“be part of the san francisco grin crowd” sfds poster ... · (415) 824-2713 mahtab sadrameli,...

Volume 60 • Number 3 • June 2007 • San Francisco Dental Society • Organized 1869

MISSION STATEMENTThe mission of the

San Francisco Dental Society is to serve the needs of its

members, advance the art and science of dentistry,

and promote the improvement of the health of the public.

IN THIS ISSUE...On Your Behalf . . . . . . . . . page 2

Editorial . . . . . . . . . . . . . . page 3

Member’s Spotlight . . . . . . page 4

And More! . . . . . . . . . . . . . . . . . .

PRESIDENT’S ADDRESSCurtis Raff, DDS

Government regulation. It canlead to quite heated debates.When a segment of the popula-

tion is not being served as well as somefeel is possible, some call for the govern-ment to intervene and direct a solution.Others feel the government already mis-handles its responsibilities, and furtherregulation is not the solution.Regardless of whether you have a gener-al opinion or form one on a case by casebasis, you are working in a city that hasan unusually high amount of regula-tion. And you better be ready for more...

Most of you already know about payrolltax. This has been law in San FranciscoCounty for decades. What I am sur-prised to find is that many dentists donot realize this tax does not exist inmany cities. In my first few years ofpractice, I would call my accountant,

Government Regulationand Your Future

“Be Part of the San Francisco grIN Crowd”SFDS Poster Contest 32nd Year Extravaganza

continued on page 7

By Dennis D. Shinbori, DDS, Chairman

Imagination and imagery aboundedat the 32nd Annual San FranciscoElementary School Poster Contest.

“Be Part of the San Francisco grINCrowd” theme brought over 2,500entries. The Awards Ceremony at theArthur A. Dugoni School of Dentistryon Friday, Apr. 20th brought togetherhundreds of family members fromboth the San Francisco public and pri-vate schools.

Dr. Dennis Shinbori and Dr.Stafford Duhn served as Chairmanand Vice Chair for the event. Dr.Shinbori was the Master ofCeremonies and Dr. Duhn was incharge of all the prizes. This year wewere honored with the presence ofCalifornia State Senator Leland Yee,

who presented the winner, his teacherand principal with Proclamationsfrom the State Senate. Also present toaward prizes were our SFDS PresidentDr. Curtis Raff, Mrs. Wendy Shinbori

California State Senator Dr. Leland Yee with First Prize Winner NickLoBue, along with Nick’s teacher Mrs. Barbara Conti (third from the left)and St. Stephen School Vice Principal Ms. Joanne Fitzpatrick

continued on page 8

San Francisco Dental Society •

2007 SAN FRANCISCO DENTAL SOCIETY OFFICERS AND

BOARD OF DIRECTORSPresident

Curtis Raff, DDS(415) 564-7525

President-ElectIrene Hilton, DDS MPH

(415) 657-1708

Immediate Past-PresidentClaudia Masouredis, DDS MPH

(415) 753-2777

Vice PresidentJoseph Gabany, DMD MSD

(415) 392-2086

SecretaryYan Kalika, DMD MS

(415) 752-0654

TreasurerDavid Ehsan, DDS MD

(415) 395-9987

CDA TrusteesDonna B. Hurowitz, DDS

(415) 391-7525Dan Davidson, DMD

(415) 239-2740

Executive DirectorDeborah A. Elam, MS

(415)928-7337

Newsletter EditorDavid Rothman, DDS

(415) 333-6811

DirectorsWayne Del Carlo, DDS

(415) 362-8725Gail Duffala, DDS

(415) 986-0382Frank Grimaldi, DDS

(415) 986-4556Hibret Hailu, DDS

(415) 409-3368Lauren Hebel, DMD

(415) 362-2167Natasha Lee, DDS

(415) 731-9311Peter Lee, DDS MS

(415) 681-8500Carlos Nogueiro, DDS

(415) 824-2713Mahtab Sadrameli, DMD

(415) 751-5405Sima Salimi, DDS

(415) 567-8170Lewis Specker, Jr., DDS

(415) 982-7443

StaffRonnica Merritt–Admin Asst/CE Programs

Well-Being CommitteeConfidential assistance to professionals,

spouse and staff for drug and alcohol abuse. Call Dr. Bruce T. Hiura at 415.776.5855

ON YOUR BEHALF –LEGISLATIVE UPDATE

By Mahtab Sadrameli, DMD, Chair Legislative Committee

Every year CDA hosts “LegislativeDay”, to create an opportunity fordentists from across the state to

meet Senators and Assembly memberswho make decisions on legislations thataffects our practices and small business-es. These meetings are designed to be abrief interactionbetween our dentistsand the legislativemembers to educateour elected legislatorsabout issues andcauses that affectsour industry and pro-fession. This year inparticular, we havetwo bills (SB 387 &AB 895) that affect allof us practicing in thestate of California;regardless of whetherwe are general practi-tioners or specialists.

While we will have a full re-cap of ourlegislative day scheduled for May 23rd,2007 in a later issue of the bridge, Iwould like to review some of the issuesthat we will be discussing and educatingour senators and assembly members on.

SB 387 - Dentist's Death orIncapacity:

California’s Dental Practice Act specifiesthat only a licensed dentist can own andoperate a dental practice, including hir-ing other dentists. This law is rightlyintended to prevent the corporate prac-tice of dentistry, but it has significant,arguably unintended consequences for

families and patients when a dentistowner dies unexpectedly and his or herspouse or estate wishes to keep the prac-tice operating while they attempt to sellit permanently. Because of the currentlegal restrictions, a non-dentist spouse orestate representative cannot employ den-

tists temporarily inorder to maintaintreatment for exist-ing patients, who arethereby forced toseek new dentists fortheir treatment. Toremedy this uniqueand temporary situa-tion in a way thatencourages continu-ity of care forpatients, CDA thisyear is sponsoring SB387 by SenatorElaine Alquist (D-

Santa Clara). This bill will allow anestate, trustee, or other legal representa-tive to employ or contract with dentistsand otherwise operate the practice of adeceased or incapacitated dentist for upto 12 months, while assuring thatpatients are appropriately notified andassuring that the temporary operator ofthe practice does not interfere with acontracting dentist’s professional judg-ment.

AB 895 - Dental Plan Coordination ofBenefits Policies:

“Coordination of benefits” is the meansby which two insurance plans determine

“This year in particular,

we have two bills (SB 387

& AB 895) that affect all

of us practicing in the

state of California;

regardless of whether we

are general practitioners

or specialists.”

continued on page 14


What do babies and the elderlyhave in common? This oldjoke refers to the cycle of life

in which we return to where we’veworked hard to escape. I see this oldjoke as symbolic of two similar andunderserved populations, the pediatricand geriatric patients. Twenty fiveyears ago, middle aged adults wouldtalk of who had a stroke, a myocardialinfarction, cancer or died. Now theaging baby boomers talk of who’s hav-ing orthopedic surgery so they canplay tennis or ski. Is this common toall aging baby boomers and pre-WW IIbabies or is it limited to our smallsphere of interest?

Recognition of the problems of theaging adult is starting to be identified.These are not just physical but emo-tional and financial and are beginningto tax our collective society. Therehave been many articles in publica-tions such as “The New Yorker” (TheWay We Age Now, April 30, 2007) onthe problems of aging and managingthe medical needs of the elderly, less byintervention and more by listeningand guiding the people along the irre-versible road. The front page articlelast week in USA Today talked of theelderly driver and the issues of aging,physical limitations, reaction timesand taking away licenses. The New YorkTimes magazine section of May 6, 2007was devoted to middle age and beyondand painted a somewhat rosy pictureof the future of the aging babyboomer. What was subtle was its tar-get market; the educated upper middleclass with expendable incomes and theconnections and ability to manage

the number of disabled and other spe-cial care needs patients. The underly-ing problem has and will be poor reim-bursement levels for treatment in theelderly. The medical model of geron-tology demonstrates the problem: youopen a center to study and treat theelderly and it soon closes becausefunds dry up and people on fixedincomes, if given the choice of whereto spend their dollars, are less likely topay for health care. Studies in healthcare and educational intervention inchildren and their families by theRand Institute have shown favorablecost/benefit ratios including the needfor decreased interventional treatmentlater on if patients are put on educa-tional and guidance programs. Canthis method be applied to the elderlyand will it demonstrate the same bene-ficial results?

And where do these elderly receivetheir care? The Americans withDisabilities Act made physical accesseasier but what about transportationto and from appointments? Shoulddental schools be responsible to pro-vide care not only as a public servicebut as a way of introducing the stu-dent to gerontology? Should centers inelderly care homes be developed tocover the population in the home? Orshould private practitioners take onelderly as an underserved minority andtreat pro bono or on a reduced reim-bursement scale? Will there or shouldthere be “Give the Elderly a Smile”campaigns? Far be it for me to set up

EDITORIALDavid Rothman, DDS

From Diapers and Strollers toDiapers and Wheelchairs

continued on page 7

their future. The article failed toaddress the healthcare needs of theelderly on fixed incomes without sav-ings. Neither optional cosmetic sur-gery nor orthopedic surgery feeds theelderly a nutritionally balanced,healthful meal as their dentitions fail,their oral musculature weakens andtheir incomes decrease.

The numbers of elderly are rapidlyincreasing. From The New Yorker arti-cle, today there are as many five yearolds as fifty year olds and in thirtyyears there will be as many eighty yearolds as five year olds. These are stag-gering statistics which will requirerefocusing of the healthcare industry.It is generally accepted that over eightypercent or more of the healthcare dol-lar is spent in the last 6 months of life.

And how much do we really knowabout the dental needs of the elderlyand the process of aging? Do we needto develop a specialty of geriatric den-tal care; it should not only be a subsetof special care dentistry. The numbersof elderly far exceed and will exceed

“...today there are as

many five year olds as

fifty year olds and in

thirty years there will

be as many eighty year

olds as five year olds.”


COMMUNITY

CORNER

If you are a dentist who believes in thepower of a healthy smile to improve apatient’s self-confidence, please considerdonating your services, or if you have den-tal equipment, to one or more of manyworthy causes:

• Spreading Smiles, a non profit organiza-tion founded by UC Davis pre-dental stu-dent, Cedric Papa, is organizing a humani-tarian expedition to Bolivia. With rampantdecay and generally poor health conditions,the purpose of the trip is to educateBolivian children as well as adults about thebenefits of proper dental hygiene.Spreading Smiles is seeking sponsors tounderwrite efforts--asking local dentists,oral surgeons, orthodontists and otherrelated specialists to sponsor the trip. Pleasecontact Cedric Papa at 1-916- 718-8732.

• Delancey Street continues to look fordentists to provide dental services to par-ticipants. This would include cleanings,fillings, crowns, partials, etc. The gift ofself-confidence to men and women whoare looking to enhance their lives would be

the springboard for their success in life.Please contact the Delancey StreetFoundation at (415) 512-5118 if you areinterested in contributing to this endeavor.

• SafeHouse, a clean and sober living com-munity for women, seeks the services ofgeneral practitioners who will each pro-vide service to one of their clients. Pleasecontact SafeHouse, Susan Biancalana at(415) 643-7861.

• The Apollo Hotel, a non-profit low-income residence that provides permanenthousing for formerly homeless adults seeksa dentist(s) who can provide periodicdemonstrations on dental self-care, plusprovide samples and address questions orconcerns for 10-15 tenant participants.Time commitment would be about 45 min-utes on a weekday; late afternoons or latemornings tend to work best for communitymembers. If you can volunteer some time,please call Ari at 437-2868 ext. 304.

• Central America Resource Center DentalClinic, serving low-income populations in

San Francisco, is seeking donations ofdental equipment. Please contact Nora at415-642-4414.

• Glide Memorial Health Services Clinic,serving over 3,000 individuals per year,seeks free dental services for a large por-tion of their patient population, particu-larly patients needing root canals, crownsor dentures. If you can provide anyamount of free dental care, and are willingto see one patient a quarter, your helpcould do wonders for needy individuals.To offer your services, contact PatriciaDennehy, NP, Glide Health Services, (415)764-6140.

If you know of or participate in an organiza-tion that has needs for the underserved,developmentally or physically challenged,please contact the SFDS and we will includethe request in our next newsletter. ❖

PBj

MEMBERS IN THE SPOTLIGHT

TRANSITIONS

We would like to recognize our newly retired SFDS members….

Warren Wheaton, DDS, a graduate of UCSF, 1974, joined the SFDS in 1976 and held a successful General Practice at 2001 Union St, Ste 430.

Yoshio Nakashima, DDS, a graduate of the College of Physicians and Surgeons, 1961, joined the SFDS in 1961 and held a successful General Practice at 3400 California St, Ste 302.

Dr. Nakashima also served for several years on the San Francisco Dental Society’s Peer Review Committee.

Congratulations for achieving retirement status!

Congratulations to Dr. Maria Majda, on the opening of her new practice, located at 390 Laurel St, Ste210, San Francisco, CA 94118.

Congratulations Dr. Schiff…winner of the SFDS April 5th Door Prize Drawing, a lovely bottle of vinocourtesy of the SFDS. Now you can’t say “I never win anything”. Dr., you’re a WINNER in our book!

Congratulations to the California Dentists Guild for the milestone achievement of 40 years as the first"turn-key" retirement plan in the country that is exclusively for dentists and their staffs.


San Francisco’s new Sick LeaveOrdinance provides the perfectexample of the “law of unintended

consequences.” The new Sick LeaveOrdinance, promoted by the Board ofSupervisors and enacted by voters, pro-vides mandatory sick leave for tempo-rary, part-time and full-time employees.With employee benefits already averag-ing a whopping 44% of payroll expendi-tures for 2006, as reported in the USChamber’s 2006 Benefits Study, how canthe small business owner continue tomake ends meet? Already, larger organi-zations are relocating to business friend-ly jurisdictions (San Mateo, Marin,Alameda, et al). Many non-profits (andfor profit) entities moved to the Presidiobecause on federal land, the ordinancedoes not apply to those business entities.We share your frustrations. In response,the SFDS has provided information ses-sions for members and we’ve attendedseveral of the hearings hosted by theBoard of Supervisor, the SF Chamberand the SF Office of Labor StandardsEnforcement (OLSE). The OLSE contin-ues to hold hearings in order to clarifythe details of the ordinance and updatescan be found at www.sfgov.org/olse. Besure to visit this site often, as the FAQsare changing frequently.

Several members have called or written toask if they could have employees signwaivers to the ordinance under the “col-lective bargaining” provision. A collectivebargaining unit is a third party entity thatwould negotiate a collective bargainingcontract between employer/employee,representing the employee interests.According to OLSE, unless your employ-ees are represented by a bona fide bar-gaining unit (a union), the answer is NO.

I started this article talking about unin-tended consequences, yet we have manyopportunities to shape intended conse-quences. A perfect example is CDA’sAnnual Leadership Conference. Duringthis year’s CDA Leadership Conference— attended by SFDS President Dr.Curtis Raff, President Elect Dr. IreneHilton, Director, Dr. Sima Salimi,

Director & New Professional ForumChair Dr. Natasha Lee, New DentistCommittee Member, Dr. CourtneyFitzpatrick, CDA LeadershipDevelopment Committee member andSFDS New Dentist Committee Member,Dr. Blake Robison, Trustees Drs.Donna Hurowitz and Dan Davidson,and I — leaders and executive directorsfrom around California had opportuni-ties to learn from leading edge expertson change, how to bridge the gapsbetween the known and unknown, howto motivate and develop componentsleaders, how to inspire groups to newlevels of productivity and creativity.The take-home messages were:

• Attitude is everything

• With change there are goldenopportunities

• Each of us must take responsibilityfor positive results—our futuredepends on it.

• Demonstrate your integrity in allactions/decisions

• The rewards are plentiful

• Connect, let go of stuff, laughoften, love, learn, unlearn andrelearn—it is okay to have fun: (Andwe did—watching 200+ dentists,arm-in-arm, singing and dancing isa testament to what fun leadershipcan be).

Do you want to contribute to your pro-fession, to have an impact, to learn andunlearn, to laugh and have fun? Weneed new leaders to carry on the visionof our forward thinking leaders whosetenures are coming to an end. Help usdevelop new ideas and bring fresh per-spectives to the table. Let your passionsand abilities flow with an eye towardleading your Society forward. We knowthat your time is valuable and we wantto make certain that your experienceswith the SFDS are just as valuable. Ifyou have not already completed theSFDS One Task Pledge card, located inthis issue of The Bridge, I invited you todo so now and drop it in the mail or faxit to (415) 928-5297. Come join us forsome fun, participating in all that yourprofessional community has to offer…

“Call it a clan, call it a network, call it atribe, call it a family. Whatever you call it,whoever you are, you need one.” Jane Howard (1935-1996, writer) ❖

“...how can the small

business owner

continue to make

ends meet?”

EXECUTIVE POTPOURRIDeborah Elam, CAE

Consequences


A STANDING OVATION…TO OUR NEWEST SFDS MEMBERS:

Alnette Dela Rosa, DDS; General Practice; UCLA, 2006; 4867 Mission St, San Francisco

Patrick J Ferrillo Jr., DDS; Dean, UOP School of Dentistry; Baylor College of Dentistry, 1976;2155 Webster St, San Francisco

David T Ho, DDS; Faculty, UCSF School of Dentistry; UCLA, 1994; 100 Buchanan St, SanFrancisco

Linda Uyen Linh Huynh, DDS; General Practice; UCSF School of Dentistry, 2006; 1515 Irving St,San Francisco. Post-Grad, Orthodontics, UCSF, graduating 2009

Anne Mathew, DDS; (reinstated member); General Practice; UOP, 2002; practice address pending

Francisco J Ramos-Gomez, DDS, MS, MPH; (reinstated member); Faculty-Pediatrics, UCSFSchool of Dentistry; Univ Tecnologica, 1980; 707 Parnassus Ave, San Francisco

Jennifer Denise Terry, DDS; General Practice; UOP, 2004; 3349 17th St, San Francisco

Helen Thai, DMD; General Practice; University of Pittsburgh, 2006; Ste 309 838 Grant Ave, San Francisco

Hung Quang Vo, DMD; General Practice; Tufts, 2002; Ste 101 500 Howard St, San Francisco

Dr. A. Jeffrey Wood, DDS, graduated from dental school at the Medical College of Virginia in 1984 and received his certificate in pediatric dentistry in 1987, is Professor and Chairperson of the Department of Pediatric Dentistry at theUOP, and serves as Director of the Dental Auxiliary Utilization (DAU) program. He holds an adjunct faculty appoint-ment at the Arizona School of Dentistry and Oral Health. In 2005 he received the American Dental Association’s GoldenApple Award for Outstanding Mentoring of Dental Students, interested in Academic Careers. Dr. Wood serves as VicePresident of the California Society of Pediatric Dentistry and he has a number of publications in pediatric dentistry professional journals.

Evening CE MeetingDr. A. Jeffrey Wood Presents:

“Johnny’s/Juanito’s/Xiao’s First Dental Visit: When, Why, and How”

Thursday, September 6, 20076:00 pm to 9:30 pm

Marines Memorial Building 94102$59 each member dentist, 2 Ce Units - Category I

You will learn:

• The appropriate timing for a child’s first dental visit

• Practical pointers on what to do at the first visit

• Rationale for early dental evaluation and care

• Appropriate first visit’s evaluation and procedures


inquiring about this bill from the city forthousands of dollars. As he put it, “Youknow doctor [so-and-so] in Daly City?He keeps that money.”

A couple of years ago, an additionalgross receipts tax was defeated by a public vote. If passed, it would havemeant paying the city a percentage ofevery penny you collect. I don’t knowabout you, but I noticed a field on mylast city payroll tax form asking for gross receipts. That certainly causes me some concern.

More recently, we have the Paid SickLeave Ordinance. Though written withgood intentions, in my opinion this lawalmost encourages abuse by employees.The use-it or lose-it benefit has never satwell with me. In addition to the com-

plexities of the law, it has created arecord-keeping fiasco. At this point, it iswhat it is and unless there is a miracleand someone can get a measure to ballotand get the public to pass it, this law ishere to stay. And don’t think that regu-lation stops there. Remember amalgamseparators, air compressors, x-raymachines, and the list goes on.

If I have not yet raised your blood pres-sure a little, next up is mandatory healthcare. There are numerous politicianswith their own proposals, thus it isuncertain what we will be left with. [Seeenclosed table of proposals]. The onething that is for certain is that until it islaw, you might be able to influence whathappens. We all get asked to write ourpoliticians, but few ever do, including

me. I have finally realized that this is acase of put-up or shut-up.

In this electronic age, it is much easier tocontact political entities. Go towww.sfgov.org, select your district orneighborhood from the left drop-downmenus. After a few clicks of followingyour Board of Supervisors’ name, youcan click “Contact” to get voice, fax,email, and snail-mail.

If you choose to do nothing, rest assuredthat the SFDS Legislative Committee isworking hard to keep informed, takeaction, and notify members. But quanti-ty often counts in situations like these.The more people that raise the sameconcerns to the politicians, the more ofan impact it will make. ❖

Government Regulation and Your Future (continued from page 1)

competition for dental care dollarsbetween the geriatric and pediatric popu-lations but it will come down to this inthe days of limited and decreased fund-ing. The treatment of the elderly is nodoubt low reimbursement, possibly lessrewarding and competes in the office ofthe busy dental provider for the high dol-lar cosmetic dental procedures. And whowill be the “Dental Czar” who will sit injudgment and say who will or will not getthe treatment; who will define necessaryor which of two treatments will be ren-dered based on the pool of healthcaredollars. I can’t help but think of KurtVonnegut’s short story, “Welcome to theMonkey House” in which the govern-ment advocated ethical suicide parlorsand mandated all people over a certainage to commit suicide to prevent themfrom becoming a burden on the pristinesociety that was developed.

Is this a problem that will eventuallyburn out or turn out not to be a prob-lem? As overall healthcare/dentalcareimproves through midlife with the use offluorides and routine care, as people age

will we decrease the dental care burdenin advanced age? Currently, 40% of 80year olds are missing teeth. Will therecontinue to be such extremes of diseaseand neglect? Even with better education,will people still make bad choices andnot follow the recommendations of thedental care providers? Hot button topicslike global warming take the press’sattention. Let’s not let the dental care

needs of the elderly be moved to a sec-ond class position and eventually fallfrom our sites until it is too late or thecrisis is overwhelming. We need to take aleadership role, become educated, setpolicy, become politically active and goout and treat this population; remember,we’re all heading that way; we might aswell drive rather than be the passenger. ❖

From Diapers and Strollers to Diapers and Wheelchairs (continued from page 3)


“Be Part of the San Francisco grIN Crowd” SFDS Poster Contest 32nd Year Extravaganza (continued from page 1)

of the SFDS Auxiliary, Mrs. Paula Baumand Ms. Cathi Fuller SFUSD Nurses, andMs. Deborah Elam, CAE SFDS ExecutiveDirector.

Photographer John Draper capturedmany smiles as the young artists cameup to accept their awards, often accom-panied by proud parents and teachers.

The winner of this year’s contest is NickLoBue, a fifth grader from St. StephenSchool. His 1st place prize was a week-end hotel package at the Marriott SantaClara, Paramount’s Great America tick-ets, $50 cash, and an Oral B batterytoothbrush.

The Dental Poster Contest, held everyFebruary during National Children’sDental Health Month, promotes learn-ing about dental health through anartistic means of inspiration… and chil-dren have great imaginations. The artwork this year was magnificent and espe-cially colorful of city sites, animatedteeth from a happy, diverse population,and all promoting this year’s theme: “BePart of The San Francisco grIN Crowd”.Kudos to all 60 winners. Each winnerreceived prizes.

You will be able to view many of our win-ning posters at the SF Public Library,Main Branch, Fischer Children’s roomduring the summer.

The University of the Pacific, Arthur A.Dugoni School of Dentistry and Dr.Eddie Hayashida, associate dean,deserve a special thank you for their yearsof support, attendance and providing theSFDS with a location for the AwardsCeremony. By recognizing the value ofcommunity, education, and making itcome together with fun, color and a littlecompetition, we all get to enjoy the bene-fits of how our children learn and changethe world to be a better place. We hopeall the children will go forth and floss!

A special thank you goes to our ownCristina Simona, executive assistant, forall her efforts in helping to put this con-test together.

The San Francisco Dental Society pro-motes dental health and educationthough numerous programs and volun-teer efforts, including those of the SFDSDental Health Committee. If you areinterested in serving your community

and working on one of the DentalHealth Committee’s many programs,please give us a call.

For any SFDS members interested inshowcasing our young artists’ work inyour offices, the SFDS has many won-derful posters available for pick-up. Justgive the office a call at (415) 928-7337!

Last but not least, we would like toacknowledge the following donors, who,without their generous donations thiscontest would not be able to take place:

Auxiliary to the SFDS, Braun Oral B., Dr. Antonio Cucalon III, Dr. John Fong, Dr. Gail Chan Jang, Dr. Stephanie Jee, Dr. Albert Kadosh, Mitchell & Mitchell,Paramount’s Great America, Pfizer Inc., The Pierre Fauchard Academy-Northern Ca.,Lawrence Ratner, CPA, Dr. Peter Rengstorff,Dr. Glen Young & Dr. Rodney Lee, San Francisco Public Library, Sunstar –Manufacturer of Butler, Teacher’sEducational Exchange, Tiret AccountancyCorporation, Dr. Frederic Warren, UOPArthur A.Dugoni School of Dentistry. ❖

SFDS President Dr. Curtis Raff with happy 2nd place recipient

SFDS Auxiliary, Mrs. WendyShinbori hands out prize

Teachers and Students happily celebrating President Raff celebrates morewinners

SFUSD Nurse Ms. Cathi Fullerwith winning child

President Raff celebrates morewinners

SFUSD Nurse Ms. CathiFuller with young artist

Executive Director Deborah Elam poses withprize winners

Executive Director DeborahElam poses with prize winners

SFUSD Nurse Mrs. Paula Baumpresents prizes


“Be Part of the San Francisco grIN Crowd” SFDS Poster Contest 32nd Year Extravaganza (continued from page 8)

SFDS Auxiliary, Mrs. WendyShinbori hands out prizes

SFUSD Nurse Mrs. PaulaBaum presents prize

SFDS Auxiliary, Mrs. WendyShinbori hands out prizes

From left to right, Poster Contest’s ViceChair Dr. Stafford Duhn, California StateSenator Dr. Leland Yee and PosterContest’s Chair, Dr. Dennis Shinbori withFirst Prize Winner, Nick LoBue

Poster Contest Judges 2007: From left to right:Executive Director Mrs. Deborah Elam; SFDSPresident, Dr. Curtis Raff; SFUSD Nurse, Mrs. PaulaBaum; Cristina Simona; SFUSD Nurse, Ms. CathiFuller; and SFDS Editor, Dr. David Rothman.Holding the winning poster are SFUSD Nurses CathiFuller and Paula Baum.

Dr. Shane White Provides SFDS Membership A Comprehensive Comparitive Analysis of Implants vs. Root Canal Research, at the April 5, 2007 SFDS General Membership Meeting


Almost every dentist considers hir-ing an associate dentist at somestage of their dental career. There

are many motivations, but the mostcommon are:

a. practice has too many patients for one doctor

b. desire to grow the practice

c. dentist owner wants more time off without decreasing production and income, and/or

d. owner dentist wants to transition out of the practice over a period of time

However, after talking with colleaguesand hearing horror stories of “associateproblems” many dentists dismiss theidea of an associate. This is unfortunate:there are benefits to both owner andassociate, as well as to patients and thestaff team. The mistakes, and questionsposed below, are offered for considera-tion by owner dentists and possible asso-ciates. These common mistakes can beavoided with a little planning andthoughtful consideration.

The owner did not establish his/her reasonsfor bringing an associate into the practice.What are the benefits of adding an asso-ciate? Is the doctor owner looking for apartner (or sale) if both work well togeth-er? Or, will the relationship be withoutownership potential? Is the owner will-ing to mentor a newer dentist, or onlywants someone with several years ofexperience? The owner should be able todescribe the “ideal” associate for his/herpractice before deciding on a specificassociate. Both the immediate and longterm considerations of an associateshould be clarified early in the planningprocess.

Duties and responsibilities of the associatewere not defined. It is important that therole of the associate be understoodbefore the search beings: the “right”associate is available only if the job

should be not be ignored. This relativelyshort but comprehensive agreementcommits both doctors to a period oftime, associate duties, schedule, compen-sation, patient ownership, etc.

Associate was not properly integrated withthe team, and office policies and proceduresbefore treating patients. If there has neverbeen another dentist in the office, theteam members are understandably loyalto the owner, and it takes time to changetheir routines to facilitate a new doctor’spersonality into office procedures. Theteam members need to feel comfortablewith the associate, and be given specificguidance for marketing the new doctor topatients. The associate also needs toknow the office policies and proceduresso that staff and patient communicationis accurate. This can only occur withgood communication among the teammembers and both doctors.

Properly introduce the associate to patients.Some patients do not care about whichdoctor they see, while others only want tobe treated by a specific dentist. Will let-ters be sent to the patients when the asso-ciate signs the agreement? Will theowner be present to introduce many ofthe patients to the associate and explainwhy the new doctor is in the office? Theaddition of an associate should not resultin patients leaving the practice. Patientsshould not be surprised by the associateat a treatment visit; the introduction (andbenefits to the patient) must be commu-nication to patients in advance of meet-ing the associate.

The smooth addition of an associate isthe result of planning and clear commu-nication. Associates can add a fresh per-spective to a practice and provide theowner dentist many benefits. ❖

Ellen M Grady is a Clinical AssistantProfessor, USC School of Dentistry and owner,Ellen M Grady & Associates, a managementconsulting service in Pacific Palisades..

Reprinted with permission of the WLADS.

description is known. Will the associatetreat patients that are already in treat-ment? Will the associate establish treat-ment plans independent of the owner?Will the associate see new patients? Willpatients be assigned to each doctor foron-going care? Will the associate beexpected to bringing in new patients (ornew referral sources, if a specialty prac-tice)? Any specific communicationattributes desired?

The staff team was not involved in theplanning. All too often the staff team isnot well informed about how the associ-ate will work in the office, and what pos-sible modifications might be needed tooffice policies and procedures. The val-ued team members have great ideasabout how to handle the many detailsthat need to be arranged before an asso-ciate arrives. This is especially importantif the team has not previously integratedother associates into the practice.

The owner and associate were not wellmatched. Cloning the owner dentist isnot the objective, but the associate mustfit with the patients and office team.Knowledge of what the potential associ-ate wants out of the relationship is alsoan important criteria in choosing thebest applicant. Interviews and talks dur-ing working hours by both the ownerand potential associate are important tosee if the relationship will be a good fit.

No written Associate Agreement. Thereare protections for both associate andowner dentist with these agreements,and the value of this written document

“What are the

benefits of adding

an associate? ”

Is an Associate Dentist in Your Future—Common Mistakes to AvoidBy Ellen M. Grady


Bike Commute Hotline ..................585-BIKE

Cars – Abandoned ..........................781-JUNK

Cars-Blocking Sidewalk ..................553-1200

Cars-Parking Citations....................553-9888

Cars—Towed Vehicles ......................553-1235

City Trees ............................................665-2162

Curb Painting Requests ..................554-2336

DPW.....................................................554-6219

Dumping (illegal) .............................695-2017

Graffiti Removal............................241-WASH

Mayor’s Office ...................................554-6141

[email protected]

Noise Abatement ..............................554-5815

OLSA....................................................554-6235

[email protected]

Police—Anonymous Tip Line ........614-3451

Police- Emergency (anon.)..............553-8090

Police-Non-Emergency....................552-0123

Street Cleaning..................................695-2017

Street Light Repair ...........................554-0730

Supervisors

D-1 Jake McGoldrick .................554-7410

[email protected]

D-2 Michela Alioto-Pier ............554-7752

[email protected]

D-3 Aaron Peskin .......................554-7450

[email protected]

D-4 Ed Jew ..................................554-7460

[email protected]

D-5 Ross Mirkarimi....................554-7630

[email protected]

D-6 Chris Daly.............................554-7970

[email protected]

D-7 Sean Elsbernd ....................554-6516

[email protected]

D-8 Bevan Dufty .........................554-6968

[email protected]

SOME IMPORTANT NUMBERS:

50% Sold to MDs and Oral Surgeon. New 10 unit office + retail commercial condos in elevator building ready for build to suit, equipped w/CAT5e, coax and fiber optic wiring, and individual HVAC for each unit; all separately metered for utilities. 4 ADA bathrooms in common area. Square footages are approximates and measured from the exterior wall per surveyor.

Call for appointment with Golden Coast Properties, Kevin Wong 415-290-2927.

3107 – 3121 Geary Blvd. (Spruce/Cook) Office Condos for Sale

Floor Unit SqFt *Price 2nd 3107 1,065 715,000 3rd 3117 645 475,000 3rd 3115A 660 495,000 3rd 3113 1,053 725,000

Ground 3121 698 535,000 *Prices as of 03/31/07 and subject to change. The information contained herein has been provided by various sources which may include the seller, public records, multiple listing service or others. Golden Coast Properties has not verified or investigated the accuracy of this information.

R

D-9 Tom Ammiano ...................554-5144

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D-10 Sophie Maxwell ................554-7670

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D-11 Gerardo C. Sandoval ......554-6975

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UOP Arthur A Dugoni School of Dentistry…

On Saturday, April 21, UOP students spent a day getting ready for the “real world” of dentistry, meeting with practitioners fromthroughout the Bay Area, and listening to voices of experience on transitioning from student to practitioner. The San FranciscoDental Society was invited to participate in UOP’s Mentor Day, with SFDS leaders Drs Curtis Raff, David Ehsan and Lauren Hebelaccompanied by SFDS executive Director Deborah Elam meeting with this year’s graduates, many wishing to stay in the area. Pleasekeep us in mind when looking for an associate…we have a list that we are happy to share with members looking for associates.

UCSF School of Dentistry…

Dr. Bertolami, current the dean and professor of Oral & Maxillofacial Surgery at the University OfCalifornia San Francisco School Of Dentistry has been named the 14th Dean of the 142-year-old New YorkUniversity School of Dentistry. He will assume the post at NYU’s College of Dentistry on September 1,2007. During his 12 years at the UCSF School of Dentistry, he has led the nation in overall NIH fundingfor dental schools. In addition to expanding the school's research capacity, he has also: enhanced theschool's clinical and teaching programs, including renovating clinics and laboratories; implemented a newcurriculum reinforcing integration of basic and clinical sciences in dental education; established andexpanded joint degree programs; and established a year-long post-baccalaureate program for studentsfrom economically or educationally disadvantaged groups. Congratulations Dean Bertolami.

CAMPUS NOTES

SFDS ONE TASK PLEDGE

Name: ____________________________________ Date: ______________________________

E-Mail: ____________________________________ Phone: _____________________________

I appreciate the work of the San Francisco Dental Society (SFDS) and will pledge to do “one task” for theSFDS during the coming year. I understand that the SFDS will contact me upon receipt of this pledge. I will: □ Write an article for The Bridge□ Mentor a new member □ Serve on a committee □ Serve on a task force□ Participate in our Kindergarten School Screening Program

□ Other (specify) _____________________________________________________________________________

_______________________________________________________________________________________________Return your pledge to the: San Francisco Dental Society, 2143 Lombard Street, San Francisco, CA 94123Or fax: (415) 928-5297

� �


their relative responsibilities when apatient has dual coverage, typically whenthe patient’s spouse has his or her owndental plan that covers spouses and/ordependents. In recent years, CDA’smembers and their patients have seenincreasing instances in which dentalplans that are the secondary payers areusing “non-duplication” clauses andother similar policies to deny any addi-tional reimbursement beyond what theprimary plan has already paid. CDAbelieves that these policies unfairly short-change patients and employers who havepaid premiums to the secondary payerwith the expectation that benefits will infact be provided. This year CDA is spon-soring AB 895 by Assembly MemberGreg Aghazarian (R-Stockton), whichwill require dental plans, when they aresecondary payers, to provide supplemen-tal reimbursement for treatment provid-ed, not to exceed the total amount of theclaim, and will require all dental plans toclearly disclose their coordination of ben-efits policies in the evidence of coveragedocuments they provide to theirenrollees.

AB 834 - Children’s Dental DiseasePrevention Program (CDDPP)Enhancement:

CDA is sponsoring AB 834 by AssemblyMember Mary Hayashi (D-Hayward),which among other things will change

the $10 per child reimbursement cap to aper-child minimum, encourage thebilling of government programs therebyaccessing federal matching funds, andcreate a state advisory committee to pro-vide ongoing program guidance. Thiswill allow more children to be served andsignificantly more dental sealants to beprovided to those children.

AB 17 - California Dental Corps LoanRepayment Program:

In 2002, CDA sponsored legislation thatestablished the California Dental CorpsLoan Repayment Program, designed toprovide incentives for newly licenseddentists to practice in underserved areas.That law only provided funding for aperiod of three years, allocating $1 mil-lion per year for three years from thereserve funds of the Dental Board ofCalifornia. There are currently no fundsavailable to maintain this important pro-gram, and CDA therefore is sponsoringAB 17 by Assembly Member BillEmmerson (R-Redlands). AB 17 willrequire the Dental Board to give dentistsan opportunity make a voluntary $50donation to the Dental Corps LoanRepayment Program at the time of initiallicensure and at each biennial licensurerenewal. This will help increase access todental care in underserved areas by estab-lishing a stable, long-term source offunds for this program.

SB 534 - Licensure of DentalHygienists – Separate Board:

Under current law, the Dental Board ofCalifornia is responsible for licensureand regulation of dentists, dental hygien-ists, and registered dental assistants. TheCommittee on Dental Auxiliaries(COMDA) is a separately appointed com-mittee of the Dental Board, whichadministers the licensure process fordental hygienists and dental assistants,but otherwise acts in an advisory capaci-ty to the board. Last year, SB 1472(Figueroa), which would have created aseparate California Dental HygieneBureau within the state Department ofConsumer Affairs, was opposed by CDAand ultimately vetoed by the Governor.With Senator Figueroa having left thelegislature at the end of 2006 due toterm limits, this year Senate PresidentPro Tem Don Perata (D-Oakland) hasintroduced SB 534, which is intended tocreate a separate regulatory board fordental hygienists, equivalent in generalstructure and authority to other regula-tory boards including the Dental Board.

We are excited about this year’sLegislative Day and will be informingyou of all of the developments regardingthe above legislations in the next issue ofThe Bridge. ❖

On Your Behalf continued from page 2

Published by the San Francisco Dental Society2143 Lombard Street • San Francisco, CA 94123

415.928.7337 • Fax 415.928.5297 • Email: [email protected]/Design - Nova Graphic Services

Printing - Sundance Press

Advertising rates and information sent upon request. Acceptance of advertising in The Bridge in no way constitutes approval or endorsement by the San Francisco Dental Society of products or services advertised. The SFDS reserves the right to reject any advertisement.

Opinions expressed by authors are their own, and not necessarily those of the SFDS or The Bridge editorial board. The SFDS reserves the right to edit all contributions for clarity and length, as well as reject any material submitted.

The Bridge is published bi-monthly by the SFDS, 2143 Lombard Street, San Francisco, CA 94123, 415.928.7337. Subscriptions are $35 per year to cover postage and handling. � 2007, San Francisco Dental Society. All rights reserved.

Deadline for May 2007 publication is: April 1, 2007


Ihave had the pleasure of represent-ing a number of excellent dentistsover the last twenty years. Over that

period of time, I have also observed thatmany of the claims involved a similarpattern of conduct. The following arebased on cases I have had, and I offerthese as suggestions so that you canavoid having to make that call to yourinsurance agent to report a claim.

1. Don’t begin treatment before mak-ing sure your patient knows whatyou are going to do. Many claimscan be avoided by the simple step ofconfirming with the patient what youintend to do that visit. I was involvedin a claim by a patient who was toldby the front office staff that the doc-tor would smooth out her incisor tohide a small chip. After seating thepatient, the doctor immediately start-ed what he thought was the plannedprocedure – a full crown!

2. Don’t bill for work until it hasbeen completed. Most insurers payfor work when complete. Don’t billthat crown until permanent cementa-tion or you risk not only problemswith the insurer, but also the patientif they go elsewhere for permanentlycementing the crown only to discovertheir insurance won’t pay the newdentist because they already paid you.

3. Don’t scare your patients intoagreeing to have multiple crownsdone. Avoid using purchased intra-oral slides showing horrible, decayedand broken down teeth for the pur-pose of convincing your patient tohave crowns made. I represented adentist whose insurer paid six figuresto settle a claim by a patient whoclaimed she was scared into agreeingto have multiple crowns to avoid herteeth falling out like the slides.

4. Be careful about suing yourpatient for unpaid bills. In myexperience, patients refuse to paytheir bills for one of two reasons.Either they cannot afford it, or they

9. Refer those patients who needtreatment beyond your comfortzone. You know what your comfortlevel is. If you decide to treat apatient for a procedure that mostreasonably competent general den-tists would have referred, you will beheld to the same standard of care asthe specialist. I have had many failedendo cases and many extraction caseswhere the result was less than opti-mal and the patient sued, claimingthat the endodontist or oral surgeonwould have achieved a better result.

10. Do not ignore the inquiry letterfrom the Dental Board. If youreceive an inquiry letter from theDental Board, do not ignore it. TheDental Board is required to investi-gate patient complaints. Many ofthese complaints are unwarrantedand totally without merit.Nevertheless, do not assume that theDental Board will figure that outwithout your having to waste yourtime responding to their inquiry.

You probably noticed that most ofthese are really a matter of commonsense. Good communication withinyour office will greatly reduce your riskof being sued. If you do get sued, how-ever, there are also a number of thingsyou can do to reduce your risk of anadverse result in the lawsuit. Yourdefense attorney is a valuable resourceand I urge you to make the time tomeet with him/her so that you can beassured of an optimal result. ❖

Reprinted with permission of the MidPeninsula Dental Society

are unhappy about some aspect oftheir treatment. If they are unhappy,the minute you commence aggressivecollection, they will commence find-ing an attorney to represent them insuing you for malpractice.

5. Be sure to tell your patient aboutthe broken file tip in the canal.While breaking off the file tip in thecanal may not violate the standard ofcare, prudence requires that thepatient be told about it so that thepatient can be on the alert for anysigns of problems. You don’t wantthe patient’s first knowledge of it tocome from the new dentist down thestreet.

6. Do not allow your patient’s insur-ance coverage to dictate treatment.I represented a dentist who held offscheduling his patient for badly-need-ed crowns because the patient’s den-tal insurance had been used up forthe year. The patient sued when shewent to a new dentist several monthslater and learned that the long delaycaused her additional injury – thechart said nothing about the reasonfor the delay in scheduling.

7. When you make a mistake in thechart, do not erase it. Do not eraseor obliterate entries in the treatmentrecords. When a mistake occurs,rather than erase or obliterate theincorrect entry simply draw a singleline through the entry, mark it“error” or “incorrect entry” and dateit to show that it was discovered andchanged on that date.

8. Do not alter the patient treatmentrecord. Resist the temptation to addinformation in the chart after-the-fact. If you failed to properly notatethe chart, that can be dealt with byyour defense counsel (who will arguethat it is a rare case where the failureto notate something in the treatmentchart caused injury to the patient).Alterations give the appearance ofhiding something.

Ten Ways To Dodge The BulletBy James C. Haigh, Esq.

JUNE6 CPR at SFDS

2143 Lombard6:00-9:30 PM, $60, 4 CE

7 Legislative Committee Location TBD, 6 PM

21- ADA New Dentist Conference 23 Portland, Oregon

26 CND Seminar Series2143 Lombard6:00 -8:30 PM, $10

28 Board of DirectorsLocation TBD, 6:30 PM

JULY4 Holiday - Business office closed5 Executive Committee

SFDS, 2143 Lombard, 6:30 PM

16- ADA Mgmnt. Conference20 Chicago, Illinois

27 Council on MembershipCDA Sacramento

AUGUST2 Executive Committee

SFDS, 2143 Lombard, 6:30 PM

10 DBC Required Infection Control& OSHA Bloodborne PathogensSFDS, 2143 Lombard8:00 am -12:00 PM, $85, 4 CE

10 DBC Req. Dental Practice Act,SFDS, 2143 Lombard1:00-3:00 PM, $45, 2 CE

10 Hazard Communication PlanSFDS, 2143 Lombard3:00-5:00 PM, $45, 2 CE

10 Peer Review WorkshopCDA, Sacramento, 9 AM – 4 PM

10 Social Hour, Tony Niks1534 Stockton, 6:30 PM

14 New Dentist Seminar SeriesSFDS, 2143 Lombard6:30 PM, $10

SEPTEMBER5 CPR at SFDS

SFDS, 2143 Lombard6:00-9:30 PM, $60, 4 CE

6 CE Evening MeetingMarines’ Memorial6:00-9:30 PM, $59 2 CE

14 DBC Req. Dental Practice Act,SFDS, 2143 Lombard1:00-3:00 PM, $45, 2 CE

19 Board of DirectorsSFDS, 2143 Lombard, 6:30 PM

27- ADA Annual Sessions 30 Moscone Center, go to:

http://www.ada.org/prof/events/session/index.aspfor more information

2143 Lombard St., San Francisco, CA 94123

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