A Little Periodontitis Mistake That Cost a Dentist $200,000

periodontitis malpractice lawsuitA dental patient has sued his dentist for malpractice, claiming supervised neglect, which caused him periodontitis.

Former patient Harry Berkowitz asked for compensatory damages from his dentist Dr. Dennis Miller (D.D.S) for his failure in diagnosing the periodontal disease that was silently progressing for years and ultimately destroying his teeth.

WorldDental.org reports that Berkowitz, who was a steady patient of Dr. Miller, always maintained regular dental checkups. It was at just one of these regular check-ups in 2009 where Berkowtiz learned from his Physician that he would need extensive root canal therapy. Since this seemed out of the ordinary from his usual dental treatments, Berkowitz decided to obtain a second opinion with another dentist.

The second dentist told Harry Berkowitz that he was apparently suffering from a severe periodontal disease that was badly affecting all his upper teeth. He was referred to a periodontist who extracted all but two of his upper teeth and then replaced them with permanent bridges and dental implants.

In his legal claim against his regular dentist, Mr. Berkowitz stated he was never asked for an x-ray examination to diagnose the periodontal disease that claimed most of his upper teeth. Dr. Miller countered this allegation by stating that he had suggested several treatment options to Berkowitz over the 20 years he was his patient, but Berkowitz declined some of the doctor’s treatment suggestions by insisting that full dental care would be too expensive.

The malpractice case was settled in the amount of $200,000.

When I first started as a dental management consultant — over 20 years ago — attorneys were attending seminars on how to sue dentists for periodontal neglect. And of course I had one of my doctors sued for this. The case was dismissed when we presented the scheduling book (yes a real hard copy book) showing the patient had missed or no-showed for continuing care appointments eleven times in a two-year period.

The issue was documentation of the patients failure to accept and complete treatment. Your ultimate protection is to dismiss the patient!

How do you screen for periodontitis? What do you do when patients refuse your dental treatment suggestions?

For more on this story see: Matters of the Law: Patient Sues Dentist for Neglect.

Dental Marketing: A Guide for Avoiding Negative Online Reviews

dentists negative online reviewsIn customer service it used to be said that an unhappy customer would tell nine to fifteen other people about their negative opinions.

Today an unhappy dental patient can influence hundreds of people by leaving a negative review on an online review website, in their Facebook stream or on Google Places.

Negative reviews can be painful, but is there a way to avoid a dental marketing disaster?

Mike Blumenthal of the Rapid Web Division of Blumenthals.com advises the following for avoiding negative reviews — I’ve adapted them for dentistry.

1- Do your follow-up.
Follow up with patients immediately after the completion of treatment with a call and/or an email to be sure that all went as planned. Identify problems early on in the cycle so that you can correct them before they become complaints.

2- Make complaining easy.
Build a culture that is truly ready to receive the complaint at every level of your practice, from the front desk to the doctor. Train your staff and train them well to not be defensive and to solve most problems immediately.

3- Respond quickly to complaints.
When you do receive a complaint, follow up quickly and try to resolve it. Nothing rankles like a dental patient stewing about your bad service like waiting for a return phone call.

4-Respond to negative reviews online.
Once the issue is resolved, circle back with the patient about the review. A recent survey has shown that an appropriate response to a negative can get the negative review removed in a third of the cases. A roughly an equal number of consumers posted a positive review after receiving a response to their bad review. Having a plan and responding appropriately to a negative review is critical to this process.

5-Never fake reviews or enter them on behalf of your patients.
It is imperative that you not provide reviewers with any trace that you are abusing your review corpus. Getting slammed by a patient review that questions your ethics calls into question your trustworthiness and integrity. It is the most difficult type of negative review to deal with, even if it is not true. Responding online to the question, “Do you beat your wife with a stick or a club?” creates a no-win situation.

6- Communicate with your local competitors.
Competitor spam reviews are becoming more common than ever. If you are on speaking terms with them, you are much less likely to fall victim to a puerile spam review attack. The reality is that other similar local practices are not the long-term determinant of your success, nor really your major competition.

Just remember that when you are dealing with a negative review, it’s important to avoid appearing sarcastic and placing blame on the patient.   Try and find out what may have set this dental patient off and see if you can prevent this from happening again in the future.

There may be a hidden opportunity in a negative review — if you handle it right — it can become a dental marketing opportunity

There is a story about an Italian restaurant that received an online negative review about their spaghetti. This lead to another negative review, and another, until the owner sat down one night and ate a plate of his spaghetti. He had to agree that his spaghetti was awful, and here he was running an Italian restaurant.

He decided to run a contest inviting people to taste different spaghetti recipes at his restaurant and vote on the one they liked best. The promotion ended up being a big success, and his restaurant ended up with a new, improved spaghetti recipe that customers loved.

He then went on to promote his restaurant as one that actively listens to what the customer wants. He turned a negative into a money-making positive, and past customers are coming back to his restaurant too.

How would you handle a negative online review?

Dentist Survey: Do You Own or Rent Your Dental Practice Real Estate?

Dental real estate: rent vs. ownThis survey by The Wealthy Dentist asked about a major dental practice management expense. Do dentists lease or own their dental real estate?

More than three-quarters of the dentists surveyed own their practice facilities.

Despite unstable real estate values across the U.S. within the past 10 years, dentists still prefer to own rather than rent.

Only 3% of the respondents own and are worried about their mortgage. The majority of dentists either own the building free and clear ( 35% ),  or own it and pay a reasonable mortgage (39% ).

Do dentists rent or own their dental practice facilities?“Always own your property; best investment you can make.” New York dentist

“If the facility is a good investment – own it.” Tennessee dentist

“It all depends on location but generally owning the dental practice real estate affords one a greater opportunity to build wealth.” Nevada dentist

“There is security in knowing that my rent will not go up and I will not have to move due to a change of ownership.” Texas dentist

“Much better to own the right building in the right location. Problem is the right location is changing as dental practice is changing.” California orthodontist

Fewer than one quarter of our dentists rent their facilities, with 10% on a long term lease, and 13% on a lease expiring in less than two years.

“Owning would be far preferable to renting, but unfortunately my landlord won’t sell. Real estate is very limited in my area.” California oral surgeon

“Tenant improvements (and repayment) are the real killer!” California dentist

Do you think it’s better to own or rent your dental practice real estate?

Retirement for Dentists: These Days, Retirement is Totally Optional

Dental Retirement Survey ResultsOne in Five Dentists Can’t Afford to Retire

In a recent survey, The Wealthy Dentist asked dentists about their retirement plans. Two-thirds of our dentist respondents say that they expect to choose keep working part-time to keep themselves busy. Only 13% replied that they’re on track financially and will retire completely once their financial goals are fully met. One in five dentists would like to retire, but aren’t sure they will be financially able to afford it.

We also asked dentists about their target retirement age. And aren’t the specialists lucky! They’re planning to retire an average of six years before their colleagues practicing general dentistry.

What’s your target retirement age?
Average: 63 years old
General Dentists: 64 years old
Specialists: 58 years old

Check out the complete dental retirement survey results

Dental Practice Fraud Causes 200k Embezzlement Warning

dental embezzlementThe Colorado Dental Association recently sent an email alert to member dentists regarding a $200,000+ embezzlement that occurred in a dental practice related to the processing of credit cards.

According to the Metropolitan Denver Dental Society, experts estimate that more than 50% of dentists are embezzled with an average loss of $50,000.

But, because embezzlers often steal relatively small amounts over a long period of time, the misappropriation of funds goes unnoticed.

The U.S. Chamber of Commerce estimates that 75 percent of all employees steal at least once, and that half of these steal repeatedly. The Denver District Attorney’s Office website warns, “embezzlement is at epidemic proportions accounting for 20 percent of all cases filed by the Denver District Attorney’s Economic Crime Unit.” In 1970, one in 200 employees was dishonest; it is estimated that today, one in six employees is dishonest.

The MDDS states that the most common method of embezzlement in a dental practice occurs through theft of cash, checks or supplies.

Here are a few embezzlement scenarios that occur in dental practices –

  • Cash is pocketed from patients.
  • Petty cash is stolen.
  • Cash or checks are removed from the daily deposits and replaced with subsequent receipts.
  • Insurance fraud.
  • Endorsements are forged.
  • Writing duplicate accounts payable checks or writing checks to phony vendors.
  • Stealing supplies and re-selling or returning to vendors for refunds that are pocketed by employees.

In a survey The Wealthy Dentist performed in 2010, 59% of the dentists surveyed said they had discovered evidence of embezzlement. With such a high degree of fraud, how does a dentist diminish the risk of embezzlement?

The American Bar Association offers the following checklist on how to prevent fraud and embezzlement –

  • Adopt an effective, documented system of internal controls to protect against acts of dishonest staff.
  • Bank and credit card statements can be delivered to the business owner’s home or separate address for personal review.
  • Checks and debit transactions should be reviewed with the statements.
  • Checks should require two signatures, or be reviewed by the owner.
  • A copy of the bank reconciliation should be attached to each monthly bank statement and reviewed by two parties.
  • Finance or accounting personnel should not be signers on all bank accounts.
  • Checks received in the mail should be immediately endorsed by a two-person team who opens and processes the mail.
  • After checks are properly endorsed and verified, the bookkeeper should take charge of the checks for deposit.

Have you recently experienced embezzlement in your dental practice?

For more on employee embezzlement and how to prevent it see – The Metropolitan Denver Dental Society Watchdog

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