In this ecomony

Hey all,

Eleven days until my marathon. It is too late to do anything really meaningful in my training, so it is what it is. It is going to be a real struggle but I guess that is why it is called a marathon instead of "a nice little stroll through the city." 45,000 people entered in this race!!! Isn't that crazy? How do you manage that many people? I guess we are going to find out. Look for the "Chicago Marathon" blog; it is bound to be a classic.

I almost forgot - Silly Bandz. I know you know what they are. Well, have you ever seen a tooth silly band? We haven't. I Googled it, and there is nothing on it. So our office made them. We called a company and had 5 "Smiley Bandz" made. A molar, a tube of toothpaste, a thing of floss, a set of lips and a toothbrush. And we have packaged them in fives.

I think we are going to sell them for $1 to $1.50. We are going to go to the ADA this weekend and sell them to all those toy companies. I will also get the word out to our local pediatric dentists. I will tell you how it goes. I know the window for Silly Bandz is closing fast and I probably should have done this a year ago, but...

Topic -

I know I have talked about this before, but it keeps coming up so I am going to talk about it again. In this economy, consumers have some high expectations. And providing good service a given. You have to deliver a good product but if you don't do it with good customer service, you are done.

That is a good thing about this economy - the companies that have no business being in business are going out of business. I don't know how it was with you, but in Florida, we were forced to work with guys we just didn't like. The guys that were good and nice, they were booked out years in advance so if we wanted anything done, it amounted to, "Thank you sir, may I have another?"

I had a sign company that I was working with. They have been my sign company for over 6 years. We have this electric sign that has fluorescent lights behind it. It is about 18 years old, and is always giving us trouble. They are doing some minor repairs on it about two to three times a year.

Last year I had them place some bars on the sign that stick out. Now I can hang a banner out announcing something going on in our practice, like our Dentistry Day from the Heart, or a teeth whitening special that we do in December around the holidays, etc.

The last two times I called my sign guy, they said they were going to do it and never called me back. Hmmm. I chalked up the first one to, "It is just a $175 order." Maybe they are a big company and they don't deal with little things like that.

The second time I called them, they dropped the ball again. At that point it became a "Fool me once, shame on you. Fool me twice, shame on you."

About three weeks, ago I called another guy that I have worked with in the past. This is the company I used to make my business cards and they did a pretty good job.
When I talked to him about this he told me he could do it. We both laughed at the poor service I got from the old place. I wanted him to make me a banner to market this Candy Buy Back I am doing for Halloween. He said no problem.

Usually when I put the ball in someone's court I just forget about it. But I was doing some thinking when I was running the other night, and realized this guy has not called me back. So I called him.

He gives me the "I am so sorry, it is on top of my pile. I am so going to get to it today." I could not believe this guy forgot about me. I hung up the phone shaking my head.

And when I was running last night, I realized that about 4 months ago I got the ball rolling on changing my letterhead. To put into perspective how overdue this is, I changed the colors in the office to warmer tones about 2 and a half years ago. Browns and tans and dark wood stuff to make it warmer. My letter head is still teal (hello 80s!).

About 4 months ago I had the guy in and we talked about what I wanted. I wanted what I have now but just with a different color paper. We narrowed it down to my top three. He printed them up and brought in about 9 different styles. We picked one but wanted to make some minor changes. We told him the changes and that was the last we heard from them. Are you kidding me?

Most of the time I try to delegate responsibility. One of my staff members was in charge of this whole deal. So I called and left a message on the machine and told this person (I know she gets the messages), and told her I wanted it done NOW.

At about noon today I was in my office and called her (from my phone in the back to her phone in the front because walking up there would be too much effort), and asked if she had followed up with the letterhead. She said she called and left a message and hadn't heard back.

Then I just sat there. I sat there in silence not knowing if I should blow a gasket right there or breathe and count to ten backwards. I did nothing and she said, "Do you want me to call them again?"

As calmly as I could, I said, "Yes, I think that would be a great idea."

As much as I want to pick on my staff, the ownership of this issue is definitely the printer. This guy has been our printer for about 20 years. We do everything through them. This kind of service is unacceptable.

I can't stand incompetence. I can't stand when I have 40 things to do on my desk and I check one of them off because I put the ball in someone else's court and they drop it. i have filed it away in the "taken care of" file.

And I am probably going to keep using this same printer because it would be too hard to switch; he has all our .jpg files and all our stuff. All we have to do is call and say, "I need 400 business cards," and they show up. But they have gone down on my happiness scale. And one more ball-dropping is going to be fairly costly to them.

But what is happening in your office? Do you get that call from a friend saying, "I called your office last week and tried to get a New Patient Exam appointment and I am waiting to hear back from your office. I think my previous dentist sent my x-rays?"

John, count to ten backwards. This makes my blood boil like you wouldn't believe.
I go to my staff and ask them about it. "Yeah, I called that doctor and requested the x-rays and they never sent them."

Then I say, "Okay, but do you see how this is making us look?"

Not calling back is totally unacceptable. You give the office a week. If they don't call you back or you don't have the x-rays in your hand, you call them again.
But after you call them again you call the patient again and tell them, "I tried to call your previous dentist and they dropped the ball. I called them again. We will give them one more chance and if they don't send them this time you are going to have to either go and pick them up or we will take some new ones."

But not doing anything is not the Gammichia standard. And it is my friend telling me this. How many times does it happen when it is not my friend? How many people are we dropping the ball on and just losing before they even come in the door?
We spend all that time talking internal marketing to our patients. They finally send one of their friends and we blow it before they even meet me.

Customer service - it will make you or break you. Go up front today and just talk to your peeps about how they do stuff. Go over you process. Do you have checks and balances? Does your front desk person have 65 post it notes for things to do?

It is YOUR office. It is YOU the patient is coming to see. I just hope they make it in to see YOU. Because we are about 90% and that has to improve.

I would like to hear you thoughts.

Have a great Wednesday,
john

Orthodontists, beware

Hey all,

I am at a meeting today, so I got a ghost writer to post today. He is a little ticked, to say the least.

I have been biting my tongue long enough. I want to preface this blog by saying that, if you are an orthodontist, I would love your feedback. I would love to hear about the reasons you cannot accomplish what you know is a successful case. In fact, I would love to hear anything from you because another issue I have with you is that you are fairly poor communicators.

Ouch! I am not starting out very friendly, am I?

Orthodontics

I don't know a thing about how to move teeth. I don't know the stresses that are on orthodontists. I don't know the limitations to moving teeth. I don't know anything. I know what a Bolton's discrepancy is, but that'ss about it.

But I do know is what a good bite is supposed to look like. It kind of looks like Class I. ONE. It is the first bite classification that we learn in dental school.
It is what we learned at the first day of the first continuum at the Pankey Institute. Mid-lines lining up. About 30-40% overbite. Anteriors actually touching. Canines lining up so that when the jaw moves to the left or right, the canines guide the occlusion. I think this is called CANINE GUIDANCE. What I also know that when someone's teeth are in a good class I occlusion, their teeth last longer.

This is something I know because I have seen it. I know from looking at 5,000 65-year-olds with all their teeth. I know that having a good bite will make teeth last longer with less dentistry. Simple.

So why is it that only about 40% of my patients come back from the orthodontist with a bite I can be proud of? And I feel like I refer to really good orthodontists!

Here is my deal. Regardless of what the orthodontists think, WE, the general dentists, are responsible for this patient. They see this patient for 2 years but we have to see them for the rest of their lives.

While I can't speak for the rest of the general dentists, I feel responsible when I refer someone out. It stands to reason that, when I give a patient a recommendation to an orthodontist, I am somewhat responsible for the result.

So when then come back to me and their front teeth don't touch, I feel responsible.
When they come back with a 10% overbite and they don't have canine guidance, I feel responsible. All because I know the long-term implications to a bite that doesn't have canine rise.

Before I forget, I am not sending you a patient of mine to straighten their teeth. Straight teeth might be what my patients and their parents are looking for, but not me. I have seen tons of people with perfect bites that have crowded front teeth. And these people are far better off dentally/occlusally than the straight-toothed person that has no bite to lock into.

I live and die by my results. I want my patient to be happy with my dental work. But really I do dentistry to make me happy. Let me explain.

My patient doesn't know anything about dentistry except what they can see and feel. They can feel a shot, whether it hurts or doesn't. They can see if a filling looks good or not, and if it is a "white filling." They know if it hurts afterwards, and if it looks okay, they are thrilled. That is what the patient knows.

Me? I know about the decay. I know about the bonding materials that will make this thing last longer and not have any sensitivity. I know the composite materials I put in this restoration. I know the matrix bands I use. I know anatomy and making this thing look like a tooth. And I try to do this at a fair price.

When the filling looks good, and I know all everything that went into it, and I call them the next day and it doesn't hurt them, I know they are going to be thrilled. But most importantly, I'm thrilled.

I can't imagine that you, as an orthodontist, can't see what I see. Are you seeing this kid in this end-to-end occlusion and resting well at night? Are you thrilled with this result?

If not, then what the hell are you doing sending them back to me? And you send them back to me with a form letter with your signature on it. "Looks great, great kid. Thanks for your referral."

NO, it doesn't. I am supposed to tell you that it doesn't look great?!?! You should know.

If it doesn't look good, you know, and I know it. Why do you send that letter? It should be a hand-written letter telling me why this case looks the way it does. It could tell me the issues you were having. It could tell me about this kid's non-compliance. It could mention that the teeth, regardless of the force, would not move. It could tell me that the narrow palate was too much to compensate for. It could tell me about how the angulation of the mandible was a crutch that you couldn't overcome. But don't insult me by telling me the result was great.

The worst part of it is the money. Not that I think that it is not worth it. I am not talking about how much money it costs. I am talking about what some parents have to go through to afford orthodontics for their children. They go into debt to have their kids in braces. There are parents who can't afford it but still do what is ever in their power to pay for their kid to go into braces. They take money out of their 401k. They keep buying their clunker cars. They don't go on vacations. And all so they can do for their kids what they think is best for them.

This is very hard for me to swallow. I take this very personally. I know my patients and, sometimes, I know their struggles. Sometimes I will do things for a reduced price in order to make it more feasible for them to afford it.

Then, when it is all said and done, I have to go out in the reception area and lie to them? I go out and they say, "She got her braces off. Doesn't it look great?"
And I smile and say, "They sure are straight."

We both know that she has non-working interferences, she is end-to-end on her molars, and her anterior teeth don't touch. But they sure are straight.

Is he alone on this island? Is he the only one frustrated? I don't want this to be an orthodontist-bashing session; I want it to be constructive. I do have to agree with him on some of this. I agree that communication has to improve, but I think it must start with him.

You can comment now. But remember, no ortho-bashing. Just tell us what is on your mind.

Have a great weekend,
john

P.S. If you are an orthodontist, take a deep breath, marinate on this. Do not spit your venom yet. He is not saying that you don't care about all of the things he cares about. He knows you are passionate about your work. He knows you care about the money and how the parents have to sacrifice to have the work done. He knows you are good at what you do.

Think about this being the first step in treating your patients better.

Hey all,

On Monday, David, Noah, and I all went for haircuts. Here are some photos.

Now, THAT is a mullet. Business in the front, party in the back.

He almost has a real comb-over going on.

(That is my sister. She owns a hair salon in Orlando.)

"Okay, you stand in front of him and distract him, and you stand behind me and hold his shoulders."

"Daddy, I love my new haircut."

Noah, Noah, Noah. Man, I am telling you he is one funny six year old. In the car on our way home from getting hair cut, he said, "Dad, when David came out of mommy's belly button, could you see inside?"

"You mean could I see her guts and stuff?"

"Yeah", he said.

I said, "Yeah, I could see all of her guts." While I am saying this, I am thinking is it time to tell him that kids don't come out of the belly button. So I continue, "Noah, I think it is time I told you that babies don't come out of the bellybutton."

"Well, where do they come out of?" This is where I almost said, "Ask your mother," but I was in this so I might as well go all the way with it.

I said, "The babies come out of the pee pee hole." He said, "WHAAAATTT?!!!!" Listen, I was not going to get into all the parts of the anatomy with my six-year-old; pee pee hole is simple.

I hear him back there talking to himself, "How do the?... What can you?... David came out of the?..."

"Dad," he said, "How can a baby come out of there?"

"Well" I said, "God made women very strong and their skin stretches to let the baby out." I said, "It hurts, but they can do it."

"WOAH!!" he said. It was quiet in the car for a minute or two, and I wondered why the questions about babies, because I know he didn't want to know all that.

So I asked him, "Why did you want to know about babies and mommy's guts and everything?"

He said, "I just wanted to know if you could see the stomach and if you could see the stomach, could you see food in the stomach?" So all that because he wanted to see if you can see food in your stomach. I am telling you, he is hilarious to be around.

I ran 22 miles this weekend and I did great. The Chicago Marathon is less than 3 weeks away. I am not saying I am going to break any records or anything, but at least I feel better about it. I think I did so well because the weather is changing a bit here. It was 74 degrees at 4am on Saturday. This is a big change from 82 like it was last month. I am a sweater so being a little cool is better on my body (let's not get too excited: it is supposed to be 92 this afternoon). And Chicago will be much cooler than here... I hope. So I am excited about that.

Topic -
BPA... You guys been hearing much about this?

Well, it is a chemical whose derivatives are in dental sealants. And they are saying that after a sealant is done this derivative metabolizes into actual BPA. Who are "they?" Well, all you have to know is that CNN and other major networks are running news bits on the controversy regarding dental sealants, all sparked from an article published in the Journal of Pediatrics.

BPA is bisphosphenol-A, a toxic chemical that is an endocrine disruptor. BPA is used in many plastics and also used in the lining of metal cans, and they think it might be linked to a variety of medical conditions in adults and children. Some physicians say it can cause "disruption" in very small doses.

Don't think I am all that smart and I know all this off the top of my head. I just did a Google search to get all this information. The article I was reading quoted a doctor saying that "you can get more estrogen in your mother's kiss than you can get from a sealant."

The article also went on to say that the biologist Fredrick von Saal, the well-known critic of BPA from Missouri, still had his kids' teeth sealed.

But after I read this and let it sit for awhile,I started to think. What if this thing got traction? ( We all know it doesn't take a lot for something to get traction. It doesn't need facts or truth to get traction.)

If this thing got traction, do you know how much trouble our industry would be in?
If BPA is plastic and most of the stuff we use is resin - resin fillings, resin cements, sealants, composite crowns, all the composite veneers - this is all going to come into question? WOW.

Think of the world of crap our profession would have to go through. What would our profession be without resin? Amalgam was getting a bad rap in the mid to late 90s,
but we had an alternative that everyone loved. It was easy to say, "I just won't use amalgam if it is going to cause my patients to be concerned."

But we don't have that alternative to resin. Gold, ceramics but that is it, and both of those are much more expensive. Can you imagine if some needed 8 fillings, and you had to do 8 gold inlays? You have just increased the cost of dentistry by 500%. (Maybe more, as gold continues to go up past $1600 an ounce).

I have never been the "world is falling in" kind of guy. But I don't know about this stuff. I want to hide my head in the sand and hope it goes away. But I know how media is, I know our profession, and I know there is a big to-do about access.

This could be a pretty bad thing. I am not saying I want to put bad things in my patients' bodies. No - I want the scientists to find that it is not a bad deal. I want my products to be safe to my patients. I want to go on, and my life not to change. Is that too much to ask?

Have you heard of this? Do you know enough about this that you can enlighten us? Have patients started asking you about this? If you don't know about this, you might want to brush up on it because people are going to start asking you about it.

Have a great Wednesday.
John

P.S. I am going to the Florida Academy of Cosmetic Dentists annual meeting this weekend - should be fun.

P.P.S. I just realized the ADA annual meeting, for which I have signed up to volunteer (I was supposed to host a little-known speaker named Gordon Christensen), and have signed up and paid for 7 classes at, is on the same weekend as the Chicago Marathon.

I swear, I am such a dumbass sometimes.

I may not know aerodynamics, but I did stay in a Holiday Inn Express last night

Quick write-up today as I just have a half-day today and it is packed.

I hadn't planned on addressing it at all, but as I was driving in today I passed a pack of cyclists. Interestingly, my blog must have made the papers because all but one of them were wearing loose fitting shirts. Amazing, I don't know how they could tolerate the heat in a loose fitting micro-fiber shirt. And since I mentioned it here, I never said in my prior blog that there were not benefits to choosing your wardrobe based upon your activity. There are multiple fabrics that are moisture-wicking that are not skin tight also. I never said I run in cotton shirts and shorts, I just said I run in loose fitting shirt and shorts - amazing that micro-fibers can be made in a variety of sizes.

Now, on to dental issues. I attended the Kansas AGD Annual Meeting last Friday and had an awesome time. The speaker was one I have been wanting to hear for quite some time and he was amazing. If you have not had the opportunity to meet and/or learn from Dr. Lou Graham, you are missing out. As the KAGD President, I spent some time with him before and after the meeting and he is just a wonderful man, very down-to-earth and practical in his dentistry. I love learning dentistry from wet-fingered dentists!

OK, better leave it at that today. I am going to let the voices relish in the fact that the KC Chiefs are 2-0 and the Dallas Cowboys are 0-2.

Have a great week,
ric

Dunkin' Donuts

Hey all,

I was on my way home on Wednesday when, as I was pulling up to an intersection,I saw what I thought was someone hitting a garbage bag with a car, and garbage flying everywhere. It reminded me of when the bird flew in front of that Randy Johnson pitch.



Well, it turned out was a man on a motorcycle being hit by an oncoming car. The stuff flying everywhere were pieces of his motorcycle, and then I saw the guy flying across the intersection. I want to say he flew about 75 feet (to quote Clark Griswald, "50 yards").

I was pulling up to a red light. My heart started to race. What the heck do I do?
I started to call 911 but, as I was dialing, I saw this guy start to move. I threw the phone down and ran to him. I didn't know what I was going to do when I got there, but I ran.

He was starting to try to sit up. I put my hand on his shoulder and told him that he was in an accident and it would be best if he just laid down. He was scraped up pretty badly and his leg was starting to bruise. He had a 4 inch gash on his side but he was not bleeding anywhere. I did a quick check of his teeth and they appeared to be okay, so I maxed out all my emergency skills.

He could move all his extremities and he was fairly aware. Next thing I know, there were about 5 people around me. Someone was flashing some sort of badge but he was not a police officer; he could have been a correctional officer for all I know, but it looked official. I called out for someone to call 911. Some woman was walking around this guy praying out loud calling for Jesus' blood to pour out on this man. A couple of people were milling around trying to make heads or tails of the whole thing.

There was no sense in me asking him if he is alright because he wasn't. But he wanted to try to get up. I put my hand on his shoulder and told him getting up would not be a good idea. He pushed against me; I pushed him down.

It was about 4 minutes of me just kneeling beside him with my hand on his shoulder staring at him and making sure he didn't do anything to make his condition worse. Then I heard all the sirens. Within 2 minutes of me hearing the first siren there were about 12 policeman, 2 fire trucks and an ambulance.

But I am shocked at the casualness of the police officers. I mean, a guy lying in the middle of the street cut open that was just flying through the air after being hit by a car is a big deal to me. To the cops it was like... whatever.

I am not saying they weren't concerned, but it was so everyday for them. It is kind of crazy how this stuff happens really everyday for them and it could get kind of -for lack of a better word - boring.

Anyway, it wasn't boring for me. But after I saw that everything was under control, I kind of just went back to my car, pulled around the fire truck and nine cop cars and continued to drive home. Just in a day's work.

Okay - topic de jour.

I have a patient, very nice, 38 year old female, couple of kids, been a patient for 5years or so. After her cleaning and exam tells my staff she wants to talk to me. I never know what to think of this. Most of the time I hate people wanting to talk to me. Because most of the time it is not to thank me for just being such a great guy and they are thankful everyday for what me being their dentist has meant to them and their family.

So I bring her in a room and she wants to ask me a favor. OH BOY, it is one of them. I already know what this is. She wants something big from me. What is going to be? Her son is on a baseball team and she wants me to be the sponsor? Her daughter is in dance and they are having a performance that needs a title sponsor? Is she starting Amway and she wants me to try some products?

Then she tells me the story. She gets coffee every day at our local Dunkin' Donuts.
She has gotten to know one of the employees and she couldn't help but notice this girl's teeth. She is 25, cute, getting married in a couple of months and has held off getting her wedding pictures because her teeth are so bad. My patient has asked me if I could take care of her.

There are a couple things that I can't say "No" to, and they include people that can't eat and people that can't smile. I said I would see this person and I would see what I could do.



WOW!!! She wasn't kidding.

Do you guys ever get this? Do patients ask favors of you? Is it because I do my dentistry from the heart? Is it because I am just nice? Is the word getting out?

I mean I don't even really know this patient very well. I know she probably knows I go to church, but that is all.

Okay, let's say this happens to you. A patient says that she knows someone that makes $9 an hour needs and $2,000 worth of dental work. And there isn't any way they are ever going to be able to afford it. So they put it in front of you.

Do you say NO? Do you say I will split it with you? Do you say I will do it for a discounted price and have the patient pay you? I didn't know what to do and I still don't do anything.

Sometimes, I feel like if I say I will do it for half price the girl is not going to be able to pay for it. But I know what you are going to say. You are going to say that the patient has to pay something to give it value. So do I charge her $200? Will this make her value $2000 of treatment. But again the $200 would not be for me (because it doesn't do it justice, but it is for her)
I don't know but I think I will do this next time but this time I just went ahead and did it. I think it took me 2 appointments and it took a total of 2 and a half hours.




I got to tell you, I love making people be able to smile. I changed this girl's life. I had fun. I could take photos. Did I tell you I changed this girls life.

You can say I am a fool. You can say that I can't help everyone. You can poo poo all this but....
What better marketing can I do?
I called her to see how she was doing, and she said she was doing great. She also told me she gave the owner of the Dunkin' Donuts my card. She said everyone is noticing and she is giving everyone my card (I really hope she is not telling them I did it for nothing).
And, OH!! That patient that asked me for a favor? I sent her before and after photos and I am pretty sure she is a patient for life.

What would you do?

Have a great weekend,
john

I've got a 22 mile run staring me in the face for tomorrow. So, if you need, me I will be on the couch all day after my run. It is going suck because all I will be able to watch on TV is college football. It is really going to suck.

Who's the boss

Hey all,

I just signed up to do the Halloween Candy Buy Back. This is what it is: I will buy back all your Halloween candy. I will pay kids $1 per pound of candy. Then I will send all the candy oversees to our troops. I haven't done it before, but I have heard about it and have always been jealous of the guys that do it. So, I just did it. I am having a banner made for my sign (which I can use every year) and am making a press release as we speak.
Hey, I think this would be good press. And I can rid the world of dental decay one kid at a time. Not much going on otherwise.

Today's topic is going to be on Office Hierarchy. Who is the boss?

I am going to speak from a dentist's perspective. So let's talk a little about the different styles there are. I am going to list them in no particular order, and I am not going to knock any style because they all have benefits and issues.

There is the dentist that is a dictator. This style is, "This is my office. I dropped all the Benjamins to get this thing going. I am the chief. I like to make all the decisions and all decisions that I don't make have to go through me." The good about this one is the employees, for lack of a better term, "know who's boss."
Now, if you are an employee and are reading this or one of my employees reading this, don't get all bent out of shape. Let me explain myself.

When you come into a dictator's office there is none of this, "I think he/she should do this and when he/she does it, I think they should do it this way." No, this doesn't happen, because this is not even in the realm of possibility. Because if you mess around like that you would be gone in a heartbeat. This kind of dentist does not mess around. It is like North Korea: if the government hears about you complaining or talking bad about them, you end up in jail or you end up floating in a river.

The issue with this style is that you are on an island at work and, while that might be just fine for some dentists, to me, making all the decisions is very difficult and draining.

The second style of running an office is the exact opposite of the first. In this style, the dentist hates managing an office so he/she farms this job out. You will see this type of dentist hire an office manager and let this employee run the show, so to speak. The way they feel important is having the office manager give them a report. They can get involved if they so chose, but if things are running smoothly then they try to stay out of the way. This style is appealing to the dentist because they don't have to manage people or insurance or missed appointments or anything. And if something does go wrong they can blame someone else. They get to do dentistry and be concerned about teeth and that is all.

The issue I find with this one is that when there is an issue in the office and they want to change it, they get frustrated because they don't know how to communicate. So they leave it alone (hoping it will get better, even though they know it won't). And the only time they really speak up is when they are so pissed off they explode in anger. They yell at the staff but the only one they are really mad at is themselves because they should have spoken up when this fire was a spark and they know it.

The next management style is an office democracy. The dentist and the staff constantly work together to make decisions. For the dentist that likes to make decisions but doesn't want to hold all the responsibility, this is the perfect place to be. This gives the staff some ownership. In theory, they would be invested in how the office does. The job becomes a little less than a 9-5 thing.

But the issue is that have you ever tried to get 9 women and one man to agree on something. You give people decision-making power, and they might take this a little too far. One person is a little more forward than the others and the quiet person feels slighted because they haven't been heard. Or when you make a decision that wasn't what everyone wanted (say it was a 60-40 vote), 40% of your staff is going to be upset. (Please see the present American government.)

These are the three that I am going to cover today. Of course, there are blends of all of these, but I think I have hit a majority of the ways to govern.

Now here is my take. I have seen all of them. I have a friend that is a dictator. He is a super guy, but has always built a wall between him and the staff. He doesn't get emotional. Most things are black and white. There are things you can do and things that you can't. If you talk about him behind his back, you will be terminated.

There is complaining. I don't think they even have much of a Christmas/Holiday party. This is just how he rolls.

I am a people person. I am an approval-seeker, so I want constant feedback from my staff. So this style doesn't work for me, but I can tell you when poop is hitting the fan you will hear my say, "I wish I did it like he does it."

Democracy. I think it is awesome for our country, but it is tough in a dental office. I do govern this way sometimes. Like I said earlier, some people are going to be upset. Now you know that I have an alpha dog assistant and she kind of chews my ear off everyday about the way I should do things. Then she goes around and makes others understand (being very politically correct) her train of thought. Now, with the staff I have now, everyone really gets along and making a decision is easy. But this way doesn't work all the time in my office, or it might not work at all in other offices.

The office manager way of governing is the way my father did it. And it worked well for him. He is not a very confrontational guy, so if there was ever a staff issue, the office manager took care of it. She took care of insurances, she took care of getting the carpets cleaned, she talked to the lawn guy about the dry spots in the grass, she ran the staff meetings, she hired and fired. She did it all. The problem is, we don't have an office manager anymore so now we are kind of aimlessly governing.

For the first 10 years of practice, I was able to punt all decisions. If I was having a staff issue all I had to do was go to her. Let me tell you, this is a great way for a young dentist to get started. I was so concerned about not hurting a patient and getting my dentistry right it was nice not to have to deal with ANYTHING.

Now though, I think I am a combination of all three. There are times when I am a dictator. It is not always, but I have found it in me to put my foot down on some issues. It is tough for me, but I realize to be a good leader and to make myself happy sometimes I have to do it MY way.

I run the office like a democracy most of the time. I feel like it gives the staff some ownership and it makes them feel heard. And I think they make good decisions most of the time. I mean, they are consumers too. They know how about customer service. Just as long as they know they are making a decision that I would make. "How would John do it?"

And I think I run the office with an office manager sometimes too. The way I do this is by giving staff responsibilities. I will make someone responsible for a project. I tell them to make it their own. I will ask someone to get the carpets cleaned. I will ask someone to be in charge of a marketing plan for us. I will put someone in charge of all our aquariums. So everyone will be an office manager at some time or another. It seems to work. Again for me it is all about making them own this place, which I hope gives them more of a reason to like their job. And when they like their job and do it well, I am so much happier.

That's that. What do you think? Am I missing something? How do you manage?

Have a great Wednesday,
John

I want to be aerodynamic

Driving my kids to school a couple of weeks ago:

Despite its reputation, Kansas is not perfectly flat. Particularly on the eastern edge of the state, we have a number of rolling hills and the drive from my house to my kids school (although only a few miles) is pretty hilly. Since it is also in the suburbs, it is a very popular area for bicyclists to train and ride for exercise. It is not uncommon on the weekend to run into packs of 15-20 riders out for what must be a 2 or 3 hour ride - between the hills and the ever present wind, it can be quite the workout.

I am not a bicyclist. I do have a bicycle, but I also have a circular saw and no one would say that I am a carpenter. I enjoy riding, but it is not my chief form of exercise - that would be running. I know what you are thinking, the guy in the upper left hand corner of this blog post does not look like a runner. I agree, God did not bless me with long legs or a thin torso - but I run none-the-less. Most evenings you can find me running on one of the many trails around the Kansas City area. I will be the big guy in the baseball hat, baggy shirt and baggy shorts. Actually, if you do see me biking I will look the same, except with a helmet, baggy shirt and baggy shorts.

This is what makes me laugh at the "bicyclist" I saw when driving my kids to school. Anyone who has watched even a snippet of bike racing knows that the bicyclists look like European NASCAR drivers. They are wearing tight, skin-tight, singlets with the names of sponsors all over them. They are very brightly colored and just look fast. They are slick and shiny, and on a 130 pound man, probably improve aerodynamic efficiency and can result in seconds being saved off of a time trial or kilowatts of power being saved on a mammoth climb in the Alps.

However, to the easily 250 pound man riding up the hill a couple of weeks ago, I do not think a skin tight racing suit is reducing your aerodynamic drag. I'm pretty sure it is your gut. I too am gasto-intestinally challenged and find that my gut reduces my aerodynamics. I don't think cramming that into a sausage casing is going to help me any. Just because I dress like an athlete doesn't mean I am one. In fact, since it appears you are trying to exercise for health and possibly weight loss, increasing your drag will only increase the calories burned - work smarter, not harder.

I love to take these random moments and make tenuous links to my practice. And since I celebrated my 4th anniversary of my 1st patient on Saturday, I am going to take the liberty to do just that. See, the reason people dress like Lance Armstrong when they are riding the bike is because they want to imagine that they are Lance Armstrong. They put on the clothes not for the purpose for which they were intended. Lance Armstrong doesn't wear those clothes so that he feels like a bike rider; I'm pretty sure you can ride the Tour de France in jeans and a sweatshirt. He wears those clothes because they make him better at what he does.

Our practices are the same way. The reason my practice works and survives is because I do things that make me better. Dr. G. does the same thing - what works for him may be silly if I do it and vice versa. This works for so many of the things that we have discussed on the blog over the past year - what clothes you wear, what equipment you use, what CE you attend.

The best armamentarium is the one that makes you better at what you already do very well - it is the icing on the cake (pardon the caloric analogy). I didn't start my practice trying to look like it does today, it looks like it does today because I have continued to fine tune it and adjust it. I have become more stream-lined and aerodynamic in all phases of my practice. I can dress my office up in signs and music and fancy gizmos but if I'm not already good without those things, people will notice. It is called a dental PRACTICE because we never get it right - we are always adjusting and fine tuning. If we get bored or feel like it is stagnant, maybe we need to look and see if it is time to increase our aerodynamics. Maybe it is now time to wear a skin-tight suit to work with ads for GC America and AGD on your back.

Or maybe it is time to realize that the practice you are frustrated with is not really what you wanted it to be. You were like the guy dressed like Lance Armstrong but frustrated because you can't climb a simple hill in a Kansas City suburb without hitting your cardiac max. Maybe it is time to take off the costume and embrace who you really are. May your practice reflect you - not your dad, mentor, management consultant, colleague.

That's it from me today. I'm going to let the voices enjoy doing some dentistry.

Have a great week!

ric

Happy Friday to you,

It is September 10. I usually listen to sports on the radio, but today I was tired of all sports (this is very rare... I think it is because none of my teams are doing very well). So I put it on regular talk radio and this particular guy was asking everyone about their recollection of what was going on in their lives on 9-11. I found myself crying on the way to work today.

I can tell you that I don't know of a single event that is more etched in my brain, and I have four kids. I remember everything about what was going on the morning of September 11, 2001. I remember who I was working on and what happened when I went to the staff lounge and watched our little 5 inch TV. I remember my knees almost buckling as I watched the second tower come down.

It was such an incredible event. I find myself still going to the World Trade Center website to see the progress of the new building. Do you know what's going on at Ground Zero? They are building another tower (just one) that will be 1776 feet tall. Please note the symbolism of the exact height. They just finished the 20th floor and they plan on making a floor every ten days from now on. Completion date is April 2013.

This weekend, as you do your thing, sports, kids, beach, work, don't forget what went on 9 years ago. Say a prayer for our fallen heroes and our soldiers that stand in harm's way so we can do our thing over here.

Luke played in his second game yesterday. Well, all I can say is that I am so thankful for the rain. With 5 minutes left in the second quarter, it really started to come down. I mean started to pour so much that they called the game. It was 35-6. Yes, you read that right - it was 35-6 after 9 minutes of football.

We were two small Christian schools playing but only one team had small players.

Luke is #12. Take a look at the guy who he is lining up against.

I saw Luke was on the kick-off team.

So I took a couple of pictures of the first play and then I took a picture of Luke after the play on the sidelines. Let's just say he didn't fair well. At least he made it to the sidelines on his own strength.


(Don't forget to double-click on the image to get a larger version.)

Great stuff. After the whole thing was over he was just so excited about getting in the game and being part of the action.

Today, we have a Ghost Writer.(Just so you know, if you want in all you have to do is ask. If you want to write about something ,just get a hold of me at Jgammichia@aol.com.)

I am going to give this another try. My first (and last) blog was about the Invisalign fiasco. I am still not over that mess and I am still not doing Invisalign. Like most others I have spoken with,August was a slow month. There were last minute vacations, the panic of school starting… every year the same thing. You would think after a few years of the pattern I would get used to it!

I have been a dentist for about eleven years but the first seven were in the Navy, so running a business and tax issues are still pretty new to me - but I am learning fast. My current accountant likes to have tax planning sessions. Recently, I had my midterm meeting with my accountant. Going to the accountant for a tax planning session or what could be called a “a tax check-up.” It feels like what I would think going to a proctologist for a “check-up” would feel like, or maybe a patient's view of a periodic exam at my office. I have never felt this way about an accounting meeting until recently. Typically it is all bad news and this meeting was similar, but with a glimmer of hope.

My accountant tries to put a positive spin on it - like me smiling and telling someone they just need endo treatment so I can save their tooth. I have gone through three accountants until finally finding this one who runs his business and treats his “patients” similar to the way I do. I want an accountant that will spend time to educate me and discuss with me what I can do differently to save taxes and keep myself out of trouble. The one I am with now is pretty good about this. He is a young guy - my age - at the same point in his life both professionally and personally, growing his company and family. He is really focused on client satisfaction with fair fees. Previous accountants would not return emails or phone calls until weeks later or would charge me for every little question or email. I got nervous to say hello to one of my previous accountants with the fear that I would get an $85.00 bill in the mail.

Lawyers and accountants have devised their billing to be about time spent and their “knowledge shared” or “advice,” and not about a physical product they give the client. I try to manipulate my fees if I know a case is going to require more time, but this can be difficult with insurance companies. Dentistry seems to be much more geared toward a physical product, especially insurance-based PPO care. I give away so much “free advice” to my patients and if I was to charge patients for every phone call or answering every question I would either lose many patients or be able to retire early. However, I do not run my office that way and routinely have no charge consultations. I have heard several lecture circuit people tell me why I am wrong not charging for consults, and that I am “devaluing” my services by giving it away for free.

Anyway, back to the “accounting check-up.” He told us, of course, we are going to most likely have a hefty tax bill that we need to start planning for. The only bit of good news was that we need to go out and eat on the business more. We have only spent 0.6% of our business income on meals. Just about every meal I have with my wife we end up talking shop since she works in the office. It seems like business talk between us is unavoidable at dinner. So my accountant told us we could go out to eat on the business more. I know some friends that are very “creative” with their business expenses, but I get a little nervous doing almost anything. I always feel that I will be the one that gets put under the IRS microscope. But, we took his advice and went to a nice restaurant right after and discussed our tax situation.

How do you feel about doing a business write-off? What creative (but legal) expenses do you have?

Interesting. I am not a tax guy but... If you are going to go out to dinner all that means is you are still paying for dinner but you are getting a 30% discount. You are still paying for dinner. Like the supply rep saying that you can buy this thing and the American Disabilities Act is giving a $1500 rebate. Well, the rebate is good, but I still have to come up with $38,500.

I give stuff away to the local homeless shelter, I grab a receipt. Why not? I give to my church and heck yeah I will take the deduction. But I don't know that I would give $1000 to my church so I could get $300 off my taxes. If you are going out to eat and you are talking about work then, heck yeah grab the receipt. But I never understood going about it the other way. Like I have told you in the past, I am terrible at this kind of business stuff, so I may be way off.

What do you guys think? And like the author asked, do you get creative? Tell us.

Hey, have a great weekend.
john

Mid-Life Crisis

Hey all,

I hope you had a good weekend. I hate the Monday holidays. Mainly because I am usually off on Mondays and when everyone else is off on Mondays, I just don't feel very special. And you know it is all about me.

Did I tell you I am reading a book called I Sold My Soul on eBay? This guy, an atheist, decided to sell 50 trips to church on eBay. He was willing to hear what someone had to say and give them 50 chances to convert him. He ended up selling this particular service for $504. This book chronicles events of his church experience. It is well-written but hard to read. This guy goes into church,critiques what he sees, and he tells you what he is thinking. That is kind of like a patient, who let's say is a computer programmer, who tells you how you should do your fillings or even worse, how to run your practice.

I don't think that churches can't learn from him, but he says things like, "I keep hearing them talk about being saved. Do I need to be saved if I don't feel lost? I feel like I have it all together and I know for sure that I am not lost at the present time." But most things churches do (and people in them believe) would seem silly to someone that has NO faith. I just don't want to read about how silly me and my church look.

I watched an old movie this weekend called "Causalities of War." It has Sean Penn and Michael J. Fox in it. It is pretty good. It is about five guys on a long mission during the Vietnam War. Along the way, the guy in charge raids a farm village and kidnaps a young woman. One of the five is very vocal about how he thinks this is wrong. They take her along with them and you can imagine what they do with her, all along the one guy protesting. When they get back he tells his superiors, "What happens in the bush, stays in the bush." Then he goes to the highest guy he can find; the general says, "Forget about it." Well, he takes it all the way to the top and is finally vindicated. It was pretty good.

Alright - enough of the fluff, let's get to the topic...

I was thinking a lot about Friday's blog. I know it might have struck a chord with a lot of you, but I feel like there might be an underlying issue. Fifteen years after becoming a dentist, i sit and think a lot to myself. Sometimes I think to myself, "Damn, this is awesome. I absolutely love what I do."

But you know what? There are also times when I say, "This is it?" I look around and think, I went to four years of college, four years of dental school and worked my ass off as an associate for 8 years. Then I bought this practice and I am seven years into that and...

Most of the time it is a grind. It is becoming less and less exciting to see the same things over and over again. I understand this feeling, and I understand see how people can see that same thing going on in a lot of avenues of their own lives. For instance, their spouses...

My assistant is a mother of two. Her daughter and son-in-law moved away for work and her son is still in town but is trying to go to school and work and is not around alot. She told me she was sitting in the pool this weekend floating by herself. Her husband was sitting inside watching golf and she could not help think to herself, "Is this it?!?!"

It is this way with so many things in life. How about kids? Everyone says kids are so great. And they are. They really are, but there is a point where you say to yourself, "What the @$#%$T$@% was I thinking?" And I haven't even hit the teenage years yet.

How about your car? I can see how having a nice car is cool. It is nice having luxury. I don't have this, but I do get to ride in nice cars once in awhile and I can see how it is addicting. And when you have a nice car but it is 3 years old and all the new cars have so many more bells and whistles, you start to feel a desire for a new one. Same with houses. I love my house but I can tell you when I go to the muckity muck neighborhoods I start to say, "Man, I want that."

Why would it be any different with our spouses and our professions? Now I know I have talked about this recently but it keeps coming up (I guess I am mid-life crisis age so it is hitting home). I think what happens is we get into thinking it is going to be great and it is great. But even great can get boring. And great sometimes doesn't buy us all we want. So we start to change. The things that made us great at what we do get put to the side. The things that made us sleep better at night are not that important. It could start to become about YOU, and that could be bad.

I can see how some people get cold. They don't care about the relationships anymore. The tooth probably can get away with doing a filling but why bother with all that, when "well, let's see how this goes," will get you by? Let's take all the emotion out of it. "It needs a crown," and walk out of the room. I don't need to know about all the money issues you are having. Do you see what I am saying? Or am I rambling?

I mean, we all get those patients that come in for a "second opinion" after their dentist told them they needed 20 fillings. You look in there and don't see any issues at all.

Some dentists get tired of being at the office. You can see how people can get tired of sitting around the office. They don't have any patients so they don't come in. Why would they? Me, even if I don't have any patients, I am still coming in. There is so much that can happen while I am here - and besides, at this point in my life, I don't have much going on outside of here. What is happening is that dentistry is becoming a means to an end, and that is bad.

If you are young, you must prepare for the day that everything you find exciting can become mundane. But how do you prepare?

I have to tell you that luckily I don't feel this way. I feel like if I make the day exciting it will be less mundane. I try to have fun. I play around all day. I play 80s music. I joke constantly. As far as making teeth more, I have begun to study more and have been reading more peer-reviewed articles. I still love getting to know my patients. I try to make the office fun for me and my staff and my patients. I might do a surprise root beer float party at the end of the day. I cut out comics to put up in the staff lounge. My motto is "Fight complacency."

And the same with my marriage. If it becomes mundane and boring then you can see how people will think the grass is greener on the other side. I am not going to tell you how I make my marriage less mundane (let's just say a trip to the adult toy store is in order... OH GROSS!!!!) because you have to figure it out yourself.

Mid-life crisis or mid-practice crisis, some of us have been through it. Some of us are in it. Some of us think it will never happen to us (to you young guns, imagine doing your 30,000th filling) and that is great, but know that it might happen.

My last bit of advice is this - make practicing fun. Make life fun. (Am I sounding like Tony Robbins or what?) I am not saying quit practicing dentistry or leave your wife. No, I am saying remember why you fell in love with it and do that (maybe it involves a trip to the adult toy store).

Have a great Wednesday. See you on Friday.
john

Friday...what else can I say?

Hope you all have had a good week. I have had a tough one. I bruised my ribs on Sunday playing basketball. If you have ever hurt your ribs, you know what I am saying. The pain will bring tears to your eyes. If you haven't... well... everything hurts - when you sneeze, when you cough, when you bend over, when you sleep and roll over (by the way I haven't slept since Sunday night because it is impossible to sleep). Leaning over people to fix their teeth is very difficult: you can't take a deep breath, you can't touch the area at all.

So this week I have been living on ibuprofen like clockwork. But last night I think I turned the corner. I am still very tender and I am can't take a deep breath without pain, but I don't have to pop pills every 4 hours.

I know you have been dying to find out about the football game last night. Not college football - the Orangewood Christian School's middle school tackle football game. Well, we had a bit of a setback. Yeah, the game didn't really go our way. To be honest with you, they creamed us. The final score was 39-6 and it wasn't that close. It was 33-0 at half and then the other team called off the dogs and we scored on the last play of the game.

I watched Invictus last night. This was with Matt Damon and Morgan Freeman about a Rugby team in South Africa. It was okay. I liked it but it was a little too predictable. Country is in turmoil. New black president. Lots of tention. Rugby team stinks. Everyone starts liking the rugby team, the country has a lot less tension and more unity as the team starts to get better. The team wins the world cup and everything is great.

Okay, I will get right to it today. I have always said this blog is about life. Most of the time the life of a dentist revolves around... well... dentistry.

Today, I am still doing dentistry, but my mind keeps wondering off to my friend.
Let me digress and tell you that when you get to my age (the ripe old age of 41), a lot of people that you know you call friends, but you haven't seen them in a bunch of years. For instance, I don't see many of my high school friends because I am not Catholic anymore. A lot of us still live in town but they are probably running in the Catholic circles. School, sports, confirmation class, all that stuff. I see them but not all the time. I still enjoy their company but we don't see each other much.

I have people that I know from college that I might not have seen in a long time, but love it when I see them at a game. And guys/gals from dental school I really like. We have this very special bond. We have gone through the toughest part of our lives together. We are a bit of a band of brothers/sisters. So yes, I call these guys my friends. I may have seen them only 5 times since dental school, but they are still my friends. Do I really know them now? Probably not. Do I know what is going on in their house? No.

Well, this week I found out one of my friends was caught cheating on his wife. Now I have not talked to this guy in a couple of years and it happened awhile ago, but I am just finding out about it now. Is it the first time one of my friends has cheated on his wife? Unfortunately not.

And like I said, I like the guy, we had great times together, but I don't know what is going on in his house. But every time it happens, there is much discussion around my office. I always start a discussion with my assistant about what she thinks.

If you haven't already figured this out, in my operatory, we feel comfortable talking about everything. I feel like as long as you talk with the patient - not around the patient - they get into it. A lot of times they will make me stop working so they can say something. Or they will wait until our procedure is done and then give us their opinion. It is kind of fun. Anyway... we started talking about this guy.

My assistant has been happily married to her present husband for 25 years; they have a very open and honest relationship. This is her 2nd marriage. Her first husband was - and still is - a shmuck. He was cheating on her while she was in the hospital having their second child. I would say she is jaded but honest; she would yell, "I'm a realist!" Then she would say "Men are men, " or "Men are all jerks."

The more I live and the more I talk to people, and the more I hear what my patients are going through and what my college classmates are going through... I would tend to agree. Okay not all of them but...

I ask her, "don't you think, in times like these, men are being bombarded with sex in magazines, on TV shows, commercials, the Internet?" I said that life is like a catalog. Remember the story about when SEARS was struggling with one of their international stores because people weren't buying their stuff? They put out a catalog and everyone saw all the things they didn't have, and they bought like crazy.

I was thinking that men would be a lot happier if they would just love their wives. But when everything is a digital catalog to everything they are "missing," it is tough battle. Now my assistant (who is jaded, remember) calls bullsh!@#$%$t on that one. She says what about in the time of the Depression when people didn't have TV and magazines and the Internet, and it was still going on then? (What do I know what was going on in the Depression? I had to shut up.)

I am more of a half-full kind of guy and believe people CAN be integrous and faithful. 'I mean lets not kid ourselves, marriage is hard. It is about love and COMMITMENT. I am committed to my wife and she is to me. I know it is not always going to be great, not because of anything she did, but because life is hard. But if we both know that life is hard and we both know that we are committed to each other, we can feel a little easier that the other person is not shtupping the neighbor (and when she looks at all my Internet history and checks all my emails and texts, it also helps). Am I around women all the time? Yes! Do I have a hot body that some women find irresistible? Yes!
But...

My assistant says, "It is what it is." So I talk to her about her daughter. I say, "What about her? Do you really not have any faith in your son-in-law? Do you have any hope for their marriage?" She does say that she talks to them about how hard marriage is and how it has to be a commitment. But she says, kind of off the cuff, "But if he cheats, she will just kick his ass to the curb."

I don't know if that is a way to get into marriage. I mean, if you think all men are jerks and it is bound to happen, why get married? Why get excited about her wedding? I don't know; I want to believe in more. And I want to say that because I am a Christian and I hang around men with conviction that it won't happen in my circle of friends, but it already has. Hell, it even happens to pastors, for crying out loud.

Okay I have to finish this up. I know it is Friday and I don't want it to be very heavy, so I am going to stop. But I haven't even talked about women or what happens after an affair. Like, that grass is going to be greener or something. Maybe later...

Do you have any thought? Have you been cheated on? Did you cheat?


Have a great holiday weekend,
john

But what if...?

Hey all,

Hope you are having a good week. I made it through the weekend of watching all four kids. The pizza party was absolutely crazy; we ended up making 7 pizzas. The kitchen was a disaster, but I think everyone had a good time. I don't know, because all I did was make pizzas all night. My mom came about at 7pm and helped with getting the baby a bath and into bed. By the way, said baby is teething and is a crying, snotty mess most of the time.

Got up at 3:30am to run, it was a beautiful 77 degrees out. The run totally sucked. I did pretty well until about 16 miles, and then I just didn't feel like running anymore. One problem - my truck was 4 miles away from where I stood. So I had to get my sweating, tired, cramping, angry butt back to the parking lot. I am not going to be ready for the marathon at this pace. It is in 6 weeks and I am feeling like I am in big trouble. One problem is that I have already spent over $1200 getting the f!@#$%^ing tickets to run in this f!@#$%^ing marathon with the flight, the hotel, the registration. Isn't running great?

Saturday I couldn't really move from the couch because I just didn't want to. Madison went to Disney and me and the boys just hung out. On Sunday, everyone made it to church with clothes on, so I call that a total success. It was very nice to see my wife again, with much more appreciation for her than before she left.

One last thing... We haven't talked about TV in a while, but for us right now it is all TNT and USA network. We are watching "The Closer" and sometimes "Rissoli and Isles" on Mondays. The rest of the week we are watching stuff like "Burn Notice," "White Collar," and "Covert Affairs." This week I started taping "Flashpoint" on Friday nights. We tape them all, so I don't really know when they come on, but we really like these summer shows. And, of course, "Cake Boss." Forgetaboutit.

Tomorrow is the START OF COLLEGE FOOTBALL!!!!! Are you kidding me?!?! I am so excited. But you know what else is starting tomorrow? Orangewood Christian School's middle school football. It is not going to be televised, so I will let you know how it goes.

Topic

I want to talk about getting hurt. Not hurt like "I got a boo boo on my little finger." I mean hurt like you have to miss work hurt. Like, if you broke your hand playing basketball with your kid. Or if you tore your ACL during a coed soft-ball league game. Or if you were in a car accident and had something really serious happened to you.

Back in the old days my father was part of a group. There were about 10 dentists that got together and vowed that if anyone ever got hurt the other 9 would take shifts working at his office to keep the office afloat.

I heard a couple of months ago that a local orthodontist had cancer. I don't know him very well (in fact, I wouldn't know him if I bumped into him on the street), but I know he lives in my neighborhood. So I called his house (neighborhood directory) and talked to his wife. I told her that I just heard about her husband and asked her if the family needed anything. I asked if they needed meals and I told them I would be praying for them. Then I asked if the practice was going to be okay and if she needed anything from me in that capacity. She then told me about the group he is in. Turns out he is in one of those groups of about 5 orthodontists and they are working at his office.

It got me thinking. Now, I have never had to worry about this kind of stuff. I am in a practice with my dad, so if either of us gets hurt then the other one picks up the slack. I have had some mishaps (broke my wrist, had surgery on my finger) and it was no big deal. My father has had to have some surgery and he wanted to take time off to recover and it was nothing.

But what does the solo practitioner do? Do the groups still exist? Do you just cross your fingers and hope nothing ever happens? What the heck is going to happen to our practices if we get hurt? And... what would happen to our families?

Do you have disability insurance? I have to admit that I have disability insurance, but don't know how much. I don't know the parameters of the plan. I don't know when they start paying. I don't know how much they would pay. I don't know anything. I THINK that it will start paying out in 90 days and I THINK it is tax free and I THINK my income would go down significantly.

I know I have the maximum insurance, but I don't think it would cover all of my income. I just found out that insurance will only pay 60% of your income (seems that if they will give 100% of your income the incentive to go to work goes way down, and all of a sudden that hangnail will keep you from work).

I have to pay for so many insurances that I stopped caring about all the insurance decisions I have to make. For me, it is out of sight, out of mind. I have never used it, so why would I have to keep it fresh in my mind? I know, I know that is a bad attitude to have, but I don't have the capacity to store all this information. (I can, however, tell you all the stats for all of the last 9 Gator quarterbacks... weird, huh?)

How is it for you? Are you burying your head in the sand and not worrying about it?
Are you over-insured? Do you have advisers? Do you have an insurance agent who basically tells you what to do? Do you ever double check him/her?

Let's not even talk about malpractice insurance. I don't know a thing about that. I think in this instance I am over-insured. Come to think about it, I hate ALL insurances. I know it is called insurance for a reason. It is "just in case." But I pay all this money for my car insurance, and have never been in an accident. I pay all this money for disability, and I never get hurt. I pay all this money for malpractice insurance, and have never had a claim against me.

I pay for fire, flood, theft, car insurance that I never use. In fact, in the fifteen years I have carried all this insurance, I remember using the insurance once. Home, office building, work, car. All of it, ONCE. So why would I bother understanding all the ins and outs of all my policies?

And the worst of it... I have this huge life insurance policy. If I "expired," my wife would be living very large and here I still write you - living. Go figure.

Have a great Wednesday
john

Tomorrow... college football... who cares who is playing? YEAH!!!!