Monday, December 7, 2009

Jeremiah 29:11

Hello depression, welcome back.

I swear I wasn't like this before starting my business 3 1/2 years ago, and I have never been diagnosed so I don't mean to offend anyone with diagnosed depression ("what's the deal with cancer").

However, the voices are back.

Not the fun happy sarcastic voices.

The "YOU SUCK" voices.

Ever get those? Ever have one of those weeks where you are just worn down? One of those weeks where you are a walking panic attack. An actor who walks around the office smiling but has to hurry back to the privacy of my private office before the true emotions come through. A week where you know you have snapped at your kids and wife when they didn't deserve it. A week where you had unfounded, random fears of being diagnosed with cancer or having a family member die (yeah, I have those voices a lot). Then to cap it all off you hit a weekend where instead of relaxing and recharging you spend 6 hours rebuilding a hard drive in one of your operatory computers (can't wait to get that bill) and then spend Saturday seeing a patient in severe post-frenectomy/extraction pain who can't wear his new denture because of the inflammation.

I don't even know where to begin so if this is stream-of-consciousness and you don't like it - fine, skip to Wednesday. I'm lying on the couch now, ready for the healing to begin.

November was one of the worst collections months in the brief history of this office. It was a month where I am still juggling bills so that everything clears on time. It was a month where you realize that there is no such thing as a "profit margin" in a dental practice with the start-up costs we have. It was one of those months where I felt like Bernie Madoff - is this really a successful business or simply a fancy maxillo-mandibular-ponzi scheme.

It was one of those months where I had to expend all my energy juggling bills and fighting the pressure to "diagnose to help the bottom line". I don't know the technical term, but I don't think non-dentists can appreciate that pressure. Is it only me?? I am extremely conservative on my diagnosis. If a practice manager came in I'm sure the 1st thing they would say is to cut 2 staff members and the 2nd thing they would say is to start diagnosing more crowns. BUT I WILL NOT COMPROMISE, I WILL NOT SETTLE, I WILL NOT STOP FIGHTING. I hate the pressure of having a stack of bills on my desk and still diagnosing as if I am Bill Gates. I don't like leaving an operatory frustrated because the tooth isn't cracked a little more to justify a crown.

It is the holidays, I want to be generous and happy. I love giving things to people - that is my gift and my curse (thanks granddad). I employ a single mom, a young woman putting herself through college, and 2 new moms (one of whom's husband recently lost his job). I have a responsibility to these people. They have each worked so hard this year, and we are growing but there is just nothing extra. How do you do Christmas bonuses?? I am not going to be able to do much and that just bugs me.

There is an analogy that I use all the time in situations like this. If you enter a strange room and the second after you enter the room all the lights go out, if you continue moving across the room your mind will retain the brief image of the furniture in the room and you can navigate across the room without hitting anything. If, however, you stop, you lose that image and it is more difficult to make it across the room. I can self-diagnose and give myself that advice. It seems dark now but remember your vision, just keep moving forward, stay the course. I know we are doing fine (Mr. Banker if you are reading this - believe me, we are doing fine - promise). That said, it is a hell of a lot easier to cross the room with a freaking light on.

Well, I can't put it off any longer. I have to go through the stack of mail on my desk and start figuring out what bills to pay. Time to put on the iTunes and just do it. Hopefully next week will bring back some of the mania that everyone enjoys so much more.

Have a good week,



Anonymous said...

Unfortunately in addition to paying the bills you are also paying your dues in life. Most everyone goes through this unless you are lucky. Hang in there. Been there and done that, it will get better eventually.

Anonymous said...

John told me to read your post as I drove home from work and called him complaining about similar situations and the pending annual holiday party. Sorry. It looks like my November and December will be the low months again. I'll not earn a nickel over Chrismas but pay my staff the same. Owning a small business changes us. I am a Scrooge and Grinch hybrid on steroids. Hope thigs get better.

Anonymous said...

I have owned my own practice for 15 years and I have seen tremendous growth during that period. But that fear of failure always haunts me whenever I have a poor billing day or a below average month. Are patients unhappy with me? Is someone bad mouthing me because the patient had higher expectations than what was delivered? Even though I was very clear in the consultation that the complete lower denture would have poor retention without implants or that tooth with the MODBL restoration will eventually fracture unless crown lengthening and a crown is done or whatever. By far, most patients are happy. But it is the select few that create all the anxiety. And what if someone lodges a complaint or initiates a lawsuit because that molar endo which was obturated 2mm. short on the MB1 root fails? All this stuff can drive me crazy if I let it and sometimes I do panic. I will also snap at my wife or kids when they don't deserve it and then I feel guilty about it. We both need more confidence. Success will come for you. Be patient and stick to your philosophy. Treatments should always be based on patients needs not your own.

Anonymous said...


Your words are a comfort. So many of us struggle with the same things. It encourages me to hear you fight the urge to diagnose more crowns. You are one of the good guys. Hang in there, and thank you for sharing. Remember, you are also laying up treasure elsewhere.



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