Wednesday, October 21, 2015

What Is Wrong With You People?

I am currently reading a book called “Beloved.” This is a book my son has to read for school, so I thought I would pick it up. It is a bestseller and the writer won a Nobel Prize in Literature. These artsy book types are usually not my cup of tea but I will give it a try. I am on Page 11…so nothing yet.

Now for the topic de jour:

I am the type of middle-aged dentist that loves to show off. I want to show off my staff, my office, my work, my family, and my muscles.

So when a young college student asks if they can shadow me…I am a pig in poop. I have multiple young, aspiring dentists in my office every year. I had a young dentist email me and tell me that he is new to town and wanted to just come and hang out. I said, “Sure.”

This person came toward the end of the day. He came to watch us work for a little bit, but then we were able to just sit down after work and talk about the profession. It turns out we had the same philosophy about dentistry: We believe we have a gift and we want to use it to help people.

Fast forward a couple of years.

We have kept in touch and he texts me when he has some questions about life and work. He came in the other day and had some restorations done, which provided us a chance to talk. He has been working for “the man” in town, and corporate dentistry had not been kind to him. He tells me he does what the patient needs, so if they need a filling he does a filling. But on most plans fillings are either free or very, very cheap—like not enough to pay the dentist cheap.

He owes $500,000 in student loans and he was barely making enough money to pay rent. So things had to change. 

He moved to the Northeast to be with his girlfriend and try to start over. He got himself a great job with a mother/son practice. The mother is 79 years old and obviously planning on retiring soon. And as she phases out, he was going to phase in and eventually become partner. The son is a periodontist, so he will do the perio and my friend will do all the general dentistry. Sounds awesome right? 

Well, by his third week there he had some down time. He just was walking around the office watching, trying to learn the systems. How do people answer the phones? How do they schedule? How do the assistants interact with patients? How do they clean, and what do they clean with?
And he started to see some flaws. Like, a person came in for fillings and on the schedule it says “Extract  No. 12.” He saw a lot of backstabbing between the staff. He saw the assistants wiping down the handpieces and putting them back in the drawer. He saw those same assistants saving used burs and putting them in hydrogen peroxide. The air/water tips were being wiped down and not replaced.

Whoa, wait a minute! He was thinking that there were some shady things going on there.

This is when he called me and asked me what I thought. I have to admit I am a pretty naïve guy. I told him that maybe he doesn’t know the correct OSHA protocol for sterilization. He told me that once he saw the improprieties, he brought them to the junior partner (soon-to-be senior partner),who told him that all this was okay.

My friend told him straight up, “No, this is not okay.” So the junior partner started talking about how they were down a couple of handpieces and that when they got new handpieces then they would start sterilizing them properly.

For my friend, the writing was on the wall that it was time to leave. And not let’s see how it goes and then I will leave. It was “take your loupes and light home after work because you ain’t coming back” leave.

I asked him about other jobs. He told me that he went on an interview with a man who lost his license because he was writing pain prescriptions for his ex-wife and he needed a dentist to come in and do the dentistry in the office. Things were great until my friend smelled alcohol on the guy’s breath. “Run, Forrest, Run!”

He went on another interview and it seemed like a nice place. They needed an associate. He talked to them about how it would work. They told him that they would be doing all the treatment plans and would be monitoring all his work. He asked, “Is this a probation thing? Like will you be watching me just until I get my bearings?” They said, “No, you will always be doing the treatment planning, and we will be monitoring all of your work, all the time.” It was like an episode of “Big Brother.”

This kid loves dentistryat least he did love dentistrybut is getting a big dose of reality. There is some crazy stuff going on out there. He just happened to interview with all of them. He is starting to think the only way to make sure he is not working with a cheap, overbearing alcoholic is to buy a practice of his own. And unfortunately I don't think that is going to happen, especially considering he is already $500,000 in the hole from school.

I may be sitting in my ivory tower and judging, but you gotta do what you gotta do. I buy handpieces and I sterilize them between patients,I buy the best products, I update my furniture in the reception area, and I buy new uniforms when they are looking like rags.

I just thought everyone else was doing the same thing. Sure I am cheap and I hate spending money like the rest of you, but it is the price of doing business.

Back to my friend—yeah, he presently doesn’t have a job. I like the guy so much that I told him that if he ever moved back that he would make a great addition here (that is how much I like him). I am hurting for him. And I have to admit, I am a bit embarrassed by the crazy people that are our colleagues.

Anyone in the Northeast hiring an associate? Do you have any stories that might make my friend feel any better? Do you have stories of crazy bosses? How about cheap bosses? Those are always fun.

Have a great day,
John Gammichia, DMD, FAGD


Mike Plambeck said...

I think this comes from the rise of chain dentistry locations like "Aspen Dental" I feel like these places are for profit dental mills, just grinding through the patients, and it's tough for other dentists to compete, so negative things end up happening at other dental offices.

Jenn and Steven said...

Another great article, John. When are you going to come give a lecture in Texas?

Anonymous said...
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rachel said...

A very interesting and horrifying article. I feel like there are rigorous standards to get a dental license but no systems in place to check that the standards are being upheld after that. To the other commenter, Mike, I feel that it is insulting to both dentists that work at chains and to those that do not to imply that the existence of those chains can cause normally ethical people to behave unethically. I believe that dentists that cut corners and have substance problems have been around since before chains.

Brad Strong said...

This article hit home for me as I have worked a few different places, including a corporate office, before buying my own office. Each office was different and it was interesting to see what each office felt was important and what they would let slide. The corps are targeting these young docs with all that debt. They are the only places these new grads can go, but unfortunately, I believe they are learning a different kind of dentistry than they would learn in a traditional dental office. I have had some great mentors, and not so great. We learn what we see/experience. Until the # of grad and the dental school debt are under control, it will be hard for these new grads to learn traditional dentistry. They need the $$ a dental corp can provide and there just aren't enough traditional docs to mentor all these new grads.


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