Disaster-proofing your practice

April 5, 2004
From personal injuries to technology crashes to embezzlement, it's never too early to be prepared.

Dentists can't always avoid crises, but a carefully considered plan to disaster-proof one's dental practice is crucial in today's world, according to an article in the April 2004 issue of AGD Impact, the newsmagazine of the Academy of General Dentistry (AGD).

From personal injuries to technology crashes to embezzlement, it's never too early to be prepared. Dentists should surround themselves with consultants-such as lawyers, accountants and computer experts-to advise them on how to best run various aspects of their dental practice.

Consider the case of Manuel Cordero, DDS, MAGD, a GP from Sewell, N.J. Three years ago, Cordero was blinded when his retina detached in one eye. Dr. Cordero feared he would never work again before deciding to undergo a retina reattachment procedure that would keep him in recovery for six months.

In Dr. Cordero's case, he was part of a network he and a few colleagues had established to help dentists keep their practices running in times of emergency. After the surgery, a team of eight rotating dentists took on his patient schedule. That group probably saved his practice, he said.

"My patients are very spoiled and attached to me," Dr. Cordero continued. "But they knew that [the rotating dentists] were my friends. If I had hired someone from the street, my patients would have left."

It's not just physical injuries that wreak havoc on practices. Technology is another culprit.

In the November 2003 issue of the Journal of the American Dental Association, pediatric dentist Larry Lipton, DMD, recounted the morning he arrived at the office to find his hard drive destroying itself.

Then there are the surprises. Disgruntled patients sometimes sue and employees sometimes steal.

"I sit in on many depositions involving dentists being sued and one of the main areas of criticism is that there is no diagnosis in the records," says Richard Engar, DDS, FAGD, who runs a dentist-owned malpractice insurance company in Utah and writes the Risk Management column in AGD Impact. "Take the time to list diagnoses and the reasons for them. It just makes the whole presentation look a lot better.

"The majority of people who sue dentists owe them money, so that means you also have to carefully maintain financial records," Dr. Engar says. "The smartest thing to do is to stay on top of accounts receivable and limit what you do for deadbeats. The common thread we see [in cases] is that the dentist does the treatment, then the dentist puts pressure on the patient for payment and the patient sues."

Embezzlement is also fairly common in dental practices. "It's one of the biggest pitfalls in dentistry," says Barbara Freet, president of Human Resources Advisors in Lafayette, Calif. "Dentists go into practice to be dentist and tend to overlook the business side. They over trust and often think that their staff couldn't be robbing them. That's not being realistic. There is also an unwillingness to document."

"Dentists need a team around them to address things they are not authorities in," says John Jameson, DDS, of Davis, Okla., a national dental practice consultant. According to Dr. Jameson, this team should include lawyers, accountants, computer experts and practice-management consultants.

The AGD is a non-profit organization of more than 37,000 general dentists dedicated to staying up-to-date in the profession through continuing education. A general dentist is the primary care provider for patients of all ages and is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.