Gifting Your Estate to Dentistry

We make a living by what we get; we make a life by what we give. -- Winston Churchill

A dentist donates $10,000 to his dental school and get his name on a chair in a lecture hall. For $5 million, the lecture hall will bear his name. And for $100 million, it will be renamed the Dr. Generous School of Dentistry.

Barney Neufeld, PhD, director of development for the University of the Pacific School of Dentistry calls this "donor recognition."

"It’s important for each generation of students to know that their school didn’t just happen, every piece of it was built through gifts. Their turn will come, but they need to know it," Neufeld said.

Dentistry has been a wise career choice for many. After years of laboring in the profession that helps others, dentists start wondering how they can continue that spirit of helping, even if it is after their death.

Many people have a will spelling out how their estate is to be distributed, but John Koch, planned giving consultant with the Planned Giving Office, working with CDA Foundation, says a will is only a start. He said each person should also ask themselves four questions about their assets:

1. Where should they go?

2. Who can they help?

3. How can they make a difference?

4. What kind of legacy can I leave?

Although the "whys" are as individual as snowflakes, estate giving to family and charities is thought of less today as a "dying thing." There’s no joy in hoarding more money than one will ever be able to use while loved ones are struggling.

Instead, dentists are choosing to assist children and relatives during significant stages in their lives when it will make the most difference -- college, first home, business -- instead of at their passing.

Neufeld suggests that dentists teach their children and grandchildren, by words and deeds, that philanthropy is a family value. They should be told that they will receive their inheritance during the dentist’s lifetime, instead of at his or her death.

Dentists can tell family members, "I want to be around to see you enjoy my gifts to you when you most need them. What’s left when I die, dentistry gets because it has brought me and the family so much."

"Making gifts while you’re alive is more fun," Neufeld said. "Plus, if you wait until you’re dead, your kid might be 75 year old. Your son is then a retiree so when he gets the $1 million, it isn’t going to be, ‘Woo-hoo, let’s party!’"

The same holds true for gifts to charity. Often overlooked is the joy that comes in sharing in the mission and successful outreach of one’s favorite charities while still alive.

An alternative to lifetime gifts to charity are testamentary gifts or bequests, which may be worded in many ways. Here are a few examples:

* Specific -- "I give to ABC (Foundation or Dental School) $______."

* Percentage -- "I give to ABC ____ percent of my estate."

* Contingent -- "I give to______ (a named noncharitable beneficiary) $____, but if he or she shall not be living, then I give the same to ABC."

* Residuary -- "All the rest, residue, and remainder of the estate, both real and personal, of whatever kind and wherever situated, which I may own or have the right to dispose of at the time of my death, I give to ABC.

"People don’t give because of tax advantages, but ..." Neufeld said, leaving unsaid that the tax deductions are a big bonus, lessening the amount given to Uncle Sam. By leveraging tax-wise the power of lifetime gifts (made while living instead of at death), the dentist can keep more money. "For example, naming the CDA Foundation or your dental school as the owner and beneficiary of a life insurance policy that you no longer really need anyway will generate a current income tax deduction for you roughly equal to the cash surrender of that policy," Koch said.

A few examples of tax-advantaged giving:

Life Estate. A dentist can make a current gift of his or her home or vacation home to the charity, but the dentist reserves the right to live in it for the rest of his or her life. The dentist gets a generous current income tax deduction, and the charity can profit from the sale of the home upon the dentist’s death.

Charitable Remainder Trust. This life income gift enables dentists to give highly appreciated assets, such as stock or real estate, to a tax-exempt trust and receive a generous income tax deduction. The trust can sell the asset without paying capital gains tax on the sale. Neufeld explained that proceeds are typically reinvested for growth and income, and the donors (for example, a husband and wife) receive a lifetime income stream from the trust. After their deaths, the trust’s remainder passes to the chosen charity.

How to Look into Setting up A Gift

Dentists should contact the director of their dental school’s development program or their favorite dental association’s foundation (typically in charge of philanthropic gifts) to set up an appointment to meet. Of course, after talking over the options, the dentist should seek independent tax and legal counsel prior to implementing any estate or charitable tax planning strategy.

For questions, Neufeld can be reached at bneufeld@sf.uop.edu; Koch can be reached at thePGO@attbi.com. Questions regarding CDA Foundation should be directed to Jon Roth, Executive Director, CDA Foundation, at jonr@cda.org.

Dental Access Day to Debut in 2003

A one-day event aimed at promoting access to dental care for needy children will be a centerpiece of next year’s National Children’s Dental Health Month in February.

ADA members across the country will be asked to volunteer to provide dental screenings and care for underserved children on a designated access day.

The program has been given the genial working title of "Give Kids A Smile." The date of the event and other details are still being worked out.

The ADA Board of Trustees endorsed the access day concept as a way to spotlight the dental care needs of indigent children and organized dentistry's role in helping meet those needs.

The event is expected to involve organized dentistry’s local, state and national levels.

"We’ll be communicating with societies about existing access activities, because I know many of you have such programs in place," James Bramson, DDS, ADA executive director, told state and local dental leaders in a written message shortly after the Board meeting.

"Ideally," he added, "we’d like to have a national umbrella program that would deliver value to your own programs by getting them more attention. We’re also talking to industry about tapping into some of their access programs."

In a follow-up message, Bramson told tripartite leaders that the association’s goal "will be to help existing programs as needed, spur new programs and enable individual dental practices to participate."

Author Finds Upside to Having a Toothache

Dentures or a Toothache? That’s no excuse for not eating well, according to Jim Moran. In his new book, Cuisine Après Dentist: All About Cooking, Eating, Laughing, and Helping Yourself After You’ve Been to the Dentist (Rutledge Books, Inc., $12.95), Moran provides readers with tips ranging from "how to fill a tummy after filling a tooth" to making the most of precious after-dentist time.

His humorous compendium of tips and recipes for people who have toothaches, dentures, or other chewing problems includes instructions for making Smashed Potatoes in Nine Flavors (including salmon, broccoli, and cheddar cheese), Indian Pudding, Red Flannel Hash, Eight Soft Turkey Croquettes and more.

Moran has devoted more than 20 years to the improvement of food quality. From McDonald’s hamburgers to Hershey candy bars, from Hawaiian sugar to Taiwanese rice, his objective has been to make food better and safer for the consumer. Holder of six U.S., Canadian, and European patents on food inspection systems, he was chosen to receive the Outstanding Achievement Award in the field of engineering in 1981 from his alma mater, Rutgers University.

Views in Research Papers Often Do Not Represent All Authors

Research papers rarely represent the full range of opinions of all those scientists whose work it claims to report, according to an article in the June 5 issue of the Journal of the American Medical Association, a theme issue on peer review.

Richard Horton, editor of The Lancet, London, conducted a study to determine whether the views expressed in a research paper are accurate representations of contributors' opinions about the research being reported. The study included a sampling of 10 research articles published in The Lancet during 2000, with qualitative analysis of answers to six questions about the meaning of the study put to contributors who were listed on the byline of these articles. Fifty-four contributors listed on the bylines of the 10 articles were evaluated, and answers to questions were compared between contributors within research groups and against the published research report.

The author found: "A total of 36 (67 percent) of 54 contributors replied to this survey. Important weaknesses were often admitted on direct questioning but were not included in the published article. Contributors frequently disagreed about the importance of their findings, implications, and directions for future research. I could find no effort to study systematically past evidence relating to the investigators’ own findings in either survey responses or the published article. Overall, the diversity of contributor opinion was commonly excluded from the published report. I found that discussion sections were haphazardly organized and did not deal systematically with important questions about the study."

"I have found evidence of censored criticism; obscured views about the meaning of research findings; incomplete, confused, and sometimes biased assessment of the implications of a study; and frequent failure to indicate directions for future research," the author writes. "Some papers have more complete evaluations of findings than others. What was striking was the inconsistency in published evaluations, especially regarding weaknesses."

"The results reported herein indicate that more careful organization of the discussion section of a research paper might provide the framework for not only a fairer and more accurate representation of contributors' views, but also a more complete analysis of the data being presented," the author concludes. "Editors might also explore ways to recover the plurality of contributors’ opinions."

Reflux Disease Increases Children’s Risk of Tooth Erosion
Children who frequently vomit after eating and suffer heartburn symptoms may be at risk of tooth erosion, according to a recent study reported by Reuters.

Researchers found that children with gastroesophageal reflux disease -- the general term for the back-up of stomach contents into the esophagus -- were more likely than others to have lost some of the enamel covering their teeth.

The findings indicate that children with dental erosion should be evaluated for gastroesophageal reflux disease. And children who have already been diagnosed with reflux should have regular dental exams to check for erosion, according to the report in the Journal of Pediatrics.

Dr. Ahmed Dahshan from Oklahoma University in Tulsa and colleagues explained that gastroesophageal reflux is common in infancy and childhood and can increase the risk of bleeding, anemia and inflammation of the esophagus. To investigate whether the condition was associated with dental erosion, investigators examined 24 patients with reflux aged from 2 to 18.

Erosion of at least some enamel was noted in 20 patients or roughly 83 percent, and affected the posterior teeth. Half of the patients had mild erosion and one quarter had severe erosion of the enamel, the researchers found.

Employing Quality Staff Is Best Investment for Practices

Of all management areas, outstanding staff management is the most important in building a successful practice, said Jennifer de St. Georges in the spring issue of New Dentist.

When dentists mishandle human resource responsibilities, this causes untold stress, high financial costs and, in today’s climate of litigation, a good chance of expensive lawsuits, she said.

She said that current research shows that today’s dentist has been, is, or will be embezzled. The embezzler, de St. Georges notes, is usually the most trusted employee, with the average theft being $80,000. The primary task should be to surround oneself with the best quality staff, she said.

In a general practice, dentists contain staff costs to about 33-35 percent, she said. Although the financial figures may be a good guideline for managing a practice, de St. Georges said dentists need to look beyond the figures to see the long-term financial benefit of hiring quality staff.

She recommends hiring the most experienced clinical staff that money and the marketplace will allow. For administrative staff, she recommends that well-established practices hire nondental staff. According to de St. Georges, the most clinically trained staff does not thrive in the administrative arena.
She cites five areas outside dentistry which provide outstanding dental administrative staff:

• Banks
• Airlines
• Restaurants
• Travel agencies
• Hotels

According to de St. Georges, people from these five areas of business have high levels of customer service training and experience. These employees have strong communication skills and can handle people.

For new practices, de St. Georges recommends hiring the most experienced and usually most expensive employee available. New dentists, she writes, lack management expertise. A good professional can single-handedly grow a practice in weeks and months to a level that could take years with lower-quality front desk employees.

Collections Depend on Solid Financial Policy

Dental practices lose one-fifth of what patients owe if they don’t pay at the time of treatment, according to Sally McKenzie, CMC, in the April issue of Today's FDA, journal of the Florida Dental Association.

McKenzie notes the cost of staff time spent on billing and collections, printing costs, postage, the cost of aging receivables, and the expense of noncollectible debts total at least 20 percent.

Dentists must have a firm financial policy that includes payment options that work for the practice and for the patients. Payment for products and services shouldn't surprise anyone, she notes, and it won’t if there is a written policy. She stresses that the dentist and the staff must make sure patients know the policy and must enforce it.

Although payment arrangements should be based on what’s comfortable for the practice and the patients, she recommends establishing a structured series of payments that patients make as treatment progresses.

According to McKenzie, the most successful practices have an arrangement with a dental financing company. Instead of expending credit to a patient who can pay only $25 or $50 a month on a $1,000 balance, she says to consider letting a financing company assume the liability and pay the dentist at the time of treatment.

McKenzie said an alliance with a financing company frees the dentist from the task of determining who’s a credit risk and what terms would be most appropriate for their risk level. And, she said, it keeps money from affecting the doctor/patient bond.

She said the best way to ensure payment is to have patients co-plan and co-own treatment. If dentists organize treatment plans by urgency or potential discomfort, McKenzie says it is simple to get patients to understand the need for treatment.

When a dentists has established need and the patient considers payment affordable, treatment-plan acceptance should be "a slam-dunk," she wrote.

Upcoming Meetings

2002

Aug. 16-23 Fun in the Sun, Costa Rica, (818) 716-1791, www.estheticprofessionals.com.

Sept. 25-28 Academy of Periodontology’s 8th Annual Meeting, New Orleans, www.perio.org.

Sept. 26-28 American Society for Dental Aesthetics, 26th International Conference on Aesthetic Dentistry, Las Vegas, (813) 264-2772, www.asdatoday.com.

Sept. 27-29 CDA Scientific Session, San Francisco, (916) 443-3382, Ext. 4470.

Oct. 11-13 National Association of Filipino Dentists in America Annual Meeting, San Francisco, (818) 988-3910.

Oct. 19-23 ADA Annual Session, New Orleans, (312) 440-2500.

Nov. 3-9 United States Dental Tennis Association Annual Meeting, Palm Desert, Calif., (800) 445-2524.

Nov. 6-9, American College of Prothodontists’ Annual Session, Orlando, (312) 573-1260

Nov. 7-9, Excellence in Dentistry, Las Vegas, (800) 337-8467.

To have a meeting included on this list, please send the information to Upcoming Meetings, CDA Journal, P.O. Box 13749, Sacramento, CA 95853 or fax the information to (916) 443-2943.