Wednesday, April 30, 2008

Deja Vu, part II

Now we are at the counter of Gate 29 and we have just seen the door close to our dreams of making it to Myrtle Beach at our desired time.

My wife is loosing it and starts with the "John, I am so sorry, I don't know whahappntometomakme....(she was crying and apologizing at the same time). I tried to stay as calm as I could. Getting hysterical was not going to make things any easier. Even though in my head, I was close to hysterical.

I forgot to tell you that when we were in the plane, waiting for the doors to open, I called my assistant. I told her to cancel the car because there was a good chance we were going to make this flight to Myrtle Beach.

Remember, if we couldn't make the flight to Myrtle Beach there were some options.
I talked to the guy at the counter and told him our dilemma. (right before talking to the guy in a calm manner, I thought about the yelling option, "YOU KNEW WE WERE COMING YOU MOTHER "F"er, THE FLIGHT ATTENDANT TOLD US YOU KNEW WE WERE COMING. DIDN'T YOUR COMPUTER TELL YOU WE WERE ON OUR WAY. WHY DIDN'T YOU WAIT FOR US?) Man did I want to reach over the counter and ring his little neck. I told myself, not to get hysterical. There is only room for one hysterical person (and that was my wife, at the present time. I love you honey, I know my pillow and blanket will be on the couch. This is too funny not to tell).
Anyway, I am talking to the guy at the counter and he puts us stand by for the Wilmington flight which leaves in 35 minutes and it is right across the way. And then he books us for the Charleston flight that is scheduled to leave at 11:15pm.

We go across the hall and let the woman at the counter that we are here and will wait for your call right here. I then call my assistant who I tell what to do. I need you to get me a rent a car with a GPS so I can get from Wilmington to Myrtle Beach. BUT there is a small chance you will be cancelling that and getting me a car from Charleston to Myrtle Beach.
"Just do it" I tell her. And she does it. She understands the stress I am under and is a huge help. I know I will pay for it later but it is worth it.

Okay the Wilmington flight. It is a 50 person plane and we are 1 and 2 on the STAND BY list.
Wouldn't you know it but ALL 50 people show up for this flight.
This must be the first time in history everyone showed for a flight.
Also the first time in history three flights in a row, all on time. Are you kidding me? When have, in the history of the world, there been three consecutive flights on time?
At this point when the Delta person lets us know that everyone was on the plane, my wife is in full breakdown mode.
I assure my wife it is okay (I know if I am nice to her, there is a real good chance for lovin' later on in the weekend) and that we will get there. We knew we were on the flight to Charleston and we were going to have to do this.
Now I call my assistant back and tell her to cancel the car in Wilmington and go with the car in Charleston. She is loosing it on the phone. I am telling her if she thinks she has it rough, try being in our shoes.
So we are now at the gate for the Charleston flight and it is LATE. Can you believe it? The flight we are on and are there and it is late. Now if one of the other flights were just five minutes late we would not be in this predicament.
We then realize we are going to get into Charleston after midnight. More like 12:30 and that the car rental place probably closes at midnight. OH SH#$!%@T . We immediately call Hertz, and they assure us they will wait for us.
Now we are on a promise from a dude we don't know that is in a totally different state than the one we are going in.

There is another part of the story I didn't get into but I will bring you up to speed. In the Atlanta airport when we were on standby for Wilmington we met this guy. Turns out he missed the same flight to Myrtle Beach as we did. But his problem was the airlines fault, so he tells us he has a hotel voucher. We told him we have the same problem as him. I told him that we had a car if we wanted it but we were going to try to get closer and then drive. I hear him out of the corner of my ear say, "Well, I am game." (visions of Planes, Trains and Automobiles in my head).
He was trying to tell me that if we wanted to drive that he would split the cost with us and the driving.
For a split second, I entertained it.
We missed this flight and he was standby behind us and he obviously missed it too. We didn't say anything to him after that so we assumed we heard the last from him.
So off we went to the Charleston gate and five minutes later he was rolls up to this gate.
Then we went and got a bite to eat and guess who sits on the table next to us. Then he tells me he is a Gator fan and strikes up a conversation.
Now I am getting a little suspicious that this guy is a weirdo. He hears us talking about getting a car in Charleston and asks us about it.
Then my wife and I start whispering to each other about how he is giving us the creeps.
Then he asked about if he could get the number to the rental car company we used.
Then we moved on to the gate and he rolls on up and tells us he is also on this flight.
Now it is officially creepy. And he tells us that he was not able to get a car because they were closed.
Now I just start envisioning him stabbing us in our rental car that my assistant reserved with her credit card. That would suck for her.
So we then went into full avoidance mode for the next two hours.
Then we are in the rental car line and see him coming. We get the agreement and run out the door (looking behind us the whole time). Weird.

So we get to Charleston and the car is waiting for us. This was a Toyota Corolla with a GPS system in it. Plug in the digits and start our 2 hour journey to Myrtle Beach. Oh by the way it is 1:15 am when we pull out of the airport.

3:15 am we roll up to the Sheraton. I asked for a 7:30 am wake up call. We settle in and crash.
You know when you go to a nice hotel and they have alarm clock on the nightstand. Well we were at a nice hotel and they had one of these sweet alarm clocks. And guess what happens when the person staying in this room the day before sets the alarm for 6:15. You guessed it.
6:15 comes along and it goes off. Pitch black in the room and we have no idea how to shut this fancy alarm clock off.
Needless to say, I was up and never going back to sleep.
I am simple going to have to give my lecture on fumes.

I did it. I think it went great.
I was asked to play golf in the tourney and my team won.
Ruth's Chris for celebration dinner.
Things are all good in the Gammichia world.
Then back to the hotel for an early bedtime (this time with the alarm clock pulled out of the wall).

Crazy stuff,
Talk to you Friday.

Monday, April 28, 2008

Deja Vu, all over again

Okay, in my last post I told you I was leaving in an hour to Myrtle Beach.
If you are new to this blog, I was giving a lecture for the South Carolina Dental Association at 9am the next morning.

Now my wife is my administrative assistant when it comes to plane reservations. For the first time in all my lectures she was going with me. Because of this, I really checked out when it came to getting on a plane. When I don't have to make a decision I don't force an issue. I ask, "When do you need me ready?"
So I have done absolutely nothing to get ready for the trip. My wife even asked me what I needed in my suitcase because she packs for me. (Yeah, I know, "must be nice", it is).
So we are hanging out about 4:30 on Friday waiting for my sister (who was watching the kids for the weekend). When I asked again, "What time EXACTLY is the flight?"
I was outside water some plants and my wife yells out that the flight is at 6:05 not 7:05.
It is 4:30 and the airport is 25 miles away and it is the dead of rush hour on FRIDAY.
We put it into high gear, it was worth a try. We HAD to go and I HAVE to get to Myrtle Beach, we have to do something, so lets give this a go.
We were moving as fast as someone can move, and we made it to the highway. Traffic was terrible on the other side of the highway but moving pretty good on our side. It is a three road trip and the first two went pretty fast (they were both highways). The last leg of the trip is this 8 mile road with a traffic light about every 400 yards (it could be real bad) and it went pretty good.
Then I had to make a decision to take a park and ride or the airport parking. The benefit to the park and ride is that they drop you off right at the ticket counter but you run the risk of the bus waiting to fill up with people so it is not bringing only one couple on this trip or if the bus is already full you run the risk of being the last one dropped off.
But at the airport parking you run the risk of taking 15 minutes trying to find a space and then it being a mile from the terminal.
I decided to do the airport parking. We found a spot as soon as we got in the garage, then we started to RUN. Then there was a man in a golf cart that said, "get on, I will drive you", (Was this an angel from God. Was he telling us that we needed to rely on Him and He would take care of us. I was going with this) . I was feeling good. We were flying to the airport. We had too check in. We did it with little problem, except the computer would not give us seats. This was not a good sign. But we were still hopeful because it 5:35. If we get through security and get to the gate I think we have a chance.
In the Orlando airport after you leave the check-in area the airport opens up to this huge atrium area. There are shops, eateries, a hotel and a huge board with all the flights and times on it.
There was a sea of people, but we were moving to the security area when we realized that the sea of people were all waiting in line for the security check in.
There was at least (and I am not exaggerating) 800 people in the security line. There were about 12 lines and they were all long.
My wife is a basket case. At this point we are holding it together alright.
It took almost 30 minutes to get through the line (what a zoo).

On an aside, there are security lines and they are labeled. One line is for expert traveler, the next line is for casual traveler, the next line is for families and the next is for people who are in need of assistance.
So we get in the expert line and think this is really going to move. The problem was two fold...the sign designating the lines were about 20 yards from the TSA dude who checks your ticket, the problem being the lines were 50 yards long.
Then there was a TSA person walking up and down the line and we told her there were families in the wrong line. She said she was not allowed to tell people they were in the wrong line.
Things that make you go hmmm.

After we made it through security we started to RUN. I am not kidding. I felt like OJ Simpson hauling a@#!%s through the terminal. We got there 6:07 and much to my dismay, the person at the desk is handing the person in the shoot a passenger list (and after this happens, that is it).

Okay we had to get it together here because there was no stopping. Couldn't cry over spilled milk. At least we didn't have time to.
Our flight was suppose to take us to Atlanta where were to hop on a plane (after an hour and fifteen minute layover) and take it to Myrtle Beach.
There was another flight to Atlanta in one hour. The wheels started to churn. If we get on this flight there is still an outside chance we could still make our connecting flight.
At this point I called my assistant. I started to work on PLAN B.
I asked her to go online (there is no wireless Internet in this terminal) and rent us a car, with a GPS, in Atlanta. I figured if we missed the flight we would jump in a car and drive there. She informed me it was a 6 hour drive. That would mean we would get in at 2:30am.
Not a good option but still an option.

We were 3rd on the waiting list. And as it turns out we made it on this flight. Where things starting to turn our way?
The plane left on time and went pretty smoothly. I flight attendant was unbelievably nice. She knelt down next to us and mapped out everything we could do. If you can't make your connecting flight you still have a chance to fly into Wilmington and this is only about 80 miles from Myrtle Beach. If you can't get that, you can fly into Charleston and drive from there.
When we touched down in Atlanta things were looking pretty good. The attendant said, "Oh yeah it looks like you are going to make it. Hurry to the gate because they know you are coming. Their computer tells them you missed your first flight and it also tells them you are on this flight."
I asked her is there any way you can call the gate and tell them we are coming. She said, "NO, they don't allow us to do this. But it is the last flight of the night, they know you are coming, they usually will hold the door for you."
We were encouraged. Which made us run faster.
So the plane light came on and we were out the door in a hurry. We started to run, as everyone was yelling, "Good luck".
My wife is yelling, "Go on ahead", so I take off in a full gallop. I am yelling "excuse me" for what felt like a half a mile.
We got there at the EXACT time of the flight. Which apparently meant we missed it. I saw the tarmac pulling away from our plane.


When my wife finally makes it up to the gate and I make her aware we missed this flight her eyes start to glaze over. She is sweating profusely and now apparently about to full on loose it.

This is where I am going to stop for the night.
This story is about half over because, lucky you, things did not get any better after this.

I am not making this stuff up.
Can you believe this?
It is funny to look back on this but when you are in it, not so funny.

I can't wait to tell you the rest of it.
See you Wednesday,

Friday, April 25, 2008

Myrtle Beach Bound

Oh, my gosh. It is Miller Time.

Man, I am stressed out.
I am leaving to Myrtle Beach in about an hour. If you are a new reader I am going to speak at the South Carolina Dental Association Annual Meeting. Trust me it is not all that glamorous. It is cool but just hard work. I mean I am a perfectionist and this is just another thing I have to micromanage.

I left work early to go to my kids school for "Young Author's Day".
Man that stuff is fun. My daughter is so bright (we know that, but being the second child, she is a trooper). And I am not just saying that because she is my daughter.
But we worry more about the boy, because...he is a boy.
But, most of the time he surprises me and really takes a lot of pride in his work.
He dedicated his book to ME.
Man was I proud of both of them.

We get into South Carolina at about 10:30 and I speak in the morning at 9am. NO PRESSURE.
In my lecture I use interactive software that all the attendees get a remote control and when the time comes I will put up a multiple choice question and everyone can answer by pressing the appropriate button on the remotes.
I borrow this stuff from Captek, who's main office is in Orlando.
They shipped all the remotes and the sensors to S.C. and they arrived today. In the morning I will have to go to the lecture room and put a sensor up high so it will can read every ones answers. This is a cool little toy that goes over big with the audience.

I have been going over my lecture every free minute of every day for about 4 weeks. Every free minute, well that is about 9 minutes at about 11pm.
Lately, I haven't been able to sleep.
I have been waking up at the butt crack of dawn (4am) for the last couple of days because I am so nervous. I wake up saying to myself, "I don't want to forget to say this...I can't forget to show this."
Yesterday I started to get angina (I am serious about this) I took my own blood pressure at the office yesterday.
But the read out said something like "139 over 75... but dude if you don't settle down you are going to have a fricking heart attack by the time you are 50." (I thought this was odd coming from a blood pressure monitor).
Not to worry you but my dad had TWO heart attacks before he was 54 years old.

In my lecture I am going to have a contest (I thought of this on Wednesday) but I needed a prize. So I called the SC Patterson head person and asked him to give a $100 gift certificate to Patterson (it was more like 12 phone calls). He said, "no problem, but do you know your lecture is in 2 days. Nothing like last minute. (he didn't say this but I felt like it).
So I got all this running through my head.
OH, and I still have a practice to run.
Did I tell you my dad is on vacation in Mexico this week? So I am pulling double duty at work.

Are your coronary arteries clogging while you are reading this? Mine are.

My sister is taking care of the kids. She is 26 years old. She thought it going to be like babysitting for the night. She thought she would just show up on Friday and say...Ok, where are my favorite nieces and nephews?
But after the couple hours of instructions her head was spinning. "Okay, lets go over this again. Luke has a game at 6pm. Make sure he brings his glove and hat. When you are watching the game remember to bring some money because Madison likes to snack. But make sure you watch Noah because he will like to play on the playground. But he can't go with any big kids because..... WHAT?!!!
Good luck Jenny.
But also we have a pool and we don't like even joking about the pool. Here in Florida it has been in the mid to upper 80's and we have been swimming for the last month. But it is always supervised.
I don't even want to think about it.

Okay I HAVE to go. My wife needs the computer to print out our tickets.
Wish me luck.
Did I say, "it is Miller Time"?
I meant it.

Talk to you Monday,
If I am in a bad mood you know it didn't go so well,

Have a great weekend.

Wednesday, April 23, 2008


The wedding was great.
They are super people and I think they were still shocked that we showed up.
Very appreciative.
Everyone kept saying, "Oh, you are the dentist."

I have been thinking a lot about the word COUNTERFEIT.

I think there is a lot of it in our profession.
As in every profession but you see I am a dentist so all I can talk about is dentistry.

I told you that I am going to give a lecture in South Carolina this weekend. My target audience is young dentists. I give a lecture called "What you need to know about the first five years of practice".
I tried to remember what it was like to be a young dentist in a dog eat dog world and then put it in a presentation.

One of the topics that I hit on is Failure.

Oh my gosh did I fail alot. I was failing the relationship part of career, with staff and patients (yes, I am still failing at that) and failing at my dentistry.
No one ever tells you that you are going to fail. No one ever tells you that unless you want to be miserable be prepared for failure.
And if anyone ever tells you things are great, they are lying.
This career is about failure. Not, are you going to fail but what you are going to do when you fail.

One thing I show my audience is regular dental periodical (you know magazine. Periodical sounds so much more stuck up) that I get in the mail. There is an article on how great this person does root canals. They talk about how this product helps me the best he can be. Come to find out in the last paragraph of the article the dude is getting paid by the makers of this product. Then you flip the page and there is a full page advertisement for this product. It could be legit, but it stinks to me. This is counterfeit.

I get so much crap in the mail. I look at my mail with a trash can under my desk for fast throw aways. But one thing caught my eye and it was a letter from a dentist that says, (and I quote) "I produce $4,500,000 a year and don't even break a sweat.
So to someone that doesn't have a bullshit meter to filter this stuff through, this could make them feel a little insecure (I am sorry about the cussing but I couldn't think of anything else that fit).
Imagine the guy who produces $350,000 and is working his/her butt off trying to do that. How do you think this letter is suppose to make them feel. I WANT WHAT THAT GUY HAS.
(No, they don't. I would be that guys patient if you paid me) Counterfeit.

I got so down on myself I almost quit dentistry about 4 years out of school. I came home and asked my wife if she would mind moving back to Gainesville. I told her I was thinking of quitting dentistry and going back to school to be an endodontist (because they have the life).

We try so hard to be just like the others. The problem is the others are lying to you.
I was sitting at a young dentist conference once and I had my back to this guy that talked very loud (or maybe I was just ease dropping) and I overheard him say that he put in 26 units yesterday and they went in like nothing.
I remember it like it was yesterday.
Now at the time I was vulnerable. First of all I hadn't done 26 units the whole year and I remembered the week before when I was putting in 2 units and it didn't go very good. So this means I must really suck, right? I didn't have a filter. I felt like crap.

Now this guy is not trying to make others feel bad, he is just trying to make himself feel good.
And I am not saying I don't have an embellish gene either. I mean when I do something good I want to shout it from the mountain top. All the pictures I have in my lecture are all the BEST work I have ever done. The best fillings, the best crowns, the best veneers. I don't show all the 60 in between appointments or for sure I never show them my failures.
(When I show them good stuff, I try to quantify it by saying they don't all come out this way. Or these veneers look good but it was the third try...stuff like that. I don't want them coming to my lecture and leaving feeling worse about their dentistry).
So we all tend to be a little counterfeit when we talk about ourselves.
We have to have this aura of success for people to like us or think we are okay.

Like my neighbor, he spends so much money on his house. He has plasmas everywhere (I have a 32 inch tube television that I bought in college. I want a 70' inch plasma but I wont spend that kind of money on one). He has a plasma TV outside in his porch. He is constantly doing stuff to his house. There is construction going on at his house all the time. His house is gorgeous but he still tries to improve it. I start to get jealous. Wow, he must have a lot of money. It must be nice.
Come to find out his business has really hit the crapper and his wife had to go back to work to help pay for the cable bill (they have 13 year old that will come over and tell us their life story).
I like the guy. I even like him without the theater room with a 100' TV with electronic lazyboy chairs (yes he has that).

Knowing this I try hard to act real around people. I like to tell people that I fail. I like to make it okay for people to fail around me. (No, that is not why I do it more often).
But do you understand. I tell people I don't have a big TV because I can't afford it.
People that know me and my wife and my kids that we are nuts just like you. We scream at each other when someone is a crappy mood. We spank out of anger. We cuss. We are impatient.
We make bad decisions. We fail.
But for us (and I try to make everyone know) failure is okay.
It is a part of growing. Your character is molded by your failure. But you have to get better because of it. You do it a little better the next time. That is life.

I want to change that. I once wrote an article in Dental Economics called "Failure is an option".
It was a big hit. People emailed me from all over the country saying how refreshed to read someone who finally felt the way they did. I hope I am doing this with this blog.
Maybe too real sometimes.

Am I rambling on?
You get what I am trying to say. Try not to be counterfeit in anything you do.

I will talk to you on Friday. It may be a short one. I have a flight out early in the day.
Wish me luck.

Monday, April 21, 2008

The wedding

I am working today.
"John, I thought you don't work on Mondays."
I don't .
Sometimes I don't mind when I work on Mondays.

I have a patient that is getting married tomorrow. (Wait, what day is this? Yes, tomorrow, on a Tuesday. I thought it was crazy too.)
But let me finish.
I think the wedding is going to be an intimate affair (you know, family, friends, and dental staff) and her family didn't care what day it was on.

But the thing is, she invited me and my staff (I will get to the reason later).
So my staff and I talked about it at a staff meeting and they all wanted to go.
So we voted (if you think I make the decisions around here, you are dead wrong) and we decided to work today and have the day off tomorrow to go to the wedding.
So after work today they all got in a van and drove to the beach, where the wedding is going to be.
So they are going to get a place (the beach is about an hour drive away) and party tonight and go to the wedding tomorrow.
I am excited about the fact the staff likes each other enough to plan something together.
And I am excited we all are going to share in the wedding of one of our patients.
This bride is really a great patient. She is about 45 and has been a patient here for about 9 years.
See this bride was born with some issues with her face. She was born without some tendons and muscles in her face. So things seem to droop and pull to one side. She has had a bunch of surgeries when she was young and the doctors did the best they could to prevent things from getting any worse (since she has been a patient here I have sent her to an Oral Surgeon around town that specializes in what she has, and he said there was nothing he could do for her that her previous surgeons did not do).
She is a wonderful woman and has always had a great attitude. But I can remember her telling us when she got engaged, how excited she was (I know every woman is but with her it was better).
All the staff gathered around her to hear her story.

Her next recall she brought in the lucky man. He had to meet the whole staff. We all wanted to meet him. It was funny, he is a cook so he brought food. We all ate.
Tomorrow is going to be great. She is getting married on the beach and having a little to do at a hotel.

But the blog is not all about this... it is about the relationship we have with our patients.
When I first got into this career I knew I was a people person and I liked teeth so I thought, yeah dentistry will be cool.
But I didn't know it would be this cool.
I mean I think I have something special going on here when a patient invites you and your staff to her wedding (AND WE WANT TO GO).
I can just remember all the crap we have to wade through on a daily basis. I can remember the people that are pissed at me for one thing or another. I can remember not being paid or unappreciative people but this will never overshadow the things I am talking about today.

We all work so hard at making people like us and it is really really cool when people actually do. But when people take it to the next level it makes me forget all the hard times.
Not just, "yeah, my dentist is cool" (or in my case, "yeah my dentist is really good looking and cool.") , it is more than that.
When they like me in a way to call me their friend, I feel like I have made it. We treat them the way they want their friends to treat them. So we become their friends. They become ours.
Isn't what this job is all about?
Yeah, I love doing a great filling or a great veneer case but what I am talking about here is even better.

In December I am always so blessed to open up Christmas cards from my patients. Not specialist that send a template card with everyone on the staff signing it.
No, a real Christmas card (Holiday card, for all you politically correct people). Hand written, "Thank you to you and your staff for always taking care of me and my family. The Owens"
Think about all the cards you send out. Do you send any of your family cards (not the office ones) to your optometrist or your podiatrist? If yes then good for them.

So my staff likes each other (in spite of me)
My patients are great.
At least one of them likes us enough to invite them to their wedding.
And we want to go.
This warms my heart.
Yeah, I don't mind working this Monday.

Have a great Monday,
I will talk to you Wednesday,

Friday, April 18, 2008


Learn to do good, seek justice, rescue the oppressed, defend the orphan, plead for the widow.
Isiah 1:17

One of the institutions that I support financially is IJM.
The International Justice Mission.
This organization was started by one dude a little over 10 years ago.

Gary Haugen was a Harvard graduate that went to the University of Chicago for law school.
In 1994 while working with the Dept. of Justice, he served as the officer in charge of the UN's genocide investigation in Rwanda (Did you ever see the movie Hotel Rwanda? The real pictures of this are horrifying).
While in Rwanda Gary's eyes were opened to the atrocities that are going on all over the world. The things that we Americans turn a blind eye to (I truly don't want to know most of them).
I told you in a recent blog about how USA makes up only 4% of the worlds population. I guess my eyes are opening to the fact that it is a big world out there and what goes on out there effects me.

Are your eyes opening? If you are younger than me (39) don't wait. If you are older than me, (ha ha, you are old) stop turning your head to the world.

Mr. Haugen began to collect data and it started to pull on his heart.
There are presently 27 million present day slaves.
What did you say?
Yes, you read me right. 27 M-I-L-L-I-O-N slaves.
I will give you some facts then I will tell you some stories.
There are 2 million children that are sex slaves (and I am not talking about the polygamists).
Human trafficking is a $32 Billion business (that is billion with a "B").

Mr. Haugen was moved to create IJM. He is an attorney and his closest friend was a big wig in the military. Along with some other help, retired policemen and the like, they all started IJM.

He would find instances of slavery. Lets say in the Philippines.
There is a story of a woman that was at a train station. She started talking to this really nice man. Next thing she knew she was drugged and woke up in a brothel. They said to her, either you work for us or we will kill your family. So there she works prostituting herself for zero money to make sure nothing happens to her family.
The folks at IJM get word of this. They do some investigating. They case the joint. They use some pretty high-tech equipment to go in and talk to the woman. They can talk to the women because they go in as customers and hire the woman for the night. They bring them to a hotel room and interview them on camera. The whole experience is now on video tape.

So you think the cops get the video and just go and bust the culprits. NOT EXACTLY

They spent a month putting the video together and bringing it to the authorities. Then the cops got together and set up a time for a raid.
They raided the brothel. Only one problem, one of the cops tipped off the owners of the brothel and then there was no one there.
The problem goes way beyond the cops. The judges are crooked. The government is crooked.
During one story (by the way I get these stories from a book called Terror No More by Gary Hausen) the evil went so high that Gary had to lean on our government and have our Justice Dept. threaten their government with a trade squeeze just to get some pimps prosecuted.
So when all these problems have been solved and the people that are doing the crime are finally doing the time.
There is the mess they have left in their wake. You have victims.
So IJM's job does not end when the brothels are raided. They also have Victim Aftercare and deal with victims and rehabilitate them.
They have houses set up to board them until they feel safe enough to go home. While they are being housed by IJM there is some serious counseling going on.

Now I want to give you some hope.
IJM has served 1663 clients in 2007. And even better they have CONVICTED 900 traffickers since 2003.
I know that seems like a drop in the bucket but the word is spreading that evil will not win out.
IJM started in Gary's home office and is now a 10 million dollar organization. They have offices in 15 countries.

They have casework types that include, sexual violence, slavery, illegal detention, police brutality, illegal property seizure, and sex trafficking.

In the book there are stories of a man that owes $50 to someone. The guys says you owe me so you can work it off. The problem he pays the man $2 a day and charges him $2.50 a day for room and board. The man will work for 10 years trying to repay a $50 debt.
Or stories like children working in a brick factory for 14 hours a day in deplorable working conditioned to pay off their father's $10 debt.
The evil goes so deep (maybe that is why I turn a blind eye to it).

I wanted to introduce you to this awesome agency.
There website is Have a look.
The book is Terror No More. It is a first account of IJMs first major conviction. From the first time they were made aware of a brothel and all the way through the conviction and victim rehabilitation.

Have a great weekend,
I will try to have something more uplifting on Monday.
But this is good. Social Justice is good.

Ps Carl from New Mexico. Thanks for the props. Email me anytime Jgammichia@aol.comh

Wednesday, April 16, 2008

...and doggonit people like me.

I had a patient the other day.
She is one these patients that likes everything we do here.
She is in her mid-thirties and appreciates the atmosphere that try to create.

They say (who is they you ask, I don't know) that the office with attract the people in age group around 10 years from the age of the dentists.
So I can see that my practice is filled with 30-50 year olds.
I think I break the mold a little because I am 39 (NOT almost 40) but I act like I am 25.
So my crowd does dip into the 20's as well.

Anyway, this patient really likes me.
She proceeded to tell me this story.
She was referred by this family. Dad, mom and two daughters, who at one time liked me (So much that they were referring their friends).
When this patient was coming in last week she was at their house and said I have to go to Dr. Gammichia's today.
She was talking to the Dad, when he said, "Yeah, mom and the girls still go to him and like him but I am not going to him anymore."
She said, "What happened?"
He said, "He said something that made me mad and I won't go there anymore."
"Well, what did he say?" she said.
He goes on to tell her that one time him and I were talking and he asked me if I would take his front teeth out and give him some sort of denture.
Now this kind of stuff turns me off. People not taking care of themselves and then just asking me to do stupid stuff like this. I don't do this kind of dentistry which is why I am not surprised by my smart-al-ick response.
She said I said to him, "If I take your teeth out, how am I going to feed my kids?"

I shook my head like, yeah, that is something I would say.
I was thinking to myself, "that's it?" He was mad at me for that. I was kind of relieved because I have a tendency to tick people off for way more than that. If you think the blog is the only place I get in trouble, well you are way wrong.

We have a practice that has a certain niche. We do great work here and I find that your office kind of attracts the people that you cater to. I cater to the people that care about their teeth. We, without knowing it, talk people out of the dentistry we don't like to do and into the stuff we do like doing.
Same with the type of people. We could care less about the people we don't like and bend over backward for the people that we like. So we build a practice full of people we like and do all the things we like doing.

I don't like grouchy people and I like to save teeth.

So I ended up defending myself to this patient. I said, "Listen, when I was younger, this story would of been a crushing blow." I had the mentality that EVERYONE must love me and anything else is failure.
But now that I am more mature (and I use that term loosely), I tell myself that I am okay with everyone not liking me.
I went on to tell her, "I am a certain way. I am a jokester. I like a light atmosphere. I like to make people feel comfortable, sometimes with hugs and sometimes with humor.
I do this day in and day out. MOST people like it. I am not going to change the way that I am. I think I have a good thing going here (and she was nodding in agreement). If one person doesn't like it then I have to be okay with that."

I have been watching a bunch of Stuart Smally and agreeing with his philosophy, "I am good enough, I am smart enough, and doggonit people like me".

I want you to know it pains me to say this. I still in my soul want everyone to like me but....
I can't do it. I have so much crap going on in every aspect of my life I don't have the energy to go after the one percent anymore.
Now all you people out there that feel the same way as I did, stop. Stop trying to please EVERYONE. You can't do it.
I think dentists are wired a lot alike. We are a breed that takes failure very hard. We liked to be liked.

So, of course, I say this to you but in the back of my mind I keep thinking should I pull this guys chart. Should I write him a little note. Should I give him a call and apologize. I...can'
I mean do you think the Ritz-Carlton's motto is "Let's try to please most people"
But again, as good as they are they don't please everyone.

This is how I justify this to myself.
Listen, I have a wife that loves me, unconditionally. I have kids that love me (because they don't know any better and genetically wired to do so). I have a great practice (I think) and some really great friends, and I am going to heaven when all this is done.
What more can a guy ask for?
As the great Billy Donovan said once, "Don't mess with happy."

See you guys Friday,
I hope you are enjoying the blog,

Monday, April 14, 2008

AGD Fellowship

Okay I have a dental topic I want to talk about.

Oh, before I forget my wife wants me to tell you we don't beat our kids. In the last blog I spoke of spanking our kids and smacking the attitude out of them. To all HRS and child service employees out there. It is more like gentle rebuking.

I want to talk to you about the AGD Fellowship Award.
I have always been an organized dentistry person. I have always been a big believer in continuing education.
I have always thought that the AGD was the perfect organization for me. I am a big believer in raising the bar.
I am in the AGD because they speak my language. Always in the back of my mind I have thought about the Fellowship Award they give.
As a young dentist I knew it existed but thought it might be 15 years before I got all the hours needed to qualify.
Then at an AGD annual meeting I saw a person I went to dental school with. She was in the class under me. She said she was taking the exam. Humm, I said to myself.
If she could do it, maybe I am getting close to being eligible.
I called the AGD (a person answered, what a concept) and they were able to tell me how many hours I have. I think it was something like 625. I said, "I asked how many hours do you need to be eligible for the award?"
She said, "500".
What me, a fellow? I started to get really jazzed.
I then told her I where she could send my award.
She told me I needed to take the exam and then go accept your award at an annual meeting.
WHAT?!! An exam. Whatyoutalkinaboutwillis?
I thought I was done with that. I barely passed all my exams in dental school what makes me think I can pass this one.
It took me awhile to call back but I did. I then bought the study review packet. This packet gives you a bunch of information but what it does is gives you past tests to review. It gives you the question and it breaks down the answers. Why one is right and the others are wrong.

I start to take a review test. I think I started with pathology. Big mistake. I got ALL of the questions wrong. Not all but one but ALL. I went to read the explanations and it was like I was reading a Chinese manuscript.
I took a deep breath and decided to try one that I know I am a ringer at. Operative dentistry. This is my favorite topic in all of dentistry. Of my 600+ hours of C.E. more than half are on this topic.
I don't know why I am wasting my time taking the review test because I know it all.
I got less than a 50%. WOW. What a blow to the ego. What the heck am I going to do now.
If I stink at the stuff I (think I) know then I am in real trouble when it comes to this exam.
Oh, by the way, when I signed up to get the review packet I payed to take the exam.
So I was going to take the exam the question was when.

Let the procrastinating begin.

I told myself I would study and I didn't. I didn't want to fail.
But I would say to myself, "I am too busy to study. I have to do this thing. My kids need me."
So time went by and nothing.
Then I heard from someone that just got the award that he took this review at the annual meeting and then took the test. It went great, he said.
Okay this is what I was going to do.
I signed up for the review and the test in Denver. Very nice meeting. Great city.
The review days were Thursday and Friday and the test was on a Saturday. Perfect, I thought.
I was so excited about this review that was going to get me through this test.
Oh my word.
I am trying to describe the review in words and I can't. It was a 18 hour review that if done properly could of been done in about a 100 hours.
There was so much information that there was not enough time to absorb it. At the first break my head was spinning. It was like all of the book work in dental school wrapped in a two day course.
I was out of my league.
I needed my mommy.
I tried to stay positive though. The second day came and it was so so bad. Oral path, systemic path, pharmacology, pediatric dentistry, endo, prostho, radiology and all the other topics that apparently I don't know anything about.
I went back to my hotel room and told my wife there is no way I am passing this exam.
But I had paid my money and I am hear. I might as well take the thing.
The next morning I took the test. WOW. It was very difficult. Although the review reminded me of the information that I don't use anymore (like, if you move the xray cone beem back, how does that affect the KVP?) I didn't know it enough to get a question right.
Man did I feel small. Did I mention that I was out of my league?

I blew it. That night we went to a Colorado Rockies game and that was the last time I thought about the exam (at least this is what I told myself).
6 weeks later I was sitting at my desk and a letter from the AGD came. It sat there for a couple of days. I kept telling myself that I was a good dentist. People liked me. No one is really going to know if you failed. (except for my staff. They were waiting to let me have it if I failed).

I finally opened it. I PASSED.

I don't believe it. The passing grade was a 50 (thank God for the bell curve) and I got a 51.
I am not ashamed. Passing is passing. YEAH BABY. (and I didn't have to hear it from my staff and to tell the truth they were quite proud of me).
Now let the bragging begin. I told everyone. Mom and dad. My kids, my patients, people I passed in the streets.
I kicked that test's butt. It was NO PROBLEM. Yeah, that test was easy.

In all seriousness it was hard. But I am proud.
I do like to tell people I am getting my award in Orlando this year. I stick my chest out a little (I don't tell them the 51 thing).
I am going to buy the graduation picture and I am going to put in up in my office.
It is not something that was a walk in the park, but I am so glad I did it. Things have a way of working themselves out.
I am proud to be a AGD member and I am really proud to be a Fellow in the AGD.

Have a great Monday,

And to be honest with you I am eyeing that Masters award now, but don't tell anyone.

Friday, April 11, 2008


I know this is a mostly dental blog but there are so many social issues that come up all the time I think it is better to be dynamic.

So here is a social issue that is really "blowing my skirt up".

I was listening to the radio yesterday morning in the office. Not a terribly loud or obnoxious station (which I have been known to have on). It is a mix between 70's, 80's and 90's.
You know, an office station, Sheryl Crow, James Taylor, Sade. Now yesterday morning the DJ was asking people to call in with secrets they keep from there spouse.
So this 28 year old woman calls in. She obviously has a couple of kids because you can hear them in the background.
The DJ asked the woman, "Do you have a secret that you keep from your husband?"
Let me preface this with this could of been a funny bit if they have the right people called in.
Something like...
I like wearing my spouses underpants or I have my own separate checking account or I get up in the middle of the night and eat crackers in bed while watching the reruns of the Oprah show.
You know what I mean.

But it was just their luck that this woman called. She said "Yes, I have a secret but I could get in trouble if I say it."
Now with a little egging on from the DJ she goes on to say that she just went back home to see her parents and she "got together with the boyfriend she had before she got married."
Now she went on to say that they didn't "do IT" or anything but she hasn't kissed like that since she was 13.
She went on to say that everytime she goes home her husband is accusing her of shacking up with her old boyfriend. And goes on to tell that she has never done anything so this time she just went ahead and did it.
The most disturbing part about the story is all throughout the story you could hear her kids in the background.

This is totally unfair to the husband. I can see the conversation when she got home from one of trips back home.
"Hey honey, how was the trip? Great, how is the family? Great, did you see anyone? Oh, you saw your old boyfriend again. What!? I thought we talked about that. I don't have a problem with your old boyfriend but I know you think you are just friends but I am telling you men can't be friends with woman without thinking of IT. You are fooling around with him aren't you?"
(I can assure the conversation is not like it reads. There most definitely some screaming and some F-Bombs going off, but you get the point).

"Why do you have a problem with my old boyfriend and I being friends. I have known him since high school and just because we did IT in high school doesn't mean we can't be friends now."

Now the DJ played along and played the neutral party.

I was shocked by the whole story.
My assistants and I haven't stopped talking about it since yesterday.
I know before you go there, I am very naive. I truly don't know the ways of the world.
I have been sheltered all my life but I can't help it. I am about to give you opinions but you know what they say about opinions... (if you don't email me and I will tell you...too crude for this family blog). I know people have affairs and it is for many reasons. I know people are unhappy and hurting and look to the arms of another but...

Where does it say that this life is going to be easy? Where does it say that this marriage is going to be without strife? Did I miss the waver or the consent form?

Where does it say, "If it feels good, just do it". Or "if it is tough, just quit"?

I keep shaking my head at this woman. The kids are in the fricking backseat. KIDS. The things in the back that when you decide to have them you are to realize that the world does NOT revolve around YOU.
They are the people you give things up for. The people you are suppose to sacrifice for. The people you are suppose to work for.

Now one of my assistants is "worldly" and occasionally takes the side of the world. She said, "Sometimes people cheat in a marriage but still want to be married to their spouse."
My thing is that if you are unhappy in your marriage, do something about it. TALK. COMMUNICATE with your spouse.
Is this this woman's way of crying out to her husband? "I cheated on you, now will you listen to me?" Oh and by the way I told everyone in Orlando today because I announced it on the RADIO.

The worldly assistant does have some valid points sometimes (when she agrees with me). She says she thinks it is the way we are brought up. Parents give their kids everything. If they don't the kid cries and the parent then give it to them anyway.
If the kid is in trouble at school with a teacher the parents have to step in and not encourage discipline by the school but to be their advocate.
This is BS. If my kid gets in trouble at school and I hear about it, they are going to get whipped at home.
How about when they are at college? Mommy, my Chemistry professor is being mean to me (you have to say it in baby talk). Okay, mommy will call up the Chemistry professor at Cornell and ask them to stop being mean to you.
Or how about when they get a job. My boss is being a real ass, I am just going to quit.
Good honey, you just keep quitting jobs until you find a real nice boss that lets you do whatever you want. And, Oh, if you need money for rent when you are unemployed you just come back to mommy.
My wife blames our social issues entitlement.

We think we deserve everything. Where does it say this? I do deserve things but it is not EVERYTHING.
I deserve to get fired if I suck at my job. I deserve to go hungry if I don't have a job. I deserve to lose my house if I can't pay the mortgage (MOMMY).
or on the other hand some of our thought are...

I deserve to have a sweet automobile even if I can't afford it. I deserve to buy that stupid thing that I can't afford to impress the people I don't like.
I am being to naive.
I am being to conservative.

The bible speaks a lot about raising kids...
There is a proverb that says, "Train (that is a good word, train) up a child in the way he should go and they will not depart from it."
Well, unfortunately in some cases, this is what is happening. We are training our children to act this way and they are becoming adults that act this way.
My eight year old is starting to complain everytime he doesn't get what he wants. Now I have given him grace up until now. I told him the next time he complains to me about not getting what he wants, not only will he NOT get what he wants, he is going to get the "rod of discipline".
This is the Bible's way of saying, I am going to beat the attitude out of him. Do I like "disciplining" (we don't call it spanking anymore)? Hell no. It totally sucks when I have to spank my kids (I mean discipline). I hate it. But another Bible verse is "...spare the rod, hate the child."
I discipline him or her because I LOVE him or her.

Now back to this woman. She has just "kissed" the rest of her life away. Do you think it was worth it. Now comes the arguing. Then the separation. Then the divorce. Then the custody hearing (Judge: Son who do you want to live with? Your mom or your dad?).
How many marriages will she go through until she grows up and realizes what it takes to make it work? COMMITMENT. WORK. SWEAT.
How many people are going to be ruined before she learns?

Damn, I am opinionated.
Well, what do you think?
Am I off my rocker?

Have a good weekend,

Wednesday, April 9, 2008



Well, I have been to Augusta National. I think I have a glow (like Moses did when he came down from the mountain).
My father and I got back last night at about 11pm (yes, I am working today, I have to work to pay off those tickets).
I want to tell you about it but I don’t know where to start.
The trip up to Augusta was good. It was about 6 and half hours but we MapQuested it, so even though we felt like we were lost at some points we stuck to the directions (it helped to see middle aged men with golf caps in the car next to you).
We got to Augusta about 7:30pm so we decided to go right to the course just to see the entrance.
Well there isn’t really an entrance. When you think Augusta you think a huge entrance with fountains and lights on a huge sign saying AUGUSTA NATIONAL. No so. It is just an entrance with a guard gate. The exit must be somewhere else because the entrance was no bigger than one side of the road.
So from the street you have no idea what is back behind the wall of trees.

So to the motel we went. This was a bit of a challenge because it is dark by this time, you are in a foreign place and there was construction everywhere.
We finally get to the motel after 3 phone calls to the guy at the counter (notice I didn’t say concierge). I thought we would never get there. My father and I have ZERO short term memory (I swear it is genetic). I hear my dad on the phone with the dude, “Go South on SR 20, take exit #194, go left and then take the second left. You say I can’t miss the hotel. Thank you so much sir, I guess I will see you in 5 minutes”. So dad what did he say, “He said, take exit #120 and we can’t miss it.”
“That can’t be right, we just passed exit #195, #120 doesn’t seem like 5 minutes away.” Do you feel my pain?
We get to the hotel (and I use this term loosely). I am looking at this place and asked my dad how he came to rent this place. He said, “I got it online. I did a search as the closest and least expensive place to the golf course.”
I can ‘t argue with this, this is probably what I would of done but this place is what Bart Simpson calls the Rusty Pelican. It was a roach motel.
So the dude at the counter says, “Okay one room with a king size bed.”
Visions of Planes, Trains, and Automobiles start coming to mind. “Those aren’t pillows!!”
I looked at him and then looked at the dude and said, “Do you have rooms with two double beds (Please God)?
“Yes” he said “but it is going to cost a little more.” As an aside he could have said it was going to cost $400 more and I would have paid it.
It was twenty dollars more. SOLD.
We dumped our stuff off and went out to eat. We went to Sticky Fingers Rib Shack. It was good and here is the first place where we came into contact with people.
People in Augusta are so nice. Everyone was excited to have us. We sat at the bar and had dinner. Being our first time we asked everyone questions about parking and such. They all wanted to help. Next thing you know we have two guys righting directions on a napkin telling us where the least expensive parking is.
Back to the motel, no problems this time, where we watched the second half of the NCAA basketball championship game. I am the only one that thought it was kind of boring without the Gators in it?
I was awoken at about 3:30am by my dad snoring. Now I am a light sleeper as it is but this was bad. He can really snore. (imagine if we were in a king size bed together). He sounded like Chewbacca with a chainsaw. There was no sleeping with that going on.
So I didn’t know what to do so I took all the covers and blanket and put myself on the floor next to the air conditioner. White noise.
Now this did drown out the snoring but now I was cold and I was on the FLOOR of the roach motel.
The wake up call came at 6am (which the night before sounded like a good time) and according to my calculations I slept about 4 and half hours.
We arranged for a round trip car service to pick us up. This turned out to be a great idea because we would leave the entire decision making up to someone else.
We got in the car and the driver said, “You are not going to bring that camera are you?”
I said, “Yes, everything I heard so far was that you could bring in a camera for the practice rounds and NOT for the tournament.”
He said, “I dropped someone off yesterday and there were signs that said NO CAMERAS.”
I ended up putting my camera back in the car in the parking lot of the motel.
We got to Augusta National Golf Course and we were so excited. We were early and they had us all waiting in line. Everyone that worked at the course reminding everyone NO CELL PHONES.
We were in line and funny thing, I was seeing a bunch of cameras. So asked someone in the know and he assured me that it was okay to bring in a camera. DAMN IT!!
I mean all I have seen so far was the parking lot and even it was nice.
I tried to put it out of my mind. I will think about it later. Let’s just go in and see what is up.
The first thing you come to is practically a strip search. Metal detectors that airports would be proud of.
The second thing after you get in was the gift shop. We had some previous advice, “Go to the gift shop first and buy all you want, check the bag and then don’t think about it again.”
We went into the shop and WOW. It had more Masters stuff than you could ever imagine. Now you have to understand. There is only one place to buy Masters stuff and that is at the Masters. So we loaded up. Shirts and a bunch of golf crap that all your friends would be jealous of. $500 later we were done with that (the guy at the register next to me bought $1200 worth of stuff, all before 8am). Double click on the image and you will see the gift shop at 7am.
Then it was off to the course.
I have three words to describe the course…OH MY GOSH.
I imagine this is what the Promise Land looked like to the Israelites (a land of milk and honey).
If you are not a golfer or a golf fan, the Masters is not all about the sport of golf. It is not just about Tiger and Phil or Jack or Arnie, it is about history. It is about beauty.
It is almost indescribable. The grass is perfect. But that is not all, the course is on rolling hills surrounded by blooming azaleas and dogwood trees. There is cascading water that just adds to the perfection.
The best part about it was my dad. He said to me, “Before I forget, I just want to say thank you (I bought these tickets for my dad for Christmas). I never thought I would ever get to see this.” He was like a kid. He kept OOHing and AWHing all day. A lot of “this is amazing” and “unbelievable” and “did you see that?”.
It is a place where not many people get to see other than on TV. It is a place where a 63 year old man can just walk around and just be at peace. It was a place where you can go and forget about work and just admire God’s creation (and what pesticides and millions of dollars can do with it). And it was cool to hear him on the phone telling his friends about it.

This is getting long so I will stop here.
I was able to get a ride back to the hotel and get my camera (fricking taxi driver).
So here are some photos.
I will tell you more about it on Friday.

Wow what a couple of days.
I am off to a baseball game then Bible study tonight. I have got to get some sleep.
Talk to you later,

Monday, April 7, 2008

What a week

Okay, now that the lovefest with Mark is over, you got me.
I have to write this kind of rushed because of my crazy schedule.
I am working today (now you know I don't work on Mondays) because I am off tomorrow.

I am leaving in 10 minutes to drive to AUGUSTA NATIONAL to go see the MASTERS practice round. Yeah, you read right I get to see Tuesday's practice round.
(Don't think I am that special, if you had $700 you could go too).
I am so excited I couldn't even sleep yesterday.
I get to go with my father. I bought him these two tickets for Christmas. It seems silly but when you get to see your father cry over a gift you know it is special. Then he asked me to go. Even better.

I am all packed and ready to go.
I know you are all GREEN with envy.

But let me tell you real quick about last week.
(I will get to the consent forms soon, I am doing some research)
It was spring break in central Florida.
This is affectionately called HELLWEEK for our office.
From the very beginning I see kids. My dad would rather not see kids or anyone under 16, so this is how I built my practice. I went to schools, I sponsored baseball teams, I coached flag football and basketball. I started seeing alot of kids. I treated then well (if I don't say so myself). My practice started to grow. I then started seeing the kids parents and their neighbors. Then the kids grandparents. You know how it goes.
I still love to see kids. I think this is the engine that drives my practice.
But I forget how hellish Hellweek is.
Now you know that on spring break EVERYONE wants to get their kid in to get their teeth cleaned.
On Tuesday, I did 21 hygiene checks. On Wednesday I did 17 and on Thursday (a light day) I did 15. I couldn't wait until Friday afternoon.
I don't know how the pediatric dentists do it.
I have a full day on my side and then every 25 minutes or so I have to leave. Then they squeeze in an emergency and OH MY GOSH.
In the meantime we are in the process of hiring an associate (I will tell you about this after it is over, I don't know if any of the candidates read this). I am down to two.
So I have to talk to them because they are both waiting to hear from me.
I am giving a lecture on the 26th of this month for the South Carolina Dental Association and it is on my mind.
WOW!! My heart is racing just writing about all this.
My dad is in the car honking the horn. I have to go.

I will talk to you guys on Wednesday. I am sure I will be on cloud nine.


Friday, April 4, 2008

A Changing Profession (editorial)

Here is the deal. I write 50 posts and get a comment here or there. Mark writes one blog and lights up the comment section. Now when I said lets do some dialoguing here I didn't mean make John look bad.
Now the powers that be are thinking....Hmm, maybe we got the wrong cat to do this blog. Nice, real nice, way to go.
No, in all seriousness, it was great. I appreciate all your passion, as well as Marks.

Have a great weekend and I will talk to you next week.

As promised, here are my thoughts on the article.

When I first read the editorial, my knee jerk response was one of anger. I wanted to personally send a verbal triad in response to the attack on the profession I care so much for. This is just another in a long line of attacks on general dentistry. A reoccurring theme of each of these attacks is the famed “access to care” issue.

It amazes me that all these different dental groups have a different definition of this “access to care” term. It is also amazing that the solution to solve this yet undefined problem lies in some types of gain for the organization or group. All the solutions will transform the face and practice of general dentistry drastically.

After a period of cooling down, I thought of who wrote the editorial. These are two educators who see things very differently than someone who is actually in the trenches treating these patients. I believe the more practical solution should come from someone who is actually treating these patients, day in and day out. One would think dentists who treat these patients have a pretty good grasp on the situation.

While this idea and that idea may sound great, in the real world, it would never work. Dr. Glick relates to the medicine model which he claims to be so wonderful and successful. In the past the ADA has championed the slogan, “Dentistry is health care that works.”

Is Dr. Glick implying that this slogan is no longer valid or applies to dentistry?

Even with the flaws, I still believe it works better than medicine. How can the editor of the ADA discredit that slogan? Even while Dr. Glick expounds on the success of the medical health care system in American, I hear the two Democrat Presidential hopefuls talk about how the health care system in the United States is broken and needs a major overhaul. Dr. Glick also talks about the Surgeon Generals Report on Oral Health. Again, two people looking at the same thing and interpreting it differently. I have studied the Surgeon General’s report on Oral Health and I do not believe there is a reference to a mid-level provider. I do remember much was said about prevention, specifically fluoridated water, and oral health literacy.

Being an educator, Dr. Glick surely knows that more dental schools are opening therefore in the near future; more dentists will be delivering care. Why perpetrate second rate care on the American public when there will be more highly educated and trained dentists entering in the workforce in the near future?

Lastly, I believe the access to care issue is a funding problem. Period.

The ADA has championed this in the past, but has not correlated it directly to a funding issue. In a 2003 issues of JADA, the ADA championed the Michigan Healthy Kids model to solve the access to care issue. What happened? It was decided in Michigan through legislation to raise reimbursement rates to market values. Within a year, utilization rates increased dramatically which directly correlated to the fact that the number of dentists that became Medicaid providers increase enrolled and treating patients. One fact that is over looked is that the distance traveled by patients for appointments was cut in half. Simply, the program was funded and dentists provided the treatment. Great news! Why can’t folks understand that this is funding issue not a workforce issue? If the program is properly funded, utilization rates will increase because more dentists will come on as providers.

I wonder if Dr. Glick’s embrace of the mid level provider is also the stand of the ADA. After all, the ADA 2007 House of Delegates agreed to the Community Dental Health Coordinator. This CDHC is not a mid level provider, but its creation does open the door for another provider of dental services.

You be the judge. Is the ADA advocating for the practice of general dentistry?

They have known about the ADHA’s ADHP for sometime and have not addressed the issue. They have remained silent. Where does that leave the general dentist?
The landscape of the practice of general dentistry may be changing. If it happens, it could be detrimental to the practice of general dentistry, all under the cloak of access to care.

The AGD is the only dental organization that has the general dentist’s best interests at its core. No other organization in the world will advocate specifically and solely for the general dentists.


Wednesday, April 2, 2008

A changing profession

As of now, you must be able to tell what kind of guy I am. I take what happens to me everyday and laugh about it. I am very passionate about dentistry and doing what I do better. I love what I do but am wired a certain way.
I practice dentistry and HOPE someone else it taking care of my advocacy issues. That is why I love being a part of the AGD.
I have never been very political. But thank goodness some are. Some dentists are just wired to do advocacy.

There is some really scary crap going on around us and Mark (not really a ghost writer if you know his name) has some really good points.
At the end if you feel like commenting do so and we can have a discussion (especially if you have an opposing comment).

Ps. I told you I was going to talk about consent forms but I thought this blog takes some precedent.
So here it is...

Change is always happening around us – sometimes good, sometimes not. Some changes we have to accept but others we can resist and fight against.

I sense a change in the practice of general dentistry. The change I am sensing in the practice of general dentistry is not natural. It is also not good for the practice of general dentistry. As a matter of fact, I think it is an attack on the practice of general dentistry. This change will transform the practice of dentistry as we know it today. If this transformation takes place, I believe the practice of dentistry will no longer be the esteemed profession that it is today. You may be asking yourself, “What is he talking about?”

Consider the trends; in 2004, the American Dental Hygienist’s Association (ADHA) House of Delegates passed a resolution for a mid-level provider to diagnose and treat dental disease. At their recent winter meeting, the ADHA Board of Trustees adopted the Competencies for the Advanced Dental Hygiene Practitioner (ADHP). Their Web site says “The ADHP model has been created by ADHA as an answer to the oral health crisis in America.” In the summer of 2006, the ADHP language was in the U. S. Congressional Committee Report, S. Rep. 109-103, which accompanied a bill making appropriations for the Departments of Labor, Health and Human Services, and Education and related agencies. The report “encouraged HRSA to explore development of an advanced dental hygiene practitioner... which prepares the dental hygienist to provide diagnostic, preventive, restorative and therapeutic services directly to the public in rural and underserved areas.” Now, the Minnesota legislature is seriously considering expanding the scope of the dental hygienists on the ADHP model that would allow the mid-level provider to perform extractions and restorations without the supervision of the dentist. Also this year, Senate Bill 2723 has been introduced and has language for an Allied Dental Health Professional. The most recent attack came from the American Dental Association in an editorial in JADA entitled Lessons Learned: Implications for workforce. The editorial basically asked the profession to embrace the mid-level provider and that the dental education community was in the “driver’s seat” to bring about this change in the profession.

These trends should cause most private-practice general dentists in America to take notice and be concerned. Change is always occurring around us – sometimes the change is good, sometimes not. I know this issue can be debated because some, even AGD members, feel it is time to have a mid-level provider that will diagnose and treat dental disease with less training and education than a dentist. The mid level provider will not affect the practice of any dental educator or dental specialist. It will only affect the practice of general dentistry. AGD President, Dr. Vinny Mahyer, wrote a letter to the editor in response to this editorial. I am very appreciative of Dr. Mayher’s quick and pointed response, but I want to carry it somewhat deeper. What are your thoughts about these trends – I’ll share some more of my own on Friday but I am interested to hear what you think.


Okay, to me this is some heavy deep stuff. Usually, when someone starts with the committee report section 109-103, I check out.
Today I stuck with it.
Is anyone lost?
Does everyone know what the mid level provider is?
Does everyone understand the crux of this argument?
The benefit to the blog is you can comment anonymously.
Okay so you have lots to comment on...
Give Mark you opinion so he feels wanted.

Talk to you later,


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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.