Strategic Planning For Your Dental Practice After Hurricane Ian

By Dr. Richard Huot

In September 2004, the author was experiencing one of two hurricanes to hit his dental practice in a matter of three weeks.  His first article, “Prepared for the Worst,” appeared initially in the October 2004 issue of Dental Practice Report. After Hurricane Katrina hit the Gulf Coast and New Orleans, he wrote “Protecting Your Practice Against Disaster” in the November 2005 issue of Dental Economics.  This article is about what to do after the impossible:  a category 4 near 5 hurricane direct hit on your home and practice such as some dentists have just experienced recently with Ian.

The impact on the individual dental practices will be devastating, and some practices may be slow to recover, quite possibly never opening again due to businesses leaving the area.  Your preventive maintenance schedule will be thrown into disarray, and as “snowbirds” slowly return to Southwest Florida, those appointments may be skipped or postponed, as we have seen in COVID-19 and past hurricanes.  The survival tips below are intended to help my fellow dentists cope step-by-step as they slowly rebuild their lives.  The tips are based on the experiences we relied on, and passed on to our clients, to help us get through those tough times.

Take Care Of Your Family First

Our loved ones need to be reassured that there is hope, despite what appears to be the contrary. I can still remember my then 6-year-old looking at me very seriously and asking me if our home was destroyed.  As dentists, we provide a pretty affluent lifestyle to our children, and they need to be told honestly and gently that life as they know it will change quite drastically for them for at least the foreseeable future.  Initially, while the damage is too extensive to navigate back to your homes and offices, I would recommend that you concentrate on looking for a healthy diversion such as a “change of scenery” in another geographic location.  Some homeowners’ insurance policies cover meals, housing and other expenses while you are not capable of occupying your primary residence. You might even consider attending a continuing education meeting in that time frame!  Regardless of what you choose, I would encourage you to keep all of your receipts for food, travel and lodging until you can determine coverage, and stay away from dramatic news coverages to avoid focusing on events that you have no control over, at least for now.

Another option is to reactivate a license you may have in another state as a “backup” if you are looking at possibly being out of your office for anything more than a few weeks.  It would also be beneficial to look into the process of obtaining a license in another state if that particular state has a recognition program with another.  The process time varies from state to state, but licensure by credentials has been fast tracked since COVID, and many states are looking for practitioners in areas you may like or have visited in the past.  Most practice interruption insurances have deductibles or wait periods and have been hard to obtain since prior hurricane years, so finding employment in that extended time frame is certainly in order.

Take Care Of Your Staff Next

Hopefully, prior to the storm, you have given your staff a copy of all the telephone numbers (cell) and addresses of everyone.  This “phone tree” will be helpful to get an idea of where everyone is and, as owner, you need to reassure your staff members that you will lead them through these tough times.  Until each situation is assessed, I would not make any promises of employment or pay until the local municipalities tell you how they will deal with power and water issues, and you have time to estimate how long your practice will be inactive.  A liberal use of available personal time and vacation time is in order to pay your employees in the meantime, if they have accumulated that time for 2022 and prior years.  Your staff needs to know that you have empathy concerning their plight, but your financial health has to be secure in order for theirs to be.

In our case, my office manager was a volunteer first provider in the area, so I kept her salary going as she helped our community.  She was also able to provide me critical information and advised me when it was safe to come back.  She also kept the staff appraised and slowly had them report as work for them to do become available.  Once electricity is restored, the office manager can assist you in determining when it is appropriate to start scheduling patients and having staff back.  It is critical to instill in your staff that reestablishing a normal work schedule at the soonest time possible is key to the financial health of the practice.

Contact Your Dental Society For Help

The Florida Dental Association and its affiliate dental societies are doing a fantastic job in contacting all dentists affected.  Take a look at the FDAS “Storm Proof” guide for helpful hints after the hurricane hit, and how your practice can recover.  https://issuu.com/todaysfda/docs/hurricane_guide_2022

The American Dental Association has recovery materials that include methods for managing pay and leave issues following a hurricane, tips for accessing patient information during an emergency and links to guidance from the Occupational Safety and Health Administration.

Contact Your Local Bank Or Finance Company For Help

If you haven’t done so prior to the storm, you should have a business line of credit established with the institution where you deposit your earnings.  A good rule of thumb is 1.5 times your monthly overhead expenses.  That should allow you to pay most expenses prior to insurance coverage processing and give you financial piece of mind.

If you don’t have one already, a wireless laptop computer goes a long way in keeping you in touch with your community, and on the laptop, you should have all the vital information that keeps your practice running, along with an alternate power source.  Your accounts payable software should be loaded, to pay invoices from away, and keep track of the situation in Florida via the internet and email.

Make arrangements to retrieve your practice information from the cloud and, if necessary, install a new workstation/server so that information can be accessed by either you or your office manager if equipment was damaged in the office.

Contact Your Colleagues For Help

With the unprecedented number of hurricanes we experience in Florida, it is truly a pleasure to see how dentists “pitch in” and help their fellow colleagues.  We are small businesses and independent as a group, thus may be reluctant to ask for help.  Even after utilities are restored, it may make economic sense for two or more practices to merge, due to economies of scale and the permanent loss of patient base due to businesses relocating and financial hardship.  Even in affluent areas, going to the dentist will be way down the priority list for a good amount of time for all patients.  For any practice agreement of any large length of time, I would advise to get the “space sharing” arrangement in writing to avoid conflicts related to patients, expenses, etc.

For a dentist older than 50, it may make economic sense due to retirement plan rules to sell your practice to a younger practitioner.  Starting from “scratch” is a daunting task, capital intensive and may not necessarily the best financial choice at this stage of your practice life.  My advice would be to seek practice management consultants who have experience in this specialized area, and to identify practitioners in your immediate area who are potential candidates for merger, buyout, etc. 

Maintain A Positive Attitude!

After Hurricanes Frances and Jeanne in 2004, there were some days after we returned where it took everything to assume a normal life, especially since we evacuated once again in a matter of two weeks. Much of the same can be said for what it will feel like once you reach your community.  You can avoid “hurricane shell shock” by striving forward and attacking each hurdle one at a time.  Designate a fellow colleague or business acquaintance as a “wingman” and share your experiences with people who can help you get through this. Sometimes just having someone there with a different outlook or ability to spot a solution is all that is needed in the tough times ahead.

Dr. Richard Huot founded Beachside Dental Consultants, Inc. in 2004 and is a lecturer and author.  He served on the American Dental Association (ADA) ADPAC board from 2008-2012 and was Treasurer in his last year.  He was on the ADA Council of Government Affairs and is currently a member of the ADA Standards Committee for Dental Informatics (SCDI); he also serves as chair of the Council on Insurance and Retirement Plans (CMIRP).  Dr. Huot graduated from the College of Financial Planning in 1996 and is currently enrolled in the Chartered Financial Consultant program at the American College of Financial Services.

Hurricane Practice Prep

We’ve all seen the dramatic effect hurricanes can have, both the initial wind and rain and the floods and devastation that follow. There are steps you can take to stay safe and reduce damage to your property in the event of a storm.

BEFORE A HURRICANE

  • Install storm shutters.
  • Remove yard debris, such as dead tree limbs, that could become flying missiles.
  • Make sure your practice communication plan is in place and ready to be put into effect.
  • Make sure you and/or employees know how to shut off utilities, including water main.
  • Look through your emergency kit to ensure it is fully stocked and up to date with necessities for preparing your practice.
  • Back up computer records and store them at least 50 miles off-site.
  • Gather important papers to take with you if you must evacuate, including inventory lists and insurance information.

DURING A HURRICANE

  • Know your community’s evacuation plan and, if asked to evacuate, do so immediately.
  • Stay inside and away from windows, skylights and glass doors. Avoid elevators.
  • Avoid washed out and wet roads that can hide downed electrical lines or underlying currents that can carry your vehicle away.

AFTER A HURRICANE

  • Water is a major cause of damage after hurricanes. The longer your house is exposed to water, the more damage you’ll see to your roof, ceiling, walls and floors, as well as any personal belongings inside. After the storm has passed, it’s important to dry out anything water damaged.
  • Open windows and doors to allow air to circulate and speed up the drying process.
  • Clean up any broken glass and remove debris.
  • Board up broken windows and doors.
  • Cover roof damage with tarps or plywood.
  • Save receipts for any temporary repair expenses.
  • Move any wet items to a dry place.
  • If possible, place any damaged items in a safe, secure area where they can be inspected later.


Content provided by Safeco Insurance.

This article was originally published in FDA Services’ Hurricane Guide, “Storm Proof.” Be prepared for the 2021 hurricane season with articles about how to prepare, loss and damage, and making a claim. Visit fdaservices.com for more information.

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.

 

Storm Proof: 2019 Practice Readiness Guide

Hurricane season begins tomorrow and every Floridian knows it’s time to hope for the best, but prepare for the worst. This year’s updated issue will help you Storm Proof your practice with guides, resources and tools for any of your storm prep and post-storm problems.

Check it out at bit.ly/stormproof2019.

 

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