Wednesday, October 27, 2010

The times... they are a-changin'

Hey all,

My mood hasn't changed since Friday so. It is supposed to be 92 degrees here today, this could be one of the reasons.

We have this nice (but old) building that was built in the late 70s. If you don't remember, we have 3600 square feet here. Well, air conditioning must be different now than it was 35 years ago. We have 5 (yes, I said Five) air conditioner units. Yesterday, one of the units stopped working. I swear I had sweat dripping down my back and my gloves were sticking to my hands. My assistants were grouchy yesterday because of tough working conditions. It sucks when you get up and you have pits.

I saw the Time Travelers Wife this weekend. YYYYYAAAAAWWWWNNN!!! I woke up half an hour later, looked over and my wife wass crying like a little girl. I leaned over and whispered, "I love you that much, too," and then went back to sleep. Hey, you have to take advantage of vulnerable moments like that.

I wanted to talk about... what else?... the economy. No, I am not going to talk about Obama; I am going to talk about how it is effecting the way we practice dentistry.

I want to give you a perfect example of what happens at my office. Three years ago, the dentist ruled the doctor/patient relationship. There were rules and policies in place that the dentist wanted. For instance, here we do a new patient exam. This is a 90-minute appointment that a new patient gets with me. We do X-rays, an interview with me, then data collection (cancer screening, bite, teeth and cavity check, TMJ, and perio).

We USED to be adament about not having the patient get a cleaning on the same day as the exam. This was a hygiene-driven rule. Looking back on it, it was kind of a stupid policy. The mindset behind the rule was that we needed to know the patient before we started treating them. We needed to know their dental health before treating them.

Let's say we scheduled the 90 minutes with me and then a cleaning afterwards and they needed premedication before a cleaning because of a hip replacement. Or they were going to be referred, because of major perio, directly to the periodontist. Then you have a hygiene spot going unused. Or what if they didn't show? Then you are screwed twice instead of once. Who cares if it was convenient for the patient? We had a policy and it wasn't going to be broken.

Now, if the patient wants to get their teeth cleaned on the day of the new patient exam, NO PROBLEM. I recognize there were some legitimate reasons for having those policies, but, we've relented.

A couple of other things come to my mind. The cosmetic guys really have been hit really hard in this economy. So the guys that shrunk their practice to veneers and full mouth reconstructions have either changed their hours to 10am-1pm three days a week or they are opening up their repertoire.

Ten years ago, a friend told me he didn't see kids. I was shocked. Kids are a huge part of my practice. Not the restorative part, but the cleaning of their teeth and seeing the whole family, from kid to great grandma. I wonder if he is reconsidering.

I have heard through conversations at study clubs that people that haven't been doing root canals for years are now picking the gutta percha back up. I am thinking this is a little bit dangerous.

I have tried to not get into doing things that won't be A+ stuff. For example, if I don't normally do root canal retreatments, I am not going to go out and buy chloroform (that is what they still use, isn't it?) and start that because my day is slow.

Okay, I know I tried to extract that #18 when I had no business doing so; I am chalking that up to a brain fart. But, I have definitely loosened up the reigns a little bit on my policies. It is not full-on "Whatever you want" policy, but it is getting close. If it is within reason, we are doing it. If it doesn't compromise A+ work, we are doing it. And you know what? I think the patients are really appreciating it. SERVICE. I keep preaching it and I hope we are doing it.

How are you practicing different? Have you loosened the reigns? Did you have stupid policies? Are you doing different procedures? How is it going?

Let me know. Don't tell me I am alone on this one.

Have a great Wednesday,


Hannah said...

It's a little scary knowing that some dentists are starting to offer procedures they haven't practiced since dental school. I also think it's sad when a dentist won't work with the patient to make it the most beneficial for them. I think it all has to do with the dentist's purpose: are they running their business for the purpose of helping people, or for the sole purpose of building up a cushy retirement?

gatordmd said...

Now Hannah, you have brought up a couple of different points.
First, I was not saying a dentist hasn't done a procedure since dental school. I am talking about a dentist who use to do root canals...for example, I am 41 years old. I have done probably close to 2500 (yes, that is two thousand five hundred) root canals in my career. Now if I stopped and didn't do them for 10 years, I still think I would be pretty good if I picked the stuff back up.
Then you talked about dentists working with people...I think the VAST majority of dentists have very big hearts and it shows all the time. Now if you don't have one...well then you need to find one that does. I work with people all the time.
And lastly, I have found that helping people and helping them well is very profitable. And if you read my blog then you know that I am very pro-patient. But I find that being pro-patient makes me very marketable and people send their friends and loved ones.
I love doing what I do. I am blessed to do what I do and I try to bless others.
Am I going to have a cushy retirement? I hope so but I want you to have one too.

Thanks for reading and I hope you like the blog and keep commenting.

Hannah said...

I agree with you entirely. I think I must have worded my comment poorly, because I am definitely pro-dentist! I have an amazing dentist, and I know several other amazing dentists as well. I was simply referring to the few who do those things I mentioned (and who thus cause their poor patients to avoid seeing ANY dentist for years). It's hard explaining to a distraught patient over the phone that not all dentists are like the one with whom they had an awful experience several years back.


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