Monday, August 30, 2010

My trick knee tells me when its gonna rain

First and foremost I must pause and wish my mom and dad a very happy anniversary. Yesterday, they celebrated their 40th year of marriage. Susan and I had the privelege of going to dinner with them on Saturday night, and it was so much fun. By the way, if you are ever in KC, I highly recommend Michael Smith's, the food was fantastic. The one show on television that I have programmed my DVR for is Top Chef on Bravo! The food was exactly what I imagined cutting edge, fine dining food to be.

I thought my Mom summed up their 40 years best when she wrote: ‎"8-29-70, Metropolitan Bapt. Church--fast forward 40 yrs, 5 children, 3 weddings, 5 grandchildren, 2 funerals later---we bear witness to God's faithfulness." I may not say it often enough, but I am who I am and am where I am because of my parents. Thank you, and may the next 40 years be even better.

Now for what's happening in the news...

I always laugh when I hear the "experts" on the news channels talking about the state of the economy, as they describe the statistical factors that point toward an improving job market or hint at deflationary pressures, etc. I laugh because all these geniuses need to do is call up a small business owner - particularly a dentist. I can tell you exactly how the economy is doing at any one moment in time by looking at my schedule. I would bet that if I graphed my last 24 months of production and then did an overlay of the last 24 months of economic indicators they would line up perfectly.

Right now, my patients are starting to exhibit the same cautionary signs that they did in '08 as this recession was first being acknowledged. The chief indicator for me is the patient who starts to complain about the 4 month perio maintenance interval because it isn't covered by insurance (even though it is probably cheaper than the cut and color they get every month in a salon).

Having a patient base that is 75% insurance also gives me an insight into the corporate world because my patients talk about rumors of layoffs or benefit cuts and that impacts their willingness to spend. So, much like a grandpa can tell you when it's going to rain because their knee gets sore, I can tell you that unless the Fed changes the capital requirements for banks - permitting them to start loaning money again to small businesses operating with small reserves, we are absolutely headed for a double dip recession.

This bit of happy news was brought to you by the letter "D" and the number "2". It is a scary time to be a small business owner but I still wouldn't do it any other way. Security is for sissies.

Film at 11.

Have a great week!

Friday, August 27, 2010

Money, cash money

Hey all,

This is going to be a very short blog.
I am off today and watching all the kids for the weekend. My wife has left to the beach to have a girls weekend.
This is way out of my comfort zone. I mean I can do this but....
I usually end up losing it and screaming at kids that don't deserve it.

I am suppose to be running 20 miles on Saturday at 4am.
I have my mom coming over tonight to sleep here so I can leave.
I am having a carb loading pizza party tonight for my running group and some friends.
My daughter is going to Disney World tomorrow morning at 7am with her best friend.
She doesn't sleep over people's houses well so my mom is going to have to get her up early to get ready.
Sunday means getting four kids up and out before 9:15 to church.....NO PROBLEM, I got this.

Topic de jour....

Have you ever heard of a Red Neck Savings Account (no I am not talking to all you Crimson Tide fans)?
This is where you pay Uncle Sam too much on your taxes and you get a refund check.
Well the Gammichia's apparently are rednecks because we just sent in our taxes from 2009 and we overpaid by a lot.
Now don't get me wrong. If I did not over pay we probably would not have been disciplined enough to save it so I am kind of glad.
The story goes that about 2 months ago we knew that we were going to be coming into this money.
So many things go through you mind. What can I do with this money?
Man there are so many things that, because of the economy, we have neglected.
When the money is flowing in it seems like you have enough for being smart and being stupid.
So when the money stops flowing and you stop buying stupid things and when the money is even tighter you have to even cut back on the smart things.

So instantly I start thinking about what I am going to do with this money. The first things I think of are all in the stupid category.
The devil on my left shoulder says, "LIVE A LITTLE YOU BIG WUSSY". I can really use a TV out on my back porch. The carpet is a little worn and I am just sick of the color.
Then the angel on my right shoulder says, "Come on, be smart. You can pay down a lot of debt with that money. Or how about getting those new tires on your truck since you have been spinning out in the rain a lot."
So for two months this went on. Every time I came to something in the yard that would look nice I would say, "Don't worry, when we get that check I will be back to buy you."
A week ago we signed and electronically sent our return. Now the battle between devil and angel began. I knew the money was coming but I was thinking it would take a month or two.

The trees need trimming. We need some painting done in the house that I really don't want to do. I really am thinking about getting a new car soon (my truck has a 167,000 miles on it).
I really do want a LCD TV outside.
Man this is going to be awesome when I get that check. Everything is going to be a credit card swipe away.

Well, today I got that check. It is almost paralyzing. It was easy to think about getting that money and what to do with that money when I finally got it but it was kind of like a game.
Now it is a reality and I kind of want to go back to not having it.
As it turns out we are probably not going to do anything.
We paid off some bills that were current.
We bought our airline tickets to Chicago for the marathon.
We are going to buy an alarm system for the house (we have lived here 6 years with out an alarm or fire/heat alarms either....stupid I know).
But really what will probably do is sit on it. We will pay down debt and maybe pay school off in advance.
So the tires are going to have to wait (I mean really it only rains EVERYDAY here).
The new car is going to have to wait.
And as much as it pains me the TV on the back porch is going to have to wait (I can see the living room TV from the porch if I really squint).

Being smart is so boring. I hate it.
But it sure was nice to dream about doing not so smart stuff. REAL NICE.

What would you do? Are you smart/boring like me or are you like my red friend with horns and a pitch fork?

Have a great weekend.
Think of me tomorrow at about 3:30am when that alarm goes off.

See you Wednesday.

Tuesday, August 24, 2010

What is your Passion?

Hey all,

Noah had another doozy this weekend - a "Noahism." My son went to a birthday party in a neighborhood with some huge houses. After the party, I took my 11-year-old, my 6-year-old and another 11-year-old boy around to look at the big houses. As we are driving it was a lot of "Wow, that is a big one there," and "Look at that one, it is huge." After about 10 minutes, we started to drive home and Noah said, "Whoa!!! THAT is a big right there." I said, "Yes, Noah that is a big one, but that is something we call... a HOTEL." I laughed all weekend.

Luke, my 11-year-old, is playing tackle football for his school this year on the middle school team. He is in the sixth grade and is playing for a team that consists of 6th, 7th and 8th graders. Luke is 81 pounds. He has a friend that is also in the sixth grade that is 185 pounds. So you can imagine that the range of body styles and sizes are huge.

The coach sent out an email this weekend recognizing this.
He said that he is not going to put our kids in a situation that where could get hurt,and that we should talk to our kids about how committed they are to football because of the possibility of not playing this year. I talked to Luke and he is loving it. He loves practice, he loves hitting, he loves being small. So here we go. The first game is in 9 days. I will let you know how it goes.

Today I want to talk about passion. I was out with an attorney friend of mine on Saturday night. His job consists of "branding" people; he helps people market themselves, so he is always looking for an angle with people. He asked me what my passion was.

I thought about it, and thought about it, and thought some more. And I gave him my most thought out answer, "I don't have one." I go to work at 6am and get home at 5pm. Then I do home stuff. Could be the lawn, could be the pool. Could be homework, could be playing football, could be watching football, but it is mostly stuff around the house or family. And I do this until about 9pm. Then I watch TV for a hour or two before I go to bed. Then I wake up the next day and do it all again.

On Saturdays I run and then just really sit around the house and hang. Sunday is church day. We go to church around 9:15 and after all the hanging out after church and then lunch out, we get home at about 2:30. Then I hang out and usually swim and watch sports.

I am kind of a simple guy. I don't really do much outside of teeth and family. I told him that I guess you could say that my passion is teeth. But that is not what he was looking for. I guess having a passion for your job is so foreign to people.

I look at my life right now, and it is kind of boring. Not boring like I don't have much to do but when I write it down seem so boring. I mean, it's not like my passion is flying, or anything exciting like that. Yeah, flying would be cool. I can join all sorts of flying clubs, buy a plane, and go after work every day for a fly. Then, if I wanted, I could go to places like Sannibel Island for a romantic weekend with the wife, spur of the moment. I could go to Boston to see a RedSox series with the Yankees with my boys. My options would be limitless. Doesn't that sound like what this guy was looking for?

Or something like restoring 1965 Shelby Cobras. Yeah, I could restore my car and go from town to town and enter it into shows (you know the ones on Friday night at Steak-n-Shake) and yell at kids for coming by and putting there grimey hands on the polished paint job. I could ride with the top down on all the back roads near the beach. That sound awesome, doesn't it?

Or travel. Yeah, traveling would be a great passion. The French Riviera, Rome, the wine country in Sonoma, Vienna, London. Yeah, my passion could be travel. That would also be awesome.

So, when I tell him teeth, he looks at me like I have two heads and his smile kind of drops. I can see how it is not very exciting. But I am in the time of my life where all I have is my practice, my house, my kids, my running and church. THAT IS IT. To me that is a lot.

I've got no time to fly, I don't know the first thing about cars, and I have no time (OR MONEY) to travel. It is what it is. I have the tooth gene and sometimes loving teeth is not that exciting to other people. I am in the stage of my life that my wife and kids need me, so that is that. Maybe in 15 years I can have all that other stuff. I can get a motor home and travel all around following NASCAR or something crazy like that. Or I could afford a beach house and spend half of my weeks at the beach. But for now, I have to pick up Luke from football practice, go to the periodontist to pick up some healing caps for a case I have tomorrow, go home and eat with the family, and then I am off to a study club at night. Passion? Yes. Boring? Yes, but passion none the less.

So, sorry dude, but I know loving teeth is not really a brandable commodity. You are going to have to move on to the next guy that loves music or something. Yeah that would be cool to travel around following my favorite band... Maybe later.

Have a great week and I will talk to you on Friday,

Monday, August 23, 2010

Will you take a post-dated, out-of-state, 2 party check for $ .02?

Well, I am sitting here in my office on a beautiful Monday morning. As I do every day, I am wearing burgundy silk pajamas with a matching robe/lab coat with my office logo on it. Closed toe, velvet slippers keep my feet warm and OSHA compliant. I like to smoke a pipe in the office but while working on patients I don't want to drop hot ash on their face, so I installed a Hookah pipe. Over the sound system is the best of Eminem. A giant University of Florida pinata hangs in the children's play area - the kids use Florida State baseball bats to beat the living *&^$* out of it. When it bursts open, orange gumballs fall out and "Rocky Top" is played. Talk about a practice builder. . .

I could go on and on, but I don't want to give away all of my practice secrets.

Seriously, I have really enjoyed reading the blog for the past few posts and love the passionate discussion on dress in the office. I'm going to give you my 2 cents - but since it is payday, could you wait to cash it until Thursday? ...Awesome...

When I opened my office 4 years ago, the clothes I wore and the uniforms my staff wore were designed to convey the image that we were an established office. That is the same reason I hired 2 employees instead of one (or none at all). When people walk into an established office there is usually more than 1 employee. In 4 years, I have had to tell a patient how long I have been in practice exactly once and that was 2 months after I opened and the patient was coming in for a 2nd opinion because the dentist he had gone to "was brand new out of school" and he didn't trust him. Come to find out, he was a classmate of mine (although 8 years younger). He was dead-spot on with his diagnosis but the patient had an image in mind of who was trustworthy, and age was important to him.

The image I wanted, and still want, to convey to every patient has to be consistent. From the marketing material, our website, the magazines in the reception room to the appearance of the front-desk, the staff image, the operatory image, the music we play, and finally, me. It all has to say the same thing - but what it has to say for me is not what it has to say for you. For me, I needed it to say that this 34 year old, salt-and-pepper haired dentist isn't brand-new out of school - he just relocated to this area. The final piece of that image was the self-confidence that I conveyed when I walked into that operatory. For me to feel self-confident I had to be wearing what we call business casual.

As any of my friends can tell you, after growing up in a school that required ties since 1st grade, then practicing law for several years (did I mention that judges expect ties to be worn?) - I'm done wearing ties. I wear them when I speak on behalf of the AGD and when I go to funerals, but not in the office.

I do not wear scrubs for one simple reason: to me, they do not convey the image of professional. Outside of the OR, they convey the image of "I want to convey the image that I am a real doctor," and that doesn't work for me. I also see scrubs worn by the carousel operator at the mall. I haven't asked, but I'm pretty sure she is not moonlighting from her regular orthopedic surgery job. OK, maybe there is another reason - I don't look good in scrubs. If I was buff and cut, maybe I could pull it off (like a Nip/Tuck DDS kind of thing).

So, that said, what works for your office may be completely different. What demographic do you draw from? What image does your physical space convey? If I work in a spa-like setting and come out wearing loud ties and bright colors, something is going to feel off. If I am a young dentist working with a patient demographic over the age of 50, I might consider wearing a tie. To me, the clothes you wear have to fit the personality you have, otherwise you will not be relaxed and the patient will, at least subconsciously, feel that something is not right - and that hurts the bottom line. And as anyone who has read my blog for the past year knows, I'm all about protecting the bottom line.

Have a great week!

Friday, August 20, 2010

Its my party....

Hey all,
ITS FRIDAY!!! You made it.

Tell me what you think of this. My 9 year old daughter is named Madison. This summer, she told that she wanted us to start calling her Elizabeth (this is her middle name). We all laughed at her and we all made a joke of it. She went to orientation at her new school, met her new teacher, and told the teacher that she goes by Elizabeth. WHAT?!!

So we keep getting these cards in the mail and emails referring to Elizabeth and we don't know who they are talking about. I asked MADISON why she wanted to be called Elizabeth, thinking it is because last year there were three Madisons in her class. No, her reasoning is that you can get more nicknames from Elizabeth. Now my sister is calling her Ellie and my other sister is calling her Elle. This is all great, but this is not the name we gave her!

I don't really care about what we call her but I just thought it was crazy. Now her family at home and all her old friends will call her Madison, and everyone else will call her Elizabeth. People tell me it is just a phase, but if her teachers are calling her Elizabeth, I am afraid it is going to stick.

Topic de jour. This is kind of a follow up to Wednesday's blog. First and foremost, I want to preface this blog by saying that we all have our opinions, and sometimes we are passionate about our opinions. I don't want you to think that when I give my opinion, I am knocking someone that has another opinion. I think we all have our reasons for doing the things we do and I think my blog is just a way of making you think about those reasons again and if they still apply. It is a way of asking ourselves questions. Is there a valid reason for my dressing this way? Why don't I dress up more? If I dressed up more, would I pull in more of a mature patient pool? I am sorry if I came across as if my way was the only way or I was putting other opinions down.

That being said, I was interested in how the comments came across. And I thought they were very spirited. It all comes down to what we like. But it got me thinking about our needs/likes versus patients needs/likes. Okay what I am thinking is, when does what we like trump what we know what the patient desires, and vise versa? When do the patients desires trump what makes us happy?

It can be as benign as what radio station we listen to all the way to if a tooth should be extracted or not. Some of the comments were kind of like, "I like what I wear and if patients don't like it they can go elsewhere," or "If the patient is leaving my office because they don't like what I wear then good, they didn't need to be a patient here anyway." Now I do not have a problem with dentists having this attitude, but again, when does it end?

I think we all have to weigh the pros and cons to "It is my practice I will do it the way that I want." If you are a young dentist and were brought up with hip-hop music but you have just bought a practice in a retirement community, you might have to listen to music that is not all your style in order for all the established patients to stay.

I think dentists think that "I am a good dentist and people should come to me because I am good." Meanwhile, they have not put a dime into new equipment in 20 years. The office looks like crap, with worn carpet and countertops that have been cleaned so many times that the color is gone from the linoleum, but people are still going to come to me because I am good.

People come to me because I am good and they don't care that they have to sit through electric guitar on classic rock station (Zeppelin kicks ass, man) during their recall appointment.

People come to me because I am good and they don't care if my prices are high.

People come to me because I am good and they don't care if I am running an hour behind.

People come to me because I am good and they don't care ______.

Do you see what I am saying?

The Ritz-Carlton is a hotel that caters to the rich, but I can assure you that they care about their clientele. The rooms are impeccable and the people are unbelievable. You have never heard, "It is my pleasure," more times in your life. (By the way, I have only stayed at the Ritz three times in my life, but you know what? It made a huge impression on me and how I want my patients to feel when they are here and after they leave.) This hotel that knows it has it all going on but still wants to know how they are doing. I think we all should want to know how we are doing. I have even received calls from my mechanic about how they did. MY MECHANIC!!!

I am not saying that because you dress casually, you don't care about what people think. I think about making myself happy, BUT there is always a caveat. I try very hard to make myself happy all the while thinking about how it makes my patients feel.
And I know what you are saying, "Then I am the only one that is NOT happy." Well, yes, sometimes.

But you know what makes me happy? When my staff and patients are happy. Of course, everyone is not always happy (please see previous blogs), so it makes it very hard for me to be happy. I don't know the answer. I am a people-pleaser, and it comes out in the way I operate my practice.

I don't want to come to the office on the weekends but I put my home and cell number on the machine at work because I want to help the person that needs my help, even if it is an inconvenience to me.

So where are we. I get the wanting to please me, but you know what? I think my patients liking me trumps my being happy. Does that make sense? I will wear clothes that might not be as comfortable just to portray an image. I will spend a bunch of money on my office so my patients will feel comfortable. I will spend an hour a week hand-writing letters to my new patients to make them feel welcome. Is it what I want? Well, I would rather be swimming with a beer in hand (hey, it is about 3 hours away). I think we all have to weigh our own happiness versus the client's happiness.

Good stuff today. I think this is a good topic. I welcome your discussion.

Have a great weekend.

Tuesday, August 17, 2010

27 Dresses

Hey all,

I don't know if you have noticed this, but my mug is now at the beginning of the blog. The powers that be thought it would be great to show you who is writing that particular day, and I thought it was a good idea, considering I like to look at my picture. And if you are new to the blog and want to know what I looked like 5 years ago, then there you go.

I had a pretty good weekend. I finished my book, A Land Remembered, and it was fantastic. My son is now reading it. For the most part, it is family friendly; it has a couple of cuss words in it but it was too good for me not to want him to read it.

I started a new book, Jim and Casper Go to Church. Have you ever heard of the book I Sold My Soul on eBay? Well Jim is the guy who bought the soul on eBay, and this book is about his next project.

I also watched the movie Adam this weekend. This is a romantic comedy about a man with Asperger's syndrome. It is pretty good. Remember As Good As it Gets with Jack Nicholson and Helen Hunt? I really like this movie but the thing that I never got about the movie was the end. They end up getting together but she never really does accept him as him - she just kind of overlooks his issues. And with Adam it was the same thing. I have my issues, what can I say?

Today's topic is about how we dress at work. I got into a discussion with one of my best friend's parents. They are really great people and we all enjoy each others' company, all six of us. They were in town visiting my friends and the grandkids and they usually come over to hang. Around the lunch table we got into this discussion about how people dress.

This is how it got started... She is a therapist/counselor. And some guy came in and she asked her patient how he came about coming to her. This patient said that he went to another counselor and the counselor was wearing jeans, and Birkenstocks and had long hair with a ponytail and he was turned off by the unprofessional look. A long discussion about how professionals dress ensued.

Let's look at me for a minute "Look at me, look at your man, look at me, now back at your man." (I love that commercial.) In a professional/relative sort of way, I have always been on the mild side of anti-establishment. But as I am getting older and more wiser I am getting more and more pro-establishment (say it ain't so, doc).
I have always worn a scrub top at work. That is, slacks on the bottom and a scrub top.

About 5 years ago, I got a bit more intentional. We now wear khaki pants and a black monogrammed scrub top (khaki monogramming). I wear a black t-shirt under my scrub top and it looks pretty good, if I do say so myself. My assistants now where khaki uniform pants and a black monogrammed scrub top as well. And when I graduated, I established "Casual Friday". That is, everyone can wear jeans and any type of black shirt. I mostly wear a black T-shirt (one of my Dentistry from the Heart shirts or a "Got Teeth" shirt) on Fridays. I will occasionally wear a black polo shirt on Friday.

My friend's mom went on to say she remembers when "bank tellers used to wear suits,"
but she went in the other day to the bank and one of the fellas working the counter had a sports jacket on. When she was called up, she mentioned to him how good he looked, and they got into a conversation. He went on to tell her that the bank management does not allow him to wear suits. Even banks are dressing down.

In our discussion, I gave her my reasoning for the "dressing down" at my office. I told her that dentistry has always been a profession that has intimidated. The dental office is not always people's favorite place to visit. People were, and sometimes still are, afraid to come to the dentist. I have always felt like it is my duty to make everything more comfortable in coming to the dentist. So this is the way I approach most things at the office - my personality, the way I talk to patients about a procedure, the way I talk about money.

The older guys had always worn a shirt and tie and a white lab coat. And it used to be kind of a "sit down and shut up" mentality (I am not saying that this is bad, I am just saying it is). My reason for "dressing down" is to try to make my patients more comfortable with me and my office. I have a really nice office with nice furniture and nice things to look at in my operatories. I am trying to be a guy that is on their level - a regular guy, just like them. I know this place can be intimidating and I want them to know that I will do my best to make them as comfortable as possible.

Now, I have some friends that work in Winter Park, which is the real nice section of town, and they wear shirts and ties (at least pressed shirts, not always ties). And it really does look classy. I can see how the way they dress makes a statement about themselves. I see them and I think, "This guy has got it all together." That is the other side of the coin.

But there are guys that take my approach and over do it. Like church. Church is kind of swinging to the more casual. It use to be "Sunday best," but the mindset probably was that the church was alienating the people that couldn't afford suits.
So to make church more appealing to the masses, people just dress nice. So now everyone dresses in slacks and a polo shirt or slacks and a button down shirt. And I have even see some shorts and flip-flops lately. And that's just the guys, now the girls. Lord have mercy on what the girls wear nowadays. I can't say anything other than that because I know I will get edited. But the filter is getting wider and wider.

So back to dentistry "Look at your man, back at me, back at your man, now back at me." (I laugh every time.) People can take the casual, the "don't want to intimidate you" look all the way to unprofessional. I mean even turning people off. What am I saying to the guy who comes in to my office and he is a small business owner and wearing a suit and he is ready to spend a ton of money on his teeth and he just happens to show up on a Friday? Am I turning him off?

What about the VP of the local hospital and she is wearing a power suit and I am dressing down? Are they feeling "comfortable," or are they going to find another guy who is going to take his business seriously?

I don't know the answer. I know how I want to make people feel but I also know that the dress I choose can affect the way people feel about me. And as a young guy trying to find his place here, I might have to change my mentality.

Think about that... Then tell me your thoughts; I really would like to hear them.

Have a great Wednesday and I will see you on Friday,

Thursday, August 12, 2010

The Show

Hey all,

In line with what I talked about on Wednesday, I am calling this blog "The Show."

Because, for me, when I work it is "The Show." I have this reputation of being happy and fun and outgoing all the time. Patients expect it, patients come in to see it, patients tell their friends about it. I think I am good at what I do but I don't know if patients really know about how good I am or care. What they do know is that I am nice. I am fun. I treat them well and they feel good well they leave here (they might have a droppy lip, but they feel good).

So what does that mean? It means when I leave my personal office and go to the clinical part of the office, it's on.

Like I was talking about on Wednesday, when the spouse calls in the middle of the day and the poop is hitting the fan at home, your stress has to end at the phone call. When you are having money trouble, you have to leave it at home. When you are having car trouble and it is going to cost an arm and a leg and it is an old car and you don't know weather to fix it or get a new car, but you don't know if you are ready to take on the payment of a new car, you have to leave it at home. Your kid just got accepted to MIT and you are so excited but you don't know where you are going to come up with the $51,000 for the nine month tuition and room and board. You have to leave it at home.

If you are just graduated and you have bought a practice and you are swimming in debt and you have two patients that day, you still have to perform. You have to go out there be the man (or the woman) and do it with this giant smile on your face.
What about if you are totally understaffed because you just had to let go of some of your staff because of the economic downturn, but then you have this one day that is crazy? Everyone working is being slammed. DO NOT LET YOUR PATIENTS SEE YOU SWEAT.
Smile and walk into the room. They don't want to hear about your hard day. They don't want to know that you squeezed them in a spot and you are rushed. They want your best. They demand your best.

How about when you are pissed at your assistant and you go into the room and have to sit next to her for an hour or so? Oh, I can remember hating an assistant one day. We would have these little tiffs from time to time, but this one was a full on fight. She was having a hormonal day or two (That sounds sexist doesn't it? I swear she would agree with me), and I probably wasn't being "sensitive to her needs" (and yes I am saying this with a tone), and we were going at it. We were cussing at each other in the hallway and it leaked into the room. Luckily it was a seven year old kid and he didn't know the "F" word yet. You have to leave it in the hallway.

You have a leak in your plumbing at the house. Your teenager is hanging around the wrong people. There is a huge sale at Macy's. Your spouse is a jerk. There is a huge sporting event that you are missing. Your sports team sucks this year (you know what I am talking about). It can get stressful.

Your practice is slow and you don't know what to do. Your 401k is half of what it usedo be. You check you stock market portfolio between patients (you know who you are), and the situation is bleak. The ADA didn't pick you as one of their speakers. You just don't feel real good about yourself.

I know this is tough to do but you have to LEAVE IT ALL BEHIND. You have to bring your "A" game. You can't afford not to. The next referral could be at stake.

To me, this is exhausting. It is exhausting being nice to people all day. Now don't get me wrong - I love people and I love what I do, but being in The Show can be tiring.

I think I am a pretty nice guy and I think I am a good husband and father. But I can tell you that the wife and kids get the brunt of my exhaustion. I have to admit that I am pretty nasty sometimes. It just gets to the point that I don't feel like putting on a show anymore. I do not have the capacity to be nice. My friend once said, "He was all out of nice."

My assistant says the same thing. When she gets home she tells her husband to just leave her alone for a while. On Fridays, I do like to go home, jump in the pool and have a beer because it puts me in my happy place.

I don't have any solutions. The Show can get exhausting but you know what they say. "The show must go on." (I had to say that.)

How is it with you? Are you able to handle The Show and still go home energized?
Are you nasty to your loved ones? Do you kick the dog when you get home?

For me it is about 5 hours until I am sitting in the pool with a cold one, and I am looking forward to it.

Have a good weekend,

Tuesday, August 10, 2010

Tiger Woods

Hey all,

18 miles on Saturday. I am pretty proud of myself. I did get lots of time to sit on the couch on Saturday and tried to pick up my book several times but ended up falling asleep out on the porch.

Did you know that my kids started school today? Doesn't that sound crazy? August 11th. Seems really early to me.

Remember the ADA lecture thing I was trying to do? Now that the August 6th deadline came and went for the New Speaker stage, I was wondering why I have not been contacted. So I went to find the website or the phone number and I see that on the flier it says, "The council on the ADA Session will notify individuals of their acceptance by August 6th." OOOOOOhh. I guess I didn't make it.

This is a bit of a setback to my world domination on the lecture circuit, but I must keep going. It seems like all my roads are being blocked. The school won't allow me to come and be associated with them (which I still haven't gotten over), now this, but I am not going to give up that easy.

In past, I just put a packet together full of the articles that I have written, a letter to the meeting director, and a bio. It worked - I was pretty busy for a couple of years. But it is a lot of work. Maybe I should get an agent. Yeah, that's the ticket.

Enough about me... On Monday I was doing a lot of errands in the car and the whole Tiger Woods thing kept coming up. (By the way, one of my errands was to visit the periodontist to get my teeth cleaned. Very good reports. The one area that was a 6 maybe a 7mm is now a 3mm. Not bad. Maybe my periodontist does know what he is doing.)

Okay let me back up and tell everyone that has been living under a rock for a year, Tiger Woods is in big trouble. His life is falling apart. He was caught cheating on his wife, and she is divorcing him. Half his sponsors are firing him. His golf coach left him. Things are not good in the Tiger camp.

But this week the wheels really fell of of the proverbial cart. Tiger has been the #1 golfer in the world for the last 10 years or so, maybe even longer. He played the worst golf of his life this weekend. He came in third from last place. That is out of 81 golfers, he came in 78th place. He was 18 OVER par.

So the talking heads started Monday morning, dissecting his post-golf interviews. Yhey say that all his life stuff is affecting his play on the course. Okay, I get all that. They say golf is all played "between the ears." So he is having some life issues but how do you go from #1 in the world by light years to third from last?

He says he hasn't been able to practice because of the kids. Here are my thoughts on this whole thing... "WELCOME TO THE REAL WORLD TIGER." Come to think about it, most professional athletes are so far from reality it is sickening.

If I hear, "I just have to do what is best for my family," one more time I am going to puke. How about the big time baseball players that just need a rest? The manager takes them out of the lineup to rest. You know what else is tough? Working 52 weeks a year like the rest of the working world. And the rest of the working world does not make $2-25 million a year.

Okay lets go back to Tiger. He is going through a divorce, he has to deal with the kids. This is kind of thing that you and I have to deal with EVERYDAY. Not necessarily divorce but lots of other things that I am sure Tiger doesn't have to deal with. Tiger will never have to worry about anything that costs money. I am not saying that he doesn't have stress, but imagine how much stress we deal with, almost on a daily basis, that has to do with money. Eliminate money issues out of your day and what do you have?

We deal with this stress everyday and we still have to function on a professional level. Our minds have to be in it all the time. A tornado of crap is going on at home and you have to leave it at the door. You and your staff are fighting and you have to leave it behind. You are having computer problems, there is a leak in room 2, the carpet looks like crap in the reception area, a patient wants their money back. You have a big case coming up and the temps are not back from the lab.
You have be right "between the ears" all day, every day. Because, at any moment, if you do screw up, your life is going to change BIG TIME. We can't go out there and pull a third from last score because "the kids were not letting me practice."

We have to be at our best after being up all night with a puking kid. We have to be at our best when the bills are piling up and we don't know which one to pay first. We have to be our best when our spouses are calling us upset about something we did (I love you honey).
Have you ever seen a professional golfer on the cell phone, during a round, arguing with his wife? Do professional golfers get a call during a round from his wife telling him, "The car is broken down. What should I do?" SHANK, DUCK HOOK.

I think that most of us are pretty strong mentally. We have to bring our "A" game regardless of the circumstances. We have learned to deal with stress on the run. We have learned that stress is part of the day. We fly along pretty high, but know someone could come in at anytime and knock us off our little pedestal. Things could be going so well and in comes Mrs. Smallmouth with a broken bridge that you just cemented in 7 months ago. Or the call from the wife about something going on at home. We have to keep it together. We are a pretty mentally tough bunch; we HAVE to be.

So Tiger might be able to throw a tournament, but the everyday dentist can't. Not the everyday, real problems, real stress, kind of worker. Third from last is not acceptable. Top 10 is the only place for this profession. I am proud of you all for being rock solid. So go home and tell the kids you whooped up on Tiger this week.

Have a great Wednesday,

Just think, it could be your first day of school.

Monday, August 9, 2010

"Are you new here?"

Ahhh, Monday, my old friend. Why are you always so strange?

What a great weekend. It is only like 100 degrees here in middle-America with 70% humidity - but for some reason, the national networks are not doing wall-to-wall coverage on the heat wave in the Midwest. If only I could live in New York where 100 degree weather is a national news event. Here it just means another day in the summer - suck it up east coasters.

So anyway, eldest daughter had a soccer tournament this weekend. Four games in 100 degree heat on artifical turf (at one point the turf temperature was 160 - I kid you not). She played great, the team played great, the parents complained about the heat great (I think I drank more Gatorade than she did).

The culmination of my weekend was a text informing me that my only Monday hygienst wasn't coming in because of a family illness. That's a whole other discussion that I'm not comfortable having on this blog but if someone wants to post anonymously how you handle these situations I would love to read about it. As for me, my wife and I have 3 kids, both work, have no family within 3 hours of us and never had to cancel patients (shuffle within the day yes). I'm not real sympathetic on a payday when I have to reschedule $300 in prophies.

As for the remaining hygiene patients today, I have been able to see them myself (in between restorative cases). It is actually a lot of fun to spend that much time with the patients and to get to interact with them. For the first 18 months of my practice I did not have a hygienist at all, so I am still pretty comfortable grabbing the Pieso scaler and hand instruments.

However, the first patient today gave me a real wakeup call. This is a patient that has been into the office 5 or 6 times for hygiene (initial exam and perio maintenance 3x/year). He has never had restorative work but has had several exams from me. I went to the reception room and brought him back to the chair. As I am placing the bib on him he says, "Are you new here?"

%*@#$(! Am I new here??!!??!!

I just smiled. "No, I'm the doctor... The fact that you don't recognize me must mean that we are doing a good job of keeping your mouth good and healthy so you haven't had to spend much time with me over the years."

Lest I ever think I matter that much.

Have a great week!


Friday, August 6, 2010

Are you a "modern" dentist?

Good Friday to you all,

I hope you have had a good week. Oh, my Lordy, it is so hot. I ran last Saturday and it didn't go very well. As you kno,w I am halfway through my marathon training. I was supposed to run 14 miles last weekend. I ended up only running 12 miles because I was starting to get dizzy. This is a big no-no in running. When I got home and weighed myself, I had lost 6 pounds that morning. That is with eating and drinking during the run. I am a sweater. You know it is going to be a bad day when you are sweating in the car on the way to the run at 5:20am.

I watched Frost/Nixon last night. I have to say that I thought it was going to be boring but I was pleasantly surprised. I liked it.

I am reading a book called A Land Remembered by Patrick Smith. It takes place in Florida in 1866. Sounds boring, doesn't it? Well, I thought so too, but about 10 people told me how great this book was. I picked it up and it is fantastic. I should be done with it by the end of the weekend because I know I am going to be sitting on the couch all of Saturday recovering from my 18 mile run.

I have started to read other blogs (which I don't recommend to you all, stick with this one ONLY. If you have nothing to compare it to then you will never know if this one sucks or not), and I came across a survey. I wanted to share it with you because I want to know your thoughts. I have to say that I don't really agree with the thing. I think I am getting kind of crotchety in my old age.

It is a survey to patients to see if your dentist is a "modern" dentist. Lets discuss it after you have read it. Here it is.

Give a “zero” for each “no” answer and a “one” for each “yes” answer.

1. Does your dentist have a clean office?

2. Does he/she take at least 30 hours of continuing education per year?

3. Does he/she have modern equipment such as digital radiographs (xrays) and paperless charting (digital charts)?

4. Does your dentist discuss implants as an option to missing teeth?

5. Is he/she involved with a study group?

6. Does he/she or the hygienist use a periodontal probe to measure your gums to evaluate the health of your gum tissue?

7. Does he/she offer an oral cancer screening test using a light?

8. Does he/she offer sedation for procedures to reduce anxiety?

9. Does he/she use ultra-modern reinforced ceramic restorations?

10. Does he/she use non-metal fillings?

11. Does he/she consistently use magnification with illumination to check your teeth and/or treat them?

12. Does he/she use a laser to check natural teeth for decay or cracks?

13. Is there an intra-oral camera available to monitor the status of old fillings and other dental conditions?

14. Does he/she understand the new theories and research on tooth decay?

15. When treating teeth, are cavity detection dyes used to remove only decay and preserve tooth structure?

16. If he/she says they are a cosmetic dentist, has a recent course about it been taken?

17. Does he/she have photos of their own work to show?

18. Is your bite checked to help avoid cracks in your teeth, chips on the edges, or increased muscle tension?

19. Does he/ she keep you informed about the connection between dental problems ( e.g. gum disease) and the rest of the body?

20. Does he/ she do a panoramic xray every 3-5 years to check for cysts, etc. that are normally not found on “checkup xrays”?

Rate your Dentist
15 – 20 — Your Modern dentist is Jetson-like. Good job!
10 – 14 — Your dentist could definitely improve some things. Just ask.
0 – 9— Your dentist may be working in the Flintstone-era

What does "modern" mean? Modern does not necessarily mean "good at what they do." It does not mean "passionate." Do you see the difference? The author is leading people when by equating technology with skill. And, it seems, the author is behind on the technology research as well. I took the test for myself and I passed, so it's not that I am pissed about failing the test.

I will buy the clean office question and the magnification question. I like the probing of the gums question. But some of them don't make any sense.

Does he/she use non-metal fillings? Hmmm? I have a problem with this question. I think amalgam, although not modern, is a material that has been in dentistry since GV Black. I sometimes see patients with amalgam fillings in their mouths that are over 40 years old and they look like the day they were put it. How are we now bashing it because it might not be aesthetic? Does "modern" mean aesthetic?

Does he/she use a light to do an oral cancer screening? Does he/she use a laser to aid in decay detection? According to the research that I have read, the light doesn't work for cancer screening and the laser doesn't work for decay detection (sorry Diagnodent users).

You know I am big on CE. But doing 30 hours of CE and never leaving the office is too easy now a days.

And the question about being a cosmetic dentist? I just never got how we started equating veneers with modern. I can be a dentist that cares about conserving teeth and a dentist that has an eye for cosmetics. I would not consider myself a cosmetic dentist but I certainly know when veneers or other cosmetic dentistry is necessary.

I understand the questionnaire. And yes, I think keeping up with the stuff that makes you a better dentist is important. But I also know that I have jumped on technology in the past and the new and best thing ever is sitting in my closet somewhere because it didn't work the way it was supposed to or the research told me it wasn't that great.

I understand what the author is trying to get out of it. But I also know how expensive getting a digital x-rays costs. And I know that now that I have digital x-rays it doesn't make me a better dentist, and it doesn't make more passionate. It doesn't make me care about my patients more. It doesn't make me fair.

I told you I am getting crotchety. What are your thoughts?

Have a great weekend,

ps. My kids start school next Wednesday.
Wow, summer is gone.

Monday, August 2, 2010

Two sides of the same coin

Okay, funny kid stuff:

My 5 year old daughter was playing by herself in her room with her dolls. She is the only one of my 3 children to have the ability to play by herself, and is also the only one to play with dolls. -I digress- She is very imaginative and expressive and oftentimes Susan or I will eavesdrop on her and enjoy her role-playing. Last week she was playing "Cooking Show." Don't ask me where she got that idea from - like I said, she is very imaginative. So she ended the episode like this: "If you would like more information about the recipies we talked about on today's show go to" It is a new generation, boys and girls.

If you hadn't noticed, I have been pretty spotty about posting for the last month or so. I had a good friend ask me about it the other day (implying that he missed the witty reparte - right) and I told him what I will tell you - it is a weird responsibility to be one of the AGD bloggers (albeit the lesser one), and when all I feel like posting is depressing crap, I sometimes follow my mom's advice and don't say anything at all.

That being said, I have been reading Dr. G.'s posts and feel like I need to get back in the groove of bringing ya'll down every Monday with some small business owner reality. I have been wrestling for the past couple of months with this question: Is my business successful? Seems like a simple question, right? But here is the rub - how do you define "business," and how do you define "success?"

Now, the 2nd definition would seem to be the more obvious and, as everyone knows, varies based on the person. So let me start there. Am I successful because I still open my doors to see patients 4 days a week after 3 years, 10 months and 20 days since embarking on this adventure? Am I successful because I employ 4 staff members (having created 4 jobs that did not exist 4 years ago)? Am I successful because I have 1,300 active patients?... I could go on and on with dental practice metrics, but you get the point. If I were to ask people to look at my practice and give it a thumbs up/down based on measurable, visual parameters, I would be a success.

>However, I am not just a dentist who owns a practice - I am a business owner. And that role measures success differently. Am I a success even though I have hundreds of thousands of dollars in total debt? Am I a success even though my schedule is not as full as it could be? Am I a success even though my production is down in July '10 versus July '09? Am I a success even though I can't offer my staff any ancillary benefits?...

And I haven't even gotten into the definition of a business. I mean, what is a "dental business?" By all accounts, I am a very good dentist. I am not going out and giving seminars on dentistry, mind you, but I am damn good at what I do. I am extremely caring, compassionate, considerate, technically good, etc. But I am also constantly paying bills at or slightly after their due dates. I make judgment calls on which bill will be OK to wait on until next month. I struggle to bring home more so that my family can have less stress. I struggle with how to schedule - do we continue to grow and add more hygiene hours or do we start more of a long-term stability business model?...

All of those things go on in my head - and in the head of every business owner - all the time. This is why I like that you get to hear from Dr. G. more than me. I am not considering buying a new piece of equipment; in fact, I am praying that all of my existing equipment doesn't break down because I don't have the money to fix it. You are getting two sides of the coin with John and I. A profitable, long-standing dental practice in a transition and a new dental practice in its infancy. Both are dealing with this economy and struggling in their own ways - but as the infant, I dream of the day that I will feel the pinch of the economy and wonder whether I can finance a $75,000 purchase.

In the meantime, I will continue doing what I do. I will continue to kick myself for taking off a week during a hot streak because the rest of July was spent catching up on income and I am already planning for next July, when, with the 4th of July holiday and the AGD Annual Meeting, I will be working all of 12 days.

I better go now, I feel the energy to face the pile of bills and that is a rare feeling. Now I just have to wait until the mail gets here to see if we have money to pay any of them... 1 more week until payroll...

Have a great week!


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