How to properly store physical HIPAA documents

From Medical Economics:

ME: If physical copies are converted to electronic records, can the physical copies then be destroyed?

Rangel: Yes, you can destroy the paper records after they’re scanned. Usually, after they’ve been reviewed for a certain amount of time, generally speaking, 30 to 60 days, once you can actually qualify that all of the material is properly scanned, that the quality is there and that it is the natural representative of what was scanned. Once you have that, you can destroy those records.

Source: How to properly store physical HIPAA documents

An interesting article worth the click.

The article brings up the old worry that exposing an open file in the office is a HIPAA violation. This is true and we should always strive to keep all patient information confidential. However what the HIPAA privacy rules are really concerned with digital data and the possibility of major data breaches. The occasional exposed chart is not what the law is all about.

Nevertheless there are important issues regarding paper files and we do need to be aware of them and practice good stewardship and respect our patients.


Selling hours

More wisdom from Seth Godin:

This might be the workplace question of the decade.

Does the boss buy your time or your productivity?

Source: Selling hours | Seth’s Blog

As always with Godin click through and read the whole thig. Very interesting and something that will definitely be an issue in the dental office of the future.

General Management Software

 The Dentrix Office Manager Blog

A GREAT resource for Dentrix Users.

Source:  The Dentrix Office Manager Blog

Digital Marketing Management Paperless

Communications in the 21st Century

E-mail58% of consumers start their online day by reading their emails. 

76% of dental patients say email is the best way for companies to communicate with them.


So the question is…are you using it? Or even better are you gathering patient e-mail addresses in order to use it?

Most Practice Management Systems like Dentrix have e-mail address as a field in the patient information field. Be sure you get it filled in. It has to be on your intake form, if you are still using the forms you had in 1999 you need to update.

All those existing patients who started with you last century and didn’t have an e-mail address need to provide it now. Make it part of your health history update. Ask for it and give the patient a good reason to provide it.

For example advise them that you will send e-appointment reminders rather than bother them with a phone call and most (76%) of patients will give it to you…but you have to ask. Another idea is to offer an incentive. For example: Dr. Digital has written a list of the five ways to save money on dental care. If you give us your e-mail we will send you a free copy.

Now that you have e-mail addresses how do you use them?

The best way is with e-services. Dentrix provides a good example of these services.

Appointment reminders are an obvious use for e-mail. However you can also use e-mail to direct patients to your web site to fill out forms.

NOTE: Online forms are not just for new patients, this is a great way to make sure all existing patients have up to date personal and medical information on file. And better yet it is on file in a digital format so you can eliminate those pesky paper charts.

E-mail is a great way to follow up with thank you notes, after treatment follow up including post op instructions, after treatment satisfaction surveys (which can lead to positive online user reviews), information on new treatments,  and acknowledging life events like birthdays and graduation.

Doing all this may seem daunting. After all you are too busy now how will you or the staff do all this extra stuff. That’s where e-services come in. For the most part e-services are automatic. You set it up once and then forget it. The service will send out reminders (or whatever) for ever after.

In addition to Dentrix some of my favorite e-services are:
Sesame Communications and Action Run,

Social Media? What about social media, isn’t that the 21st century way to communicate? Sadly no. Facebook is public and not appropriate for personal messages but even more significant is that Facebook filters your posts. Roughly only 6% of people who have chosen to “like” you on Facebook will see your posts.

General Paperless

“Good” Charting Software

dentrix screenGood charting software has many features. One of the most important is that it eliminates all paper. That means the software must accommodate all the bits of paper data that accumulate in a chart and it must have a method of importing virtually anything either with a scanner or file import function. If some bit of paper possibly a lab slip or patient letter must be stored in a folder then you have lost one of the primary benefits of an electronic chart.

Another important feature is full integration. That means that each item is entered one time and then transfers to where ever else it is needed electronically. For example a procedure will progress from diagnosis to charting to treatment planning to scheduling to treatment to insurance to payment. This is called single entry. If the user has to re-enter information such as procedure codes, tooth numbers or fees at any stage then the software is not fully integrated.

Good charting software must accommodate all the information we used to record on paper. That includes existing restorations, conditions, diagnostic findings, treatment plans, periodontal probings and tissue conditions, tooth surfaces, materials and procedure notes.

Charting software must be easy to use. Every mouse click or keystroke slows down the process and makes the program harder to use, which means it doesn’t get used. The more the user can customize the chart the easier it is to use. That means the user can create shortcuts, eliminate features they don’t use and designate functions for each button.

Data entry needs to be fast and easy. The standard is still mouse clicks and keystrokes however faster more intuitive entry methods are available. Like voice; we’d all like to talk to our computer just like Star Trek. Some charting programs allow users to speak in clinical findings like pocket depths, tooth conditions and restorations. Another alternative entry is touch, instead of clicking a mouse the user touches the screen. The latest is “Ink” a special function that allows users to write or draw on the chart just as if it was a piece of paper.

Digital Marketing Internet

SEO or SEM? What’s the Difference?


At the most basic level SEO (Search Engine Optimization) is the use of key words and other techniques to help get your website high in the “organic” results on Google. That was the big thing a few years ago when we first started to understand how the Internet and Google works. SEM (Search Engine Marketing) is the next step and uses paid ads PPC (Pay Per Click) and other techniques to get your site in front of potential customers.

Just like traditional marketing Internet marketing costs are determined by how large the market is and the potential return.

Dentists in a small town don’t need to spend much as they will show up on any search just because there aren’t a lot of dentists in town. All you need in a small town is a decent web site.

Dentists in a big city with thousands of dentists will need to spend big bucks to outbid the competition. In New York City a dentist is spending over $100,000 a year to stay on top. Is it worth it?

Mid-size towns of seventy-five thousand to several hundred thousand people and twenty to one hundred dentists seem to be the best fit for SEM. There are too many dentists in town for you to appear on page one by default yet the cost to get listed with SEO and SEM should be no more than $1,000 a month.

Beware of firms selling these services. I have seen and heard of dentists being taken advantage of by vendors who do not understand the dental business. Two of my favorites I am comfortable recommending are TNT Dental and Sesame Communications.

Digital Marketing Internet Management

A Great Website is Useless

A website is useless if it attracts prospective new patients who never make an appointment or accept recommended treatment.

Many dentists are spending considerable time and money on websites, SEO and social media to attract people to the office. But what happens when the patient calls?

If your office is getting calls but finding it hard to turn them into appointments or if you are wondering why your team is spending so much time on the phone answering questions instead of scheduling appointments, you may be wasting all the time and money you have spent to develop a great Internet presence.

Follow this link for some communication and phone skills taught by my friend  and fellow AADPA member Danny Bobrow of AIM Dental Marketing. Be sure to check out TAFI (The Art of First Impressions) a complete training and coaching system.




It is a tired old cliché that you never get a second chance at a first impression. That is certainly true. However there is another side to it we also need to consider. We do get multiple chances to blow it and make a bad impression!

Each of these encounters is a “first impression” of sorts. If the dentist or the staff fails at any step the new patient relationship will suffer or worse yet never get started in the first place.

  • Web Page
  • First Phone Call
  • Arrive at the Office
  • Meet the Dentist

Great technology can only take you so far. In the end, it is still our personal relationships that make the difference.

Digital Marketing Management

The Average Referral

Dentists are extremely dependent on powerful word of mouth referrals. Why should we expect anyone to refer us if we are just average? To be noticed we have to be noticeable; provide an experience that is not average.

Over time what was exceptional becomes average and expected. It isn’t good enough to be friendly, on time and accept insurance. Everybody does that!

Technology can be seen by patients as an exceptional above average practice feature. If the technology is exciting and the patient is invited to participate then they will be more likely to mention it to others. For example if a patient can fill out forms online before coming to a first appointment that is the type of experience they will remember and tell others about. If they are then given an opportunity to mention it on a social media platform they end up telling not just one friend but hundreds.

Dental Speaker Management Paperless

Pacific Dental Conference 2018

I will be presenting four sessions at the PDC in Vancouver March 8th and 9th

Paperless records are just the beginning; digital technology ultimately empowers dental team members with a more efficient – digital workflow – utilizing online communication and electronic services. Digital technology is revolutionizing every aspect of the dental practice; including how we communicate how make clinical decisions and how we manage the everyday flow of patients and staff in the office.

Source: Pacific Dental Conference 2018

Digital Marketing Internet Management

Website “Git er done”

Your dental practice website could make or lose you tens of thousands of dollars every year. What do you need to do to “git er done” when it comes to your website?

Obviously, you need to start with a professional and creative web developer. However even the best developers cannot create a web site without your help. They need to start with the basics, your address, phone number, logo and branding. Then they need professional photos of the doctors and staff. They need biographical information of every team member. They need a description of the practice, your philosophy and your areas of expertise. They need your financial options, credit cards, financing and insurance. They could also use videos, patient testimonials, before and after photos, services provided, special technology and more.

Your practice web page will only be as good as the information you provide the developer. If you choose to use DIY (do it yourself) team photos you take on the fly between patients or amateur videos you take with a phone, then your web site will look DIY and amateur.

According to my friends at TNT Dental it is this critical step that derails most dental web sites. The doctor and team have the best of intentions but the tyranny of day to day urgencies keep them from following up in a timely fashion.

The result is endless delays in creating the site, out of date photos and information, poor key word optimization and ultimately lost patients and income.

Tim and Tim, the founders of TNT (and the source of the Ts in the company name) have a two-step plan.

First, they send a professional video and photography team to your practice to create the needed videos and images. Second, (this is the best part) They invite the doctor and key team members to a three-day, high impact, creative retreat in Dallas to generate then fine tune the details. The retreat is like a working (tax deductible) vacation. You will spend some serious time developing your site including marketing, practice building, access to exclusive data, call listening, sharing of best practices and more, combined with free time for recreation and relaxation Think golf and spa. At the end of the retreat you will have everything you need for a world class dental website.

Of course, professional video teams and creative retreats cost more than DIY. However, Tim and Tim believe the fast turn around and quality result will quickly pay off with more satisfied patients.

If you are ashamed of your website, or worse yet do not even have a practice web site it is time to “git er done” and TNT can help.


Who is the Best Dentist?

Let’s try a thought experiment:

Imagine that you are a well-educated middle class adult American. You are looking for a dentist. You know nothing about dentistry except what you see on television or have experienced in the past. You have two dental offices to choose from Dr. Adams and Dr. Baker. Both are convenient and have been recommended by a friend.

Doctor Adams: sends you an e-mail welcome and allows you to fill out forms online before your appointment.

Doctor Baker: calls and leaves a reminder message and hands you a clip board when you arrive for your appointment.

Doctor Adams: takes digital photos and x-rays which the dentist shows you that instant on a large monitor to help you understand your dental condition.

Doctor Baker: does not take photos and takes film x-rays which the doctor looks at when they show up at the end of the appointment.

Doctor Adams: prepares a crown and delivers it that same day as you wait.

Doctor Baker: prepares a crown, takes an impression, places a temporary and has you return in a few weeks to have the crown delivered.

Based on these experiences which office would you believe to be “the better dentist”.

It would be nice if patients judged us by the quality of the dentistry we deliver. But of course patients have no way to judge the marginal integrity of a restoration or the cleanliness of a root surface. So they judge us on easily observed superficial factors

It is possible that Dr. Baker is a better dentist than Dr. Adams. It is possible, but the patient will never figure it out.

Here is the kicker. Most likely Dr. Adams is in fact a better dentist. Dentists who take the time to keep up with the latest technology and up to date procedures are almost by definition better dentists.

e-Services Management

Yes, Technology can Pay for Itself

Management Software

Dentrix Tip

Your dental office has several team members, and sometimes the same documents are unknowingly scanned more than once and stored in the Document Center. If you have duplicate files or have attached a document to the wrong person in the Document Center, it is okay to delete that document to reduce redundancy and save storage space

Source: Dentrix Tip Tuesdays

Lots of great tips for Dentrix users. I suggest you make the weekly tip part of your Tuesday morning meeting then do a monthly follow up to see if the team is using the tip and if it is working.

We all tend to stay in our comfortable rut and will continue to do things like we always have even if it is not the best way to handle the task. Change happens when we are pushed into trying something new and then are held accountable for the change.

Dental Speaker

The Hinman Dental Society

I will be presenting next year at the wonderful Hinman Meeting in Atlanta.

The High Tech Paperless Office 3/22/2018, 8:00 AM – 11:00 AM Speaker(s): Lawrence Emmott Keyword(s): CommunicationDental AssistingPractice ManagementTechnology Google Juice for Dentists 3/22/2018, 12:00 PM – 3:00 PM Speaker(s): Lawrence Emmott Keyword(s): CommunicationPractice ManagementSocial MediaTechnology Digital Workflow – Beyond Paperless 3/23/2018, 8:30 AM – 11:30 AM Speaker(s): Lawrence Emmott Keyword(s): CommunicationDigital DentistryPractice ManagementTechnology Google Juice for Dentists 3/

Source: The Hinman Dental Society



This is a very cool super easy to use tool from Dr. Bicuspid.

Get a free practice valuation when you answer a few quick questions.

Source: DrBicuspid-Snapshot™

It seems almost too easy. Just a few minutes answering basic questions most dentist know or can easily get from Dentrix and you have a valuation. The makers of the site do have a disclaimer including this, “This calculator is for illustrative purposes only and is not intended to provide advice or portray actual results” among other things. Nevertheless it seems to be fairly accurate, the goal is to be within 10-15% of actual practice value and is a great place to start. You can also plug in different numbers to see how the results might vary and from that make some future plans or set some future goals.

For example you can add a treatment room or change the percentage of PPO service you provide and see a change in your valuation.

One of the best features is that you can compare your results to national and regional averages.

The formula used in the estimator was developed in collaboration with John F. McDonnell of The McNor Group, providing a comprehensive range of services to dentist clients nationwide, specializing in dental practice sales and buyer representation.

Dental Speaker

Technology on the Rocks 2017



Stuff or Staff?

There are three possible outcomes when adding technology to the office; only one of which is good.

One: The office buys a new high tech system then throws team members at it with little or no training and no plan for implementation. This all too common approach almost always results in frustrated staff and wasted money.

Two: The dental office spends the money to buy a technology system then spends additional time and money training a staff person to use it. The staff person clings to the old way of doing things, fails to implement the system and blames the technology for the failure. She is the wrong person for the job and either quits or even worse stays in place like a roadblock preventing things from progressing. The result again is frustrated staff and wasted money.

Three: The dental office buys the system, sets up multiple training sessions, develops protocols to use it effectively and engages team members to use the system, learn and get better. The result is faster better service, decreased costs and happy staff.

The determining factor in our three outcomes is not the technology, the stuff. It is the people using it, the staff. How they are trained, how th

Dental Speaker Management Paperless

Digital Workflow – Beyond Paperless Free Webinar

Webinar October 12

The course is this coming Wednesday, you still have plenty of time to sign up.

Sponsored by Sesame Communications

October 12 2016 – 11:00 am PST

Paperless records are just the beginning; digital technology ultimately empowers dental team members with a more efficient – digital workflow – utilizing online communication and electronic services.

Source: Digital Workflow – Beyond Paperless | Dental Marketing & Practice Management| Sesame CommunicationsDental Marketing & Practice Management| Sesame Communications

Even if you cannot attend the live webinar sign up and you will be able to download the recording for later viewing.

Dental Speaker Paperless

Expert Business Strategies

From the ADA “Expert Business Strategies”



I contributed a chapter on Paperless Records. I am honored to be included along with Cathy Jameson, Rita Zamora, Roger Levin, Susan Gunn and others.

Order Here:


Starting at Perfect

Dental practiceThe expectation from any patient getting a filling, whether it is an indigent getting it free at a Medicaid clinic, a middle class salesman getting it at a typical office paid for by insurance or a well-to-do matron paying top dollar, in cash, at a Beverly Hills boutique practice, all those patients expect a perfect, defect free, functional filling.

There is a disconnect between price and quality. In fact price is not the right word; it is value. If most people do not see a difference in value from one dentist or clinic to the next but see all dentistry as being either perfectly acceptable or a complete failure then dentistry is no longer a valued personal service but a commodity. If dentistry is a commodity, that is one dentist or clinic is just as good as the next, then it is logical to shop for price. After all we will get a perfect filling from any of the options.

This kind of thinking is what allows third parties to control patients. If the service is always the same why not just go where my insurance plan tells me?

On the other hand patients do make value judgments about their dentist based on factors other than the quality of the filling. They judge us on how friendly we are, if we are on time and how up to date we are. The level of sophistication of your office technology and how proficient you are using it tells your patient you have more value. Doing a filling just tells them you are a dentist.

An attractive office in a nice neighborhood with modern technology has greater value to a patient than the quality of the filling, which is considered by default to be perfect. How much more value? How much more will people be willing to pay? If the insurance pays $100 and you charge $200 will the patient say to themselves “That’s OK that is the price I pay for a nice office with superior technology.”? Or is the patient more likely to say to themselves,”What a rip off the dentist is overcharging me.”?