here and now - amazon web services · 2018. 5. 17. · office design crowley recommends a prominent...
TRANSCRIPT
There’s no need for dentists to wait until the end of the year to take advantage of equipment tax breaks.
Here and Now
For Dental Sales Professionals September, 2012
For Dental Sales Professionals June, 2010A partnered publication with Dental Sales Pro • www.dentalsalespro.com
S p e c i a l e q u i p m e n t i S S u e
www.firstimpressionsmag.com : First Impressions : September 2012 : 3
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September 12
An Eye for DesignPatrick Crowley helps dental practices create appealing, efficient office space. ......................p.4
Here and NowThere’s no need for dentists to wait until the end of the year to take advantage of equipment tax breaks. .................................................p.14
Climate improves for financing ...........................................................................................p.20
Dust BustersClean air helps ensure that dentists and their staff can breathe easy that their practice is safe. .......................................................................................p.26
Problem SolverOne service tech says it’s the people who make the difference .............................................p.29
Investing In IDS ..............................................................................................................p.32
News .............................................................................................................................................................p.34
p.20
“The equipment rep is the best friend the
dentist will ever have. They understand the equipment and they
understand the needs of the dentist,
and they can help the dentist make
decisions.”– Ray Doherty,
president and CEO, Healthcare Professional Funding
4 : September 2012 : First Impressions : www.firstimpressionsmag.com
office design
An Eye for DesignPatrick Crowley helps dental practices create appealing, efficient office space.
Life is too short to work in an old office, Patrick Crowley tells his dental practice customers. And patients aren’t too wild
about it either.With offices in Boston and Or-
lando, Crowley has helped hundreds of dentists design and remodel their offices. “I love what I do,” he says. “I get to work with doctors every day of the week. I sit across the table from them, take their dreams and turn them into reality.” And he considers
distributors’ equipment reps an es-sential part of the team.
Crowley’s love affair with building things began in college, when he majored in engineering and construction manage-ment. After graduation, he worked for a large firm, building hospitals, schools and prisons. They were mostly big jobs, typi-cally ranging between $28 million and $78 million. His first dental office was located in a new prison.
He enjoyed his work, but in 1989, he decided to start his own thing.
Patrick Crowley
“I advise my clients, at least once a week, to walk in
the front door of the practice and look
around. What does the patient see?”
– Patrick Crowley
“I saw there was a better way to enjoy life and help people,” he says. That meant scaling down the scope of his projects. “When you’re building a hospital or school, you’re working with committee after committee. Now, I work directly with the decision-makers.” He’s been designing dental (and some medical) offices ever since, primarily in New England and the mid-Atlantic region. Four years ago, he wrote his first book on office design.
6 : September 2012 : First Impressions : www.firstimpressionsmag.com
office design
Seen better daysDoctors often fail to notice that their office has seen bet-ter days. “It’s all about first impressions,” says Crowley. “When that patient walks in, what’s their first impression?” It shouldn’t be worn carpeting, “Leave it to Beaver” har-vest gold countertops and dark wood paneling, or chipped cabinets with peeling laminate.
Does the office have a stacking problem? That is, is there simply so much clutter, that boxes of gloves and oth-er commodities are stacked here and there? The question brings to Crowley’s mind one office in which the staff took to hanging scrubs on the panoramic X-ray unit. He still has a photo. “As soon as I saw that, I knew they needed help.”
And how about the paint job? Gray and mauve looked cool 20 or 30 years ago, but today? “It’s a telltale sign of a practice in need of change,” he says.
“I advise my clients, at least once a week, to walk in the front door of the practice and look around,” says Crowley. “What does the patient see? Then sit in the dental chair and look up. What do you see? Are there cobwebs on the air conditioning ducts?”
Planning the projectThe most important part of a remodeling or rebuilding project begins before the project commences. Crowley walks through a 14-page questionnaire with his clients. “It’s our design planning guide, and it’s one of the most
powerful tools we have,” he says. “It helps us find out their needs, their goals, their main objective for the renovation.” Equipment is part of the discussion.
Sometimes the goal and objective is simple: “My daughter is graduating from dental school next year and I need another operatory,” or “The space next door just became available, and I’d like to expand.” Crowley recalls one expansion project in which the client didn’t want more operatories, but did want to gain a staff lounge and con-sultation room. “For her, it was a quality of life issue,” he says. Asking open-ended questions helps him find out what’s really motivating the dentist.
Amenities, amenities, amenities“Today, it’s all about amenities,” says Crowley. Doctors are in busi-ness, and their patients can choose where they spend their dental dol-lars. “Patients will go someplace comfortable, professional and soothing.” Twenty years ago, the classic restroom look was white on white. “Today, we want that rest-room to be like that of an upscale hotel or fine restaurant,” he says. No more bright fluorescent lights. “We want a different feel.” Maybe some fresh flowers. And the seating area? How about a coffee bar, juice
bar and flat-screen TV?Amenities are necessary, but doctors need to be care-
ful about going over the top. “You don’t want the patient to walk in and say, ‘Wow, am I paying for this?’” says Crow-ley. The rule of thumb is this: Don’t design the office – the seating area, in particular – much nicer than the living rooms in your patients’ houses or the restaurants they visit. “But if it’s a Four Seasons crowd, make it a Four Seasons style office. Tailor it to your clientele.”
Seating area and front deskThe front desk should be one of the first things patients see when they walk in the door, says Crowley. It puts them at ease, so they know immediately where they’re headed.
Amenities are necessary, but doctors need to be careful about going over the top. “You don’t want the patient to walk in and say, ‘Wow, am I paying for this?’”
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8 : September 2012 : First Impressions : www.firstimpressionsmag.com
office design
Crowley recommends a prominent logo wall with an ac-cent color, so the patient can be reassured he is, in fact, in the right office.
Automation has meant many good things for dental practices, not the least of which is the elimination of the patient record “wall” immediately behind the front desk. “I hated walking into the office with that wall of 8,000 charts,” says Crowley. “I don’t want to be one patient among 8,000.”
The front desk staff should have a commanding view of all the chairs in the seating area. “I don’t want a blind spot,” says Crowley. That way, staff can make sure that all patients have indeed signed in, rather than sitting down and quietly waiting to be called. “Also, what if there’s a medical
emergency, someone slumps in their chair?” Crowley also frowns on bisected seating areas, in which visitors must walk between rows of seats to get to the front desk.
“And I never put a clock in the seating area. If the office is running late, do you want to reinforce that?” It’s better to keep patients distracted, perhaps by a coffee bar or flat-screen TV. “But I’m not a big fan of having a TV over the front desk,” he adds. “I want to steer patients away from looking at the front desk. The staff isn’t there to entertain patients.”
One final note about the seating area: Sight lines should be taken into consideration. “Patients should not be able to see into an operatory,” he says. “Nor do I want them seeing a staff member carrying a soiled tray back to the sterilization area.”
OperatoriesEfficiency is the key word in office design. “Doctors are spending a small fortune on their new office,” he says. “It’s
our job on the design and construction team to make that office as efficient as possible.”
Because the doctor spends the majority of his or her day in the operatory, it should be a pleasant room. “It needs to be efficient, patient-pleasing, and a happy place for the doctor and staff to work.” Some doctors are concerned that their new facility or office space lacks windows. “A great design team can overcome that,” says Crowley. They can do so by carefully selecting the paint color on the walls, installing a flat-screen TV, or even building simulated windows.
Equipment considerations are all-important. “I tell my clients to create an equipment list on a room-by-room ba-sis,” he says. “We want to know where it is going; we want
to make sure it has a home.” Today, every room has at least one computer and at least one monitor, often more; as well as microscopes, lasers, milling machines, etc.
The design and construction team must make every effort to ask detailed questions about equipment prior to the job, says Crowley. “We want to look at all equipment needs, down to the curing light.” Does it need electrical power? A dedicated circuit? How about compressed air? A costly – and easily avoidable – mistake is to skimp on the number of electrical outlets in the operatory. Installing an outlet during construction costs a hundred bucks, but much more after the job has been completed.
The equipment rep is crucial to this stage of the proj-ect. He or she can ask probing questions of the doctor and staff to help them determine the optimum layout of the operatory. For example, what is the doctor’s preferred delivery method?
As it is throughout the office, lighting is crucial in the operatory. “Inadequate lighting is the largest source of
“Doctors are spending a small fortune on their new office. It’s our job on the design
and construction team to make that office as efficient as possible.”
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office design
eyestrain in the operatory,” says Crowley. Typically, what happens is, the dentist focuses on the highly illuminated oral cavity, then shifts his or her gaze to the countertop, which may be in shadows. His or her eyes must adjust, and then it’s back to the oral cavity. “We want to keep the light in the room as uniform as possible,” he says. Under-cabinet lighting can help.
Ancillary areasImaging stations, sterilization areas and labs must be carefully thought out prior to construction, says Crowley.
Dark rooms are increasingly rare. In fact, given the rise of digital imaging,
Crowley hasn’t built one in many years. Instead, today’s offices have digital imaging stations. Crowley recommends dentists think ahead. “We recommend they plan for a pan-oramic X-ray, even if they don’t have one today. And we also advocate that they plan for a cone beam unit.”
A poorly designed or undersized sterilization area can be one of the biggest bottlenecks in the clinical zone, says Crowley. Having the appropriate number of autoclaves and adequate square footage can go far in increasing the efficiency of the practice. As in operatories, Crowley pre-fers under-cabinet lighting to help illuminate the work sur-face for the staff.
“We try to make the sterilization room light and bright,” he adds. “I want to instill confidence in patients walking by, that ‘This is for your health and safety.’” Only the clean side of the room should be visible to patients in the corridor. “I don’t want them looking at a tray with
bloody gauze pads on it. I want them to see neat, clean, sterile, bright.”
Labs are best located in a remote spot in the office. They tend to get dirty, dusty and noisy. Crowley advocates
installing exhaust fans for odor control, particularly if the practice uses acrylics.
CheckoutOne of the most important rooms in the office is the consultation room, says Crowley. “It can be the most profitable room in the practice.” This is where the doctor makes clinical presentations and, ideally, the financial coordinator makes financial ones.
Like the rest of the office, the consultation room should be light and bright, says Crowley. “I advocate us-ing glass doors and windows; the patient should never feel trapped.” The consultation room is a great place for doctors to hang their credentials. “We call it the ‘halo wall,’” says Crowley. As the doctor is making her clinical presentation, behind her are diplomas and awards, each re-inforcing her professionalism and competence.
Ideally, the consultation room is located next to the checkout side of the front desk. “Finances are a tricky subject for a lot of people,” says Crowley. “Some people might have a problem saying, ‘I can’t afford that,’ or ‘My wife was just laid off.’” In the consultation room, they can discuss financing options and billing questions in confi-dence. There’s another plus to this setup: “You don’t want a patient who’s checking in to listen to someone arguing about their bill.”
Dark rooms are increasingly rare. In fact, given the rise of digital imaging, Crowley hasn’t built one in many years. Instead, today’s
offices have digital imaging stations.
12 : September 2012 : First Impressions : www.firstimpressionsmag.com
office design
The consultation room can also serve as an overflow checkout area or, if needed, a VIP seating area for pa-tients who are in discomfort or who have special needs. It serves another useful purpose – as a buffer between the seating area and the clinical zone. “We don’t want sound transferring from the operatories to the seating area,” says Crowley. Speaking of buf-fers, he advises against locating the staff lounge or a doctor’s private of-fice immediately adjacent to the seat-ing area. “If the doctor or a staff member is in the lounge making a personal phone call, you don’t want the patients listening in,” he says. A restroom is also an option for a buffer.
Like the sterilization area, checkout can be a bottleneck, particularly as practices increasingly collect payment and set up re-appointments on the spot. That’s why Crowley ad-vises all practices to have at least two checkout stations. One of those stations should be a sit-down station; elderly pa-tients, or those with special needs, will appreciate the oppor-tunity to sit down to settle their accounts. One more point: Though chairs without arms conveniently slide under the desk when not in use, they are also more difficult for some patients to get out of. Chairs with arms are preferred.
CaveatsAt his day-long seminars on dental practice design, Crow-ley finds that doctors are eager to learn the most common mistakes their colleagues make when designing and building offices. The foremost failure, he tells them, is rushing the project. “They’re making a significant investment; they’ll be in this facility 10- or 20-plus years. The floor plan needs to be perfect. So keep working it, revising it, until you get it exactly the way you want it.” And don’t rely on incomplete plans and specifications. If cabinets are indicated in the plan, the doc-tor needs to make sure he or she knows how deep and tall they are. And what’s under the front desk window – painted
drywall, decorative tile, cherry wood? “Doctors can overspend because they don’t have complete plans. That can lead to change-orders.”
Another common mistake: Se-lecting the low-cost builder, espe-cially if that person or company has little experience in dental offices. Building dental offices is complex, and the mistakes and re-work by an inexperienced builder can cost the practice more than coughing up big-ger dollars upfront for experience.
One of Crowley’s pet peeves is the use of one color of paint through-out the entire office. “I say, add a bold
accent color,” he says. And allocate 1 percent to 2 percent of the construction budget to artwork, he says. What’s more, think about hanging some attractive sconces on the wall in the corridor.
Some doctors try to save a few dollars by bringing their old furniture to their new or newly designed office. Patients will notice, he says. “You just spent $400,000 on the project; let’s spend another $4,000 or $5,000 to spruce it up.”
The equipment repThroughout the entire process, the distributor rep plays an essential role, says Crowley. In fact, he works with them every day. “They might be the first person to know that the doctor wants to design, build, remodel or expand,” he points out. They are on hand to monitor construction, and they’re there when equipment is delivered. “It’s great hav-ing an experienced set of eyes.”
For the distributor rep to play an important role, he or she – like everyone else – must stay in close communication with builders, contractors, architects, etc., he says. “Sometimes the equipment rep leads the charge, sometimes the architect, sometimes the contractor. But it’s a team approach. So long as we’re all working for the benefit of the doctor. He or she is making a significant investment. It’s our job to make sure he gets a maximum return on that investment.” [FI]
Editor’s note: Patrick Crowley is the author of Dental Office Design: 1001 Practical Tips for Creating Your Ideal Dental Office, and may be reached at [email protected].
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14 : September 2012 : First Impressions : www.firstimpressionsmag.com
cover storycover story
Why wait until Decem-ber to make personal resolutions? And, for that matter, why let your dental customers wait
until Thanksgiving to take advantage of equipment tax breaks? Indeed, tax breaks are available to dentists year round, notes Kirk Greenway, field sales consultant, Henry Schein Dental. “They don’t have to wait until December to get a tax break. That just happens to be the time of year when it is on their minds and when their accountant is dis-cussing it with them. But, the reality is they can take advantage not only of the tax break, but the benefits of their new [equipment] investment any time [during] the year.”
There’s no need for dentists to wait until the end of the year to take advantage of equipment tax breaks.
By Laura Thill
Here and Now
16 : September 2012 : First Impressions : www.firstimpressionsmag.com
cover storycover story
It’s human nature to take a wait-and-see approach, adds Jim Connor, equipment specialist, Burkhart Dental Supply. “The end of the year is a good time for personal reflection – a time for dentists to think about what they would like to do differently before heading into the new year,” he says. “Also, dentists often meet with their ac-countant at the end of the third quarter, and the accoun-tant may say, ‘Now is the time to make changes and take advantage of tax breaks, such as section 179.’” It’s natural for dentists to be concerned about how tax breaks will affect them in the coming year, he notes. This is also a time when sales reps are motivated to discuss equipment purchases, he adds.
That said, some dentists plan large-scale projects at the end of one year – and the beginning of the next, notes Connor. “Then they can get tax benefits two years in a row,” he says. “These are not dentists who are mak-ing last-minute decisions. These are the dentists who work with good accoun-tants. There are dental-specific CPAs who can project two- or three-year equipment purchase plans,” he adds.
Need or desire?In Greenway’s experience, dentists base their equipment purchases first on need, then on revenue. “I think the hierarchy for year-end purchases is typically needs-driven, followed by equipment or tech-nology that makes them new money or expands their ser-vice mix,” he says. “Last, [they ask themselves], ‘What is something I want or that will make my life easier?’” His customers typically look to add or replace an operatory at the end of the year, or add/replace technology such as sensors, panoramic x-ray, cone beam and/or CAD CAM.
No matter what time of year dentists make a big pur-chase, they want to be certain it is an investment – not unnecessary overhead, Greenway continues. “Purchasing equipment just for the sake of purchasing equipment [often]
creates new overhead,” he points out. “Purchases become an investment when there is a return associated with them – such as when they allow dentists to create a better experi-ence for their patients, leading to new referrals.” Equipment purchases that enable dentists to offer new procedures – rather than refer those services to specialists – generate ad-ditional sources of revenue for the practice, he adds.
Timing can also impact an equip-ment purchase, according to Connor. When making end-of-year purchases, “dentists generally look at products that are easy to install in the 11th hour,” he says. He agrees that prod-ucts that yield the greatest return on investment tend to be high on den-tists’ wish list. “Some may be looking to redo an operatory and many are still making the switch from [film-based] x-ray to digital,” he explains. “But, the bulk of what we see are products that can be easily integrated into a practice without the disruption of construc-tion.” Some examples are digital ra-diography, panoramic radiography, stand-alone chairs, curing lights and digital sensors. “That’s not to say these are cheap items. But, they are relatively easy to install,” he adds.
“Some dentists look at the cost of adding new products, while others look at their cashflow,” says Connor. “In my mind, they should be looking at both cash flow and return on investment.”
It’s not always how much a product costs, but how much rev-enue it can generate, he points out, “and some dentists have a better aptitude for this concept than others. Also, dentists should ask, ‘How will I integrate this [new equipment] seam-lessly into my practice? Will this be a headache for my staff to learn to use?’” Asking the right questions up front can help ensure more efficient results.
One dentist’s experienceFor Sheri Doniger, DDS and owner of a Lincolnwood, Ill.-based practice, “it’s always good to start the year off
“Some dentists look at
the cost of adding new
products, while others look at their
cashflow.”– Jim Connor,
equipment specialist, Burkhart Dental Supply
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18 : September 2012 : First Impressions : www.firstimpressionsmag.com
cover story
with new and fresh.” However, she bases her purchasing de-cisions on need. “As does any wise consumer, I do research to determine the best product for the best value,” she says. “End of year promotions are attractive but, as with any purchase, you must need something before you buy it. Also, some offices may feel the [effects of the] recovering economy more than others. There are areas of the country where the economy still has not bounced back and the pa-tient load is not where it was a few years ago. Other offices may feel that the economy is rebounding and plan for a larger volume of patients in the coming year.
“We did not see a huge growth this year, but we are cautiously optimistic for 2013,” she continues. “The dis-tributor sales rep who is familiar with our practice should be cognizant of our current ordering patterns and not advise huge increases. One other factor is product avail-ability. If a dentist does research on a particular item, the distributor sales rep should understand that if [his or her] company does not carry the product or piece of equip-ment that is sought out, [he or she] should expect the den-tist to go to a different source for purchase. The dentist will be grateful for the rep’s understanding and will return to [him or her] for future purchases.”
As to whether the end of the year is the best time for Doniger to make equipment purchases, that depends on the needs of her practice, she says. “I believe dental practices
should set up a replacement cycle program for equipment in their office. Certain pieces do have a specific life. Dentists should [finance] preventive maintenance on their equipment to determine the usage life. Manufacturers are aware of the approximate length of service for each piece of equipment (depending on average usage). Dentists also should be aware of this concept [to avoid] surprises during the year.” She speaks from experience. “I had an interesting situation last spring, when I needed a new dental chair due to [the original breaking],” she explains. “That was an unexpected drama in our office. I prefer a research [approach] rather
than a [having to] buy whatever is available [approach].” Typical end-of-year purchases for her practice include large equipment and office furnishings, as well as disposables with a long shelf life.
The rep’s roleDentists often depend on their sales reps for an explanation of tax ben-efits. “We are expected to know the tax story,” says Connor. “Customers now expect us to know about tax credits and reimbursement rates for specific procedures, [whereas] years ago they didn’t. So sales reps need to stay current on these matters, he points out. “I send a tax proposal
with every order.” Based on dentists’ order history, he can project what they can expect with regard to taxes, he adds, noting that Burkhart provides its sales reps with appropriate information and forms to help them work with customers.
Given the recent economic downturn, however, Do-niger cautions sales reps not to look as closely at dentists’ purchasing history. “I know of several offices that [tradi-tionally have] remodeled at the end of each year,” she says. “But for the past few years, things have been different. We [have been] cautiously optimistic for 2012.” Indeed, while many patients have avoided going to the dentist for finan-cial reasons, “there are so many untreated dental problems out there, they have to [return] to our offices sooner rather than later,” she says. And the sooner they do so, the sooner dentists can resume their old purchasing patterns.
www.firstimpressionsmag.com : First Impressions : September 2012 : 19
The more dentists understand about tax codes and their ramifications, the better off they are, says Doniger. “If distributor sales reps have a condensed version of Sec-tion 179, they should leave it with their dental customers. With Section 179, businesses can elect how much depre-ciation expense to take, which is not defined in a depre-ciation table. This increases the amount of depreciation expense dentists can utilize in the year of the equipment purchase.” When sales reps explain this in laymen’s terms, they may encourage dentists to make larger purchases, she adds, noting that “to fully take advantage of depreciation expenses, [dentists] should have an end-of-year profit. If dentists know they have a profit, [they’ll see it is] beneficial to make a large equipment purchase.”
“Dental dealers have a responsibility to educate their dental customers on all purchases,” says Connor, who
likes to initiate an equipment/technology discussion with an open-ended question, such as “Have you been thinking about adding anything new?”
“Then I stop and listen to what they have to say,” he ex-plains. Potential follow-up questions include:
• “Doctor, are you thinking about making any specific technological changes to your office?”
• “Have you thought about how this new equipment will help you better service/educate your patients and attract new business?”
Greenway agrees that servicing customers requires good communication skills on the part of the rep. “I address my [dental customers’] concerns through lots of discussion,” he says. “I provide a thorough analysis of how the doctor is cur-rently working and the type of dentistry [he or she] desires to provide. Then I can provide information to help the doctor make a decision that works best for [him or her].
“I will ask [my customers] questions as simple as, ‘What equipment purchases are you planning on making this year to maximize your tax savings?’ It makes sense for dentists to [de-vise] a specific plan to create the office of their dreams.” They should consider not only implementing new technology and services, but also to keep the office aesthetics in line with their mission, he points out. “They need to continually look at their practice through the patients’ eyes. When you work in [the same] environment every day, you tend not to notice wear and tear on equipment, fading colors, etc. But, when new patients come in, they notice these things right away. The visual expe-rience is critical to the type of patient care that’s provided.”
Why wait?Whether it’s a matter of shopping for Christmas or ex-panding one’s business, “human beings tend to wait until
the last minute,” says Connor. Furthermore, “we all reflect at the end of the year and get caught up in [an end-of-year] mentality. But, I think we’re missing the boat. I would want my tax breaks – and my equipment – as soon as possible.”
Besides, it doesn’t make good financial sense to wait until equipment breaks to replace it. “When it comes to [expensive] technology, dentists can’t always chew off the whole thing in one bite,” says Connor. “They need to set up a replacement schedule.” And, they should understand this, he points out, particularly since their patients are in the same position when it comes to financing expensive procedures.
“As I’ve said, all dentists should have [an equipment] replacement plan,” says Doniger. “If they buy new, they will have a better idea of how long the equipment will be in service.” The life of equipment varies, depending on usage and how well it’s maintained, she adds.
Every dental practice is different, says Connor. It’s up to sales reps to help customers evaluate their needs and determine the best solutions to meet those needs. [FI]
“I will ask [my customers] questions as simple as, ‘What equipment purchases are you planning on making this
year to maximize your tax savings?’ It makes sense for dentists to [devise] a specific plan to create the office of their dreams.”
– Kirk Greenway, field sales consultant, Henry Schein Dental
20 : September 2012 : First Impressions : www.firstimpressionsmag.com
cover story
“You can look at newspa-pers and online articles to see that financial institutions want to lend, but only to those with good credit,” says Keith Drayer, vice president, Henry Schein Fi-nancial Services. “So, combine the better credit of the over-whelming majority of dentists, and the fact that banks are inter-ested in lending to good clients, and that makes for favorable conditions today.”
“The climate today is very good,” says Ray Doherty, presi-dent and CEO, Healthcare Pro-fessional Funding, Boston, a subsidiary of the Bank of Maine. “Any dentist looking for financ-ing, who doesn’t have a major credit issue, will be able to obtain financing in the marketplace today.”
Equipment reps need to be prepared to talk with their customers about financing, according to those with whom First Impressions spoke. Lenders are eager to help by giving reps tools to help them discuss payment terms, payment
schedules and equipment payback periods with their customers.
The reason for debt“The financing is available,” says Doherty, whose company offers what he calls cradle-to-retirement financing, that is, financing for start-ing or acquiring a practice, buying equipment, selling a practice, “and everything in between.” Today, elec-tronic office management systems are at or near the top of those items for which dentists are requesting financ-ing, he says. Cone beam and milling machines also remain near the top, as they have for several years now.
“But there’s some pent-up de-mand,” he says. “Many dentists are waiting to see what will happen in the marketplace before replacing or up-grading their equipment. What’s hold-ing them back isn’t availability of fi-nancing, but their questions about how the economy will affect their practices. There’s a unique opportunity for den-tists to get financing today. Saying that, they will need to fill out more paper-work than they did in 2007.”
“Financial institutions are looking more closely than in the past at ‘What is the debt for?’” says Drayer. “But debt for good reasons always makes sense.” Today, big and small companies alike are using leverage to invest in and grow their businesses, he says. Dental practices are no exception. “Investing in a practice is still a great reason [to pursue financing], and those financings are well-received.”
Climate improves for financing
In the wake of the U.S. financial crisis a few years back, lenders remain skittish about the loans they extend to business owners and private individuals. Dentists seeking financing should expect a few more questions, and a few more forms to fill out than they did 10 years ago. That
said, it’s a safe bet that professionals with healthy credit histories will receive the financing they need to build their practices.
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cover story
“Technology, technology, technology” is driving fi-nancing demand among dentists, says Drayer. “Services that make practices more efficient, effective and profitable are truly in demand. Some of the best advertising a dentist can do is creating a professional and patient-welcoming atmosphere. Investing in an office that you would person-ally want to be treated at is essential. Patients with good experience produce referrals.”
Student debtNo discussion about debt would be complete without speaking of student debt. Almost 90 percent of dental students graduate with debt, reports the American Den-tal Association. More than 75 percent of graduates have more than $100,000 in debt, and more than 44 percent
have more than $200,000 in debt. The numbers are daunt-ing, but young dentists can obtain financing nonetheless, according to those with whom First Impressions spoke.
“It’s not a secret that undergraduate education as well as dental school costs have been going in only one direction,” says Drayer. “Specialists with extended edu-cation and residencies have even greater debt than gen-eral dentists. But experienced financial solution provid-ers expect to see these debt loads and know that the long-term prognosis of the earnings ability of dentists is excellent.”
“Student debt is going up, but we expect to see it,” says Doherty. “We look at it as an investment in [the den-tist’s] future. Our biggest concern with student debt is this: Has the doctor made the necessary arrangements with the
institutions – banks, the federal government, etc. – to fix his or her payments over a [defined] period of time?
“We look at the monthly payment. If that dentist is starting a new practice, it comes down to, ‘Can he gener-ate enough revenue to pay off the debt? We’re concerned about monthly payments, and that’s determined over how long he or she has spread the debt.”
Dental schools could and should do a better job of training young doctors on the business side of running a practice, says Doherty. Many young graduates fail to understand that running a business means managing em-ployees, dealing with accounting systems, etc., he says. Yet more than 90 percent of graduates will end up in private practice. That’s why he encourages young dentists to serve as an associate in another dentist’s practice prior to starting
their own shop. “It not only gives them a chance to learn how to practice dentistry in real situations, but it gives them an opportunity to see how a practice runs and how the owner manages it.” Another encouraging trend finds many young dentists hiring CPA firms to assist them on the financial side of their business.
Rep’s roleEquipment reps should approach the issue of financing not with di-
rections or suggestions, but with questions, says Drayer. “Open-ended, probing questions can yield answers and lead to a productive dialogue,” he says. “There are no bad questions to ask. If you want to close the sale, don’t pi-geonhole yourself. More options and probing questions will help you get to ‘Yes’ sooner.”
“The equipment rep is the best friend the dentist will ever have,” says Doherty. “They understand the equipment and they understand the needs of the dentist, and they can help the dentist make decisions.” When equipment reps talk to the practice owner, they should focus on his or her estimated monthly payments for new equipment, as op-posed to purchase price, and the potential profitability of the new equipment or system, he says. The financing ex-pert can carry the ball from there. [FI]
“ The equipment rep is the best friend the dentist will ever have. They understand the equipment and they understand the needs of the dentist, and they can help the dentist make decisions.”
– Ray Doherty, president and CEO, Healthcare Professional Funding
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24 : September 2012 : First Impressions : www.firstimpressionsmag.com
cover story
There are tax benefits to be had for those who take advantage of them. Tax codes may be overwhelm-ing for some dentists to navigate, but many today take time to explore the advantages they may offer their practice. The more distributor sales reps un-derstand about Section 179 – the section of the IRS tax code that allows businesses to deduct the full purchase price of financed or leased equipment and qualifying off-the-shelf software for the current year – the better they can advise their customers.
The good news is, the dental community does not appear to be lagging behind other areas of healthcare in its awareness of Section 179. “All healthcare providers seem to have many questions about the tax code, its implications and its applica-tion to their business,” says Jim Aycock, director of marketing and business development, Midmark Corp. “There are many questions about tax codes on their minds, and everyone is always very cautious because they don’t want to make a mistake. It is only natural for a healthcare provider to think critically, be cautious, and act conservatively.”
So, what does this mean for distributor sales reps? Quite a lot, says Aycock. “The role of distributor reps in a dental office is very complex and ever-evolv-ing,” he points out. “They serve as advisors, partners, suppliers, confidants, subject matter experts and more. To better help their doctors understand Section 179, distributor reps should make this part of an on-going communication and discussion. The tax code is not a year-end special or just part of a sales pitch. An appropriate and thoughtful plan for managing tax burden is an important aspect of running a successful business. Section 179 should be part of all business conversations dealer reps have with their doctors.” That said, dentists must work closely with their tax advisors, he adds. “Ultimately, dental customers need to discuss this matter with their tax advisor to ensure
they qualify for the deduction and that it is beneficial to them based on their tax situation.”
What and whySection 179 allows most small businesses to expense up to $139,000 of qualifying equipment additions in 2012, according to Aycock. “However, there are limitations, which could reduce or eliminate eligibility for Section 179,” he explains. “For example, the business in ques-tion must have taxable income in order to qualify for Section 179. Also, the maximum Section 179 deduction of $139,000 is reduced dollar for dollar of [one’s] total investment if qualifying property exceeds $560,000. For dentists who don’t qualify for Section 179 or [for whom] the benefit is limited, there is bonus depreciation avail-able in 2012. Under the bonus depreciation provisions, dentists currently can deduct 50 percent of the qualify-ing property additions without limitation in 2012. Bonus depreciation is only available on new property.
“We believe dentists would be more proactive in planning out their growth and building out their practice if they better understood Section 179,” he continues. “Den-tists would be able to enjoy, profit and improve the care they deliver sooner – and for a longer period of time – if a thoughtful plan was created that included the benefits of Section 179. Technology and large equipment investments would naturally increase as thoughtful planning develops.”
The economy requires everyone to be smarter and more diligent about his or her finances, Aycock points out. And that’s a good thing. “The best investments will still do well, and marginal investments will not pass the test of careful scrutiny,” he says. “Our experience is that dentists are not resistant to large equipment purchases. They require more data, thorough research and un-biased analytics for these purchases. Many seem to recognize that a good investment is a good investment when times are good, and an even better investment when times are tight.”
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26 : September 2012 : First Impressions : www.firstimpressionsmag.com
service techs – dust collector cleaning and maintenance
Dust BustersClean air helps ensure that dentists and their staff can breathe easy that their practice is safe.
The ins and outs of dust collectionDust collection technology is not new. It was introduced on a basic level many years ago as simple devices with filtration media. Early suction technology was inefficient, according to experts, but at the very least, it removed some harmful debris from the lab environment. As dentists and indus-try experts grew increasingly cognizant of health hazards, the technology improved. Today’s dust collection systems
reportedly can be used for all lab appli-cations and incorporate state-of-the-art drum filter technology designed to filter the smallest dust particle.
At the same time, the mechan-ics of dust collection has managed to remain uncomplicated. At the core of the system is a sealed compartment and air filter, through which contaminated air must pass. The contaminated air is sucked into the system via a vacuum-like motor – or a motor with a blower wheel.
While dentists may see the value of having a dust collector in their lab, some may not realize that they are much more than a luxury. Air quality in the lab can be adversely affected during the fabrica-tion of prosthetics, note experts. Dust collectors are a must to ensure work-ers’ health and safety, they point out. Furthermore, OSHA has been known to fine dental practices when dust col-lectors are not apparent at inspections. Service technicians should remind their customers that dust collection is essen-tial to maintaining a healthy environ-ment for lab technicians.
Working with customersA service call to a dental office or lab is not complete unless the service technician considers dust collection, according to experts. Addressing dust collection on a regular basis can save dental customers money and alleviate health con-cerns, they note. By inspecting the dust collector on each service call, technicians can observe how well the practice is maintaining the system. They can advise the user of the
Busy dental lab technicians have enough on their minds without having to worry about the quality of the air they breathe. Without a well-maintained dust collection system, however, the lab can become
a breeding ground for dust, odor, bacteria and germs. Service technicians do their dental lab customers a favor when they take time to inquire about their dust collectors. By inspecting the dust collector at every visit, service techs can monitor how well they are kept up and what repairs are necessary.
28 : September 2012 : First Impressions : www.firstimpressionsmag.com
service techs – dust collector cleaning and maintenance
status of the system and provide as-sistance in a timely manner.
Service techs should advise their customers of the importance of fol-lowing manufacturer instructions re-garding proper maintenance, cleaning and filter replacement. In fact, much of the maintenance and cleaning should be completed by the individu-als using the dust collector. Opera-tions manuals are available to instruct the user on cleaning and maintenance protocol. Unless the user fails to fol-low directions, duct collectors should continue to perform efficiently. While larger, centralized dust collection sys-tems tend to be more complicated and require more attention, smaller single-station units are more com-monly seen and generally require little technician intervention.
Service technicians should get in-volved when motor brushes need to
be changed or when the motor needs to be serviced. Dust buildup on work surfaces, as well as loss of suction or airflow, or a change in noise level, are further signs that the dust col-lector is not working properly or that the motor is failing.
When calling on a dental practice, service techs should be pre-pared to help their customers learn about – and understand –
the importance of using a dust collec-tor and how to care for it. Customers typically pose questions such as:
• “What type of dust collector does my practice require?”
• “How much do dust collectors typically cost?”
• “How large are dust collectors? How much space will one take up in the lab?”
• “How often should we clean our dust collector and replace its filter?”
• “Who is responsible for setting up a new dust collector? How is it done?”
• “Are there special electrical requirements I should be aware of with regard to my dust collector?”
Dust collection technology to-day is better than ever, according to
experts. Many units have two or three built-in filters to collect dust, odor, bacteria and germs. HEPA filtration and UV technology are said to be particularly effective in con-trolling the spread of infection. By working closely with dental customers and taking time to field their questions, service techs can help ensure more practices are on board with the newest, most efficient technology. [FI]
Editor’s note: First Impressions Magazine would like to acknowledge Handler International for its assistance with this piece.
• Today’s dust collection systems reportedly can be used for all lab applications and incorpo-rate state-of-the-art drum filter technology designed to filter the smallest dust particle.
• Dust collectors are a must to ensure workers’ health and safety, they point out. Further-more, OSHA has been known to fine dental practices when dust collectors are not appar-ent at inspections.
• Addressing dust collection on a regular basis can save dental customers money and alleviate health concerns.
Talking points
Dust collection technology today is better than ever, according to experts. Many units have two or three built-in filters to collect
dust, odor, bacteria and germs.
www.firstimpressionsmag.com : First Impressions : September 2012 : 29
Problem SolverOne service tech says it’s the people who make the difference
Darrell Maraggia is an outdoorsman. But he wouldn’t want to work there.
Raised on a farm in Victoria, Texas, 50 miles from the Gulf of Mexico, Maraggia,
who is regional service manager for Midwest Dental Sup-ply, knows all about working outdoors. His father was a manager in one of the big oilfield companies, and young Maraggia knew he could get a job there. “But working out-side in the heat and the rain all the time – I wasn’t into that.” But he did have mechanical ap-titude, which he honed while working on farm equipment at home.
From the time he was in high school, he knew he wanted to make a living fixing things. “So I looked around, saw a brochure from a tech-nical college and saw the word ‘bio-medical,’ where you repair medical equipment. I said, ‘That’s air-condi-tioned all the time.’ And that’s why I went into the medical side of things.” He’s only half-joking.
Dental service repair tech?After getting an associate’s degree in biomedical engi-neering, he got a job at a hospital in Fort Worth. But two years later, when the hospital decided to outsource many of its services, he looked for other opportunities. “I went through the paper and saw an ad for a dental service re-pair tech,” he recalls. “I didn’t even know they had dental service repair techs.” But he inquired and, in 1991, took a job with Reeve Dental in Dallas. He stayed with the com-pany following its acquisition in 1998 by Burkhart Dental. About 11 years ago, he joined Midwest.
“When [Midwest Dental Supply owner] Matt [LeVas-seur] hired me, I was the only service tech in the Dallas/Fort Worth area,” he says. But as Midwest grew, Maraggia assumed management responsibilities for a growing group
of techs while remaining an active service tech. “Managing yourself is one thing. But when you have others to help out and teach, and put out fires for, then the management part comes into play.”
So he’s on the road, doing installs, repairing equip-ment, making emergency calls and visiting customers whose equipment is down. “They’re upset, not at their equipment, but at whoever is there in front of them,” he says. “But that’s part of it.”
Without his iPad, the work would be even more stress-ful. “I remember when we didn’t even have cellphones. Someone at the desk would page and tell you to call Doc-tor so-and-so. Technology has really come quite a ways.”
With his iPad, Maraggia schedules calls, takes notes, accesses the Internet, fires off e-mails and takes photos to document installs. “I share that information with the other techs, so everybody has a picture of what’s going on,” he explains, speaking of the photos. “If the contractor needs spec sheets, I have them and I can shoot them out in an e-mail. It’s made things much easier.”
The equipment Maraggia works on has undergone many changes too. “When I first started, there wasn’t a digital X-ray in the dental field,” he says. The first was in-troduced by Trophy Radiology. “It was a great big cart they
service techs
Maraggia is an outdoor enthusiast. The Maraggias at a Rangers game.
30 : September 2012 : First Impressions : www.firstimpressionsmag.com
service techs
wheeled into each room, and it was really slow. It took eight minutes for the image to come up.” Digital intra-oral cameras were just coming out. They too were wheeled around in big carts. Now, Maraggia can barely recall the last film processor he installed or serviced. “Everything is USB,” he says. “Everything is plug and play.”
Microprocessor-controlled equipment is easier to work on than older mechanical equipment. “If the ma-chine isn’t doing something or it’s acting weird, you order a new PC board; you don’t have to trace down one faulty relay out of 20.” And it’s all good. “The ultimate goal is
to fix problems. As long as the problem is fixed and you minimize downtime for the office, you’ve achieved your goal.” That said, there was something fun about hunting down that faulty relay.
Customer focusMaintaining that focus on the customer is the key to success for any service tech, says Maraggia. It starts with integrity. “If you’re honest, and the customer or your co-workers can depend on you to do the right thing, that goes a long, long way.” Neither doctors nor staff know the integral work-ing of the equipment they use, and a dishonest tech could take advantage of that situation. But that tech wouldn’t last long, he says. There are two other components of success:
showing up on time and being dependable. “It all kind of lumps together – doing the right thing.”
Maraggia considers anyone and everyone in the office – from the front-office staff person to the hygienist to the doctor – to be his customer. If any of them ask a question, even if it’s about the fluorescent lamp on their desk that’s flickering, he tries to answer it. And if he doesn’t know the answer, he finds out. “This whole business is relationships. And the No. 1 ingredient is communication. If you can communicate with people, really listen to what they say, you can fix anything.”
And those relationships extend to Midwest sales reps as well. “The Mid-west reps expect that, when they call me with a problem, I will call back and answer their questions. They’ll call and ask, ‘Darrell, what do you think I ought to put in this office? What do you suggest?’ They expect me to use my knowledge and experience.”
Practices expect the same thing when considering new equipment pur-chases. “They’ll ask me, ‘What do you not have to work on a lot?’ he says. “And they take what we say to heart.”
In fact, service techs are becom-ing more like customer service repre-sentatives every day, in terms of an-swer customers’ questions. And those who are most successful can help dif-
ferentiate their companies in the customers’ eyes. “Ev-erybody sells composite and equipment,” he says. “It’s the people who make the difference, and that’s why cus-tomers keep calling them.”
When he’s not working, Maraggia is fishing on Cedar Creek Lake in Gun Barrel City, Texas, where he lives with his wife, Angie; his son, Jordan; and his daughter, Marissa. Every year, he and Angie go to the coast for a big fishing trip. He laughs when recalling his father’s idea of a vaca-tion – doing work around the farm, perhaps building a fence. “That was my upbringing,” he says. “So with my kids, I’d say, ‘Let’s take a vacation – let’s do some work stuff.’ And they’d say, ‘No, let’s do something else.’”
They won. And he’s just as happy. [FI]
Maraggia’s daughter Marissa, and wife Angie.
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32 : September 2012 : First Impressions : www.firstimpressionsmag.com
DTA column
There are less than six months before the next International Dental Show (IDS) March 14-18 in Cologne, Germany and the dental industry is busy planning, preparing and budgeting for the
largest dental meeting in the world. For sales representa-tive, this meeting offers insight to the treatment trends and products influencing your sales. For companies, IDS is the place to showcase the equipment, supplies and service you provide your customers.
In 2011, as the U.S. and other western nations were coming out of one of the worst economic down-turns in decades, the organizers of the IDS welcomed nearly 110,000 attendees through the turnstiles of the
Koelnmesse complex in Cologne. Visitors from more than 85 countries traveled to Cologne to buy, sell, distribute and increase their dental product and equipment activi-ties. There are more authorized distributors, government healthcare agency representatives and hospital purchasing agents at IDS than the combined total number of attend-ees at most of the largest dental meetings in the U.S. That is why so many of our U.S. and Canadian companies ex-hibit at the IDS Meeting.
Once again, DTA is working in tandem with the IDS to provide a variety of benefits for member companies wanting to make those international connections. DTA in
conjunction with representatives of Koelnmesse, is selling turnkey exhibit space that includes decorations, signage, table, chairs, carpeting, countertop space and a listing in the IDS Directory. DTA members receive a discount on exhibition booths and have the opportunity to select their booth location ahead of non–DTA member companies. In addition, there is a DTA exhibitor lounge with free In-ternet service, translators, private meeting space, beverages and snacks. Also, there are additional networking oppor-tunities in the DTA exhibitor lounge after the exhibition closes each day.
In addition to the DTA/U.S. Pavilion, we have dis-counted hotel rooms with American-style amenities in
many of the better hotels locat-ed either near the Koelnmesse complex or across the river close to the main train station. These rooms are available in a variety of price points and all rooms include a full breakfast.
DTA provides assistance for anyone that has not pre-viously visited Cologne. The
DTA Export Committee has developed a superb IDS Handbook that provides travel tips, explains what docu-mentation is required, offers restaurant recommenda-tions and explains local customs such as tipping in hotels and restaurants.
The dental industry has become a global market place. U.S. dental products are in great demand because of qual-ity, reputation and currency exchange rates. For these rea-sons, companies are focusing more resources on the IDS and new international business. With an assist from DTA, companies will continue their successful investment in the IDS Meeting and other international opportunities. [FI]
Investing In IDS
To reserve exhibit space or for questions about the IDS opportunity, please contact DTA at 703-379-7755. Be sure to friend us on Facebook (http://www.facebook.com/pages/Dental-Trade-Alliance/160917053994300) and follow us on Twitter at @DTANews for all the latest IDS-related information.
By Gary W. Price, Dental Trade Alliance CEO
Once again, DTA is working in tandem with the IDS to provide a variety of benefits for member companies wanting to make those international connections.
34 : September 2012 : First Impressions : www.firstimpressionsmag.com
news
Henry Schein completes three acquisitions for strategic planHenry Schein Inc (Melville, N.Y.) announced three acqui-sitions that advance key priorities of the company’s 2012-2014 strategic plan. Together these acquisitions represent annual sales of approximately $61 million and will be neu-tral to the company’s 2012 diluted EPS. Financial terms were not disclosed. Schein enhanced its position in the dental specialty market through the acquisition of Ortho Technology Inc (Tampa, Fla.), a $24 million orthodontics business; furthered its physician office laboratory presence through the acquisition of Modern Laboratory Services (Bakersfield, Calif.), a $22 million medical distributor; and expanded its geographic footprint in Asia through a merg-er with Accord (Bangkok, Thailand), a $15 million full-service dental dealer.
NDC announces 2013 exhibitionNational Distribution & Contracting Inc. (NDC) (Nash-ville, Tenn.) announced it will hold its annual meeting on June 10-12, 2013 in Nashville, Tenn. NDC’s Inter-national Exhibition 2013 brings NDC distributors and vendor partners together for education, networking, en-tertainment, and a large trade show exhibition. Save the dates: June 10-12, 2013 at the Renaissance Hotel and Nashville Convention Center. For more information, visit www.ndc-inc.com.
Midmark launches M3 UltraFast sterilizer promotionMidmark (Versailles, Ohio) is now offering an M3 Ultra-Fast automatic sterilizer promotion, entitled “Why M3?” The M3 sterilizes unwrapped instruments and handpieces in six minutes and pouched instruments in just over 10 minutes. Other features include a 25-minute drying time, one-step loading, automatic water monitoring, and front reservoir drain. The promotion order period runs through September 30, 2012. Dentists and dental facilities that pur-chase an M3 UltraFast automatic sterilizer and make a do-nation of an old sterilizer to Direct Relief International (Santa Barbara, Calif.) will receive a rebate of $700. In
addition, for every M3 sterilizer purchased and redeemed online, the dentist can receive a free Hu-Friedy sterilization kit, an approximate retail value of $200. For more infor-mation, go to www.midmark.com.
Pelton & Crane, Kavo donate $70K worth of dental equipment to NCOHFPelton & Crane (Charlotte, N.C.) and KaVo Americas (Charlotte, N.C.) donated $70,000 worth of cabinetry and equipment to the National Children’s Oral Health Foundation (NCOHF) (Charlotte, N.C.) to better equip its affiliate network of nonprofit children’s community programs. The donation will benefit three NCOHF af-filiates. Through the generosity of supporters like Pel-ton & Crane and KaVo Americas, NCOHF has deliv-ered nearly $10 million in direct funding, donated dental products, and educational resources to its nonprofit af-filiate network and community programs throughout North America.
NJ dental school to use $2.5M grant for faculty developmentThe University of Medicine and Dentistry of New Jersey-New Jersey Dental School (NJDS) (Newark, N.J.) will use a $2.5 million grant from the U.S. Department of Health and Human Services (HHS) (Washington, D.C.) to address a critical shortage of faculty. NJDS is initiating a program to recruit and train 45 practicing, general and pediatric dentists, who will then join dental school faculties in New Jersey, New York and Pennsylvania. Special emphasis will be on developing culturally competent faculty members with expertise in treating underserved populations. The end result will be increased access to oral health care for everyone who seeks it. The two-year program, known as From Practice to Preceptor, is free of charge for qualified practicing general and pediatric dentists. Those who en-roll earn continuing dental education credits, receive free use of an iPad while enrolled, gain access to many of the school’s resources and receive a small stipend. Enrollment will begin in fall 2012.
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