The Consumer Price Index (CPI) is a measure of the average change over time in the prices paid by urban consumers for a market basket of consumer goods and services.

Comments by the Fed – FMOC: Suggest the Fed is trying to gently convince their adoring public that inflation may actually turn out to be “a little stronger than they forecast for a little longer than they forecast.”

Grant Williams’ notes in Things That Make You Go Hmmm:

We may be facing demand-driven inflation as a consequence of misguided monetary policy and misdirected fiscal stimulus. Monetary stimulus had some effect, of course, and the latest growth forecasts suggest, it is already dissipating. The Fed has done so much, so fast, it produced a self-limiting recovery in which supply – chain inflation (caused by all the container ships anchored / waiting in Los Angeles / Long Beach) tend to cap potential growth. The trucking industry may also be a part of the log-jam, backing up deliveries.

5.9% Announcement by Social Security

That is the increase that retirees receiving Social Security will pick up next year to account for inflation. It is the biggest jump in 39 years and captures what consumers have been feeling acutely over the past year: Stuff is getting more expensive.

The fact that Social Security payouts will reflect higher costs is certainly a plus for that portion of retirees’ income streams. Inflation may prove fleeting, a short-term blip resulting from pent-up pandemic demand and snarled supply chains, or it could persist. Or, it could be that the medical premium portion of Social Security could be increased and consume much of the 5.9% announced increase. No one has said much yet, other than the increase of 5.9%.

Dentist’s and Retirees Take Note

I believe all dentists and retirees can learn to think about inflation more individually and holistically. We can start with taking stock of our own rate of inflation, which is not a standard CPI. We can look at the details of our Personal Spending Plans (Budgets); a function of what we spend our money on and how much inflation we are seeing in those outlays. Inflation considerations also extend to our portfolio; think about our withdrawal or “burn” rate, if retired, as well as what kind of inflation protection to embed in our portfolio’s. (more on this below)

We can also look at, and think about inflation today, examine our own personal inflation rate, and safeguard against inflation’s corrosive effect on our investments and our Economic Engine. For most dentist’s, our Economic Engine is our dental practice. We can study our line items on our Profit and Loss Statements and/or our Management Income Statements (MIS), year-over-year or twelve month roll, looking for inflation creep in line items like; consumable dental supplies, laboratory costs, salary and benefits (hygiene, clinical, and administrative teams), occupancy total costs, administrative supplies and services, notice the rise in dental equipment cost (replacement costs), along with financing costs. All of the above will combine into our Personal CPI, which may well require an adjustment in our dental fees.

Calculating Our Own

As we collect our personal and practice inflation data, be willing to ask a question; what are we discovering? If looking at the FOMC CPI weightings and they look nothing like our own, when considering our increased household and practice spending, we are most likely on the right track. Our outlays for housing may diverge significantly from the CPI percentages, especially if we live in a paid-off home. We will still have costs for upkeep, insurance, and property taxes, which are also included in Housing Costs.

By doing the above exercises, we can learn to tweak inflation expectations, pro-actively while attempting to keep then in-line for each of line items, and incorporating our own experiences and discoveries. At the same time, it is important to not come away with a false sense of precision with respect to inflation. For one thing, inflation statistics can vary by section of our country, state, and even town by town. Moreover, a number that can bear paying attention, is the trend in our actual, all-in spending, which depends on a few key variables: our fixed and discretionary expenses, as well as, what is going on with inflation in each of the spending categories. Ultimately, our aggregate household and practice spending trend matters more because we exert a level of control over some of our spending, where the overall inflation rate is out of our hands.

Early Retirement

Is early retirement is on your radar? Data suggests that the case for a growing share of workers, inflation protection is an even bigger hurdle. That is because we will be using our retirement dollars, and spending them over a longer time horizon, when starting early. This increases the odds that inflation could flare up sometime during our drawdown period: pay attention to withdrawal rates, portfolio construction, and Social Security adjustments.

Investment returns over the next decade might not be so great, some experts warn. Be prepared to rein in our spending in case a lousy market materializes. A threat of experiencing big portfolio losses early on in retirement, when our portfolio value is at its highest, is one of the key threats to the durability of any retirement plan. And sequencing risk looms particularly large in environments like the current one, when bond yields are low and equity valuations are on the high side. If market returns are indeed lower than our two decade averages, in the first few years of retirement, our best defense is to cut our spending. For younger dentists reading this a lesson to be learned is “keep shoveling it in” and increase the percentage of present income earmarked for saving and investment; over time, through compounding, this will ease your worries and provide a greater measure of choice in financial decision making.

What we may want to discussed, in this context, is the other side of the same coin. Yes, today’s retirees can become more conservative on the withdrawal rate, and use a safer withdrawal rate closer to 3% than 4%. What may matter more is the dollar amount we can pull out, not the percentage. Thanks to elevated portfolio balances, a 3% withdrawal of a larger portfolio may translate into a withdrawal that is every bit as large as 4% on that same portfolio ten years ago. In addition to balances being larger, retirees can enlarge their lifetime portfolio withdrawals by employing a flexible withdrawal approach rather than taking fixed amount withdrawals; helping to reduce portfolio demands and a requirement for bonds with minuscule yields.

It is good to remember to continue to use and learn from the Financial Tools, which have always been available to us: Personal Spending Plan, Personal Net Worth Statement, Potential Cash Flow Analysis from All Cash Flow Streams (Dental Practice, Tax-Deferred Portfolio, Personal After-Tax Portfolio, Investment Real Estate, and other holdings. It is a good thing most of us have been given enough years to layer our financial learning, with intention!

Keep a Moving Target Orientation!

Invest in Yourself
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Two Courses to Consider:
Creating More Financial Freedom / Mastering Business Essentials

Here are three tips that have helped me in organizing my practice so we can best manage same-day emergency patients and not disrupt the quality time we spend with already scheduled patients. Each of these tips enlist the help of the dental team.

Tip 1

At the morning huddle, we sit around the table, and it is the responsibility of the assistants and front desk to identify and clarify where the best spot in the schedule would be for an emergency patient. It could be a patient of record or someone who is new who has a great referral. If it is someone new without a great referral, appointing that person depends on whether it makes sense for the patients already scheduled that day.

Tip 2

Over the phone, we make sure the conversation with the emergency patient includes an important question – “How can we help you today?” In the case of a patient of record, we look at their chart and plan to address their concern that day but not over address it. Oftentimes a patient will say, “I don’t have a lot of time today. I just want to drop in and get the chipped edge smoothed and get scheduled for the restoration.” This provides us with an opportunity to slip in a short appointment to help the emergency patient and not interrupt how we are scheduled to best help our other patients that day.

Tip 3

When I walk in the operatory, I have a 3-way conversation with the dental assistant and patient. The assistant and I no longer have a conversation in the hallway that takes time, and I no longer walk into the room and have a separate conversation with the patient. In front of patient, the assistant describes the information that has been collected and the concerns of the patient. The patient can agree with, add to, or clarify what the assistant tells me. This has made us more efficient. It also spares me from walking into the room and taking over, thinking I have all the information. The 3-way conversation accelerates our ability to help the patient.

Father of Index Funds

John Bogle has many books to his credit. We all may benefit from reading one or more of them as a part of a New Years Resolution focused on Raising Our Financial Literacy! A perfect Stocking Stuffer, with a future focus in mind! John C. Bogle, the founder of Vanguard, changed investing forever for ordinary Americans, and wrote a dozen books over his lifetime, selling over 1.1 million copies worldwide.

An editor that worked with Bogle said, “I don’t think there’s an author who spent greater care on the words he chose,” and, “when he did a book, he was so meticulous; he’d rewrite and rewrite. He always went the extra mile to make sure there wasn’t a single person who could not understand what he was saying.”

“Jack,” as he was referred to by many, made it his mission to educate people about the benefits of index funds and not paying high fees to mutual fund managers. Below are some of the best books he authored:

1. Common Sense on Mutual Funds: New Imperatives for the Intelligent Investor

The first edition of this classic was published in 1999, and Bogle wrote a completely updated second edition a decade later to help investors understand mutual funds and how his simple and low cost investing strategy can be used to outperform stock pickers.

2. The Little Book of Common Sense Investing: The Only Way to Guarantee Your Fair Share of Stock Market Returns

This 304-page hardcover book is one of Wiley Publishing’s Little Book investing series and has proven to be an incredibly popular tool for investors. In this investing bible, Bogle presents his ideas succinctly for the layman.

• Warren Buffett advised in his 2014 letter to shareholders that rather than listen to the “siren songs” of advisors, “investors – large and small – should instead read Jack Bogle’s The Little Book of Common Sense Investing.”
• Bogle said even he needed to be reminded of his own advice in trying times. “How do I feel when the market goes down 50%?” he continued. “Honestly, I feel miserable. I get knots in my stomach. So what do I do? I get out a couple of my books on ‘staying the course’ and reread them!”

3. The Battle for the Soul of Capitalism

John Bogle was a vocal critic of Wall Street and the American financial system, and in this book the insider revealed what he knew about the unethical practices of money managers and corporate executives, which add costs to millions of small investors.

• The New York Times called it “yet another important contribution in an illustrious career,” and it was long listed for the Financial Times and McKinsey’s Business Book of the Year Award in 2005.

4. John Bogle on Investing: The First 50 Years

Bogle’s senior thesis at Princeton University was titled “The Economic Role of the Investment Company,” and it contained the very ideas that Vanguard would be built on. It is included in this compilation of his best speeches.

5. Stay the Course: The Story of Vanguard and the Index Revolution

At the time of publication, Vanguard had more $5 trillion in assets under management, and the road to that number wasn’t easy. Early on it was dubbed “un-American” and mocked by Wall Street professionals.

• Named after his most iconic piece of advice, Bogle’s last book is a memoir that traces the history of the Vanguard Group and provides new details. He addresses his critics, his regrets and even his Vanguard successors.

Sign-up for Courses to Continue Advancing Your Financial Literacy
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Have you ever had a night guard or other full coverage dental device come back with contact only in the posterior or heavy in the posterior? It is a fairly common phenomenon. And it is a big challenge when doing two-jaw hybrid surgery and placing the temporary restorations on the day of the surgery.

I became aware of this big challenge when my oral surgeon came across the parking lot one day to discuss the upper and lower hybrid case of one of our mutual patients. This was the first hybrid case we would be doing together. He had been using a company with a software platform that does his implant planning and digital setup, and then produces his surgical guides and provisional restorations. It can even produce the final restorations. He related to me that when he tries in the initial prostheses, he always finds they are heavy in the posterior.

So, I asked him, “When they ask you for records, what do you send them?” He said they request either an upper and lower scan, or upper and lower BPS impressions, or upper and lower models. They also want a bite record and a shade. As he went down the list, something was missing that has to do with heavy posterior contacts.

Whether it is premade upper and lower provisional restorations when you are doing extractions, implants, and hybrids — or it is a nightguard you get back from the lab or Invisalign trays that you receive from Invisalign, there are occasions when we find prostheses are heavy on the posterior contacts. Sometimes there are no anterior contacts. That’s because, across the board, prostheses need to be fabricated knowing the arc of rotation, which is the distance between the hinge axis at the center of the condyle and the upper anterior teeth.

A full arch impression taken without a facebow transfer, either hand articulated or with a bite registration only over the prepared teeth, only provides the same information about maximum intercuspal position as a triple tray. If we mount the full arch impressions on a simple hinge articulator, the articulation used does not represent the arc of rotation. If we are digitizing the impressions for a digital system, we also are missing this essential piece of diagnostic information. We must have impressions mounted on an articulator with a facebow or dental-facial analyzer (DFA).

I explained this to my oral surgeon who became concerned he would not be able to deliver this information to the implant planning company he was using. But this story has a happy ending. He called the company to learn if they could use articulated models mounted with a DFA or facebow. It turns out they much prefer this! And they told him the specific articulator systems for which they have corollaries in the digital world. If he sends the models mounted on any of these, they can digitize them and know the arc of rotation.

Those who have been in my presentations have heard this many times before. The more esthetic and functional information we send to the laboratory the higher will be our ability to efficiently manage the functional and esthetic issues of the case precisely. A lesson we can learn from this story is the value of conversing with the specialists on our interdisciplinary teams and in our interdisciplinary study clubs about the importance of capturing and communicating the arc of rotation. If a laboratory is not requesting this information, have a conversation with the laboratory.

The primary purpose of Panadent’s DFA or any of the earbow/facebow systems is to capture this critical piece of information we call the arc of rotation. There is other information these systems capture but the arc of rotation is critical in establishing proper occlusion. I’ve written about Panadent’s DFA in a previous blog. For an in-person, hands-on lesson in the dento-facial analyzer, we invite you to attend our Essentials 1 Pankey course. You can also watch this video for a quick refresher.

Why is well-being at work so important now?

In the latest Gallup organization interviews, one in four Americans reported feeling a lot of sadness the previous day. During the pandemic, a mental health crisis has impacted employee and patient sense of wellbeing. A large 28% of U.S. employees reported feeling burnout on the job very often or always. One-third of Americans have shown signs of clinical anxiety or depression, and the current state of suffering globally has risen significantly to seven in ten people worldwide.

The authors of Gallup’s 2021 book Well Being at Work: How to Build Resilient and Thriving Teams, Jim Clifton and Jim Harter, say “The right place to start reversing this trend is in the workplace. People want a good job with a good manager where they can use their strengths every day,” and this book empowers leaders and managers to create thriving cultures that involve (emphasize) employee participation and focus on the wellbeing of everyone involved.

Of course, when I read this book, I found it immensely applicable to dental practice. I was energized to communicate with you the basic Gallup findings and add my personal push for dental practice owners, leaders, and managers (in most cases, private dentists) to focus on building resilient, thriving teams. And Mary Osborne and I offered to start a Pankey Virtual Study Club centered on just this, titled “Ignite Your Team.”

Currently in our world, when the overlapping demands of work and life are greater than ever, maximizing employee wellbeing takes on urgency.

Flexibility within a framework is the future of work

Clifton and Harter state that “Organizations have the power and responsibility to improve their employees’ wellbeing. When leaders and managers cultivate the whole person at work — not just the employee — they promote the success of every individual in the organization.”

To maximize your team’s wellbeing, Gallup’s leadership experts encourage us to regularly gather feedback from employee about their opinions, needs, and experiences, then make decisions based on not only this feedback but also our experience, foresight, and understanding of the business (dental practice) and its goals. In a dental practice, this means placing high value on a culture that is positive, supportive, and focused on the overall wellbeing of yourself first and team members next, so together you can focus on the wellbeing of your patients.

I am reminded of two “Rich-isms” or teachings that Richard A. Green promotes within the Pankey community.

1. Always recognize that the team that co-develops a framework of structure and systems, embodies and operationalizes these systems. “If they help form it, they own it and support it.”
2. Make your office look more like an educational organization by creating a developmental, coaching, counseling, and consulting culture. Listen to the team. Involve team members, while considering your values and life-long vision supporting your mission and purpose.

What adds up to a thriving life?

In this new book, we learn that Gallup’s 100 million interviews worldwide have resulted in five universal elements that “add up to a thriving life.”

1. Career wellbeing: You like what you do every day.
2. Social wellbeing: You have meaningful friendships in your life.
3. Financial wellbeing: You manage your money well.
4. Physical wellbeing: You have energy to get things done.
5. Community wellbeing: You like where you live.

To develop a “Net Thriving Team,” start with reflecting on and journaling about these five stages of wellbeing. I’ll be back with “Zeroing in on Wellbeing at Work (Part 2)” next month.

A Reflection: Although most of our early educational classrooms have not often fostered it, an essential participatory experiential exercise can help ground our discoveries and anchor our adult learning, in which we can be “known through” an experience with self and others, more than knowing anything by our own thought. An authentic encounter with a teacher/mentor can foster, in time, our discovery toward a feeling of true knowing, in our heads, our hearts, our hands, and our bodies, as well. This understanding, authentically discovered, can emerge, in unique ways with each individual, and becomes an opportunity for True-Self seeing. It is quite unlike the intellectual “knowing” most of us have been taught to rely on. This experiential kind of “seeing,” can take away much of our anxiety concerning figuring it all out fully for ourselves or requiring ourselves to be “right” about our formulations beforehand. At this point, a teachers’/mentors’ facilitation can become more like a verb than a noun, more a process than a conclusion, more an experience than a dogma, more a personal relationship than an idea.

Life then becomes more like a verb than a noun…We were not put on this earth to describe life, rather we are invited to actively live it,,,! In time, there often can be someone dancing with us (maybe sitting on our shoulder), and we are not afraid of making mistakes. We learn through experience, mistakes, doubt, while allowing a reviewing process to become an intentional part of our experiential learning. It is often best, if we are not told first… Rather, we can be invited to discover it for ourselves! Hmmm…Isn’t that interesting?

“The true wonder of learning is discovering for ourselves!” Carl Rogers, PhD

Through our own experience we can discover while having many encounter’s in which family, patients, team members, friends, and colleagues become our teacher’s / mentor’s. Even when we are doubtful, we can look in the mirror, at our authentic self and say, “Yes” – knowing full well, there is much more to be experienced and it is bound to add layers to our understanding and learning on the job! What ever the “Job” may be or become! Learning becomes a “Two-Way Street” and our teachers and mentors can become participants, team members, patients, spouses, parents, grandparents, adult children, children, and grandchildren, in all age groups. Success then, is a moving target… Not a fixed destination; instead, it can be a becoming!…Isn’t that wonderful…!