How the ADA's Response to the COVID-19 Pandemic Helped Dentists

Today's Guest Dr. Daniel J. Klemmedson American Dental Association www.ada.org 885-PPO-GAIN membership@ada.org

 

The Transcript

Art Wiederman, CPA And hello, everyone, and welcome to a very, very special edition of the Art of Dental Finance and Management with Art Wiederman, CPA. I'm your host, Art Wiederman, and we're bringing this podcast to you today. We're recording on Wednesday, February 10th, we're date stamping these because of all the new stuff that's going on with all of the Paycheck Protection Program, the Employee Retention Tax Credit and everything else we've got going on.

But today is very, very special for me. You might recall about three or four months ago, we interviewed Dr. Kathleen O'Loughlin, who is the executive director of the American Dental Association. Well, today it is my honor and privilege to speak to Dr. Daniel J. Klemmedson, who is the president of the American Dental Association. He is an oral surgeon out of Tucson, Arizona. And we're going to get into what's going on in dentistry, the ADA's response to the COVID-19 pandemic and where ADA is going in the future.

And that's going to come from a practicing, highly skilled specialist. And it's going to be a wonderful conversation, which we'll get to in just a moment. I just want to give you a little bit of information. Number one, if you are interested in our webinar series, The Business of Dentistry, actually tonight, if you will, actually, this will be recorded on the 17th. You'll be able to get it on online. If you're interested in our webinar series, go ahead and go to www.EideBailly.com/dentalseries and you'll be able to register for all those series.

In addition to that, we are going to be doing a special one on March 10th on the Paycheck Protection Program and the Employee Retention Tax Credit. Do go to our partner Decisions in Dentistry magazine. Amazing, amazing clinical content and advisory boards, second to none with great continuing education courses. And also you can get you can see our podcasts on there. That's at www.DecisionsinDentistry.com.

And folks, with everything that's going on, if you are not working with a member of the Academy of Dental CPAs, we are 24 member firms across the United States representing over 10,000 dentists. I am the Southern California member. I'm a dental director at the CPA firm of Eide Bailly. Please go to our website, www.ADCPA.org.

Let me give you just a couple of quick updates and things that you need to be remembering. This is again, going to get published on the 17th of February because of the fact that the Congress passed the bill on December the twenty seventh, the coronavirus stimulus bill of 2021. It now allows doctors who had a greater than 50 percent reduction in revenues, most likely in the second quarter of 2020 to go back and claim not only full forgiveness on your PPP round one loan, but also to claim up to a five thousand dollars per Employee Retention Tax Credit.

And we're waiting for guidance from the government, but we believe that this could put tens of thousands of dollars in your pocket. And again, on March 10th, I'm going to be doing a webinar on that. And if you want to register, go to our Eide Bailly website or just email me. So our recommendation to everybody is do not file for SBA forgiveness for your round one until these rules come out and we see if you're eligible. Also, remember that you're going to have to go ahead and apply, not apply, but you're going to have to go into the HHS Provider Relief Fund portal, go ahead and register. They're not ready to take your information yet, but go ahead and register. And we're hoping that they're going to give us a date sometime, probably March 15th or April 15th, that you'll have to report your lost revenues and also your PPE and all those expenses to justify the money that you got.

OK, anyway, with that said, I would like to bring on my guest, Dr. Daniel J. Klemmedson, who is the president of the American Dental Association. Dr. Klemmedson is a graduate of the USC School of Dentistry 1980, he has been in organized dentistry for a long, long time. He was the president of the Arizona Dental Society, and he's been involved on the ADA board of Delegates for over 10 years and he is now the president. So Dr. Klemmedson, who is actually a full time practicing oral surgeon and president of ADA. Welcome to the Art of Dental Finance and Management.

Dr. Daniel J. Klemmedson Well, thank you very much, Art, it is a pleasure.

Art Wiederman, CPA Well, thank you for taking your valuable time. First of all, do you ever sleep? That's the first question I have for you.

Dr. Daniel J. Klemmedson I sleep less than I would like to, but I've always been a pretty hard worker and I get up every morning at 4:00 and work out for an hour or get to the office by 6:00, generally home by 6:00 and during the day I may have four or five Zoom calls and then try to do reading before I get so tired, I just hit the pillow.

Art Wiederman, CPA Oh, that is absolutely remarkable. But again, thank you for your contribution to the dental profession. Everything ADA's doing, which we'll be talking about on this call. Let's start out why don't you kinda give us a little bit of your background and your history I shared a little bit, but why don't you tell our listeners about your journey?

Dr. Daniel J. Klemmedson Well, I grew up in the West as I followed my father around, as he got his advanced degrees and ultimately ended up in Tucson, Arizona, where he was a professor in the College of Renewable Natural Resources. But I spent a lot of time in the dental office and I don't know the reason why, but I tell a lot of my patients I either had to be a dentist or marry a dentist. I had so many issues. And in 1976, we were unfortunate, unfortunately we did not have the percentage of women dentists that we have now. And I might have made a different decision now, but I'm happily married to a former schoolteacher who ended up as a vice president of our teaching hospital in Tucson. So I've done well.

After dental school, I did microsurgery training. Then I went back to medical school and then my wife asked me if I liked what I do. And I said yes. And she please she said, asked me if I would please get a job. And so I you know, that wasn't quite that bad. But relative to dollars and cents, it still was a lot. So I came back to Tucson and was fortunate enough to join an oral surgery practice. Both of my partners had been involved in organized oral surgery. And so they got me involved really pretty quick. And so I got involved at the dental level and at the oral surgery level.

And I got asked to serve as a delegate to the House of Delegates. I got asked to serve on a couple of councils. I was actually on the Council on Dental Benefit Programs in the 2007 area and I was on a strategic planning committee. And so you get into organized dentistry at that level and you realize that there's a whole lot of stuff that goes on that's very important outside of an individual's practice. And so when you go back to your practice, you work real hard and you realize that thank God somebody was doing something on the national level to keep me out of a few problems at the local level.

And I became a trustee and. Usually one of the four senior trustees runs for president, usually a couple do, and I stepped forward and everybody else stepped back. And so I was I actually ran unopposed, which was nice and allowed me to kind of concentrate on doing the right things for our members. And other than this crazy pandemic that happened, I enjoyed the big philosophical issues that we have to deal with.

Art Wiederman, CPA Well, and we're going to talk about what ADA's response has been to the pandemic and where ADA is going with this. But why don't you share with our audience, Dr. Klemmedson, what does a president of the American Dental Association do? What are your job duties and responsibilities? And maybe a little background on ADA in itself? I know they have a lot of people that work at ADA.

Dr. Daniel J. Klemmedson Well, the ADA has well, total employees is close to four hundred, I believe, at this point in time. Nice 22 floor building on East Chicago Avenue, just off Michigan Avenue. A beautiful place.

Art Wiederman, CPA I've been there. It is beautiful. Yes.

Dr. Daniel J. Klemmedson There's a board of trustees of seventeen, one from each of the districts. And to be honest, once you become president, you don't have nearly as much power as if you were a trustee. The president is essentially the representative of the ADA in any interactions with civic groups, government entities, businesses and other professional organizations. So I'm kind of a spokesperson and I have to make sure I'm always saying the right things. And I know ADA policy inside and out and just work to support the reputation of the ADA and all the good things we do.

I also take the role seriously in that I have to kind of constantly be surveying the environment so I can kind of envision or see some of the issues coming down the pike because we live in the present, but we really need to think for the future. And so I try to bring some of those perspectives to the board where we have to make a lot of decisions. The other area where a lot of decision making gets done at the ADA is through councils and councils are actually committees of the House of Delegates. And so the House of Delegates selects these House committees. They have issues that are important to all members in a variety of subjects and that that gets fed up to the board of trustees.

Art Wiederman, CPA So you're a busy guy. So I know that the ADA has four congressional lobbyists. So you're not really going to talk to people on Capitol Hill. You're talking to maybe like the president of the American Medical Association and other groups like that and sharing all of your concerns. And again, I will tell you folks, and I promise this is not a paid commercial for the ADA. I have learned more about the ADA in the last 10 months because I didn't have a ton of interaction with the ADA.

But what this organization has done for the one hundred and sixty three thousand member dentists is unbelievable that I want to share a story as we get into kinda the pandemic, doctor. I actually ended up having to have a root canal a couple of weeks ago and then, you know, the tooth needed a crown. I got the crown yesterday and my dentist, who's a wonderful doctor in South Orange County in Mission Viejo, California. He and I, we talk dentistry all the time because he knows what I do. And I said to him, I said, well, jeez, you know, tomorrow I got a real treat. I'm interviewing the president of the American Dental Association. Here's what he said.

He said, I want you to tell him what a wonderful job ADA has done and how we, and not only me, but all my colleagues here in South Orange County, because we have study clubs that we're in, have been able to get through this with all the resources. And he mentioned specifically the ADA tool, the reopening tool kit that you guys put out. And he said, please tell the ADA president what a wonderful job that they've done. And that's, he said, I don't know where our practice would have been without the ADA.

So with that and again, I did not I didn't make that up. That's exactly what he said to me yesterday. So what's it been looking like? I mean, your presidency is in the middle of a pandemic, doctor. Not exactly your first choice. But tell me kind of what your life has been like as president, how this pandemic has affected everything?

Dr. Daniel J. Klemmedson Well, typically, the president well, I, actually as president elect and as president, you do a lot of traveling. You get invited to multiple states, all the constituents, all the big meetings, some of the scientific meetings, and so you spend a lot of time traveling. If you go back about three years and ask Joe Crowley about his year as president, he tells everybody, I spent thirty seven days in my own bedroom. And so it's a busy, busy year. I have a beautiful office on the 22nd floor overlooking Michigan Avenue that I haven't seen since February of last year. 

Art Wiederman, CPA Right.

Dr. Daniel J. Klemmedson But, you know, the problems in dentistry that practitioners have, that the public have, that are patient have still goes on and we still need to solve those problems. We just have adapted and find other ways to get those things accomplished. When the pandemic hit, to be honest, when it really kind of escalated up, I was at the American Student Dental Association meeting in St. Louis and we could just see what was coming down the pike. Within the next day, some of the dental schools were closing down and that's pretty much when we went absolutely into overdrive.

The ADA sent all of its employees to work from home. They had to create all kinds of IT solutions. We ramped up the web page. We developed task forces that produced all of the information. We thought long and hard about whether or not we should pause or recommend only emergency care. But we felt because of the unknown nature of this pandemic, it was important for us to understand the science and take a look at how we could best one, protect our patients, protect our staff and protect honestly, protect our ability to make a living on the other end of this thing.

And so we worked real hard, as you know, because you mentioned our lobbyists. We have a Washington lobby group that is absolutely phenomenal. And with all of these COVID packages, they were on the Hill. They were making changes. We knew when dentistry wasn't being taken seriously, we weren't included in a lot of the original emergency protection items for PPE and stuff like that.

And then when all these complicated funding mechanisms came down, that's when our lobbyists and Mike Graham called on you guys actually. Saying, hey, can you explain this and put this into easy language so that we could understand it? That was probably the hardest thing for us to do, believe it or not, is we don't understand it as well as you do. So we have to reach out to the experts who can help us. Go through that complicated process.

Art Wiederman, CPA Well, I agree, I will tell you, Dr. Klemmedson, Mike Graham, Megan Mortimer, David Lynn, I don't know your other two lobbyists. Those are the ones I've had interaction with. Megan and I are, we talk a lot. Our president, Alan Schiff, has done webinars for the American Dental Association. He's had over 10,000 people on it. We've been doing everything we can. We have a joint fact sheet about the Paycheck Protection Program. I'm sure we have more coming up. And in fact, we've got more coming up with all the new changes in the round two. The government has certainly come through to help the dentists with, you know, with everything.

But, yeah, I mean, the relationship that the ADA and the Academy of Dental CPAs has had has been amazing. And you've got a great, great team here. So, you know, you guys have done a lot. A lot. What have your members been saying to you? What are their biggest concerns? Obviously, making a living and keeping their practices going. But, you talked to, you know, hundreds, thousands of dentists on webinars. What are your members saying about what your response has been? What's the feedback been?

Dr. Daniel J. Klemmedson I think that the vast majority have been very happy with our response. When, and actually, if you ask Mike Graham, Mike Graham would send out emails so that we could get messages sent to our legislators regarding a lot of these COVID packages. And his team actually got messages from some of these legislators basically saying, stop with the dentists, they're sending us too much stuff. We understand. The volume of emails and messaging and communication that went to legislators office increased, I don't know, five, 10, 15 fold over previous issues that have come up in the past. And that's what shows really the value of mass action and communication of an organization. As an individual dentist, I couldn't get any of this accomplished. But when I get ten thousand of my favorite friends or 50,000 of my favorite friends to all email the head of the Finance Committee on Capitol Hill, we can get some action done.

Art Wiederman, CPA Well, I'll tell you, the good news is that the message got out from the from the ADA, from all the state components. I know here in California, the CDA are from our Academy of Dental CPAs and all the webinars that you guys the ADA did a lot of our dentists, a lot of your members got these PPP loans. They were able to get some EIDL loans. They've also been able to apply for the Department of Health and Human Services Provider Relief Fund.

So fortunately, I told people early on, Dr. Klemmedson, build a war chest, because we don't know how long this is going to last and we don't know what it's going to look like. Now obviously, after I mean, you know, March 16th will be, believe it or not, one year since this really started. And but a lot of our doctors, fortunately, have been able to do that. A lot of them have come back, you know, a lot. So that's good news.

So also, another thing I wanted to talk to you about is dental safety. I know you've been passionate about that. You know, even before the pandemic and with the House of Delegates, I guess there was a three year initiative addressing safety and dental practices that was passed in 2019. I have those priorities changed? Have you amplified them? I mean, talk about safety. Obviously, that's been the number one concern, I would think.

Dr. Daniel J. Klemmedson Well, that's still going on. And the safety culture of safety issue actually began several years before the pandemic. And medicine tackled this about twenty years ago. I have a medical degree as well. And so I practice in the hospital and in the hospital their protocols are a little bit different than the protocols in dentistry. And dentistry is inherently safe and probably safer than medicine just because of the kind of more focused nature of the stuff we do. But that doesn't mean we can't do better.

You know, we certainly occasionally have some anesthetic issues and we have other issues that are critically important for us to, I tell people we need to raise the bar. You know, there's a lot of people out there that want to do what we want to do and if we want to keep our patients safe and keep our profession safe, we got to keep raising the bar as we have the opportunity to do so. And so COVID allowed us to do a lot of things that the safety committee has actually been looking for.

Take a look at screening your patients better, look at your medical history better, evaluate what is the most appropriate procedure. And so there's lots of simple things. Make your facility better, maximize your PPE. Look at all these little tiny things which all add up to create increased safety. And so this is going to go on. This is going to be a project that's going to take years, but we need to learn from each other. I may have an individual problem in my office if I don't tell somebody about it or it's not reported somewhere in an anonymous fashion, nobody ever hears about it. And so as an individual, I need to help my profession get better at what we do. And so that will continue to go forward.

Art Wiederman, CPA You know, and we were chatting a little bit before we turn the record button on today, I guess there have been studies that have come out. One was out of Qatar that said that people who have periodontal disease are more likely to end up in intensive care, to end up on ventilators. And one of the studies said that there was like nine times more likely to pass away from COVID-19 if they had periodontal disease if they didn't. I mean, this is a really important message that dentists need to deliver to their patients. ADA, I'm sure, is helping the doctors with that messaging, too, I would think.

Dr. Daniel J. Klemmedson Yes. And the relationship of oral health care and oral diseases, periodontal and others has long been recognized as being related to OK and complementary to and can exacerbate many other medical problems. And COVID in particular is known to be much more severe in patients who have comorbidities. Well, the inflammatory response that's related to periodontal disease is just one of those comorbidities that can affect the way an immune system responds to a more generalized infection.

And I talk to my physician friends about this particular disease process and I say, have you ever seen anything like this? And most of them haven't. And there have probably been 20 to 30 thousand scientific articles at this point about a disease that literally began only a year ago. So we will continue to evolve and continue to find out what we need to do, how we need to do it, how we need to mitigate it, and we have to just kind of keep the ball rolling.

I think this will be something that will go on for some time. I'm hoping that the downslope we're seeing right now is not the calm before another storm, but we need to prepare either way to make sure that we get completely out of this before we relax. We're clearly fortunate because we've been able to return to relative productive practice much sooner than other some other aspects of the industry like restaurants.

Art Wiederman, CPA Oh, my goodness. Yeah, I mean, the dental profession has been very, very fortunate in how they've come back. Most of my clients, after they reopened in May and June, were there was a lot of pent up demand and 100, 120 percent that backed off a little bit. But again, you know, the I think that the messaging and we were talking to our clients as CPAs, the ADCPA was about how the total health, a dentist has to be concerned with someone's total health and what a as horrible, horrible, horrible as this thing has been, Dr. Klemmedson, what a great opportunity for your members to message this to their patients and say, listen, this virus is not going away. We may have a vaccine, but it's not going away. And another reason why to keep your mouth clean and why to have good periodontal health. I mean, my goodness, that's just it's great messaging.

So, you know, I want to touch on it, but I so much I wanna talk to you about. You know, you've talked about access to dental care sometimes might be an economic challenge. We see what this pandemic has done to the to the middle class of America and some of the folks that we're not as fortunate. And it's brought these issues to the surface, necessary dental care in communities. I know that you guys have a program. It's called Give Kids a Smile in communities. How is ADA helping to bring dentistry to the underserved communities?

Dr. Daniel J. Klemmedson Well, the ADA for many years has been involved on a number of fronts, give kids a smile is really just one part of a program that kind of brings attention to the absolute need of many underserved individuals. This year, one of our counsels, the Council on Advocacy and Access for Prevention, has a huge project involving Medicaid.

We have a situation where we can serve most kids because kids are covered under CHIP in the ACA. But once you become an adult, there is no adult Medicaid in many states. And so we're trying to solve that particular problem, even though it's difficult and there are 50 different states. We're trying to look for some uniformity. We're trying to improve reimbursement. We're trying to improve the problems associated with some audits. But at some level, if we can take care of the underserved, clearly they become more educated. And one of these days on their own, they're going to seek out dental care rather than having to get it.

Another thing that's equally important from an economic standpoint, this nowadays is a lot of people lost their jobs and so they've lost some of their dental benefits as well. And so our entire industry is probably hurt at all levels, whether you have no insurance, the best insurance or you're independently wealthy. That's always bothered me that no matter what your status, probably 40 percent of the population doesn't see their dentist in a given year. And if there was some way we could figure out to reach even 50 percent of that group, we would have to open our doors on Saturdays and Sundays.

Art Wiederman, CPA Yeah, that is an issue that I have in 36 years of being a dental CPA that I have never understood is and some of it may be cost. Some of it may be just quite frankly, if I guess Dr. Klemmedson, if it doesn't hurt, there's nothing wrong, right?

Dr. Daniel J. Klemmedson Well, there are many people that think that. Yes. And. You know, what a dentist considers obvious and valuable is not always what a patient does, and so sometimes it's just a matter of we need to figure out how better to communicate with those people and make access available. And, you know, when a patient wants something, they're going to go after it. You know, if we could figure out a way to make dental care as attractive as an iPhone, again, wouldn't that be wonderful?

Art Wiederman, CPA Maybe you guys can partner up with Apple and put your heads together? I don't know. Maybe. But. So what do you think priority should be for the dental practices going forward then I want to talk about kind of what ADA's got in store for 2021. But what do you think dentists should be thinking about their big priority for 2021 as their small business owners navigating the pandemic?

Dr. Daniel J. Klemmedson Well, I think that we have to understand that this pandemic is going to stretch out a little bit longer. And so we need to be very thoughtful about managing our resources. We are being squeezed by increased costs for some of our supplies, even though it's interesting, even though we're in the middle of this pandemic, some third party payers are still putting downward pressure on reimbursement. We have to figure out how to create that balance, maintain our patient volume, maintain our ability to get workforce, which is becoming a little bit more of a problem now following the pandemic and you know, kind of get through this tough time. I do think there's still a lot of patients who aren't coming back and when they come back, the dental disease hasn't gone away. And so we need to figure out a way to get them in and get them done and make sure that we have the successful business by doing so.

Art Wiederman, CPA I think some encouraging, you know, conversation you and I could have is I mean, you remember back to 2008, Doctor, when we had this massive economic downturn. I've read a lot about this and people don't realize how close we came to 1929. I mean, it was very close. I had clients calling me back then saying, you know, Art, should I put my money out of the bank. I had two in one day that was really scary.

But what we found and what I told them and I'm sure what you were telling, you know, you're talking to your colleagues about is the fact that back then, you know, people didn't have money to come to the dentist, but dentistry doesn't get better on its own, just like you and I, just like you said. And we found that the doctors after 2009, 2010, 2011, 2012, were banner years because all this demand, the people that were not coming in and all this dentistry that was going bad and all this disease and everything, I mean, we could be seeing some of that.

I think the statistics you have Marko Budisic I think I said his name. I practiced his name a bunch. I finally I think I have it down. I've listened to his webinars on the statistics of the pandemic and all the statistics point to that you know, 15, 20 percent of patients just will not. Not only will they not come to a dental office, they won't go out of the house. And when they start coming back, that's going to be helpful too. 

So what do you think as far as going for what is ADA got in store for 2021. I mean, we're at the knock wood hopefully at the back end of this pandemic. What kind of programs are you guys working on now that you've got 10, 11 months of experience under your belt with this pandemic?

Well, for the most part, relative to the pandemic, we are really trying to keep patients safe, keep doctors safe. And we are pushing as hard as we can on this vaccination effort. We have three pillars get vaccinated ourselves and give vaccinations if we can. And there's now about 21 states where dentists are being allowed to give vaccinations. We still have a supply problem. And then the last pillar is to encourage our patients to get vaccinated. If unless these new variants create a huge problem, the ability to get herd immunity is probably the thing that is most likely to get us to a point where patients will start feeling comfortable coming back in to see us.

And so from a COVID standpoint, you know, that's what we're trying to do. Beyond COVID, though, all the problems and all the issues that we have to deal with are still there. We still have third party issues. And so we have to have a program called FIITF. It's called Fight Insurance Interference Task Force. And they help individual states with third party issues in their legislatures. And it started out with about six states last year, with 17 states this year we have 31 states that are all being actively supported. And so the third party issue, that third party people and us, we kind of are in a big tug of war. They push, we pull, they push, they pull, they build a better mousetrap. We try to build a better mousetrap.

That's the nature of the game. And we have to keep fighting that because it's still third party issues are still the number one concern of all of our members. And so we will continue to do that. We're developing a registry which one of these days will be phenomenally important because it allows us to gather the data relative to utilization. If we can get diagnostic codes, we can analyze outcomes so that we have the big data, so that we can provide the kind of information that others, you know, why does Facebook and Google do so well? Because they have the big data. They can monetize the big data, they can prove their points. And that's what we need to do. And so we're working real hard on that as well.

Art Wiederman, CPA Well, we and again, the third party payer is a big challenge. I see it on my end working with CPA, with our CPA clients. Our dentist clients are ADCPA members see that also. And that some of the reimbursements, you know, you can't make a profit. I mean, you can't make a profit in a dental practice when you're getting 40, 50, 60 percent of your UCR fees because you don't get to go to your employees. Oh, by the way, we're only getting paid 40 percent, I can only pay you 40 percent of your salary doesn't work that way. You're in business, Doctor, you know that. And but again, you know, the insurance companies are the eight thousand pound gorilla.

And I think as a combination of education to the patients, I mean, we all know that dental insurance doesn't cover a whole heck of a lot. I mean, it covers a thousand or fifteen hundred dollars. Maybe indemnity insurance is a dinosaur. So we know all of this. And also what ADA is doing, you know, on Capitol Hill and at the state level, which is important.

And that brings me to something else I want to talk to you about. I want to talk about encouraging younger dentists to get involved in organized dentistry. I know I've talked to lots of people in the profession about that, but what kind of we've got a lot of young dentists that listen to this podcast. And I know that because they email me and they call me, I'd like to maybe give them a message about the benefits of being involved in organized dentistry and what they can do to help their profession.

Dr. Daniel J. Klemmedson The best way to help our profession, it won’t be a member in to get involved locally. What the ADA does for me and the reason why I pay my dues and always have, I belong to probably 10 different organizations, including the American Medical Association. They have enough mass and strength and knowledge and people in that group who know how to get things done that I don't have to do it, they can do the things I can't do as an individual. OK, I can't write bills. I can't go every week and talk to the people on Capitol Hill. Mike Graham, you can call up Senator McConnell and probably meet him for lunch. He can get stuff done that we can't do. It's kind of like having insurance. We every year we pay, we pay our car insurance. And then when the car breaks, it's fixed. OK, for us, it's insurance. They I'm paying them to maintain my ability to practice.

And that's really what we do. We may sometimes we don't win big things, but we certainly prevent a lot of losses. This year we had a great win, McCarran, Ferguson, that was a phenomenal win. That limited antitrust exemption that the health care insurers had is now gone. Now, whether that creates an immediate or something that you can recognize in your personal practice, perhaps not, but additional pressures that get put on the big third party payers by the Department of Justice will change them very subtly. It will encourage other people to get into the market. If you have more competition, potentially prices come down and benefits go up. And so this was a huge win for us.

Art Wiederman, CPA Yeah. And again, young people who it's like going out to vote. You just say, well, gee, I'm just one vote. My vote doesn't make a difference. Yes, it does. Your involvement doctors in your local, state and national organization does. I wish you could see what the ADA is doing in their building in Chicago and all over the country and what these folks are doing.

I've had it I've had the experience working with Megan Mortimer and Mike Graham, you know, firsthand, and how they fight. And, you know, Megan will be on my podcast. She's in Washington. She'll come on at 9:00, 10:00 at night. She'll email me at all hours. I mean, they're working tirelessly to try and help.

But we need the younger generation to the 27, 30, 35 year old doctors who are just getting started. We need them to come and follow up with your legacy and all the people because, you know, at some point your well, you may never retire. I mean, you said you have an oral surgery practice, you're president the ADA and you're member of what'd you say ten organizations? You probably don't play golf three days a week, do you?

Dr. Daniel J. Klemmedson No I don't play golf. But you bring up, with young people, you bring up a good point. And if there's if there's one issue that I think needs to be changed at the ADA or the ADA could get better if we had more young people actively involved. And the reason is I'm I am within sight of retirement. I could coast to the end. But I always tell the members of our new dentists committee in the younger early career dentists that are involved. I said, you guys are the future, you have to be thinking about and designing what dentistry is going to look like 10 and 12 years from now.

Old guys like me don't you know, I'm a pretty good thinker, but some of us don't think that far out and that's absolutely critical if we're going to advance the profession of dentistry and graduates have the ability to have a successful practice like I did.

Art Wiederman, CPA Exactly. Exactly. Couple more things I want to chat with you about. I know that I had a chance to meet your former your predecessor, Dr. Gehani, and he was doing a lot of work in the area of the ADA's digital presence. And I you know what you've been trying to continue. So what kind of digital work is ADA doing to, you know, with everything else going on? I know that they're doing a lot of stuff in that area.

Dr. Daniel J. Klemmedson Well, it's certainly going on and it's going on over the course of about three years. But clearly, the IT infrastructure at the ADA needs to get ahead of the ball game just like all industries has to. And so we need to be able to do that so that we can communicate seamlessly with all the younger people who text everything, Instagram everything. We need to get that information out. And clearly, in terms of how our profession will improve in the future, the interaction with high tech type stuff is going to be phenomenal. And the listen AI is going to influence us as well. And so we're just trying to stay up with the Joneses on that.

Art Wiederman, CPA Oh, yeah. And again, like I said, I was in my dentist's office and I experienced firsthand how a digital scanner works. And I asked the doctor to explain to me, you know, how does this work? And he showed the technology. I remember, I tell this, I've told this story once or twice on the podcast. The first interoperable camera that ever came out in dentistry came out in 1989. It was debuted at the California Dental Association convention. I was lecturing there and it was manufactured by Fuji. And it was the size of your office, probably maybe bigger. And it was 42,000 dollars back in 1989. I mean you look at it today, a digital, I mean an interoral camera is a little something that you hold between your two fingers and it's a couple of thousand dollars and but the digital scanning and again, especially what you do as an oral surgeon with CBCT and everything, I mean, how is the technology just as being a dentist, an oral surgeon, how is that affected dentistry?

Dr. Daniel J. Klemmedson Well, it makes, one it does make us safer. We can see things we could only envision before. We can take that data and we can pretreatment plan. We can do real time implant placement, looking at a screen and now there's robotic or partial robotics that can be used for items like that. And so it's all so phenomenal. And that's all on the macroscopic level. If you look at some of the new dental materials, they'll make dental materials in the future that can repair themselves. They'll be able to decide whether or not the PH is going up. They will be able to tell if caries is going on. There'll be all sorts of things that will just amaze us.

Art Wiederman, CPA I mean, the technology is unbelievable. Something else I want to talk to you about, and this has been an unfortunate effect, probably not only for dentists, but for lots of people. Is dentists handling the emotional impacts and stress during this time? I know that one of our local dental executive directors I work with, most of them in Southern California, sent me some information that the you know, over 50 percent of dentists are having issues sleeping. And just what's going to happen in my practice. Is ADA, I'm sure you are aware of that, obviously. Is it is there something that you, some advice you can give something ADA, some tools or resources that you guys might have to help our doctors during this unprecedented time?

Dr. Daniel J. Klemmedson There are some resources on the ADA website, the Council on Dental Practices, a subcommittee on wellness, and they developed there have been some webinars and podcasts on that. And so it is it's clearly an issue because we're all small businessmen and women. We have worries. We have staff we have to take care of. We have patients. When you worry a lot constantly over the course of ten months and you have to wear a mask and you can't interact, it's natural. But, you know, we have there's lots of resources at the ADA.

Art Wiederman, CPA And I know also that one of the things ADA did was I think FEMA now recognizes the dental profession, I think the number four most critical of the health care professions, how is PPE? I know that was a huge, huge challenge at the beginning of the pandemic. I think that's gotten better. Is ADA still working towards getting, making it easier for dentists to get their hands on?

Dr. Daniel J. Klemmedson It's dramatically better than it was, but that's because production has gone up. Originally, it was a huge problem because we weren't included with the physicians and other frontline workers, but we had that remedied relatively quick. Supply chain issues were a huge problem and everything was going to the front line workers in the hospitals at that point in time. We were able to distribute something like I'd say five to 10 million masks and a number of gowns as well.

We just finished our last distribution to nonprofit health care centers just last week. The problem now is that the cost of PPE has gone up. And so that is a dramatic issue that's affecting us all.

Art Wiederman, CPA Yeah, and the problem is if you're contracted with a third party payer, you can't call them up and say, oh, by the way, insurance company, my costs went up. I need to. No, no, no. Unfortunately, insurance companies have two objectives. Collect as much money from the people that are insuring as possible and pay as little as possible to the providers. Well, Dr. Klemmedson, I will tell you, you are, thank you so much for taking this really valuable time of yours to talk to our audience.

Do you have any anything else that you might want to share with our audience as far as anything ADA is doing in the future? Any advice you might give to members and any closing thoughts that you might have?

Dr. Daniel J. Klemmedson Well, I would just say that the dental profession, the ADA has been around for 160 years and I'm kind of a history buff. And so I've gone back and read a lot of this stuff and some of the original transcripts. The problems that we seem to, that are new today, have always been problems. We've always had issues with licensure. We've always had issues with people's ability to pay. We've always had issues with some of the science. But, you know, dental disease is still a problem. We still need to take care of the public. We have a social contract with them. If we treat the public right, they'll treat us right and we will have a very good and profitable profession.

Art Wiederman, CPA And, you know, it's interesting. When I have a doctor that retires, I will sit down with that doctor and someone buys their practice and I will tell them, I say, Doctor, I want you to think about and this is what I've been harping to all of you is folks, you are not just fixing people's teeth. You are about a better life, a better relationship, a better self-esteem. How many lives have you saved? If you've been a doctor. Dr. Klemmedson, you've been 30, 35, 40 years as a practitioner. I mean, how many lives have you saved? How many have you made better? I mean, this is what you guys, your wonderful men and women do, which is why I've been thrilled to devote my professional career to the dental profession.

And if we remember, this is a call, I think this is a call to action, this pandemic, for the dental profession. It's a call to action to say, listen, you know, these statistics that they're showing that, you know, we've got to get rid of your periodontal disease. We've got to make sure that your mouth is healthy. This is where the disease starts. And if you do that and God forbid you get this horrible virus, whatever strain it is, you've got a much better shot at it. And so I want to encourage all of you to think that way.

I want to encourage all of you to get involved in your local dental society and your state, your component group. I think we have 32 of them in California. The CDA is wonderful. You know, just look at the ADA's website with all the stuff. I mean, that kit you guys put out early on, I mean, I can't tell you how many comments I got about it. Like I said, my dentist. But, you know, if you're not a member of ADA, you need to become a member of ADA and just get involved. Because, folks, if you don't work on your profession, nobody else is going to do it because although I think Dr. Klemmedson might work, go until maybe you're one hundred and twenty or something? I don't know.

Dr. Daniel J. Klemmedson I'm just a temp. I'm just a temp. I got about eight more months and then there's going to be another temp coming along. But we need, we need people to fill the pipeline. And if we don't do it, nobody else is.

Art Wiederman, CPA Well, I do hope, Dr. Klemmedson that before your, I think your term is up in October or November, correct? Yeah. So I hope before your term is up that you get to get on an airplane and go to meetings and see some people and do the job. I know that you've spent many years, you know, getting ready for and, you know, God bless you and all the and Megan and Michael and all the people at ADA and everybody who helps the dentists, because it's been, it has been a very, very, very challenging time. So if you could I'm going to kind of wrap this up here. If you could stay on as I take us out and we'll chat a little bit afterwards.

So, folks, thank you for the honor and privilege of your time. Great information from Dr. Klemmedson. You are well represented at the ADA building in Chicago and in Washington, D.C., and the ADA's fighting for you every single day, because I see it, I'm involved in it, we've helped at the ADCPA. So if you want to get a hold of me, folks at my office in Tustin, California, my number is 657.279.3243. My email address is awiederman@EideBailly.com. Go on to Decisions in Dentistry magazine that's DecisionsinDentistry.com for all the great resources that they have. And again, if you need help with all of this alphabet soup, the PPP, the ERTC, the HHS, ESPN, HBO, Cinemax, whatever you need, we're here for you at the Academy of Dental CPAs. 24 CPA firms that represent over 10,000 dentists. Again, Eide Bailly is one of them. We work with about 800 dentists in our firm. Go to www.ADCPA.org.

Dr. Daniel Klemmedson, thank you so much for taking your time and visiting with us today. I'm sure your insight and what ADA is doing is so valuable to all the dentists out there. Well with that folks, that is going to be it for this edition of the Art of Dental Finance and Management with Art Wiederman, CPA. Again, please go to our website and register for our courses on March 10th. I'm going to be talking about the interaction between the Paycheck Protection Program and the Employee Retention Tax Credit, which could put more money, tens of thousands of dollars in your pocket based on how the government shows us what the rules are.

But for, with that said, this is Art Wiederman for the Art of Dental Finance and Management with Art Wiederman, CPA signing off. Have a wonderful day and we'll see you next time. Bye bye.