How do you like the new photo?
I thought I might change the picture once a month.
Oh, before I forget, I am looking for someone to help me with Monday's blog.
As you can see I am having trouble getting a Monday blog together. So I was thinking someone could, once a week do an article review.
If you read a lot of articles and want a forum to talk about it then it could be you.
Write me at Jgammichia@aol.com.
Magic are in the Finals. WOW!!! I was lucky enough to go the 6th game in Orlando.
It was AWESOME.
I WITNESSED LeBron cry.
I just finished this book called The Glass Castle and I don't know if I told you or not but I am reading a book called Hope's Boy. They are both very good. Remember the Glass Castle is about a woman that came from a really poor home to become a correspondent for MSNBC.
Hope's Boy is about a kid who bounces around from foster home to foster home. Then end's up going to Harvard Law and now is an advocate for foster care kids.
I think what is so great about these books is people that against so many odds succeed.
But the reality is that they are about .000001% of the norm. Which is why these kids that are abused emotionally spin around and around and never get out.
And if you ever have heard me talk about my nephew (I wrote a series of blogs on him) now THIS would be a memoir of a emotionally abused kid and how he never comes out of it (and he is still in it).
I guess it wouldn't be as exciting if the kid wallows in his own misery. It is like the main character in a movie getting killed.
He lived with us for 7 years and then his mother came and took him from us saying, "it is time Seth lives with his mother." Only one problem, she didn't have a place to live. So they lived in a car for two months.
Anyway, to more happy thoughts...
I saw Rocky III with the kids. I pity the fool. Awesome movie. Now I know why the Rocky movies were so popular.
I also saw a movie call Nothing But The Truth. It was very good. It was about the one female reporter that wrote a Pulitzer Prize quality piece and then the law came down on her for not revealing her sources. She ended up going to jail. It was about the highs of writing the article to the lows of losing her family because she was in jail.
Okay topic de joir.
I wanted to talk about this patient I had. This patient was referred by a great patient.
A lot of times you can tell what kind of patient they are going to be by who referred them.
The referring patient thinks I can walk on water and sings my praises all the time.
So this referred patient comes in and their mouth is a train wreck.
I mean not only do they have broken teeth but their teeth are just plain ugly.
So we do an exam and this person has periodontal issues, missing teeth, decay issues and occlusion (bite) issues.
This patient need a multiple facet treatment plan and needed to see more than one specialist.
I did a full work up (doing a lot of educating of the patient) and spent a lot of time talking to my specialist and working up something that I was so excited about because it would have been life changing.
So when it came down to talk about getting started this patient says, "Nothing hurts so I don't want anything."
I was a bit shocked but that is okay.
As long as the patient understood all the things that are going on in his/her mouth and know what will happen if nothing is done. Well that means I did my job and it is their decision. And we all know that if someone does something they don't understand or don't want then they start to resent the provider.
So this patient disappeared for a couple of years and came back in pain.
The patient had a perio abscess. I explained to this patient that there is no easy fix. You have teeth that are unrestorable. You have teeth that need to come out because they can't be fixed. Now you don't want to spend any money on teeth that can't be fixed do you?
I think this is when this patient went to the periodontist and had an exam and never followed up with him.
Another year goes by and this patient shows back up and this time says that it is time.
Now this is not a patient that is excited about doing their mouth. This is someone that kind of blames me for things.
Now I am starting to get a bad vibe from this patient but I still continue.
This patient is plain grumpy.
I am okay with this but it is certainly easier to work on appreciative patients. This person is not a warm fuzzy kind of patient and I am okay with this. But you know what I like working on warm and fuzzy people. It makes it easier to come to work.
And I like warm and fuzzy people to refer their warm and fuzzy friends.
But not this patient.
Not everyone is going to fit the mold of perfect patient and I have to be okay with this.
So we are going to get started and we have had a couple of just talking appointments. Just to educate. This is what we are doing and this is what we will do the next appointment....things like this. Then this patient would go up to the front and say something different than what I just said. So then we move this patient back to the consultation room and reiterate what we just talked about.
Then this patient tells me that they only want to do the lower teeth. "They are the teeth bothering me, so this is what I want to do."
Now all along I am hoping this patient will change dentists.
I am still the friendly, warm, happy go lucky dentist and this patient is maintaining grumpy.
I am thinking that we are not jiving and they are just going to go somewhere else.
But they keep coming back.
So we end up doing the lowers in temporaries. I had to remove some teeth and this patient claimed they were going to go to the periodontist and do some implants. So I told them I would see them after they were done at the periodontist.
A year goes by and no one has heard from this patient, they have disappeared again.
Finally, the temps break after a year and a half and this patient calls. They want to know why these crowns didn't last.
I said because they are temporaries. Temporary crowns means they are temporary.
This patient is confused because they thought they paid for final crowns.
Back to the consultation room. "This is what we did. Remember we talked about this and then did the work and then you said you were going to go to the periodontist."
"I guess." They say.
"Okay so I guess what I am saying is that I want to finalize things but I am not going to the periodontist."
So I know what you are thinking. Why haven't I told this patient to find another dentist.
The answer is, I DON"T KNOW.
Every time this patient would come in my energy would be sucked out of me.
So before we got started I sent this patient a certified letter.
The letter spelled out everything we have done in the past. Everything we are going to do.
I spelled out the limitations by not going to the periodontist and the limitations if the upper is not done. I then spelled out what he has paid and what he is going to be responsible in the future.
The patient shows for their three and a half hour appointment.
But the patient wants to talk to me about the letter first. The letter upset this patient because they claimed all I cared about was money.
The letter was about a lot of things and money was one of them but I just didn't want them to be shocked when the work was done and then my people say you owe $8000 and then say, "I had no idea."
So even though they were pissed at me they were ready to get to work.
I kept saying to myself, "This patient doesn't appreciate me. This patient doesn't like me. This patient doesn't value their teeth. What am I doing?"
Do you have this patient?
Is it just me?
I did the work and saw this patient for the prep and impression appointment. A metal try-in appointment and a cementation appointment. Everything went great. The work turned out great. And nothing from the patient. No accolades. Never warm, just very matter of fact.
This patient always seemed to hate it here and my staff and I kind of hated working on them.
I tried to just do my job and do great work but it is no fun unless you are working WITH someone not ON someone.
Am I making sense?
And the kicker, we were all finished and we showed this patient their new lower teeth and they said, "I don't really care about my teeth, but I know you guys are good so I don't really want to see them."
Was that kind of a compliment...I guess this is progress.
But where do you draw the line. I like doing dentistry. I like people. I like working with lots of different types of people.
I don't know.
Do you have any feelings about this?
Have a great Wednesday.