Palmer.

Over the past couple of years, I have had the honor and pleasure of visiting with residents and young practitioners regarding their plans to transition into private endodontic practice. Often our conversation turns to these issues of practice management, and many of you may have heard me say that a good practice can be managed, but a great practice must be led. The choice to become leaders may be the most important decision that we make as practice owners.

Unfortunately, dentistry is just now coming to realize what business organizations have known for some time: leadership is the missing link that can transform businesses and endodontic practices alike. Leadership training is now a $12-billion-a-year industry in America, and comprises the largest single expenditure of the corporate training budget of American corporations. A financial commitment of this magnitude is proof that corporate America understands the significance of leadership to their bottom line. To help you share in the lessons this kind of training provides, I’ve outlined some of the benefits brought about by organizational leadership below:

  1. Leadership increases productivity and profitability. Numerous studies prove that value-based leadership results in higher productivity and profitability than quantitative or results-based management approaches.
  2. As leadership skills increase, management problems decrease. People will commit to values. They can only comply with rules. Value-based leadership creates a culture of commitment versus compliance. To paraphrase a famous quote that I often use, "If cultural values are present, rules are not necessary. If cultural values are absent, rules are irrelevant."
  3. Leadership improves staff retention and recruitment. In more than 30 years of private endodontic practice, I have observed that well-led practices become magnets for exceptional staff.
  4. Leadership creates a happier and more fulfilling environment. Value-based leaders believe in the value of people. They understand that it takes much more than money to create a happy and fulfilling environment. They know this because it is much more than money that brings them joy and fulfillment as a leader.
  5. Leadership fosters commitment. A significant body of research has found that there is a strong causative relationship between the values of the leader and the culture of the organization. This relationship becomes even stronger in smaller organizations. As such, leaders of small organizations like endodontic practices who have identified their deeply held values, will create a clear core ideology to which organizational members are able to align. Alignment to commonly shared values is the essence of organizational commitment.

These are just some highlights of the business side of leadership. Honing leadership skills brings many personal benefits that are perhaps of even greater importance.

Joel C. Small, D.D.S., M.B.A.
Dr. Small is in private endodontic practice in Plano, Texas. He received his endodontic training at the University of Texas at Houston, and his M.B.A., with an emphasis in health care management, from Texas Tech University. He lectures throughout the United States on the topics of leadership, practice management and specialty practice transitions. He is a co-owner of Phase Two Associates, LLC, a specialty dental practice brokerage firm located in Dallas, Texas. Phase Two Associates deals exclusively with practice transitions for the dental specialist.

Make the Answer "Yes"
Submitted by Kirk A. Coury, D.D.S., M.S.

A friend of mine taught me a very important lesson, although I didn’t realize it until many years later. Whenever I asked him for a favor, he would say "yes" before he even knew what I wanted. Then, he would follow with, "Now, what's the question?" His response, the same no matter the time of day or circumstance, always put me at ease and brought a smile to my face. He made me comfortable because I knew that he would come through for me. Did it mean that he would do the impossible or risk life or limb to help? Probably not, but it was more about the relationship between us than about the literal act of saying yes when he had no idea what I wanted.

Building and maintaining referral relationships is a lot like that. In today’s highly competitive endodontic practice, it is crucial that we set ourselves apart from the competition. There are many ways of doing this. Aside from the most important facet of establishing relationships, we must know who we are and what kind of practice we want to manage. Secondly, we have to develop a brand that accurately reflects that vision, and lastly, we should capitalize on our strengths and reinforce those qualities that make us unique. Availability is one area that can set you apart and build your practice.

When referring dentists call to make an appointment for their patients, it is typically an "emergency"—the patient must be seen immediately! There are times when it can be very inconvenient to work that patient into your schedule. But in a new endodontic practice, seeing that emergency patient can be crucial to busyness and practice development.

Even in more established practices, emergencies are part of what we do as endodontists. You could tell the referring office that you don’t have time. You could explain that you are in surgery, then lunch, then two more surgeries. You could sigh and say, "I just don’t know where we’re going to put him." Let me suggest, however, that you consider the concept of "owning the patient." Have the patient come right over. This will allow you to assess the situation for yourself, determine the best treatment, and decide what to do for that individual and when.

Often, the patient will opt for a one-visit treatment, if possible, with one injection rather than multiple visits to treat their problems. But regardless of this result, you will own the patient! In our office, we tell our staff that our referring doctors are not interested in our internal problems. They do not need to know the details of our scheduling conflicts or any other administrative details. It is perfectly fine to let them know we're busy (after all, busyness equals success) and subtly imply that we are accommodating them specifically. Besides allowing you to triage the patient personally, having them come right over is good marketing.

Ask your scheduler to say something like this, "Dr. Coury has given me explicit instructions to always see your patients, Dr. Peters, so please send them right over." By doing this, you ensure that the patient will not be sent to your competitor's office. It won’t take long to determine if this referrer truly values your services and availability. I have found that what the referring dentist really wants is the assurance that their patients are "taken care of." Ability is expected; availability is desirable, and can be accomplished through our willingness to be accommodating, and by training our team that a practice philosophy of "the answer's yes, now what’s the question?" will help us not only build our referral base, but set ourselves apart in a very unique way.

Kirk A. Coury, D.D.S., M.S.
Dr. Coury is a graduate of Baylor College of Dentistry in Dallas, Texas, and received his Certificate in Endodontics from the University of Texas at Houston. He is a Diplomate of the American Board of Endodontics and an active member of organized dentistry, having served on various committees of the AAE and as a past board member of the AAE Foundation. Dr. Coury practices full time and is a partner with Amarillo Endodontics, LLP in Amarillo, Texas, which he founded 20 years ago. Aside from the clinical aspect of endodontics, Dr. Coury has a special interest in marketing, referral relations and public awareness as it pertains to building and maintaining successful endodontic practices; he is currently involved with all aspects of marketing activities at Amarillo Endodontics.

A Place to Call Home
Submitted by Jane Peck, RN, M.B.A.

"I’m just looking for a place to call 'home'"—How many times have I heard that from someone who is no longer working for me?! In 2006, the average length of stay (turnover) of dental staff was two and a half years. While many offices have seen little turnover since the recession began, it is not a fair indicator of staff satisfaction, given that available jobs have been limited. Costs of turnover are both tangible and intangible; they include lost productivity, disappearing knowledge about your practice, reduced customer satisfaction and lost profits.

Understanding what makes employees happy and willing to stay at a job is critical to reducing turnover in the workplace. For the first time in history, there are four generations of workers in the workforce at one time, adding new challenges for employers. Generation X employees (born 1965-1981) seek "career security" and thus strive to expand their knowledge to advance their careers. If you do not provide opportunities for growth within your practice, they will seek them elsewhere. Unlike baby boomers who were willing to work long hours, Gen-X and Millennial employees seek a strong work-life balance. Millenials (born 1982-2000) tend to express a need to understand the big picture and their role in the organization. It is important for them to know they are making a difference in their work. Awareness of these generational issues in potential employees will help you to create a workplace environment that supports staff retention.

Early in your career, take time to put in writing what values you want to emphasize in your delivery of patient care. Your values should drive your hiring process and be communicated to your staff periodically. They might read something like this: "exceptional customer service, integrity, innovation and fun." As the leader of the team, it is your responsibility to create a workplace culture and establish ground rules for behavior in your workplace that will make staff feel safe sharing their concerns. By exhibiting leadership that encourages a stimulating work environment and fosters personal and professional growth, you can communicate a strong commitment to your employees—a reason often cited by happy employees for staying with an employer.

While pay is on the list of reasons why employees leave, it is not at the top, so don’t open your wallets just yet! The truth is that the most important thing a staff wants does not have to cost a dime. Consider this: the most often-voiced complaint in a workplace is "We don’t feel appreciated." Take time to listen to your employees and make them feel involved. Helping your staff understand your vision and allowing them to participate in its evolution will keep them engaged and create loyalty. You can’t praise enough! Acknowledge contributions. Encourage employees to seek out new learning opportunities in the workplace. Show them you are committed to their success as well as your own. A mentor once shared with me, "We all want to be loved." Take the time to show your employees that they are appreciated and they will call your office "home."

Jane Peck, RN, M.B.A.
Ms. Peck is the practice administrator for Endodontic Specialists of Colorado, P.C., an endodontic group practice with 29 staff members and seven endodontists serving the Front Range of southern Colorado. Jane received her undergraduate degree from the University of Southern California in Los Angeles, a nursing degree from Mount St. Mary’s College in Los Angeles, and her M.B.A. from the University of Colorado in Boulder. She has been working in the health care field for over 25 years. Jane has been an affiliate faculty member for Regis University Health Care Administration M.B.A. Program since 2000.

Creating Local CE Creates Earnings
Endodontists Can Establish Partnerships by Offering Continuing Education Opportunities
Submitted by Diwakar Kinra, D.D.S., M.S.

In today’s turbulent economy, many practitioners are facing greater challenges than ever before. The ongoing problems have been well documented, and they range from decreases in insurance benefits for current employees and retirees to the outward migration of many long-time residents. The country’s high unemployment rate has created an environment that makes it remarkably more difficult to attract new patients and retain those that are currently active with their dental treatment.

While it would be easy for us to bury our heads in the sand, turning such a cold shoulder to the reality of the situation would be the most counterproductive step of all. Instead, to take a proactive step in confronting the issues at hand, we must capitalize on our biggest asset—our networks. Specifically, we must access the strong, vibrant and forward-thinking continuing education offerings provided by local dental societies.

While one may not first think of CE as a way to boost your bottom line, there’s substantial merit to the idea that through a united network of professionals, long-term relationships can be established and nurtured, leading to increased treatment acceptance rates from patients.

If you’re not attending state and local CE meetings, you’re missing out on valuable networking opportunities. Similarly, if you’re not attending these meetings, you’re missing out on the opportunity to enhance your clinical skills while gaining a better understanding of how to present a given treatment plan to a patient, or more efficiently perform the newest dental procedures.

As a new endodontist to an area, you can become a valuable asset to your local dental society by giving back to these CE opportunities. Take the time to learn how to provide CE credits, whether it is through the ADA, state dental association, local dental association or industry. Your first presentation should be a topic you are familiar and comfortable lecturing on to groups of dentists. Prepare about 1-2 hours of material.

Informing general dentists about case selection and the quality of endodontics in your office will allow them to concentrate their efforts on procedures they are more profitable performing. It is important to convey that performing quality endodontics will make their crown and bridge work that much more successful. If content for a lecture is difficult to obtain, ask your program director, turn to the AAE or inquire with your local endodontic supply representative. A presentation will make a larger impact in marketing yourself than several other activities might accomplish. After a few successful presentations, you will be known as the local expert and a well-versed specialist in your area.

Another strategy to identify yourself as a leader is to team up with other specialists to provide cross-disciplinary CE. Focus your efforts on incorporating cutting-edge technology and the newest dental procedures that may not yet be part of the dental school curriculum. Also be sure to emphasize how your course will make your referring dentist more knowledgeable and profitable. Try working through study clubs, lunch-and-learns or local organized dental meetings. You might include a lecture series, such as hands-on workshops for practice management, all porcelain restorations, pediatric care, implants or an orthodontic update. Ultimately, the objective is to help local practitioners learn from local experts, allowing a dialogue to continue even after the course is concluded. Stress how you will always be available to the participants for follow up after the course is completed—and be sure to live up to that promise!

As you can see, in addition to the standard CE offerings, a local dental society can provide education courses that are relevant, timely and have the opportunity to keep all members well networked. Through networking, all of us learn from each other and become better connected, better clinicians and better business owners.

Diwakar Kinra, D.D.S., M.S.
Dr. Kinra received his dental degree from the University of Michigan School of Dentistry in 1999. At that time he proceeded into private practice for the next three years. In 2002, he retuned to obtain his masters degree in endodontics at the University of Detroit-Mercy School of Dentistry. In 2004, after the completion of his postgraduate degree, he immediately began his solo private practice limited to endodontics in Flint, Mich. Dr. Kinra is an adjunct professor of graduate endodontics and graduate periodontics at the University of Detroit-Mercy School of Dentistry. He is also an adjunct professor of graduate endodontics at the University of Southern California. He serves as the committee chair for the ADA Committee on the New Dentist. Dr. Kinra has spoken on clinical endodontics and practice management since 2005. He has spoken at over 20 universities domestically and internationally. Clinically, his lecturing focuses on cleaning, shaping and packing the root canal system. On the practice management aspect, Dr. Kinra provides insight on how to transition from graduate endodontics into clinical practice.

New Faces of the Resident and New Practitioner Committee

Cameron M. Howard, D.M.D.
Dr. Howard graduated from Nova Southeastern University in Fort Lauderdale, Fla., with a Certificate in Endodontics and a M.S. in dentistry in June 2010. He has plans to move to Tampa, Fla., and work for a dental group firm. He will be moving with his wife, who will be attending the University of South Florida to complete a pediatric medical residency.

Steven L. Richardson, D.M.D.
Dr. Richardson has been part of public health dentistry since 2001 as a dental assistant, dental student and finally as a dentist. He was a member of the inaugural class at the Arizona School of Dentistry and Oral Health in Mesa, Ariz.; he graduated in 2007 after completing six months of internships. Upon graduation, he worked at Maricopa Integrated Health Services, a public health hospital in Phoenix, Ariz. His principal areas of interest were endodontics, HIV patients and Hispanic patients. Dr. Richardson began his endodontic residency, where he still remains, at the University of North Carolina in June 2009. Although it has been one of the most challenging and difficult years of his dental career thus far, it has been the most rewarding.

Farid Brian Shaikh, D.M.D.
Dr. Shaikh is currently an endodontic resident at Albert Einstein Medical Center in Philadelphia, Pa. He and his wife recently moved back home to Philadelphia from Honolulu, Hawaii, where he completed a one-year AEGD program through Lutheran Medical Center. He received his undergraduate degree and his D.M.D. from Temple University and the University of Pennsylvania, respectfully. He was inspired to become an endodontist for a combination of reasons: his fascination with the complexity of the field, the ability to relieve patients from excruciating pain and the fact that there is so much unknown about endodontics, meaning there is always more to learn in the field. Outside of endodontics, Dr. Shaikh has a passion for learning and exploring new things—he enjoys hiking, kayaking, scuba diving and other outdoor activities. He spent time studying abroad in Italy and completed international missionary trips.

Craig B. Thiessen, D.D.S.
Dr. Thiessen currently practices at his private practice, Thiessen Endodontics, in Wausau, Wisc. He received his B.S. in biomedical science from St. Cloud State University and his D.D.S. from the Indiana University School of Dentistry. After practicing general dentistry for three years in Wausau, he obtained his Certificate in Endodontics from Indiana University School of Dentistry in 2010. Dr. Thiessen likes the challenge involved in endodontics—consistently providing the highest quality of treatment in both nonsurgical and surgical root canal therapy. He feels that the specialty fits him well because of his passion for detail-oriented work and surgery. Outside of endodontics, he enjoys golfing, travel and fishing.

Do You Have News to Share?

The Resident and New Practitioner Committee is looking for fun news about your program to include in the next issue of The Paper Point, the quarterly e-newsletter sent to all residents and new practitioners.

  • Have any exciting happenings in your program?
  • What were your residents up to this summer?
  • What types of groundbreaking research are happening at your institution?
  • Any famous alumni?

Please direct all questions or send any news items to Alyson Hall, AAE development coordinator, at ahall@aae.org, or by calling 800/872-3636 (North America) or 312/266-7255 (International), ext. 3008.

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American Association of Endodontists
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