Why We Partner with a Cardiologist

March 12, 2021 Barbara McClatchie, DDS

Despite headlines you may have read, heart disease is still the number one killer in the U.S., followed by cancer and then (hopefully only temporarily) COVID-19. Gum disease is on the rise in this country. This condition affects much more than just a person’s mouth. We need to shut down the dangerous anaerobes that live in our tissue and bone that drive the oral and systemic inflammation. The bacteria that live in our mouth do not stay in our mouth! Hygienists are not only cleaning deposits off of teeth; they are managing dangerous bacteria and saving lives!

Patients see their dentist more often than they see their physician. The start to providing optimal care is having informative conversations with our patients when discussing their health history, their medications, and the tie in their periodontal and endodontic health.

Married to a cardiologist, it was beneficial for both my dental patients and his medical patients to receive integrative care, and to that end, we worked together to build a center for my restorative practice that includes oral-systemic health diagnostics, counseling, and treatment.

Pushing the Standard of Care

My practice, Complete Heath Dentistry of Columbus, is distinguished from other practices by pushing the standard of care to treat patients based on his or her risk factors for developing systemic health issues. Saliva/oral DNA testing enables us to take this proactive health approach. This testing allows us to learn if our patients have dangerous oral pathogens. It helps guide us on how to better treat our dental patients with periodontal therapy and with oral probiotics, as well as Perio Protect trays.

My husband, Dr. Eric Goulder, and I opened the first medical center in the United States with an accredited Cardiologist and Dentist to practice the Bale Doneen Method testing and care under one roof. We passionately believe a medical Bale Doneen provider cannot optimally help their patient without the assistance of a dental team that understands the value of their work.

With every patient, we discuss oral health risk factors for cardiovascular disease and strokes. We use saliva/oral DNA testing to proactively calculate the CVD risks of our patients with the recommendation they create a health plan with their doctor geared toward overall health. With focus on prevention and the elimination of disease, we work with patients to achieve optimal oral and systemic health.

Pushing Dental-Medical Integration

Across the country, dentists are teaming with cardiologists to better understand the oral-systemic connection and to help their patients discover developing risk factors for heart attack and stroke, among other diseases such as diabetes. You do not have to have a cardiologist under your roof to similarly help your patients.

You can explain to your patients that one of the most painless tests that can reveal hidden heart attack or stroke risks is a carotid artery scan (CIMT scan) that measures carotid intima-media thickness. It is an important test for individuals with few risk factors for developing cardiovascular issues. Under traditional care, 75 percent of heart attacks happen in people with normal cholesterol levels. Through this no radiation ultrasound procedure, the neck is examined so that a doctor can uncover whether or not a patient is heading for health problems. This screening detects atherosclerosis, a condition where deposits hide within the arteries. Also, it is possible to find the “age” of a patient’s arteries.

Through CIMT ultrasound testing, a cardiovascular problem can be identified 10-15 years prior to an event. While 50% of the population does not know they have a growing cardiovascular problem, this simple test provides an early diagnosis for lifestyle counseling and dental-medical treatment.

Working with your patients and their physicians, you can also recommend the NT-ProBNP blood test that is a part of the blood testing involved with the Bale Doneen Method. This test measures the amount of BNP in the blood.  When the heart is under stress, the body excretes high levels of this substance. If elevated levels are detected, it is a red flag that a person may be heading for a stroke or heart attack.

Dr. Eric Goulder and I are on a mission to push physicians to be proactive, to understand what is going on inside arteries, discover why the disease is present, and observe the disease stabilize after treatment. I encourage you to become familiar with the Bale Doneen Method if you have not already done so and become familiar with cardiologists in your area who can be of assistance to your patients. Two-way referrals are a natural outcome of developing these relationships, and patients are very appreciative.

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Barbara McClatchie, DDS

Dr. Barbara McClatchie is on a mission to enrich the quality of life for every person she meets. Her practice, Complete Heath Dentistry of Columbus, Ohio, employs a team of professionals specializing in general restorative dentistry and uses researched-based methods that ensure optimal oral, mouth and heart health. A native of the Toledo area, Barbara graduated from The Ohio State University in 1978 with a Certification in Dental Hygiene and Bachelor of Science in Education and received her Doctorate in Dental Surgery from The Ohio State University in 1986. After that she was selected to attend a hospital based general practice residency program at OSU. She continued her study with The Pankey Institute. Dr. McClatchie won the Worthington Chamber of Commerce small business owner award for 2016-2017. She and her She has shared tips for optimal oral and heart health on Good Day Columbus and has been featured on 10TV and Columbus CEO Magazine. She is a founding member of American Academy of Oral Systemic Health and a member of many other dental organizations including the American Dental Association, Ohio Dental Association, Columbus Dental Society, OSU Dental Alumni Association, Pankey Alumni Association, AAOSH, Worthington Chamber, Worthington Chamber Board Member and the Bale Doneen Preceptorship.

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Dentistry Post Corona: The Good, the Bad, and the Ugly

January 18, 2021 Barry F. Polansky, DMD

The Great Pandemic of 2020 has created mass disruption in the lives and work for most people. In a current bestselling book, Post Corona, author Scott Galloway has an interesting perspective on the many various changes that we have seen and reveals his theory of what the “new normal” will look like. But don’t be shocked to discover it will just be more of the same.

The virus has been an accelerant.

As the premise of his book, Galloway uses a quote that is often attributed to former premier of the Soviet Union, Vladimir Lenin: “Nothing can happen for decades, and then decades happen in weeks.” Of course, Vlad was speaking about the Russian Revolution, but we can apply that logic to what we have witnessed over the past 11 months.

In other words, social and business trends that were already in motion went into turbo mode. The virus has acted as an accelerant. It has affected every one of our lives and every market in the world. Take e-commerce as an example. We have been using Amazon.com for years, yet e-commerce has only grown at a rate of 1% every year. Just before the pandemic, e-commerce was 16% of the economy. Then, from March 2020 through April 2020, that number jumped to 27% in just 8 weeks…just like Vlad said.

Think about other instances like virtual meetings and the emergence of Zoom. I hope you bought their stock. Zoom was around before the virus…now look at it. Stay at home stocks have been on a tear. With gyms closing and people social distancing, Peloton, and Lululemon’s Mirror have really taken off.

What about dentistry?

Early on, dental practices were seeing the effect of fears of close contact and aerosol transmission. Then things eased up. Practices became busier. Now, with the rise in cases, the fears are returning.

Private dentists with reputations for genuinely caring about what is in the best interest of their patients, have earned patient trust already that helps immunize their patients from fear.

One thing we must respect is that we have no control over other people’s behavior. And we have no control over the pesky virus. The vaccine is coming but human behavior will prevail.

As a retired dentist, people continue to ask me one question: “Is it safe to get my teeth cleaned?” My answer, as a dentist, is always yes, but as a patient, they will be asking that question for a long time to come…vaccine or not. Dentists must see this through the eyes of their patients.

What should we expect post-Corona?

Galloway, in his book Post Corona, tells us that the existing trends will continue to accelerate:

  • The good ones (like hand washing and stay at home practices),
  • The unpopular ones (like masks and excessive PPE), and
  • Even the ugly ones (like misunderstandings in business and within families).

So, what do we do?

As a good Stoic, I would advise first to accept what we cannot change the circumstances. Just like a war…it’s unfortunate and not fair but a Stoic accepts the challenge and moves forward. It never pays to get frustrated or angry. Now is the time to build resilience and pay attention to leadership and communication skills.

Yes, the troops are coming, and there is a light at the end of the tunnel. (I love clichés.) But basic human behavior will prevail.

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Barry F. Polansky, DMD

Dr. Polansky has delivered comprehensive cosmetic dentistry, restorative dentistry, and implant dentistry for more than 35 years. He was born in the Bronx, New York in January 1948. The doctor graduated from Queens College in 1969 and received his DMD degree in 1973 from the University of Pennsylvania School of Dental Medicine. Following graduation, Dr. Polansky spent two years in the US Army Dental Corps, stationed at Fort. Dix, New Jersey. In 1975, Dr. Polansky entered private practice in Medford Lakes. Three years later, he built his second practice in the town in which he now lives, Cherry Hill. Dr. Polansky wrote his first article for Dental Economics in 1995 – it was the cover article. Since that time Dr. Polansky has earned a reputation as one of dentistry's best authors and dental philosophers. He has written for many industry publications, including Dental Economics, Dentistry Today, Dental Practice and Finance, and Independent Dentistry (a UK publication).

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On Addressing Traumatic Experiences

September 4, 2020 Paul Henny DDS

When we have experienced a deeply traumatic event, such as an emotionally laden death, or the near-death of a family member, what is often left behind is emotional debris with the potential to follow us around indefinitely. Subsequently, we can become haunted by memories of what happened, or what we should have done to make things better. These kinds of recurring thought patterns can easily bleed over into our daily lives and negatively influence our behavior—and our future.

On a neurobiological level, this occurs as our brain is designed to keep self-preservation as its highest priority. Thus, possessing the ability to quickly recall traumatic events protects us from similar things happening in the future. But commonly, this constant re-remembering can lead us into a state of psychological paralysis, depression and/or chronic anxiety, and poor decision-making.

At the present time, many patients live in fear of going to the dentist, because they believe there is too high of an infection risk. Concurrently, they consider the process of addressing their dental needs as being a lower life risk. These shadows of fear can remain strong in their mind, particularly when they have a family member who is in a high-risk category. Simultaneously, some dental team members have made the decision to leave dentistry for similar reasons. However, both challenges are happening at significantly lower rates within relationship-based / health-centered dental practices, as these practices have already built strong, enduring bridges of communication within their patient pools.

The Shadow

A contagious virus is a concept most people understand. The level of anxiety this virus has generated world-wide is something many cannot successfully manage alone. We have all had patients whose past dental experiences were so negative and their thinking about it so distorted they cannot recall why certain situations trigger their dental PTSD. Carl Jung referred to the source of these recurring thoughts as “the shadow.” Buried memories and their emotional associations can be so strong that they take complete control over a person’s behavior.

Letting Go

The brain does not stop maintaining its focus on traumatic memories until it has come up with a rational explanation for why they happened and a plan for how to avoid them in the future. On this, Jung stated, “Until you make the unconscious conscious, it will direct your life and you will call it fate.”

CoDiscovery was designed to address the influence of the shadow’s influence on current behavior patterns, in much the same way as psychotherapy facilitates the exploration of the past and associates new meanings with those memories. It is intended to help patients associate new meanings with what they are learning about their dental past.

The “Rogerian” therapy model of unconditional positive regard, congruence, and non-judgementalism is an ideal format for patients to safely explore their fears, beliefs, values, and priorities. And that’s why Bob Barkley and Nate Kohn, Jr., Ph.D., leaned so heavily on Carl Rogers’ work. Bob Barkley put this re-experiencing process under an umbrella he called, “Three Phase Adult Education,” and the rest became history.

The Future

As optimistic as the future appears to be regarding the successful management and treatment of COVID-19, this pandemic experience has reshaped our thinking—our “shadows,” forever. How we manage these memories, conscious and subconscious, will have a lot of influence on our success going forward. If we demonstrate we are on the same side as our patients in preventing COVID-19’s negative impact, we create yet another strategic advantage we can leverage against our transaction-oriented competition. On the other hand, if we allow our patients’ fear-driven “shadows” to drive their decision-making, we will rue the day we allowed this proverbial cart to be placed in front of their psychological horse.

Bob and Nate had it right. CoDiscovery is the pathway to deeper understanding, hence better decision-making. And better decision-making is exactly what our profession needs right now.

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Paul Henny DDS

Dr. Paul Henny maintains an esthetically-focused restorative practice in Roanoke, Virginia. Additionally, he has been a national speaker in dentistry, a visiting faculty member of the Pankey Institute, and visiting lecturer at the Jefferson College or Health Sciences. Dr. Henny has been a member of the Roanoke Valley Dental Society, The Academy of General Dentistry, The American College of Oral Implantology, The American Academy of Cosmetic Dentistry, and is a Fellow of the International Congress of Oral Implantology. He is Past President and co-founder of the Robert F. Barkley Dental Study Club.

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Acute Versus Chronic Dental Pain During COVID-19

August 31, 2020 Lee Ann Brady DMD

During this time, while we are working through COVID-19 in our dental practices, some of you are helping patients in need of emergency dental care. One of the “urgent care” challenges we all cope with during normal practice applies during Coronavirus…and maybe in a new way. This challenge is helping patients understand the dental pain they are experiencing and what we can do to address it.

Acute Pain

In dentistry, we are accustomed to dealing with patients who have pain. The majority of the time it is acute odontogenic pain. With acute pain, patients seek diagnosis and treatment promptly, reporting that the pain is intolerable and getting in the way of their normal function. When patients seek diagnosis and treatment promptly, standard treatment modalities more predictably eliminate the pain.

Chronic Pain

However, in the case of chronic pain, when patients are not experiencing an intolerable level of pain and have found ways to function around it, or when the pain is intermittent coming and going over a period of months and patients have not promptly sought help, we have a greater challenge. This is because, when pain occurs constantly or intermittently in the same location for more than 90 days, the neurological system tends to rewire itself. Now, when we treat the original source of the pain with standard modalities, we may not get a satisfactory pain elimination result. The pain has become the diagnosis itself. It has become a pain disorder.

Listening to what the patient tells us, helps us understand whether the pain is acute or chronic. In the case of chronic pain, patients have suffered with it for months and typically report attempting to figure out the source themselves and holding on to the ope that it would just go away. They may have been to more than one clinician seeking a diagnosis. Perhaps, they have had treatment and pain has persisted.

Communication is Key

We need to communicate to our patients that we want to diagnose and treat pain before it becomes chronic and that, once the pain has persisted for more than 90 days, it becomes a diagnostic and therapeutic challenge. As we enter the second phase of COVID-19, I have communicated with my own patients that I can see them for urgent care and to please call me if they are in acute pain. We can perform standard treatments for emergency dental needs at this time.

The message for chronic pain sufferers is more challenging. If their lives have become so disrupted that they cannot normally function, I want to help them and can do a teleconference consultation during which we talk about the history of the pain, I help them understand the nature of chronic pain, and we discuss how we can partner now remotely in finding a pain management strategy and later partner in my normal clinical setting.

The relationship we create with our patients, during this time, may be more binding than ever before. Treat these relationships like the most prized jewels.

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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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I’ve Learned a Lot About Face Shields

June 17, 2020 Lee Ann Brady DMD

Most dentists have some stories about buying and trying different types of face shields as we have started to practice again. The challenges of fit, being comfortable and working with loupes are common conversations. I have tried six types to date with more on the way.

I started with “What can we get?” Then I moved on to “What will be the most comfortable and best on our loupes?”

I and my two hygienists wear loupes. I wear a 4.0x power, flip-up loupe. The hygienists wear 1.5x power loupes. In addition to the loupes, we wear a light.

We’ve tried face shields that hang from a visor. This is the kind my assistants love and wear all the time. However, this type of shield does not fit over my loupe. It fits over my hygienists’ loupes but by the end of the day, they have a headache from the pressure of the temple pieces on the visor.

We tried the disposable face shields that hang from a headband with foam padding. They did not fit over loupes.

A third type from Bio-Mask® turned out to be my hygienists’ favorite and the one I wear when I am doing a consult and not wearing my loupe. This type of visor frame has replaceable face shields. It is lightweight and comfortable (due to its weight, adjustable head strap, and foam padding), and it is designed to be worn with loupes. The replaceable shields can be washed with hot soapy water. The shields are designed to protect from splatter and spray that might come over the top of the visor, so you have full-face protection. I can wear it over my loupe by enlarging the headband and resting the front of the visor frame on my light.

Just recently I came across a different face shield designed to wear over dental loupes that I really like. It’s the PRO-TEX® extra-wide 13″x 7″ shield (model FSX). It clips directly onto the frame of my loupe. I wear eyeglasses, a face mask, my loupe with a light, and then clip the face shield to my loupe frame. This is the least pressure on my ears and temples that I have discovered. The shield can be washed between patients with warm soapy water.

I know a lot of people are praising loupe face shields from Ultra Light Optics®. I am looking forward to trying these when they come in because they are designed so you can mount your light outside the shield and not have to reach under the mask to flip down your light.

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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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The Journey of Uncharted Waters? Really?

May 20, 2020 Kevin Muench DMD, MAGD

As I watched the pandemic unfold from my vantage point in New Jersey, somehow the innocence of a child passed through my mind as I thought, “That won’t happen here.” As the pandemic got a death grip on the New York Metro area, the stark reality of “It happened here” came into full view. At first, we spread the patient visits with gaps for safety and eventually just closed our doors except for emergencies. As the weeks have turned into months, the economic impact and the sense of isolation has started to metamorphosize into a NEW reality. The phrase of “epic proportions” and “uncharted territory” were thrown around on every news cast.

Is this journey really uncharted?

Are we really cast to a horizonless sea? Haven’t we been preparing for this type of event through our education, study clubs, reading, and conversations within the community we call the “Pankey Family?” These examples come to mind:

After reading Gene D. Cohen’s book The Mature Mind, I learned that I’m resilient. I survived the big “C”, a 300-year flood in Havasu Falls, and my wife’s health issues. I realize “I’ll be able to get through this.”

Through the Gallup’s Strengths Finder and the leadership program with Dr. Richard A. Green at Gallup, I learned that my strengths are Ideation, Strategic, Learner, Communication, and Maximizer. Today I trust that the ideas and strategy will come to me. I have leveraged the Strategic strength over and over again.

The book How to Think Like Leonardo DaVinci by Michael J. Gelb tells us that when DaVinci was faced with challenges such as these, he trusted the answers “would appear.” He trusted the challenges would “seed the unconscious” to find a solution.

Waiting for the Unconscious…

While waiting for solutions to challenges, I’ve learned to free my mind and spirit by “chopping wood and carrying water”—TAO! So, when my practice closed normal operation, I went to Home Depot and bought paint…a LOT of paint. On day two I started painting my office. At first, I thought I would paint just the reception room, but as time went on, I had time to paint the entire office. I know myself, and I was doing all I could not to jump onto the “downward spiral” that I learned about in The Art of Possibilities: Transforming Professional and Personal Life by Zander and Zander.

Staying in Community

As the weeks went by the first solution to pop up was creation of a protocol for dealing with virus containment. If a patient did need to come in for emergency care, I needed to have a strategy. Joan Untershuetz and Denny Byrne presented new information last year at their Inspired Facilitation workshop about how the brain needs community. So, I formed a Zoom account and started weekly team meetings. We discussed what we were each doing to stay safe. This piqued my curiosity to wonder what patients were doing to stay safe and could they help me develop a protocol that would help them feel safe?

I recalled Dr. Irwin M. Becker lecturing in C1 on first steps to integrating this new way of practicing. He challenged us to select patients that trusted us already, and he called them “friends of the practice.” I asked my current team to list those they consider to be friends of the practice—those who put smiles on our faces when we see them on the schedule. The list was formed. The ball started to roll. I facilitated my first ever Patient Focus Group and asked two simple questions:

What have you been doing to keep your home safe from Covid-19?

What would you need to know in advance of an office visit in order to feel safe?

New Dimensions of Individualized Care

The focus group responses helped me understand that the protocols they were following at home ran the gamut from washing hands and taking off shoes to something resembling a chip manufacturing plant. I realized that individualizing the protocol could be another level of “values-based relationship-driven” individualized care.  I learned that my patients had high trust in my ability to forage through the regulations and come up with a safe protocol, and they thought it would help them to know the what, how, and whys before they came to the office.

Thanks go to several colleagues who helped by reviewing and critiquing my office protocols as they developed. Much thanks to Joan Untershuetz, Richard Green, Rolando Cibischino, Christine Shagaki and Dennis Stiles for letting me bounce ideas off of them and for their in-depth critiques.

Something else I did to stay in face-to-face contact with patients was to implement a form of “teledentistry.” After watching a presentation by Laurie Owens from DevDent at one of the ACT Dental CE online CE days, I set up an account with Doxy.me and now have regular telehealth hours. I get a push notice when someone is in the “waiting room” to have a tele-dialogue.

A Journey? Yes…Uncharted? No

There are boundless opportunities to put our best Pankey training to masterful use. We were all taught to slow the practice down and be more intentional. We were taught about personality styles and values. Open dialogue and full transparency can be the threads we hold with our patients to deeper levels of trust and appreciation. I feel poised and ready to bring my best self forward in these times that hold endless possibilities for values-based, relationship-driven, uniquely individualized care.

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Kevin Muench DMD, MAGD

Dr. Muench started his private practice in February, 1988. Graduated from Boston College in 1980 with a B.S. Degree in Biology. In 1987, he graduated from New Jersey Dental School with honors and was elected into the Dental Honors Society, OKU. He received the Quintessence Operative Dentistry Award and the Dentsply Fixed Prosthodontics Award. In 1993, he received a Fellowship in the Academy of General Dentistry and in 2002 received a Masters in the Academy. He has completed greater than 1500 hours of continuing education since Dental School. He is an alumnus, visiting faculty, and an Advisory Board member of one of the most significant continuing education groups, The Pankey Institute. Kevin resides in his family home in Maplewood where he was born and raised. Kevin and his wife Eileen have three boys; Colin, Tommy, and Michael. They strongly believe that participation in community efforts are what make the difference in Maplewood NJ.

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My Office Is Closed. Now What?

March 27, 2020 North Shetter DDS

Covid-19 is a true Black Swan event for everyone around the world. Suddenly all dentists are banned from practice, except for emergency care, for at least several weeks. We are all feeling the impact of this strange new virus. How we choose to respond will make a significant difference in the long term impact of this crisis on our lives and our practices. Here are some ideas and information that may be of some help. 

Stay Positive 

Yes, your office is closed, and your team members are not working. There is legislation in the works that will allow you to pay your team with funds from the government. Sit down with your team and reinforce that this situation will not go on forever. Life will return to a more normal scheme. You are not going out of business, and they will have a job.  

Tell the Truth

Most of your team are hourly workers and this is really scary for them. Be honest about what you can and cannot do for your staff. Communicate openly with your staff and patient base. Make sure patients have access to you or a designated team member 24/7 if they need urgent care. Prepare your office totally for the event of having to care for someone with proper protocols and all the needed PPE. Take time to discuss what is happening with your family. Since church will not be an option for the near future, this might be a good time for some family prayer time. This is an opportunity to grow together and support one another and to demonstrate and ask for accountability.  

Take Advantage of the Time Off

Are there projects that you have been putting off at home or the office? Could some of your team be doing a deep cleaning or re-organization at the office? Could you be setting up some additional team training that can be done within the parameters of safe spaces or by video? Doctor, how about taking advantage of some of the video and other CE at The Pankey Institute that is online? 

Collaborate with Your Peers

Pick up the phone and call your friends. Share the information from the IRS. It is a big deal for your bottom line. Discuss putting together some group events when you can gather again. If you know of someone who needs a helping hand or some cheering up, just do it. 

Look at the current situation as a learning experience in coping. Keep the big picture in mind. There may be lines in stores and some folks with a “me first” attitude about toilet paper. However, we have power, water and food. Let’s do what we need to do to get past this and move on. Stay safe, wash your hands and pay it forward. 

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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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