Braces for Adults Makes the WSJ!

Highlighting what many dentists and orthodontists already know, the October 6th 40351510_sarticle, More Adults Need Braces and It Isn’t Like In High School, by Sumathi Reddy, is full of information. It covers the numbers, for example 1,225,850 adults receiving orthodontic care in 2012 the most recent data available (up 39% from 1996), the pros and cons of care provided to an adult, the motivation of adults to have an attractive smile, and the need to have periodontal disease at a minimum.  In my view, this is an exceptionally beneficial article that orthodontists should discuss and link to on their websites, blogs, and for that matter consider ordering reprints to give away at consults. This article hit a prime demographic of generally affluent business oriented adults that are interested in improving themselves and have the financial resources to pay for care.

Ancient plaque – who knew it would be so interesting!

Superb mini article, Dentist to the Dead, Scientific American,Blog-Skull-25175164_s October 2015,
opens a window on the work of Christina Warinner, an anthropologist at the University of Oklahoma who studies Vikings and Stone Age farmer’s teeth. In my view, this is an article to copy and provide to patients for fun and education!  Her work and that of other scientists indicates that fossilized plaque is “the richest source of DNA in the archaeological record.” According to the work done to date, plaque “carries between 100 and 1,000 times more nucleic acids per milligram than another other known source.”

Resources for the “Conversation”.

Doctors, just like everyone else, get older. Along with our parents and older relatives a part of life becomes telling those we care about our wishes for end of life. Blog Senior Woman 35078093_sCheck out Conversation Starter Kit, free,   . You or those you care about will be guided thought a number of questions important to planning your affairs. Also have found it helpful to review, Center for Practical Bioethics, free materials at  on clarifying values, and desires to pass on.

Inspiration for new LLMs

“… it was all great fun and a professional challenge working with you to adapt what I knew about physicians and other providers to the dentists which you represented. We had a ball working together, didn’t we? Thank you, Randy, for (your) kind words. It’s what I always hoped my adjunct teaching position would accomplish, and you should be very proud of how you picked up the ball and ran with it.”  L. EdwardEd Bryant Aug 2015 Bryant, Jr. writing to me recently. Ed is a long-time friend, mentor, colleague and my all-time favorite professor during my LLM in Health Law at Loyola (Master of Laws in Health Law). Recently, at a wonderful breakfast near Evanston, we talked about old times and new, and I thanked him for his comments. I share those comments here in part because they mean a great deal to me and in part to hopefully inspire new LLM’s to follow their interests in developing their health law career and to have fun while doing so. Ed was honored for his early and significant contribution to health law development and transactions when the Beazley Institute for Health Law and Policy established the L. Edward Bryant, Jr. National Health Law Transactional Competition.

China Potential Economic Downturn

Thought provoking Opinion page article in 8/17/2015 Wall Street Journal, A Global Recession May Be Brewing In China, by Ruchir Sharma. Many Blog-China Flagdoctors and their practices were significantly adversely impacted over the last 5-6 years of the economic downturn. Is another looming? In my view always better to be informed  prepared than not. Check out

Dentist Associate Compensation Pointers

Most practice owners and prospective associates want to find a fair compensation approach. The devil, of course, can be in the details and that ticklish word “fair”. What is fair for the practice owner is an associate providing the best care he or she can and participating with staff in the life of the practice, including marketing / social media or practice management. Regarding what is “fair” for the associate is a compensation format where the owner identifies the normalized practice overhead (adjusted to true expenses not including those that are discretionary or tax driven), any additional expenses related to bringing on the associate, and the profit hedge desired based on the associate’s anticipated collected gross. Associates should have an understanding of the process the owner used and can evaluate the offer against their own break-even analysis given their comfort level with the anticipated collected gross the owner has arrived at. Here at Berning & Affiliates we have applied all of the above and have well developed cash flow worksheet that assist owners and prospective associates to arrive at a fair associate compensation.


Our goal is to empower Doctor CEOs to move forward in the right direction by providing insights, commentary, interviews, recommendations, information and a bit of levity, to help Doctor CEOs make a positive difference in their practices and personal fulfillment.

New Associateships and Practice Valuation ADA Publications

ADA ValuationADA AssociateshipsI am pleased to announce that the newest revisions of the two American Dental Association publications I have co-authored are now available. The two publications are, The Practical Guide to Associateship: Success Strategies for Dentist – Owners and Prospective Associates and The Practical Guide to Valuing a Practice: A Manual for Dentists. They can be ordered directly from the ADA or from our webstore at Note Berning & Affiliates also offers a Companion Reader for each title that directs readers considering a practice transition to key sections of the pertinent ADA publication.

In all I have undertaken six revisions of the publications since 1988, with the titles modified by the ADA from time to time. Thousands of doctors have purchased the publications over the years. I have been very fortunate to have outstanding co-authors. My co-author for the first 5 revisions was Larry Domer, MBA, DBA, AVA, now Professor Emeritus at the University of Colorado School of Dentistry, and my current co-author is Paul Baumann, CPA, ABV, CFF, CGMA, ASA, partner at Baumann Moreau.

Why Dentistry Will Always Trump Medicine

iStock_HELPIt is no secret that the practice of medicine is under attack, a national debate for years has spawned cost controls and a presidential initiative culminating in the Affordable Care Act. In case you missed it, or for future reference, here is the complete law, all 906 pages (381,517  words) as printed by the Government Printing Office. With an additional reported 11,000 pages of regulations or or 11,588,500 words. Oh, and there was a Supreme Court case about the validity of the Act that you might want to read, someday.

Okay, so physicians have gotten the message, cut costs, if possible. In an article The Team Can See You Now by Laura Landro, a description is provided of the concept and implementation of a team. The team basically divides up what used to be considered a doctor patient visit among a variety of non physicians reserving an actual visit with the doctor. Here is one telling quote, “Winning over patients to team based care can be a challenge. A 2012 survey of more than a 1000 low income people in California by the Blue Shield of California Foundation found that a majority preferred to be seen by doctors.” Imagine what those that are not low income would prefer?

And that is why dentistry will always trump medicine. Dentists and dental specialists see their patients, provide care to their patients and are usually available to discuss care with their patients. In my view, in dentistry the special aspect of the team is to support the doctor patient relationship not change, constrain or undermine it.

Three Must Do Steps BEFORE Hiring An Associate

As a practice owner you may be thinking that now is the time to hire an associate. Assessing the option of adding an associate can originate in a wide set of situations from having a growing practice and wanting help to a semi-retired doctor with Over The Rainbow MP900398747excess time on a schedule. No matter your situation the suggestion is to list

1) the personality, capability and maturity a candidate must have to successful fit into your practice. Way too many practice owners miss this thoughtful assessment and end up with a good looking or great qualification candidate that does not fit.

2) Write out your philosophy of care and put it in front of the candidate and ask, “Can you accept this and live it?” Remember, it is your attitude toward ethics, choice of treatment methods, and practice building that must rule. If you don’t tell it, then you may have a big disconnect later!

3) Determine if you want a “pair of hands” to do dentistry or need a candidate with an interest in management and practice administration.

A lot of practice owners have be smart building their practices. They need smart younger doctors to fit in and keep building. Quite different are the doctors that tell me they do not what anyone messing with how the practice runs, “so find me an extra pair of hands”. Take some time and reap the benefits of these three must do steps. Call if you want to schedule a Tackle It! Consulation to talk it through for your practice!