As I’ve been giving presentations about business systems to dentists, I’ve discovered that there are six prevalent myths surrounding 401k retirement plans. In Parts 1 and 2 of this series, I hope to help dentists who are also small business owners develop a better understanding of what is possible.

Myth 4: It’s Possible for a 401(k) Plan to Be Free

The reality is that a 401(k) plan is never free. Equitable, for example, has a specific retirement plan for dentists. They claim to have a plan with no direct costs for dentists. What they do is take a part of the participants’ total investment to cover the costs. In most cases, the person paying the highest percentage of the fee is the dentist because the dentist puts the largest amount into the fund. As a dental practice owner, I don’t want the costs to come from my account. Instead, I want my business to cover the costs because the fees are tax deductible for the business and my retirement funds accumulate to their greatest potential.

When someone is marketing a free plan, be aware that there is no free plan and the costs are going to come out of your account, just as much or more as any participant’s account in the plan and those costs are not going to be tax deductible on personal taxes. In the case of Equitable, about 20% of your earnings are being siphoned off for fees and this has a significant drag on your net accumulation.

Myth 5: Being a 401(k) Fiduciary Is Risky

The first responsibility of being a plan sponsor is that you have the fiduciary responsibility. No one else can assume that responsibility. I believe you can meet your fiduciary responsibilities rather simply by doing the following.

The 6 Fiduciary Responsibilities Are to:

1. Meet financial investment responsibilities.
2. Meeting administrative responsibilities.
3. Pay only reasonable expenses from plan assets.
4. Deposit employee contributions timely.
5. Maintain adequate ERISA fidelity bond coverage.
6. Select and monitor 401(k) service providers.

You do need to maintain fidelity bond coverage, and $50,000 to $100,000 of bond coverage costs $200 to $300 per year. I do not think this is expensive and I think it is not difficult to fulfill your fiduciary responsibilities.

Myth 6: Switching to a Low Cost 401(k) Provider Is Difficult

An existing 401(k) plan cannot be simply terminated and then you start a new one. You must go through the following four steps, but this is easy to do.

The 4 Steps in the Conversion Process Are:

1. Asset transfer
2. Document preparation
3. Investment selection
4. Participant enrollment

Here are two examples of vetted companies that I believe provide low-cost plans with robust features. The first is 401Go.com. It provides advisor-led retirement plans for small businesses. This company is very easy to work with, has payroll integration, and you can set convert your plan quickly.

The second company is EmployeeFiduciary.com. This company has incredibly low establishment and conversion fees—some of the lowest in the industry. With Employee Fiduciary, you have access to 30,000 share classes and 377 fund families. These include low-cost options like Vanguard, Fidelity, and Schwab index and exchange-traded funds. You can also elect to include a self-directed brokerage account from TD Ameritrade, which allows you to invest in any fund on the market.

I hope this instills some curiosity in understanding your existing 401(k) plan. Examine your fees and your options if you were to convert your plan. I encourage you to do this because fees can significantly drag down your investment accumulation over time.

If you are interested in taking a deeper dive into financial freedom, I highly encourage you to sign up for Mastering Business Essentials. This course is the blueprint for running a dental practice with long-term growth.

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

Myth 1: Fees for 401k Plans Are Similar

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

Myth 2: Setting Up a 401k Plan Is Difficult

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

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

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

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

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

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

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

Related Resources:

• Dispelling Myths Associated with 401k Retirement Plan Fees – Restorative Nation
• (14) Pankey Webinar: Essential Business Systems for Every Dental Practice – YouTube

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

In my dental practice, we often use mounted models for diagnostics and restorative treatment planning. Three years ago, we began 3D printing these models.

One of the benefits of printed models is their higher durability compared to stone models. Also, long term, we do not need to save the printed models because we have the digital models saved in the patient’s file. But the greatest benefit has been the efficiency gained in mounting models on articulators. As a result, we have decreased our overhead and increased our mix of services.

What made this mounting efficiency possible is software called “Blue Sky Plan” from Blue Sky Bio. Blue Sky Plan is advanced dental treatment planning software used for milling and printing dental products. One of its applications is printing surgical implant guides, but it has many dental and medical applications for anatomical modeling, surface editing, and offsetting. It allows for CT scan importation and analysis, and export to STL format for 3D printing.

When dental models are printed, the interior can be hollow with a waffle pattern on the back that makes articulator mounting super easy. The process is as simple as opening the software, going to editing, importing your scan, and then selecting a hollow model with the waffle base. To print the waffle base on the model, you need to scan the entire pallet.

When I think of the small things my practice does on an everyday basis that have a big impact on patient relationships, patient satisfaction, and case acceptance, the first thing that comes to mind is what we call check-in and debrief.

Early in my practice years, way back when I was practicing corporate dentistry, when I walked into the operatory, the patient already had topical in place and my job was to get them numb. There wasn’t much of an opportunity to have a conversation. Over time, I learned the concept of check-in and debrief, which is really about how you can use the time at the beginning and end of the appointment to influence the relationship you have with the patient.

These are ideal times to build value for what the patient has agreed to do at that appointment and to tie the goals of the patient to the value of the treatment the patient is receiving, or you hope the patient will accept.

Usually, the check-in and debrief each take about two minutes. My assistants participate in this process with me, so they have increased understanding as well.

Previous Conversations Inform Me

I can be mindful and successful with my conversations if previous conversations with the patient were documented. My assistants take notes for me during my conversations with patients. I need to know:

• What is important to them,
• What they are hoping for, and
• What could get in the way of accomplishing what they believe is best for themselves?

My Check-in Conversation

During the check-in, I aim to converse about what we have planned to do and how this fits the overall goals of the patient. Usually, I enter the room and there is a little chit-chat. Then I ask, “What is your understanding of what we are going to do today?” The response helps me gauge the patient’s awareness. Following this conversation, I may ask, “What is your understanding of how this is part of your long-term health plan?” Or, if the patient has a stated a good understanding of what we are going to do, I say, “Yes, and this is how it fits into your long-term goals for your teeth.” They should now have a good sense of why the appointment time is of benefit to them.

My Debrief Conversation

During the end-of-the-appointment conversation, I aim to thank the patient for being cooperative, talk about what they can expect as a result of today’s appointment, and what they can expect as we move towards their preferred future. No matter what happened during the appointment, I want my patients to hear how much we appreciate them being our patients and being there today. When we talk about what to expect from today’s appointment, we can go over any post-op instructions, which are also presented in written form. Lastly, I want to give them hope that we are accomplishing steps on the road to their preferred future and that we can get there with their continued cooperation. I want to see the rays of hope register on their faces.

I believe all of this is of high value to the patient personally and in building value for the practice. It is well worth the time, and for me, it is a standard part of every patient visit.

White and brown spot lesions on the anterior teeth can be very distressing for the patient and a frustration for clinicians. Normally, they are decalcification or deposits on the teeth from fluoride or other minerals.

They do not require restoration. We are hesitant to do this and sacrifice good tooth structure, but esthetically they can really bother patients. They reduce a patient’s confidence in their smile. Recently, I have found a solution to this clinical situation that meets both the patient’s esthetic demands and my desire to be conservative.

Reversing Lesion Color on Anterior Teeth

Icon, from DMG America, is a translucent resin infiltrate that reverses the color of the lesion. It brings the tooth back to its natural color, requires no tooth preparation, and protects the tooth from further decalcification or progression into a carious lesion.

After we isolate with a rubber dam, the tooth is etched with a special etchant included in the kit. The protocol requires a longer etching time then we are accustomed to with other procedures.

After each etching procedure, we rinse and dry the tooth. Then we apply a special drying agent that allows us to evaluate the final result prior to proceeding with the resin.

If the tooth color has not yet been optimized, the etchant is applied again. This can be repeated up to five times. Once we have completed the etching process and confirmed the result with the drying agent, the resin is applied and then cured.

The entire procedure is done without any anesthesia and is very comfortable for the patient. Icon can be used on the facial and also on interproximal areas.

The resin is not visible on an x-ray, so the kit comes with a card to give the patient. This is so that if they see another dental office in the future, they are aware that the interproximal areas will still appear decalcified on an x-ray but have been fully infiltrated with resin.

I really enjoy offering this incredible, conservative esthetic service to my patients.

(Link to Getting Team embers to ‘Pull On the Rope’ Part 1)

Questions That Will Improve Team Engagement

Employees in a dental practice need to feel valued on multiple levels to do their best work.

In Part 1 of this series, I discussed the importance of team engagement and how it affects a business’ success. Below, I dive into the fundamental needs that can change your team’s satisfaction with their day-to-day employment.

Understanding the 4 Team Needs That Will Change Your Practice

Wagner and Harter’s 12 elements from “12: The Elements of Great Managing” are divided into four categories based on the concept of a triangle and Maslow’s Hierarchy of needs. The first two have to do with basic needs, the next four with individual. If those are met, the next four have to do with teamwork and the final elements are related to growth.

Basic Needs

Example: The first element that must have ‘yes’ as an answer is, ‘I know what is expected of me at work.’

This is the most important category. When people know what’s expected of them, their basic needs are met and it’s easier to move on to their individual needs.

Individual Needs

Example: Element four is, ‘In the last 7 days, I have received praise for doing good work.’

This is about recognition for team members that do good work. You must make sure they’re in an environment where that type of response is supported.

Teamwork Needs

The next need is teamwork. I find it interesting that Gallup asks about best friends. Certainly something I see with my own team is that when team members are actively engaged in relationships with each other, they come to work engaged because of those friendships. They don’t call in sick because they want to spend time with their friends at work.

Another example: Element seven is, ‘At work, my opinion seems to count.’

I’m a fantastic micromanager and I always think I have the best ideas. The more I’ve given up on that, the more I’ve noticed my team members are happier with what they’re doing.

Growth Needs

And lastly, growth.

Example: The final element is, ‘In the last year, I have had opportunities to learn and grow.’

Employees need to feel challenged in their tasks, not bored or stuck in stasis.

My encouragement is to look through the Gallup Q12 Index questions and consider whether you have had similar conversations with your team members individually. Ultimately, if your team members can respond affirmatively to these questions in your practice, then I’m sure you will discover that they are ‘pulling on the rope.’

How do you help your employees have a more fulfilling work experience? Please leave your thoughts in the comments!

3 Types of Team Members Who Make or Break Success

Keeping team members engaged throughout the year is a struggle if you don’t have a communication-based framework in place.

During a recent course I received many questions about how I get my team members engaged. This left me reflecting on lessons I’ve learned over the years from research by the Gallup organization.

Read on to learn what causes disengagement and how you can avoid the downfalls of a disgruntled team in your practice.

The 3 Types of Team Members

In the book, “12: The Elements of Great Managing,” Rodd Wagner and James K. Harter use research from Gallup to describe the three types of team members that exist in corporate America. I believe these types are applicable to dentistry as well:

1. Engaged: They have the magical ingredient of passion.
2. Not Engaged: Pretty much checked out. They put in time but there’s no energy in their work.
3. Actively Disengaged: They’re not only unhappy, they actually undermine what engaged team members try to accomplish.

How Engagement Determines Business Success

What the authors found is that the ratio of engaged to actively disengaged employees is quite different in highly productive corporations versus average corporate America.

Engaged team members in average corporate America were 30% versus 63% in highly productive organizations. Similarly, not engaged was 29% in the highly productive versus 50% in the average. Most shockingly, the actively disengaged employees were more than twice as high in the average corporate office: 8% versus 20%.

This had me thinking of the analogy of a 10 person bicycle. Three people are pedaling really hard at the front. Five people have their hands on the handlebars but their feet are up in the air and they’re not pedaling. Then there are two people way in the back who are actively holding onto the break. This either means a stalling ride or one that could be much faster if everyone were like the first three.

The 12 questions in the book and their corresponding need categories are useful for sussing out what matters most to promote engagement. They show us what can we do about low morale in our dental offices.

Look for Part 2 of this blog series next week where I’ll outline the four team needs that will change your practice.

What do you do when you notice team members are disengaged? Comment below with your thoughts!

(Link to Getting Team Members to ‘Pull On the Rope’ Part 2)