It Doesn’t Get Easier, You Just Get Stronger

Okay, so not all profound quotes have a distinguished author, but they can still be profound. I saw this one on a T shirt on an attractive woman on the beach at the Dominican Republic and was glad I took the time to read it. For several reasons. Watching my wife’s efforts of working on her instrument pilot rating has been a prime example. This has been a year-long project that has been as hard as getting a PhD degree. Not only does one have to learn all matter of physics, meteorology, navigation, rules, regulations, the language of talking to controllers, higher mathematics, and interpreting charts, one also has to have the physical and mental skill to be able to put an airplane through its paces for a successful and safe flight. I saw her frustration when she began this project. She was totally overwhelmed by her abject ignorance of all of those elements, with self-doubt that she would ever be able to have the faintest understanding of any of it.ADS Blog.png

But with an enormous conviction to study, understanding, and practice, her mastery of the project slowly began to develop. At times it has been very frustrating, but she has doggedly pursued her studies and flying, and her mastery of this project has been absolutely astounding. She is proof that nothing gets easier, but if we’re smart and resourceful, persistent and apply ourselves fully, we do get stronger – incredibly stronger – allowing us to prevail in our goals, whatever they be.

ADS South, LLC 
120 Istoria Drive
St. Augustine, FL 32095

Phone: (770) 664-1982

ADS South:

Since 1984, ADS South has served practice transition, apprasial, associateship services, pre-retirement transition support and expert testimony needs. ADS is known by its impeccable reputation as being fair, honest and effective in helping dentists plan and implement their transition strategies.

 

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Transitioning To Retirement

As we baby boomers work our way toward retirement, we need to consider how best to accomplish this final stage of our careers. Most of us have made some mistakes along the way, but we were able to repair most, if any, damage. However, in this last career step, we need to nail it the first time. There is no reset button. We won’t be able to repair the damage.

In preparing for retirement, it is critical to work past the transition myths that have been floating around the profession for years, and to learn some of the principles that transition experts have discovered. Consider the myth: “If you’re thinking about retiring, october-2016-6bring in an associate so you’ll have a built-in buyer when you want to retire.” I have seen too many disappointed owners who tried this tactic, only to find out that it seldom works.

When thinking about retirement, we need to understand how dentists are wired. Consider these fundamentals. Associates work for other dentists; they don’t buy practices. Buyers buy practices; they do not work for other dentists. If a dentist is wired up to be an associate, he or she is not likely to become a buyer in the near future. When a dentist hires an associate, the owner should not expect that associate to become a buyer when the owner snaps his or her fingers and decides to retire. If the associate does buy the practice, that’s fine, but I would not structure a retirement plan that depends on that happening. When you want to sell a practice, search for a buyer, not an associate.

When should you consider adding an associate to your practice? The single criteria for adding an associate is that there is more work than the owner is able or willing to perform – not because you’re thinking about selling your practice. If the dentist’s (not hygienist’s) schedule is booked for three weeks or more, there is likely adequate work to add an associate. If the owner refers out treatment regimes that a qualified associate could perform, that indicates potential production an associate could treat. If an owner wants to reduce his or her schedule, that would contribute further opportunity for associate production. If you cannot demonstrate enough production for an associate to be busy, you should not add one. Few things are more disruptive to a practice – to the owner, patients, and staff – than adding an associate who does not have enough work to support him/herself, only to have that associate leave.

The owner should have a reasonable pro forma of the financial outcome of adding an associate. Both the owner and the associate need to have a realistic outlook as to what to expect financially before entering into any arrangement. We do not start instrumenting a root canal without first measuring the root. Similarly, the same principle should apply to measuring the financial outcome of adding an associate.

I always strongly recommend that a contract be in place before the associate starts to practice. Too many times, it isn’t. After an associate starts working in a practice is not a good time to begin negotiating the terms of such an agreement for either party.

In states where a covenant not to compete is enforceable, I strongly recommend including that element. Without a covenant, the production an associate performs belongs to the associate, not the practice owner. I will typically give an initial period of 90 days from the start of the agreement until the covenant begins, since an associate is extremely unlikely to be able to harm a practice during such a short term. If the arrangement doesn’t live up to expectations, then the associate is not punished in the process.

Covenants can also be drawn on a graduated basis over a period of several years, starting with a shorter distance and time, and then advancing over a three-year period as the associate becomes more involved with the patients and practice.

Another term that should be carefully crafted in the agreement is the right of first refusal to purchase the practice. If the associate is given a traditional right of first refusal, he or she is able to match any offer from any other prospect who ever makes an offer. The problem with this kind of right of first refusal is that few buyer prospects will want to spend the time, money, and effort on due diligence to generate an offer if they know that someone else can take their offer and step in front of them. This type of right of first refusal can be a poison pill for a seller.

I propose an approach whereby the practice is appraised before the associate begins to work in the practice. This can help determine the financial outlook for owner profitability and associate income, and it also shows the associate what kind of pricing structure to expect in the future when the owner decides to sell the practice. If the dental associate doesn’t think that the pricing structure is fair, he or she may not want to enter into the arrangement to begin with.

At the point when the owner wishes to sell, the associate would be given an updated appraisal price and 30 days to decide if he or she wants to purchase at that price. If the answer is yes, the practice sale is completed. If the answer is no, the owner can then sell the practice to any other party at any other price without the associate having the right to come before another purchaser prospect.

I don’t advise giving an associate the option to purchase the practice unless the owner is absolutely sure that at any point in time he or she is financially and emotionally ready instantly to step aside. An option to purchase is different from the right of first refusal. In the right of first refusal, the seller gets to decide when he or she wants to sell the practice. In the option to purchase, the timing of the sale can be determined by the associate.

I strongly advise paying associates on a percentage commission. That is the only compensation method that will always be exactly right. A fixed salary will likely be the wrong amount, and someone will end up unhappy. A commission gives an incentive for associates and rewards them for going above and beyond. It is helpful to offer an advance draw on the commission to help the associate earn a living during the initial two months of entering the practice.

Carefully consider the termination terms. Will there be a covenant if the associate terminates with cause or if the owner terminates without cause? The minimum contract term and how much termination notice shall be given are issues that should be settled in advance. Document issues such as how re-treatment will be handled as well.

Owners should consider an insurance funded buy/sell agreement in the event of their death. A properly crafted buy/sell agreement can instantly solve what could become a very disastrous situation.

Owners can advertise for associates in many venues. Printed media, such as this periodical, reach a wide circulation. There are also many Web sites that owners can use to search for associates. Many transition consultants also offer associate searches and can screen applicants for the owner as well as suggest transition attorneys who can provide effective legal agreements.

If associateships are not researched, structured, or documented properly, they can create difficult problems from the outset, especially when an owner decides to sell. However, carefully documented and structured associateships can provide an owner with freedom, profitability, and security that is otherwise unattainable.

by Earl M. Douglas, DDS, MBA, BVAL |

ADS South, LLC
120 Istoria Drive
St. Augustine, FL 32095

Phone: (770) 664-1982

Fear of the Dentist

Blog Title Fear Of the Dentist

What do clowns, spiders, monsters, and the dentist have in common?

They scare the living daylights out of many people; how many people? Over 75% of adults report some form of dental anxiety, and up to 10% suffer from full-blown phobias.

The causes for anxiety differ, but the escape is all the same: not scheduling that much-needed appointment. Avoiding clowns and monsters is fine, as they can’t offer services that could save you from tooth loss, gum disease, and potentially life-threatening heart diseases – but your dentist can, and that’s why it’s important to find a solution to your dental anxieties and make sure you’re keeping your smile as healthy as the rest of you.

Some causes for dental anxiety include:

  • Fear from a past experience
  • Fear of a painful procedure
  • Fear of the medical bill

The solution to all of the above is simple: Talk to your dentist. There are ways around each and every one of these that will allow you to ensure your dental health is taken care of and you are not at risk for unnecessary health complications!

If you had a painful experience in the past: Talk to your dentist! There are many ways to work around the issue – either by an alternate procedure, or perhaps a discussion about sedation dentistry to calm your nerves. If you tell your dentist the problem, they can work to find a solution that works for you.

If you are afraid of a painful procedure: Talk to your dentist! Again, there may be a less-painful procedure as an alternative. Or perhaps it’s not as painful as you originally feared. In many cases sedation dentistry is a fantastic option that either takes the edge off your nerves, or anesthetizes you entirely. What’s better than waking up with a shiny new smile and no fuss for you?

If you’re afraid of the potential bill: Talk to your dentist! You never have to be handed a bill you didn’t expect. First, get an estimate on the necessary procedures. Then talk! There are many options for those strapped for cash, including payment plans or various subsidies. But your dentist cannot help you answer a question that you didn’t ask! Remember as well, your health is an investment. You can pay to prevent or pay to correct, and the latter can be extraordinarily higher than the former; nothing can replace regular appointments and consistent care.

Remember, 75% of adults admit to some form of dental anxiety – your dentist has heard it before and will be happy to work with you to ensure you walk out with a smile that you’re both proud of.

By the way, fear of the dentist? That’s called odontophobia, and it doesn’t have to ruin your smile. Talk to your dentist and save your phobias for spiders and clowns.

ADS South, LLC
120 Istoria Drive
St. Augustine, FL 32095

Phone: (770) 664-1982
Fax: (678) 965-1812

EEffects of Osteoporosis on your Oral Health

Osteoporosis isn’t a new discovery, or a disease unheard of by many. That being said, many people don’t realize how closely tied to your oral health it can actually be.

In short, osteoporosis is caused by an insufficient consumption of calcium and vitamin D. It affects the bones, making them less dense and thus more likely to break. Osteoporosis is directly tied to your long-term dental health as this weakening of the bones may heavily compromise the jaw bone.  A weakened jawbone can have a host of detrimental consequences for your teeth, including increased tooth mobility, or complete tooth loss.

The best cure for the degradation of the jawbone is avoiding it all together with a balanced diet high in vitamin D and calcium, and getting a sufficient amount of exercise. Barring that, be sure to attend your dental appointments regularly so that way the structure and health of your mouth can be monitored, and any problems that may develop are addressed immediately and not permitted to deteriorate.

As it is, due to hormone imbalances and changes over life, women are most at risk to developing osteoporosis, but it can absolutely develop in either gender depending on a host of lifestyle variables, not limited to diet and exercise.

Symptoms to pay attention to that may be indicative of osteoporosis affecting the jaw include: pain and/or swelling in the gums or jaw, as well as infection; injured gums not healing in a timely fashion; teeth that become loose for no reason or after only minor strain; numbness or discomfort in the jaw; or at worst, exposed bone. If you experience any of these symptoms, don’t hesitate contacting your dentist to prevent exacerbating the issue.

ADS South, LLC
120 Istoria Drive
St. Augustine, FL 32095

Phone: (770) 664-1982
Fax: (678) 965-1812

39 Tips and Alternative Uses for Everyday Dental Hygiene Items #LifeHack

 

Life Hacks

Life Hacks – The Dental Edition!

Today we’re sharing our office’s best tips, tricks and secrets to making difficult tasks easy and fixes for the most annoying problems. Get ready to have your mind blown because ALL of these use dental related items!

Denture Tabs
Did you know they can also be used to help clean common household items? Here are six alternative uses for denture cleanser tablets:

  1. Put them in with a diamond to spruce up that sparkle
  2. Remove mineral deposits from glass
  3. Pop a denture tablet into your coffee pot, run the water through and then rinse. Cleans up stains in a snap! BONUS: also great at removing coffee and tea stains in Denture Tabsmugs
  4. Toss a tab in to a full toilet or bathtub and watch the grime dissipate
  5. Use to clean enamel based cookware
  6. Great for unclogging drains

Dental Floss

Be sure to use the dental floss that is flavorless, otherwise you are going to have some unsatisfactory results for some of these hacks.

  1. When your shoelace breaks and you need a fix in a pinch— lace up with floss until you can get a replacement!
  2. Got long hair? When your ponytail’s elastic band snaps off, wrap some floss to create a new hair tie
  3. Sentimental pictures stuck to your scrapbook page? Or cookies stuck to the baking sheet?  Wiggle some floss gently in between to release
  4. Slice clean pieces of bread, cheese or cakes by holding the floss taunt and gliding down the soft item you are wanting to “cut”
  5. Are you travelling and you need to “lock” you luggage? Wind some floss through the zippers to secure
  6. Create a makeshift clothes line out of floss
  7. Use as string for crafts and jewelry making
  8. Leaky faucet? Tie floss around the spout and let the rest hang into the drain to eliminate the dripping sound

Toothpaste
The miracle worker!

  1. Remove scratches from DVD’s and CD’s by applying a little white toothpaste and gently rubbing over the surface
  2. Ring Around the Collar: take some toothpaste on a toothbrush (double dental life hack!) and scrub in a circular motion over the stain before normal washing
  3. Got Kids? Do they have crayons? Use toothpaste as an abrasive to scrub the crayon right off the wallsToothpaste
  4. Scuffs happen. Shoes, furniture, other surface areas, etc.  Put some toothpaste on a toothbrush and scrub away to watch the scuffs vanish
  5. Did someone forget to use a coaster? Rub toothpaste over the ring and wipe clean with a damp cloth
  6. Use as a deodorizer for baby bottles. Remember to rinse thoroughly after soaking!
  7. Rub toothpaste over mirrors, glass, and water goggles then wipe clean to create a fog deterrent
  8. Make your sink and faucets shine by polishing with toothpaste!
  9. Ink and lipstick stains are no longer a problem with the help of toothpaste
  10. Helps remedy stubborn pimples: dab a little toothpaste on the problem area before bed and wash your face in the morning.
  11. Foul scents lingering? Wipe some toothpaste over the area and rinse thoroughly
  12. Remove carpet stains by using the paste with a scrubber

Mouthwash

Mouthwash can help out with more than just bacteria in your mouth and odorous breath!

  1. Use mouthwash as an antiseptic replacement when you run out
  2. “That’s going to leave a bruise!” Heal up faster by rubbing it with some mouthwash on a cotton ball
  3. Poison ivy itches! Smooth over the affected area and discard the used cotton ball to avoid cross contamination
  4. Hand sanitizer substitute!
  5. Did you forget deodorant? Swipe a little mouthwash to remove “ripeness”
  6. Great as a disinfectant
  7. Soak nails and toes in mouthwash to help with fungus and athletes foot
  8. Also works as a great for helping to soften and soothe feet
  9. Can be used as a temporary face astringent
  10. Soak smelly containers in mouthwash and rinse. Say goodbye to stink!

Toothbrush
Toothbrushes make excellent cleaning tools and are great scrubbers. Here’s a few of our favorites uses!

  1. If you need to touch up your roots, use a toothbrush to assist in the hair dying process
  2. Works wonders as an exfoliater
  3. Nail brush – work out the dirt under your nails gently

If you carry little travel sizes of mouthwash, a toothbrush, white toothpaste and some denture tabs, you are fit to solve almost any spill, scuff or stain! These items are great to always have on hand.  Next time one of these problems tries to kick you when you’re down, remember these dental life hacks!  Give them a try and let us know how well their magic works for you!

ADS South, LLC

120 Istoria Drive
St. Augustine, FL 32095
(866) 294-8917

7 Serious Health Concerns That Also Affect Your Teeth

Mouth and Body Go Hand-in-Hand

Did you know that poor oral health care can be the cause of many different health issues within your body itself?  There are many connections between taking care of your mouth, teeth and gums and the rest of your body.

People with gum disease have a 40% increased risk of developing a chronic June FB Candy (6)health condition. Bacterial build up on your teeth and gums give you a greater probability of infection which may then spread throughout other areas of your body.

Common Health Issues That Affect Oral Health

  • Diabetes: causes oral inflammation and affects the body’s ability to process sugar.
  • Heart Disease: about 91% of those with heart disease are also found to have periodontitis. Inflammation in the mouth corresponds with the inflammation of blood vessels which then leads to less blood flow causing an increase in blood pressure.  There is also a chance of plaque that is attached to the blood vessel itself, breaking off and traveling to the heart and/or brain resulting in a heart attack or stroke.
  • Issues during Pregnancy: pregnant women with gum disease run the risk of premature birth, low birth weight, and susceptible to developmental issues such as learning disorders, lung and heart conditions.
  • Osteoporosis: osteoporosis, like periodontitis, causes bone loss. It’s common for those with osteoporosis to also have some degree of gum disease.
  • Rheumatoid Arthritis: those with rheumatoid arthritis battling gum disease have found gum disease treatment may also reduce overall body pain in regards to their arthritic symptoms.
  • Smoking: bad for your health, both overall and oral.  Nicotine interferes with your gums’ ability to fight infection.  This also extends the recovery period for those gum infection treatments.
  • Obesity: those with 20% or higher body fat percentage have been linked to rapid progression of gum disease.

Taking excellent care of your oral health has a positive domino effect for the rest of your body.  Same can be said with your body – taking care of your health and body can positively affect your mouth, teeth and gums.
If you care about your health and yourself, you in-turn need to care about your mouth.  Be true to your teeth, or they will be false to you!

ADS South, LLC
120 Istoria Drive
St. Augustine, FL 32095

Phone: (888) 714-7410

Fax: (678) 965-1812

Preparing for Your Transition: Experts for Dental Practices Tax & Financial Planning Workshop

 dental office tax workshop

Preparing for Your Transition

Registration & Breakfast: 8:00-8:30 am

Program: 8:30 am-Noon Followed by Luncheon Roundtable Discussion

 

Topics & Speakers

The Experts for Dental Practices Tax & Financial Planning

Tax Offense & Defense: Tom Stowe, CPA, Stowe & Stowe CPAs

Earl Douglas, DDS, MBA

Earl Douglas of

ADSsouth.com

 

10 Biggest Transition Mistakes: Earl Douglas, DDS, MBA, BVAL – ADS South, LLC

The Legal Side of Transitions: Joe Jordan, Attorney at Law

Protecting Your Business: Victor Holloway, MBA – Consolidated Planning, Inc.

Preparing for an Exit: Brian Cogan – Bank of America Practice Solutions

Reserve Your Seat Today!

Breakfast & lunch included for just $49.99 per person

Bring your spouse for just $24.99

Please RSVP to 980.819.2212 or admin@mosaicw.com by Tuesday, January 15th!

rsvpJan15-2013

Contact ADS South
www.ADSsouth.com | (770) 664-1982
Earl Douglas: Earl@adssouth.com