Ed Rabinowitz

Arun Garg, DMD, never thought he would make 42 trips to the Dominican Republic. At least not within a relatively short period of time.

Eight years ago Garg and several of his colleagues made their first trip to the Dominican to do implants, bone grafts, and to teach. He figured to make the trip once every two years, perhaps once a year.

But then the phone began to ring. And it didn’t stop ringing. The originally planned annual trip became semi-annual. Then every three months. Then every other month. And now the trip has become a monthly event.

“And the number of [dental professionals] we take with us has grown,” Garg says. “The benefit to the locals is they receive incredible care at no cost. And I get to do what my passion is, which is teach.”

, leads a team of more than 25 dental professionals to the Dominican Republic every month for three days to provide a wide range of services, from simple cleaning to complex surgery—all free of charge.

Through the charity he founded, The Garg Foundation, Garg has sponsored traveling missions to various countries, but the trips to Santo Domingo in the Dominican have been the most frequent.

“We do three days of surgery,” Garg explains. “There are Thursday, Friday, and Saturday surgeries.”

All of which is ironic for someone whose father, a retired academic physician, encouraged him to go into engineering because, “Medicine is tough. You should do engineering instead, and work for a company 8 to 5.” Yet here he is, in addition to his regular work, making weekly trips to the Dominican Republic.

“I would do all of this for free,” he says. “What bowling is for some people, what watching sports on television is for some people, this is my golf. This is my bowling. Just as someone is on the golf course on Saturday, I get to operate on Saturday. It’s my relaxation, my hobby. And they pay me for my hobby. Wow.”

Garg recalls the first of his 42 trips to the Dominican. He selected the location because it was home to a member of his staff, and she helped make the arrangements. Garg also made a preliminary trip so as to eliminate any possible surprises. Still, it was an eye-opening experience.

“It was a bit more rudimentary than I expected,” he says. “I expected maybe a little more as far as the physical facilities. But the patients were much nicer than I ever expected.”

Garg overcame the initial culture shock, and has since worked with city officials in Santo Domingo to construct a building dedicated to seeing patients. The 26-chair facility, which was funded by his foundation, is complete with state-of-the-art dental equipment enabling Garg and his colleagues to provide approximately $2 million in free dental care on each trip.

But it’s important to note that The Garg Foundation is not your garden-variety charity.

“A lot of times what charities do, they’re in the business of raising money,” Garg says. “They do charity balls, and charity events, and they raise money. And who knows how they spend it.”

Instead, Garg established a charity that 

“So far, 99% of the money that’s been donated to my charity has been me,” he says. “We bought a two-story apartment building and gutted it. And so the framework was there. We added steel beams and a third floor for a freestanding clinic. And shipped everything from America. It may not surpass every clinic in America, but it’s equivalent to the top one or two percent. Everybody I know tells me that.”

Garg spent 18 years as a full-time professor at the University of Miami School of Medicine. He trained residents, published eight textbooks, and developed many new surgical techniques. But after leaving the university and opening three private clinics in Miami, he still had a passion for teaching.

 as a way to provide continuing post-graduate dental education programs nationwide. His curriculum and conferences have trained thousands of dentists across the country in the techniques and procedures for successful implants.

“Folks go to dental school or medical school and they come out with the latest and greatest,” Garg says. “But five years later new techniques become available, or new equipment becomes available. Would you want your physician or your dentist using techniques from 1970 on you?”

“There are techniques now where there’s zero sting; where I can give an injection to the patient and they’re wondering when I’m going to start giving the injection,” Garg says. “If we can take that sting away for the patients, then the 18-20% who don’t go to the dentist every year, we open up care for those folks. It improves the practice, and it improves patients’ quality of life.”

Garg doesn’t have a great deal of spare time today, but he played competitive tennis throughout high school and in college, and still tries to get out at least once a week to play.

“I play tennis for the fun of it,” says Garg, who also enjoys water sports including boating and fishing. But he acknowledges that the competitive nature of sports has likely carried over and contributed to his competitive and entrepreneurial spirit in his career.

“I think so,” he says when asked of the connection. “I’ve never read studies or anything to that effect, so it’s just a gut feeling. But I definitely think playing competitive sports contributes to developing that competitive edge.”

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Arun Garg, DMD, has a competitive spirit and a passion for oral health. What he's accomplished in his career would be hard to beat.

Passion for Education Prompts Florida Dentist to Make Monthly Mission Trips

When it comes to the medical field, there is often a significant disparity in the care received by individuals residing in rural areas compared to those in more urban settings. Unfortunately, it’s no different where dentistry is concerned.

But MORE (Medical Oral Expanded) Care, an initiative developed by 

, a leading dental benefits administrator, is looking to change that. It’s new South Carolina initiative has set a goal of providing greater access to preventive oral health services.

“The rural healthcare system is a fragmented one,” says Dr. Sean Boynes, director of interprofessional practice for DentaQuest. “There are a lot of different pieces, but not necessarily fairly devised in a way that allows for communication between all of the partners who can be involved in a patient’s healthcare. And so what we wanted to do with MORE Care is to address the health needs, but also start looking at how oral care can impact systemic wellbeing.”

Boynes explains that MORE Care grew out of the Institute for Healthcare Innovation’s triple aim proposals, which recommend improving the patient care experience; improving the health of populations; and reducing the per capita cost of healthcare.

“We wanted to look at that as to how we can improve oral health’s role in the rural areas, as well as be able to focus the medical/dental partnerships that could come to fruition from that,” Boynes explains.

The South Carolina initiative is still in the pilot stages, with Phase 1 focusing on how communities in rural areas can start bonding with or responding to one another. In other words, breaking down some of the barriers that have been in place, allowing for smoother communication for each of the providers, as well as for the patients in navigating through the healthcare system—with oral health being a large component of that.

If you look up inter-professional dentistry, the definition refers to care being provided by multiple types of dentists—surgeons, periodontists, orthodontists and the like. But inter-professional practice, the term coined by DentaQuest to better define and understand the MORE Care concept, goes beyond that.

“If you picture [inter-professional practice] as an umbrella, underneath this umbrella would be integrated care and coordinated care,” Boynes says. “Integrated care is basically an interdisciplinary approach to healthcare. And it incorporates specific procedures of other disciplines on a daily practice and allows for an enhancement of inter-practice relationships. And the idea here is it would improve outcomes.”

Coordinated care, on the other hand, which Boynes says is particularly starting to blossom, is using a continual care pathway approach that allows the patient better navigation and understanding of their needs. As an example, if a patient sees his or her dentist, the dentist might ask, “When was the last time you saw a medical provider?” If the patient doesn’t have one, then the dentist would help find one.

“That seems to be where we’re heading,” Boynes says. “At the end of the day, the idea is that these components improve the system by either reducing costs, which should make care more affordable; or improving patient outcomes, which should reduce the cost of disease and the burden to the patient.”

The benefit here for dentists, Boynes explains, is they will be able to produce better outcomes for their patients. Rather than providing care for a tooth or an area of the patient’s mouth, they’ll be treating the patient as a whole.

And there’s also a bottom-line benefit.

Boynes says that in some states, like Oregon for example, dentists are taking part in accountable care organizations, or coordinated care organizations, which is allowing them to benefit from the shared savings program coming out of the Affordable Care Act.

“It’s hard to say how this will all work out,” Boynes acknowledges. “But we hope that there would be a way for dentists to start being more involved in the outcomes-based payment structure that’s on the medical side.”

The MORE Care initiative began in South Carolina in August 2015, and Boynes says DentaQuest expects to add two to four more states in 2016, with a large multi-state platform rolling out in 2017.

Meanwhile, he wholeheartedly endorses dentists reaching out in their communities not only to other dentists, but to primary care physicians and specialists as well.

“The more professional care we have, the better it’s going to be,” Boynes says. “And if there are certain states that are more advanced than other states, then when we come in with the collaborative, they will be so much more further along in being able to innovate. And at the end of the day when we have to eventually leave and go focus on something else, they’re going to continue to be champions and continue to blossom in the practices that they’ve changed.”

When it comes to the medical field, there is often a significant disparity in the care received by individuals residing in rural areas compared to those in more urban settings. Unfortunately, it's no different where dentistry is concerned.

MORE Care Initiative Attacks Rural Oral Health Disparities

Do you know why people like eating at diners? It’s because the menus usually offer a wide array of options. And who doesn’t like options?

So when it comes to planning your dental practice exit strategy, starting that process as early as possible is essential to providing you with an assortment of options.

“We say it over and over, because the earlier the better,” says Kevin Fine, director of healthcare advisory services with the Florida-based accounting firm of 

. “The longer we have to define certain plans, the more creative we can be. And we never want to be in the position of having to rush and take away from the next stage in their life.”

The problem is that too many dentists aren’t listening.

Fine says that, unfortunately, the majority of dentists he sees start to plan their practice exit strategy too late. They talk about retirement, but that’s all they do. And then the years roll by faster than anticipated, and all too quickly they find themselves deep in the fourth quarter with the clock winding down.

“We tell our clients all the time it’s never too early to plan,” Fine says. “We beat them in the head with that, literally.”

One of the advantages of planning early is the ability to develop both a short- and long-term strategy. And because an individual’s needs change, family requirements change, and overhead and different elements of a dental practice change, the retirement plan needs to change as well.

For example, what process you select for planning your dental practice exit strategy has a lot to do with your own personal goals and desires. If you have a solo practice you can bring in a junior dentist and transition them in over time. Or, can choose to sell to a larger group, and be part of that group for a couple of years and then exit. Or, you might simply choose to sell your practice completely and walk away.

“All three of those components and opportunities are based upon an individual’s needs,” Fine says. “That’s why we go back to that planning phase in the beginning and constant analysis, because everyone’s needs and wants are different.”

Even though you may be planning to wind down your career, that doesn’t mean you should wind down your practice’s revenue. On the contrary, Fine says it’s important to show that your practice is always growing, always profitable. If profits diminish, so might the interest of a potential buyer. Likewise, so do your retirement options.

It’s also critical to make certain the practice is compliant with all regulations. That’s where the operating agreement comes into play, ensuring that all regulatory and legal requirements are in order. But there’s more.

“We also look at the component of a tax liability,” Fine says. “Is there a way we can diminish or create tax efficiency on all sides? There’s an entire process that needs to be followed. From our perspective, we do it the right way or we don’t do it at all.”

And then there are the practice’s records. Fine says he maintains an inventory of a practice’s assets, and allocation of the value of those assets. Having that information readily available is absolutely essential to move forward in an exit strategy.

“That’s something people will want to look at,” he says. “The more you’re prepared to present the information, the easier it is for everybody.”

There’s also the element of the dental practice staff. They may not be immediate family, but they become family. In a small or solo dental practice employees often have significant longevity. As such, there are times when exiting dentists tie these employees into the deal, requiring the purchaser to retain the employees.

“Someone could have been [employed at the practice] for 30 years, and now they’re faced with the prospect of not having a job,” Fine explains. “So, sometimes they become part of the deal, or the deal doesn’t go forward.”

Fine says that being prepared is a critical component to the lifecycle of a dental practice. Therefore, planning for retirement, the earlier the better, should be part of the practice’s strategic plan.

“Nothing beats time,” he says. “I would rather have 15 or 20 years to plan the correct strategy for our clients than three or five years.”

That element of planning can make all the difference in dentists maintaining their same lifestyle post-retirement, or not.

“Maintain an active approach to how you want to walk away from your practice,” he stresses. “Even if it’s 20 years out, it doesn’t matter.”

The sooner you start thinking about an your retirement and exit from practice, the more options you'll have, according to an expert in the field.

Start Early When Planning Your Dental Practice Exit Strategy

Strategic decision making sounds more like a term reserved for large corporate ventures or key battlefield maneuvers, but it’s just as appropriate when dental practices contemplate insurance options.

For example, does it make sense for your practice to sign on with a PPO plan? Or is fee-for-service the better alternative?

 is ranked as one of the top 100 accounting firms nationwide. Megan Urban, dental services manager, and Doug Fettig, CPA, dental business manager, frequently help dental practices navigate plan participation and other reimbursement issues. They agree on the importance of dentists understanding the business of their practice when selecting insurance options.

“Depending on where you are and what type of practice you have, what is your overhead?” Urban asks, rhetorically. “You’re losing money if you’re taking on a patient that causes you not to be able to meet your breakeven point and make any kind of profit. It’s giving away dentistry.”

Urban explains that there are certain states and areas of the US that are saturated with PPOs. As such, dentists often develop a sense that they need to participate in that PPO in order to “play in that area.” It’s a strategy particularly employed by younger dentists who take on a few PPOs in order to obtain new patients.

“We like to call it getting some butts in the chair,” Urban says.

But at some point, as relationships with patients develop, Urban and Fettig work with these dentists to help them determine if it makes sense to drop a particular PPO. And in doing so, how does that change the landscape?

“You can’t just drop [a PPO] and expect things to go on their merry way,” Urban explains. “There are some important considerations to successfully dropping a PPO.”

It starts with running the numbers. What if you drop a PPO and lose 50% of your patients? Of the 50% who stay, will that percentage go up or down? Dentists, Fettig says, need to examine their breakeven point—that point on the ledger where they are breaking even for the month or the year. How will adding or losing a patient impact the bottom line?

“Each dentist has his or her own breakeven point,” Fettig says. “With a PPO client, dentists need to consider whether they’ve reached their breakeven point.”

Dentists who decide to remain fee-for-service often focus on what Urban refers to as the new patient experience. In other words, what happens the minute the patients phone the office? How are they treated?

“We all want to go where we like the people and the atmosphere,” Urban says.

That means going above and beyond to establish that rapport with the patient. But also providing the best quality material and the highest technology. That way, if the practice does drop a PPO, it might not lose any of its patients because the patients are happy to pay slightly more to go to that dentist.

“Dentists that we find that can be non-PPO, they’re picking up their patients and their practice in a holistic manner from the moment they walk up to that office,” Fettig says. “And they’re thinking about that entire patient experience.”

In addition, many dentists offer their patients the opportunity to sign up for financing options like 

, a healthcare credit card that allows patients to pay off elective dental treatments over a period of time with no interest.

“Studies show that every year more patients get procedures done because of being able to use Care Credit,” Urban says. “That said, it doesn’t mean every option they offer is one every dentist wants to take, depending on the interest or how much they pay. But yeah, they have some really, really great options out there.”

Urban says that over the last 10 to 15 years some dental practices have begun offering patients an opportunity to join wellness plans. There might be an initial, up-front payment of $200, or a monthly payment that covers periodic exams and x-rays. Patients may then be offered a 10% discount on all other treatments.

“We’ve seen those become a little more popular,” she says. “But the trick is finding a way to easily maintain and monitor it so that it doesn’t become a big expense problem. And make sure patients don’t think it’s insurance. It’s just a discount plan.”

Enabling patients to avail themselves of different payment or insurance options can be extremely beneficial to practices. But Urban cautions that dentists need to examine each option closely to see which ones make sense, and which don’t.

“Because when it comes to PPOs, they’re not all created equal.”

The decision of whether to accept PPOs (and which to accept) can be perplexing for dentists. The best answer will vary by practice. Here are some things to consider.

Weighing the Benefits of Dental Insurance Options

The times may change, and trends may come and go. But lawsuits remain the single biggest fear among dentists. And with good reason.

, says the litigation environment is relatively strong for all healthcare-related services. In other words, lawsuits are prevalent.

“People are not afraid to go after their practitioner if they believe they’ve done something wrong,” Jurkowitz says. “The biggest risk is negligence.”

Jurkowitz acknowledges that new technologies and products often affect the practice of dentistry. If a practitioner is not properly trained in using these products, or does not understand the side effects and possible consequences of using a new product, there’s an increased risk of harming a patient. And once a patient is harmed, the door is now wide open to liability and litigation.

“Negligence is definitely the number one problem between a dentist and his or her patient,” he says.

How insulated are dentists from product lawsuits? Is there a clear line between when the dentist is at fault and when the fault lies with the product? Jurkowitz explains that anyone who is in the chain of supply theoretically could be exposed to liability for a defective product. For example, if a tire is defective, the company that made the tire, the company that puts the tire on the customer’s car, and the dealership that sells the tire could all technically be liable for a defective product.

“You would think that ultimately the liability would reside with the manufacturer, if it was a true manufacturing defect that a dentist could not have easily discovered,” Jurkowitz says. “But if the harm to the patient is more on the use of the product, such as using it in a way it shouldn’t have been used, then that could be the dentist’s fault.”

He adds that it’s simply prudent to not make use of any products or tools unless you are completely comfortable with them, and are going to use them in a safe and effective manner.

Having a poor bedside manner is often a lament that doctors hear from patients. The same is true where dentists and their staff are concerned. And Jurkowitz says there’s a “tricky line” between being sympathetic and admitting you’ve done something wrong—the latter of which could be used against a practitioner in a lawsuit.

“Be understanding; be receptive,” Jurkowitz says. “I think that goes a long way. There are people out there who will sue a practitioner just to get money, because they think it’s a possibility. But I think a lot of times people feel wronged. So, if they have a sympathetic and understanding dentist or practitioner, then that feeling of being wronged is lessened. And I think you certainly can avoid some lawsuits that way.”

As an example, Jurkowitz says that if a patient has to have work done for an infected root canal, it’s certainly an annoying inconvenience. But if the doctor is sympathetic and understanding, even in terms of what the patient is charged—perhaps offering a partial reimbursement, potential lawsuits can be avoided.

“It’s not a good idea to be defensive,” he says. “You’re trying to defend yourself, but what the patient hears is, ‘You’re calling me a liar. You’re just cold-hearted, and all you care about is money.’ So don’t be defensive. You just need to be understanding, sympathetic, and listen to the patient.”

Jurkowitz suggests that, where feasible, it can be helpful to designate a staff member as the point person with regard to risk management. Of course, it’s essential that person is up-to-date on trends and issues, as well as possessing good communication skills.

“That would be a great person to direct patients to,” he says. “In any customer service industry, having someone who can say, ‘I’m sorry that happened. I will let the dentist know right away and he or she will get in touch with you,’ can be very beneficial.”

Making yourself completely immune to liability is not realistic, Jurkowitz points out, simply because people are human and they make mistakes. But two areas where there is definitely room for improvement are with technique negligence, and billing—particularly when it comes to billing or dealing with insurance companies and government payers.

“When it comes to techniques, make sure that what you’re comfortable with what you’re doing in your office,” Jurkowitz says. “Make sure that your employees, technicians and assistants, are receiving the proper supervision.”

In addition, make certain that billing is being done honestly and correctly, and that it’s being reviewed periodically—either by the dentist or by an outside billing consultant.

“A lot of liability is exposed both criminally and civilly because billing is not being done correctly.”

Practicing dentists face an ever-present risk of a lawsuit, even if they never do anything wrong. However, attorneys say there are a number of steps dentists can take to minimize their risk of being sued.

Proactive Measures Can Lessenâ€”But Not Eraseâ€”Risk of Lawsuits

When Lincoln Parker, DMD, was a teenager, his father sat him down and asked what kind of lifestyle he wanted to lead. Not, “What do you want to be when you grow up?” Because at that age, Parker likely had no idea.

“He was wise in that he knew my personality,” Parker recalls. “That I was open to many different things. So he decided to focus on what I wanted out of life.”

Then he listed several career options that would afford that type of lifestyle. Dentistry was one of them.

But that wasn’t the only factor in Parker’s decision-making.

“The dentist who I grew up with ran a practice that was relationship-based,” Parker recalls. “And I grew up I realized that relationships are really what makes you happy. With dentistry, relationships can be built over decades. So ever since I was around 16, that has been my goal—to be a dentist.”

, based on Ladera Ranch, CA, and he has taken his recognition of the value of relationships to heart.

Three years ago, at a time when his practice had been open for all of five months, Parker launched a partnership with Laura’s House, a local domestic violence nonprofit. He also connected with the 

—an alliance of dental teams committed to charitable work.

“Crown Council has been doing this for just under 20 years now,” Parker says. “So far I think it has raised more than $36 million for charity, through whitening and other related events.”

Participating Crown Council dentists donate their time. Ultradent, makers of Boost and Opalesence, donates the teeth whitening materials. Patients make a minimum donation to have their teeth whitened, and 100% of all proceeds go to charity.

“Relationships are key to me,” Parker emphasizes. “Building a better local community is something that’s really important to me and to my practice going forward. I want to be an influence for good in my local community.”

Parker was involved with many charities while growing up, and though it felt good to be contributing in some fashion, he also recognized that there wasn’t a lot of change brought about by his efforts. He wanted to do something impactful; something that would have a positive impact going forward.

“As an undergrad, I volunteered at a domestic violence shelter and saw firsthand that these are people that are in dire circumstances and in dire need of somebody to lift them out of their current situation,” Parker says.

But what really had an impact, he recalls, was how the shelter helped individuals become self-sufficient so that they didn’t find themselves in such dire circumstances again. So when Parker signed on with Smiles for Life, he began looking at local charities where his practice could have a positive impact going forward. That led him to Laura’s House.

“The change that’s brought about can be generational,” he says. “It gets the victim and the kids out of that situation, and sets them on a path so that hopefully those kids don’t ever have to be in a situation like that again. [Laura’s House was] an easy partner to join up with.”

Through the Smiles for Life campaign, from March 1 through the end of June, whenever patients whiten their smile at Parker Dentistry, 100% of the proceeds go to Laura’s House to help those in need. Two years ago as a first-year effort the practice raised $1,500. Last year that figure climbed to just over $6,000. This year, Parker has his sights set on the $10,000 mark.

“One of the fun things to see is we set it up as a minimum donation,” Parker explains. “You know, this is the minimum ($50) that you need to donate in order to participate. But we see patients open up, you know, and donate six to 10 times what we asked them to donate.”

Parker says patients will often apologize that they’re able to donate only $50, but he tells them that every dollar makes an impact. Those dollars can help purchase activity books to keep children occupied while their parent is going through therapy sessions or legal sessions with attorneys.

“It costs about $3,000 to sponsor a family,” he explains. “That’s a pretty big number. If we hit that, we’re pretty excited. We didn’t only help with the small stuff, but we were able to help at least one family get on their feet and get out of that situation. And hopefully, changed their lives and their world going forward.”

That’s important, Parker says, because those who successfully graduate from programs like Laura’s House go on to become an incredible influence on those around them. They’re able to empathize with people who have fallen on hard times, and are dealing with difficult situations in their lives.

“These people now have the tools to help others around them,” he says.

Parker Dentistry also reaches out to the community in general. The practice is involved in sponsoring Little League and other youth sports teams, as well as doing a career day activity at local schools to teach oral hygiene. Parker and members of his team are also personally active in local community events.

“We try to stay local and lift the community,” he says. “We want to be a good influence and leader within the local community.”

That includes the cosmetic and general dentistry performed every day. And from those daily activities come some of Parker’s most rewarding experiences.

“The other day we took a single mom, somebody who’s confident and going back to school and making sacrifices for her kid,” Parker says. “She’s a professional, but her teeth were in pretty bad shape. She sat in the chair and cried for 10 minutes when we were done. All the hard work to build my office to do the type of dentistry that I want to do, and be different, it’s all worth it for that 10 minutes that we shared just talking about how her life is now going to be different, forever.”

A California dentist has modeled his practice after the community-oriented dentist's office he grew up going to.

California Dentist Places Volunteer Work at Center of His Practice

There’s an old expression that laments the problems arising from too many bosses and not enough leaders. But the reality is that to run a dental practice effectively and efficiently, and to maximize production, virtually every member of the practice team should be a leader.

Ann Marie Gorczyca, DMD, MPH, MS, owner of 

,” believes that every member of the practice team should be a champion in some specific area.

“This is especially true when it comes to customer service,” Gorczyca says. “You want each dental assistant to be a leader in customer service; to see how they can best serve the patient, and whatever they see needs to be done, they own it and they resolve it.”

Gorczyca talks about transformational leadership, an approach that brings about change in individuals and social systems. For example, Michael Jordan was always known as a player who made others around him better. Tom Brady has done the same in football.

In a dental practice, transformational leaders inspire their team members to transcend their own self-interests for the good of the patients, and the practice. Office goals are clearly explained, and they’re reviewed in a charismatic manner. The result is team members are excited about the office goals.

“The mission is understood, accepted, internalized, and expressed by all,” Gorcayca says. “Individuals are working to be part of something; part of a larger purpose. And they’re excited to be part of it.”

Idealized influence is leadership by example, Gorczyca explains, pointing out that dentists lead by their example—their attendance, their work ethic, their character, and their integrity. That inspires teams to great accomplishments.

“The team members are invested as stakeholders in the success of the dental enterprise,” she says. “They’re inspired to, ‘Do this together,’ and ‘Let’s make this happen.’”

Can leaders be developed? Gorczyca believes that 

 leaders are developed, and that they are developed based on their own interests, such as the work they do. Along the way, they have three things in common: courage, communication, and candor.

“Effective leaders always speak the truth about what’s going on,” she says.

Communication is key. Gorczyca references Mary Parker Follett, an American social worker and management consultant in the late 19

 century. She was also a pioneer in the fields of organizational theory and organizational behavior. And she had a very insightful phrase.

“It is only by friction that we polish,” Gorczyca says. “And what that means is, it’s only by discussing what needs to get better that we actually get better. That’s the job of the leader, to continuously be changing and transforming the office to keep it better.”

That also means having vision, and knowing in what direction you want to move your practice, not unlike the captain of a ship.

“But the lowest form of leadership,” Gorczyca says, “is 

 leadership. That’s when the leader abdicates responsibility. It’s the type of dentist who says, ‘Oh, ask the office manager.’ In that situation, employees need to be self-motivated and do things without guidance.”

And it’s not as rare a situation as you might think. Gorcayca recalls being at a meeting with dental office managers, and one of the managers noted that her dentist never comes to the monthly meetings.

“She’s rather play golf,” the office manager said.

Gorczyca couldn’t believe what she was hearing. “That’s 

Gorczyca believes that running a dental practice is more work than doing dentistry itself. It’s all encompassing, and requires keeping your finger on the overall pulse of the practice.

To that end, Gorczyca recalls the words of Jack Welch, considered by many to be the world’s foremost authority on human resources.

“He was a very smart guy,” she says. “And he said, ‘You are not a leader to win a popularity contest. You are a leader to lead.’”

That’s important to remember as the leader of a dental team, Gorcayca says. It’s important to press forward with what you’re trying to achieve. People will no doubt periodically object, but that should lead to lively discussion.

“When you have team meetings, there should be lively discussion,” Gorczyca says. “I mean, if there isn’t lively discussion, people are not engaged. You need to press forward, and not everyone will be in agreement, but that’s the way it is.”

And to be a good leader, you need to be comfortable with that.

Leading a dental practice is about much more than being skilled in the exam room. Dentists must also learn and leverage management skills to creat a high-performing team.

Transformational Leaders Inspire Dental Practice Teams

Christine Ellis had no intention of following in her father’s footsteps. In fact, the daughter of a successful central Florida-based orthodontist was determined to forge a different path.

“I wanted to do my own thing,” Ellis explains. “That was my thought process in college.”

But three years in, her thought process changed.

“I came to realize there were a lot of things about dentistry that I liked, and a lot of things about medicine that I was not attracted to,” Ellis says.

Part of that was managed care. Ellis recalls it was the 1980s, and there weren’t many physicians talking about how great their career was. Before she knew it, she was indeed following her father.

“People I knew who were dentists besides my dad spoke very highly of it,” she says. “They loved their job. It was a pretty compelling argument.”

Today, Ellis, DDS, MSD, is a highly successful 

 who opened her first private practice late in 2015. And she took a bit of a circuitous route getting there.

For 20 years she cared for patients at Children’s Medical Center of Dallas. But the unusual part of her journey was the regular trips she made to Orlando to practice with her father. Ellis routinely flew back to her hometown to practice at least one week—sometimes two&mdash;each month. She still makes those trips, though not as often.

“We’ve worked together for 20 years, since I came out of school,” Ellis says. “I’m happy I’m working with him, but the first year working with my dad was not fun.”

That’s because her father never had an associate. It was 

office. So not only did he bring on an associate, he brought in his daughter. But once they figured out how to work together, it was great.

“He’s a great mentor,” Ellis says. “He has a very good practice. And I get to go back and see my parents.”

Ellis has spent years serving as a special expert and witness on fraudulent Medicaid and billing practices in the dental industry. Her Congressional testimony has helped bring attention to an issue that costs taxpayers tens of millions of dollars each year. And it all began when she joined the craniofacial team at the Children’s Medical Center.

“Most of the kids who have a craniofacial issue, their orthodontics is going to be funded by Medicaid—at least in Texas,” Ellis explains. “I was involved in the Medicaid program for about 10 years. And over the course of those 10 years working in the hospitals, I saw cases coming in that were not my cases. They were being treated in the community. And the reason I got involved in it was not the financial issue, it was the harm.”

Ellis says the children who were coming in for treatment were being poorly treated. The oral surgeons at the medical center had to take risks in their surgery because the treatment that the children were receiving was so bad.

“I was concerned about patient harm from negligent practitioners more than I was from the taxpayer point of view,” Ellis says. “I mean, obviously, as a taxpayer, that concerns me as well. But the bigger issue was the patient harm in pediatric dental Medicaid settings.”

Ellis says her goal in becoming involved was to put a stop to some of the abuses that were occurring. That has happened.

“The crazy every child who has teeth gets braces scenario has changed,” she says. “So I’m glad we touched the needle there. But Medicaid fraud is still a huge issue. I learned a lot about the political process, and I’m glad to be a dentist.”

Also glad because she has the mindset to work with a patient base of children with craniofacial issues and special needs.

“Not every doctor is going to be one who finds that environment rewarding,” she explains. “And that’s not a judgment call on them. Everybody’s got their gift and their calling. That’s something that was really interesting to me.”

Ellis believes that taking on complex orthodontic cases has made her a better orthodontist. She also acknowledges that the degree of improvement she sees with these children is tremendous; their lives changed to such a great extent. And she loves the team environment in which she works.

“You get to work with other really smart medical professionals and dentists,” Ellis says. “If you like collaborating with people, working with a group, it’s a nice setting to be in.”

Now Ellis—while still putting in time at the Children’s Medical Center, and traveling, albeit less frequently, to work with her father in Orlando&mdash;is launching her own private practice.

“I’m almost 50 years old,” she laughs. “If I didn’t do this now, I was not going to do it.”

Thus far, seven months into the process, Ellis admits that it’s been a daunting but not overwhelming task. She says she has learned a great deal about putting systems into place, and appreciating the things that “you can’t put a dollar sign on.” That’s because now she’s an owner.

“A lot of dentists work where they’re employed,” she says. “As an owner, I definitely have an appreciation more for that now than I did a year ago.”

But she still finds time for her family, including attending Little League baseball games and swim meets, as well as herself. She enjoys reading, as well as riding her bike at White Rock Lake, a nearby public park.

“There aren’t too many safe places to ride a bike in Dallas,” she says. “So if you’re going to get into country riding, you have to put your bike in the car and get out of the city.”

It gives Ellis a chance to recharge her batteries, and reflect on a challenging but rewarding career.

“I’m almost 50 years old, and I feel like I’m almost kind of starting a new career that keeps what I’m doing really interesting, but it’s still in the same line of work,” she says. “I’m very glad I ended up as a dentist.”

A Texas orthodontist took a circuitous path to opening her own practice.