An Irresistible Call

By Anne Baer
Photos by Dr. Fred Melton

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A donated tent for school in remote village of Nepal

In choral music, performers have a wide variety of choices to set the stage, showcase their talents and engage both the audience and their fellow singers. The “call and response” style is one of the older methods. One voice sings out or “calls” the melody, and the audience, choir or an instrument responds. The first phrase is presented like a question that prompts the second phrase to reply. It’s a style known the world over, showing up in the music of sub-Saharan tribes as well in the latest Carly Rae Jepson single. Musicians favor this simple and applicable style since it allows them to build on each other’s musical offerings and work together to create a sound that’s inventive and collective.

It’s a style that almost perfectly describes Dr. Fred Melton’s own journey in dentistry. For Dr. Melton, the first response came during his travels with “Up With People” in the early ‘70s, a global education and arts organization that, through service and music, builds bridges to span cultural barriers and create understanding. Following high school, Dr. Melton toured with the group from 1973-1974, forging lifelong friendships and planting the seeds for a unique definition of ambassadorship through travel and service. Upon returning to the states, Dr. Melton’s journey continued with college courses focusing on Latin American studies and a minor in Spanish.

Like Father, Like Son
The next step on the path was less clear. He first explored a career in the State Department, but that endeavor did not gain much traction. Dentistry was not his first choice, but as his father was a dentist, Dr. Melton said, “I just decided to go with that.” Graduation from Baylor College of Dentistry was quickly followed by a one-year general practice residency at the University of Washington. From there, the New Mexican native chose to put down roots in Central Washington, first purchasing a practice in Leavenworth then in Wenatchee. But the desire to travel was a tune that kept playing in the background.

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Dr. Melton with an Egyptian dental student

Answering The Call
Operation Smile was one of the first major calls to which Dr. Melton responded. A medical mission team that brings together international doctors to repair cleft lips and palates, Operation Smile was a great way for him to experience how skill and the desire to see more of the world could combine to create substantive change. Dr. Melton says, “Using dentistry to make a difference in someone’s life is a way to have major impact. Individuals get to do what governments can’t do. And it’s these human connections I view as nothing short of micro-ambassadorships.”

The desire to explore persisted. Dr. Melton has travelled to Vietnam, Egypt (as part of Operation Smile), Afghanistan, Kenya (at Dr. Ray Damazo’s Maasai clinic), and Northern India near Pakistan. Along the way, others helped fill needs with donations of money or materials. In particular, the response from his Account Manager, Reedy Berg, has been steadfast. With Reedy’s help, Dr. Melton delivered much-needed pediatric forceps to a Nepalese dental school.

A Life Without Dental Pain
Dr. Melton explains, “In a way, I got my wish from long ago. On these trips, I consider myself a representative of the US. I consider it a unique and personal opportunity to show the world that human beings are the same wherever they live. We love our children, just like everyone else. We want to provide for our families. We’d prefer to live a life without dental pain.”

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Dr. Melton putting sealants in Northern Indian children

The Tune Continues
As the desire to see more of the world grew, a new phrasing entered Dr. Melton’s life. In 2012, he elected to sell his general dentistry practice and work as a part-time associate. This key change allowed him to travel to Nepal with Health Volunteers Overseas as their first dental volunteer. As Dr. Melton points out, “Frankly, I go mainly for me. It’s a selfish choice about where I want to be. I go where my heart is pulled, and I receive a thousand times more than I give.”

More Than Dentistry
Following last year’s major earthquake in Nepal, Dr. Melton again saw how this same lesson played out. The earthquake hit the day after he had wrapped up a two-week volunteering gig. Dr. Melton stayed on to help with clean-up, distribute clothing and assist in treating earthquake victims. With so much structural damage and continued after-shocks, finding a safe space to treat patients became an issue. Upon his return to the U.S., he turned to friends and colleagues for help: the alumni of his “Up With People” touring group, as well as local Wenatchee dentists and a former Baylor classmate. A resounding chorus of “Yes!” was the answer. Within a short period, over $10,000 was donated toward temporary shelter and the rebuilding of community infrastructure.

Pointing out the impact a few people can have, Dr. Melton states, “In these situations, people can and do donate a tremendous amount of money, but they don’t often know where it goes. I got to see the immediate and personal impact of the donation of four tents to provide classrooms in a village where teachers taught under wind-ripped plastic tarps.”

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Locals piling in to a truck at a Kenyan market

When asked why he continues to listen carefully and respond to the siren song of global dentistry, Dr. Melton explains: “I don’t see any greater human deed or experience than the attempt to lessen the suffering of others. The greatest pleasure dentistry has ever offered me is this ability to get people out of pain.

The Power of Face-to-Face Interaction
We can throw money at suffering. Unfortunately, the tossed dollars don’t always hit the target. Time is the only commodity leveling the playing field. We can make and give more money, but we can’t make more time. I truly believe it’s the face-to-face interactions of human beings that fundamentally change the world.“

That is a tune worth putting on “repeat.”

Incredible Success

By Greg Biersack, Burkhart VP of Operations and Mark Beagley, Marketing Manager

Congratulations to Dr. Amanda Mayes of Silverdale, WA and her team for their incredible success with the Supply Savings Guarantee (SSG) program. A Burkhart client and part of the SSG program since 2010, Dr. Mayes’ savings in 2014 was reflected in a $30,002 supply cost reduction. In 2015, she exceeded this level by saving $33,980. Applause also to Bill Melius, Burkhart Account Manager, for his tireless efforts to save amanda.mayes.headshotDr. Mayes money and always do what is in her best interest.

Recently, we had a chance to ask Dr. Mayes some questions about the Burkhart SSG program and working with Bill.

How long have you been with Burkhart and the SSG program?
I was first introduced to Burkhart as an associate as the group practice was a Burkhart client. When I bought my own practice, I used another supplier for six months before Burkhart. We’ve been working with Bill (Melius) now for six years, always as an SSG client.

What was it that made you want to work with Burkhart?
Bill is so amazing. He always checked in to see if I was doing okay, even when I was with another supplier. He shared how he could manage our supply inventory. It’s kind of silly to hire an employee to manage the inventory, so it was just kind of a no-brainer.

What was it about the guarantee that originally caught your attention?
I didn’t know what the SSG was. Bill showed what he could save us each year—guaranteed—and that really caught my attention.

What part of the SSG do you find most valuable to you and your practice?
We don’t have to call Bill for anything—he’s always on top of it. I know I’m saving money as well as staying on top of new products and opportunities.

How does BILL help
you reach your goals
as a dentist and
business owner?
Bill is always bringing in articles, whether on practice management, CE, or competitive analysis which keep us up-to-date as a practice. He also helped me convert to digital and is really good at knowing what products are working and what new technology is available. I feel that same level of service in every part of our contact with Bill, not just the SSG. You can tell Bill cares about you as a person. He’s invested in my success.
How has the SSG
helped your staff
be more efficient?
Bill takes a lot of burden off them because they don’t have to worry about ordering supplies. They know Bill will get it done.
They just focus on taking care of the patients.

What would you say to a doctor considering the SSG program?
It’s hard to navigate supplies. We get a ton of things in the mail and a lot of sales people. It’s so nice to have someone who manages all of that for you plus have your best interests in mind.

Any final thoughts?
It’s important to pick someone with great customer service and good at finding products you need. Our entire team was very impressed when we switched to Burkhart. We’ve been so happy, and my assistants love it when Bill comes in. He’s always there to help. It’s a gift to have such a great company in our area.

Expanding Care in Their Community

By Hilary Joyner
Photography by Becky Burris

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On June 4th, 2016 Yakima Valley Farm Workers Clinic (YVFW) celebrated the opening of their new clinic in Toppenish, WA. YVFW first opened in 1978 as a fully formed community health center, but their mission really started in 1973 when physicians Dr. Paul Monahan, Dr. Donald Gargas and Dr. Julie Ricking saw the need for healthcare for migrant and seasonal farm workers. Their care for the community inspired them to build a Joint Commission-accredited community/migrant health center. With clinics throughout Washington and Oregon, they are becoming the largest community based health center in the Pacific Northwest.

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The Toppenish location is their main hub, the oldest of their clinics. It’s been remodeled a few times over the years and with the growth the valley is experiencing they decided that a new, bigger clinic was necessary. The new clinic will include more services such as dental, medical, pharmacy, and optometry. When thinking of the design for the clinic they thought about how patients and services relate to each other and how that could be incorporated.

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Burkhart worked with YVFW from the beginning stages of the new clinic’s inception. When asked about the experience working with Burkhart Equipment Specialist Jim Waller and Account Manager Reedy Berg, lead dentist Dr. Mark Koday said, “I can’t sing Burkhart’s praises enough. Burkhart’s been with us for 20 years, and every time we need something they’re there.” Jim listened to their needs and worked with them to come up with a design that would accommodate all of their requests and worked with their in-house architect to help build that dream.

Dr. Andy Soderstrom: A Q & A with California Dental Association Foundation Humanitarian Award Winner

By Greg Biersack

Photos by Scott Allan

Burkhart is proud to serve Dr. Andy Soderstrom, a pediatric specialist in Modesto, CA. He is an active community member and a recipient of the California Dental Association Foundation Humanitarian Award. He believes strongly in the importance of dental association involvement and the incredible value of preventive care to oral and overall health. We recently had the opportunity to inquire about his background, his passions and his concerns for the future.

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Q: I see that you are the son and the grandson of dentists and wanted to know a little about when you knew dentistry was something you wanted to do. What was the calling? What did you learn from your dad and your grandfather while you were growing up that influences your practice and how you practice dentistry today?
A: Actually, for a long time, I really didn’t want to do what dad and grandpa did. I actually went to pharmacy school right out of college. The easiest way to get to my classes in the pharmacy school was to walk through the dental school so I was doing that every day.

The concept at the time was that all the hospitals would have satellite pharmacies on the wings of each floor and there would be a team that would include the doctor, the pharmacist and the nurses. Once managed care hit medicine, that put that concept on the block. Basically, that meant you were going to be working at CVS or Long’s or one of those kind of pharmacies. I just kind of decided that was not for me.

All those walks through the dental clinic kept all those memories open. That was when I made the decision to jump ship and switch to dentistry.

Both my dad and grandfather were very similar—both very simple, humble people who did a lot of things in the community. They were both very active and gave back to the community—which were things I noticed and really carried in the way I built my practice and my involvement in the community.

Q: How do you define success for yourself and your practice?
A: For me, success is more about my personal satisfaction. Were my patients happy? Were they getting a good service? That was my primary focus: just taking care of them. I like working with parents to get the outcome they can afford financially and what they want for their child. As a result of that, the other things come—the financial kind of things.Soderstrom-48

Q: You’ve been very involved with the CDA (California Dental Association) including serving as the president from 2010-2011. Tell me how your involvement started. What message would you have for young dentists about involvement in dental associations?
A: Part of that goes back to my grandfather. He was president of the Northern California Dental Association. He was always very active, had a lot of contacts and was very well-respected by all the dentists in town. The first person who got me involved was from Hughson, CA and was a year behind me in dental school, Dennis Hobby. He was involved in the local dental association and brought me into Stanislaus Dental Society’s leadership roles. That got me started on my dental political career and where it really all started.

I think more so now than ever with the changes that are occurring and will occur in dentistry, it’s important to be involved. There’s the old saying, “If you’re not at the table, you’re on the menu.” With the whole change in reimbursement, I see us moving more to a medical management model rather than a drill and fill model.

If we want it to be what we think is the ideal system, we just have to be involved. Not only to try and protect the financial side, but the patients as well. The bureaucratic model does not take into consideration what’s really best for the patient. They’re just looking for the least expensive way to deal with the treatment of the disease.

I am encouraged seeing the new graduates. They do want to be involved. They do have their own set of rules on how they want to participate, but I’m a lot more optimistic about this generation and getting new members now.

Q: Congratulations on receiving the CDA Foundation Humanitarian Award. Could you share a little bit about CDA Cares? How did it develop and what is its mission? How many patients do you typically see per event? Do you hold this in different cities throughout the state all within the same year?
A: In 2004 at the ADA, I met with a group of dentists from Connecticut who were doing the Mission of Mercy. For about the next four years, two of the guys harped on me that we should be doing it in California. They’d had an event in Portland in 2009 and that was the first Mission of Mercy west of the Rockies. So I went up there with some other CDA volunteers and staff and scouted it. We were going down about 5 AM to get the clinic opened and ready for the patients and there are about 1,700 people in line, 29 degrees and misting. Most of them said they had been there since midnight. How the clinic came together and the outcomes that were accomplished over the next two days really confirmed to me that it was something we needed to do. I went back to the CDA and they agreed. We had our first event in March of 2012.

Typically, we see about 2,000 patients at each clinic. Our services rendered are in the $1-1.25 million per event and, if you multiply that by nine events we’ve had, we’re up to a total of $15 million.

We hold two events in the state each year, one in the spring and one in the fall. We’ve been trying to rotate between Northern and Southern California. We try to go to areas where we know there are some definite access problems and the Central Valley is one of those. We look for areas where there is the most need. It’s a little bit defined by the facility available. America Cares Foundation has a guidebook that helps guide the selection of the site.

Q: Can you share a little about the mission dental care that you’ve done?
A: That was actually with a Rotary Group and was probably my first adventure. It was in Honduras. Rotary partnered with a local medical clinic and got a dental

clinic in to it. We did spend part of day working with dental patients. For me, it was my first experience treating patients outside my office. I had gone to Cuba with the American Academy of Pediatric Dentistry a few years before that, so I was clued in to how things were set up with more of a clinic feel. It definitely makes you think about how good things are around here. In Cuba, what was most impressive was their focus on prevention. If you have limited funds and resources, prevention is paramount because treatment is far more expensive for anything than to prevent the problems from developing. The kids would go every six or eight weeks and get their teeth checked, get a prophy and fluoride. We didn’t see a whole lot of rampant decay in the clinics. To me, it was a well-thought out plan to make do with what you had.Soderstrom-28

Q: What are the biggest challenges you see in the future of dental care? What advice would you give to someone who is thinking about going in to dentistry as their professional calling?
A: I have a hard time when people say dentistry is expensive. I get it, but when you compare it to medical expenses, it really isn’t when you look at it from the side that not all but a pretty large percentage of it is preventable. When you’re talking about people with cardiovascular problems or diabetic patients, I would say their oral health is really important to their disease process and having good oral health has an impact on the amount of medical care they need.

I think what holds my concern is the direction we are going in our reimbursement model and combining that with the amount of debt these students are coming out with now. I’m just not sure how financially viable dentistry is with that kind of debt load. As a profession itself, I think it’s great. The large group practices and corporate practices will continue to expand. So I think there’s a whole lot of uncertainty out there. In the next four or five years, I think a lot of these questions will be answered. I think I’ll be more optimistic at that point.

Q: What excites you most about what is happening in dentistry now?
A: Part of it is seeing the younger dentists coming out and being excited and being engaged. Again for me, it’s the realization that dental caries is a disease and can be managed in the medical model.

The most exciting thing and one that would keep practices alive and going is the need to have a huge sea change in the thought process of how reimbursements are done. Take the focus and the dollars away from the “drill and fill” side and put it on the prevention side. It’s both exciting and scary because medicine is a little bit ahead of us with all these new things going on. My biggest concern—and this is where membership and getting new members involved comes in—is that if dentists don’t get out there, be part of these discussions, get their opinions out there, and try to persuade the legislators and regulators that this is the way to do it, medicine is going to do it. They are already being reimbursed based on their outcomes. If they are seeing how periodontal disease is affecting A1C levels for diabetic patients and those patients aren’t getting in regularly to get their gum disease taken care of and under check to reverse that, then medicine will figure out a way to do that. It’s a great opportunity to put the “mouth back in the body,” connect the two again and get dentistry and medicine working collaboratively to not just improve oral health, but overall health.

What You Need to Know About Online Reviews for Your Practice

By Ian Mcnickle, MBA, WEO Media

Imagine you’ve just arrived in a city you’re not very familiar with and it’s dinner time. What do you do? If you’re like most people these days, you’ll pull out your smart phone and search online review sites such as Yelp for nearby restaurant reviews. In fact, over 90% of consumers now read online reviews to help them decide where to go and what to buy.1 While it is true the most commonly searched category for online reviews is restaurants, most people don’t realize the second most commonly searched category for online reviews is dentists/doctors.2 The days of ignoring your online reviews are over.

Why Online Reviews Matter
There is a major trend towards patients researching their healthcare providers before visiting an office, even if they were referred by a friend or another healthcare provider. Recent surveys have found that 80% of consumers trust online reviews just as much as personal recommendations from people they know. For many, this is an amazing statement, but the reality is that our society is changing at a rapid pace and dental practices must focus on their online reviews and online reputation.

The Big Four Review Sites for Dentists
In the dental industry, the most important review sites are Google+, Yelp, Healthgrades, and Facebook.

Google
Google represents about 65% of all online search traffic and features its own reviews from Google+ so those reviews will generally attract more readers than other review sites. Reviews on Google+ have the added benefit of helping your website search engine optimization (SEO) perform better in online searches related to dentistry.

Yelp
Yelp has become one of the leading review sites in the country and regularly ranks highly in local search results when people search for dentists. In addition, the Bing search engine displays Yelp reviews as its primary reviews shown in search results.

Healthgrades
Healthgrades is the largest healthcare directory and review site in North America and has over one million visitors every day. As with Google+ and Yelp, a solid Healthgrades profile helps both online reputation and website SEO.

Facebook
Over the last few years, Facebook reviews have become increasingly important since Facebook is the dominant social media site. Facebook has over 1.5 billion regular users and most of them look at reviews on Facebook business pages when researching a business.

What You Can Do For Your Practice
To get the maximum benefit from these review sites, WEO Media recommends the following strategies:
Completely fill out your review site profile pages with business information, photos, videos, office hours, specials, and any other relevant information about your practice.
Link to your review sites from your website to encourage existing patients to write reviews and potential new patients to read your reviews.
Implement a proactive strategy to generate more patient reviews on these review sites. However, we highly recommend you contact your state dental association or dental board to make sure you understand the rules for soliciting reviews from patients in your state.

Bragging Rights! 5 Front Office Key Performance Indicators

Unlike the clinical team that is guided in large part by a detailed daily schedule of patients, the front office team must work directly with those same patients as well behind the scenes keeping the business of dentistry running smoothly. What indicators are available for the front office to brag about? We will highlight five key performance indicators that will allow the front office to evaluate their role and possibly hone in on systems within the practice that can support their personal achievement and the success of the practice.

1. Collections:
98% of Adjusted Production
If your monthly gross production (the sum of the fees you normally charge patients) is $85,000, and your monthly adjustments (courtesy and insurance writes offs) are $15,000, your total adjusted production is $70,000. Your collection goal would be $68,600 (70,000 x 0.98). If you are collecting less than the goal, look into systems for correction:

  • Emphasize with the team that every patient must check out with a front office team member and not duck out the door.
  • Ensure signed treatment plans are in place prior to treatment. Remind the team to use the “inform before you perform” rule to prevent treatment from being added on chairside that creates financial surprises for the patient and for you!

2. AR over 90 days: 5-10%
Aging AR should be closely monitored and managed. The odds of collecting balances after 90 days become slimmer, with less value on the return after you add in the overhead costs to make calls, send statements and track down overdue accounts.

Is your AR over 90 above the 5-10%?
Review these systems:

  • Are the outstanding balances from delayed insurance payments or the patient portion?
  • Are in-office finance options supporting balances in full
    within 90 days?
  • Do you collect credit card data and authorizations so you can run monthly charges?
  • Are clinical chart notes thorough enough to support narratives for quick insurance reimbursement?

3. Total Accounts Receivable: 3-4 Weeks of Production
Keep a close eye on the total accounts receivable-it should stay equal to 3-4 weeks of production. In other words, if you produce $100,000 per month, the total AR goal would be $75,000–$100,000. Why is this important to monitor? If AR is off, it can indicate a breakdown in several systems.

If it is too high:

  • Are the financial policies in the practice clear from the doctor?
  • Is the patient portion being collected at time of service?
  • Are the estimated patient portions incorrect or are patients seeing themselves out the door rather than having their appointments set complete by a front office team member?

If it’s too low:

  • Are the financial policies in the practice clear from the doctor?
  • Is the practice not offering outside funding options, or is treatment being recommended, but not scheduled, due to financial limitations by the patient? If this is the case, treatment presentation skills need to be honed.
  • Is a consult room being utilized and are good verbal skills from all staff members in place to uncover financial barriers in order to provide options to help patients get the treatment completed?

4. Recare Retention: 88%

Statistics show the average dental practice has an attrition rate of 12%. This would lead us to believe it would be reasonable to maintain an 88% retention of hygiene patients. The new patient flow needs to make up the difference for those losses and any additional growth the practice is targeting. Run a recare report to calculate the percentage of patients due vs. scheduled each month.

Below 88%? 

  • Remind clinicians to schedule chairside, if possible.
  • Review, perhaps “revamp,” the recare system. Hygienists can call overdue periodontal patients as they will be more successful in re-activation.
  • The recare coordinator should print reports and manage the system. The team needs to be involved in making calls and sending reminders.

5. Case Acceptance Rate: 80%
It’s not reasonable to assume the entire case acceptance for the practice falls on the shoulders of the front office team, but it is reasonable for them to track this number. A front office team member should be tracking the number of cases presented vs. scheduled every day. Keep in mind, it is considered scheduled if the next step is scheduled-not the entire treatment plan. When this percentage falls short, it should become a subject of the next staff meeting. There are a number of systems that feed this number:

  • Evaluate presentation skills:
    Make sure the exam is occurring early in the hygiene appointment
    to give the patient processing time, and the hygienist time to reinforce
    the diagnosis.
    Note: When patients are confused about treatment or ask clinical questions at the front desk-this is a key indicator something went wrong during presentation.

How did you rate? If you scored within the benchmark on all five topics, you deserve to brag a bit. If you identified some challenges within your systems-you still deserve to brag a bit as you can now be the conduit for change. The Practice Support Team is a no-fee consulting service for Burkhart’s clients, and we’d love to help you implement systems for greater business success.

Click here to see the original article.

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