Dentists in History
Fredericksburg Fluoridation Vote Results Called into Question
For the first time in over a decade, the U.S. Department of Labor has issued a final ruling on an increase to the salary threshold for exempt employees. Starting on January 1, 2020, employees will need to be paid a minimum of $684 per week or $35,568 per year to meet the salary qualification for exempt status. This is an increase from the current exempt threshold of $455 per week or $23,660 per year.
What Does This Mean for Dental Employers?
If you are paying any of your employees on a salary basis you need to know whether you are paying employees as “salary exempt” or “salary non-exempt” – and if you are in compliance with federal rules.
To understand this, you need to separate the payment method from the classification. Salary and hourly are payment methods. Exempt and non-exempt are employee classifications. More specifically, the latter categorizes employees by determining whether they are exempt from the Fair Labor Standards Act requiring non-exempt employees to be paid minimum wage and overtime pay. You are not required to pay overtime to exempt employees so long as they are paid the same amount of salary each week.
Exempt vs. Non-Exempt Employees
Most employees in a dental practice are non-exempt because they do not meet the two standards for exemption. To consider an employee exempt from FLSA, they must be paid at least the minimum salary threshold and meet a duties test in at least one of the three categories: executive, administrative, or professional.
You know the new salary threshold but let me simplify the duties tests. In most cases, it’s likely the only two positions in your practice that meet qualifications for exempt status are your Dental Associate (professional exemption) and your Practice Administrator (executive exemption). The PA or Office Manager can be exempt so long as they are directly managing at least two employees with the authority to hire, fire, or discipline those they supervise. The Office Manager who just makes the schedule and deals with patient complaints while still taking on the regular front desk administrative duties would not qualify as exempt.
All other employees should be considered non-exempt. In some cases, there can be exceptions made for a hygienist who has completed four years of professional study. However, their education must be obtained from an accredited college or university that was approved by the American Dental Association’s Commission on Accreditation of Dental and Dental Auxiliary Educational Programs at the time of study. If your hygienist consistently works less than 40 hours per week, it’s likely not worth the risk of classifying them as exempt if they do not meet the qualifications.
Pro tip – you won’t have any problems classifying an employee who could be exempt as non-exempt; however, you could have an expensive problem if you classify an employee who should be non-exempt as exempt. The safer course is to consider the rest of your team as non-exempt employees, require them to track their time, and pay the overtime rate (1.5x regular hourly rate) for any hours worked over 40 in a 1-week period.
What If I Pay All My Employees A Salary?
Occasionally, an owner dentist will tell me they pay their entire team on a salary basis. Either they heard it was a good idea for employee retention or they don’t want to deal with time sheets. Regardless of the reason – or whether this is a good idea, which is an entirely different article – there needs to be an understanding of the regulations surrounding employee classification.
You can have a “salary non-exempt” employee. However, because this employee does not qualify for exempt status, you should require them to track their time and will need to pay the overtime rate for any hours worked over 40 in a 1-week period. To calculate this rate, divide their weekly salary by 40, then multiply by the number of overtime hours worked and add to the base salary pay for the week overtime was earned.
It’s not as complicated as it seems. Just be aware that if you have a truly exempt employee, you need to ensure they are paid the minimum salary threshold each week they work to avoid paying overtime. If you are paying a set salary to non-exempt employees, regardless of how much the salary is each week, you need to have them track their time and are required to pay them overtime (or make sure they don’t work past 40 hours in any given week). Stay compliant!
By Kara D. Kelley, SHRM-CP, Dental HR Consultant at Parkhurst Consulting CPA PC
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Hiram Wesley Evans (September 26, 1881 – September 14, 1966) was the only dentist to appear on the front cover of Time Magazine. Evans was born in Ashland, Alabama, on September 26, 1881, and moved to Hubbard, Texas, with his family as a child. He was the son of Hiram Martin Evans, a judge, and his wife, Georgia Evans. Evans attended Vanderbilt University and became a dentist. He operated a small, moderately successful practice in downtown Dallas, Texas until 1920, when he joined the Klan’s Dallas chapter. Rumors later arose that his dental qualifications were “a bit shady”. He quickly rose through the ranks and became Imperial Wizard, the national leader, in November 1922. Evans transformed the group into a political power. He was the Imperial Wizard of the Ku Klux Klan from 1922 to 1939.
Evans had led kidnapping and torture, but he publicly discouraged vigilante actions for fear that they would hinder his attempts to gain political influence. In 1923, Evans presided over the largest Klan gathering in history, attended by over 200,000, and endorsed several successful candidates in 1924 elections. He moved the Klan’s headquarters from Atlanta to Washington, DC, and organized a march of 30,000 members, the largest march in the organization’s history, on Pennsylvania Avenue. Evans’ efforts notwithstanding, the Klan was buffeted by damaging publicity in the early 1920s, partially because of leadership struggles between Evans and his rivals, which hindered his political efforts.
In addition to his white supremacist ideology, he fiercely condemned Catholicism, unionism, and communism, which were associated with recent immigrants from Eastern and Southern Europe. Historians credit Evans with refocusing the Klan on political activities and recruiting outside the South; the Klan grew most in the Midwest and industrial cities.
Evans described himself as “the most average man in America”. Of average height and somewhat overweight, Evans was well dressed, a skilled speaker, and very ambitious. He was also a Freemason.
In his writings on the subject, he cited the nation’s illiteracy rate as evidence that American public schools were failing, and he considered low teacher salaries and child labor key obstacles to reform. He supported the idea of a federal Department of Education, hoping that it would lead to improvements in public schools. Evans wrote four books in the mid to late 1920s: The Menace of Modern Immigration (1923), The Klan of Tomorrow (1924), Alienism in the Democracy (1927), and The Rising Storm (1929).
In 1924, the group convinced Republican Party leaders to avoid criticizing it, prompting Time to put Evans on its cover. That year, the Klan supported Calvin Coolidge in his successful candidacy for president of the United States. Although Coolidge opposed many key Klan platforms, with the exception of immigration restrictions and prohibition, he was the only major-party candidate who did not condemn them. Nonetheless, Evans declared Coolidge’s victory a great success for the Klan. Evans’ attempts to elect Klansmen to public offices in 1924 saw limited success except in Indiana.
Evans’ service as Imperial Wizard proved to be a lucrative position, allowing him to maintain a large residence in a prestigious Atlanta neighborhood. In the mid-1930s, however, Klan funds dwindled, and he worked for a Georgia-based construction company selling products to the Georgia Highway Board. In 1940, the state of Georgia charged Evans and a member of the state highway board with price fixing. The Attorney General of Georgia, directed legal proceedings against Evans that resulted in a $15,000 fine. As late as 1949, Evans served as a commentator on Klan activities, speaking as the former Imperial Wizard. He died on September 14, 1966 in Atlanta.
Dr. Charles W. Miller, Texas Dental Association President
The January 21, 2020 meeting will feature your president speaking on current issues at the Texas Dental Association. Dr. Miller’s presentation will be followed by a lecture course by:
Kirsten Mason, Pharm.D, BCPS & Dusten Rose, Pharm.D, BCIDP, AAHIVP
Sinking Your Teeth into Opioid and Antibiotic Stewardship in Dentistry
Date: January 21, 2020
Time: FREE Happy Hour: 5:30pm – 6:30pm * Meeting starts at 6:30pm
Austin Country Club – 4408 Long Champ Dr, Austin 78746
Lecture Course * 2 Hours CE Credit
Cost: $40 member dentist/$50 members with late registration (if available)
$50 guest of member dentist; $70 nonmember dentist
RSVP: By 10:00 a.m. FRIDAY, JANUARY 17
To RSVP & PAY with Credit Card, go to www.capitalareadental.org
To RSVP & PAY with Check or Cash, call 512.335.1405
If you need a vegetarian, vegan or gluten free meal, tell Nancy when
making your reservation. Reservations are released at 6:30pm
Reservations not cancelled by 10:00am Friday, January 17 will be billed
Opioid and Antibiotic Stewardship in Dentistry
Antibiotics and opioids account for three out of every four drugs prescribed by dentists in the United States and up to 10% of all prescriptions nationally. The consequences of inappropriate prescribing of these classes of medications is associated with increased antibiotic resistance, risk of opioid-use disorder, and adverse side effects for patients. This presentation will review guidelines and strategies to optimize antibiotic and opioid prescribing by dentists in the inpatient and outpatient setting.
- Describe the burden of antimicrobial resistance (AR) and opioid use disorder (OUD) in the United States and patterns of prescribing in the practice of dentistry
- Review guidelines on antibiotic use for the prevention and treatment of infections, dental pain, and intraoral swelling
- Identify strategies for optimal antibiotic selection in the setting of antibiotic allergies and resistance trends for organisms associated with odontogenic infections
- Evaluate evidence-based opioid alternatives and pain management in patients with opioid use disorder
- Apply opioid-related regulatory changes to oral healthcare practice
Kirsten Mason, Pharm.D, BCPS
Kirsten Mason, Pharm.D, BCPS, is a graduate of the University of Tennessee Health Science Center College of Pharmacy. She completed a PGY1 Pharmacy Residency at the Memphis Veterans Affairs Medical Center and her PGY2 Internal Medicine Residency at the University Medical Center Brackenridge in Austin. After residency, Kirsten accepted a clinical pharmacy specialist position in cardiology at Northwestern Memorial Hospital in Chicago. In 2016, she relocated back to Austin and joined Dell Seton Medical Center at University of Texas as an internal medicine clinical pharmacy specialist. In this role, she assisted in the development of an inpatient opioid use disorder treatment service. In 2018, Kirsten transitioned into a new role as a clinical pharmacy manager at Ascension Seton Medical Center Austin with an emphasis on project management and pain management.
Dusten Rose, Pharm.D, BCIDP, AAHIVP
Dusten Rose, Pharm.D, BCIDP, AAHIVP, is a Network Clinical Pharmacy Specialist in Infectious Diseases at Dell Seton Medical Center at University of Texas and the PGY2 Infectious Diseases Pharmacy Residency Program Director in Austin. He is an undergraduate of Michigan State University and Ferris State University College of Pharmacy. He completed his PGY1 at St. Mary’s Health in Grand Rapids, Michigan and specialty training in infectious diseases from UC Davis Medical Center in Sacramento, California in 2010. Following residency, he practiced as the Infectious Diseases pharmacist at Indiana University Health in Indianapolis for four years prior to accepting a position in Austin in 2014. In this role, he divides his time between rounding with the Infectious Diseases consult service, participating on local and national committees developing guidelines for appropriate antimicrobial utilization, and educating healthcare providers on antimicrobial stewardship.
Dr. Charles W. Miller, TDA President
Dr. Charles Miller was born in Fort Worth and raised in Arlington. He graduated from the University of Texas Arlington and then Baylor College of Dentistry in 1980. He completed his pediatric dental residency at the University of Illinois College of Dentistry in Chicago. Dr. Miller returned to Texas in 1982 and joined Drs. Phil Bailey and Jim Hyde as an associate in their pediatric dental practice. Two years later he became a partner. Dr. Miller was introduced to organized dentistry at his first Fort Worth District Dental Society meeting almost four decades ago. Prior to becoming the 2019-2020 TDA President, Dr. Miller served in the TDA House of Delegates, and then the TDA Board of Directors. Dr. Miller met his wife of 42 years, Dru Ann, during his sophomore year at Arlington High School. They have two grown sons, James and Andrew. Dr. Miller’s hobbies include gardening and photography.
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