For those Baby Boomers (and older) the term is largely pejorative, owing to its association with those who aided the Axis Powers during World War II. But there is another side to the collaboration coin. It is synonymous with team work. 

When all one has is a hammer, every problem is a nail
	

In caring for patients, health professionals have historically had to ‘go it alone.’ This is changing.  Professionals across the health spectrum realize that patients deserve to be treated by those with a ‘well stocked tool box,’ as no one provider can possibly offer all the tools. This is why it is incumbent upon those whose raison d'être is delivering optimum healthcare to establish and build a professional referral network.

The increasing acceptance by dentists, physicians and the public of the links between oral and overall health represent an unprecedented opportunity for dentists to grow their practice while delivering superior care to their patients. We see this as a four step process. First, place yourself in the shoes of prospective network members to ascertain ‘what’s in it for them.’ Second, identify those with whom you already have a relationship (usually more than you think). Third, continue to acquire and share your proficiency in collaborative care with your network.  And fourth, armed with confidence and know how, expand your network.


	Ways you can help your physician deliver a higher level of care include:

Management of oral Inflammation to control systemic inflammation: Dentists are, and will likely remain, the only source for this care.

Management of Sleep Disorders: Dentists can order sleep studies and help physicians determine and deliver appropriate treatment (surgery, CPAP, oral appliance, etc.).

Early Identification of Diabetes: Dentists have the opportunity to identify unrecognized diabetes and pre-diabetes in dental patients and refer them to a physician for further evaluation and care.*

Treatment of Migraine Headache: Dentists’ understanding of the trigeminal nerve, link between the mandible and cranial base and other dentoskeletal structures have proven invaluable in providing relief for thousands of headache sufferers and so owe it to physicians and their patients to become part of the solution.

Identify those who would be a fit for your professional referral network. Sandi Warner Roggow, RDH shares what is perhaps the easiest way to prime the MD referral pump: “We educate our medical professionals at our own check-up appointments.”  In like fashion, use the time treating your physician patients to educate them about how your practice can help enhance their level of patient care.  Commit to ‘wowing’ them with your knowledge and ability to ‘make them look good’ in front of their patients. Create a truly comprehensive examination protocol, and feel free to liberally sprinkle more clinical content, cite studies, your personal experience as you acquire it, etc. so you physician patients are duly impressed by your ability to help them and their patients. Be sure you dental team members are similarly equipped to impress their physicians with your scope of service and system for collaborative care. 

As noted above, begin with the proverbial low hanging fruit. 

Many dentists prepare a health status folder for their patient to take to their next physician appointment. When their MD asks where they got it, they simply answer “My dentist gave it to me.”

Prepare a communication (what we call our 

) for MDs with whom you share a patient.  This is an effective method for getting your feet wet so to speak because your patient’s physician is ethically obligated to communicate with you about the condition of your shared patient. Your communication should begin with your diagnosis and recommendations, as well as an invitation for the physician to feel free to refer any patients who might be similarly assisted by your offering.  Their positive impression and experience with you will lead them to naturally think of you when similar collaboration opportunities arise. Be sure to make it not only desirable, but also simple for them to refer.  Provide them with referral cards, enroll them in an email campaign to educate them while branding your practice as the ‘go to source’ for answers and treatment to medical conditions with a dental solution, hold open houses and webinars, and in other ways continue to share and remind them of your existence and value. 


	Collaboration with physicians has the added benefit of helping your patients obtain insurance benefits for their medically necessary dental procedures, which makes it easier for patients to say yes to your recommendations. A strong relationship with your patient’s physician can help establish the medical necessity of procedures.

*Identification of unrecognized diabetes and pre-diabetes in a dental setting.
	 Lalla E, Kunzel C, Burkett S, Cheng B, Lamster IB.

Daniel Bobrow, MBA, is president of the AIM (formerly American) Dental Marketing Company, a dentistry marketing and patient communications consultancy. He is also Executive Director of 

. Readers interested in learning more about integrated marketing and patient communication products, systems and services are invited to contact Mr. Bobrow at 312-455-9488 or

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Back by popular demand, our Dental Cartoon Contest has returned. We will be posting exclusive dental cartoons every month for your viewing and caption writing fun. We are asking you to tell the story of what's happening in the cartoon. Write your most creative caption and submit it below to see if yours will be featured as a finalist.

Dental Cartoon Contest

In the last edition of Best Cosmetic Dentistry Practices I discussed the 7 Steps to help your patients understand how recent advances in cosmetic dental technology can directly benefit them. With the Holidays upon us I want to add to those suggestions and share a few thoughts on how you can help your patient's have a radiant, self-confident smile when they are at family gatherings, office parties or simply celebrating the season with friends.

Your patients of record have given much to you over the years. Their loyalty, referrals, kindness and the ability to provide them with services that enhances their health while providing you with a very satisfying career. As a profession we have much to be thankful for. 

One way to express your gratitude to your patient's is to offer them a dazzling smile for the holidays.  Here's how you can do that while saying "thank-you" for their continued support.  Start by having 

patient fill out a Holiday Smile Wish List form. At the end of this article you will find a copy of the Silverman Institute's Holiday Smile Wish List Form.

I have found that the best cosmetic dentistry is often the least cosmetic dentistry that can dramatically transform patient's smiles without destroying healthy tooth structure. That is why I often combine in-office tooth whitening with only 1 - 2 non-invasive, in-office, same day LifeLike Veneers™.

Case Example: Please see the photo above. After inviting me out to her office and to train her team on how to take her cosmetic practice to the next level Dr. Ortega learned one of the simpler cosmetic practice building secrets that I share during the on-site Boot Camp Program.  If you are like many of your colleagues you may overlook this as well. Many patients of record have prominent canines. After teaching her the LIfeLike Veneer™ procedure, Dr. Ortega easily enhanced this patient’s smile. She combined tooth whitening with the same day veneer procedure and obtained a very pleasing transformation. From there Dr. Ortega took on more challenging cases and created some beautiful smile transformations with LifeLike Veneers™.

Have your patients fill out the Holiday Smile Wish Lift form. Depending on your operating expenses and where you practice you might be able to do one in-office veneer at no charge – or the whitening at no charge. In any event, have your team inform your patients that you are appreciative of their ongoing support and that your Holiday gift to them is your Holiday Smile Wish List. If your patient ever wanted to enhance the appearance of her smile this is an opportunity where you can create awareness of how subtle (as well as dramatic) changes can give them the smile they always thought of having but may have held back due to financial considerations. 

Please let me know how this works out for you. I would love to see some examples of your before and after Holiday Smile photos to include in an upcoming edition of Best Cosmetic Dentistry Practices.

Happy Holidays filled with warm, radiant smile to you, your patients and your team!

Dr. Harvey Silverman has been successfully coaching / training dentists on how to expand their cosmetic dentistry practice since 1984. In addition to teaching simplified technical skills and creating team and patient excitement for cosmetic dentistry Dr Silverman patented / developed the original OTC tooth whitening system as well as pioneered one of the original porcelain veneer systems.If you want more information about how the Silverman Institute’s Cosmetic Dentistry Boot Camp Program can take your cosmetic practice to the next level contact Dr. Silverman at 216-256-4599 or e-mail him at incrediblesmiles@aol.com. 

In the last edition of Best Cosmetic Dentistry Practices I discussed the 7 Steps to help your patients understand how recent advances in cosmetic dental technology can directly benefit them. With the Holidays upon us I want to add to those suggestions and share a few thoughts on how you can help your patient's have a radiant, self-confident smile when they are at family gatherings, office parties or simply celebrating the season with friends. Give back

A holiday smile

While he was watching the late night television news broadcast in Chicago recently, cosmetic dentist Jack Manikowski was touched by the story of an 18-year-old man who had been bruised and bloodied while being dragged along the street during a carjacking. The victim also suffered several broken teeth.

Manikowski was eating dinner with his wife, Lana, when he saw the story, and knew he wanted to help. 

“He was an innocent victim,” said Manikowski, owner of 

 in Chicago. “He had his hand over his mouth when he was talking and you could tell his mouth had been injured.”

In October, the young man, Edwin Rodriguez, was in a car waiting for his brother to get off of work at a hotel in Chicago when someone came up to the car and told him the vehicle had a flat tire. When Rodriguez got out to look, one of the thieves allegedly got in and began to drive away. Rodriguez grabbed the door and was dragged a city block before he was able to let go.

Seeing the young man on T.V., Manikowski was not sure if Rodriguez covered his mouth because he was in pain or was embarrassed about how his broken front teeth now looked. After learning a bit more about Rodriguez through stories in the media, Manikowski reached out to him and made an offer to help the young man restore his smile.

“He comes from a very nice, hardworking family that clearly didn’t have the means to take care of a cosmetic problem,” the dentist said.

At the first appointment, Manikowski discovered that teeth 7, 8 and 9 had been severely fractured, but were still vital. He estimates that it has taken 8 hours of work over three appointments to fix the broken teeth.

“The treatment was scaling and root planing and subsequently one long appointment for direct bonding," Manikowski sasid. "Fortunately, he didn’t need implants or any interdisciplinary intervention.”

Manikowski, who has been in practice for 15 years, has previously volunteered to help restore the smiles of women affected by domestic abuse through the American Academy of Cosmetic Dentistry’s Give Back a Smile program. He said it’s not unusual for dentists to encounter patients of limited means, and he was glad this time to be able to help a young person who needed it.

“We all see patients that don’t go through with treatment because of a lack of financial resources,” he said. “But (this case) looked like a slam dunk cosmetic case. It could be an immediate fix.”

After learning of Manikowski’s offer, Rodriguez said in a local television news story that he was overwhelmed by the dentist’s desire to help him.

"I'm speechless because I didn't think anybody would offer me anything. I'd like to say 'Thanks' to him and I appreciate it a lot,” Rodriguez said.

Chicago dentist provides carjacking victim with new smile

When a tornado tore through Joplin, Missouri on May 22, 2011, it destroyed 23 of the town's dental offices, and left four dentists homeless.

Recovery from the horrific event that affected 40 percent of the community’s dental practices has not been easy, but the 

 has taken a leadership role in helping those dentists return to treating patients and running their businesses.

The association not only documented victims’ personal stories of the destruction in its members’ newsletter, but has been there to do something it had never prepared for: coordinate a tornado response effort.

Paul Roberts, director of advocacy and outreach for the association, had only been on the job three weeks when the tornado hit. After the magnitude of the disaster was realized, he helped create a document outlining the association’s tornado response effort and it shows how the disaster thrust the dental association into a role it never had planned on taking.

According to the document, “this project was not anyone’s calendar prior to late Sunday evening, May 22, 2011.” No organization charts or job descriptions were in place. There was no ‘tornado response’ budget. Yet, it became imperative to figure out the best way to respond swiftly and to identify and provide needed assistance to the dental community.”

Most of the dental practices that were affected by the storm were in the area of St. John’s Hospital in Joplin.

“The tornado cut a half-mile to three-quarter mile wide and six-mile-long path,” said Roberts. “It moved through Joplin like a lawnmower.”

To help dentists recover, the association first needed to assess the damage that was caused. It was learned that 27 active or retired dental offices were destroyed and 23 of those were MDA members. 

The association dedicated a page on its website to providing information about assistance from the Federal Emergency Management Agency, Small Business Association loans, licensure and healthcare provider information, and city regulations. A resource page also was established to post all non-financial sources of help such as supplies or donated equipment. Applications for urgent financial assistance also were posted on the website. 

“We need to provide centralization of logistics so when news came in they’d (dentists) get it,” said Roberts.

Within the first ten days following the tornado, the MDA held its first meeting on-site with dentists in Joplin.

“Our members were stunned, but engaged,” wrote Roberts. “We gathered valuable information and started to address their most pressing need: Help me get back to work.”

A local leadership team was put in place and a staff member from the MDA assigned to it. Every dentist affected by the tornado was called directly for an assessment and an assurance that the association was there to help.

The association has been able to assist dentists to cope with breaches in Health Information Privacy rules when records were strewn over a vast area. There is a legal requirement that patients be informed when a breach of their records has occurred and the association was able to help dentists with that.

“We were getting calls (about found records) from six counties away,” said Roberts. “We acted on behalf of the dentists. We ran ads telling patients that your records may have been compromised.”  

If the association had not run the ads, Roberts said each dentist would have had to write a letter to each of their patients about their records being breached.

“This (the ads) saved members untold time, expense and stress during a chaotic time,” Roberts wrote.

The association also started a disaster relief fund and has accepted applications to review how to distribute more than $175,000 in financial assistance to dentists.

“There was an outpouring of funds and donations,” Roberts said. “We started a disaster relief fund and have been dispensing it based on need.”

Roberts said dentists immediately had to consider all options and start making decisions about how they would continue their practices whether that meant finding new space, renting a trailer, or even relocating to another community.

He is happy to report that none of the affected dentists have moved out of Joplin due to the tornado. 

“No one decided to leave as far as we are aware,” Roberts said. “And there’s has not been an issue of patients not receiving care.”

He said the association has placed ads in local newspapers to promote dentists’ new office locations and ran a continuing education workshop to help dentists address their needs and practice management decisions in light of the disaster.

Roberts said dentists in Joplin are getting back on their feet.

“Everytime we go down there the spirit has been better and better,” he said.

There was no budget or outline for how the MDA would help affected dentists, and there is no deadline for when the assistance will no longer be needed. Although life will never be like what is was before the tornado, Roberts said he and other members of the MDA are happy to see dentists return to doing what they love.

“Life is not normal, but dentists are once again doing what they love to do-serve the public and address oral healthcare in their community,” he wrote.

As a result of the tornado, Roberts said the MDA has created new forms, procedures and resources to assist when disaster strikes. Setting up such a large charitable effort was one of the small association’s large challenges.

Roberts said, however, that “it sets up the MDA to better serve members after future natural disasters” and the association will continue to share and learn from “lessons of heartbreak and healing.”

When a tornado tore through Joplin, Missouri on May 22, 2011, it destroyed 23 of the town's dental offices, and left four dentists homeless. Recovery from the horrific event that affected 40 percent of the community’s dental practices has not been easy, but the Missouri State Dental Association has taken a leadership role in helping those dentists return to treating patients and running their businesses.

dentalproductsreport.com-2011-12-01

Marketing Insider: Be a collaborator

Dental Cartoon Contest

A holiday smile

Chicago dentist provides carjacking victim with new smile

Rebuilding after devastation