Prosperident Pulse #80 March 2019

Dental Prosperident Pulse from Prosperident
Issue #80 — March 2019
Our CEO recently got the chance to do a podcast with Dr. Glenn Krieger. Glenn is an orthodontist and one of the most interesting guys in dentistry. Check it out HERE.
Liven Up Your Meeting
Did you know that there are some topics that we will ONLY discuss at closed-door, live events?
Not looking happy, is she? Roxana Dusenek was arrested for stealing more than $400k from the dental practice where she worked.
See us live if you want the full story.
Here are some places where we will be speaking soon:
Mar 1 Ortho2 User Group Meeting, Fort Worth TX
Mar 13 Patterson Dental, Philadelphia PA
Mar 27 District of Columbia AGD, Washington DC
Apr 12 American Association of Endodontists, Montreal QC
Apr 13 New Dentist BOOST Study Club, Philadelphia PA
Apr 26 Maryland State Dental Association, Columbia MD
Apr 26 Star of the North Meeting, St. Paul MN
Apr 29 Vancouver & District Dental Society Vancouver BC
May 3 American Association of Orthodontists, Los Angeles CA
May 4 Richardson Group, Seattle WA
May 7 Seattle Study Club, Atlanta GA
May 8 North County Women’s Study Club, Carlsbad CA
May 9 Patterson Dental, Portland ME
May 10 Patriot Dental Conference, Foxborough MA
May 15 Patterson Dental Totowa NJ
May 16 Patterson Dental, Portland ME
Jul 8 University of the West Indies
Sep 13 Orthopreneurs Summit, Dallas TX
Sep 21 Dallas Dental Symposium, Dallas TX
Oct 7 Colorado Prosthodontic Society, Denver CO
Nov 11 Thunderbird Study Club, El Paso TX
Nov 19 Memphis Dental Society, Memphis TN
To book us for your meeting or study club, click HERE or call us at 888-398-2327.
Did you miss a previous newsletter? We archive them HERE.

Why do People Steal?
One of the most frequent comments we hear once the identity of an embezzler is confirmed is that he or she is “the last person I could imagine stealing”. Their surprise is understandable. We all have preconceptions about how criminals look, dress, speak, and act. Our mental image of the criminal is shaped by what we see on the news, TV dramas and by direct observation in our own communities.

Embezzlers will never fit this stereotype; many of them remind me of Sunday school teachers (which, in fact, some of them are). The explanation for why embezzlers do not fit the preconception is simple – you would never hire someone who looks your image of a criminal. So as an employer, you have already eliminated certain people because they haven’t passed your personal “smell test”, whereas everyone you hire has.
Something to Talk About…
Winter is still hitting many of us full-force, but with March comes the promise of finally being “in the home stretch.” Winter is not a race, but if it were, then March and all of the changes it will bring are certainly a way of feeling that we are close to the finish line.
Warmer temperatures, longer days, and for a few lucky folks, crocuses will soon be in bloom. March offers us a newness that is different from that which we associate with New Year’s Day or our birthdays. With March and spring come a desire to shake off the winter cobwebs and dive into some much-needed spring cleaning. After a long winter confinement many of us can’t wait to open up our windows, shampoo our rugs, empty the ashes from our fireplaces, and finally rake the last of the fall leaves that we were able to ignore while they were covered with snow. And maybe, just maybe, while we are hard at work cleaning up all of winter’s little messes, we will have cause to pause and ask ourselves; “could my business need a good spring cleaning too?”
My team and I hope that most of you can answer that question for yourself, without feeling that there is any major work to be done. For others, you may feel that it’s time to have a chat with us or visit our website to see if there is something we can do to assist you with a more thorough spring cleaning of your office. For nearly 30 years the team at Prosperident has been proud to serve the dental community, and we hope that you will never need our services, but if you ever feel you want to talk to us about what our team can do for you, we are always here for you, and we are always happy to help.
David Harris
We are Prosperident, Dentistry’s Embezzlement Experts

Why do People Steal?


One of the most frequent comments we hear once the identity of an embezzler is confirmed is that he or she is “the last person I could imagine stealing”. Their surprise is understandable. We all have preconceptions about how criminals look, dress, speak, and act. Our mental image of the criminal is shaped by what we see on the news, TV dramas and by direct observation in our own communities.

Embezzlers will never fit this stereotype; many of them remind me of Sunday school teachers (which, in fact, some of them are). The explanation for why embezzlers do not fit the preconception is simple – you would never hire someone who looks your image of a criminal. So as an employer, you have already eliminated certain people because they haven’t passed your personal “smell test”, whereas everyone you hire has.

Criminologist Donald Cressey probably had the greatest influence on the development of our current understanding of economic crime. In his landmark 1973 book Other People’s Money, he proposed a framework called the Fraud Triangle. Cressey theorized that there were three necessary preconditions for fraud — Pressure, Opportunity and Rationalization.


Donald Cressey’s Fraud Triangle

Pressure can be either financial or emotional, and we sometimes label embezzlers with these characteristics as “Needy” and “Greedy” respectively.
Needy embezzlers steal to address a financial need; some event has created a financial imbalance where more money is being spent by their household than what is being earned, and this deficiency has threatened their ability to keep themselves afloat. They steal to fund necessities like rent and mortgage payments. There are many possible triggering events. Some common ones are divorce, a spouse losing his or her job or an addiction of some kind.

In contrast, Greedy thieves steal to address an emotional deficit. In many cases, they feel that society (represented by you, their employer) has failed to recognize the true value of their talents, and they steal to address this perceived inequity (and to prove how truly smart they are). They may, perhaps even with justification, look at you as an intellectual peer. They conveniently forget the outlay you made to acquire your education and the financial and emotional burdens of practice ownership, and in their simplified worldview, it seems unfair that you earn ten or twenty times what they do. Most of your staff, including any embezzlers you might be harboring, chronically overestimate what you take home. This overestimation increases the embezzler’s perception of inequity.

There are also those who derive emotional pleasure from the act of successfully taking a risk; they are somewhat analogous to the “celebrity shoplifters” we occasionally hear about in the media. A spectacular example of this is one embezzler who we investigated who had been stealing from her doctor for several years when she won a $3 million lottery prize. If most dental staff members had that kind of lotto winning, they would probably quit their job, and on the way out the door, would tell the doctor what they really thought of him or her.

This embezzler did not quit her job; she kept working. She also continued stealing and here is the interesting part. After her big win the amount she was stealing monthly increased. Since she clearly did not need the money that she was stealing, at that point her stealing was to address an emotional deficit and not a financial one.

One of the differentiating characteristics of Greedy thieves is how they spend their money. Needy thieves steal to protect their basic standard of living, but Greedy thieves spend conspicuously, and normally on luxury items that would otherwise be unaffordable; we have seen $140,000 automobiles, yachts and in one notable case the chartering of a plane to take friends on a shopping trip. The “egotistical” spending that we often see reinforces the view that the Greedy are stealing to address a self-esteem deficit.

A question I am often asked is whether embezzlement is more common when the economy is booming or in recession. Economic conditions affect our two cohorts differently. Tough times create more situations of financial desperation, and therefore more Needy thieves. When the economy is doing well, the perception that their friends are getting ahead more quickly than they are motivates some people to join the ranks of the Greedy.
Embezzlement could take place at any point in a dentist’s career. An employee’s decision to become dishonest actually has relatively little to do with you, and is far more related to their own needs and wants. I would describe someone’s decision to start embezzling as a statistical “random walk”.

While there is no correlation between the existence of embezzlement and career stage, my view is that dentists who are in the first five or last five years of their careers are likely to take longer to realize that they have a problem than mid-career dentists. I think that in the case of new dentists, their inexperience in business, plus often trying to juggle their practices, the effort needed to build their clinical skills, and often raising young families at the same time. The dentists in the twilight of their careers are (hopefully) financially comfortable and probably are not watching the pennies as closely as they once did. Also, many senior dentists who started practicing before practices were computerized have never become conversant with their practice management software, and that puts them at a marked disadvantage when it comes to detecting embezzlement.

What isn’t often understood is how powerful the motivation to steal is, and how the combination of determination, cleverness, and knowledge of how your office operates creates a climate where embezzlement can be successfully carried out, at least for a time.

In addition to feeling some form of pressure, an embezzler needs to decide that stealing from you is an acceptable way to address the pressure that they are facing.

We are all taught from an early age that taking other people’s things is wrong, and every embezzler must get to the point where they can tell themselves that “it is ok to break that basic rule because…”
I often explain rationalization as an ethical “bar” that a thief must be able to jump over before stealing. This bar has different heights for different people, and various factors can have the effect of lowering the bar.

Sometimes (probably without realizing it) the actions of the dentist may have the effect of lowering the bar for someone in their office. For example, if staff members see you cutting ethical corners or cheating on your income taxes, or if you do something that a staff member interprets as rubbing your relative affluence in their face, you are making it much easier for them to justify stealing from you.

I remember a doctor taking his entire team to a conference in an exotic location – great idea, except that the doctor purchased plane tickets in First Class for himself and his wife, while the rest of the team were crammed into Coach seats on the same plane. Another doctor used to regularly complain to staff about how expensive repairs to his Mercedes were; you can imagine the animosity this caused since the car cost more than the annual salary of any member of his staff.
At a minimum, this kind of behavior shows the doctor to be insensitive; it can also provide the would-be embezzler with sufficient rationalization to start stealing.

Other rationalizations that I have heard are that “the doctor would only waste the money anyway” or that the doctor is greedy or exploits patients or insurance companies.

The final precondition for embezzlement is opportunity, and opportunity exists in every practice.

The biggest misconception I encounter, and I think a major enabling factor for embezzlement, is the belief that policies, procedures and “checks and balances” can prevent, or reduce the likelihood of embezzlement. Unfortunately, this misunderstanding afflicts not only practicing dentists, but also the large community of those advising dentists.

To be clear, the misunderstanding is an honest one; most of us understand other types of crime better than embezzlement, and there is a tendency to assume that what is effective in controlling other criminal activity will also control embezzlement.

Most people understand that a burglar alarm installed in a house or business dramatically reduces the chance of burglary. Locking your car’s doors decreases the probability that your car’s contents will be stolen. We assume that the same approach (i.e., increasing the perceived difficulty of stealing) will reduce the likelihood of being embezzled, and that is where we have misapplied the analogy.

The difference between burglary and embezzlement is that it is quite easy for a burglar to switch victims. If a burglar is standing on your doorstep with the plan to rob your house, a burglar alarm sticker or loudly barking Doberman will cause them to reconsider. But what happens from their reconsideration? They do not abandon their plan to steal; instead, they modify it. So if your neighbor’s house looks less protected, the burglar simply robs your neighbor instead. So all of your control measures did not convert a would-be thief into a law-abiding citizen; instead, they caused adaptation.

But here is where analogizing to burglary reaches its limit – for a burglar, changing victims is an easy adaptation. I simply walk a few yards down the street to find an easier victim. In contrast, changing victims is a major undertaking for a would-be embezzler; they would need to quit their current job and find a new one, preferably with a doctor who they have assessed and determined to be an easy mark. Then, the thief would need to spend sufficient time in the new practice to understand the controls in place well enough, and build sufficient trust with the doctor, to steal. Thieves simply aren’t that patient, and a much easier adaptation is to keep working for you and find a different way to steal.

Put another way, what embezzlers can control, and therefore what you can influence, is not their choice of a victim; it is their choice of methodology. If you block an embezzler’s first idea for stealing from you, they will move on to their second, third, or twelfth choice until they find something that works. And with dental offices being highly porous in this respect, thieves have lots of options.

Relating this back to Cressey’s Fraud Triangle, I view Opportunity as a binary factor – it either exists or it doesn’t. For embezzlement, more opportunity does not correlate with increased probability of embezzlement, and reducing (but not eliminating) opportunity does not decrease the likelihood. Let’s assume that you have a motivated thief in your office who knows you well – what are the chances that they will be unable to find some method of going through or around your controls? Sadly, their chance is excellent.

Back to Jail for You — CA Woman Arrested for not Paying Restitution

Update September 20, 2020:

Apparently Ms. Morales’ various legal troubles have not stopped her from looking for employment in the dental field. Our friend, consultant and dental image expert Janice Hurley, recently caught Karla applying for a job with a practice in Bakersfield CA.

Janice kindly supplied this recent picture of Karla.


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Original Story:

A Bakersfield dental office employee has been arrested after failing to pay back monies stolen during a fraud scheme.

In June 2018, 42-year-old Karla Morales was charged with 45 felonies, including insurance fraud, identity theft, forgery, and grand theft after Department of Insurance detectives discovered she had submitted 78 fraudulent dental insurance claim forms for services she or her family never received. The fraud amounted to over $46,000.

Her husband, 47-year-old Raymundo Morales Jr. was also charged in connection to the fraud.

In November 2018 Morales was sentenced to one year in jail, five years probation, and ordered to pay restitution.

On Wednesday, Morales was arrested for failing to pay the restitution and is being held without bail in the Kern County Jail.

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Prosperident note — there is a Raymond Morales, formerly of Delano, CA, with date of birth June 25, 1956, who is a registered sex offender. We wonder if this is the same Raymondo Morales named in the article.

Employee Accused of Stealing from Cassville, MO dental practice


The office manager of a local dentist’s office is accused to stealing over $10,000 from the dental practice that changed hands  to a new dentist in September 2017. According to affidavits of probable cause, the office manager of what was Dr. Carolyn Hunter’s, DMD, and then Dr. Jared L. Spears’, DDS, office took the money from cash deposits starting in December 2016 and continuing until June 2018.
                The Cassville Police Department investigated the case, and Dr. Spears reported the office manager, Karla Monte Wolf, was responsible for deposits, and between March 3, 2018, and June 28, 2018, $4,932.40 was missing from the deposits. Wolf allegedly admitted to taking the cash without permission.
                When interviewed by the Cassville Police Department on August 24, 2018, Wolf told officers she had been stealing money from Dr. Hunter, as well. An audit showed $10,195.50 missing from December 20, 2016,through August 23, 2018.  
                Wolf was charged with two counts of  felony stealing $750 or more on Nov. 5. She is currently being held in the Barry County Jail in lieu of a $30,000 cash, 10 percent or corp surety bond.

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Prosperident note: Ms. Wolf has an extensive criminal record. We wonder if Drs. Hunter and Spears were aware.

What do You do When You Can’t Steal From the Dentist? Steal From Patients!

Arieta Gouvakis

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ROCKY POINT, Long Island (WABC) — A Long Island dental assistant is under arrest, accused of stealing jewelry from patients.

Arieta Gouvakis, 38, worked as a dental assistant to Dr. Elliot Koschitzki at Long Island Implant and Cosmetic Dentistry in Rocky Point.

She is accused of removing jewelry worth between $1,000 and $3,000 from two patients who were being treated at the office under her care on January 31 and February 1.

The patients were in “twilight,” under Nitrous oxide, Suffolk County police Chief Stuart Cameron said.

Neither patient realized their jewelry was missing until after they left the office, according to authorities.

The Suffolk County Police Property Recovery Squad recovered the stolen jewelry from local pawn shops.

The dental office cooperated fully with the investigation once they were notified of the allegations.

Gouvakis was arrested at her home in Manorville at approximately 12:30 a.m. Friday. Authorities say she has prior arrests and that her motivation may have been to feed a drug habit.

She is charged with grand larceny and criminal possession of stolen property.

Dr. Nick Augenbaum, with the dental practice, said Gouvakis was hired only three weeks ago. She has since been fired.

“As soon as we were notified by our patients, we called the Suffolk County PD,” Augenbaum told Eyewitness News reporter Kristin Thorne.

He thanked Suffolk police officers for quickly recovering the patients’ stolen items.

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Embezzlement by A Spouse? Yes, it Happens!

The conventional wisdom is that you are completely protected from embezzlement if your spouse runs your office.

While it is true that, in normal circumstances, your economic interest and that of your spouse line up perfectly, embezzlement can still take place even if your spouse manages your practice. In other words, most of the time, it would give your spouse no advantage to steal from your practice.

First, the embezzler may be someone other than your spouse, such as a receptionist or financial coordinator.

Second, there are times when your spouse’s interest is no longer harmonized with yours. The most common example is when they have decided to leave the marriage and simply haven’t told you this yet.

If your spouse is your employee (and therefore has no income that in independent of your control), they may have a need to put some money aside for the day when they tell you that they are leaving. Their expectation is that you will terminate their employment in this circumstance and they will have expenses for making new living arrangements and paying an attorney, all while deprived of their normal salary.

So embezzlement sometimes happens in this situation. The court case below shows an example of alleged embezzlement from a spouse in the context of divorce.

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Stephanie Negron

Look out for This Person!


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Forensic Hiring Webinar

Alexandra Counts-Thompson’s lengthy rap sheet has over 30 convictions, including several for embezzlement. Most convictions are from North Carolina and Virginia.

She is known to work in dental practices.

She uses several variants of her name including:

  • Alexandra Counts Thompson
  • Alexandra Nikole Counts
  • Alexandra N Counts
  • Alexandra Nicole Counts
  • Alexandra Nikol Thompson

We would urge extreme caution in dealing with this person.

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Head of IT Department Accused of Embezzling $800k from California Non-profit Clinic


North County Health Services, is suing this man, Hector Ramos, for allegedly embezzling $800,000 from the organization.

North County Health Services provides health care, including dentistry, to low-income residents of California.

Mr. Ramos, who was residing in Murrieta, CA at the time, has also been charged with a number of criminal offenses. Bail was set at $1 million, with an additional stipulation that if posted, that proof of the legitimacy of the source of bail funds be provided.

Mr. Ramos allegedly created two fraudulent corporations that invoiced North County Health Services for purchases of computer hardware. Instead, it is alleged that funds were used to pay for trips, clothing, and a large payment to a Porsche dealership.

Mr. Ramos’s biographical information from a North county Health Services PowerPoint presentation indicates that he has been with the organization since 2014, has two graduate degrees, and speaks four languages.

Mr. Ramos has been arraigned and has pled not guilty to 49 charges.


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For more information, please check out the story at

Connecticut Dentist has $18,000 Payroll Theft


GRAFTON — A local dentist office reported the theft of $18,300 after a hacker instructed a payroll company to make a payment to an unauthorized bank account.

According to Grafton police, dentist Karen Deak of Deak DDS and Kramer DDS Inc., reported Monday that on Aug. 10, her son, Andrew Deak, also a dentist who works for the business owned by her and her husband, completed and emailed the company payroll request.

Karen Deak told the police that unknown individual(s) then used her son’s email login and password to access the account and sent a request to Service 1st Payroll, 1008 Vivian Drive, Grafton, for a payment of $18,300. The payment request indicated the payment was for a subcontractor at 9:15 a.m. Aug. 10. By 11:18 a.m. the same day, another email was sent from her son’s account, once again requesting $18,300. On the second request, an IRS W-9 form was attached with the name “David Micheal David” with an address of “21 Weasel Road, Rolling Hills 82637.” No state was indicated. The bank information was used in the email for the transfer the funds to the Navy/Army Community Credit Union, Corpus Christi, Texas, police said. As indicated by the ZIP code, the address is in Glenrock, Wyo.

After the first attempt successfully received funds, a second attempt was made to have a subcontractor payment provided, this time in the amount of $23,900 to Bank of West in Casper, Wyo.

That is when the payroll company contacted Andrew Deak, who informed the employee that neither he nor his parents authorized payment of either $18,300 or $23,900.

Since the theft crossed state lines, the FBI was contacted, Grafton police said.

The case remains under investigation.

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Unhappy UK Dental Employee Steals from Practice


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A disgruntled dental nurse stole almost £4,000 from the practice where she worked – and spent it in Iceland .

When caught, Rebecca Seymour told the police she couldn’t get the time off work she wanted, and didn’t like where she worked.

The 31-year-old, worked as a dental nurse for Genix Healthcare when she started helping herself to money.

She deleted random patient payments, took cash for herself and fiddled records, backdating payments to cover her tracks, Teesside Crown Court heard.

She thought the game was up when members of head office came to the Middlesbrough practice.

She left without explanation, believing they had arrived to investigate her at the two surgeries on Linthorpe Road.

In fact, it was her nervous behaviour and rapid departure which aroused suspicion, said Michele Turner, defending.

Iceland trip A manager found CCTV footage which showed Seymour in the surgery on a Sunday.

Prosecutor Harry Hadfield said: “She had no reason to be in the practice at that time.

“She had gone in to steal money from her employer.”

The audit trail revealed 164 transactions to the value of £3,997 over almost a year.

Seymour went to the police and confessed to taking the money, but said she was shocked at how much she had stolen.

She said she spent it straight away on shopping, “going to Iceland”, and was ashamed and sorry for her dishonesty.

She told officers she did not have money problems and her motive was dissatisfaction with her workplace.

She was not happy with the practice and believed less qualified people were earning more money than her.

“She said she felt undervalued. She didn’t like where she worked,” added Mr Hadfield.

“She couldn’t get the time off she wanted and she wanted to try and find employment elsewhere.”

New employers ‘might find out’.

Seymour, of College Road, Thorntree, Middlesbrough, admitted theft between May last year and April this year, her first conviction.

Ms Turner said Seymour showed obvious remorse for her crime.

She now had a new admin job and was doing well, but had not told anyone of her conviction because she was so embarrassed.

“They might find out,” said Judge Simon Bourne-Arton QC, the Recorder of Middlesbrough.

Sentencing, he said the theft was a “gross and obvious breach of trust”.

He told Seymour: “Over a period of nearly a year you were stealing from your employer.

“And you were doing so in a very well-organised manner.

“This was planned, it was well-executed and it was persistent.

“You took steps to cover your tracks so that you would not be detected, but eventually you were.”

She was given an 18-month community order with 140 hours’ unpaid work and a tagged curfew between 7pm and 6am.

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