We do this all, sometimes, within a fleeting hour. And every crown we fashion brings us face to face with our most formidable critic: ourselves. This unyielding quest for perfection, cultivated through our academic and professional journeys, often leads to an overlooked truth: imperfection is an inherent aspect of our human condition. The relentless drive for an unattainable ideal not only takes a toll on us physically, as we hunch over in painstaking diligence but also emotionally, marred by self-criticism and a lack of self-acceptance. As busy as we are chasing the perfection that will never come, we might have overlooked the fact that amidst this struggle lies a profound opportunity for redefinition and growth.

By acknowledging our own human nature, the sense that we are perfectly imperfect, we could be liberating ourselves from the shackles of faulty expectations. Accepting this could lead us to cultivating a healthier relationship with our craft—one that embraces improvement over the illusory goal of perfection. This realization could mark the beginning of a more fulfilling professional journey settled with peace and satisfaction; a new journey stemming from a clarity that striving for excellence and striving for perfection are two very distinct paths.

THE EARLY YEARS

The initial chapters of this unfolding narrative often begin in the youthful corridors of academia, where, driven to attain the most opportunities, we compete with our contemporaries. We find allure in high scores and esteem ourselves in the percentiles of students below us. These numbers and accolades ignite a competitive streak in us, attaching our intrinsic self-worth to grades and rankings. This early calibration of self-esteem to external validation becomes a deeply anchored blueprint for us. It dangerously develops toward an addiction of sorts, driving us to chase at full speed, at whatever cost, toward academic and professional triumphs.

Far too much is stacked on our plates; rest and sleep take a backseat. Aimless wandering and even a faint air of boredom, which has been proven to ignite creativity, endanger our future. And we feel as if our perseverance, one that leads to sleep deprivation and exhaustion, has been all worth it when we open the letter of acceptance into our chosen dental school. Here, though varying distinctly today, with the comparison of decades prior, the harsh tones of our attending dentists make self-doubt the soundtrack of our lives. As we further develop into clinical practice past graduation, we come across experts whose work leaves us in awe. We are in awe of what others create but crumble at our lack of replication within our operatories.

We imagine, uncorrected, that since one photo is displayed as the conclusion, the work of art must have been concluded in a single sitting, a single appointment. And many educators do not over-disclose to correct that. The glamour it carries sustains them as experts, and it is much of what they have worked for. The draw of the audience is the return on their hard work. We return to our clinical practice, expecting the very same results on the very next day. And that furthers the soundtrack of our self-doubt. I had lived much of my two-decade career in this falsehood. Until one kind, one brave educator, who had displayed his cherished case, shattered that notion.

The lecturer disclosed that the case he’d just put up on screen for us to admire did not take a single appointment to complete, nor a single appointment with the laboratory in matching the shade. To gain his ideal, uniform and balanced, barely distinguishable single tooth anterior restoration, it took seven tries. Seven. The audience gasped, myself among them. The lecturer may have shattered the intrigue with which he may have initially presented but gave us all a gift in the end. A gift of self-acceptance and a hope that our clinical work may not be so far behind his. It is with the help of the mentioned educator that we can finally venture into practice and toward life, full life, with a beautifully stark realization drawing upon us: perfection is unattainable, but excellence is. Excellence is not the sum of perfect outcomes but rather a state.

Excellence is a presence filled with perseverance, learning, and an unwavering commitment to our patients’ well-being. The experience with said educator is something we might call a sliding door experience, one where our life and knowledge are in stark display of the before and after. I wish both you and myself many of these experiences in our dental careers, understanding fully that the changes these experiences bring about are heavy and take quite an effort to unpack.

FROM PERFECTION TO EXCELLENCE

To navigate this profound transition, we must extend towards us the grace of forgiveness for our imperfections, recognizing that they do not diminish our capabilities but rather illuminate the path for continual growth and learning. It is also of utmost importance to realize that our lack of pursuing perfection does not equal sloppy, substandard, cheap, fast, and clinically unacceptable outcomes. Life will be a future full of sliding door experiences and endless possibilities, especially as we come to recognize that the incessant pursuit of perfection we so often chase is not just daunting and exhausting; it doesn’t exist. There is no place in this world, in the real world for perfection.

Accepting excellence on its very own behalf is the best way that we can find alignment with our authentic selves. And then, pursuing excellence is our opportunity to leave behind the soundtrack of self-doubt. Pursuing excellence is what will allow us to foster humanity, shared humanity. This humanity will transcend the confines of the dental chair and will connect us deeper to the people we serve. Our gift to them will not be a perfect restoration at the expense of our own self-worth. It will be an homage to honoring them as patients in need of healing and ourselves as a multidimensional human. Perfection, the notion that we must walk away from, has very little to do with the procedure, with the patient or with their healing.

Perfection is simply a way we have of judging ourselves. Perfection is about us, not about them. But when we chose to become healers of people, when we chose to become the physicians of the masticatory system, we chose to do it for them, and we chose to do it ‘to help people.’ Excellence is far more about how the outcome affects the patient and less about how it strips us of esteem or self-worth. This narrative of transformation, though rooted in the specificity of dentistry, echoes a universal chorus of self-discovery and resilience—reminding us that in the delicate dance of imperfection lies the beauty of all that humanity represents.

A CASE STUDY

It is not easy to blazingly attack a concept of attaining perfection, or the source of our self-worth, without a roadmap of how to detour it. Though I wish I were a master at this, I am still in my very early years of evolution. After all, even as I near my 50s, I’d spent far more time chasing unattainable perfectionism, than I have growing past it. With each day and each experience, however, I create new neuropathways to replace the magnetic hold perfectionism holds over me. My journey has involved a significant amount of reflection, yes, understanding, also…but what’s helped the most is recognizing how often I’d attached my self-worth to perfectionism. Having recognized and named those instances, I would be given an opportunity to reframe my point of reference. For example, as a general dentist, I have always loved endodontics. Currently, at least half of my day is spent diagnosing pulp disease, interpreting CBCTs, and performing root canal therapy. I have spent a significant amount of my continuing education hours dedicated to endodontics. There are days that, despite my best efforts, utilizing the proper disinfection and sealing techniques, my endodontic fill might not look ideal enough to grace the pages of a textbook. Not every fill has a puff of sealant past the apex.

Take a look at this case. After gathering diagnostic data, I was able to find that the lower bicuspid had two canals. Under magnification, I was able to locate the additional canal. The working length x-ray looked like the files were dancing, which made me ‘oh so happy’—yes, I attached self-worth here. I was able to clean and shape under a rubber dam and was able to fill the canals. But as the final x-ray appeared on the screen, so did a frown on my face. I didn’t see a puff of sealant at the apex, and I saw an air bubble where the GP could have been condensed more ideally. But I caught myself here. When my knee-jerk reflex was to reduce my self-worth on account of this, I recognized it; I slowed down and told myself: “You are attempting to gain self-worth from the way the fill presents radiographically. You have performed the procedure to the highest standard of care. You have taken care of your patient. You have healed an infection. You have attained excellence.” And yes, the self-talk is kind of silly; you don’t have to speak those words out loud. But doing this exercise day in and day out really does change the narrative; it changes perspective, and in time it leads to a lighter, more joyful existence.

I cannot tell you how difficult it is for me to disclose this case and show my results. This is NOT my best work. I fear being judged as an unworthy practitioner. Unworthy of the platform within which I am presenting. Maybe these were also the fears that our colleague and educator mentioned above felt when he first disclosed his seven tries to excellence. I am showing you my imperfect work, knowing there will be sharp comments sent my way, which will be inevitable considering our current societal currents. Vulnerable, anxious, and nervous, I am showing you my imperfect work so that you can gain acceptance for yours: imperfect but excellent.

ONWARD…

Wherever you are on your journey as a dental professional, I encourage you to take a deep breath and release the weight of your pre-programmed, decades-reinforced, carried perfection. Embrace your imperfections with self-compassion, humility, and understanding. Leave behind the endless journey that began in the youthful corridors of academia. Remember that your work, even with our craft’s technical nature, is a reflection of your humanity, not a measure of your worth. Embrace yourself and your work as perfectly imperfect, with steadfast dedication, and not as the unachievable absolutes we have been conditioned to chase. Unveil a reality where you gain ground, moving from self-criticism to grace and self-compassion. A reality with more fulfillment, more purpose, passion, and more gift to those in your care.

ABOUT THE AUTHOR

Dr. Maggie Augustyn is a practicing general dentist, the owner of Happy Tooth, a faculty member at Productive Dentist Academy, an author, and an inspirational speaker. She obtained her Doctorate of Dental Surgery from the University of Illinois at Chicago (UIC). Augustyn is passionate about reading, researching, writing, and speaking on topics that encompass the human experience, including our struggles, pain, and moments of vitality.

Maggie Augustyn, DDS, FAAIP, FICOI

Her personal mission is to inspire individuals to embark on a journey toward a more authentic self-actualization. She has a notable presence in the media and is a frequent contributor to Dental Entrepreneur Woman. Dr. Augustyn takes great pride in her role as a contributing author to Dentistry Today, where she publishes a column titled “Mindful Moments.”

She has also been featured on various podcasts and is a sought-after national speaker, emphasizing the significance of authenticity and self-discovery.

Julieanne O’Connor and Holland Haiis Leading the Mindset Movement in Dentistry

“Once dental professionals realize that the key to sustainable success in dentistry is their mental wellness, they thrive,” said Dr. Kyle Stanley.

Drawing from her extensive experience as an influence coach for high-achieving dentists and CEOs, while working closely with ZLinked Marketing to provide branding and social media strategies for dentists, Julieanne O’Connor understands the profound impact mindset has on performance. O’Connor and Haiis provide dentists and their teams with a unique opportunity to deepen their understanding of effective leadership principles, dental sales, and team building, while honing their mindset for success without burnout.

The collaboration between O’Connor and Haiis signifies a synergistic blend of expertise, combining O’Connor’s deep insights into the nuances of the dental industry with Haiis’s proven track record in leadership development across various sectors. Together, they offer an unparalleled experience designed to empower dental professionals to overcome challenges and cultivate a culture of excellence both personally and professionally.

Central to the leadership retreats and courses curated by O’Connor and Haiis is a holistic approach to personal and professional growth, encompassing mindset mastery, effective communication strategies, and leadership skills tailored specifically for the dental context. Through immersive workshops, interactive discussions, and hands-on exercises, participants gain practical tools and actionable insights to drive positive change.

O’Connor and Haiis’s commitment to fostering collaboration and community within the dental industry is evident in the design of their retreats and their own personal relationships within the field. By providing a platform for networking, honest conversations, knowledge sharing, and peer support, they empower dental professionals to leverage collective wisdom to accelerate their growth while maintaining healthy boundaries with work-life balance.

O’Connor and Haiis have gained widespread media recognition for their contributions in dentistry, enhancing the credibility of their collaborative initiatives in elevating leadership skills in the field. Their joint efforts represent a significant advancement in the attention to mental wellness in the dental industry.

For more information, visit InfluentialDentists.com.

Image by Cezary from Pixabay

However, the winds of change have swept across the landscape of dentistry, reshaping its contours and redefining the essence of mastery. It is a metamorphosis fueled by an unwavering commitment to excellence, a hunger for perpetual learning, and the integration of cutting-edge technology. Today’s dental professionals find themselves at the vanguard of a transformative revolution, challenging the boundaries of traditional dental specializations and embracing a new archetype—the “super generalist.” These practitioners, in my view, are akin to dental superheroes—admired by many, esteemed by most, and have clearly separated themselves from the common main street dentist.

The notion of the super generalist extends far beyond the mere mastery of dental procedures; it’s an embodiment of the unwavering dedication of dentists committed to delivering comprehensive care and fantastic results for patients. It’s a symphony composed of diverse skills—flawless cosmetics, intricate surgical prowess, finesse in endodontic procedures, and harnessing the potential of clear aligners. This harmonious amalgamation transforms a dentist into a versatile artisan capable of crafting exceptional dentistry under any circumstance—a true maestro of the oral realm.

Continuing education and the assimilation of technological marvels serve as catalysts propelling this transformative journey. Dentists today are not just healers; they are perpetual scholars, constantly delving into the realms of knowledge and immersing themselves in a wealth of continuing education opportunities. It’s more than just mastering the intricacies of procedures; it’s about decoding the complexities of treatment planning and unraveling the enigmas of the oral cavity as well as having a seamless understanding of financial surroundings in the practice.

Moreover, the advent of technology has redefined the landscape of dentistry, infusing it with newfound capabilities and efficiencies. Innovations such as rotary instrumentation revolutionizing root canal therapies and state-of-the-art CBCT x-ray machinery facilitating precise implant placements have empowered dental professionals to expand their horizons. Clear aligners, once deemed the exclusive domain of orthodontic specialists, now empower general dentists to correct malocclusions, expanding the scope of patient care and patient retention. This simply allows the clinicians and business owners to grow their practices as they expand their procedural menus. Cutting costs or using inferior materials within the practice is not nearly as profitable as increasing the level and dental applications we are providing for our patients. In other words, it is a more sustainable practice when the practice grows by performing a greater breadth of procedures than using cheaper materials.

The artistry of dentistry is no longer just about performing procedures or as some call it, “prescription dentistry.” It’s about sculpting treatment plans that resonate with patients’ needs, fostering trust and ensuring satisfaction.

In essence, the metamorphosis of dentistry from specialized expertise to a wholistic, patient-centric approach represents a monumental paradigm shift. The pillars of continuous education, technological integration, comprehensive treatment planning, and the ability to navigate the financial terrain stand as the bedrock upon which dentists erect not just thriving practices but also a legacy of unparalleled patient care and enduring success. My experience has led me to believe that these are the clinicians who are also able to construct a fabulous work-life balance as well.

Continuous Education: The Pillar of Excellence in Dentistry

Continuous education is the cornerstone upon which the edifice of modern dentistry stands tall, illuminating the path toward mastery and innovation. In this era of boundless information, the dental professional of the 21st century embodies the spirit of a relentless learner. Engaging in continuous education is no longer an option but an imperative—a gateway to staying ahead in an ever-evolving field with the ease that their knowledge base comes readily available at a click of a button and yet can deliver optimal treatment. Technological strides have revolutionized dentistry, propelling practitioners into a new realm of precision and efficiency. The advent of sophisticated tools like rotary instrumentation and root canal locators has propelled dentists into a realm of heightened efficacy in performing intricate procedures. Dental CBCT x-ray machinery, a true marvel, has magnified the capabilities of clinicians, allowing for precise implant placements through guided procedures, fostering exponential growth in the repertoire of the super generalist. Also, as I mentioned before, the introduction of clear aligners has broadened orthodontic treatment, empowering general dentists to rectify malocclusions, once the exclusive domain of orthodontic specialists.

The crux lies in comprehensive treatment planning, the fulcrum of successful dental practices. It is no longer just about executing procedures but about crafting treatment plans that align seamlessly with patients’ unique needs, engendering satisfaction and trust. This transcends beyond being proficient in procedures; it’s about embracing a wholistic approach that encapsulates patients’ desires, oral health goals, and overall well-being.

The evolution of dentistry beckons the practitioner to embrace a more expansive perspective, one that integrates multiple modalities into treatment plans. This amalgamation, reminiscent of the symbolic “5 fingers of the Dental Hamsa,” enables dentists to exercise greater control over costs; retain treatments in-house; and, most significantly, perpetuate a continuous stream of high-quality care for patients and develop further allegiance to our patients as well.

In essence, the evolution of dentistry embodies a transformational journey—one that transcends the realms of technological innovation and procedural mastery. It is a testament to the shift in mindset, steering away from the myopic view of dentistry as a collection of procedures. The integration of advanced modalities into treatment planning will continue to fortify the foundation of successful dental practices, nurturing a continuum of excellence and patient satisfaction.

Building Sustainable Practices and a Bright Future

Building sustainable practices requires a multi-faceted approach that extends beyond clinical proficiency. In today’s dynamic environment, dentists must navigate financial intricacies, optimize operational efficiency, and ensure a harmonious work-life balance. While clinical skills are foundational, understanding the business aspect is equally crucial.

Financial sustainability serves as the backbone of a thriving practice. It’s imperative to comprehend the practice’s financial health, carefully balancing revenues and expenditures. Knowing the costs associated with technology, staffing, marketing, and overheads is pivotal. This awareness aids in making informed decisions, ensuring the practice’s long-term viability. Understanding several nuances of a lease can allow practices to navigate a burst of growth via expansion or a downsize due to catastrophe much earlier and in a less burdensome way.

Efficiency in practice operations is paramount. Streamlining workflows, implementing efficient scheduling systems, and enhancing patient experiences contribute significantly to success. Seamless patient journeys, from initial contact to treatment completion, foster satisfaction and loyalty, underpinning the practice’s sustainability.

Balancing professional commitments with personal well-being is vital. Preventing burnout by maintaining a healthy work-life equilibrium not only supports the practitioners’ mental health but also enhances the quality of patient care.

Moreover, succession planning secures the future of the practice. Training and mentoring the next generation ensures the continuity of values, standards, and patient-focused care. Preparing an exit strategy, whether transitioning to new leadership or a sale, guarantees a smooth shift and sustains the practice’s legacy.

Technology integration is pivotal, not just in acquisition but also in strategic utilization. Leveraging technology for enhanced patient communication, streamlined record-keeping, and data-driven decisions elevates practice efficiency and patient satisfaction.

Looking ahead, the future of dentistry gleams brightly for those committed to ongoing education and comprehensive patient care. Dentists equipped with diverse skills and expertise are the super generalists. These practitioners deliver exceptional dentistry, craft intricate treatment plans, and facilitate practice growth by expanding procedural options—all while prioritizing efficient procedures and patient contentment.

In conclusion, dentistry’s metamorphosis from specialized expertise to patient-centric care represents a transformative shift. Continuous education, technological integration, comprehensive treatment planning, and financial astuteness are the bedrock upon which dentists build not just successful practices but also a legacy of exceptional patient care and a robust practice succession.

ABOUT THE AUTHOR

Dr. Liechtung earned his DMD degree at the University of Pennsylvania School of Dental Medicine, followed by a fellowship in Advanced Restorative Dentistry at the university’s Post Graduate Clinic. He has been in practice in New York for more than 28 years. Dr. Liechtung is the inventor of Snap-On Smile. He currently produces the podcast Dentistry Beyond the Numbers and is managing partner of the New York region and executive director of partnership development for Guardian Dentistry Partners. He can be reached at mliechtung@gmail.com. 

Disclosure: Dr. Liechtung reports no disclosures. 

Mimicking their successful approach in Audio, H3D are focusing on dental labs rather than clinics. The company’s motto is “built with labs, for labs”, and there is a strong emphasis on quality. This is welcome news for dental labs, who have been increasingly neglected as dental CAD companies prioritize clinics and chairside.

“Labs are the gold standard in terms of quality levels, and our ambition is to create the world’s best AI CAD, so partnering with them was a natural choice for us,” says Damian Png, Dental BU Director at H3D.

The strategy is certainly working in the Audio industry. H3D’s AI CAD boasts an order acceptance rate of >90%, enthusiastic product reviews, and a 100% customer retention rate. They work with iconic brands, such as Sennheiser, Amplifon, and Formlabs. Such customer fanfare is in stark contrast to existing AI CAD solutions in dental, who have a reputation for poor quality and consistency.

“H3D’s AI CAD designs look very promising – high quality standards, fast turnaround times, and competitive pricing,” explains Matt Smith, General Manager at Andent.

Labs see H3D’s AI CAD as a solution to the labor shortage of CAD technicians, which will ultimately help them scale their businesses. Currently, CAD takes x1 CAD technician 10-20 minutes per order. However, there is an industry-wide shortage of CAD technicians, so labs are forced to reject new business.

“H3D’s AI CAD has the potential to be hugely impactful for our industry. It will enable us to significantly increase our production and overcome the capacity issues caused by the shortage of CAD designers. It will also facilitate the transition from thermoformed to digital splints, resulting in better quality products for dentists and patients,” says James Squirrell, CEO of Modern Dental Pacific.

With H3D’s AI CAD, 100s of orders can be processed within 5 minutes. It’s been intentionally designed to be so simple that it can be operated by lab staff who aren’t CAD technicians.

“I started working on 3d digital technology in 2009 and it changed the whole game – staffing, quality consistency, speed, costs—and it’s clear that AI CAD is the industry’s next big innovation,” says Stefano Negrini, KOL and CEO of Ortodonzia Estense.

As the dental industry continues to embrace digital dentistry, H3D sees AI CAD further accelerating the trend towards intraoral scanners and 3D printing.

“We’re regularly approached by 3D Printing companies, IoS companies and resellers. For them, CAD is holding back the industry, so solving this bottleneck is hugely important,” says Iain Mcleod, CEO at H3D.

H3D’s AI CAD for splints will be released in Q3 2023, with crowns, dentures and aligners following shortly.

The company is currently accepting expressions of interest for their Innovators program, which provides early access to the AI CAD product, as well as discounted pricing.

About H3D

H3D is an Australian PhD research spinout whose mission is to make custom-fit medical devices accessible for everyday people. They do this by providing labs their AI CAD product, AutoDesign, which helps labs scale their businesses. Since launching in 2021, H3D has become the industry’s leading provider of AI CAD Automation and counts iconic brands as customers, such as Logitech, Modern Dental Pacific, and Dreve.

Expert Michael W. Davis, DDS, is back. Continue reading for more of his coverage of the risks and rewards of being a dental industry whistleblower.

US DEPARTMENT OF LABOR

Employees (or misclassified “independent contractors” or “managers”) may file a complaint with US Department of Labor’s Office of Administrative Law Judges and/or their state labor department for a variety of violations inclusive of misclassification of employment status, workplace discrimination, and failure to provide overtime and required break periods.

The government suggests victims also retain personal legal representation.

Employer retaliation is specifically prohibited by adverse actions inclusive of:

• Firing or laying off
• Demoting
• Denying overtime or promotion
• Disciplining
• Denying benefits
• Failing to hire or rehire
• Intimidation or harassment
• Making threats
• Reassignment to a less desirable position or actions affecting prospects for promotion (such as excluding an employee from training meetings)
• Reducing or changing pay or hours
• More subtle actions, such as isolating, ostracizing, mocking, or falsely accusing the employee of poor performance
• Blacklisting (intentionally interfering with an employee’s ability to obtain future employment)
• Constructive discharge (quitting when an employer makes working conditions intolerable due to the employee’s protected activity)
• Reporting or threatening to report an employee to the police or immigration authorities

This includes full-time, part-time, and temporary employees. Staffing agencies and the host employer may both hold potential liabilities.

The US Internal Revenue Service (IRS) and state taxation authorities may additionally file a demand for unpaid taxes, interest, and penalty in situations of misclassified employees by employers.

One lawsuit in the dental industry filed under violations to the federal Fair Labor Standards Act resulted in a $1.3 million dollar settlement. This particular class action was filed against a dental service organization (DSO) which allegedly denied dental clinic office managers overtime pay.

OSHA VIOLATIONS

Workplace safety whistleblower complaints may also be filed through OSHA. Employer retaliation upon whistleblowers may result in additional penalties.

OSHA’s Whistleblower Protection Program enforces the provisions of more than 20 federal laws protecting employees from retaliation for, among other things, raising or reporting concerns about hazards or violations of various workplace safety and health, aviation safety, commercial motor carrier, consumer product, environmental, financial reform, food safety, health insurance reform, motor vehicle safety, nuclear, pipeline, public transportation agency, railroad, maritime, and securities laws.

The dental industry is not immune from OSHA compliance requirements.

Numbers of compliance training programs exist to assist the dental industry.

OSHA COVID-19 VIOLATIONS

With the advent of the coronavirus with the pandemic, OSHA has enacted added safety standards to protect workers, most particularly in the healthcare industry, but not exclusive to healthcare workers. The US Department of Labor has released a listing of inspections with resulting related violations.

Offenders range widely, from nursing homes and elder care facilities to government healthcare and border immigrant programs, to food processing centers. Most, if not every state is represented among offenders. Not excluded among wrongdoers are dental clinics, both smaller operations and larger DSOs.

Reuters News has reported that approximately two-thirds of violators are not paying their fines.

All the while, regulators are frequently ignoring OSHA COVID-19 complaints from workers.

FALSE CLAIMS VIOLATIONS

In the dental industry, these sorts of qui tam actions are typically filed for alleged Medicaid fraud.

Generally, one or more whistleblowers will file a lawsuit(s) in civil court with their private attorneys.

Government attorneys general (state and/or federal) may then later elect to join the lawsuit on behalf of plaintiffs.

Whistleblowers (called “relators”) may range from patients (or parents), to doctors, to dental auxiliaries, to office managers. Relators may receive 15-25% of the eventual settlement or judgement (in an intervened case), depending on their contribution to the prosecution and their time order in filing.

Because the federal False Claims Act allows a treble damages penalty, and the common dollar amount of Medicaid fraud often being millions of dollars, payouts for prevailing relators may result in substantial sums.

However, most successful False Claims litigation may take several years, just to reach a settlement. Many cases are never joined by government attorneys, and private law firms may lack financial resources to bring cases to conclusion. Further, qui tam False Claims litigation is a legal specialty, which many or most attorneys are ill-prepared to prosecute.

Additionally problematic for relators is that government attorneys or courts may weigh the service of some relators more valuable versus others. It is not unusual to see one relator in a major DSO Medicaid fraud case to receive over a million dollars, while another receives virtually nothing beyond coverage of their attorney fees.

Michael (Mick) Greenwald, DDS was a primary relator in government’s False Claims action against Kool Smiles Dental. The lawsuit eventually settled with no admission of wrong-doing for $23.9 million. Greenwald offered solid advice for any whistleblower. “Get real time, solid unequivocally true and accurate information.”

He cautioned “I knew someone who actually called the feds and told them what she saw. They asked if she had hard evidence. She said no. They said… we won’t investigate based on hearsay.

Evidence, evidence, evidence!”

COMPANY RETALIATION

Although numbers of statutes are designed to afford whistleblowers legal protections, company retaliation is common. Company threats, intimidation, and efforts to disparage whistleblowers or potential whistleblowers are frequently evidenced.

Moreover, companies which include unlawful activity as an essential element to their business models, often require new hires to sign nondisclosure and non-disparagement agreements. Additionally, as part of employee severance packages, exiting workers are frequently required to sign similar nondisclosure and non-disparagement contracts.

In settlement agreements, which usually includes a financial payout by the offending company, there is generally no admission of wrong-doing. Whistleblowers are again most often (not always) required to sign nondisclosure and non-disparagement agreements. As such, the public learns little about what really is happening.

The following email was submitted in public record evidence against a certain dental chain, in a civil lawsuit. The legal action among other issues alleged the parent company forced defective quality laboratory work upon doctors and their patients. The email’s author was a dental chain corporate officer, and the recipient was a former sub-franchise owner dentist.

“Doug,

I couldn’t agree with Cindy more.

Go f*** yourself, and do us all a favor and never say you ever knew us.

You worthless, despicable piece of s***.

This will follow you forever, but maybe you’ll do the world a favor and disappear.”

Employers may create hostile workplaces for employees who decline to work under unsafe conditions, such as with mercury spills.

Employment hours may be reduced accompanied by threats and cursing.

In research for this article, a vast number of dental industry whistleblowers were contacted. Almost all declined to be interviewed on-the-record, because of contract obligations and fear of retaliation by former employers.

WHISTLEBLOWERS WITH MEDICAID MCOs

Some of the most fascinating alleged fraud centers around alleged misrepresentations proffered by dental Medicaid management service organizations (MCOs) to respective states like Texas, in order to gain contracts to administer a state’s dental Medicaid program. Such whistleblowers merit protections.

A lack of full transparency by bidding MCOs has led to rejection of the apparent lowest bidders.

Such was recently the case in Arkansas.

Other times, there exists alleged collusion between a state’s dental Medicaid director and an MCO, to deny patient access for certain providers and effectively excluding them as Medicaid providers, as was allegedly evidenced in Tennessee and Massachusetts.

Disadvantaged patients may be denied access to care. Providers may be denied access to patients.

However, states save money and willingly share their savings with an alleged accomplice MCO.

CONCLUSION

Edwin J Zinman, DDS, JD explained “A whistleblower has to decide which direction his/her moral compass is pointed. In the dental community some dentists (and DSOs) may try to defame the whistleblower. However, if convicted of dental fraud the fraudulent dentist (or DSO) would likely be reluctant to blame the whistleblower and further publicize their fraud.”

“In any defamation case- truth is a defense to defamation. I have not seen violating dentists (or DSOs) filing defamation cases against a whistleblower for that reason.” (Author’s note: although rare, I have provided consultation to a whistleblowing dentist who was a defendant in a defamation lawsuit.)

Zinman added, “Whistleblowers in qui tam suits can recover a portion of the monies the government collects from the wrong-doing dentist (or DSO) for dental fraud. Also reporting tax evasion provides a portion of the taxes and penalties due to the government as an incentive reward to the whistleblower.”

Greenwald was asked if he would step forward again. “Personally, with all the stress, anxiety, (slow) wheels of justice process, and last minute mudslinging as THEIR last minute Hail Mary to discredit me…. I’d do it again, month after month, year after year.”

ABOUT THE AUTHOR

Dr. Michael W. Davis practices general dentistry in Santa Fe, NM. He also provides attorney clients with legal expert witness work and consultation. Davis also currently chairs the Santa Fe District Dental Society Peer Review Committee. He can be reached at MWDavisDDS@Comcast.net.

FEATURED IMAGE CREDIT: StockSnap from Pixabay.

vTail, the Healthcare Communications App connecting healthcare professionals directly to medical products companies, is expanding into its second medical specialty arena in the USA – Dentistry.

Barry Wolfenson, vTail CEO, states, “We are excited to bring our truly unique app to the dental community, and I applaud our team for the incredible amount of work they did in a short amount of time to expand our offering beyond our initial launch market of advanced wound care.  Given the new-normal that exists in the world of healthcare, we are proud that our solution has helped remove the key points of friction between clinicians and company reps. As a result, we’re seeing more frequent engagement with less hassle for everybody.  Given the size and dynamics of the dental market, we are confident in the value our platform will deliver to our customers and investors.”

There are over 120,000 clinically practicing dentists in the US today. The dental industry suffered early on during the pandemic with the lack of PPE and mandated office closures. Dentists typically have less access to manufacturers that hospital systems do. When practices started reopening, new protocols for cleaning and disinfection made it challenging to bring in sales or service professionals.

Chief Marketing Officer for vTail, Michael McCarthy, MBA states, “Our research suggests dental professionals and companies will eagerly embrace vTail. Dentistry needs support and time saving efficiencies which the vTail app can easily provide. On any given day, a dental office can house upwards of 10,000 individual branded products from hundreds of different manufacturers. We want dental professionals to have an easy, intuitive way to get what they need from manufacturers on a timely basis, without searching for representatives’business cards.

We’re also providing dentists with a searchable product database and a newsfeed which provides relevant content to dentists, dental specialists, registered dental hygienists, and office managers.”

vTail is free to all healthcare professionals. The HIPAA-enabled app has built-in safeguards that allows clinicians to communicate with companies without needing to share their personal phone numbers or receiving unwanted inbound calls or emails.

About vTail

vTail (www.vtail.co) is a newly launched digital healthcare communications platform designed to connect healthcare professionals (HCPs) with representatives from the medical technology, pharmaceutical, biotechnology and diagnostics industries. The company’s early launch focus has been in medical technologies in the US, having now launched in the advanced wound care and dental markets, and planning to launch into the orthopedics market. In 2022, the app will move into more clinical areas and into international markets.

vTail was selected as a Top 10 Clinical Communications & Collaboration Solution Provider for 2021 by MD Tech Review.

dntl bar is Known for Providing Enjoyable, Patient-First Care in New York City

Gone are the days of booking a dentist appointment months in advance and dreading the impersonal and often painful experience that comes with laying in a dental chair as someone pokes and prods your mouth. dntl bar—New York City’s most enjoyable and convenient dental practice from the team behind CityMD, the Northeast’s largest urgent care provider—puts patients at the center of its service at its three Manhattan locations, offering quality care and same-day appointments, clear pricing and comfortable visits. Forget old magazines in stuffy waiting rooms, now patients can watch Netflix, use aromatherapy products, stay warm under a cozy blanket and relax in massage chairs at the dentist office.

“The dental industry, like most healthcare systems, has evolved into a payer- or provider-first oriented system. While not necessarily the intent of many hard working clinical professionals, it has nonetheless become a place where the consumer is found standing last in line,” dntl bar co-founder and CEO and CityMD co-founder Nedal Shami says. “From making an appointment, following up for your care, paying a bill or even the basic principles of respecting your time and starting on time, nothing is simple for the patient. We think we can change that.”

Shami thought he could apply what he did at CityMD and reinvent the experience of going to the dentist to make it accessible, affordable and enjoyable, instead of outdated and impersonal. Shami grew CityMD into a billion dollar company with 150 locations, transforming the way customers sought emergency care, and believes people should get the same access to dental care. So in 2019—dntl bar opened its first location in Chelsea which received immediate validation in the market with an industry-leading amount of new patient appointments and raving customer reviews. dntl bar has since added two more locations in Union Square and the Financial District, and plans to open two more sites by the beginning of 2022.

dntl bar stays open seven days a week from 8 am until 8 pm on the weekdays and 9 am until 5 pm on the weekends, making it easier for patients to find time to get to the dentist for everything from check-ups and teeth whitening to teeth straightening and emergency work. Unlike at standard dentist offices, dntl bar never wants patients to have to wait to see one of their top-rated dentists, so they provide same-day and same-week appointments that can be easily booked online. They also offer SMS communications for patients who want to be able to communicate with ease. Because dntl bar prioritizes transparent pricing and doesn’t want patients to be surprised when they see their bill, it’s in-network with most PPO insurance plans.

When patients arrive at one of dntl bar’s three locations, they walk into a modern lounge and are greeted by a friendly front desk attendant. They can grab noise-cancelling headphones to wear during the procedure or opt to listen to music or stream their favorite Netflix series when they see the dentist. dntl bar uses high tech equipment and machinery, and the clinical staff undergoes a rigorous hiring process; they also receive regular reviews to ensure they continue to provide top-notch, patient-first care. Because of its luxury accommodations, accessibility and gold-standard service, dntl bar boasts an NPS of 90 compared to the industry average of 1.

dntl bar believes people deserve higher quality dental care that actually puts them first and aims to bring a cost-effective, straightforward option to more people than ever before. dntl bar has started a movement with its decision to center its care around patients rather than billings, and it was that transparency and industry-disrupting concept that kept people coming in throughout the COVID-19 pandemic, during which dntl bar only continued to grow and draw in new clients. dntl bar plans to bring its transparent and high-end approach to 50 locations in multiple cities within the next five years.

For more information on dntl bar and their services, visit their website at dntlbar.com.

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membersy, the digital health company democratizing access to quality dental care through subscription-based dentistry, has raised $66 million from Spectrum Equity, a leading growth equity firm focused on internet-enabled software and information services companies. The investment will support membersy’s new product and service offerings to help Dental Service Organizations (DSOs) provide greater price transparency to their patients through a modern membership experience.  

The growth-investment coincides with several board member additions that will help guide the company as it reorients the dental industry’s existing payment methodologies, empowering DSOs to engage and support their communities with subscription-based payment options and competitive pricing strategies. The new board members include Dr. Chad Wise, former Founding Partner at North American Dental Group, a DSO with more than 250 affiliated dental practices across 15 states; Keith English, former Co-Founder & CEO at LocalMed, a leader in real-time online scheduling for dental teams, and Jeff Haywood, Managing Director at Spectrum Equity.

“We’re preparing to rapidly expand our team, products, and services in response to a fast-growing DSO partner base,” said CEO and Founder Eric Johnson. “When we started in 2015, we knew there was a huge opportunity to make dentistry more approachable by modernizing the way consumers access and pay for dental care services, and we’re proud of the impact we’ve had up until this point. With new funding and an amazing partner in Spectrum Equity, we’re positioned to see that impact grow exponentially.”

Not only are younger generations increasingly interested in alternative healthcare payment structures, but, after a pandemic year that saw millions of people lose their employer-sponsored health plan, more people than ever are looking for new ways to attain affordable health services.

At the same time, many dental practices have struggled to attract and retain fee-for-service patients. Regulatory-compliant dental subscription plans offer practices the opportunity to support their patients with modern, tech-enabled payment and service procurement models. Operating as a turnkey platform-as-a-service  solution for DSOs, membersy streamlines membership plan marketing and administration to make dental care more approachable while providing dental teams with automated practice onboarding, recurring subscription payments and billing, and real-time analytics to manage and grow their member base. 

Membersy is the nation’s largest dental subscription plan platform currently operating in 41 states and boasting membership approaching one million members spanning across 4,000 practice locations.

“We are thrilled to partner with Eric and the entire membersy management team to solve a growing pain point in the broader healthcare ecosystem – the lack of access to quality, affordable dental care across the U.S. For several years, we’ve been investing in companies that are improving patient outcomes, reducing costs and increasing price transparency in healthcare. We’re looking forward to applying our experience to support membersy’s continued growth trajectory,” said Jeff Haywood, Managing Director at Spectrum Equity.

Ernst & Young Capital Advisors and Dickinson Wright served as advisors to membersy. Lathan & Watkins served as legal advisor to Spectrum Equity. 

About Spectrum Equity

Spectrum Equity is a leading growth equity firm providing capital and strategic support to innovative companies in the information economy. For over 25 years, the firm has partnered with exceptional entrepreneurs and management teams to build long-term value in market-leading internet-enabled software, information services companies. Representative investments include Ancestry, Definitive Healthcare, Everly Health, GoodRx, Grubhub, Lucid, SurveyMonkey, Verafin and more. For more information, including a complete list of portfolio investments, please visit spectrumequity.com.

About membersy

Membersy is the first and largest subscription focused company in the dental industry, providing Dental Service Organizations (DSOs) of all sizes with the tech, marketing, and administration infrastructure to launch and grow a modern membership experience. Today, more than 4,000 dental practices and close to  1 million members across the United States utilize membersy’s advanced subscription platform for a more personal and connected dental care experience. For more information, including a complete list of the membersy’s growing partner portfolio, please visit membersy.com or follow on LinkedIn, Instagram, Facebook, and Twitter @membersy.

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Top decision-making competence of the visitors Over 23,000 visitors from 144 countries – industry expects positive development in the coming months

IDS 2021, which came to a close on Saturday, 25 September 2021, after four trade fair days, set the impulses the global dental industry had hoped for in the post-Corona era. “The optimism has returned within the international dental family,” said a delighted Mark Stephen Pace, Chairman of the Executive Board of the Association of the German Dental Industry e.V. (VDDI). “We held intensive discussions with interested visitors and most of them ultimately came to make investment decisions. Many of the decision-makers consciously concluded their transactions at the trade fair. We can convey the signal to the outside: The German dental industry is moving forward. We are offering solutions in difficult times. The exhibitors I spoke to were thoroughly happy to be at IDS. And I am convinced: They will benefit from market revolutions in the aftermath of IDS! This is how it works in the world of business: Companies that were present in the exhibition halls, certainly undertook an entrepreneurial risk in the run-up to the trade fair, which makes it all the more gratifying that they were ultimately able to reap the deserved success and market shares.”

For Oliver Frese, Chief Operating Officer of Koelnmesse GmbH, IDS 2021 also clearly underlined the spirit of optimism within the industry: “All of the exhibitors and visitors were visibly pleased to groom contacts directly in person, experience products live and engage in personal encounters at the end of the trade fair day in the course of numerous networking events. That is why IDS 2021 plays an outstanding role for the re-start of the industry and of course also for the re-start of the trade fair industry overall. Furthermore, IDS 2021 is the first IDS that was staged as a hybrid event. This means there were places of physical encounter on the one hand, here in Cologne in the exhibition halls and in addition to that also on the digital platform, IDSconnect, which offered additional presentation and networking options, which went down very well.”

IDS demonstrated once again that it is the leading global trade fair of the international dental industry: Over 23,000 trade visitors from 114 countries attended IDS 2021 to inform themselves about the offer of 830 exhibiting companies from 59 countries. Especially against the background of the restricted travel possibilities in many regions of the world, IDS once again convinced with its strong international appeal. 72 percent of the exhibitors came from abroad, as well as 57 percent of the visitors – from Europe, particularly from Italy, France and the Netherlands, to Eastern Europe, the Middle East and overseas. The decision-making competence of the visitors is decisive for the success of a trade fair and here the level at this year’s IDS was also extremely high – both on a national and international basis,” Dr. Markus Heibach, Chief Financial Officer of the VDDI, summed up. The initial evaluation of a visitor survey confirms this impression: In this way, almost 85 percent of the visitors at this year’s IDS are involved in procurement decisions, indeed 33 percent of them decisively. For over half of the visitors, grooming existing business relationships and establishing new business relationships are the key reasons for visiting IDS. Good two thirds of the visitors were very satisfied with the offer of exhibits and with the extent to which they had achieved their goals and 85 percent would recommend that a good business associate should visit IDS. Around 70 percent of the respondents are already planning to visit IDS 2023.

77 exhibitors from 16 countries were present on IDSconnect with 88 items and 1,310 minutes of broadcasting time. The general event programme of IDS, such as for example the award ceremony of the “Impression Prize” of the ProDente Initiative, the Gysi prize-ceremony of the Association of German Dental Technicians’ Guilds or the programme of the German Dental Association were streamed via the platform live. All lectures, shows and presentations broadcast digitally are also available afterwards “on-demand”.

The representatives of the German Dental Association and of the Association of German Dental Technicians’ Guilds were also delighted at the successful re-start of the international dental world. “The hybrid concept that had to be adopted for IDS 2021 because of the Corona pandemic was a total success. Great praise and our sincere thanks go to the organisers, the GFDI Gesellschaft zur Förderung der Dental-Industrie mbH and Koelnmesse GmbH for this. All IDS participants were able to tour the trade fair on-site under observance of the necessary hygiene measures or virtually and thus experience the innovations in the fields of dentistry and dental technology. We were also available at the stand of the German Dental Association to provide many visitors with information and engage in practice-oriented discussions with them. We also gladly took advantage of the digital possibilities. We are looking forward to IDS 2023!” said Prof. Dr. Christoph Benz, President of the German Dental Association.

And VDZI Vice President, Klaus Bartsch, added: “The VDZI is delighted at having held many collegial discussions and being able to engage in exchanges at the trade fair. Particularly the current themes quality management and the VDZI quality management concept, QS-Dental, work protection and business-related questions were topics of high interest. The award ceremony of the renowned VDZI trainee competition “Gysi Prize”, which was broadcast live for all those people who weren’t able to be on-site, was a special highlight. The exhibited Gysi Prize entries demonstrated the talent and skills of our aspiring dental technicians. The aim behind the prize is to challenge and promote the trainees – the future of our trade.  IDS 2021 has once again demonstrated that the dental world is further developing digitally. This is having an impact on the work processes in the laboratories of the dental technicians. Company owners have to weigh up the opportunities and take investment decisions based on sound judgement. The discussions at the stand of the VDZI about the future role of the commercial dental technology laboratory clearly show: For all of the technologies exhibited, master dental technicians and their teams are indispensable for dental restorations. With their expertise and in the close exchange with dentists, they ensure that patients receive the individual treatment they need.”

Statements Exhibitors

Haikki Kyöstilä, President of Planmeca Oy

IDS 2021 – a feeling almost as normal. In my opinion, IDS went surprisingly well – about the same as normal. September as the new date for the fair has turned out to be the best choice. Friends and customers were coming up to say hello or to decide about and buy their new equipment. There?were?not?as?many?visitors?as?in?2017?or?2019,?and?even?for?the?future,?I?expect?IDS?to?be?a?bit?smaller?than?in?the?past.?But?we?will?still?initiate?and?maintain?a?lot?of?communication?here?in?Cologne?–?which?is?the?fuel?for?innovation?and?success.

Maike Wassmann, General Manager bisico, Bielefelder Dentalsilicone GmbH & Co. KG

IDS went better than I had expected. We were able to establish more contacts than we had imagined, especially with dealers from third countries. Even if we did rather miss the classic, German dentist as a visitor and it was overall quieter than usual: I am glad to have been here!

Torsten Fremerey, Executive Director, EMS Electro Medical Systems GmbH

It is a great pleasure to finally be able to present our new Guided Biofilm Therapy (GBT) products to the audience of IDS again live. It is great fun seeing the huge interest in our GBT protocol innovations and celebrate the live dental trade fair with the trade audience. Participating in IDS 2021 is a great success for EMS. The strong feedback from our customers confirms that GBT is the best prophylaxis of all time. EMS’s decision to make a strong appearance at IDS 2021 was spot on.

IDS 2021 in figures

830 companies from 59 countries took part in IDS 2021 on exhibition space spanning 115,000 m². The exhibiting firms included 228 exhibitors and 5 additionally represented firms from Germany and 591 exhibitors and 6 additionally represented firms from abroad. Foreign exhibitors accounted for 72 percent of the total. Including estimates for the final day of the trade fair, more than 23,000 trade visitors from 114 countries attended IDS, of which 57 percent were from abroad.

About IDS

IDS (International Dental Show) takes place in Cologne every two years and is organised by the GFDI Gesellschaft zur Förderung der Dental-Industrie mbH, the commercial enterprise of the Association of German Dental Manufacturers (VDDI), and staged by Koelnmesse GmbH, Cologne.

The next edition of IDS will take place from 14 to 18 March 2023.

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