Community Health

Happy 4th.
Yeah I am working today. I called my bank and the power company and they told me the bills were still going to be coming and no they wouldn't hold off on sending the bills because of Independence Day....hence we work.

Man it is these kind of holidays that make me think about what I have.
I mean can you even see the greatness of this country. We can say what we want, we can have our own businesses, we can worship who we want, we can drive cars to the grocery store that is right downt the street and if we don't like that grocery store we can just go two more miles and go to another one.
I think about how blessed I am not live in China or North Korea or Iran (they could be beautiful places, I am talking about their government).
I try to sit down with my kids and explain to them the enormity of this blessing. And when we pray I always thank God for it. It is really hard to explain to children.

We are off to our friends house for the yearly July 3rd bash. See they live about a 10 minute walk from great fireworks. So they have a party and everyone walks to the show.
Saturday the party is at my dad's. See he lives on a lake that beyond it is downtown. So we can sit on his deck and see the downtown fireworks.

I haven't mentioned it in awhile but the pregnancy is going well. We are due October 11th. Hilda is a champ. Can you imagine having three rugrats to parent and and doing all this with a basketball in your gut? Then having to cook dinner and clean the house.

Okay with all that out of the way...
Now that I talked about how great our country is I want to tell you about a government run facility that is the community health center.
As I told you before I worked there for about 5 years. I think I was there two days a week to start then I went to one for the last 3 years or so.
I was an instructor and I was "the" dentist.
I think the center is a must. People have dental pain and they have no means to pay (or they don't have all of the means). So I think it is our governments responsibility to take care of its people (now I don't want to get into who is responsible. The people are responsible for their health so is the government and so am I. But I don't think we have figured how all three can work together).
Okay so the clinic is there. I use to see patients for an exam and then we would schedule for treatment. Basic dental flow. But the first hour of the day, like I alluded to on Wednesday, is set aside for three emergencies.
Now this was first come first serve, so you never know what you are going to get. You could have someone waiting for 3 hours since 5am. Sometimes you can have 5 emergencies.
You know me. I am a bleeding heart. I don't want to know the story. I don't want to know that the guy is driving a corvette but says he can't afford a dentist. I don't want to know that this person has a dentist and a year and a half ago the dentist told them that they needed a filling.
All I know is this person is in pain, and I mean in a lot of pain, and they are in my waiting room.
At my office we do not turn away people in pain. This is where my office and my "clinic" office differ.
The employees at the clinic do not necessarily have the same attitude as me. See at my office if the staff I have are paid to be an extension of me. Now the staff at the "clinic" office are being paid to follow rules. It is a job to them.
It is a nine to five. 15 minute break in the morning, one hour lunch, 15 minute break in the afternoon.
It seemed that the attitude was, people are in pain....not my problem.
I would think that if this clinic did not have to have regularly scheduled patients they could fill a day with just emergencies.
But why would they do this? There is no incentive to see patients. There is no reason to help the fourth and fifth emergency. If they see those people they are simply working harder for the same price.
I told you I am not the boss here. There were many of times I just shook my head at the "systems".
Now all five employees have been there for over 20 years. They are working for a government organization. How easy do you think it was to get rid of employees that are worthless? It was impossible.
The front desk person, who was very nice, didn't care that over 50% of the patients didn't show up.
She didn't care if people waited for 6 months to just get into the program. It was not in her job description to be responsible for people to show up.
Now you know that we all confirm our patients. Why then do they not confirm?
Now it is not the staff I blame, it is the bossman. He was too busy getting grants and filling out pages and pages of paper work to have this facility running. I like him, don't get me wrong, but his is a real wussy. He would never get on his staff for taking a smoke break in the middle of a crisis (which I have seen many a times).
So I would go in and they would pay me a bunch of money and I would sit and do nothing for almost half the day, because people wouldn't show up, meanwhile two hours ago they sent three people away that were in pain.
And don't forget I wasn't the only one standing around. Don't forget the three assistants and the front desk person.
So what got me ticked about this whole thing was that I read an article about someone trying to be a patient in a government facility.
See to be a patient you have to call on the first day of the month and this is the only day of the month that they make new patient appointments. All the other days the recording tells the helpless patient that they are booking 6 months in advance. So someone that is calling and they call all day there is about a 10% chance they are going to get someone on the phone and if they do the first available appointment is next March (can't imagine why people don't show up).
So this poor person in the article was lamenting about trying to call at the right time and waiting months just to get someone on the phone.
Now I started to think back about my time at the place she was trying to call.
If I ran my business like them I would be bankrupt in a jiffy and if they every ran their place like I run mine they would be able to serve their community so much better.
The only problem with them running their office like mine is that they would have a staff mutiny. They just don't work like that.
I really like the hygienist there. I had a hygiene opening in my office so I asked her to apply.
She kindly declined. I couldn't understand it. But after I thought about it for awhile I thought to myself why would she want to change her job? She sees about 5 patients a day on a tough day. Great benefits. A pension plan.
The staff use to always complain about the job. One of the staff kept asking me if I had any openings in my office. I would pretend I didn't here her.
They are always talking about leaving and going to work for a regular dental offices. Man that would have been a rude awakening. I would have loved to see this.

I don't know why this article hit me so hard. I felt so bad for this woman. It just made me mad thinking about how they won't allow someone to schedule for a new patient exam because it wasn't the first of the month, knowing good and well that they have 3 hours open on TODAY's schedule.

Got to run. Party starts in two hours.
Have a great weekend,
john

Hey all,

Nothing really going on at home. I am doing a lot of running.
Did I tell you I am training for another marathon. I want to try to break 4 hours. I am realizing this is a huge undertaking. This is about a 9 minute and 9 second mile. That is if you don't take breaks.
So now the training is harder and the breaks are shorter.
We ran 14 miles on Saturday. I ran 4.5 on Monday and I did speed work yesterday and I will run tomorrow.
Like I said, lots or running.

I went to the Nickelodeon Hotel last weekend. My wife's cousins came up from Miami. See our niece and God daughter turned three years old.
Here is the deal. It appears that I have become a resort snob.
You see when you go to the pool and it looks like the scene in the Titanic and when the ship sunk and there were thousands of people floating in the water you start to think, "Oh no".
Personal space went out the window. See the rooms were all suites. So some people thought, hey lets bring 25 people and jam them into a 3 bedroom suite.
So not only was I sharing my personal space with people in the pool, I was sharing it with people with tattoos on their necks and some with tattoos on there stomach.
Now I don't have a problem with tattoos. I have problems with tattoos on your neck and hands and stomach. Like if I see a guy, who has a tattoo on his hand and when he make a fist and it says a cuss word, I am at the wrong resort.
If someone has a tattoo of a spider web on his neck or chin is swimming next to me...I am at the wrong resort. He might be at the right one but I am at the wrong one.
My kids...they loved it. Me...not so much.
I had to wake up before 8am and go and put our towel on chairs so that when we made it to the pool about 9ish there would be a seat for us.

I have finished The Same Kind of Different as Me. Everyone that read this book absolutely loved it. Me...it was okay. It was good but for me it wasn't great.
I am now going to read a book called the Unlikely Disciple. This is about a intellectual. An undergraduate student at Brown University that decides to spend a year at Liberty college. Liberty is Jerry Faudwell's school.
You know the one....No Cussing, no dancing, no music, no dating.
I have a bad feeling about this book already.
I mean I don't like people looking at religion like a science experiment (especially my religion).
Or looking at Christians like cells in a peitre dish or mice in a maze..."lets see what they will do."

I want to start a series about my experiences as an employee in the Community Health.
I have told you about my past jobs. When I started full-time at my practice I was not busy enough to warrant working here five days week. I would work here three days a week and at the clinic 2 days a week.
At first I worked under the director of the clinic and over saw the clinic. At the beginning I would work on regular patients. Doing regular treatment plans and carrying them out.
We would see three emergencies a day on a first come first serve basis every day.
After about a year of this they changed the way the clinic ran. We now became a partner with the University of Florida, and this meant that the two days I was there I was going to be watching junior and senior dental students. They would come to our clinic for a two week rotation.
I have to tell you that I like this part the best. I loved the students that came in and wanted to get away from school for a week and just do work. No grades, no professor breathing down there neck. No pressure what so ever.
I gave them a bunch of autonomy (that is me asking how they would do it and then gently telling them how I would do it, and then making them do it my way).
I would usually take the students to lunch on the first week and if I liked them I would invite them over my house for dinner.
One thing that would always get me was the ego.
Even as a junior in dental school. Now let me say I think you know about 25% of what you need to know about "real" dentistry when you graduate from dental school. How much do you think they know a year and a half before they graduate? Maybe 5%.
I saw some people really screw up some things because they wanted to proceed before coming to me and asking for some guidance.
It is so hard to talk to a student and tell them it is hard on the outside. In school if you are getting "A's" on all your tests you start to think that you have it all together.
So this is why I had them over because then my wife tells them what a mess I was 3 years after graduating.
Then I moved. I moved to another clinic. Now I worked in this clinic as a dentist doing the same thing as I was doing at the other clinic (as just a dentist) for a couple of years. Then this clinic turned into a AEGD residency. For you non dentists this stands for Advanced Education in General Dentistry, the clinic became a place where graduate dentists come and do a two year residency.
This was good. The young dentist realize how much they didn't know and came to learn more.
I loved doing this. I loved preaching. I would come in with my problem of the week and the three of us would just rap dentistry.
But one thing I would always try to do was show passion.
I never wanted the young dentists or students to think that dentistry for me was a job.
Sometimes if feels like a job, and I have to drag my ass out of bed, but it is never the job.
I wanted them to know that regardless of the problems I was having, I consider it joy.

I am getting somewhere with this series.
I will show you an article on Friday about Community Health and I will push my opinion on you.

Have a great Wednesday,
John

Just a couple of stories

Okay Noah is the funniest five year old ever. I have told you stories but this one might top them all.
He is doing Vacation Bible School for the first time this year.
It is the first time he has been with these teachers so I think he recognizes this as an opportunity to charm other woman or it is just could be natural for him.
One kid, Nathan, came into camp this week with a wad of gum hanging on the side of his head. Noah seeing this he went to the teacher.
He asked if Nathan was in his class today.
The teacher told him Nathan was in the other class today.
He said, "Good, because I think I see Nathan's brains coming out."
Now some of you may think, the kids is a goof but I tell you he had everyone rolling.

Another funny story.
I just joined the Florida Academy of Cosmetic Dentistry.
See they have an annual meeting this year in Orlando. They have put a pretty good program on this year, Dr. John Kois and Dr. John Cranham and Cathy Jameson.
I wanted to go to this meeting. I looked it up and it was free for members of the academy and it was $650 for non-members.
I thought to myself, "How much could it be to join? I mean if I join I am in the meeting for free."
I called the FACD and asked how much was it to join their illustrious academy and she told me $550.
I was like cool. I will join and save $100.
Well I paid for my membership and found out there is a $100 first time processing fee.
So I didn't save any money but now I am part of the club and I get to go to the meeting.
So the story begins here.
I get an email from the FACD...I will print it.

Dr. Gammichia,

This email is a follow-up to a voicemail left this morning. FACD recently determined that it was going to start a monthly e-newsletter as a value added benefit for its members. The newsletter will offer various tips for improvement as well as updates/changes in the profession and with your Academy.
Our first newsletter is right around the corner and one of the features will be a New Member Spotlight where we highlight a new member of FACD. Your name immediately came to mind as you are the newest member of the Academy.
If you are interested in being highlighted in our newsletter, please let me know. All it would entail is that you would need to answer the nine questions below and submit a headshot (there is an adorable one on your website with your family we could probably use).
I look forward to hearing from you and once again, thank you for your support of FACD!

This woman also left me another message on my voicemail.
I bumped up my chest and started with, "Oh they must know who I am."
I started thinking that the FACD offices were all a buzz that they now have a member in John Gammichia.
So I called them. She went over the whole thing again and I agreed to help them with this "New Member profile."
I then ended the conversation with "Why me?" I didn't really believe that I was the newest member....there had to be more.
She stated very clearly that they were doing a new member profile and that I was THEE NEWEST MEMBER.
So it was not because I am getting huge in the dental world. It is not because they know me up in the offices of the FACD. Man what a blow to the ego (the problem is I have an ego but it is all my own doing. It is not because I have deserved an ego)
I depressed my chest and told her I would do her stupid thing.
So look for the August edition of the FACD monthly emailed newsletter (it is huge) and you will see my ordinary, not so huge in the dental world mug.

Hey have a great weekend,
john

Two weeks until the AGD meeting. Anyone going? If you are you have to go to the baseball game on Friday night. I am going... and you know I am huge (almost 200lbs).

Invisalign II

Hi all,

I have been pretty busy lately. Summer is here. TV shows are no longer new (I guess that is why John and Kate plus 8 did better than all the networks on Monday night).
We are swimming everyday. It has been in the high 90's for a couple of weeks now. Our pool water temp is in the mid 80's. It is too warm. So when you jump in the pool to get refreshed you don't refresh.

So without the fresh TV shows we are in full movie mode.
I took my wife out on Monday night to see Pelam 123. It was pretty good. Not awesome but pretty good.
And the Netflix movies keep coming.
I just finished watching The Boy in the Striped Pajama's. Has anyone seen this one? It is a film about a family. The father is a higher up in the Third Reich. He is moved to the country side to "do work" for the war. Turns out he is in charge of a concentration camp. His kid is 8 and doesn't understand what is going on. He thinks the buildings he sees in the distance is a farm.
He wonders over there (even though his mother tells him not to) and meets another kid through the barbed wire.
Not knowing the evils going on around them they start a friendship. I won't tell you the rest.
I have The Curious Case of Benjamin Button sitting at home, I will let you know.

I started Same Kind of Different as Me and I am on page 20 so I can't comment on it.
I have about 5 books on my queue at home. My assistant says I HAVE to read Running with Scissors. And there are a couple of others so....I might get to all of them this summer.

Topic de jour.
I don't know if you have felt it but...the Invisalign thing is going to be huge.
I think we broke the story on this blog (I just love saying that even though it is probably not that true).
The AGD just sent out a stand to all its members and this is when I think this is when I appreciate being an AGD member the most. When companies think they are bigger than the dentists and the patients they are treating .
I can tell you my dad does not cuss.
My dad is the Invisalign guy at our office and last week we were sitting in our office doing work and I hear him say, "This is bullsh@#$%t ." I said, "what is the matter?"
He says I just got this letter from Invisalign.....so he wasn't happy. And things usually don't ruffle his feathers.


It is getting mighty steamy here in the south. The grass is growing an inch a day. This is the first time in my life I have hired a yard man and it was so nice to see the grass mowed and weeds pulled coming home from a long weekend out of town with 100% humidity and 98 F weather. That made it worth every penny.

Well thanks for the comments, like myself I have found there are several of us out there with similar feelings about Invisalign and their policies.

I was at the Florida National Dental Convention this past weekend, and sure enough so was Invisalign peddling their system. I wonder if they are telling the dentists taking Clear Essentials I that there is a yearly requirement? According to one of the dentists I know they are not. He singed up for the class at FNDC and when he found out that he was going to have case requirements he was well lets say…… upset! He called FNDC and informed that he would like to cancel his Invisalign registration and would like a refund. At first the meeting representative hesitated but then after the dentist explained to her why he was canceling she assured him he would receive a refund. I have not met one person that has seen this as a good move on Invisalign’s part.

I am finally seeing first hand why it is important to belong and support organized dentistry. The ADA has informed me that they are looking into the issue but the AGD has been the most active so far. With over 35,000 dentists members hopefully they can get the message across to Invisalign. If you have not seen or heard the Academy of General Dentistry has sent out a point paper and contacted the CEO of Invisalign for clarification on the policy. From what I have read Invisalign has not done anything yet but give out the same flimsy excuses to hide their true reasoning.

I encourage everyone to contact Invisalign to express your displeasure. It seems like all the field reps have their “talking points” and are like good little soldiers barking out the company line. The AGD email to express your concerns is Advocacy@agd.org . The ADG web site to contact the Invisalign CEO http://capwiz.com/agd/utr/2/?a=13563786&i=93073464&c=

Well if you are a fan of the Matrix Series movies you will understand this. Finally I have possibly found “The ONE”, Neo, which will help us topple the Matrix. I ran into another up and coming company called Clear Correct. They have a very nice web site that gives some basics of the system. I called and got some more detailed information and it sounds like a promising competitor to Invisalign. They are about two years old and are currently focusing on the west coast but will be moving east this winter.

One of the first things I thought about was “ok how long till Invisalign shuts them down with a law suite”. Well I called and spoke to a Clear Correct company rep, Arron (based in Houston) and he informed me they have already had a legal patent judgment in favor of Clear Correct over Invisalign proving there are no patent infringements. He stated that they knew that is how Invisaglin would try to shut them down and they took a preemptive legal strike” against Invisalign. Not to go into details but the systems seem similar top Invisalign with some additional advantages but the cost is about $600.00 dollars a case less than Ivisalign and no yearly requirements. Finally, an alternative to Invisalign and we can get “Big Brother” off of our back. This is not an official endorsement just FYI so go to the website and check it out for yourself. I would like to hear any feed back on what others think.

I definitely feel if we stick together and let these companies know that we will not tolerate their decisions that direct our care we can change attitudes and mindsets.

Have a great summer. Football season is just around the corner.

I promise I didn't tell him to say this last statement.
Have a great Wednesday,
If you have an opinion don't forget to comment.
john

FNDC

Happy Father's day.
A rare Monday blog.
I hope you Father's had a nice day yesterday.
I had a really nice day. Family, food and fun.
My garage is done so I spent some of the day moving stuff in it. I now have a new attic so I was moving stuff in there. It was 101 degrees on Saturday so going to the attic this weekend was not a pleasant experience. You went outside in the 101 degree heat to cool off.
I was just excited to finish the garage. Its looking good.

Last weekend I was driving down the road and my five year old Noah says, "Dad, you know what you need?"
I said, "What do I need Noah?"
He said, "You need a Ferrari."
I got to tell you I totally agree with him.
But things are going to have to change in my life for this to happen. The blog is going to really have to take off and I will get international sponsors or the book I haven't written yet will be a best seller. Or someone is going to have to give me one. HINT HINT.

I finished my book, To Own a Dragon. It was good.
I am now reading The Same Kind of Different as Me. Everyone that has read this one has said the same thing. Dude that is a good book.

I went to the Florida state dental meeting this weekend. It is always in June and it is always in Orlando. Very convenient.
I saw a couple of lectures.
The first one was from a guy named Jeff Plank. The course was called The Fast,Furious and Fabulous Direct Posterior Composite Filling.
It was a four hour course. I saw 5 pictures of fillings. He spent 3 hours talking about composites. He spent an hour talking about himself. He spent a 5 minutes on how he does fillings. Then showed us his work at the end.
Here is my thing. Composites have been around in the mainstream for about 15-20 years. If someone doesn't know the science behind the composite filling TOO BAD. Don't spend an hour or TWO talking about adhesives and all the generations because all the old guys are trying composites for the first time.
Don't get me wrong he did very good work and he was fun to listen to but if you are going to have a four hour lecture on posterior composites don't you think you could show me some posterior composites.
I don't want you to tell me you do good work I want to see it. And I totally love this one,
"I did this filling this week with a product I just started using and I am starting to like it."
You mean, "you got this product for free and the company is paying you to use it and talk about it."
I hate that stuff. It is okay to get paid to do this but don't lecture on a product you don't know anything about and that you might stop using next week.

Is it me or is the pipeline slowing down?
I remember about 5 years ago I was being inundated with products. New products, new and improved products. More and more and more.
Now I don't feel overwhelmed by not knowing all the products because I don't feel like there isn't that much more coming.
Now it could be that I am just not out there as much or I don't WANT to know the new stuff.
I feel like I have settled in. I like it the way it is now and don't want to change.
I am telling you...I am turning into my dad.

I saw another lecture The Day in the Life of a Top Gun Team.
By Mark Hyman and his assistant Tina Calloway.
These kind of lectures are okay to go to but you really don't learn anything.
Mark is funny and a very good speaker but...if I wanted to laugh I would go to a comedy club.
I want to take stuff home. I want to go to office on Monday (or Tuesday) with new stuff. Not, I went to this funny course. And it was suppose to be a three hour course. It was one hour and 55 minutes.

I don't know, maybe it is me. Maybe I am too critical. Maybe I just pick the wrong lecture.
I now look back at the list that I had to choose from. Quickbook Essentials...NO. Estate Planning, securing your legacy....NO. A Typical Day of Laser Dentistry...NO. The Fundamentals of Air Polishing...NO. The Dental Spa...I am not into that right now. Ask and You Shall Receive, the Art of Getting the Yes...I am not into this either, ever. And Invisalign II...I would have taken this one but I haven't had the prerequisite.
So I am not a person that puts these things together but I picked the only two courses that made any sense to me and they both were average at best.
This is why I am looking forward to the AGD annual meeting. They know how to put a program together.
I told you I am seeing Howard Farran and Gordan Christensen. I am really looking forward to these lectures.
I am hosting the Howard Farran one.
I love doing this. I have done it about ten times and I think ONE of the guys gave me the time of day. I will let you know how it goes.

Have a great day,
john

Dental Boards II

Hey,

Nothing going on.
The AGD annual meeting is less than three weeks away. If you haven't signed up yet...it is time.
I am coming in to Balitmore on Thursday night. Classes all day Friday. I am giving a little thing at the AGD Booth for my council on the Know Your Teeth website. Friday night baseball game and then classes on Saturday. Come home Saturday night.
Now that is how I am rolling now a days. No real time for relaxing. You have to relax in the mits of the rushing.

I think CBS had a left over episode of Worst Week and my DVR picked it up.
I was like, "What is this?" while looking through my DVR stuff. I watched it and I have to tell you I laughed for 30 minutes straight. I love that show.

Boards.
I still have such a sour taste in my mouth about this whole experience.
I know it is a right of passage but to have to go through dental school and still have to go through this is too much.
I had to go through putting on a good face for my professors for 4 years. I took all their demeaning comments. I had to put up with some professors who didn't give a crap about the deadline you were on and had to finished their phone call. I had to smile and say "thank you" when they were telling my work was no good and to start over.
I had to sleep at the library for weeks at a time studying so much.
I knew the custodians by name. I was in the library so much that I knew where the best place to poo and not be disturbed.
I passed all the tests. I completed all my lab projects. I kissed all their butts and now I have to do this.
It cost about $1500 to take the test (and that was 14 years ago) and don't forget paying the patients. (Also as a side note. When a dentist from another state comes to take the boards he usually takes a review course. It is like a crash course on what the test is looking for. It cost $3000).
Now the patients are who I want to talk about today.
Now as a graduating dental student you have a pool of patients. It is your job to complete certain procedures on the patients that were given to you. If your patient pool does not have the cavities you need to do, you have to get more patients or borrow from someone else.
But when you are graduating you usually have completed all the needs of your patients.
So for the boards you have to find patients that have a certain type of cavity. Your patients that you know and become particularly fond of (and vise versa) don't need any dental work.
Well where to heck are you going to find them?
So my friend and I decided about 4 months before the end of school to start soliciting patients.
We made fliers and put them all over campus of the university and the local community college.
It said something like Free Dental Exam.
Between my friend and I we probably did over 50 exam just trying to find the perfect cavity.
Now let me tell you there were some interesting people that want free dental exams.
One in particular that I will never forget.
Before you do an exam on their teeth you do an oral cancer screening. Well I started by looking at his palate and then his tongue and I started to notice little black flakes in his mouth. Then you go around to the lips and you take your thumb and index finger and rub to make sure nothing is growing where it shouldn't.
This is when I realized the guy was a snuff dipper BECAUSE HE STILL HAD HIS DIP IN HIS MOUTH.
He didn't bother taking his dip out of his mouth for me to do a dental exam.
Real fricking nice.
So as you can imagine this is the type of person that I have to bank on to show up for the most important test of my young life.
Okay so I get a young woman with the perfect "lesion" (this is what we call a cavity). Then I find a person with a really good cavity for my back-up. They both promise to be there at 7am the day of the test.
I told them I would put them up in the hotel across the street if that was more convenient. See if you do this then there is a much greater chance they will show up for the exam.
In the same manner I am also looking for a person to clean there teeth. I find this guy that hadn't had his teeth cleaned in over 15 years. He was perfect. In this test you only have to clean 5 teeth.
But needless to say that he had more than 5 teeth that needed to be cleaned. So I had another classmate clean 5 more the next day on his test. So the dude made $500 to get 10 teeth cleaned. Not a bad gig huh?
So my operative patient, the one with the perfect cavity, was a young woman of about 23 years old. Everything was set.
It is the day before the "filling" part of the test. I had just been through 3 days questions and lab stations and I was running on fumes.
I call this young woman to double check on her and confirm our date for the next day. I get her and she starts to tell me she was having second thoughts. Since our agreement, it seems she had been talking to some people and she now wants the tooth colored filling. Now for the test there is no option...we do the metal filling. I don't make the rules.
Now I try to remain calm. I try to keep my composure. Remember I told you that the test is not about ability it is about who can keep it together.
I wanted to reach through the phone and wring her little community college neck. Inside I was like, "Are you F!@#$%ing kidding me? You have this epiphany the night before my test?!"
So I told her that those are very expensive. I told her that she was making enough money to get this filling then go and have it removed and put the tooth colored filling in and still have money left over.
I then came up with this. I told her that if we do this tomorrow and I pass I would be more than happy to do the filling over with a tooth colored filling at my office at NO CHARGE.
She was good with this.
Now I knew she was a bit flighty so you have to imagine how happy I was to see her there in the morning.
We did the test together. I passed and I gave her all my numbers. My home number and my office number.
She never called. I lost 10 years of my life and she never calls.
I will never forget that woman.

One more quick story.
All your instruments have to be sterilized and wrapped and have your SS# on it.
I asked my friend to pick up my instruments for me. He FORGOT.
It was the night before my test when he told me. You are not allowed to use any one else's instruments. I had to have THIS tray.
I went to the school and everything was locked up.
If I didn't have instruments wrapped with my SS# on it I fail. So I was getting into that sterilization room if it meant me taking the hinges off the door.
Luckily it didn't come down to this. I found an employee that I knew, that could vouch for me. Then I got a janitor with a skeleton key. He opened the door.
It was funny, the room was about the size of your living room and it was filled with shelves.
And the whole room was empty. There wasn't a single thing in there except one tray.
I was never so happy to see a bunch of instruments in my life.
Now to you these stories might not be that crazy but everything in those five days are magnified. Every little problem is a life changing event.

Thats it.

Have a great weekend.
John

PS. I joined Twitter today. I don't know exactly what I am doing but I did it anyway.

Dental Boards stories

Magic lose.
I have to tell you I am not that upset. I am definitely heart broken and I hate to lose especially to the Lakers and to Phil Jackson and Kobe, but I am trying to look at the whole season.
We had an awesome season. We grew up this season. We will be stronger for it.
(I think this is what all the losers say)
But the best thing about the NBA being over....college football is right around the corner.
Oh my gosh. If you were sick about hearing about Tim Tebow and the Gators last year. This year is going to be sooooo much worse.

We watched Rocky IV this weekend with the kids.
This is the one with Dolph Lundron as Ivan Drago. My kids just eat it up. They love everyone of these movies.
Then our next door neighbor came over with Rocky Balboa and we watched that one.

My wife and I watch a movie called Shining Through with Melanie Griffin and Michael Douglas.
It was a romantic WWII movie. It was all right. Nothing special.
We watched Taken last night. WOW!! This movie was good. It was a lot like Bourne Supremacy, where the action starts and it doesn't stop until the credits roll.
Definitely two thumbs up.

I started a book called To Own a Dragon by Donald Miller (the guy who wrote Blue Like Jazz).
It is just about the author's walk through life without a father. He talks about the hole he has in his life because he grew up without a father. Then he talks about what it means to be a father and to talks about how he filled this hole in his life with his Holy Father.
But the reason I am reading this is because my "talk" with my 10 year old is looming.
I am trying to get myself pumped up for this (maybe "pumped up" is not the best wording).
I am thinking alot about how I am going to do it.
I have a good relationship with him and we talk but we have never "talked".

Okay the topic of the day.
I want to start a fun series on the stories I remember from the Dental Licensure Exam.
First I will tell the non dental people about this test.
This exam is after you finished dental school. You have to prove your proficiency. The state of Florida kind of dances to the beat of its own drum on this one. Some states will take your degree from a University as proof enough. Some states will take certificates from other states as proof.
But you have to understand how different states like Florida and California are.
Everyone and their mother wants to retire in Florida. So what happens is that a dentist who is 60 and can retire thinks about moving to Florida (by the way, it was 96 degrees here yesterday with about a 200% humidity...so it ain't that great right now) and working a couple of days a week.
So there has to be some weed out process. And the state of Florida makes a ton of money by making dentist jump through all these hoops to practice here.
So it is what it is.
Everyone who wants to practice dentistry in Florida has to pass this exam. Now, I am a liscensed dentist in Florida which means I can use this liscense and practice in most other states. But like I said it is not recipricated.
The test.
This test will bring most people to their knees.
It is not as much as who is the best dentist but can you handle the stress. Can you jump through the hoops and not have a nervous breakdown in the mean time?
It is a five day exam. Two full days of just multiple choice questions. This part was in a huge auditorium. There are two 4 hours segment where they would have a slide for every question. Like....Can you tell me what type of cell is on this slide?
Then there are two half days where we had a laboratory test. Half of the exam was in a lab and there were stations with questions. So every 4 minutes and you would move from desk to desk answering different sort of laboratory questions. FOUR HOURS.
The second half of this day was a lab profiecency test. You would have to do Root Canal on an extracted tooth. Then, you would have to do a crown on a dentiform.
Then there was two half days of working on working on live patients.
You would have to have patient that needed the exact cavity you were asked to perform a filling on.
Then the second half was to clean someone's teeth. Now it just couldn't be anyone. It had to be someone with some form on periodontal disease.

So there are so many ways things can get screwed up during these five days.
Remember the hoops I talked about, well I will try to explain.
First let me tell you that the hoops were necessary and they did it to keep us on our toes and to try to protect from cheating.
For instance, in the root canal part of the test. You were expected to take an extracted tooth (it had to be a premolar) and mount it in an acrylic block. You were to have a pre root canal set of x-rays. Now if you were thinking you would pick the easiest tooth to work on and looking at the x-ray you can a fairly high probability of less problems. But the kicker was that you had to have two potential teeth to work on. That means two blocks of teeth and two pre root canal xrays.
And they were to be labeled "A" and "B" so as someone taking the exam you did not know which tooth you would be working on.
For every part of the exam you had to have a different set of instruments wrapped in sterilization paper with your social security number on it.
Now for the live patient part of it....
You had to line up your patients and make sure they were going to show up (because if your patient didn't show up or their cavity didn't meet the criteria of the particular exam you couldn't do this part of the exam and you would fail.
This is why they have companies that all they do is provide patients. Now when I was taking this test 14 years ago people would pay in the thousands of dollars for a patient (the company would guarantee that the patient would meet the criteria).
So if you don't have a couple G's to get a patient you have to get your own. So what if the patient that you think for sure will meet the criteria fails? You have to have a back up patient.
So how do you get them to show up? Well you have to pay them just to show up. You say to them I will pay you $200 to come and show up here and get evaluated. If you "pass" and I do a filling on you, I will pay you $100 more. So you have to pay the patient and the back-up patient to at least show up. And you have to pay your "filling" patients and your "cleaning" patients.
I am explaining all the things first because when I start to tell you the stories you have some background information.
Then after the test you have to wait 3 and a half grueling weeks to get your test results.
Last thing. If you fail the test it is major deal. They only give the test 2 times a year. So if you fail, not only are you emotionally a mess, but you have to wait 6 months to take it again and all the stress starts all over.
But what that means in dollars is....if you make $75,000 in a year, you are losing $37,000 because you failed this test.
NO PRESSURE.

Okay one quick story.
My friend Jay lived in Miami. His father was a dentist. Now his dad was tickled pink that Jay was graduating dental school and wanted just to be there at the end.
His father stayed with Jay a couple weeks after graduation just to hang out and try to get Jay through the boards. Well the last day of the boards started that morning so dad said to Jay, "I am going to go home, good luck today and I will see you home in a couple of days."
Jay's dad loaded up the car and started the 6 hour drive home.
One problem....dad started the drive with all of Jay's root canal instruments and mounted teeth in the back of his sporty Lexus.
Now Jay was getting ready to leave for the exam and realized this about a half an hour after his dad left. So he borrowed his friends sports car and started down the highway at about 100mph. He figured he would catch him in about an hour.
Now you have to understand this is not the days that everyone has a cell phone so he was not able to get a hold of his father.
Also realize that if Jay doesn't have his stuff he would get a zero on the root canal part and almost automatically fail the whole thing. Because a zero is hard to make up.
Jay never caught his dad.
He got back into town about a half hour before the test was about to begin.
It was a mad scramble. He borrowed someones instruments (I think there was some fudging with this because they had to be his instruments with his SS# on it...but I don't remember). Now the tooth was the real issue.
Remember I said that you had to mount two teeth and at the time of the test they tell you which one you will be working on. Well that means people will literally be throwing out the non used tooth.
Well, after the announcement of the tooth, he went into the trash can and picked out a tooth.
Now he is saying to himself this is a $35,000 decision. Do I take something out of the trash and possibly get in trouble or do I take the zero? Now they could have caught him and banned him from taking the test again. But it is not like he is turing in someone else's work. Or cheating. So he risked it.
I can tell you I would have done the same thing Jay did.
You are so stressed (not that I am saying if you are stressed it is okay to lie) and so many things are riding on this. Jay probably was suppose to join his dad's practice in three weeks. You have to plan on passing. I can tell you your head is spinning round and round and you are definitely not thinking straight.
I am not remembering the story perfectly but I remember there was a problem with the xrays.
Like he found a tooth but couldn't find the pre root canal x-rays that went with it.
So he took a penalty by not having that x-ray.
He said his root canal totally sucked but at least he didn't get a zero. I think I remember him getting a 1.5 out of five. And I know he passed his exam.
Remember I said it is not to see if you are an awesome dentist, it is how you handle all these things. Can you keep your head? Can you keep it together long enough to pass the test?

I am sorry for the length,
I would love to hear your board horror stories,
I tell you mine on Friday,
john