Thursday, December 13, 2012

Friend and Foe

Hey all,

Only 4 blogs left. So much pressure.

I took half the family to the Georgetown game on Friday night. The wife got cold feet and decided to stay home with Madison and the baby. A 10-hour drive with a potty-training baby didn't seem like tons of fun. Georgetown won an amazing semifinal game. It was tied 4-4 after regulation and then it was still tied after two overtime periods. It went to penalty kicks.

My friend kick got blocked. OH MY GOSH! Please don't let the loss hang on him. If you don't know anything about penalty kicks, you each get 5 and whoever gets the most goals, wins. It was 1-1 after the first two kicks. Then 1-2 after he missed. It was 2-3 after the next two. Then we made our next two and they missed the last two (or our goalie blocked them). We won 4-3 in penalty kicks. WOW.

Then they had less than 48 hours before they had to play for the national championship. We went up against a perennial powerhouse in soccer. Indiana University has won 7 national championships in soccer (who knew?), and we were in the final game for the first time in Georgetown history. We lost 1-0 in the finals. We looked to have a bit of a hangover from the tough game on Friday. They were good (they had already beaten the #1 and #4 ranked team to get to the finals), and they beat us. What a season. Georgetown, national runner-up. Sounds really nice. Not as nice as National Champions, but what a run.

In the fan fare, you had to kick the ball 50mph to get a prize. I got it on my sixth try. I am still limping.

It was great being with all of this kid’s family and friends. We got in at about 1:15 on Monday morning. We let everyone sleep until 9 a.m., and then back to school. My boys had a great time. It was a great time.

Before I forget, I want to know what you do for Christmas. The comments are anonymous, so you can tell me without giving up who you are. My staff talk to all their friends from other offices and the stories continue to get taller. Yeah, the word is that a dentist down the road (single with no kids) is giving the staff $1,000 each (I don't think he has a large staff, but still…).

I mean, I love my staff. But I would have to get a loan to do something like that. We are going out to dinner and they are getting some presents and a Christmas bonus. But I can assure you the bonus is not even close to $1,000. Which brings me to my next question. What are you guys doing? The comments are anonymous, so feel free to tell me that you give $1,000 bonuses. I appreciate your feedback.

Now, the topic of the day. A friend from church called me up. I have known him for about 10 years. I like him and he likes me. We have been to a couple of parties together over the years, but we have never hung out. He asked for some professional advice. He said he needed a crown and a filling and it was going to be $2,500. He wanted to know what I thought of that price.

I told him that my crowns are about $1,150 and my fillings are about $250, so that seems a little high. He asked me to take a look at his mouth. We did a new patient exam last week. I told him that there was some good news and some bad news. The good news was that I found the tooth that needed the crown and filling. The bad news was that I found eight more cavities. This was a first for me. Usually people come to you for a second opinion because they went to the local clinic and they have never had a cavity before and this shmuck told them they have 12 cavities.

The cavities were obvious. We took a full mouth series and all of them were interproximal, but definitely there. Not just into the dentin, but really into the dentin. He said his previous dentist took two X-rays. So the last dentist took two bitewings on recall and he is missing things.

I have always been upset with dentists who overtreat and wondered how to blow the whistle on them. I have not had too much experience with guys missing things. Now, to be totally truthful, I know this dentist and I really like this dentist. He is about 10 years younger than me. He is a good guy with a good family. He is even in a couple of my study clubs.

What do I do? Do I leave this alone and not say anything? You know this is not my style. Look, I know people only take two bitewings to keep the cost down for patients. But this can come back to bite you, if you know what I mean. How do I talk to him without sounding condescending? How do I talk to him without it sounding like I know everything?

We don’t know what happened or why he missed this. We can talk for days on why we miss things. We can talk about all our systems that don't work. We all have room for improvement. I try to teach teamwork. The hygienists know that I am dealing with a ton of stuff in the treatment rooms and that I need their help.

While they are cleaning a patient’s teeth, they need to be looking around for stuff that I should focus on. They write it down and then I come in and key in on a couple of things. Do I miss stuff? Heck yeah I do. But I don't miss EIGHT of them.

I am going to think about how to approach this dentist over the new few days. My assistant asked me if I would want to be told. I want to say no, but I am always preaching that I want to get better. I just don't know if it is going to hurt. I am fragile. The problem is that I think I am awesome. I think I do everything well. Can I get better? Sure. But I need to think that what I am doing is good or I wouldn't do it. If someone else comes and tells me it is not, that is hurts.

I don't know what I am going to do. Any suggestions?

Talk to you soon,


P.S. Don't forget to tell me what you are doing for your Christmas party and what you are getting your staff.


Anonymous said...

One year I spent time opening walnuts, pulling out nutmeats and placed diamond tennis bracelets inside. Reglued halves and decorated with feathers, glitter eyes and turned each into a new years mask! The staff was so excited. Then 9 mo later. After we had moved into a new facility, I had mutiny! As they gave their resIgnations, the office manager told me the diamonds were nice, but they would rather have had money. The bracelets were purchased with my personal bank account. They were presents. I had paid for one wedding, sent a single mom and her two kids by plane to FL to Disney for a week. I always give hams and turkey breasts for Thanksgiving and Easter. I have learned that the more you do, the more is expected.

Anonymous said...

We give each staff member a small present, a christmas bonus that comes out to about $250 after taxes and take everyone out for a nice late lunch / early dinner (we close early that day). We have about 8 employees.

Anonymous said...


I'm just a dental patient who likes doing research and making well informed decisions about my dental health, which is how I stumbled upon this blog. :) I can't provide an answer regarding a dental office's Christmas traditions, but as far as the other local dentist you were speaking of, I would definitely bring it up. As a patient, I get extremely nervous putting my health into someone else's hands when I only understand half of what's going on. Think of how many people that would be affecting. I had a similar thing happen to me, where they told me they were helping me get good value by only taking a few x-rays so of course they didn't catch some problems that would've been simple back then. Now that I've switched dentists, I've discovered problems that have been 'brewing' for a while and now require crowns and more invasive procedures which literally made me cry for a couple days. I was just too afraid to challenge my previous dentist.

Just think about how you'd want someone to approach you. Do the 'Oreo' method --> give em' the good, then sandwich the bad with more good. Show respect and concern for what you found. Maybe compare records to have a lead in to what you found. Make it a positive interaction so he hears what's important out of the conversation, not just criticism. :)

Great blog by the way!

Anonymous said...

As I recently found your blog after some very bad dentistry, I would definitely bring it to his attention.

I don't understand how your friend could not feel any of the cavities. I know I sure as heck can feel one when I have one (and they're not big at that point), I can't understand how he could have eight and not feel any of them!

Can't comment on the party as I'm not a dentist, but a nice dinner out is always nice.

Alina Maria said...

Here is what we do! Each staff member gets a bonus check, the highest this year will most likely be around $350, the lowest about $100 (for a newbie). It is based on how long she's been with us, if she's full or part time, etc. We keep track of it yearly, so each year is a bit more. (The only $1000 check will be to our associate dentist who has been with us for a little over a year.)

We do a big dinner out with spouses invited. Each staff member gets a gift (these are the same for each person, usually ends up being worth about $75) and in this gift is her bonus check. We do games and prizes and door prizes. We always do the dinner the last day that we work before Christmas Day. If a staff member can't come, she gets her gift and bonus the first day back after Christmas so she doesn't open her gift and spoil the surprise for everyone else!

It is an event that our staff looks forward to each year, it is the only time we invite spouses to an outing. This will be our 6th Christmas dinner.

I hope others share what they do, it is very interesting! Thanks.

Anonymous said...

You must speak to the dentist who missed the diagnosis of caries. Explain how you fell when you see overtreatment...and then explain how it is necessary to not undertreat. A nationally known consultant feels very strongly that dentists who are complaining about not being busy are just not looking hard enough at their existing patients. Perio, occlusal discrepancies, cosmetic issues...and of course dental caries. Just let this dentist know that you are glad when you discover more to do. That is a service to the patient and to the income of the practice.

I think that a dentist taking too few readiographs to save the patient money is making a terrible mistake. He should take the radiographs necessary to do a complete and thorough diagnosis and treatment plan. The x rays are necessary and the doctor does not even have to charge the patient for that service. Then there is no guilt. I often ask my assistant to take radiographs of something that is not clear. she replies that the patients insurance will not pay for them. I tell her that I NEED the x rays. take them at no charge for me.

It is your responsiblity (ten years his senior) to let him know how you feel. Remind him of the standard of care in the community.
Dr. RB Allen Hampton VA

Indianapolis Dentist said...

Fantastic post !! Thanks for sharing this information.


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