Sunday, March 30, 2008

Study Club con't

So it is Tuesday.
Day of the Study Club.
The topic picked.
The venue set.
The members have been called.
The food is picked up.
The LCD projector has been obtained.
I put together my presentation.
I picked up my friend and we were off to this dudes office.
Remember there were special instructions about parking. Go to the third floor and go as you were going to the forth floor and then take a right.
The instructions said there will be someone to assist you when you get there.
Simple right?
We were there about 15 minutes before 6pm (the club starts at 6pm but no one ever get there this early) so really this was very early.
We went to the third floor and proceeded to the forth floor and then we took a right. The parking garage was a freaking maze. We drove around looking for signs that weren't there. We went round and round.
We went by about 3 different elevators. By the third pass we finally found the person to assist us.
She said, "Hi, park right here" We got all the crap that I was bringing (we had to make two trips) and we went on our journey to find the elevator. It was not right there. It was up a ramp, through a door and to a set of elevators that you couldn't see. When we got into the elevators you needed a key to go up.
She took us up the the fourteenth floor.
We walked us into the office and OH MY GOSH the thing was beautiful. It was amazing. 50 inch plasma in the reception area, granite, beautiful pictures. His two main operatories overlooked downtown Orlando. All the best and warmest colors. It was fully automated. Paperless. Monitors on the same tracks as the lights above the patient. Everything.
I have a nice office but this...WOW.
I had just forgotten what a mess the parking was.
Don't get me wrong, I love my office and what makes an office is not the pictures and monitors but the service and the people providing the service.
That being said, this was NICE.
OH and there was a balcony that you can go out on and just ponder your existence. Or jump off on a bad day (or when you realize how much this view is costing you).

Back to the parking. I took his lovely assistant back down with me to the car. We moved the car closer to the hidden elevators and she said she was going to stay.
Now you realize that the key to get up the elevators was the tricky part. Lets say someone somehow made it to the elevators without assistance they wouldn't be able to get the elevator to move upward.
So when I would see this woman up in the office I am thinking to myself someone is driving around aimlessly downstairs.
This next part is great...
At 6:45 the host dentist gets a phone call from home saying his daughter has broken both her bones in her forearm. He tells me he needs to leave.
He says John, I have to go. But don't worry two of my girls are staying and they will help you.
I say to myself, John take a deep breath, it is going to be okay.
He leaves.
The staff member (the one helping with parking) comes up and says, "that is probably it". I did kind of agree with her because it was 7pm. One hour after I told people to be there.
I was thinking man this is light crowd. I have food for 25 and there is 8 people here.
Next thing you know people strolling in, exhausted. I ask, "Did you find it okay?"
"NO!" they said.
We drove all around, stumbled across the elevator and then we couldn't get up. We had to find the parking attendant and then after the third degree he let us up.
Keep in mind the staff member told the parking people there is a possibility more dentist are going to be coming. If they by chance come let them up.
So when they did come he gives them a hard time.
When we finally did start there was 20 plus people there. That means more than half of them had to find the elevator and realize they couldn't get up without a key. Then find the parking attendant only to get the third degree from him before he would let them up.
We set up in the reception area.
This is a quaint little place with FOUR chairs. FOUR. (I don't know about you but I have I have 10 adult chairs and 4 children's chairs) No sweat, so we rolled in all the doctors chairs and brought in the chairs from the staff lounge and consultation room. Some people just had to stand.
I thought the presentation went pretty good. There was some good discussion with some dentists about the way they tick. Some good discussion on computers and bonding agents and such. There was some discussion on anesthetic that both the endo and oral surgeons were able to clear up for us dentists. Things like this. It was good.
But inevitably there is always things I regret not talking about.
I mean there was probably 7 specialists in the room.
I could have asked the endodontists about why they only put in one tiny cotton pellet in an access filling (and make me dig for about 15 minutes to find the bottom of the access).
I might ask the oral surgeon why they take pans on people that I have already sent a pan on.
In all seriousness (and I was serious about the two above but it might of seemed like joking) there were things that I wanted to know and forgot to ask.
Or I didn't ask people about if they are members of the AGD. Why and why not. Or what magazines do they subscribe to.
Or who does there implants the periodontist or the oral surgeon.
Or, or, or.
But all in all I think it went pretty good. I think it is important for dentists to not feel alone in what we do. You can't help feel like you are on an island most of the time. Am I the only one that feels this way. Am I the only one that has this problem. Am I the only one that feels like my head is spinning around.
The answer is always NO but if you never hear it from anyone else then you get those thoughts.

Hope you had a great weekend,
Do you remember the commercial with the Dunkin Doughnuts guy "Time to make the doughnuts"? (back in the 80's, if you don't look it up on YouTube, great stuff)
Sometimes I wake up and say, "Time to do the fillings." It makes me laugh.
Talk to you later,

Friday, March 28, 2008

Study Club

You remember the Study Club I eluded to last month. Well this month I was in charge. It went down on Tuesday. Let me tell you about it.
I usually volunteer about once every two years (or more) to do it.
But I had forgotten how difficult it is to pull this stuff off.

This study club was started by a local Oral Surgeon. We have been clubbing together for about 10 years. He was a young surgeon and he attracted a lot of young dentists. We had less than half of the members had their own practices. Now I think just about everyone owns a practice or is involved in a full-time gig. We understand young dentists so we still do cater to the associate or the new guy/gal in town.
They meet about 8 or 9 times a year (I am hit or miss, I say I make about 5 a year).
It could be on Pathology, Bonding Materials, Pharmacology, practice management stuff.
What I decided to do was do a Round table discussion. I would do a TOP TEN list. This is the top ten things that make my practice better.
It doesn't have to be expensive or big just good. I ask all the other members to bring a top five or top three so we could discuss products.

I would say about 90% of the study clubs are at the Oral Surgeons office. But for mine (I am always bucking the system) I another idea. There is a guy in the study club that just opened up a new office. I understand it is nice to spend over a million dollars on something you kind of want to show this stuff off. I said to this guy, "I am in charge of the next study club why don't we have the study club at your office?"
He said, "Sure".

I knew about when I had to give the study club a year in advance but let me tell you it came up really fast. I mean before I knew it it was March and I knew I had to do it in the next couple of weeks. So I said lets do it next week. Which means I had to call the other dentist to see if next Tuesday was okay with them and to see if he still wanted to have it at his office. I asked his administrative assistant and she said she didn't know what I was talking about. He never told them. So I told them what was going on and she said, "great". (I love staff that are friendly and jump into gear when things need to get done).
So the place was okay. Now I had to pick the topic (I had some ideas) which I did and let the members know about it. So it is Tuesday at this point and the study club is going to be the following Tuesday. What am I doing to myself?
I start composing a letter and tell one of my people to call the oral surgeon and get a list of all the current members.
When she got this I asked her to stop what she was doing and start addressing envelopes with all their addresses. I finished the letter and then she typed it. I was thinking if we could get it out in Wednesdays mail then most of them would get the letter on Thursday and some on Friday at the latest.
Now it is Wednesday and the letters are ready to go. Then I asked one of my assistants to fax the letter to the members. This is a real pain. Letter in fax, type the number, wait, letter going through, done. Put letter in the fax, type the number, wait. I think there is about 35 members in our group. In the letter I told the members about the topic and told them to bring their top 5. And I told them the location.
Then I got a call from the administrative assistant from dentist of the location we were having the meeting at. There are parking instructions. Like come into the parking garage and get a ticket. Go to the third floor and go right like you are going to the fourth floor. Then look for someone from our office and we will direct you. The letter and the fax have already gone out. Crap.
No problem, I will take care of this later.
Now it is Thursday and I have to produce a lecture. I have to say I have done many PowerPoint presentations before but it still takes time. This as you already know is a hot commodity in my life.
I begin Thursday night. I put a bunch of it together and do more at work.
Friday there is an email reminder that goes out. On the reminder the new parking instructions are in.
Its Monday. I take the list home with me and start to call all the members for the final reminder, make sure they are coming, and to remind them to bring their top 5 list and give them the parking instructions.
Are you feeling my pain yet?
This is painfully slow. I do it because I don't think I could give this instructions to my staff that would effectively portray how important things were.
Plus they have more important things to do.
Now it is Monday afternoon and now things are set. At least people are coming but I still don't have a completed presentation and no food or drinks.
Oh the person giving the presentation is in charge of providing food.
My wife asked me if she could get food for me. YES, you are an angel.
Food, taken care of.
Then I get a call from the endodontist in charge of bringing the LCD projector. He tells me another dentist has it and is going to bring it to his office and he doesn't know if he is coming to the meeting, so I have to go there and pick it up.
NO PROBLEM, that is item 70 on the list to do tomorrow.
I go to bed.
Next day, I start to work on the presentation, taking pictures of things in the office and putting them in a presentation. OH, by the way all this time I still have a job and I am trying to do dentistry to pay the bills.
I leave work and go pick up the projector. I go from this dudes office to Publix to pick up the food, beer, drinks, dessert ($170, real nice).
Rush home, change, put all the drinks in a cooler, and realize I have no ice.
I take paper plates and plastic forks and napkins and jump into the truck.
I pick up a buddy (dentist) and then we are off to the study club. Go buy ice and dump it into the cooler and then get on the highway.

This is where I am going to stop. There is a story when we got there.
So I will tell you it on Monday.
If I tell it now this blog will be 3000 words.

Next week I want to talk to you about Consent Forms. I don't use them, am I the only one?

Have a great weekend,

Wednesday, March 26, 2008


Hi everyone,
I have a lot going on that I want to tell you about but the conclusion to Mondays story is too good. So I will wait a couple of more days to write to you.
But in the meantime you are going to love this one.
My friend is jaded. Trust me when I tell you he is not always this dark but I think this situation he is in is effecting (is it affecting or effecting, I don't know, I figured I had a 50/50 chance) his personality. Like most of the stuff that goes on in our day. I know we try hard not to bring it home or let it bother us when we walk out the door of the office but sometimes you can't help it.

The man. Not sure who the man is. Do they refer to the government as the man?
If so then I’m angry at the man.

I had previously blogged about my obligation to be on federal jury duty. Then I had blogged about my pending telephone hearing with the unemployment compensation officer.

My hope was to confront both issues this past week and have them behind me. Here’s what happened.

For a week I called the courthouse past 12:30 PM and navigated through their telephone prompts. I would enter a nine digit code and they would confirm my last name. Then the most frightening part was the delay right before the computer told you whether I was actually being called or not.

I managed to go unscathed for a week. Unfortunately on Friday afternoon they requested my presence the following Monday morning. My morning patients were all cancelled and I went in.

Prior to all of this I had sent them emails pleading my case as to why I really couldn’t afford to sit around a courtroom for a few days while my life was put on hold.

While there for an hour and a half I did not utter a word or complain. Then the court clerk approached me and asked me why I didn’t make a last ditch effort to get out. I was in disbelief that she had singled me out of a room of 40 people. My emails and calls must have resonated with her. So she gives me another form which I fill out with all the reasons why I can’t serve and she makes me a deal.

This is my deal. This summer when I was suppose to be relaxing during my prescheduled week off I’ll actually be in jury duty. The alternative was that they would select TWO weeks at random and there was no wiggle room then.

It is a serious blow to a practice to be shelved for “civic duty”.

Maybe worse than all of that was getting back to the office to open mail and discover that the telephone hearing on whether my former employee was due compensation from the state funds for being unemployed went the way of the claimant. Meaning that I had lost.

I do not have the paper in front of me but certain words on it resonate in my mind. One statement was that the story of the claimant was more ”credible” than that of the employer.

I had another employee testify that she had the claimant STEAL from her purse. Then the claimant admitted to this and admitted to taking a prescription for a controlled substance to a pharmacy as she posed as my other employee.

The letter further states that the claimant used POOR JUDGEMENT but since the incident did not interfere with her duties as a dental assistant and she had received no prior warnings for this that by law she was ENTITLED to unemployment compensation.

So what I now understand is that employees can do virtually anything and because there is no prior warning when you fire them they can enjoy getting paid later without actually earning that money.

That is the moral of the story.

Keep in mind that I presented a compelling story that was told in a calm voice. It detailed her addiction problem as an additional reason for her termination. Of course I am no expert in labor laws or in the area of substance abuse but this is a person who would have periodontal surgery on a Friday. She would be prescribed a 5 day supply of painkillers. The very next day I would hear her calling the periodontist’s on call guy for more pills while she was visibly doped up and barely coherent.

I witnessed this behavior for a year through neck surgeries, root canals, extractions, and periodontal surgeries. She had multiple practicioners and overlapping of prescriptions.
Based on the observations in behavior, witnessed by many around her, she was told to get help and to try to eliminate her need for narcotics.

There were other reasons for her being let go that maybe I could go into but the point of the whole thing was that here is a person with a history of poor decisions in her personal life. She had moved 4 times in a year with her young son who had to be dragged through all of this. A person who I later learned had been run out of another state for the same reasons. A person with a reputation for suing former employers. An irresponsible individual who made errors at work that were constantly needing to be corrected and who made stupid purchases only to complain about money later.……………Her story was more credible than mine???????

The man or the system or the government is a massive abusive uncaring and unfair beast.

I told you it was good. Man OH Man this stuff is unbelievable.
Have a great day.
See you Friday,
Do you miss me?

Monday, March 24, 2008

Ghost writer

Hi Everyone, Happy Easter.

As you may know how much time it takes to write this blog. I absolutely love doing it but it does take an exhorbanant amount of time. So I do not get burned out I have asked a friend to help me. He may fill in for me maybe one week out of five.
We are not going to tell you who he is to add an element of mystery and so he may speak frankly about his feelings.
He has a style that is very blunt. At this time in his writing career he is not funny. I have this ability to laugh at all the things that happen to me. This person does not think some of the things that happen to him are that funny.
I have had him write a couple of test blogs so I can evaluate his effectiveness. I liked them.
Here is his first blog. Please let him know what you think

Over the last few months my friend John has entertained many with his amusing stories. In many ways we are similar.

I don’t know that I’ll be as funny or as pleasant to read as John. I like his writing style and since I know him so well his words come to life when I read them.

John has a wonderful view of dentistry and he feels he is blessed to be doing what he does. I am glad I chose dentistry as a profession but my perspective will be much, much darker.
You see, I have a history of making bad decisions. Some of them have been very costly and have likely taken at least a decade off my life. I wish I could see the world with rose colored lenses but I do not. If anything I identify with Johnny Cash. Maybe I’m the man in black of dentistry.

My current frustration stems from the firm belief that what I do and have done is worthwhile and often unappreciated by society as a whole. More to the point I feel government intrudes on the small business owner at will, makes enormous demands of people like me, and seldom recognizes the value of what we do. It would be nice, just once, to get a thank you from “them”.

My office is small. In a small office the staff, or team members, become like family. They are involved and interested with each other’s lives. They care for each other and coexist week after week and year after year. On occasion I make the mistake to hire someone into our group that simply doesn’t fit in. This happened recently. This particular employee had a self-destructive personality. The kind of person who chain smokes and gets in tanning beds every other day. Not a day went by that I didn’t remind her of the obvious correlations between these habits and cancer rates.

We could get past this personality trait but the straw that broke the camel’s back was when she went into the purse of another employee and stole a prescription for Vicodin. She later went to the drug store and tried to get the prescription filled. The only way I discovered this had happened was that the drug store called the office to confirm I had written the prescription. The other employee whom I wrote it for had told me earlier in the day that she had done well over the weekend and had not needed Vicodin.

Long story short, I fired the thief and gave her three days severance pay.

Now I am dealing with the local unemployment office because she feels she was wrongly terminated. Forget that she stole from another employee and admitted to it. Forget that pretending to be someone else in order to obtain a narcotic is a felony.

They have been hounding me over the last 3 months and rather than accept my explanation they now want a telephone conference. You see, the labor laws are never to protect employers. The burden of proof is mine and not hers. This entire episode is an unnecessary nuisance that I can’t seem to shake

Worse than that is the shake down I’ve gotten from another devious government agency. They are known as the federal courts. This particular court wants me to suspend my life for two weeks and “volunteer” to be a juror on a case I care little about.

My initial contact was through mail. They had decided what weeks I would take off and join them unless I had a compelling excuse. Through email I let them know I was a dentist, in solo practice, with three mouths to feed beside my own, with 5 employees who would be sent home if I wasn’t treating patients, and that they would cause a disruption in patient care.

Through email they let me know that my request of waiver was denied. I was still to report to them during my two week window. If called on I would need to leave my life to be another faceless unhappy juror.

My buddy, a middle school history teacher, told me how enjoyable it had been for him. The school paid him the same and they replaced him over the two week span.

Somehow I see a difference in levels of responsibility and potential financial setbacks between myself and my buddy, another government employee.

Both the mid Florida federal court and the local unemployment office share the same total disregard for the small business owners. These are just the ones giving me fits right now. April 15th is around the corner so I know the IRS will want a piece of me. Sooner or later the government clones from the city, the county, the tag agency, tangible tax guy, property tax guy, the department of health, the department of health’s radiation bureau, the hazardous waste inspector, the osha and hipaa drones who I know will be wanting something at some point.

The reality is that were it not for the small businesses this country would be in shambles in a hurry. Statistics support my claim. It isn’t the IBMs, Coca Colas, or Microsofts that keep this monster afloat. It’s millions of little guys (and girls). Unfortunately, g-men everywhere could care less.

As of this writing I have not had my phone conversation with the “officer” at unemployment yet. That happens tomorrow at lunch. I have also been fortunate to evade the court for three days. They give you a number to call and then they have me dial in my specific court ID. Never an actual human on the other side. I get a voice that prompts me to call the next day after 12:30. So far so good.

Sooner or later I’ll get nailed and I’ll keep you posted on my fate.

It is not funny and funny at the same time. Good stuff.
I will talk to you on Wednesday.

Friday, March 21, 2008

I hate computers

I am writing to you on Friday and not on Wednesday because on Tuesday afternoon we lost the ability to have internet for almost THREE DAYS.

Isn't if funny how on Mondays blog I talked about how things can happen beyond your control and you never know when. Then I said I will see you Wednesday unless something happens. And guess what...NO EMAIL. I hope you weren't worried something really bad happened to me. Thank you for all the emails about how concerned you were about me. Last count there were ZERO emails. I feel loved.

I want to tell you about my computer problem but first I have to go back.
About 2 to 3 years ago we got a hankering to go digital.
My father said he wanted it. So we started looking for computer people.
Of course the first place you look is in your practice.
Well Bill C. is a computer guy, maybe he can just tell us how to do it. This did not work.
I found some guy on DentalTown from California and it look like it was going to be a little to much trouble. I mean he had a huge following and a huge operation.
Not the personal touch I was looking for.
So I was at a dental conference in Charlotte of all places and found a company from the town next to me in Florida.
I gave them a call. They are a turn key operation. From nuts and bolts to wires, to computer, monitors, sound system, you name it. And they were a small company about 10 miles from me.

We had them come out.
I told them I wanted to go in stages.
1) Wire the place up.
2) Computers and server(replace the existing systems) (6 computers, 1 server)
3) Computers in the operatories (7 computers)
4) New Management System
5) Digital X-rays system

We wanted to pay cash for it and not morgage the house to do this. Thats why the steps.
We did step one and two and obviously there was problems but none that I can remember.
We did computers in the operatories. They were useless until we did step four, a management system.

This is where I started to have an issue with the local computer company. At first they were a company that didn't work for a specific company. They could get any kind of system you wanted. But by the time we got to step 4 they were a Dentrex and Dexis people. They were convinced these were the best, which I don't doubt. But now they have lost the "let me tell you about all the good and the bad about all these companies" and they became the "this is why Dexis and Dentrix are so great company".

Now I agonized over this decision for about 6 months. I tried every avenue for information about which program and digital xray system was the best.
Reality magazine, CRA, Dentaltown, the AGD forums, I called the companies, I called current users. I went to people's offices that used the products.
I had about 6 reps come to the office. But none of them stood out much further than the other.
I ultimately decided to go with the biggest company. Patterson.
My past experiences are that if you buy from a smaller company it is either going to be bought by a bigger company and let go or will go bankrupt trying to compete.
Patterson has now a branch of their company that does turn key computer stuff. Wiring, computers, sound system, etc...
Our office has been a very large Patterson account for a long time.
So I now asked Patterson take me to completion. I bought EagleSoft and ultimately decided to go with Schick digital x-ray. I felt like if there was a problem that they were going to take care of it.

So Patterson completed steps 4 and 5 for us.
This was a little under a year and a half ago. I have not entered anything into a chart since November 1, 2006.
Because we have the capacity we are trying (I am pushing and my staff is pushing against) to go paperless.
But after using paper for 100 years it is hard to complete ween off. There are parts of the paper chart that cant be replicated in a computer. It is very hard. I feel like you have to just rip it off like a band-aid.
Cut the embilical cord.

Now the issue is we are in the technological age in our office but no one, I mean no one in our office is technologically savvy. This is NOT good.
Now we use the original company to repair our hardware when we have problems. A video card goes out. The modem stops working. The server isn't backing up. I mean problems, not all the time, but none-the-less problems. We and the computer company are now married forever.

If you are paperless (or going that way) how do you have a morning huddle. My idea (not original) was to buy a laptop and have it at the huddle and pass it around if someone needed to see something in the chart.
Well I bought a laptop and my computer guys came and set it up. He put in a wireless router. This laptop will now run EagleSoft and we can get everything we need via the wireless router. This went great for one day until the hard wire modem crashed the next day. Coincidence I think not.
They came the next day and fixed it.
Then I took my laptop home and tried to use it. I didn't work at home. I called my tech guy who set up the laptop and he said he programmed the laptop to only work on one router (the one in your office).
I said, "So if I go to a Starbucks and want to use my laptop for internet use I can't?".
He said, "Yes"
I bought a $2000 laptop and I can't take out of the office?
Well, yeah.
I said I want you to come back and change this.
Why the hell would he do this?
So a couple days later I still haven't heard from the tech guys and I have a computer geek in my chair (I say this with much affection because I want to be a computer geek) and he says he can fix it. NO PROBLEM.
He sits down and it looks a little like this for about 5 minutes.


What? you fixed it?
Yeah, no problem.
Awesome dude, I love you.
Next thing I know my hard wire modem is crashing and I can't talk to you guys in 3 days.
I called my regular tech guys and it takes them all day to get here. At 3pm they show up and he does the computer thing.
In about 5 minutes he understands that the hard wire modem and the wireless router are fighting. He needs to figure out a way that they will play nice with each other.
He fixed it. I have heard this before.

But isn't if funny how we are all trying to buy better computer equipment and don't know how to use it. It makes me rely on this computer guy too much but what am I going to do.
Computers aren't they great.

Listen have a great Easter,
Lots of chocalate and eggs,
Continue to pray for Heather, who is coming home tomorrow.

Talk to you Monday,

Monday, March 17, 2008


First and foremost I wanted to start this blog out with another apology.
It seems in my desire to get out a blog on CEREC I have forgot my first rule of blogging. DON'T TICK OFF YOUR FRIENDS.
I have opinions about the CEREC but I had no intention of throwing my colleagues under the bus. I am truly sorry to those that I might of jaded in my attempt to give my opinion on the subject.

Now about Heather.

Heather is an 11 year old patient in my practice. I have not seen this family in awhile but I was not too concerned. I did see one of their neighbors and asked how the family was. She said, "You didn't hear?". I said "Hear what?"
Well their 11 year old, Heather, has a brain tumor.
So obviously the rest of the day I was in a funk.
As a father of three I pray everyday that God will keep them safe. And I know pain is coming their way and I pray that He will give me the strength to handle it.
But a brain tumor.

What do I do?
Do I call them and make them answer the same questions they have been answering for the last month?
So this is what I did. I have stationary with my initials on it for letters and stuff. I wrote them a hand written letter saying something like...
I just heard about Heather. I am so sorry to hear about Heather. I didn't want to call you so you have to hash it out with me all over again. I just wanted to let you know that my family is praying for Heather and your family. If I can help in any way please let me know. Also if you are keeping a e-journal (because people that go through this, I think, staff at hospitals recommend this. Two reasons, so they don't have to say the same thing 100 times a day and for therapy) I would like to know the link. I gave my email address.
Turns out she is keeping a e-journal.
The dad wrote me an email saying thanks for the letter and here is the link.

Turns out Heather had brain surgery 2 days after the diagnosis. Then she headed out to St.Jude's in Memphis. Where she and her mom are staying for a month. She is starting the next stage of her treatment, chemotherapy.
This sucks just thinking about it.
I read her journal and you can tell the mom is doing everything she can to stay positive. He pride in joy is in pain. He princess is throwing up at all times of the day. Her baby is sick.
At the beginning of this mess Heather thought it would be cool to get a mohawk. Now she has lost all her hair.
Imagine having an 11 year old daughter, sick, bald, in pain and smiling.

I don't know the prognosis and I am trying to get up the nerve to write the dad to talk to him.

But I was in church yesterday and my pastor talked about a specific verse that caught my attention.
Now lets review the age old questions that Christians and non-Christians are always asking, "Why does God let this happen?"
Now I am not a theologian (obviously) but some of the answers that I have heard over time are...
God didn't create evil.
God works through all things for His purposes.
Jesus suffered.
You can be more like Jesus.
And I think they are all good, but about this verse...

Is is Philippians 1:29
For it has been granted to you on behalf of Christ not only to believe on him but also to suffer for him..."

It is a little out of context (and not exactly what Heather is going through) but Paul talks about having the ability to suffer as a gift from God.

Doesn't sound like a gift we want sometimes.

It kind of puts it all into perspective for me. At anytime, any day, the time when you least expect it, your world can get rocked.
Sickness, death, bankruptcy, fire, hurricanes (I know about this one)...
It is funny I know this is coming. I know something is going to happen to me. My family, my kids, my office, my practice. I try to prepare myself everyday for the potential of rocking. At the end of the day I try to thank God for NOT rocking my world that day. I thank Him for the gift of safety that day, for my kids, wife, family, office.
But I know tomorrow is another day and another potential for rocking.

Being this is Easter week I can't help but think of suffering and the product of suffering. For Christians it is everything. It is life.
This is not why I wrote this blog but it turns out to be good timing.

Please keep Heather and the Braswell family in your prayers.
I will try to keep you updated but if you want to update yourself

Hope you had a great weekend.
I hope to see you Wednesday,
(Unless my world gets rocked, you never know),

Friday, March 14, 2008

Mr. Steve (con't)

Okay so I get the call from Steve in the morning.
I ask if I can call him back.

Now I told you I was jammed for the day. I was able to call him back at about 10:30.
We exchanged pleasantries.

Then I said what is up.
He goes on to tell me that he has a new girlfriend and they are going to have a baby together. They have been going out for a couple of years and he wants to settle down again. He has grown children and now he wants to start another family with this woman. (Fine with me).
He says she has had a past (I'll say) and that is all over with. She has a tooth ache and needs to get in.
He tells me he knows she has a ton of dental work that needs to be done. He doesn't exactly know what she needs but he know she is going to need a couple of crowns and a couple of root canals. (Now you are speaking my language). Then he says I was talking to your girl yesterday and I was not getting anywhere. I wasn't yelling at her but I was trying to get my point across. (This is man code for I was yelling).

This is where I interrupted him and said, "Yeah I heard you got M all in a tizzy." Now this was not meant to trivialise M's feeling it just came out like that. The problem was this was the exact time she walked in the door.
So to her it sounded like men talk and me NOT supporting her.

He then went on to tell me that they spent the weekend in the emergency room and her ob's office trying to get her relief. That he is at his whits end and he didn't know what to do.

As he was speaking I am looking at the schedule and it is jammed. So I look at tomorrow and it is jammed. Then I find a small window of time on Thursday (remember it is Tuesday when we are talking).
So I say, "I totally understand your frustration and want to help you. But I do understand the issue M was having trying to find you a spot in the schedule. I am looking at the rest of the day and there is nothing. I couldn't even make up something. Now I am looking at tomorrow and it is the same thing. I do however see an opening on Thursday that we can see her. How does that sound?"

"Thank you Dr.John that would be great". I went on to tell him that if anyone cancels in the next day she will be the first one we call.
He was very happy with the conversation and I thought it went well.

Now M is being cold to me. I start to feel the tension. I know what happened and I know M is not at all too pleased with me.

Now, if you know me at all you know that I am not at all confrontational. I hate it. I loathe it. I avoid it at all cost.
I know this about my personality and I lived my whole life in a way that gets around it at all costs.
Although, I have really tried, lately, to start confrontation little at a time. In the past I would not talk to my assistants and tell them what I wanted. I always felt like it would be a less than pleasant conversation.
Performance reviews are all like this, "You did a great job, here is your bonus". It was never, you need to improve on this or this is what we expect.
My dad is worse than me so I blame him for this flaw in my personality.

But I have been really trying to sit some of my employees down and tell them what I want. It is so freeing. I am so proud of myself. And I think some of them appreciate it. They know what I expect and it is easy to be a better employee because they know what I expect.

But back to Mr.S. Everything is okay with us. Everything is not okay in the office.
I know what I have to do.
I have to stand up for my staff member, I want to stand up for my staff member. But...but...I don't know if I can do it. I can just leave it the way it is. He is happy. And M will probably get over it...Oh, damn it, I picked up the phone. I dialed the number fast so I didn't lose my nerve.

He answered. I thought about hanging up. Maybe he has caller ID and he knows it me. I have to talk. I said "Hi Steve it is John again. Look I am glad I was able to get your fiance' in. And I want to treat you and your family for a long time. But Steve, M is one of best employees. She is a great administrative assistant and I plan on keeping her for a long time. I trust she treated you with a lot of respect and tried very hard to treat you well."
I went on to tell him that it would go a long way with this office if he could call M and make things right with her.
Wow, that was hard. He says, "I understand and I will do it."

I went to M a couple of hours later and asked if she got a call from Steve. She said, "Yes and he apologised and I forgave him." I was thinking great, all is well right?
Well, what she didn't know is that I called him.
She still thinks that I trivialized her feelings.
So I had to go to her and say I called Steve and told him that I backed you.
That I value you as an employee and want you here for a long time. I asked him to make it right with you.

You should of seen her. It was like she lit up like a candle. This is what woman want. Gosh I wish I knew this in high school, maybe I wouldn't of struck out so much. But in all seriousness this was hard, but it had to be done.

I saw Ms. Don't tick me off or I will run over you with my car yesterday and all is well.
He was happy, I was realived, M was consistantly great. All is well.

Have a great weekend.
Sunday is Palm Sunday.
Just so you know it the date is 3/16.
My pastor is going to preach on John 3:16.
Don't forget to rest on Sunday.

But what I started to realize that if I did not do something about this

Thursday, March 13, 2008

Mr. Steve

I am sorry for the blogs being so off but I can't tell you how busy I have been the last couple of days.

It seems I have been busy for the last couple of years. I mean not just in the practice but with life. I know you all with small children can relate.

We are interviewing for an associate, as we speak. I am so looking forward to someone coming in and maybe after a while taking some heat off me. This has been an interesting process and I will tell you in a future blog.

Anyway, about Mr. Steve...

I got a call on my day off (I hate that) and it goes something like this.
"When you come in tomorrow you are probably going to get a call from Mr.Steve. There were some fireworks and I probably should tell you about them. I was at a Braves Spring Training game. I am on the third row right behing the dugout. I have had two beers, it is an awesome weather day. I have peanut shells all over my clothes and in my teeth. Can you see this? I try not to care because s#@$%!t happens and I am watching baseball with one of my best buddies.

But this is what happened...

Now let me tell you about Mr. Steve. He is about 47 years old. He has been a patient of mine for about 9 years. He had a crappy mouth, I educated him and he did everything I said. He now has a great mouth.
He a bunch of composite restorations and a couple of crowns. He loves me to death. Has never missed an appointment and speaks very highly of me.
He runs a outdoor equipment rental shop. If I need anything I usually call him first. I don't think I have every done business with him but I have called him a couple of time.

He has a fiance'. It turns out his fiance' has a past. Her ex-husband and his family were patients here. They were always terrible patients. Her ex had been in jail for drugs and was always very careless about his teeth and his appointments. Then she started coming here and it was more of the same.
This is where the story gets crazy...
Turns out in one of their drug induced fights, allegedly, her and her ex were fighting. They were driving (she was driving, he was the passenger) on a dark back street and she stopped the car. He got out of the car and they continued to fight. Things got out of control (brace yourself) and she ran him over and killed him. You read that right. It was in the paper and it was a huge deal for our little town. She was convicted and went to jail. I think for not very long because of self defense or temporary insanity kind of thing.

Now Mr. Steve and his ex-con fiance' are pregnant and going to be married. But the fiance' has a toothache and he wants her to be seen by his favorite dentist. But before he calls here they have already been to the emergency room and has probably heard it from her for about two weeks and then he calls us.

So he calls M, one of my best employees. She can handle anything I throw at her. She has a pleasant phone voice and understands how I feel about service (very important).
He tells her the story and asked to get in. Now she is jammed when he calls. If you are in the restaurant business she is "in the weeds". She asked him if she could look over the schedule and call him back. He says, "no problem".
Now she is looking at my schedule and it is full for about a week. Not just full but packed. So I am thinking she might have been trying to confirm people to see if something might open up for him. (Just as an aside all the stuff about the running over people and going to jail happened before M got here. So she doesn't know about the squishing).
45 minutes later Mr.S calls back steaming mad. He starts in on M. "I have been a patient there for a long there a long time. I don't know who you are and if you have been there long but you might not be there much longer. Do you know who I am? I am FRIEND of Dr. John's. I also know you know about my fiance's past and can't believe you would hold that against her. That stuff is in the past and she is hurting and I need an appointment. "
She says, "Dr. John, I was trying to help him and he was being belligerent and then started in on the past thing that I didn't know what he was talking about. I had had enough of this guy and I was miliseconds away from hanging up in this guy"

"Oh, by the way GOOD MORNING, Dr. John" This was about 6:50am on Tuesday.
Of course I got a call at about 8am from Mr.Steve. I asked if I can call him back.
I mean I was jammed on Tuesday.

I will tell you what happened tomorrow.
I promise tomorrow, not Monday because I don't want to leave you hanging too long.
I hate doing this to you but it will run way long and I have to run put on my DAD hat now.

Thanks for your patience.

Monday, March 10, 2008

Malpractice Insurance

Do we really need malpractice insurance?

I was speaking to an attorney on Saturday. This particular attorney makes a living defending doctors and dentist in malpractice cases. (NO, I am not getting sued. She is a mother of one of my basketball players. We got creamed by a team that hadn't won a game. Thank goodnes it was our last game.)
So told me about a neurosurgeon that made a ridiculous amount of money and didn't have malpractice insurance. She said that he would put away $500,000 a year for insurance purposes.
Not that she was condoning this or but she wasn't saying it was stupid either.

Then we started talking about dentistry. She said that she has never been a part of or heard of a dental case that ever went to trial.
She says it either gets settled or the plaintiff decides that the process is too arduous and expensive to go through with it.

So I started to think...(I know this is dangerous), what if I didn't have malpractice insurance.

My father has been practicing for 33 years and has never even had to hire an attorney to look over something.
Now imagine if he still had all that money.

Imagine if he was just putting the money in an account and if he needed it he would use it.

Imagine if he never needed it and kept it at the end of his career.

Now lets talk about me. I have been practicing for 13 years. I have been paying premiums and have never needed it.
There has been a couple of incidences that got the butt sweat going but never anything happened.
What the heck I will tell you about them. One guy was pissed at me and maybe hired an attorney. I can't remember what he was mad about. I think he said his face swell up after I treated him. But he was a scumbag and I knew it from the beginning. So in his chart I wrote everything. When I called him and he didn't come back. When I told him to do things and he didn't do it. He was nasty to the staff and I knew he was trouble from the beginning.
There was also this woman that was the mother of a VERY famous boxer.
She had my full mouth temporaries for more than two years. She had four teeth on the top and a bunch of broken ones on the bottom. I made a little bridge on the top and gave her a transitional partial. On the bottom it was all temps.
Again I knew she was trouble and really documented her case, with words and pictures. When they broke I said, "These are TEMPORARIES". After a couple of YEARS, I had repaired them a couple of times until I told her I was going to have to charge her the next time. She said she didn't have any money to repair them (as she rolled up in her Bentley). I stood my ground and she got upset.

These are not the reasons I have malpractice insurance. I feel like if I treat people right and I "know my patient" (which is hard to do, when you are sometimes trying to get a stranger out of pain on an emergency visit). I am not concerned with messing up someones tooth.
I can fix any tooth problem. Lets just say I break a file while doing a molar endo. The endodontist can't retreave it. I tell the patient lets finish the root canal anyways and see what happens. Even though it is on the consent form, I may feel a bit responsible. Lets say the failure rate on this tooth is now about 25%. Lets say 5% of these failures blame me. NO PROBLEM. I would talk to my periodontist and he does an implant for me (maybe for free or for a reduced rate).
I can fix issues with teeth.
Lets just say someone was so mad at me (I can't imagine) that they didn't ever want me to work on their mouth again. So I pay the next guy $2000 to repair a tooth.
Do I need to pay all these premiums for this?

What would concern me the most is the big stuff. We once did a study club and our oral surgeon showed a bunch of his work. People would walk into the general dentist office and he or she would miss a bone radiolucency distal to the molars. Anyone would of missed it. But in the next year the person had swelling and then went to the oral surgeon. Guess what the little radiolucency was not little anymore. It was half of the patients right mandible. The oral surgeon said, "This one settled out of court for 2 million dollars or this dentist lost everything because of this one. "

This is what we have insurance for. But what are the chances of this person walking into your office. My father and I together have been working a total of almost 50 years and nothing.
So we are insuring ourselves for the one in a million guy that walks into your office with the beginnings of an aggressive form of cancer that we MAY miss.
The answer is Yes.

Have you ever been into a doctors office and at the front office a sign reads, "The doctor does not carry malpractice insurance"?

I am not condoning it but It might be a thought I might entertain.

As a famous pastor Steve Brown would say, "You think about that."

Talk to you soon,

Friday, March 7, 2008

Frank Spears (continued)

Cliff notes from Wednesday.
I love Frank Spears. He makes tough dentistry look easy.
I had a case that I worked up. Face bow, CR record, mounted models. Then my dad and I were stumped on how to proceed.
I thought I have spend over (between my father and I) $20,000 on hearing his lectures, I will bend he ear the next time I see him, which I knew would be in a couple of weeks.
I brought my articulator carring case with the chart to the lecture. I know, I looked real cool.

Now if you have ever seen Dr. Spear it is like a concert. At least in Orlando, there is a stage and a backstage. It is not like before the lecture he is hanging out with the little people. He is hanging out in the "green room". When it is time to start he comes from behind the curtain and he welcomes us and tells us where he ate his steak the night before.
Because he is not available before his lecture I felt like for sure I could catch him at lunch.
Now it is $1400 to see his lecture. Always in Orlando it is a packed house, about 300 people.
Do the quick math.
Included is muffins and coffee in the morning and a pretty nice lunch, both days.
Carry the one, about $300,000 a weekend for Dr. Spear. Not a bad gig.
Lets say I am uninformed, and don't realize the overhead, and he somehow ONLY pulls in $150,000. Still a pretty good weekend.
At the beginning of his lectures he tells us that there is not really time for questions and answers because of time. Now, I totally get this, you can have people totally monopolizing a lecture because they don't understand a point. Then this question opens the floor and everyone has a question. 45 minutes later you have answered everyones questions. So how he handles this is, at the break, he tells you to write you question on a sheet of paper and put them on the stage. Then he will address all the questions when we all return from a break (and or lunch).
So because he was so elusive I put a note on the pile. It says, "I am having some trouble formalating a treatment plan for a patient of mine. I brought all the xrays and study models. Do you think you could please help me. I promise not to keep you long."

So I thought he might say during his answer session, but he didn't mention it. He has some staff that usually hangs out outside the lecture hall. I told them what I did and they said, "No, he won't see you." Okay, no problem. I said, "Do you think I could email him and send him some pictures and we could just exchange some emails?" "No, they said. He doesn't take emails from dentists that he doesn't know."
I asked is there anyway I could get someone to help me with a question I was having.
They said you can try his associate.
That sounded okay with me.
I emailed his associate. Nothing in return.
Now don't get me wrong, I think the guy is a great dentist and I don't know what it is like to be him.
He has put a second to none lecture series together and I would still pay to go see it.
He is probably rich beyond his normal audience. In one of his lectures he speaks about all his cars. He has an exotic car collection, but another thing he collects is ex-wives (3 I think. I know low blow). But how can you not come done to the level of your audience? The people that afford you to have your exotic cars and ex-wives. It is like pro atheletes. If you make $250,000 a game, I would think they would be greeting people at the door signing autographs.
One time I was at his lecture and he says he is practicing 4 days a month. Now how can he not have 5 minutes to talk to me?
I once went to a lecture for lecturers and they said the first rule is make yourself available at breaks, lunch and after. Don't make your flight such that you can't make yourself available to your audience.
"I made $150,000 this weekend, I have got to go."
Last thing, he said in one of his lectures that he had this patient from Texas (he practices in Seattle). He gave this guy his treatment plan, it was $80,000. The guys says I know you are good great dentist but do you think I could get the veneers done by my regular dentist and then you can do the other stuff?
Frank says, NO.
So the guy thinks about it for a month or two and calls Dr. Spear and says, "Okay, I will do all of it with you."
Frank tells him, "No,thank you. You had your chance, now I won't treat you."

Like I said, I don't know what it is like to be Frank Spears but I am starting to think I don't want to. I love the guy as a dentist. I am not so sure I like the guy as a person anymore.

End of blog.

I have some questions for you and I need your participation....
Can you please answer? It will help me move forward and give you the entertaining blogs that you see today.

Do you visit any other blogs (it won't hurt my feelings, are relationship has not moved in this direction, YET)?
Do you have a desire to comment on this blog and don't?
Is the commenting process get in the way of commenting?
If you don't want to leave the answers in the comment section just email me.

Or if you have a topic you want me to talk about...let me know.
Don't forget to register for the AGD in Orlando. My stomping grounds. We can do lunch.

Tuesday, March 4, 2008

Frank Spears

I don't know if I told you this but I am a huge Frank Spears fan. I have seen him about 10 times.

I think, as a dentist, it doesn't get any better than his work. He makes his lecture so user friendly. When I see his work I think he is a real prefectionist. Now I can relate to this. I want to be like him.
I try to be like him. I spend a lot of time trying to make all my restorations look real. I always thought his stuff stands up to the 12 foot screen test. If you can put your work up on a 12 foot screen and you are happy with it. You pass.

When I listen to him and look at his stuff. I say to myself, "How much would it cost me to be an associate at his office?" Just to soak it all up. See how it is done. It is easy to see it done on the screen but it never is easy going back to the office and doing it.

This is the part I always struggle with, bringing it back home. Because of this I bought the $1000 DVD program that he sells. I wanted to watch it with my assistants and start to do it.

Still not so easy.

We sit down if front of the TV and again it looks do-able. We start to do it and inevitably crap happens that we don't have the answers to.

Nothing is worse when you have bought $5000 worth of stuff at a meeting (because you ARE going to do this) and then take it out of the box and it is like, s#$%*!t, what have I done. So you get this contraption in front of the patient and you are fumbling around with it.

Enough about that. But this is where the topic of this blog came to mind.

I was trying to do everything right. I took the facebow, I mounted the models. I took the CR record. Then the treatment plan was a little iffy. I talked to my dad and we both couldn't agree what the best mode of treatment was.
I thought I will ask Frank. I thought I have spent over $20,000 at his courses, he could spend 5 minutes with me.
I knew I was scheduled to go to a course of his in about two weeks. I will bring all my stuff to the lecture.
The lecture day came and I brought all my stuff, chart, models, bite restration. I felt like the biggest dork bringing in my articulator carrying case. But I was determined to do the best thing possible for this patient.

Here is the deal....I am jumping in a car to go to Gainesville to see the Gators save their season and beat the Tennessee Red Necks (I am sorry if this is insensitive, it was meant to be). I don't want to rush the next part of the story, so I will finish on Friday.

Thanks for your patience,

Monday, March 3, 2008

Is your call too small?

As you all may know I go to church.
There is a Sunday school hour and then the worship service.
My church is fairly contemporary and it is a fun place to be at.

Yesterday, during the Sunday school hour, a dude got up in front of our class and talked about (the title of his presentation) Is Your Call Too Small.
He spoke about in Genesis when God spoke to Abraham (wouldn't this be nice if God spoke to us AUDIBLY. "JOHN, GO AHEAD AND BUY THAT NEW HOUSE. I APPROVE AND WILL BLESS YOU AND YOUR FAMILY IN IT". "Honey, I am getting the vibe it is going to be okay to buy this house.") and told him to get up and go to Cannan (of course, he went to Ur instead. So yeah, you heard it right, God speaks to Abraham and tell him to do something and HE DOESN'T DO IT). But he also tells Abraham to go and I will bless you and your family and all the nations. I am paraphrasing but you get the gist.

All the nations.

We spoke of this for about an hour. So the speaker did an exercise that I can't stop thinking about.
He asked twenty five people to stand up at the front of the class room. Each person would represent approximately 250,000 million people.
So the speaker handed one guy a miniature American flag and made him stand over there.
Now this means American represent 4% of the worlds population. Think about this for a minute. 4%.
So he went on to ask us where all our thoughts are...where all of our news is focused on...where all our prayers go...where all our money goes. All to 4% of the WORLD.
So what is the biggest country, population wise in the world? You probably guessed right, China. They have approximately 1.2 billion people, five people got miniature Chinese flags.
Second most populated? Think about it. India.
I think America was third and I think Pakistan was fourth.
All of Europe got three flags and a bunch of other people in the room got a couple of flags.
This exercise obviously makes us feel pretty silly thinking about USA all the time.

So then he spoke of the worlds money.

America, 4% of the worlds population has 36% of the worlds wealth.
Between USA and Europe we have 60% of the worlds wealth.
He said, THREE of the worlds richest Americans have more money that 10% of the worlds poorest population, put together. Did you just say, "WOW!!"
He gave data that said if you have $2100 in assets you have more money that 36% of the people in the world.


Just as all of us stood there is shock, he asked 10 more people to stand.
Now these 10 represent missions in the world. They represented the amount of missionaries and the amount of missionary money.
So he took 9 of them and put them around the guy holding the USA flag. And he states 9 out of 10 missionaries and missionary money goes to the USA (remember 4% of the population) and 1 out of ten missionaries and the money goes to 96% of the worlds population.
WOW!!!! Marinate on that for a minute.

Growing up, I use to ask my dad if we were rich and he would always say NO.
When my kids ask if we are rich, I emphatically say, "YES". We can't stop thinking about where we are as it pertains to the world.
We are so lucky to be born in this country. Or if you moved here, we are so lucky to live here. Imagine if we were born in a country where we weren't free.
Free to be a capitalist. Free to worship. Free to have as many babies as we wanted. Free to write on a blog.
You are damn right we are lucky.

Is our call too small? You bet your sweet toosh it is. Our call is usually about a 5 foot circle around our bodies.
We complain about people not paying their bills, we complain that the gas prices are too high (for our fine luxury automobiles). We complain when things just don't go our way. We complain, complain, complain.
$2100, I can't shake this number. If I had $2100, I am richer than 36% of the people in the world. I turned to lady sitting next to me and I said, "My family and I are wearing $2100 worth of stuff." (I was exaggerating a little, but it is close enough).

Think about this.
I will talk to you on Wednesday.

Buckeydentist are you still with me? I miss your comments.


PLEASE NOTE: When commenting on this blog, you are affirming that any and all statements, and parts thereof, that you post on “The Daily Grind” (the blog) are your own.

The statements expressed on this blog to include the bloggers postings do not necessarily reflect the opinions of the Academy of General Dentistry (AGD), nor do they imply endorsement by the AGD.