Top 10 Things to Do Now to Increase Cash Flow During the COVID-19 Pandemic

By Dr. Rick Huot

For Florida dentists, the idea of bracing ourselves and our staff for another national emergency is quite likely not the first, nor the last, given the number of hurricanes we’ve faced in the past decade. But the new coronavirus (COVID-19) is a little different breed of emergency, since unlike our past hurricanes, it is here already — and we don’t know how long it’s going to last. Fortunately, our offices are intact, and we will be able to quickly rebound once the outbreak dissipates, and our patients will come back slowly and surely as they always do. Despite that, cash flow management will be critical in this unknown period, and it is vital you take steps now to preserve cash flow, so that your office can be restored to normal as quickly as possible.

As you can see, the current flow of information is too fluid to predict how long this pandemic will last, but you can do these 10 things right away to assure you’ll receive an adequate cash flow during the outbreak and once patient care is resumed. At the time of this writing, 25% of America had “lockdown orders” imposed on its citizens, and all workers who do not have a critical job description are urged to stay home in place. Officials have literally imposed “emergency care only” advisories for all dentists, and some states have extended that condition into late May or even mid-June. Please visit floridadental.org/coronavirus for the latest Florida-specific information. The American Dental Association (ADA) and is continually evaluating and will update its recommendation on an ongoing basis as new information becomes available.

For cash flow preservation, here are 10 recommendations, in no particular order:

1. Don’t touch your face or your 401K unless you can afford to put 2019 fiscal year money into it. I found this out by accident in July 2008 when I sold my practice. I didn’t fund the 2008 contributions for myself and my family until late March 2009. By pure blind luck, the bottom of that bear market was in March, so the funds put in were at the market low and made great gains over the years. If you’re not taking a retirement distribution, avoid the stress of constantly checking your portfolio balance while the market gyrates wildly on each rumor.

The current Dow average is around where the 2008 low was, so if you do have extra cash on hand, the market is on sale and will eventually rebound. Ignore cold calls by stockbrokers who are peddling the latest great deal on bargain stocks, and your 401K should have a small group of well-diversified index funds that are low cost and well-balanced for any financial condition.

2. Take advantage of the governor’s Florida Small Business Emergency Bridge Loan Program for an immediate injection of cash into your practice if you qualify. For more information on the program, visit floridadisasterloan.org. For questions regarding the Emergency Bridge Loan Program, contact the Florida Small Business Development Center Network at 866.737.7232 or email Disaster@FloridaSBDC.org(Source: Florida Trend Newsletter)

3. If you haven’t done so already, have a virtual staff meeting immediately to explain what your staffing will be in the immediate time period. The first thing you need to do is NOT guarantee your staff they will be made whole for the entire time of this pandemic. That is unrealistic, and threatens their future paychecks by putting you in a tight cash flow scenario. We all respect and take care of our staff, but you have to manage the business. Large companies are dealing with the same issue right now, and a friend who is a McDonald’s franchiser said they haven’t made up their minds on this yet.  You are not McDentist, and unlike McDonald’s, your patients aren’t going to make a beeline for your office once this is over.

The current Relief Package Bill that was passed by Congress just this past week guarantees 14 days sick leave to employees that have to stay home to take care of their children, or if they are quarantined. This bill will exempt businesses under 50 employees, which will likely apply to most Florida private practice dental staffs.

Liberal use of accumulated personal/vacation leave is a much better alternative to the small practice owner, and Florida dentists have likely used that route in the past in times of hurricanes. Salaried personnel such as an office manager (exempt from the Fair Labor Standards Act) can be used for phone calls, triaging emergency calls and routine office work. If this shutdown lasts more than the mandated 60 days, contact your accountant/human resources consultant for guidance going forward.

4. Stop spending on personal “stuff.” Have a family meeting and honestly outline the impact of this crisis to your loved ones. They have probably heard it before, but it doesn’t hurt to talk about it again. We’re blessed as a profession to have a stable and considerable income, but as a small business owner, we are the providers to our staff members, and if your staff sees you’re taking this seriously, they will understand the measures taken in No. 3 above.

5. Stop automatic shipments of dental supplies. Except for personal protective equipment (PPE), you should stop any ongoing supply shipment of dental or office supplies. If you don’t do this routinely, have a staff member go through all of the cabinets and drawers, and assess what you have plenty of. Many offices buy supplies on sale, and large amounts gathering dust can be slowly depleted over the next year. Just in time, inventory practices should be implemented. This is the best time to schedule maintenance on any equipment you use, including small instruments that must be shipped for repair.

6. If you must go in for emergency appointments, set up multiple teams to work at the office in shifts to prevent mass spread of the virus. That way, if one or more of the team members get infected from outside or inside the office, everybody else figures out who can’t go in anymore, and you don’t knock the whole team out. If only one person feels sick, have them get tested and then figure out the quarantine protocol for the members of that team. Hospitals are adapting this protocol all over the country to prevent a mass depletion of their health care staff, and a dental staff also is particularly vulnerable to that. Dedicate a specific chair(s) and staff area for emergency treatment to limit the potential spread of the virus to other areas of the office, and make sure the areas you use are thoroughly disinfected after each use.

7. Delay making your tax payments on April 15 by filing your taxes and you can defer up to $1 million as an individual interest and penalty free for 90 days. Your other option is the right to file for an extension, and the tax return would be due on Oct. 15. Check with your accountant for details on payments and extensions to see if you qualify.

8. Instead of paying yourself with wages, pay distributions if you have a “S” corporation. Again, your accountant should be advised of your intent to do that.

9. Run an accounts receivable report. If you have a normal billing date to send your invoices to your patients, be sure to do that, and despite the fact that your patients may not pay you right away, it’s still part of a normal office routine. You may want to insert a notice of your intent to keep your employee’s wages as best as you can, and you appreciate it greatly if they can pay their outstanding balance.

10. Run an unfinished treatment report. This will be handy once you resume normal hours in your practice, and might provide some much-needed operating capital. All of us have more spare time these days, and if your dental software can be operated from home, you can review these treatment plans from the comfort of your home office.

Please continue to check the FDA and ADA sites for more updates as we go through this pandemic. With good planning and attention to cash flow management, your office will continue to be successful, and your staff and patients will be rewarded with your due diligence.

 

The Complete Guide to Starting a Dental Blog

Dog Looking at Laptop Screen

By Aimee Laurence

Nearly every business is creating a blog these days to engage with current customers and try to get new clients. How can your dental practice create a blog with content that will be SEO-friendly, engaging to clients and relevant? Read on for a full guide on getting started.

Change Your Mindset

To start, you have to change your mindset of thinking of communicating via posts, tweets and other messages as self-promotion that will annoy people or bore them. Instead, consider that you have years of experience and training and you can give people valuable information about oral health care and dental tips. This should be in the back of your mind as you start creating content.

Think of Patient Pain Points

Your ideas for content topics should come from your day-to-day experiences. Take note of the questions that patients ask frequently and the answers — all of this is material for blog posts. Any questions or concerns that are unusual also can make for interesting reading, although you need to be sure that it’s general enough to protect patient privacy. Speak with the rest of your team to get their ideas and the questions they frequently receive. Don’t worry about writing on a topic that’s already covered online; yours will have a unique perspective.

Tips for Writing the Content

At the end of the day, you do need to come up with the actual words for the content. This is the part that most people struggle with, because it’s hard to write well. Some tips are to start the introduction to the post by stating the problem. Describe the topic, problem or concern as briefly as possible. Then, give some steps that readers can take to address the problem in clear, actionable ways. Start with the best tip so that they are interested to keep reading. For help writing and editing the content, consult Boomessays and Academized.

Presenting the Content

It’s been proven many times over that a blog post, tweet or any content will get a lot more traffic when it comes with images. To get some good, relevant images for your dental blog, look at getting stock photos from a site like Unsplash. You also should be thinking outside the box to come up with creative and fun ways to showcase what you’re writing about, like animals smiling.

You also can create an infographic to show data or information in a more eye-catching and visual way. These tend to get liked and shared up to three times more than written content. You can use some easy sites to create your own infographics. As per Martin Ford, a dental blogger at Assignment Writers and Research Papers, “You can even take your own photos of your office, staff and exam rooms of the actual dental practice. This gives readers a real insight into the practice. Make sure you have signed consent from staff members before you use them in an image.”

Be SEO-friendly

Your content needs to be SEO-friendly so that it can rank higher on search results. That includes the optimal length for a title, meta descriptions and tags, and more. Laura Fields, a tech writer at Revieweal and Big Assignments, says to “Know the keywords you want and use them, by thinking about the keywords that your patients would be searching for. Include links to other websites, which will help Google rank you higher. Link within your own website as well.”

Share it

Once all of this is done, it’s time to release it and share it. You can schedule posts, so they’re released at certain times where they are more likely to be seen and read. You should be trying to get people to engage with it and share the content, so to do that, include a call to action. This can be as simple as asking people to share what they’ve read or ask for their thoughts. It’s especially helpful to end the post with a question.

Following these tips makes it easy to create a dental practice blog. Don’t forget to be consistent with your content creation so your audience knows what to expect. Happy blogging!

Aimee Laurence is a tutor who loves writing about content creation and blogging. She works for Elite Assignment Help and Essay Writing Services, where she shares with readers her top tips and tricks for SEO and boosting audience size. In her free time, she is a freelance editor at Top assignment writing.

When is a Computer Operating System Upgrade Really Necessary?

By Larry Darnell, FDA Director of Information Systems

The other day, I sat in a room at my doctor’s office waiting for him to appear. Since I am involved in technology, I quickly notice the computer in the room. It would be what I call a thin client computer with a basic computer operating system on it and a small footprint. All of a sudden, the power goes out at this office and as you might imagine, all things electrical shutdown, including this computer. When it boots back up after the power was restored, I am shocked and dismayed. The operating system is Windows XP! It has been five years since Windows XP reached what we call end of life. That means that the maker of the operating system, in this case, Microsoft, would no longer support, provide updates, or encourage you to use it. Perhaps you remember when they pulled Windows XP out of your cold, clutching hands and gave you Windows 7 or Windows 8. You cursed Microsoft like many others. Yet it is still being used five years later? The continued use of Windows XP is ill-advised, illogical and quite possibly illegal (in health care settings).

Well, in January 2020, Microsoft is doing it again. Windows 7 (which replaced Windows XP) will reach its end of life. There also will be a server operating system that has been super-dependable, Windows Server 2008 R2, reaching end of life, too. Here at the Florida Dental Association, we have been using Windows 10 for some time now on our workstation computers (the order goes Windows XP, 7, 8, 10, there was no 9). However, we do have three servers that use Windows 2008 and we’ve had to replace them with a newer server.

So, how do you know what operating system your computer is using? When your computer starts up, it should become clear:

xp
Windows XP = VERY BAD!

7
Windows 7 = Time to upgrade

8-10
Windows 8 or 10 = Ok for now

Understand that in most cases, it is likely possible to upgrade the computer operating system from Windows 7 to Windows 10 without buying a new computer. However, you would need to make sure that all software programs and hardware devices connected also are compatible with Windows 10.

Now is the time to do a checkup on your computer systems. Do not wait. This is not a Y2K-type concern, but it’s still important that you act now. If you have a third party supporting your computer systems, ask them now about this.

If you want more information on this, you can email me at ldarnell@floridadental.org or check Microsoft’s web pages specific to each event:

 

 

 

Why Dorian Should Make You Think About Practice Transitioning

By Dr. Rick Huot

At the end of August, while Hurricane Dorian was on its unpredictable path, I headed to San Francisco for the American Dental Association’s Annual Meeting. Before my duties started as ADA Board of Trustees liaison to the Standards Committee of Dental Informatics, I sat down to write this article in the relative comfort of the Marriott Marquis. Whenever I have the Weather Channel on for more than five minutes this time of the year while away from home, you can be assured that Joanne and I are checking to see how the “wind is blowing” back in Florida. In 2004, we spent Labor Day in Maine watching as Hurricane Frances — and three weeks later, Hurricane Jeanne — give Florida the infamous “Plywood State” moniker, and as empty nesters, it doesn’t take us long to pack and secure our home not knowing what the force of nature is planning for the week ahead.

Early that Friday morning, and with help from Delta, we decided to leave a day early for our trip to California, knowing that conditions in the Caribbean were deteriorating, and there was a good chance that flights all over Florida would start being cancelled as early as Saturday. That was confirmed by the Delta folks when they graciously put me on a plane leaving out of Orlando Friday afternoon.

After a quick call to Marriott and the shuttle folks, we now had an extra day to “play,” and we quickly contacted longtime friends from Chicago now living in San Francisco for dinner, and the conversation quickly shifted from Dorian to our respective careers. Helen has been working for Delta since I was in dental school at Northwestern and continues to fly the international routes and loves her work. Mike is a successful retired businessman who invested wisely in his career since his early days in Chicago, and this year’s New York Marathon will be the 100th he has run since he started many years ago.

These days, longevity experts talk about your early 60s and what you can reasonably expect life to play out from there. Given that you are in good health, and that you also have excellent financial health, your options multiply when you could adapt to life’s curveballs and make lemonade when someone like Dorian hands you some lemons.

Kiplinger Magazine has an excellent article on the “go-go years” and beyond, and we remarked that the four of us were taking this very seriously. At this point, you may be wondering what the above events have to do with dental practice transitions, but please keep reading on, and you will see the method to my madness.

After Hurricane Katrina in 2005, I was asked by Dental Economics to co-write an article on disaster preparedness, and lessons learned from surviving the 2004 hurricane season. Although some of the material is now dated, a lot of what was learned then is reinforced every hurricane season, and other natural disasters throughout the country all year long.

Given that the solo practice model has slowly become less prominent, and the cost of running a dental practice continues to increase, a dentist reaching the age of 50 has more options today available to them, especially if there is a chance that a facility could suffer damage that would prevent dentistry from happening for a prolonged period of time.

Retirement “catch-up” provisions allows dentists over 50 to set aside more income in pre-tax programs, and the proliferation of solo 401K plans allows dentists to sell their practices, contractually “workback” as an independent contractor to the new practice structure, and give the dentist more free time to enjoy life, while continuing to practice and share management responsibilities with younger dentists who desire the private practice model, but could use a little “on-the-job training,” eventually taking on a younger dentist with similar goals in the near future.

Today, most dentists approaching that age should be looking to partner with another dentist who has a similar philosophy of practice, especially if one of the offices is more “dated.” It should be noted that the business practice model of most dental service organizations (DSOs) call for at least two dentists working four-day weeks with extended hours, and covering the entire week, and sometimes including weekend hours.

Millennials and the new Generation Z coming of working age are more prone to “shopping” and have convenient hours as one of their prerequisites for selection of a dental office. A shared office space arrangement allows dentists to fulfill that desire, with minimum disruption, and allows them to offer the same convenience features as DSOs or large group practices.

Thankfully, it appears that most of Florida dentists fared well from this latest storm. The disruption to our practice lives disrupted patient care at least all that week and may have delayed some of the “snowbird migration” that we experience this time of the year.

Back at work, ask yourself these questions:

  1. Am I ready for the “go-go” years, regardless of what happens to my practice?
  2. Whom am I compatible with practice philosophy-wise in my area, and might we benefit from a joint location/dental practice, and a reduced cost of overhead?
  3. If my office was damaged, is the cost of rebuilding/repairing my space a good return on investment, given the amount of years I’m looking to practice in the future?
  4. Is it time to reexamine my financial strategic plan, and make some major changes? More boldly, is it time to downsize, and reduce the clutter and “stuff” we have accumulated?
  5. Are my contingency/practice succession plans up to date?

I’ve completed my term as ADA First Vice President, and it has been a privilege and honor serving our nation’s dentists and ensuring them clinical and financial success for the past two years. Be well.

Dr. Huot is a Fellow in the American College of Dentists, the International College of Dentists, the Academy of General Dentistry and the Pierre Fauchard Academy. He currently serves on the FDA Political Action Committee Board of Directors and served as ADA vice president for the past two years. He had a private practice from 1985-2008, still practices clinical dentistry and is the CEO of Beachside Dental Consultants, Inc., a practice management and health consultant firm. He can be contacted at drhuot@militarydentist.com.