Retirement Plan Myths Dentists Should Know About (Part 1)

July 28, 2023 Mark Kleive DDS

As I’ve been giving presentations about business systems to dentists, I’ve discovered that there are six prevalent myths surrounding 401k retirement plans. In this brief article, I hope to help dentists who are also small business owners develop a better understanding of what is actually possible.

Myth 1: Fees for 401k Plans Are Similar

Based on research I have done and the dentists’ existing plans they have shared with me, there are marked fee differences between similar plans. In comparing two “young” plans with just over $200,000 invested for 16 employees I discovered a $3,000 difference in annual fees. This $3,000 annual fee difference represented a 60% increase in cost between the plans. The compounding effect of these fee savings over many years is hundreds of thousands of dollars.

Myth 2: Setting Up a 401k Plan Is Difficult

As dentists shop around for a plan, they often are told that it is difficult to set up a 401k plan that meets the government’s requirements for a broad investment strategy. I view this myth as a sales scare tactic. You can set up your own plan and easily meet the government’s standards. The federal government offers a plan for federal employees—the Thrift Savings Plan (TSP), which is a plan they can easily simulate.

Myth 3: Employers Must Hire a Professional Investment Advisor for 401k Investment Funds Selection

With every 401k plan, there are three responsible parties:

  1. The plan sponsor
  2. The plan administrator
  3. The investment platform provider

The plan sponsor is the dentist/employer and has the overall fiduciary responsibility for the plan. What does this mean? You are going to act in good faith to administer the plan. A hired financial advisor cannot assume this responsibility for you. The plan administrator creates the plan documents, completes annual audits, and prepares annual filings. The platform provider is the custodian of the financial assets and contributions. The platform provider maintains financial statements, updates them online multiple times per hour, and distributes summary statements to investors monthly.

Many dentists choose to hire a professional financial advisor/manager who helps participants select funds, provides investment education, and also acts as the plan administrator, shouldering the documentation and audit work that dentists and their office managers rarely want to do themselves. But some 401K providers have made these tasks easy to accomplish with automation – a robust plan can be designed and administered in as little as 15 minutes.

IN PART 2 OF THIS SERIES…I will present three additional 401k myths that are relevant to dentists as small business owners.

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Additionally, you can take a Finacial Management course with me. Essentials 2 will help you reach your goal of financial freedom by gaining the tools you need to get there. Develop philosophical-based fee schedules and continue to deepen your knowledge of investment strategies and debt management.       

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Mark Kleive DDS

Dr. Mark Kleive earned his D.D.S. degree with distinction from the University of Minnesota School of Dentistry in 1997. Mark has had experience as an associate in a multi-clinic setting and as an owner of 2 different fee-for-service practices. For the last 6 years Mark has practiced in a beautiful area of the country – Asheville, North Carolina, where he lives with his wife Nicki and twin daughters Meighan and Emily. Mark has been passionate about advanced education since graduation. Mark is a Visiting Faculty member with The Pankey Institute and a 2015 inductee into the American College of Dentistry. He leads numerous small group study clubs, lectures nationally and offers his own small group programs. During the last 19 years of practice, Dr. Kleive has made a reputation for himself as a caring, comprehensive oral healthcare provider.

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Personalized Precision Implant Dentistry

July 26, 2023 Michael J. Costa, DDS, MHA

It’s not “uncommon” for a private practice that is dedicated to personalized, comprehensive care with a mostly fee-for-service patient base to develop one or more “niche” services that distinguish it from other practices. For example, they might develop expertise in Invisalign, Airway Management, Integrated Dental Medicine, Microscopic Dentistry, or in my case, Personalized Implant Dentistry.

Passion and Purpose

I have a passion for what I do, which is making a difference in people’s lives with implant treatment and the care and attention I give them. Each patient is special to me, and I want to solve their dental problems. Becoming an associate in the practice of a Pankey Scholar and faculty member, Dr. Steven Malone, has been an incredible experience. Our relationship has been synergistic from the start! He has mentored and supported me as I built an implant practice inside his comprehensive general dentistry practice and became known in the Knoxville area as a person-centered implant dentist. With the implant practice and a full-service in-house dental lab inside our Knoxville Smiles location, Steve and I offer more comprehensive dental services under one roof than most private dentists.

Invested in Best Care

At Knoxville Smiles, we have invested in state-of-the-art equipment because it enables us to provide better, safer care and improved outcomes, but that is not the only thing that sets us apart. We genuinely treat our patients as members of our family and provide compassionate, personalized care in a comfortable environment designed to make them feel safe and at home. We take things as slowly or as quickly as each patient desires. We spend as much time with each patient as they need. And, because we are known for this, we have no shortage of patients who place priority on health and collaboratively participate in diagnosis and treatment planning. We rarely have a patient who declines to move forward or stalls out with achieving the dentistry they need and a naturally beautiful smile.

Recently, we invested in a robotically-guided dental implant surgery assistant called “Yomi.” It uses haptic guidance and comprehensive information about the patient’s oral and facial structures to guide the precise placement of implants. What “sold” me on the investment was that it provides real-time, multi-sensory guidance. With it, I can monitor nerve locations and other orofacial structures, so I can immediately alter treatment based on real-time information. With this greater precision, the implant surgical experience is less-invasive.

My experience, in the couple months that I have been using Yomi, is that the implant placement procedure takes less time, and the desired results are more predictable. We have made a point in our implant marketing to mention our “latest technology” and new patients who call say they like the idea of having their dental implant treatment done with Yomi.

Much of the Fun Is in the Adventure

If you are a dentist working in a person-centered general practice who has the desire to develop a niche within the practice, my advice is to go ahead and develop the knowledge and expertise it will take. The road to get you to where you want to go will be eventful and personally rewarding. Much of my implant knowledge and experience was gained while in the military, I completed the Augusta University Comprehensive Training in Implant Dentistry Course, and I am currently working on becoming an Associate Fellow of the American Academy of Implant Dentistry. I believe I will always be on the road to mastery because it is so meaningful. My “personalized” approach to clinical patient care is constantly being honed as I progress through The Pankey Institute curriculum and am mentored by Dr. Steven Malone. Can you tell I love what I do?

See you at The Pankey Symposium!

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Michael J. Costa, DDS, MHA

Dr. Michael Costa practices in Knoxville, TN with his business partner Dr. Stephen Malone. Dr. Costa graduated from the UNC Adams School of Dentistry in 2014 after completing his Masters in Healthcare Administration in 2010. After graduation he completed his AEGD in the US Navy where he served active duty for 3 years. Dr. Costa started using the Yomi Robot in 2021 and quickly became a Key Opinion Leader. Dr. Costa is a Pankey Alumni. Dr. Costa resides in Knoxville with his wife, Dr. Bre and their two children Bennett and Bella.

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Better Blood Pressure Readings Using BP Cuffs 

July 24, 2023 Lee Ann Brady DMD

In our office, we routinely take our patients’ blood pressure, and we have a variety of cuffs. Most commonly, both hygienists use one of the convenient, digital wrist cuffs. A few months back, they noticed a trend of higher BP readings than they thought were appropriate. We wondered if the wrist cuffs were giving us accurate readings. We did a little research and I decided to reach out to my own primary care physician to ask her advice.

I learned two important things about taking blood pressure:

  1. My physician recommended that we give our patients three to five minutes sitting up in the dental chair, relaxed, and not moving. While pleasant chitchat to reduce anxiety might help, we were advised to steer away from asking any medical history questions and other questions that might produce a bit of anxiety before taking the patient’s blood pressure.
  2. One of the challenges with wrist cuffs is that the cuff is supposed to be at the level of the heart. In a dental chair, the patient is likely to rest their arm on their leg unless we instruct them to do otherwise. She advised that we have the patient take the arm that is wearing the cuff and place it across their chest to hold it at the level of their heart. To be at heart level, the hand shouldn’t come up to the shoulder but be horizontal with the elbow.

My physician asked me if we have arm cuffs that go above the elbow. I told her that we have two digital arm cuffs. She said she prefers using the arm cuffs herself because they tend to be more accurate than a wrist cuff, especially in picking up subtle variations.

This great information has enabled us to take blood pressure readings with more confidence and would be valuable to share with your team members who measure blood pressure. 


In your dental practice, it’s important to create a restorative partnership with your assistants, hygienists & front office team. Make the handoff between your team seamless, build a stronger team & create lasting patient connections. Check out our three Pankey Team Courses that are coming up: Team Series

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Lee Ann Brady DMD

Dr. Lee Ann Brady is passionate about dentistry, her family and making a difference. She is a general dentist and owns a practice in Glendale, AZ limited to restorative dentistry. Lee’s passion for dental education began as a CE junkie herself, pursuing lots of advanced continuing education focused on Restorative and Occlusion. In 2005, she became a full time resident faculty member for The Pankey Institute, and was promoted to Clinical Director in 2006. Lee joined Spear Education as Executive VP of Education in the fall of 2008 to teach and coordinate the educational curriculum. In June of 2011, she left Spear Education, founded leeannbrady.com and joined the dental practice she now owns as an associate. Today, she teaches at dental meetings and study clubs both nationally and internationally, continues to write for dental journals and her website, sits on the editorial board of the Journal of Cosmetic Dentistry, Inside Dentistry and DentalTown Magazines and is the Director of Education for The Pankey Institute.

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Trust – A Cornerstone in Your Practice

July 18, 2023 North Shetter DDS

In a world driven by media hype and often false narratives, how can we convey, and deliver, that we are a trusted resource and provider of care? The answer is worth contemplating.

Slick websites and media ads may drive patients to contact your office but they are only a tiny fraction of what is needed for someone to schedule an office visit or commit to allowing you to physically intervene with care on their behalf. A far better resource is the recommendation of an existing client. But even that is only a crack in the door to the development of trust.

Dr. L. D. Pankey often used the phrase “Know yourself. Know your patient. Know your work.” In other words, are you trustworthy? Is your patient able to express the outcome they are looking for so you can help facilitate their health? Are you the right provider, and is this the right time? Are you capable and competent to deliver the desired outcome?

Our client’s sense of trust will be built from a series of experiences. Some items we can control; others we cannot. We can’t control their prior life and dental experience. We have an impact on, but cannot really control what others say about our office or our skills. We can control our behavioral skills and level of accountability. We can create a client experience that allows for the development of a relationship based on trust and mutual respect. This will require a philosophy shared with our team that is implemented at every point of client contact. If we want our clients to trust us, we must be worthy of trust. We must have mutual trust in our team and among team members. When this situation exists there is an unspoken aura that exists within your business. We don’t have to talk about it because our clients can feel it.

Creation of a climate of trust in our office takes time and effort. The return on the investment is lower stress for everyone involved, and the elimination of having to sell dentistry or worry about third parry concerns controlling patient decisions. Cost will always be an issue for some patients. However, in a trust based relationship we can find ways to overcome that barrier. Some people will not choose to trust and should be guided to another office. For those who choose to participate in a trust-driven relationship, we will be able to provide care, skill, and judgment that will be satisfying to all involved.


Discover more of the Pankey Philosophy and learn how to build a thriving dental practice with The Essentials Series. This comprehensive 4-part course starts with Essentials 1, diving deep into the core principles that will transform your approach to patient care and practice management. Trust is a cornerstone in building strong patient relationships, and The Essentials Series will equip you with the knowledge and skills to establish trust from the very first interaction.

🌟 Trust. Transform. Thrive. The Essentials Series awaits you! 🌟
Click here for more information and to get started.

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North Shetter DDS

Dr Shetter attended the University of Detroit Mercy where he received his Doctor of Dental Surgery degree in 1972. He then entered the U. S. Army and provided dental care at Ft Bragg, NC for the 82nd Airborne and Special Forces. In late 1975 he and his wife Jan moved to Menominee, MI and began private practice. He now is the senior doctor in a three doctor small group practice. Dr. Shetter has studied extensively at the Pankey Institute, been co-director of a Seattle Study Club branch in Green Bay WI where he has been a mentor to several dental offices. He has been a speaker for the Seattle Study Club. He has postgraduate training in orthodontics, implant restorative procedures, sedation and sleep disordered breathing. His practice is focused on fee for service, outcomes based dentistry. Marina Cove Consulting LLC is his effort to help other dentists discover emotional and economic success and deliver the highest standard of care they are capable of.

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