Wednesday, April 29, 2009

Associate stories

I just ordered the Solaris LED headlight from a company called Perioptics.
They were rated #1 from Reality.
I am so excited.
If you thought I looked like a geek with my Design for Vision loupes, just think what I am going to look like with a geek light on top of my geek glasses.
Revenge of the Dental Nerds.

I read The Appeal by John Grisham over my vacation and I got to tell you he has really lost it. It was not good.
About 20 year ago I read the Firm and it was so good. Then I read A Time to Kill and I thought that book was just awesome. But now he is on his 600th book and (shaking my head) I don't think I will every read another one of his books.
The last five of his books that I have read have all sucked. I read Playing for Pizza, Skipping Christmas...not that good.
I actually stopped reading one of his books and I almost never do this. It was so memorable I can't remember the name. I think it was the Broker.
I finished this book and couldn't believe I just wasted my time.

On another totally different topic I am going to have "THE TALK" to my almost 10 year old son soon. I have known it has been coming but I think it is going to have to be so soon.
I saw one of his classmates at the office today and she was wearing a bra.
I am totally freaking out.
I mean him and I have a great relationship but this is going to take it to the next level.
And now when I make jokes to my wife about fooling around he is going to know what we are talking about.
He is still so naive, I can joke about it right in front of him and he wouldn't know what we are talking about (at least I think so).
I am sweating just thinking about it.

My assosciateships.
I told you I had three jobs my first year of real life. I worked with my dad. I worked as an associate and one day a week I work at a capitation office. To all non dental people this is an office that primarily take patients that are referred from an insurance company.
So I took this job because I wanted to work 5 days a week. I worked there on Friday's only.
This job was weird because the company actually rented some one's office space. I would be working out of two rooms and the dentist who owned the office would occasionally see some patients in the other rooms.
The office was run by a "office manager" who told me what to do.
This job was to just for me to do more dentistry. I wanted to do as much as I could. I still was very slow doing dentistry and as I eluded to you earlier I didn't know that much, so I wanted to see more.

I got to tell you that I thought I knew a lot. But it took about a month after working to realize I was a pawn in a chess match played by kings.
I knew something but it wasnt what I was seeing.
I knew letters but I didn't know how to read.
So I had this network of dentist that I would call at least weekly.
Three days a week I was out of the care of my father but the staff kind of understood when I called and asked for my dad (in a panic voice) it was time to interrupt him.
"Dad, I was taking a temporary crown off of someone and the abutment is in the temporary.
What the f!@#$%k do I do now?!!!" (the author of this blog does not necessarily reflect the views of the AGD).

They don't teach you this kind of thing in school.
I think I had an endodontist on retainer. My father went to dental school with a local endodontist and I called that poor guy all the time. He was so patient with me.
"Dr. X, I was using these brand new files called Profiles. I put a file in one of the canals while I was doing this root canal and it came out of the canal half the size. What just happened?"
One thing I give myself credit for is actually calling these guys. I refused to do this on my own.
I use to call my dad over to my operatory just to help me find orifices on root canals and he didn't even do root canals.
I did 4 root canals in school. I did one posterior root canal in school and it took me 9 hours.
Guess what everyone needs when you get into private practice? You guessed it...posterior root canals.

Funny story, I was out about 10 months and the state dental meeting was in Orlando. I was a mess after 10 months of struggling.
I saw a dental professor there. He said, "How is it going?"
I told him I was like a fish swimming up stream. I don't know what I am doing half the time.
Nobody needs what I know how to do. I am lonely and feel like I am on an island.
Then I come to these meeting and there isn't a single course for the young dentist."
I basically needed him to tell me everything was going to be okay and he said, "Okay, great seeing you John" and walked away.
"What?! That is what you have to say to me. 'Okay, see you John'?"
He didn't want to hear it.

In my second year out I was working for another dentist (I quit my first associateship). I was going to run one of his satellite offices. I was there on my own for two days a week.
This one patient had a loose partial and I was going to change out his Precision attachments on his lower partial.
Well how many times do you think they go over this in school? NEVER.
Well I didn't know what I was doing so I locked the sonbitch on. I called my prosthodontist friend and he came to the office and helped me cut the thing off. This was a great day.
Then you go home and your wife says, "How was your day?" What can you say?
You just smile and say, "Oh, pretty good. Is there any beer in the fridge?"
Are you kidding me?

Then I would read in my "throw away" magazines how easy it was to practice dentistry.
All you had to do was do this and you can make $500,000 a year.
I didn't care about the money I just didn't want to kill anyone in my first year out.
I went to a the ADA's young dentist annual meeting and there was a guy sitting at the table next to me talking very loudly.
He was telling someone that he did 24 units on someone "this morning" and they went in just like that.
I couldn't even do one without a half a day marked off the schedule.

Well it is getting late,
More funny stories on Friday,
It is Wednesday...halfway home guys,

Monday, April 27, 2009

When I was an associate

I have to tell you that this is the third time I am writing this blog. Sometimes working with computers is so frustrating. I sometimes will put my thoughts down and save a draft and then, like Friday, I will come back to it when I have time to make the blog better. I worked on this draft for over an hour on Friday and then pressed the save button. Then it gave me an error signal and all my rewrite was lost. I was so frustrated I just left my computer.
Sometimes I will inadvertently hit the ENTER key and send in a blog that is half finished or doesn't make sense.
So it may appear sometimes that I am just too busy for the blog. But just know that if you don't get a blog on a certain day it is because I have just put my shoe through my computer monitor.

Real quick...I have watched a ton of movies.

Quantum of was pretty good. I found it very hard to believe that James Bond was not trusted by his superiors. The hole movie I kept thinking, "yeah, he has been an agent for 50 years and they are not going to trust him." and "why are they chasing their own guy?"
Then I saw a movie called Appaloosa.
It was western movie with Ed Harris, Renea Zellweger and Viggio Mortensen, the guy from History of Violence.
It was pretty good. The only thing I have with Westerns is that no one bathes for a long time and that kind of grosses me out. And they don't brush their teeth.
Then I saw Slumdog Millionaire.
I thought this movie was very good. You know that when I movie gets movie of the year it usually sucks to people like me and you (i.e. No History for Old Men) . But this one was pretty good. It had a bunch of no name actors (with the exception of one super model) in it and it was a disturbing tale of India and life without money in India. It was very redemptive, which I like.
The Visitors...very good. This movie is about illegal aliens. A man is thrown into a relationship with a couple of illegals and you really start to like the characters. But he gets pulled over by the cops and gets put in detention. Then the story on from goes from there.
Burn after Reading....did I tell you this movie sucked. DO NOT GET THIS MOVIE.
Pride and Glory....classic good cop against bad cop movie...pretty good.
Lakefront Terrace...A "fatal attraction" type neighbor makes the new people in the neighborhood miserable. I give it about a 5.5 out of 10.
The Electric Mist with Tommy Lee Jones and John Goodman. It was just okay.

Hey, as an you care what movies I watch? If you think this is a stupid part of the blog you can tell me. Remember you can comment as "anonymous" but be gentle I am sensitive when it comes to constructive criticism.

Okay topic of the day,
I wanted to do a series of blog about stories about me (go figure).
I wanted to write stories of when I was an associate.
I know what you are thinking...John I thought you work for your dad.
Well as you dentists know, you can't just bring someone in and think he is going to hit the ground running.
My father at the time was 50 years old when I graduated dental school. My dad wanted to have a two dentist practice waiting for me but how does a dentist create a two dentist practice. If you have 110% of your maximum you are going to make some people unhappy. Sure you can bring in a ton of new patients but it may be at the expense of your existing patients and there they go out the back door.
He had had an associate for one day a week to do his root canals and his extractions. This guy was not here to grow the practice. He was here to do the stuff my father didn't do, i.e. root canals and extractions and kids.
Now I was going to come into work two days a week. Partially because what this other dentist could do in one day it would take me two. Also in the down time I was to start marketing the practice (and I will get to how I did that later).
I then went out and got two other jobs.
One job was an associateship about 15 miles north of my practice. The other was one day a week and it was strictly capitation (for all you non-dental people this is a practice where the people come to this particular office because it is on their insurance).

I am going to talk to you about the associateship.
The dentist was a pretty good dude that had always had an associate. Same kind of thing my dad had always had. He wanted someone to produce, not market. I was there on Tuesdays and Thursdays and would do all the things he didn't want to do.
I would see all the kids and all the adults that acted like kids. I would see all the mean people.
I got to tell you about this doctor. As I think back on this time in my life I think very fondly of the nine months I worked with him.
But at the time I was working for him (I don't know if I was just a punk or I have forgotten all the negative things that went on in the office) I didn't have a lot of respect for him.
Maybe there was somethings that he did that maybe still wouldn't hold the mustard but now I think that I was pretty unfair toward him.
For instance, I didn't think he treated his staff all that great.
He was an introvert. He didn't have this warm personality. He didn't have a relationship with them and they never talked unless it was about the patient. He would finish with a procedure and go straight to the office.
Now, me being the young, good looking (if I don't say so myself), fun, new dentist, I would talk to everyone.
Now they would bitch to me about what they didn't like about the way the this dentist did things. They would complain and I am would join right in there with them.
I didn't abstain from the back stabbing.
I still think about that office. As much as things might not have been that great internally he gave me such an opportunity. I will never forget this.
I see him once in awhile and I try to always thank him for taking a chance with me.

Lets talk about doing stuff that doesn't hold the mustard. Now if you are avid reader you know I don't do well with cutting corners or doing things that are shotty.
Like if a group of your peers are around and they all look at your practice, would you have any issues showing them what you do?
I do everything at my office like people are watching. Not just people but other dentists.
Like doing veneers on patients in their 80's (and don't give me the "80 is the new 20" crap).
Like using bonding agent that doesn't work just because it is cheap.
Like using blue build-up material because you think the patient will desire the crown faster.
And of course over treatment.

Now, as I think back, it wasn't easy being an associate. Some of the reason I would talk to the staff is I wanted to be liked.
You all know how I have this gene (and most dentists do, especially young ones). The "make people happy at all cost" gene.
I don't know anything about dentistry except for the 15% that they taught me in school. So I and all the other newbie dentists are at the mercy of the older dentist.
Now if this dentist is not the nurturing type, who is going to teach you how to be a good dentist. I was basically flying without a chute. I had the mentality of a high school kid with a dental degree.
Now, what if you are working for that angry dentist? Yeah, you know who you are?
The guy that throws things, not so nurturing.
What if you are working for the dishonest dentist? The guy that you have "handshake" contract with. And he says I will pay you this per day and if you go over this amount then I will give you this.
Yeah, and when your paycheck comes it is drastically different than what you agreed on.
You confront the dentist and he/she says, "I never said that." How is that for shaping the future of dentistry?
How about the cheap dentist (I know that we are all cheap, present company included, but I am talking about the really cheap dentist)?
The guy who is digging through the trash to look for the possibility of a discarded instrument or upset about the amount of bonding agent the assistant is pouring out and is screaming about it in front of everyone.
I think this is a real problem. I know of only two dentists that bought into the practice they began with. Sure people have different personalities but mostly it is because of crap like the above.
By the way the above stories are all real accounts from my friends when they were associates.

This is getting a little long. I do want to tell you a bunch of funny stories from my youth. I am 40 now so I can say that. Like the time when I accidentally pulled some old ladies wig off in my first couple of months of practice. How was I suppose to know that when you put safety glasses on someone that was a possibility?

I would appreciate your stories as well. Also if you are a "boss" and have a funny story you can email me at

Have a great Monday,

ps The revision I did on Monday was much better than this one.
So blame not me.

Wednesday, April 22, 2009

Napa pictorial

Hi all,
Welcome back to me.
Thank you for missing me.

Okay here is the deal. I have thought of blogging about pre dental John Gammichia. I want to start a series on what was going through my mind when it comes to wanting to be a dentist. Most of it is going to be funny and stories we all can relate to. Today though I have wicked jet lag and I a just finishing a long day.
But I want to tell you about Napa and I will be doing this in a series of pictures. But first I have watched a ton of movies.
I will tell you which ones I watch and then talk about them later. Apploosa,
Quantam of Solace
Slum Dog Millionaire
The Visitor
Pride and Glory
Burn after Reading (sucked, totally sucked)
Lakeville Terrace
and one more that I just can't remember.

I picked up a John Grisham book in the airport The Appeal.
I am almost done. It is okay. I have found that his books have gone down hill since he started writing a book every six months.

Arrived in San Francisco
First two nights at a bed and breakfast in Sonoma County. A town called Healdsburg.
It was my first time staying at a B & B. It was real nice.
Then it was off to the Wineries.

For dinner we ate at a fancy shmancy French restaurant.
Homey don't play that. Are you serious?

Second day we went to see the Redwoods and drive on the Pacific Coast Highway.

Then back to the wineries. You don't get any better than this.
I took about 500 pictures, none of them capturing the beauty of this place.

They say that the wine on the mountain taste different than on the Valley floor.

Caught a Giants game at AT&T park.

It was so beautiful.

(look at that fat gut...I officially start my diet today)
We finished our vacation in Marin county. (We have some friends planting a church out there and we spent the last day and a half with them)
We did some shopping for the kids and enjoyed the view of the $4,000,000 homes.

Talk to you on Friday,
ps Don't forget to double click on the images and they will be easier to see.

Monday, April 13, 2009

Napa, Here we come.

I hope you had a nice Easter/Passover.

I don't think I told you but my wife and I are going to Sonoma County, California on Wednesday.
We are big wine people. My wife likes it for the taste, I like it for the friends and buzz.
We are going out there without kids for 6 days. I know what you are thinking. Man they go away alot.
Yes, and it is becoming our thing. We love going away. We have a young woman (almost 30 years old) in our church that will watch the kids and we just go.
Our office uses the American Airlines credit card to pay our bills. Now we charge EVERYTHING!!! Lab bills and even the electric bill if they will let us. Now in a two dentist practice we crank up the monthly bill. Sometimes our supply bill will be $15,000 by itself.
So we will put over $200,000 a year on the card. Now those of you who know points...that is alot of points. Which parlays into about 5 round trip tickets a year.
But we don't use them if we are going on a $125 flight. We use them to go business class no stopping to California. You pay a little more in points but it is worth it.
If you are not using a credit card this way...I recommend it.
A year and a half ago we went to Rome first class on points alone, and on our lay overs we got to hang out in the Admiral's Club. Oh yeah, this is where I belong.
So we are going to pay the sitter and a couple nights stay and are staying with some friends in Marin County for a couple days.
It is going to be great.

I am looking for a couple of ghost writers for next week.
Got anything on your mind?

I got a couple of comments this weekend that I want to talk about. I didn't want to spend to much time on Jesus stuff (not that I have a problem with it I just don't want to force anything on you) but I did want to clarify a couple of things.
First an easy one...
I can't help but wonder how many people recently slaughtered a 1 year old lamb, ate it roasted (not boiled) and spread it's blood over their doorway so their first born child wouldn't be killed by god. Please comment if you did. This passage seems to say that you are supposed to.
No, unless the Angle of Death is coming, you don't have to do this anymore. Now if you do find out the Angle of Death is coming, please let me know and I will get the word out.
Although I did some research (meaning I looked it up on the Internet) in Jewish tradition, Jew will put Mezuzah on the door frame to protect the inhabitants. This is not, although, does not represent the blood of the Lamb.

Now the next comment is a tough one.
Great sermon, John! One question, though. Did Jesus die for all people, or just His people (meaning believers)? If He died for all people, wouldn't all people be going to heaven? Think about it and let me know what you come up with.

I did a lot of thinking and talking to the right people about this one. I first talked (argued) with my wife about this topic all weekend. We consulted out pastors, we consulted John Piper (not personally, he is dead) and this is what I came up with.
I was wrong.
First I want to say that this is an "in house" discussion. Meaning if you believe in Jesus and what he did for us then you are "in". If you are "in" we can all argue the finer points of the text but we won't know for sure until we get "home".
Now I believe that his power and what He did was enough for all sins. Not for all sinners.
I do not believe that what He did saved everyone.
I believe (and it is backed up in scripture) that there is something called Limited Atonement.
I am going to give you a couple quotes of article written by John Piper on this very subject...
On the other hand we do not limit the power and effectiveness of the atonement. We simply say that in the cross God had in view the actual redemption of his children. And we affirm that when Christ died for these, he did not just create the opportunity for them to save themselves, but really purchased for them all that was necessary to get them saved, including the grace of regeneration and the gift of faith.
Off the subject a bit and I may open up a real can here but Presbyterians (PCA) believe that we don't chose Christ. Christ chose us.
We believe not that we are drowning and He throws us a life vest. We believe we are dead at the bottom of the ocean and He picks us up out of the water and breaths life into us.

More about who is saved (more Piper)...
John 10:15, "I lay down my life for the sheep." The sheep of Christ are those whom the Father draws to the Son. "You do not believe, because you do not belong to my sheep." Notice: being a sheep enables you to become a believer, not vice versa. So the sheep for whom Christ dies are the ones chosen by the Father to give to the Son.

It is very heavy, I know.
If you want the whole article it is at...

If you have any questions, just ask.
Have a great day,
See you Wednesday, maybe

Friday, April 10, 2009

Passover and Easter

Hey all,

I am going to get into it because I have a topic that is burning in my mind.

I haven't told you all this because I didn't want to get all Jesus on you but I do a men's Bible Study on Monday night. It is called Bible Study Fellowship, BSF for short.
It is a seven year study, but it goes year to year, taking the summers off.
This year the study is on Moses. BSF is an international organization and every BSF class (there is like 5000 going on in the world presently) is doing the same study from the same material.
But when you study Moses you learn so much about the Jewish faith and what is the backbone to the Christian faith.

Because it is Passover began this week Easter Sunday in a couple of days I think it was time for this lesson.
I would say you will be hearing this from a "scriptural child" so if you have some constructive criticism...bring it on.

I will start with Passover.
The Israelites.
It kind of starts with Abraham. His son was Isaac. Isaac had two sons Esau and Jacob.
Jacob would eventually change his name Israel.
People that were born of a guy named Israel were guessed it Israelites.
The Israelites were God's chosen people.
Now you ask, "Why them? Why not everyone?"
Great question. God's ways are not ours. So we will never know until we get to Heaven.
But we do know one thing...He didn't chose everyone.
So the Israelites are His chosen people and they lived in Egypt. There was a new king and he looked out and said, "Dang there are alot of Israelites" (not his exact words) and he began to fear they might take over. So he made them slaves and oppressed them.
During this period they still "multiplied and spread".
But because of the multiplying and spreading the king made a law. Every Hebrew son that was born was to be killed after birth.
Moses was born in this period. You might not know the story...He was born of a Israelite family and somehow they got him to the Nile river and let him go in a basket.
The Pharaoh's daughter found him and he was brought up in the Pharaoh's home.
This allowed him to grow up being schooled in the finest schools learning many languages and learning how to lead people and learning how lead an army.
When Moses was a man he finally was called by God to lead the Israelites from slavery to the Promised Land (modern day Israel).
So Moses was chosen to go to Pharaoh and ask for the release of his people.
Pharaoh said, "No." (again, not in those exact words)
So this is when the Lord started the plagues on Egypt, if you have seen the movie The Ten Commandments you know this. First he turned his staff into the snake and Pharaoh wasn't impressed. Then he turned Egypt's water into blood still not impressed. Then there was a series of more plagues that seemingly wore down the Pharaoh.
But he still wouldn't budge.
Moses said that if you don't let us go all the Egyptian first born sons will be killed.
The last plague was the Angle of Death.
Moses told all the Israelites, "each man is to take a lamb for his family...a male without defect...and slaughter it. Then they are to take some of the blood and put on the sides and tops of the door frames of the houses." Then the Lord says, "On the same night I will pass through Egypt and strike down every firstborn...The blood will be a sign for you an the houses where you are; and when I see the blood, I will pass over you. No destructive plague will touch you when I strike Egypt."
Now this was the first Passover (get it... PASS OVER)
Then he goes on to say, "This is a day you are to commemorate for the generations to come you shall celebrate it as a festival to the Lord." (Exodus 12)
Then the Pharaoh finally let them go.
Now, I don't want to give it away but a sacrifice is what God wants to look the other way.

So lets go a little forward in the Bible.
The same Israelites are in the desert waiting to get into the promised land.
So you know the Israelites are just like us. They became disgruntled. They found it very difficult to live by the rules. They hated the food and were thirsty all the time.
The Lord was continually testing them and they were constantly failing.
A couple times the Lord says that He is tired of their complaining and He was just going to get rid of them. And on all these occasions Moses had to step in and plead the people's case, "Give them another chance."
Okay the rules. They would break them. So God set up a system to pay for your sins.
And again this is with blood.
In Leviticus it says, "When anyone sins unintentionally and does what is forbidden in any of the Lord's commands...he must bring to the Lord a young bull with out defect as a sin offering for the sin that he has committed."
Then it goes on to say how to sacrifice the bull and what to do with the blood and how they are all suppose to eat the bull.
Again, a sacrifice is the atonement for the sins of the people.

So move ahead about 500 years to Jesus' time.
So why did Jesus come?
He lived not only to be one of and know what is like to live in flesh. He also came to show us the perfect example of how to live.
Speaking of perfect...remember the spotless or unblemished animal we need to sacrifice for atonement of our sins?
It is said that Jesus was the Lamb of God.
Yes, the Old Testament points to how we need a perfect sacrifice for our sins.
In the Garden when the guards came to get him there was a little skirmish and Jesus told everyone to let them take him...."Do you think I cannot call on my Father, and he will at once put at my disposal more than twelve legions of angels? But how then would the Scriptures be fulfilled." (Matthew 26:53,54)
It had to be done. For us to be with God again. For us to go to Heaven.
The one that knew no sin became sin for our sake.
Jesus lived to be that perfect sacrifice for all sins.
Sins we have already committed and will commit. He was crucified for all people.
Man that is heavy.

But what I am saying is Passover is the pointing to Easter.

Now the crucifixion day is today. Jesus was taken down from the cross and put into a cave for what people thought would be his grave.
Well, no one knew that when they came to visit him on the third day that he would have conquered death.
This is what I find the most complex about the Bible and Jesus. Why didn't any one of Jesus' friends get it. They were his best friends and he didn't explain to them what was going on. He always talked like, "I will tear down the temple and rebuild it in three days." And then all His buddies are like, "what the heck is he talking about?"
But He never says, "Hey guys this is what is going to happen. I am going to be crucified on Friday, but not to worry I am going to be back for dinner on Sunday."
Why did He just come out and tell them? This will be the first thing I ask Jesus when I meet Him face to face.
So what is Easter?
Easter is Sunday. The third day after Jesus' death when he rose from the dead. He wasn't dead anymore.
Jesus' not being in the cave means he conquered death and He opened the gates of Heaven.
Meaning, now the sacrifice was "finished".
Now all we have to do is believe in the power of the "perfect sacrifice" and you get to go to Heaven.
Amen and Alleluia.
But remember if you really believe it then your life will change. You will live differently. You will act differently. You will be different.

That is it. I did my best.
I hope it wasn't too heavy. If you have any questions or comments remember you can post anonymously.

Happy Passover (do people say this?) and Happy Easter,
Now I could really go for a Malted Milk Egg.

Tuesday, April 7, 2009

Diagnodent and more

Hi all,

Sorry about Monday. My kids are on Spring Break and we went the beach.
Yes it was 84 degrees yesterday (just to rub in some more the kids have been swimming in the pool for about 3 weeks now).
So when I am complaining in summer about how hot it is, remind me of these days.
(although it is suppose to be in the forties tonight...crazy).
Oh and there was this thing that I had to go to the doctor to get a tetanus shot.
Remember the garage that I am building....well, yeah come to find out that the pile of wood the guys have left behind have nails in them. Well, over the weekend, I stepped on this big mutha nail and it went right through my shoe and into my foot.
It was nasty and three days later it still hurts and I am walking with a limp and I am on a full regimen of antibiotics.

You all know that just because I write the blog doesn't mean I know all about the blog-o-sphere. I don't think most of you get to see the comments. So when I get a good comment I want you all to see it. Friday I got an awesome comment. It was one with passion. It was one with a little anger. It was one with, what I call, hootzpa.
This was the kind of comment that makes me believe people are really reading the blog.
I makes me believe that I am not the only one that loves his profession. I am not the only one that gets outrages at injustice.
I appreciate all your comments, good or bad (just not mean), because it means you are reading and you care.

But first, I need to clear something up about Friday's blog. I have no problem with the Diagnodent.
I am sorry if it sounded like I was bashing this product. I was really bashing the type of dentist who uses a piece of technology to rip people off.
And when I was saying "this new piece of technology" I was being sarcastic. I have had a Diagnodent for about 9 years. But the reason I was being sarcastic is this is how the dentist makes the pitch to sound even better...."this NEW laser technology" will help use detect decay.
Beep, beep, have 13 cavities.

Again I am sorry if I made it sound like the Diagnodent is bad an I certainly didn't mean to bash the dentist that were using it right.

But here is the comment.

You are seriously hoping that this isn't a "sign of the times", but I'm not sure you're right. It hasn't become the norm yet, and there are still alot of "good guys" left out there, but it is becoming more and more common to see the scenario you described. It's not even one type of dentist that I see this with either, young and old alike.
I used to think that dentists were innately decent guys, but my thinking has changed alot. It's sad, and I find myself becoming more jaded all the time, but I just keep plugging away. Oh, and by the way....those "salon dentists" you were talking about....I won't lie. I'm not rooting for them. To me it's like rooting for the plastic surgeons doing boobjobs on 17 year olds and cashing in because of Dr.90210 on primetime.
What I say to those salon style dentists is "sell a couple leather couches, get a hygienist, buy some forceps, and actually PRACTISE dentistry!" I don't know what an "Aesthetic Dentist" is...I know what a Prosthodontist is, but they must not do enough lumineers, or have enough TV commercials to be considered "Aesthetic Dentists"....hmmmmmm. My advice during these tough times is this - SUCK IT UP!
Dentistry is virtually recession proof. You might not be able to be fancy anymore, but your kids won't starve, and you might actually be able to send them to college. To all the Diagnodent-weilding, drill-aholics out there, I say this....go do a dental mission. Volunteer. Take a peek what the rest of the world has, and then whine and cry. Oh, by the way....when you're on your dental mission in a thrid world country, you might even get to see a 40 year old adult with 13 cavities needing to be restored....and you won't need a Diagnodent to see them. That's my 2 cents.

Now that is someone who is not casual about dentistry. He has opinions. Now it might not be just like yours but he or she put himself or herself out there.

I want to conclude on something totally different.
My wife drives a 04' minivan. None of the power outlets work in her car (and there are four).
So the first thing I thought of is a fuse. I checked the fuse and it was fine but I changed it anyway. Still not working.
I thought this was a weird problem and called my mechanic. I introduced myself and told him I was a loyal customer. I then proceeded to tell him my problem. I asked if this was something they would feel comfortable doing. He said yes.
Me being the curious guy that I am asked him, "Well what do you think it could be?"
And he kind of gave me an attitude, "Well, I can't tell you what is wrong with the car without seeing the car." You know with this tone like, "you are such a dumbass.
Then he continued, "You know, it could be loose wire or a bad receptacle, or you replaced the wrong fuse."
I said, "Now that is what I was looking for." (not the first statement of you making me feel like an idiot.)

I need a roof on my new garage. I called on of my patients, this is a family friend for about 15 years. I looked him up on our computer and it only had his home number. No one was home so I looked for his work number and we didn't have it. So I looked on the computer yellow pages...nothing. I looked in our paper yellow pages...nothing. So I called his wife at her work and she says that that he doesn't put his work number in the yellow pages or white pages for that matter. I almost said, "well how is anyone ever suppose to get a hold of him?"
So I finally got a hold of him and he said he would have an estimate for me in a couple of days.
It has been 11 days and I haven't heard from him. Some friend huh?
So I am going with the guy I don't know who was recommended to me that got me an estimate in 2 days.
I called 5 roofers and only two of them got back to me with a number.
Go figure.
People just don't get it. Why is it so hard for people to get this?
Service. Making people feel like they want to spend their money on you.

Have a great Wednesday,

Friday, April 3, 2009

The Other Dentist


I have had a pretty good week. No baseball this week because of spring break. No soccer because of rain. So we had so much time it seemed weird.
We don't have anything to do tonight. I have to tell you that this only happens about 3 times a year. I don't have to rush home for a practice or a game. I don't have to go home and shower to get ready for dinner out.

I had to send another "you can't be a patient here" letter.
I had a woman cussing at my staff on the phone.
What is it with people?
Cussing at someone at a dental office, are you kidding me?
Now seriously what could my staff member could have done to make someone say the "F" word at her?
I wrote in the letter we have a zero tolerance policy for cussing.
This job would be so easy if it wasn't for people. Boring but easy.

I am in a pretty small town. It is getting bigger but it still has a small town feel.
There are about four established dental practices. There are a couple start ups that have happened within the last couple of years.
All tiers are represented. There is a dentist that sees insurance only patients.
There is a dentist that is a home town guy. He goes hunting with his patients and does meat and potato dentistry.
I think I am the family dentist, I can see patients of all ages and I can also really do a nice set of veneers or a full mouth reconstruction.
Then there is the salon type dentist.
All of our practices are within four miles of each other. I like all of them and I think they all do good work.
The weird thing is that I hardly get people from any of these practices. Like I said I think they all do pretty good work and there isn't alot of negativity from patients about any of these practices.
I don't think there is a lot of bad mouthing of dentists from the other dentists either.
But last week I got two patients from one of the dentist.
I thought that was weird because it is pretty rare when I do and then I get two.

The weirder thing is that both of them came to me because of the same issue.
Turns out the dentist got this new instrument that helps find decay called the Diagnodent (this statement is said with a hint of sarcasm).
Both of these patients were in there late 30's and had a history of ZERO fillings.
Both of these patients came from this dentist because this dentist recommended doing 10 fillings on one of them and 13 on the other.
Now, I have seen the occassional person that has never had decay and when they get to me all the pit and fissures are black and the enamel around them are greying and this needs to be restored.
But in both of these cases the pits and fissures were a beautiful shade of yellow. NO STICK and no black. I did a full new patient exam on both of these patients and neither of them need a single thing done.
It was amazing.
I have heard the schtick on this dentist was that there is some over treatment but....THIRTEEN FILLINGS.

Is this the sign of the times?
Is this what it is coming down to? Dentists stealing from people.
I hope not. I hope this was an isolated issue.
I mean this has happened in the past, dentists over treating so I have no reason to think this is going to be a trend.
But you all know how I feel about over treatment.
I threw some people under the bus on the CEREC blog for over treatment.
To me it is the mortal sin of dentistry.
It means the dentist is thinking of the dentist instead of the patient. The dentist is thinking of $1100 instead of $250.
The dentist is thinking about paying the bills, the dentist is thinking about the new kitchen remodel, the dentist is thinking about the Mercedes S-series, instead of the person they are suppose to be healing.
I am big on treating people the way that I want to be treated. I am big on being fair.
I am the kind of guy that if the person needs a crown and they start to cry and tell me they can't afford a crown right now. I say it is no big deal, how 'bout we just put a build-up on that thing and this will buy us some time to save for that crown.
Then I do the best damn build-up they have ever seen.
I am not the guy that uses the BLUE build-up material either (so the patient hates it and wants a crown, just to get rid of the blue).

I want to have faith in humanity. I want to think that everyone thinks Service Above Self.
I, much to my detriment sometimes, will bend over backwards to serve people. And this is not suppose to be a YEAH is me thing. It just is what it is.

But you know what, I think of that new dentist. The guy who has amassed $150,000 in school debt. Then decided to open his own practice (I am using the male as an example but this could just as easily been a female). He now is 1.2 million dollars in debt.
This guy is up to his eyeballs in debt and the practice really hasn't got off the ground.
Or how about the established guy who decided 5 years ago to be an Aesthetic Dentist.
He remodeled his office...granite everywhere. Leather coaches in the reception area. Hardwood floors. He doesn't have a hygienist anymore because he really only wants to deal with veneers and such.
Well guess what...veneers are for people with extra income. Not much extra income anymore.
I feel for these guys, I really do.
If you are that guy or gal, I am totally rooting for you.
Listen to will get better.
Keep the faith. It is hard all around but please do not change.

But one thing you could do is go out and buy a Diagnodent, I heard that thing is money in the bank (there's that sarcasm again).

Have a great weekend,


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