November 2013 E-Newsletter

Practice Management, Residency Program Profile and More

This is an exciting time of the year with spectacular and mesmerizing fall colors! Summer seems to be in the recent past when we enjoyed basking in the sunshine, and now it’s time for some cool breeze. On a parallel thought, this is a thrilling time for multiple reasons—the junior residents have settled into their new life in the endodontic community and the senior residents have started exploring opportunities to carve their careers. The 2013 Fall Conference in Las Vegas, held November 14-16, just ended. The Resident and New Practitioner Committee is planning next year’s APICES at the University of Texas Health Science Center at Houston. There’s plenty of excitement in the air, and I bet you all are feeling the same way.

In our effort to continually serve residents with useful information, this issue of The Paper Point highlights an article by Ms. GorgAnna Randolph from PBS Endo. On behalf of the committee, I thank her for putting together this very practical information on practice management. I feel fortunate to be able to have a bite from her expertise of many years. I am sure all keen readers will enjoy her article and benefit from it. You’ll also have the opportunity to read an article about marketing to increase referrals, something most of you will be closely involved in soon.

I am happy to announce that we have added a new feature, Residency Program Profile. Taking into consideration that we all are like a big family spread across the U.S., I think it’s a great idea to know our family members a bit better!

I would like to thank our committee members for reaching out to the residents via the Resident Network. Also, Ms. Debby Rice and Ms. Alyson Hall have contributed countless hours towards the success of The Paper Point and all committee activities, wouldn’t have been possible without their support.

I wish you all a great season of celebration with your family & friends.

And, don’t miss out on the CRAZY CASE!


Manpreet Singh Sarao, B.D.S., D.D.S.
Chair, Resident and New Practitioner Committee

The Key to a Successful Practice: Employees
By GorgAnna Randolph, CEO, PBS Endo

One important key to a successful endodontic practice is the people in that practice. Everyone in the practice projects the culture of the practice, which gives referrals and patients a sense of who you are.

Let’s look at some examples of great practices and struggling practices, each with staff that exemplifies the culture and attitudes of the practice.

Examples of Key Employees
One of the most undervalued positions in so many offices is the receptionist, who is usually the person who provides the first impression of the practice to referrals and patients. When you speak to someone on the phone, you can sense if that person is happy, confident and eager to help you. You also know when someone is irritated and feels rushed. 

The office manager or business assistant interacts with your referrals to coordinate patient care. Referrals know when they are working with an office manager who sees that referral as a priority. The office manager can project the idea that she understands that the endodontic practice is an extension of the referral's practice. Patients know when they are working with an office manager who will help them throughout the process and minimize the hassle of all the financial details.

An assistant is required for more than just sterilization and procedures. An assistant can guide a patient and help the entire practice flow seamlessly as a liaison for the patient through the process in the office. Imagine an assistant who can put a patient at ease with a smile, a touch and confident words. 

Costs of Mediocre Staff
If an employee leaves or you decide to replace an employee, the cost of replacement is high. Studies have shown that the cost of employee turnover is 20 percent of salary. For example, an employee earning $40,000 will cost $8,000 to replace; and that's just the measurable cost! What about the intangible costs? Time has been wasted training someone who isn't performing to your level. Lower productivity is stressful for other employees who have to cover for others; each day feels a bit more chaotic. Mediocrity breeds irritability. Ultimately, everyone begins to develop a poor attitude.

Referrals and patients know indifference and unhappiness when they see it. We all can sense when the information we're getting seems inaccurate. Since referrals see the endodontic practice as an extension of their practice, referrals want to refer their patients to an upbeat, confident practice. 

With a mediocre staff, your practice may see fewer referrals and patients. With a motivated, energized, capable staff, your practice can be very successful.

Employees make or break a practice. Invest a little time and energy into finding and retaining the right team. It's worth it!

A 49-year-old African American female presented with a chief complaint, "I have had some sensitivity near my upper front teeth for about a year." The patient’s medical history was non-contributory, and she did not report taking any medications at the current time.

The patient was seen in the Post-Graduate Endodontic Clinic at Nova Southeastern University, where multiple radiographs were obtained as well as clinical photos and a clinical exam were performed. There was marked bony expansion over the apex of tooth #8 with slight palpation sensitivity over the apices of teeth #7-10; the involved teeth were also percussion sensitive and were free of any restorations. The patient denied any history of trauma to any of her dentition.

Radiographically, there appeared to be a mixed radiopaque/radiolucent appearance of the alveolar bone and this was seen in the maxillary and mandibular anterior regions. The initial differential diagnosis was Periapical Cemental Dysplasia (PCD); however, vitality testing revealed that teeth #7, 8 and 9 were non-vital. All three teeth were endodontically accessed and necrosis of the pulp was confirmed. The patient was advised to have full blood work performed by her medical doctor to rule out systemic conditions such as Sickle Cell Anemia, which may present with a similar radiographic appearance; the bloodwork was inconclusive.

The reasoning behind the necrosis of #7,8,9 and the appearance of the bone has still not been determined. The case is still in process but once endodontic treatment is complete, a hard tissue biopsy will be obtained.

What do you think the diagnosis is? Tell us!

Submit your Crazy Case to for a chance to be featured in an upcoming issue of The Paper Point!

Residency Program Profile

In an attempt to acquaint residents with their peers across the nation, the Resident and New Practitioner Committee would like to introduce the Residency Program Profile as a reoccurring feature in The Paper Point. In each issue, you can read questions and answers from residents at an endodontic program to learn more about their personal experiences at different institutions.

University of Texas Health Science Center at Houston, School of Dentistry, Department of Endodontics
Drs. Valerie Okehie and William Pack (both are currently serving as co-chairs of the APICES 2014 planning committee)

  1. How many residents are in the endodontic program?
    Nine residents total (five first years, two second years, and two third years). The program is undergoing a transition from a three-year, two-resident program to a two-year, five-resident program.

  2. How many different places in the country/outside of the country are represented by residents in your program?
    Iran, Pakistan, United States, India, Nigeria, United Kingdom and Brazil.

  3. Where is your program located in the city of Houston?
    The program is located in the medical center, at 7500 Cambridge Street, Houston, TX 77054.

  4. On average, how many hours a week do you spend in the clinic?
    We spend roughly 28 hours in clinic per week—7 hours total on Monday for morning and afternoon sessions, 4 hours total on Tuesday for afternoon sessions, 7 hours total on Wednesday for morning and afternoon sessions, 3 hours total on Thursday for morning session, and 7 hours total on Friday for morning and afternoon sessions.

  5. What is your favorite thing about endodontic residency at UT Houston?
    I enjoy the fact that we have access to a wide variety of faculty who bring with them different backgrounds and experiences. Because of this, we have the luxury of learning from these faculty a multitude of techniques for handling and treating cases.

    Also, the new endodontic clinic is like working in a brand new office. We each have our assigned bay with rear-mounted microscopes.

  6. Are you given hands-on experience with new endodontic technology?
    Yes, we are encouraged to treat every case using the microscope. We are also encouraged to obtain CBCTs on cases requiring surgery and are provided guidance on how to be able to read a CBCT accurately.

  7. What is something unique about your program no one else would know?
    We are very research-oriented and will be represented by 10 presenters at the 2014 AAE Annual Session.

    We have several guest lecturers come in throughout the year to speak about various topics, materials and techniques. It’s beneficial to hear and subsequently discuss among ourselves, about different viewpoints and new technology in endodontics.

  8. Is there anything else you would like people to know about your program?
    We are not bound to using one type of file or specific ideology. We are able to try different file systems, techniques and materials. This allows residents to see the pros and cons of the endodontic materials that are on the marketplace today.

    It's FABULOUS Program with FABULOUS residents and FABULOUS faculty!

Stronger Referrals Starts with Stronger Marketing
By Tina-Marie Adams, senior vice president, Ketchum Public Relations

Our referrals are down…. Our referrals are flat, and we want to grow…. We need more “A” and “B” referrers.

Have any of these sentiments ever crossed your mind? If so, it’s clear your practice needs to start or improve your dentist marketing. And you’re not alone.

Consider this context: in a 2011 AAE Busyness Survey, roughly half of members said they experienced a decrease in practice busyness in the previous 12 months. Endodontists identified three factors that contributed to the decrease: the economy causing patients to decline treatments, competition from general dentists who are performing their own endodontics and alternative procedures such as implants.

At the same time, the majority of members say they are not engaged in efforts to market their practice. And yet, of all the factors in practice busyness, this is the area you have the most control over! Marketing can make a defining difference in your referrals, just as it makes a defining difference for other small businesses.

But do dentists embrace more outreach from endodontists? General practitioners say yes.

The AAE’s referral research shows that general dentists want and welcome more communication from their endodontist partners. Respondents suggest endodontists improve their communications in a number of ways, most notably by increasing the overall volume of communications and/or communicating in a more timely manner.

But does that leave you saying: Where do we start our dentist marketing? Or, We do marketing, but things are feeling stale or it’s not working.

The GP Referrals Study provides guidance here too. General dentists say what they most want to hear or understand about you falls into the areas of expertise, patient satisfaction and partnership. And the channels they are most receptive to range from in-person meetings and office visits to Lunch and Learns and continuing education seminars.

But you can’t build your marketing house without a solid foundation. The free Professional Outreach Toolkit – grounded in AAE referral research as well as proven best practices –will walk you through steps you need to take to arrive at a customized and measurable approach to your dentist relations.

It starts with assessment, providing you tools to better understand your dental community and evaluate your marketing activities. Then you develop key points that serve as the basis for everything you say and a marketing plan to serve as the basis for everything you do. Best practices and templates will guide your material development and how you execute your dentist outreach.

Which brings us back to what you’re trying to achieve when it comes to referrals. Put simply: Do you want more? Know that people who have followed the Toolkit guidance have, in fact, experienced an increase in referrals.

But it all has to start with you. By making a choice to market to dentists, you’re making a choice about the importance you place on increasing referrals.

American Association of Endodontists
211 E. Chicago Ave., Suite 1100
Chicago, IL 60611-2691
Phone: 800/872-3636 (U.S., Canada, Mexico) or 312/266-7255
Fax: 866/451-9020 (U.S., Canada, Mexico) or 312/266-9867

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