New Law Requiring Eye Exams for Missouri Children

Optometry Backs New Law Requiring Eye Exams for Missouri Children

With the support of the Missouri Optometric Association, Gov. Matt Blunt today signed Senate Bill 16 into law, requiring comprehensive eye examinations for children entering kindergarten or first grade in Missouri public schools. Local doctors of optometry and the bill’s sponsors, Sen. Delbert Scott (R-Lowry City) and Rep. David Pearce (R-Warrensburg), met with Jefferson City teachers and students in the governor’s office to support this important new law.

“Clear and comfortable vision is essential for learning, and this new law will help Missouri children succeed and reach their full potential,” Gov. Blunt said. “In its first year alone, we expect that this measure will help more than 136,000 children read and see chalkboards more clearly. All Missouri children deserve the tools they need to fulfill their potential, and our students will benefit from this law.”

The new law also requires vision screenings for students beginning first and third grades. Students identified as needing further care will be required to see an eye doctor for a comprehensive exam. The law takes effect July 1, 2008, requiring eye exams for students starting school in the fall.

“Eye exams are still the best way to diagnose eye and vision problems in children early, before they interfere with a child’s ability to learn,” said Thomas Greene, O.D., president of the Missouri Optometric Association (MOA). “The MOA is proud to support true leaders like Gov. Blunt, Sen. Scott and Rep. Pearce in the effort to make children’s vision and classroom learning a top priority.”

Missouri joins Kentucky as the second state in the nation requiring eye exams for children entering public schools. In a survey conducted following the enactment of the Kentucky mandatory children’s eye exam law, 14 percent of the more than 5,000 children entering the school system in 2000 needed corrective lenses, and hundreds of children were diagnosed with eye diseases.

“Vision disorders are considered the fourth most common disability in the United States, though many vision problems in children are preventable or treatable if caught early on,” said C. Thomas Crooks, III, O.D., president of the American Optometric Association, a St. Louis based organization representing more than 34,000 members. “With nearly 25 percent of school-age children suffering from vision problems, this law is necessary to help treat and prevent diseases that can cause vision loss.”

Ten million children suffer from vision disorders, according to the National Parent Teacher Association. Nationally, about 86 percent of children entering first grade do not receive an eye exam. Comprehensive eye exams for children entering school are critical for the early intervention needed to treat diseases and disorders such as amblyopia (“lazy eye”), strabismus, retinoblastoma and other serious and potentially blinding problems that can lead to poor school performance that can ultimately affect quality of life.

Approximately 70 percent of children are insured for comprehensive eye exams through private insurance, Medicaid, S-CHIP or other state or federal programs. Optometrists, ophthalmologists and local charitable organizations have provided ongoing assistance for families in need.

SOURCE: PR Newswire

Expanding Eye and Vision Care in Medically Underserved Areas

Legislation to Expand Access to Eye and Vision Care in Medically Underserved Areas

The American Optometric Association, the voice of 34,000 frontline providers of eye and vision care in communities across America, declared its support for legislation introduced in Congress by Reps. Bart Gordon (D-Tenn.) and Joe Pitts (R-Pa.) aimed at expanding access to eye and vision care in medically underserved communities across america.

Reps. Gordon and Pitts, leaders in Congress on health care access issues, introduced HR 1884, the “National Health Service Corps Improvement Act of 2007.” The bill seeks to build on a successful federal incentive program to develop new links between highly qualified doctors of optometry and communities in rural and urban areas with limited access to eye and vision care services.

“The exclusion of optometrists from the NHSC student loan program has resulted in severely restricted access to primary eye care services,” Rep. Gordon said.

Rep. Pitts agreed, saying, “This legislation corrects this error and ensures that families already struggling with spiraling health care costs can see a local eye doctor when they need to.”

The NHSC provides access to quality health care services for millions of Americans who might otherwise be forced to do without. As part of this mission, the NHSC student loan repayment program helps bring together dedicated health care providers with the rural and urban community health centers that need their services.

The program provides financial support specifically aimed at easing the debt burden associated with a professional education, and allows carefully selected clinicians — including primary care physicians, nurse practitioners, dentists, mental and behavioral health professionals, physician assistants, certified nurse-midwives and dental hygienists — to undertake an extraordinary, multi-year commitment to safeguarding public health.

“Reps. Bart Gordon and Joe Pitts are committed to ensuring that Americans in medically underserved areas, including our seniors, veterans and children, are able to get the eye and vision care services they need and deserve,” said C. Tommy Crooks, O.D., president of the AOA. “Optometrists across the country are proud of Rep. Gordon’s and Rep. Pitts’ strong leadership on health care access issues, and are ready to meet the challenge to get care where it is needed most.”

Since the NHSC student loan repayment program was restructured in 2002, it has been made far less effective by the exclusion of doctors of optometry, the nation’s frontline providers of eye and vision care. Today, only about 17 percent of community health centers have an optometrist on staff, which severely restricts access to primary eye care services, including comprehensive eye exams; detecting and diagnosing eye diseases like glaucoma, cataracts, retinal disorders and eye infections; treating eye diseases and evaluating and treating presbyopia and other vision conditions.

“Including optometry students in the National Health Service Corps Program will help expand the public’s access to preventive eye care services in underserved areas while offering students needed scholarships and loan repayment opportunities at a time of rising student debt,” said Dr. Hector Santiago, president of the Association of Schools and Colleges of Optometry.

In addition to backing from the AOA, HR 1884 is also supported by the Tennessee Optometric Association, the Pennsylvania Optometric Association, the American Optometric Student Association and the Association of Schools and Colleges of Optometry.

Source: PR Newswire/American Optometric Association

Developing Job Descriptions for the Staff

Ensuring Staff Know What They Are Responsible For

Having complete job descriptions act as policy for a practice. When a staff member is given a job to do that is not within the purview of their job description, it can create confusion within a practice. Approved job description manuals act as written arbiters of what a staff member should or should not be doing as related to his or her position. Disagreements can be easily addressed simply by referring to the respective job description manual. Bearing that in mind, it becomes very important to invest sufficient time to creating and editing the manuals to ensure the descriptions do match the job.

The Office Manager is responsible for seeing to it that every staff member has a full written job description manual that would contain:

1. Mission Statement of the practice

2. Office Policies/Practice Rules and Level of Discipline

3. General Staff Member duties and responsibilities

4. Specific duties list and descriptions of how to perform the functions of their position.

Each practice is unique. The job descriptions in one practice can vary from those in another practice. So it is up to each practice to develop job descriptions that truly parallel the functions in that practice.

Developing job description manuals for every staff member is not an overnight process. But if it is addressed methodically, it can be done. Following are steps to follow as you are working to develop the full job descriptions for each position:

1. List out all of the positions within your office.

2. Set up a binder for each respective position in the practice, and work out the duties of each position, including your own, ensuring that they are specific to the position. The binders should include a-d above.

3. List out other areas as they occur to you that should be written out for your job description manual.

4. Present these “rough” drafts to each staff member for the respective position that they hold.

5. Have each staff member go through the descriptions you’ve created and add anything you might have missed.

6. Have the staff members return the drafts to you. From what you get back, now determine what the write-ups are that will need to be completed by the staff members for the positions that they hold. Give them a specified due date to return this to you.

7. There are going to be quite a few detailed descriptions of duties that will need to be done, but don’t try to have them all done at one time. This is going to be an ongoing project that will take teamwork.

8. Determine what the write-ups are that you or your OM should finish..

9. Set up a written project plan that lists out what is to be written up and when it is to be completed.

10. Distribute that plan to each staff member and have him or her proceed to get them finished.

11. Remember not to overwhelm yourself or the staff by setting deadlines that are unrealistic for completing this project.

12. Consider having “get-togethers” where you can all work on the write-ups together. Some offices have organized week-ending potluck “work parties” as they embark on this project.

13. Keep yourself and your staff motivated on this project, reminding one another how helpful it is going to be to the practice as a whole to get all of these job descriptions fully developed.

14. Consider having a “wrap” party once the project has been completed. That will help to provide incentive for everyone to keep pushing on getting this done.

15. Plan to have these job descriptions fully done in about 6-8 weeks.

New Hope for Pets with Chronic Kidney Disease

A new product available only through veterinarians has been shown to reduce the toxins that build-up in dogs and cats with chronic kidney disease (CKD) and may help improve the quality of life for affected pets – and possibly extend their longevity.

“By removing toxins from the system, the supplement performs similarly to kidney dialysis but makes it possible to do so by administering a capsule,” Dr. Eric Linn, director of scientific affairs for Vetoquinol USA, Inc. says of the product, called Azodyl(TM).

“Previously, the only treatments for uremia have been kidney dialysis or transplant, which are impractical for pets and cost-prohibitive for owners,” he said.

CKD is a progressive, incurable disease and a leading cause of death in dogs and cats. It can occur at any age, but is especially common in older cats. There are many causes, ranging from old age to kidney tumors. Signs of CKD include increased thirst and urination, weight loss and lethargy, Linn says.

“The kidneys clear the body of waste via urine, but when they fail to function properly, waste accumulates in the system, circulates through the body and the pet becomes ‘uremic.’ Pets with CKD are essentially poisoned by toxins, which cause the signs of the disease,” he explains.

Azodyl contains Kibow Biotics , a patented formulation of “friendly” bacterial organisms that target and metabolize uremic toxins as they pass through the bowel. The bacteria and toxins are then excreted.

In an independent study, Azodyl reduced signs of uremia in 100 percent of cats with CKD and the patients experienced “improved health and vitality,” reports a California veterinarian who published his results recently in the Journal of the American Holistic Veterinary Medical Association.

The same supplement as Azodyl is being developed for human CKD patients. Product research has been funded in part by the National Institute for Diabetes, Digestive and Kidney Diseases of the National Institutes of Health.

Azodyl capsules are administered in pet food or a treat.

Source: PR Newswire/Vetoquinol USA

From the Editor: Office Basics

Maintaining Stability in your practice

At The Practice Solution Magazine, we are constantly doing surveys of health care professionals to help determine what type of information to provide in our upcoming issues. The interviews we do often paint a vivid picture of problems indigenous to doctors in any profession. This quarter’s edition of The Practice Solution contains articles that address ensuring your practice becomes more stable through written communication that provides common policies for all members of your staff.

The key basics addressed in this issue are creating job descriptions, writing standard policies for your practice and implementing specific policy if you leave your practice for any period of time. You should find these useful

This issue additionally contains the final installment of a two-part series on conflict resolution by Daniel Bobrow, president of American Dental Company and founder of Climb For A Cause. As mentioned in our last issue, Climb For A Cause is a non-profit foundation, whose mission is to provide health care treatment and education to people in need worldwide. It seeks to encourage adventure travel, while emphasizing social action, responsibility and accountability. This year’s climb of Oregon’s Mt. Hood will be July 13, 14 and 15. While this year’s climb is now closed, if you’re interested in participating in the future, contact Mr. Bobrow using the contact information in the article he wrote for Solutions or go to Funds raised from this effort will be used to support dental education and treatment projects in both Guatemala and Cambodia.

Based upon interviews personally conducted on doctors all over the country, staff writer Ken DeRouchie has written an interesting piece on how to ensure you increase your collection percentages and create a higher standard for your practice.

In this issue we also have an assortment of news articles you may find of interest.

We hope you find the information in this issue informative and useful. And, if this is your first visit to our magazine, please take the time to look at some of our past issues for additional material that you may find helpful in the management of your practice.


Ken DeRouchie

Managing Editor

The Practice Solution Magazine

Device screens patients in minutes for periodontal disease

A portable saliva test device developed by a University of Michigan School of Dentistry professor could tell patients in just minutes if they have periodontal disease, a hefty improvement over current methods which require hours of analysis at an off-site lab.

The saliva test device was developed jointly by University of Michigan’s Dr. William Giannobile and Dr. Anup Singh of Sandia National Laboratories. Testing with the kit has progressed to the point where a dentist would need only a drop of saliva from a patient and less than 10 minutes of time to analyze the sample to determine if the patient has periodontal disease. Current sample analysis requires hours of time at a laboratory away from a dental office.

Giannobile, director of the Michigan Center for Oral Health Research, said that in recent months MCOHR has been conducting tests that are adaptable to using microfluidic technology. “Using a miniaturized lab-on-a-chip approach, we have been able to separate and analyze proteins quickly, typically within minutes of sample separation,” he said. Established in 2003, MCOHR takes discoveries from research laboratories and attempts to find ways to use them to benefit oral health care professionals and their patients.

The saliva test kit measures a tissue-destructive enzyme, matrix metalloptoteinase-8, a molecule which is released from cells that tend to migrate to periodontal lesions.

“Using just a very small sample of saliva, we found our tests to be highly accurate in identifying patients with periodontal disease, without the need for a more time consuming and comprehensive clinical examination,” Giannobile said. “This method could one day be used to screen large patient populations which could have major implications for oral health.”

From late 2005 through 2006, 130 patients were tested at MCOHR clinics in northeast Ann Arbor.

Collaborating with Giannobile are Mark Burns, professor with the U-M College of Engineering, and Dr. Christoph Ramseier and Janet Kinney, both MCOHR research fellows. The National Institutes of Health provided funding for the test studies. The lab-on-a-chip technology was developed and manufactured by Sandia National Laboratories, which has major research and developmental interests in national security, energy, and environmental technologies.

The results of an analytical test appeared in the March 27 issue of the Proceedings of the National Academy of Sciences.

The University of Michigan School of Dentistry is one of the nation’s leading dental schools engaged in oral health care education, research, patient care, and community service. General dental care clinics and specialty clinics providing advanced treatment enable the school to offer dental services and programs to patients throughout Michigan. Classroom and clinic instruction prepare future dentists, dental specialists and dental hygienists for practice in private offices, hospitals, academia and public agencies. Research seeks to discover and apply new knowledge that can help patients worldwide. For more information about the School of Dentistry, visit:

SOURCE: University of Michigan School of Dentistry

Half of General Dentists Placing Dental Implants

The Wealthy Dentist Survey Results

Half of general dentists offer their patients surgical dental implants, according to a survey conducted by The Wealthy Dentist. On the other hand, fully four out of five specialists place implants. Dental implants are an essential part of modern dental care. When it comes to implant dentistry and tooth implants, both passions and controversy run high.

Approximately half of general dentists are placing dental implants. In a recent dental consulting survey conducted by, each dentist was asked if they place implants themselves. Fifty-three percent of the general dentists in the poll indicated that they do dental implant placement themselves. The remaining 47% of general dentists refer patients to a specialist.

Not surprisingly, dental specialists had a very different profile than general dentists. Four out of five specialists responding to this poll place dental implants, as opposed to only one out of two general dentists. Those who do not place implants are endodontists, prosthodontists, and pediatric dentists.

Dental implants are a permanent solution to lost teeth. Rather than a removable denture, patients are given titanium implants. Because of its ability to bond with bone, titanium is an ideal material for surgical implants. An artificial tooth is then placed over the implant. In the past several decades, dental implants have exploded in popularity, offering a more natural tooth replacement than any other current dental technique.

Many general dentists are more than happy to accept straightforward implant patients, but refer out the more difficult cases. As a Florida general dentist said, “I place implants myself, but only in ideal situations.” Another agreed, saying, “I offer implants. It depends on the complexity of the case; some are sent to a specialist.”

Some questioned the ability of general dentists to properly place implants, a North Carolina general dentist explained, “I have neither the experience nor knowledge of anatomy that would allow me to feel comfortable placing implants.” A Florida general dentist questioned the wisdom of a single practitioner offering too many services. “Like they say: if you try to be a jack of all trades, you will be a master of none. I am fortunate to have one of the best implant specialists in the entire country in my backyard. I never have to worry about improper or sloppy placement like I get from other ‘professionals.’”

A number of dentists were left unimpressed by the performance of some specialists. “After referring to specialists for the last few years and getting back poor work (acentric, too facially inclined, off the center of the ridge, non-ossiointegrated), I thought: How much worse can I do?” commented a Georgia general dentist. “Now I offer implants. For practice doing sinus lifts I’ll get a couple of sheep or pig heads.”

From a patient’s perspective, generalists who offer dental implants can be convenient. A general dental practice in Minnesota has been pleased with the results. “After going to training in January and February, we started placing implants right away. Patients love that we can do the whole process from beginning to end.”

More and more general dentists are interested in getting into the business of offering implants. “I refer implant patients to a specialist, but I am seriously considering placing them in some of the more straightforward cases,” commented a California general dentist. A dentist from Greece agreed: “I’m taking a course in implantology, so soon I will offer them myself.”

Restorations are quite another matter. “I restore implants and I refer placements out,” said a Massachusetts general dentist. A Tennessee prosthodontist agreed, saying, “I restore but do not place implants.”

A few dentists criticized specialists and the perception of them as more qualified to place dental implants than general dentists. “Every general dentist who can extract a tooth can do most implant surgeries,” opined an Oregon dentist. “I feel that oral surgeons really do not want you to know how easy it is to do. All dentists owe it to themselves and to their patients. I restore 75% more implants now because I am placing my own. The acceptance was astonishing.”

Many general dentists are proud of the success they have had with dental implants. “I’ve been placing implants since 1984. I did an internship in implants at Midwest Implant Institute. In twenty years, I have only ever lost one dental implant due to implant non-integration,” proclaimed a Michigan general dentist. A Virginia dentist agreed, saying, “Most implants are well within the abilities of GPs. The expertise comes in knowing which ones to refer out.”

The need for referrals helps to foster a healthy relationship between general dentists and specialists (at least in some cases). “We do the prosthetic portion of the process; we do not do the surgical placement of the implant,” explained a New Hampshire general dentist. A Pennsylvania doctor was in a similar situation: “I use mini-implants in office where and when I’m able. I refer out traditional implants.” A New York dentist described his process: “I have a specialist come to my office. I do the restorative portion myself.” One Virginia prosthodontist is lucky enough to have in-house assistance: “I pick and choose. Those patients who need a more complex treatment are referred to our in-house oral surgeon or periodontists.”

“Those of you who aren’t in the industry might not know how passionate dentists can be about dental implants,” said The Wealthy Dentist founder Jim Du Molin. “Implants have been one of the most significant developments in dental care over the last century. The only problem is, it’s still not entirely clear who is (and who should be) placing them. This is so often the issue: improving access to health care without compromising the quality of care patients receive.”

For additional information on this and other Wealthy Dentist surveys, as well as more dentist comments, visit

The Wealthy Dentist is a dental marketing and dental practice management resource featuring founder Jim Du Molin. The site’s weekly surveys and dental newsletters are viewed by thousands of dentists across the United States and Canada. The Wealthy Dentist is a sister company of the Internet Dental Alliance, Inc. ( IDA is the largest provider of websites for dentists, email patient newsletters and dental directories in North America.


Center For Oral Biology Wins Major Training Grant Renewal

The Center for Oral Biology within the University of Rochester School of Medicine and Dentistry has been awarded $4 million to expand its renowned training program for oral biologists and dentist-scientists. New cross-disciplinary training programs will focus on the basic mechanisms that underlie oral diseases to help students prepare for careers within academia, government and industry.

The curriculum for the “Training Program in Oral Science” will be an integration of basic science research and clinical practice. Programs will focus on the recruitment of dentists who wish to pursue Ph.D. and dentist-Ph.D. degrees, and who want to engage in post-doctoral training. A major component of the program will recruit dental students who wish to coordinate their clinical training with Ph.D. research studies into a joint DMD-DDS/PhD program ( DSTP ).

“A greater number of clinician-scientists who can effectively respond to the growing opportunities in dental, oral and craniofacial research must be generated for society to take advantage of the dramatic advances being made in the biomedical sciences,” said James E. Melvin, D.D.S., Ph.D., director of the Center for Oral Biology and professor of Pharmacology and Physiology. “We intend to be at the forefront of that recruitment effort because of our leadership position in these fields and because of the urgency of the need.”

The training grant ( T32 ) is from the National Institute for Dental and Craniofacial Research, part of the National Institutes of Health. It results from a successful collaboration between the School’s Center for Oral Biology,and its departments of Pharmacology and Physiology, Microbiology & Immunology, Biomedical Genetics, Dentistry, Medicine and Dermatology.

As part of the program, the School of Medicine and Dentistry will offer its Ph.D. programs to undergraduate students at partnering dental schools at the University of Puerto Rico and Marquette University. These dental schools have excellent clinical programs, but no Ph.D. level training.

“We are tremendously excited about the new center as a powerful example of innovative education in translational science,” said David S. Guzick, M.D., Ph.D., dean of the University of Rochester School of Medicine and Dentistry. “More and more we are seeing that oral diseases are linked with other major diseases. The training of dentists to conduct basic and translational research in oral biology will accelerate improvements in oral health.”

SOURCE: University of Rochester School of Medicine and Dentistry