Dentist blog from Delta Dental

Tag: Delta Dental leadership

5 tips for ergonomics in the operatory from Dr. Daniel Croley

Before he moved to the world of dental insurance, Dr. Daniel Croley, Chief Dental Officer at Delta Dental, managed two practices in Chicago. While managing those practices he began to suffer from repetitive strain in one shoulder and this strain developed into a severe shoulder injury. After eight years of practice, he made the difficult decision to look for a new position that would leverage his knowledge without being a risk to his health.

Dr. Daniel Croley
Dr. Daniel Croley

Even with the help of specialists, the risk of permanent injury as a dental professional is high, and it’s not uncommon for dentists or hygienists to experience musculoskeletal disorders (MSDs) due to poor posture. In fact, at least 62% of dentists report having at least one complaint of pain. MSDs are also the leading cause for early retirement for dental professionals.

The good news is that you don’t need to accept pain as a part of your job. Here are Dr. Croley’s tips to reduce the risk of injury when you practice.

1. Position yourself

With packed schedules and deadlines, taking any additional time to properly position yourself may be easy to overlook. But overlooking your positioning time after time will take a toll on your body at some point. When you sit down with a patient, remember to:

  • Move your stool as close as possible to your patient’s head so that you don’t overextend your arms or back.
  • Keep your feet flat on the floor or the footrest of your stool.
  • Adjust your stool height so your thighs slope slightly downward.
  • Hold your wrists in a neutral position and minimize wrist movement.
  • Maintain an erect, neutral spine instead of bending forward or leaning over your patient.
  • Distribute your weight evenly in a tripod pattern, between your two feet on the floor and your stool.

2. Position the patient

The position of your patient is just as important as your own position.

  • Recline the patient so your working area is at or just above your elbow level. If you can’t get an ideal position, adjust your stool height accordingly.
  • Have the patient move to the very end of the headrest with no space at the top.
  • Ask patients to tilt their head as needed to maintain your line of sight instead of leaning.

3. Engage your core

The goal of engaging your core is to use the muscles around your mid-section to act as a brace for your upper body and spine. Whether you’re sitting down to do a procedure or standing for long periods, that support protects the weaker muscles of your upper body from the strain it takes to lean over.

Some people interpret “engage” to mean “suck in,” which doesn’t provide your body any support. Instead of sucking in, think of the way your muscles tighten before you laugh or cough. That tightening is an engaged core.

Engaging your core muscles all day can be exhausting, especially if you’re not in the habit of doing it. Consider training your core muscles to make it easier to maintain good posture for longer.

4. Use equipment

Consider using a loupe to minimize the need to perch on the edge of your stool to see. If your overhead light is too dim or casts too many shadows, consider a head-mounted light as an alternative. Avoid gripping instruments tightly.

5. Stretch and exercise

Stretch to release strain. When possible, take 10 minutes to get up and stretch your spine, arms and legs. Stretching during and after work can help relax strained muscles.

For practice owners, investing in ergonomic training and supporting healthy practices has long-term benefits like preventing unwanted retirement, reducing canceled appointments and lessening the need for disability leave.

With very busy personal schedules and maintaining the production required to maintain a dental practice, it can be difficult to prioritize time-consuming tasks like ergonomic evaluations and training.  Sometimes you just need to get into non-ideal physical positions to gain the required access.  You can’t eliminate all physical strain, reducing it is still helpful. Even small changes can have a huge impact towards becoming an ergonomically healthy practice.

Meet Dr. Jessica Buehler, Director of Dental Affairs

Whether she’s motorcycling through the Alps or hiking through Southeast Asia to bring aid where it’s needed most, Dr. Jessica Buehler approaches what she does with passion, courage and commitment. That includes her work rewriting Delta Dental’s Quality Improvement Plan and bettering the oral health of members through her wellness webinars as Delta Dental’s Director of Dental Affairs.

We recently caught up with Dr. Buehler to discuss her work at Delta Dental, her time as a frontline provider during the early days of COVID and her dual passions for traveling and musical theater.

I think a lot of people, including even some dentists, might be surprised to learn that a dental insurance company like Delta Dental has dentists on staff. Can you tell us about the work you do for Delta Dental?

My work is to support our quality program. Insurance plans are regulated by the Department of Insurance and other regulatory bodies to ensure that the care is appropriate. It takes clinicians to be a part of that process so that key decisions about care and quality aren’t made by laypeople. They’re made by clinicians who have practiced and treated patients just like our dentists.

What initially led you to dentistry as a career?

I was overseas on the San Blas Islands off the coast of Panama working with an indigenous tribe on a summer mission trip. I volunteered to help a Panamanian dentist who was assigned by the government  to do health work on the island. I saw severe infections — people who had no access to care. It opened up my heart to this way to impact the world; it showed me how much dentists can improve people’s lives, not only in the U.S. but also overseas where people don’t have access to care.

What are the biggest rewards of your work now?

I feel my ability to impact oral health in this country is much bigger working for a plan. When you’re working as a chairside dentist, your impact is limited to only those patients you touch or the community events you volunteer at. Right now, I’m giving enrollee wellness webinars that are live-cast across the country to hundreds of enrollees at once. Having an impact on a stage that’s much bigger is really fun for me.

What do you miss most about being a chairside dentist? What do you miss least?

I miss the connection with my patients. You don’t realize when you go into dental school as a young person that your patients follow you for years and years. I saw couples get married and have babies. I saw babies grow into high schoolers. I saw couples get divorced and people pass. You are an intimate part of people’s lives over time. It feels like you’re checking in with old friends every time you see these patients. And when I went through those big life events like getting married and having a baby, my patients were there for me. I’m separated from that now, and I miss that.

In terms of what I miss the least: staffing. Staffing is impossible right now. Overall, dentistry is one of the hardest jobs in the world. It’s not for the faint of heart. 

I was so impressed to learn that you were a frontline provider during the early days of the COVID pandemic. It’s only been a couple years since then, but many of us have forgotten (or blocked out!) how very scary that time was, how many unknowns there were. Can you tell me about your work during that time?

When COVID hit, I was a regional clinical director supervising over 80 clinicians and specialists in Seattle. We were the epicenter of when it was first blowing up. Things were happening very fast, and there was very little guidance at that time, but we knew we had to do something to help. We had to make tough decisions about closing our offices: We had around 30 offices, and we went down to four.

The government was coming into dental offices and taking PPE, but we were expected to care for patients. My husband’s in construction, so he got a welding face shield for me and a construction and painting P100 respirator with a mask over the end. It wasn’t just about keeping myself safe. I was dealing with a lot of anxiety trying to keep my team safe. Some of my colleagues who worked for me had at-risk relatives at home. Some of them had health conditions. I was driving around the state to gather whatever supplies I could find in the construction world to provide to my doctors who were working those frontlines. It was a really scary time.

What do you think are some of the most important things Delta Dental can do to help maintain strong, positive relationships with dentists?

I think being empathetic to how hard dentistry is. It’s easy to go into a dental office and think a dentist is just a “tooth-counter.” I’ve had people say to me, “You make way too much money for what you do.” But a lot of people have no idea what dentists do! It’s a really hard job. It’s even hard on your body, too. You have to manage the emotions of your patients; you have to manage your staff. It’s challenging to be a business leader and a clinician and everything else.

Speaking of playing multiple roles, I was interested to learn that you have a background in musical theater. Can you tell me a little bit about that? Do you feel that your work in theater and performance helped inform your daily work as a dentist at all? Do the two pursuits have anything in common?

My parents always said, “Do whatever you want. We know you’ll succeed at whatever you decide.” So, I got really involved in musical theater and lighting design when I was in college. I loved the theater, but I realized I was a bit too organized and Type A to hang forever in that world…

I still love and appreciate the theater, but I come from a science family, and I almost felt dentistry was a calling. Once I got it into my brain, I couldn’t get it out. But, the things I learned in the theater — to ground yourself, to speak and perform with confidence — are really important and have helped me grow a lot as a provider.

What do you like to do in your free time?

I’m an avid reader. I run a book club for a community inclusion group at Delta Dental, Women@Delta. I love everything outdoors: stand-up paddleboarding, snow skiing, camping, hiking, wakeboarding, all of it. Just put me outdoors and I’m a happy girl! I love to travel. I did a motorcycle tour through the Alps, hitting seven countries in Europe with my dad. He’s passed now, so that’s one of my favorite memories… I love Thailand. I love Australia. I’ve done work in Southeast Asia in countries that aren’t even open to Western aid. I backpacked in and brought dental tools and taken teeth out, all sorts of crazy stuff. I have a family now, so I don’t do as many risky things now, but I still love to travel!

Meet Jamie Clarke, VP of Network Development

Ask Jamie Clarke, and she’ll tell you she grew up in the health insurance industry. “My first career was at a health insurer, and I really loved it.”

Now Delta Dental’s Vice President of Network Development, Jamie Clarke first entered health care with a focus on building out provider networks and ensuring access to care. She found the work rewarding and spent years developing robust provider networks across the country.

Before joining Delta Dental, Jamie served as Chief Value Officer at a Nemours Children’s Health, a pediatric hospital in Delaware. It was there that she came to fully appreciate providing care and delivering positive outcomes.

“I was accountable for keeping kids healthy,” she said, “and that experience was transformative for me.”

Strong networks mean consistent access to care

Jamie leads a team focused on building out Delta Dental’s multiple networks, from Delta Dental PPO™ and DeltaCare® USA to Medicare Advantage and the Community Care Network.

“A day in the life for me is ensuring that we’re building and maintaining our networks so members have access to care,” Jamie said.

Wherever there are patients looking for care, Jamie’s team ensures there’s a network of dentists available to treat them.

An easier, more modern dentist experience

Now Jamie is turning that dedication for members towards dentists. High on her list of priorities is solving operational opportunities like the onboarding process, claims and grievances.

“We know that dentists are extremely busy caring for patients and dealing with multiple insurance carriers,” Jamie said, “so we’re striving to create frictionless, positive experiences for them.”

One way to create those experiences is with efficient technology.

“We still have a lot of paper communications and get a lot of phone calls,” Jamie said. “Resources like our online Provider Tools and electronic claims filing make it easy for providers to get answers and get paid quickly.”

Transparency is also essential.

“We want to be clear about what providers can expect from us and what we need from them to help them succeed,” Jamie said.

That’s why Delta Dental is ramping up educational opportunities and resources, from webinars and articles to continuing education courses, to offer dentists and their staff valuable tools and information.

A two-way partnership

When it comes to dental insurance, dentists are key. A strong network allows patients to get the care they need. But partnering with Delta Dental brings value to dentists, too.

“We have a large and diverse patient base,” Jamie said, “and because our benefits are structured to encourage members to stay in network, dentists can expect loyalty from their patients.”

Jamie’s No. 1 priority is ensuring that Delta Dental dentists feel heard and respected.

“When a provider gets in touch with us, we want them to feel like there’s a real person on the other side of the interaction,” she said. “They’re not just being shuffled through a queue.”

The challenges of COVID-19

The pandemic has created new difficulties for dental offices across the country. Many dentists during the COVID-19 pandemic made the difficult decision to retire or close their practice because of the economic challenges, Jamie said. Staffing challenges have also been magnified.

When the pandemic began, Jamie was working at the children’s hospital, where she saw firsthand the difficulties of providing care.

“We had to work even harder to seek positive results,” Jamie said. “We set up outdoor tents to see patients and were trying to figure out creative ways to keep children healthy.”

The dental industry is still reeling from the pandemic, but Delta Dental is here to support dentists through the challenges, Jamie said.

“Call us,” she said. “We’ll listen. We care, and we want to partner together to provide exceptional care to patients.”

How teledentistry can bring value to your practice

Since the start of the COVID pandemic, the use of teledentistry has increased significantly. This has created intriguing — and potentially lucrative — opportunities for dental practices. Are you taking full advantage of this new technology? Dr. Daniel Croley, Delta Dental’s chief dental officer, explains how.

In his new Dental Economics magazine article, “The value teledentistry visits bring to dentists and their patients,” Dr. Croley talks about the intrinsic value of teledentistry, the various types of teledentistry and how teledentistry can bring value to your dental practice and patients.

It’s no surprise that the pandemic accelerated the adoption of telehealth across the medical and dental spheres. As dental offices learned to navigate lockdown measures, extended safety protocols, and assuaged patients’ fears of becoming exposed to the virus via the dental office, virtual care has only scratched the surface of its potential in teledentistry. The market is expected to reach $2.6 billion by the end of the decade.

Dr. Daniel Croley 

Read the full article in Dental Economics.

Elevating patient care: A look ahead with Delta Dental’s chief dental officer

Dr. Daniel Croley headshot
Delta Dental Chief Dental Officer Dr. Daniel Croley

When he was receiving a dental cleaning many years ago, Dr. Daniel Croley had a conversation that changed the course of his life and career. At the time, he was a college student with a pre-med major headed toward medical school, but a serious talk with his dentist opened his eyes to a new path.

After shadowing the dentist for a few weeks to learn about his practice, Dr. Croley realized that the profession would be a great fit.

“Throughout my life, I’ve been interested in helping people, and making a meaningful impact,” he said. “I liked the patient interaction, and dentistry’s focus on prevention spoke to me.”

While earning a B.S. degree in zoology and a DMD degree at the University of Kentucky, he gained practical experience working in hospitals, where he “fell in love with patient care” while assisting patients with disabilities or medical conditions requiring stronger oversight.

Today, Dr. Croley serves as Delta Dental’s chief dental officer. In his new role, he builds on his years in private practice to inform his work overseeing Delta Dental’s dentist networks.

From private practice to dental insurance

After earning his DMD, Dr. Croley moved to Chicago and managed two dental practices for eight years. Although he loved the work, he suffered a severe shoulder injury, related to repetitive strain, that caused him to seek care from several specialists.

The risk to his health was too great, and it was an emotional decision to leave practice. He began looking for a new position that would allow him to use his knowledge and skill “in a meaningful way to help people get healthy.”

Dr. Croley worked for seven years for a third-party administration company, which eventually became Humana. He then received a call from PMI, an HMO subsidiary of Delta Dental of California, and he accepted a position to manage its dental networks.

“I found my way to the dental benefit world and it was a fit for sure,” he said. “When I was in practice, I helped one person at a time, and now I could influence many more people through my work overseeing quality delivery of care across many providers.”

Shaping Delta Dental’s care and vision

After a brief period working for the American Dental Association, Dr. Croley began his role as vice president of network development at Delta Dental.

“Having worked for other insurance companies, I knew Delta Dental to be the best in class,” he said, “and this is continually confirmed. This is a great, caring compassionate company.”

As vice president of network development, he emphasized the goal Delta Dental shares with dentists: bringing health to our communities. He described a partnership of trust that supports dentists as business owners, healers and community members.

Improving the quality of dental care

Now, as chief dental officer, Dr. Croley has another goal: improving the quality oral health care that patients receive.

“When you think about what patients want,” he said, “it’s access, affordability and quality.”

While he was serving as director of informatics at the ADA, Dr. Croley made two significant observations: (1) the value of data and using data to inform decision-making, and (2) the shared focus of dentists and dental plans — the patient.

Combining these ideas fits into Dr. Croley’s plans as chief dental officer. Defining quality is the first step in the process, he said, and then identifying objective measurements against expected outcomes.

”We will be building transparency around the quality of care that dentists deliver to patients,” he emphasized.

To do this, Delta Dental will be helping to facilitate dentists’ understanding of what quality is and empower them to achieve it in their interactions with, and services to, patients.

“I believe that our focus on quality, and the transparency of that, both internally and externally, will enhance the patient experience and the quality of care that our customers receive from our providers. This will elevate all of us to take exceptional care of our customers.”


Today’s practice challenges for dentists

The COVID-19 pandemic has taken a toll on dental practices. As dentists face ever-changing conditions in 2021, Dr. Croley sees planning as a key to the return to pre-COVID-19 patient volumes and practice revenue.

 “COVID has been hard on dentists, and it’s been harder in some states, like California and New York,” he pointed out. “Patient traffic is down in dental offices, both because some people are afraid of catching the virus and so many have lost their jobs.”

However, patient volumes nationally have increased to an estimated 78% of their pre-COVID-19 level, according to an ADA poll taken Dec. 14, 2020. Dentists have applied infection control, sanitization and sterilization measures in their practices all along, Dr. Croley observed. The key, he said, is to “just make sure their patients feel safe to come back into care.  People cannot put off their preventive and restorative dental care.”

In 2020, Delta Dental supported dentists through a temporary compensation increase for certain procedures and facilitated financial assistance through low-cost or no-cost loans.

While the pandemic has increased costs for personal protective equipment (PPE) and caused difficulty with staging and scheduling, Dr. Croley advises dental offices to adjust their business practices to the new conditions, such as changing their hours of operation.

“Dentistry is both a business and a clinical profession,” he said. “We want to help practices remain stable in the market.”

A shared purpose

Through participation in Delta Dental’s networks, which are the largest in the nation, dentists can attract patients, and patients covered under Delta Dental plans can access quality care.

Ultimately, Dr. Croley said, “Delta Dental and dentists share a fundamental purpose: improving health through affordable, quality care.”

Welcome to Dr. Kenneth Yale

Senior Vice President and Chief Clinical Officer, Kenneth Yale, DDS, JD, joined our enterprise this year to lead Network Development and Professional Services. With more than 20 years in executive management, health care, data science and governmental regulations, Dr. Yale is a strong asset to the Delta Dental team.

“Delta Dental is not only one of the largest dental plans,” says Dr. Yale. “We also have the interest to transform, and the ability to make a big difference enhancing people’s lives.”

Inspired by his parents to get into medicine, Dr. Yale broadened his formal education into law and data science. This expertise led to research and development of advanced data analytics and artificial intelligence solutions currently in use by health insurance companies. Dr. Yale also lectures and writes extensively on data science.

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