Wednesday, July 30, 2008

Dr. Kanka

Hey all,

Not to much going on in my life.
I started watching Black Hawk Down and only got about 20 minutes into before I fell asleep on the couch. Not because of the movie I have just been tired lately.

One funny thing...I haven't told you I have started Marathon training. Now for those of you who have been with me for the whole time, I think, my marathon blog was the funniest of all of them.

Anyways we are about 2 months into our training. I am signed up to do the Marine Corps Marathon at the end of October and the Miami marathon at the end of January of '09.
We are slated to run 18 miles on Saturday morning at 4:15am. It just sounds crazy as I am writing it.
The funny thing is I have not lost any weight since the start of my training. Last year, as much as I ran, I never lost weight.
So I have always wanted to be about 10 pounds lighter to make my runs a bit easier.
So I found a guy that I run with and I noticed he is a little "puffy". So I asked him if he wanted a put a little wager on losing weight.
He was in.

$100 to see who can lose 5% of our body weight first. I am 200 (listen don't laugh, muscle weighs more than fat) , so I have to lose 10 pounds and he is about 170 so he has to lose 8 pounds.
This started about 10 days ago.
Okay so I am eating less, I have cut out all desserts, and I only drink water. At the end of the week I have lost 0 pounds.
Not one or a half pounds , ZERO pounds. I am eating 6 times a day like they say to do. I am drinking all the time.
I am eating a lot of fiber. All the stuff they tell you to do. I know it is going to take time but we are talking about a $100 bucks here.
So I talked to him on Saturday and he says he hasn't been feeling so well and he hasn't been eating either so he has lost 2 pounds.
Oh, crap, he is almost half way there and I have lost ZERO.

I know through hours and hours of running together that his weakness is MandM's. So I am resorting to Guerrilla tactics...I sent him two huge bags of MandM's today in the mail.
$100, as you may know I don't part with my money well.
That was low wasn't it.
If you can't beat them...cheat.

Okay on Monday.
I talked to you about John Kanka. This is a dentist/lecturer that is from Illinios. He has been around a long time.
I told you I like his passion and he was a pretty good lecturer.
We think a lot alike.
I told you he uses and pushes his own products.
I have a hard time jumping in with both feet when someone is pushing a product that they profit from.
So I wrote to the man at REALITY, Michael Miller. Don't think I am all that and a bag of chips, because anyone can write him. If you are a member you have the ability to use their forum.
But he moderates the forum. So I wrote him and he wrote me back in an hour. I asked him a question and he didn't know the answer to so he wrote the main man at 3M and he got back with me in another hour.
I was very impressed.
What an advantage for little guys like you and me. All I have to do is ask this guy and he will tell you the 411 on anything you want to know. He has NO vested interest in any product.

So I asked him about a couple of things.
I asked him about the Duralon thing. For all of you who didn't read on Monday, Kanka pushes Duralon for pulp exposures.
This is where he wrote to the 3M (the makers of Duralon) guy and his response was...3M doesn't even think that Duralon should be used for pulp exposures.
He even showed the article that Kanka uses to back up his claim and it says Duralon should NOT be used as a pulp cap.
Then I asked Dr. Miller what he thought of Surpass. This is the bonding material that Kanka made and now endorses.
He says that Kanka has not submitted it in to Reality to have evaluated.
He went on to say that when Reality evaluated his last product, Simplicity, the results were very inconsistent. Meaning the product might not hold water, at least not all the time.

So Kanka has his own forum. So I wanted to give him the ability to defend what they were saying.
I went on Kanka's forum and asked him about the Duralon thing.
I was going to put the whole thing on here but it gets real long.
You can read it at your leisure.
You can tell by the way he writes that he kind of is an egomaniac (pot, have I introduced you to kettle?)
I am trying to get a straight answer out of him and he is being a smart ass to me.
Anyway you can read it yourself. (if you do read it I would like to hear what you think)

Lastly, in another thread, I asked him if he has sent his new product to REALITY. And he just answered, "NO."
No explanation or anything.
I kept probing and asked him why.
He says, "I don't have a real good relationship with them (meaning they don't like me)" but he adds, "Gordan Christiansen and others liked it".

I have told you before that as a dentist it is hard to make heads or tails of products.
It is hard to pick products. You think you are going to pick a guru and use his products.
Then you see another guru and he says the first guru doesn't know what he is talking about.
This is a real problem in our profession.

I still think REALITY and CRA are the way to go.
But what if these guys don't agree?
I don't even want to think about this.

Have a great day and I will talk to you Friday,

Monday, July 28, 2008

AGD annual meeting.

Things are going pretty good at the Gammichia house.
Hilda is still up and down.
But doing pretty good.
Thank you all again from the bottom of my heart.

Charlie Wilson's War, very very good.
I told you I would like.
I only found one person that didn't like it but she is kinda weird anyway.

I saw a couple of people at the AGD annual meeting that I wanted to talk about.
First, I saw John Kanka.
He had an all day lecture on adhesive dentistry.
You know (....pondering.....) I really liked this guy. He thinks the way I do (or I think the way he does... It's my blog damnit).
He is passionate about teeth. He is passionate about filling teeth.
So what makes him so good, you ask? Well, first and foremost he is a clinical dentist. He is what they use to call a wet fingered dentist.
But, he does a lot of research...
I don't know if he has a lab in his office or he is affiliated with a school but he does a lot of research.
Like he was saying this certain technique is the best way. Then he would back this statement up, not by a bunch of bar graphs, but by cutting a tooth in half and showing the infiltration of die (or no infiltration of die in this case). Real research.
Very likable guy.
I saw him about 6 years ago and I didn't like him. I thought his ego was getting in the way of his lecture. I mean big time.
This time he kept it in check.
Maybe his ego is not as big. Because you all know that this profession (and life in general) has a way of knocking you off your high horse.
In this lecture, he broke down all his techniques and walked you through all his procedures.
He is a very good clinician and wants his audience to be good at it too.

He is my thing about Dr. Kanka.
He endorses products. I am totally okay with endorsing products that you are passionate about.
I am also okay with endorsing a product that you think is okay.
For example, when he talked about a product made by a company that you are being endorsed by (my opinion), he would say, "You should have a look at this product."
He didn't say, "This product is AWESOME you must have it" just "have a look at it."
I am totally cool with that.
It is when the lines are blurred is when I start having a problem with it.
For example, he owns or is part owner of a dental products company.
It is called APEX.
He has his own bonding material.
So what material do you think he talked about the whole lecture. You guessed it...HIS.
Now, it may be the best thing since etching but...
Then he talked about how he sat down with Gordan Christiansen last week (for those of you non dental people Gordan is close to the most trusted guy in product review) and Gordan loved the product.
So no documentation of this "sit down" or the studies that you guys did, I just have to take your word for it that Gordan liked it.
Oh, I almost forgot. He had another bonding material that his company made 6 years back and in that lecture all he talked about was how great this product was.
This time he talked about his old product with not nearly as much fervor.
So was it not so good then or is he just more excited about this product or does he make more money from this product?
See what I mean, blurred lines.
I really think his heart is in the right place but...

And the other thing about his lecture is things like this....
He talked about procedures that I have never heard before. I have seen alot of CE in my day (please see the FAGD at the end of my name) and I read quite a bit, and if I have never heard of it, I start to wonder.
For instance, what product do you use if you have a pulp exposure?
Just seal over it?
He says Duralon. Yes, I said Duralon. Like the temporary cement.
Then he flashes up a studies and some slides of pulpal response to Duralon.
One problem...the study was from 1978.
Now here is my thing. If it was so great, why are you the ONLY one advocating it.
And if it was so great, why hasn't there been any research on it since 1978?
I want to believe it. Trust me I want to be confident that I am doing the best thing I can for the patient.
But, here is the good thing. On his company website he started a forum.
He use to be a HUGE dentaltown guy and has since been turned off by it (I beat him by about 4 years).
He says he is the moderator of it and he answers all peoples questions about techniques and products.
The website has videos of procedures. Meaning if you buy his product you can watch a movie instead of reading instructions. I like that.

So all in all I liked the lecture and I like him.
About his bonding agent, I wrote to Reality (I told you about these guys before, a product rating company. and asked them about his products.
I will let you know what I find out.
If you get a chance to see him...check him out.

Hope you are having a good Monday,
John Gammichia DMD FAGD (it still is cool to write)

Friday, July 25, 2008

A trip to the doctor.

You all have really been the hand of God for my family.
Thank you so much for all your emails and comments. It really means a lot.

As good as "this sucks" went pretty well.
We went to a hospital only for Women and Children, so the staff was very kind and empathetic.
My wife is doing pretty good. Still very emotional and a bit soar but pretty good.

Okay lets talk about happier things.
I finished Black Hawk Down and it was very good.
I moved the movie up the the top of my Queue. I saw it a lonnng time ago so I want to see it again.
I finished 10,000 B.C. I don't know about this movie. It was all right. I thought it was weird that people that lived 12,000 years ago spoke English, very convenient.
I watched a movie last night called The Last Battalion. It was about WWI. It was okay for those kind of movies. Not my thing though.
I started watching Charlie Wilson's War, I think this is my kind of movie.

I am going to talk to you about my Fellowship soon but my camera pooped out in the middle of the ceremony so I asked my friend to take a bunch of pictures and he has failed to mail them to me. So when he mails them to me I will write the Fellowship blog.

Because of something that happened to me, I want to revisit the Tier stuff again.
During the pregnancy my wife found another OB-GYN. Turns out her last OB wasn't delivering babies any more.
Is this a problem in your state? In Florida we are having a real hard time getting OB-GYNs to either stay in our state and/or deliver babies.
Two reasons...first, people want to sue these doctors for all the problems they are having with there newborn and second, because of the first reason insurance premiums are so high.
Can you imagine OB-GYNs not making any money? Well that is what is happening in Florida. We have had 5 pregnancies and 4 OBs.
So my wife went to this new OBs office for the first time. That night at dinner I asked her how her appointment went. (Well if kind of went like this, "Aren't you going to ask me about where I went today?"
"Yes, how did it go where you went today?"
"You don't even know where I went today, do you?"
"I am sorry honey, no I don't know where you went today. Did I tell you you look like you have lost some weight.")
So we started to talk about her first visit at her new OB's office.
"It was awesome." she said. "You are not going to believe it."
Then she went on to tell me how it went.
She checked in. Then she tells me that the office manager came out from behind the desk and introduced herself to her. The office manager told her that she has been there forever and plans to be there til the place closes down, so if she ever needed anything just to give her a call.
"That was nice" my wife thought.
Well, from then on it was more of the same.
The doctor brought her back on time and had reserved 30 minutes to be with her (in dental time this is like 2 hours).
He was very friendly. He joked with her for the rest of her appointment. He and her assistant joked and involved Hilda in their conversation. All in an attempt to make my wife more comfortable.
Then the doctor brought it all home with, "if you need anything, I am available to you 7 days a week for 24 hours a day." My wife just about fell out of her stirrups. She was impressed.

So much so that my wife came home and raved about this guy and his office.
She says to me that she is always hearing me talk about how to make my office better. She knows what a premium I put on how my staff treats patients. She knows that consumer service is neck and neck with being a good dentist on the most important scale.
I was so impressed.
I was so pleased to hear there is a doctor that cares I was compelled to write him a little note.
I told you I like the written word. I have these cards with my initials on the outside and I have them to jot a note to someone.
I got a card out and wrote him a note. I thanked him for taking such good care of my wife. I told him how impressed with what I heard about the office and that I was looking forward to meeting him.

So in all the hoopla this week, I had to go to this doctor's office with my wife.

I was excited to see the place. I imagined a very nice cozy reception area. Maybe some cappuccino and biscotties in the reception area.
I imagined all the front staff in business uniforms. The back staff in matching scrubs. I imagined warm tones and art on the walls that matched the theme.
My wife had built me up so much about the practice she didn't tell me anything about the plant.
When I walked in I was amazed. It was so BAD.
It was a reception room that was square. It had 15 or so chairs against the walls. White linoleum on the floor. NOTHING on the white or light pink walls, no art no information boards, no TV. NOTHING.
The staff where all in different scrubs.
It looked right out of the early 80's.
We were escorted back to his office. It was more of the same. Ziggy (yes, I said Ziggy) card holder on his glass desk. His circa 1970 diploma frames on the walls.

Now you have to understand my wife LOVED, LOVED, LOVED this office.
Now she knows what a warm office looks like. I am not tooting my own horn here but I think I have spent a great deal of time and money to make my office feel warm.
My periodontist"s office is so nice. My orthodontist's office is super warm.
She knows what warm tones are. Carpet and maybe a fountain on the wall. Art and uniforms and how an office can look profession.

But you know what? It didn't matter to her.
The people are what mattered.
I learned a lesson here.
You can have an awesome plant and if you don't back it up with the people you have lost. They can see right through the smoke and mirrors.
You can have awesome people and have just an okay facility and your office could knock the socks off people.
A consumer wants to know that are being cared for. I can imagine that sometimes the facility might get in the way of that.
Something to ponder.

Interesting, huh?
If you have any thoughts about this, I would like to hear from you.

Have a great weekend,
Because I took yesterday off, I am working on Monday.
Talk to you then,
John Gammichia DMD FAGD (How do you like that? Has a nice look to it doesn't it?)

Wednesday, July 23, 2008

Run Forest Run

Hi y'all,

Remember on Monday I had to cut the blog short because of a doctor's appointment. Well we went.
For the new to the blog people, I will give you a quick up date.
My wife is pregnant and everything was going pretty good.
About 4 weeks ago (at about 11 weeks into the pregnancy) we were hit with the news that something was wrong.
The baby had something called a Cystic Hygroma. This was an accumulation of fluid on the back of its neck. This was not all that great. The prognosis was such...25% chance everything was going to be fine, 50% chance there was going to be some sort of chromosome problem with the baby, and 25% chance the baby wouldn't make it.

Now since I have told you the original news, we have gone again and things were about he same.
Heartbeat was good and the baby was growing but the Hygroma was still there.
But also we have received some news from some experts that we know.
Our OB stated that, in his 30 year career, he has never seen a Hygroma before. This means that by the time he takes his first ultrasound (about the beginning of the second tri-mester) they have gone away. This was encouraging.
Next bit of news was that the word from another specialist was that if it was a chromosomal problem, that 95% of the baby's had Turner's syndrome. This is a syndrome that the female individual is sterile. They are usually a little shorter in stature and can't have babies, but other wise normal.
Also very encouraging.
So as Christian people we didn't really know what exactly to pray for.
I told you that my wife was praying for complete healing of the baby. That our baby would fit in the 25% of the kids that are born totally fine.
I was praying that God would things would be okay but if not then I was just praying the strength to be obedient.

So back to doctors appointment on Monday.
It is still kind of a stressful deal. I mean you are going in for an ultrasound and it is going to tell you how things are progressing.
I kept asking Hilda, "How are you doing?" She was always fine.
So they brought us back and the ultrasound woman began the sonogram.
There is a tense minute or so as she looks around and you know she is looking for things and clicking the buttons but not saying anything. It is eerily quiet.
I guess too quiet because Hilda asked, "Are we suppose to hear a heartbeat?"
The woman said, "Yes". There was no heartbeat.

Our baby was no longer living.

As I was watching the woman do her thing, clicking all the buttons and typing, I forgot the most important thing, the heartbeat.
Of all the things we were praying for, of all the things we were thinking. We forgot of the 25% chance it wouldn't make it.
This blindsided me. The woman said, "I am sorry guys, the doctor will be in a minute".
So it was Hilda and I in this dark room, it was tough.

But this is not the worst of it.
We had a miscarriage last July. This was not so traumatic. We found out we were pregnant and I week or two later they couldn't find the heartbeat.
Hilda had a D and C and that was it (men if you don't know what a D and C is ask your wife and if you are single look it up on the Internet, or ask your mom).
In and out of the hospital and she was in no pain, just a little sadness, and we went on with our life.
This one, because the baby died after 13 weeks, is too big for a D and C.
She has to deliver the baby.
We are going to the hospital tonight so Hilda can be induced.
Yes, like a real delivery. THIS SUCKS.
Then they went on to say that they can take footprints for you and if you want you can spend time with the baby before you leave the hospital.
Did I say, "This sucks" yet?
I wont get into all the gory details but the nurse at the hospital says she has seen this take 8 hours and she also has seen it take 3 days.
If all the stuff doesn't come out (maybe I am not sparing you the details) with the delivery, then they have to do a D and C.

So there it is.
So do me a favor, if you pray, pray for Hilda. As you can imagine it is tougher for the woman, very emotional, maybe a little guilt. Pray that everything goes well today and tomorrow and that she will heal inside and out.


Tuesday, July 22, 2008


As promised...Photos.
Here is the pier at low tide.

Here is the pier at high tide, this is the scene of the rescue.

His is what I looked like when I went into the water.
It wasn't 5 seconds after I hit the water that I had all kids on me.
So there was no floating in the water enjoying a cool libation.
Hang, dunk, hang, "throw me dad". It was awesome, just not restful.
This water was at the Dolphin hotel at Disney. This was not the grungy pool at the Colony.
I could of sworn I took some photos of the resort. I took a picture that had an extension cord (the cheap white ones that come from Walgreens) coming from a breaker box. The breaker box was open. Only one more problem, there were three extension cords coming from the first extension cord.
And I didn't get any good photos of the 80's furniture in the room.
I will talk to you tomorrow.
Now if you get this blog as an email, I don't think the pictures show up.
So you are going to have to go to
Have a good one,
I will talk to you tomorrow.

Monday, July 21, 2008

Its the little things.

How the heck are you?
Well I am back from vacation. As you already know I was in the west coast of Florida from Sunday to Wednesday, then home for one day, then off to the AGD annual meeting from Thursday to Sunday.
Wow do I have a lot to tell you.
Well, we are home now. We are broke and tired and I have to go to work tomorrow.
Tell me why we went of vacation again.

We went to a place called the Colony in Longboat Key.
In its hey day the Colony was the country's #1 rated tennis resort of about 10 years running.
We went there about 10 years ago and were very pleased.
This time was a bit different.

The place was obviously resting on its laurels.
This was a place that thought it was a Tier IV resort that was giving a Tier II product and service. See Tier Dentistry blog.
The rooms were very outdated. The carpet was old and the furniture was old. Awesome 70's pastel colors on the walls. You know, it just needed a little updating.
Not that we planned to spend a lot of time in the room but when it rains from 8am to 4pm you are kind of forced to be in your room.

Okay so the days we were not in the room (it only rained once) we went to the beach and pool.
The beach... well it was the beach.
I am being a little knit picky but the umbrellas were like 40 yards from the water. So we couldn't use the umbrellas and watch the kids. Not a big deal's the little things.
Like the little things at our offices that we think of all the time to try to make a better experiences for our patients.

They advertise in there handout that there is snorkeling available, just ask.
I went to the little bar that you rent and reserve things from. I asked about snorkeling. Well, it turns out there is no guide and no set time. The snorkeling that we advertise is we give you a snorkel and mask and you go out and do it on your own.
Wellll, Okaaayyyy.
I guess I will take my two older kids out. I say, "Can I get three snorkels and masks?"
He says, "Well we don't have any masks or snorkels."
Yeah, over the July 4th holiday they had a lot of guests and after the holiday they have been wiped out.
Not my problem. I don't care what you guys were doing a couple of weeks ago.
The pool was grungy.
I mean, am I being unreasonable to want things that are advertised.
Its the little things.

It is a beach facility and there are condos everywhere. There are wood walkways everywhere.
I was walking on one of these decks and stubbed my toe on a nail sticking up about 3/4 of an inch.
I mean you have wood decks with screws in them. You have people walking in beach attire on these decks, which sometimes means barefoot. This is something that should be a concern for the maintenance people.
Its the little things.
There is more, but I have to go, the wife and I have a doctors appointment.
I took some photos that I want to show you. But I have my camera here but the cord is at the office.
I will show you these pictures tomorrow.

I watched Rambo last night. It wasn't bad. There was alot of killing but the movie was like 88 minutes long. I hate movies that are short.
I have 10,000 B.C. and plan on watching tonight.
I am more than half-way through Black Hawk Down. It is very intense. I find my leg shaking as I am reading it because I can't wait to get to the next line.
I will finish it soon. It is not as good as Lone Survivor. It is about 100 men as oppose to 4 men with Lone Survivor. So the book is all over the place and you forget who the characters are that you are reading about.
Maybe it is not suppose to take you a month to read this book.

Talk to you later, maybe tomorrow (with the pictures).

Wednesday, July 16, 2008

Associate's first blog

I am still on Vacation.
No movies, my stupid laptop will, for some reason, play movies.
We brought a bunch of movies to watch as a family and some for adults but now an error message comes up and won't let me play any video. I have 4 video players on my laptop and none of them work.
Have I told you I hate computers.

Anyways, we are having a very relaxing trip.

You all know that my father and I brought in an associate about 2 months ago.
It is so exciting to have a new dentist around. There are some challenges, as far as scheduling and what assistant is going to work with her. But we are working it out.
It has been a great experience so far.
I want you all to meet her so I asked her to write a blog.

It has been kind of crazy in my life so I am just going to put it in and you two talk.

“It Just Feels Right”

In 2006, Shelby called me to say hi. He went to dental school in Boston and had just graduated. He told me he was working on a case of multiple veneers. I asked him how he knew what he was doing (remembering that my University of Florida dental school education of veneers was minimal, and not until my General Practice residency did I actually do a veneer). He said he wasn’t exactly sure, but he just did “what feels right.” I guess that means he was just winging it and hopefully everything would turn out ok.

I’m not sure how Shelby’s case turned out, but I do think of him when I get in a situation where I’m not exactly sure what to do. Do I sometimes just do what feels right? Yeah, I think so. Given that dentistry isn’t a 100% clear cut science, sometimes that’s what you have to do. Clinical judgment isn’t something you learn much of in dental school. When you have professors there, you can just use their clinical judgment if you’re not sure. But what happens when you’re on your own?

Do you remove that last bit of decay, though you may expose the pulp, or leave it, hoping it will arrest? Do you keep searching for the MB2 canal in tooth #3, even though you are getting precariously close to perforation? Do you agree to do a single veneer on tooth #9 for a patient with extremely high cosmetic expectations? Do you remove a 3rd molar in very close proximity to the inferior alveolar nerve to help a patient in pain when the oral surgeon’s office is closed? Or what about the patient’s old crown which seems to have a small open margin on the on the mesial, yet it’s a retainer in a 6 unit bridge. Do you recommend replacement or just “watch” it? Will your professor give you some advice? Is he or she standing behind you and watching your every move? Nope! You’re all alone. You’re experience and thus, clinical judgment will give you the wisdom necessary to make such decisions.

I’m lucky to work at an office as an associate with 2 other dentists who are very smart treatment planners and exceptional clinicians (by the way, I’m John’s associate). So that means if I have questions, I have someone to ask, but ultimately every decision is mine and it is my dental license I have to protect. I wish that all of my boo-boos were limited to dental school and residency and now I won’t make mistakes. But, I know that’s not the case. Being 3 years out of school, I have gained a wealth of clinical judgment, but I think in order to learn all there is to know about dentistry I would need another 50 years of practice – and I surely won’t be working that long! So that means I will just “do what feels right” and hope my knowledge, clinical experience, and kindness will keep me from getting in trouble.

Nice talking to you,
Lets do this again sometime.
Michelle Aliotti

See why we like her so much at our office.
I have to go. See you all tomorrow.
Even if you are not coming to see my little talk, please just come up and say "HI".
Talk to you Monday.
No blog on Friday, I AM ON VACATION.

Monday, July 14, 2008


Hi all.

I am writing to you from the Colony in Longboat key on the west coast of Florida.
We got here last night just in enough time to go to the beach for an hour or two and go for a swim in the pool.
It is perfect for the kids.

I was going to have my associate write you a blog today but something happen that I have to tell you about. I will be putting in Dr. Michelle's blog on Wednesday.

I finished my first book of the trip. I finished the last 100 pages or so of Traveling Mercies by Anne Lamont. I told you I didn't like the other book I read of hers but I have to say that this book was pretty good.

I am starting Black Hawk Down. I am on this military kick now because of the Lone Survivor book I just read (that was awesome).

Now back to my story.
This morning we get up about 8am and after eating breakfast we head on down to the beach.
We are there and there isn't a soul around.
The west is very windy and choppy this week. There are waves (for those of you who do not know Florida, the west, the Gulf of Mexico, side is very calm. The east is all about waves, surf contests and jetties). So it is not like the west coast to have chop and waves.
It is so choppy out their and the under current is so strong I have my radar on high alert. (I am a freak about my kids and water).
In this resort there is a concrete dock that jets out into the water. Now usually on the west coast this would be great. People could fish off of it, people could swim around it.
But it was so choppy I ordered my children not to go around it.

But there are people from all around staying at this resort. I met some people from New Jersey and I met people from Europe. That don't know the dangers of a concrete structures and water.

After me and the kids built a sand castle and went in the water it was time to mosey on over to the pool.
There were more people out and about. There were kids on the dock. I was going to walk to the dock before we were going to go to the pool when I saw two kids jump off of the dock.
Now the right side of the dock was the danger side. The waves continued to crash against it and the left side was easy because the current would take you away from the dock.
The kids being kids jumped in on the right. I saw all this happening while I was in the area.
I began to pick up my pace toward the dock.
The parents (I think a mom and aunt where to the left of the dock and had no idea that her kid has just jumped into a very dangerous situation).
One of the kids, who was probably 10, realize the waves kept pushing him closer and closer to this dock so he swam to shore. Shore was about 10 yards in.
But being that the waves crashed against the dock it became very deep around the dock.
So this kid (who turned out to be 8 years old) couldn't stand and the waves were pinning him against the dock.
The other kids on the dock were into their own thing and didn't realize there cousin and brother was literally drowning in the water 3 feet from them.
So of course they were not yelling or running around.
I had moved much faster now. He was bobbing so he wasn't full on drowning but he was in trouble. By the time I got there he wasn't responding to me yelling. I could reach down and he could of grabbed my arm but at this point he was in big trouble. I didn't want to jump in but I was about to if I didn't get him on the dock in about 5 seconds or less (I would be putting myself in the same dangerous situation he was presently in). I was calling for him and he wasn't looking up at me to reach his arm up.
I yelled at the kids to tell me his name. "POTTER". I was yelling at him, "Potter, grab my arm".
The next wave went over his head but it also brought his body up enough so I could grab his swim shirt.
I pulled him up in one motion. He was fine but a mess. He was standing but not really with it. I was talking to him as he was walking around but he was not looking at me or talking.
His brothers and cousins brought him back to his parents (which never even knew any of this went on).
I went on to the pool with my kids.
It started to sink in that maybe that last wave that went over his head might of been the last one.
We went on swimming.
Later on these two guys came up to me and said they watch the whole thing. One of them knew the kid was in trouble and said he was ready to jump up.
"Great save" they said over and over.

The mom eventually did make there way over to the pool and Potter pointed me out to her. She was very thankful.
I was really hoping she was going to be the wife of a prince or a sister of a major CEO in a major European business. You know like thank you for saving my son's life please take this castle in the French Riveria as a small token of my appreciation. Or I would love for you to be my guest in my VIP box at the World Series.

Just another day in the life of me. Crazy I tell you.

Well we came in the suite for an afternoon nap and plan on going back out there now.
Just to swim but you never know what is going to happen next.

Look for Dr. Michell on Wednesday and I will see you all (or maybe one of you) on Thursday 3:20pm on the exhibit floor. Be there it could save your life.

Talk to you soon,

Friday, July 11, 2008

Websites II

Another funny story...
My daughter and I had a "Daddy and Daughter Date night" last night.
We usually go out for ice cream and sit outside and eat it. Sometimes we throw in a Go-cart ride or something.
On our way home I had the radio on. And on this particular station the call line is "Music from the 80's, 90's and today". She pipes up and says "why would the radio station say, 'music from the 80's, 90's and Thursday'"?
I got a good laugh. One of those laughs when you are still kind of chuckling 10 minutes thinking just how funny it was. (Not quite as funny as the "I am a big fan of FED-EX" line but funny).

No books or movies this week. Crazy, I know.

Before I forget. AGD Annual Meeting next week. All you Orlando people (all of the Florida people for that matter) that have not signed up and are thinking about is time to commit.
I have been to two AGD Annual meetings and it is always been very well done.
Plus I will be there.

Tell me what you think of this.
The first article I ever wrote was in Dental Practice Report. Trust me it was awesome. It was called You Just Graduated From Dental School, now what? I was looking through the course scheduling and I came across a lecture called You've Graduated, now what?
Coincidence, I think not.
It looks like I am going to have to take someone out this weekend. So if you see a fight on the exhibit floor on Friday at 4:05pm, it is me marking my territory. I think the guy might be in his sixties, but a man's got to do what a man's go to do.

Okay, I did get some feedback. By the way some people email me directly so all of you may not be able to see some of the comments. You can too at
I have gone on some websites this week. You know the vast majority of sites are about the same.
Not just dental sites. All sites are about the same. The line at the top that says Home, Information about us, Procedures, Before and after photos (that are not their work), Contact us, Downloadable forms, stuff like this.
Now if you are going to have a site, the above is a must for every site, but does it have to be so boring, and the big question is...
Does something like that represent John and Victor Gammichia (and associate).
Well, I think my overwhelming thought is no this is not John and Victor Gammichia. But the force that keeps pulling me is that we HAVE to have a website.
At least get something. If it is the template now and then work on another one that is more like you. At least for now you can have some representation on the internet.
I know, as I was told in a comment, that everyone that is under 30 years old their first inclination is Google. Not yellow pages or a friend, Google.

One of the comments, I think that all of you saw, was to get a student. We have a media school in Orlando, why have I not called them? Well, lets say it is going to take 10 hours of my time to help a professional make a website. How much more time will it take for me to work with a student.
You might scoff at that but I don't really have time. I mean I have down time at night from 9pm to 11pm but all I can do at this time if veg. Totally veg. I can't even work on the computer anymore. I have zero energy left.
My good hours are from 6am to 9pm and pretty much every minute is taken up.
Okay so this what I decided to do.
I went to
this is a site that helps with dental websites. There are a bunch of templates and designs..
You pick your design and get started and pay your $39 a month and you have your website. No hidden fees. No software fees. Nothin.
Now you still have to plug in all the information. You still have to take pictures of all your staff. You still have to write all the bios.
You still have to put in all the before and after photos.
And just like if you were paying someone the big bucks you want it to be good.
Your signature is on it. is all done for you. All you have to do is make it yours.
But if you wanted to leave their before and after photos you can.
If you want all the wording that they have, there is almost no work.

Okay so now you have a website.
What the heck are you suppose to do with it. It is up to you to market your website.
You have to put it on all your business cards, your letterhead, your postcards that you send to your patients reminding them of their appointment. If you are advertising in the country club directory you put it in your ad.
So now there is some added pressure for it to be good. Because your website might be the first thing a potential patient sees about your practice.
Do you want someone that doesn't know anything about your practice to see a boring website or a simple website (you know what I mean...this is what is haunting me about using a template)?
But lets say it is a great website and you are marketing it to your patients.

What about new patients that are searching for a new dentist?
Now this is another different animal all together.
Getting your site to come up when someone is looking for a dentist is what people do for a living.
There are companies out there that will work with your website to make it come up when someone googles a dentist.
It is something called search engine optimization.
My friend is paying upwards of $1500 a month to get hits. This particular company guarantees a certain amount of hits and phone calls for his money. He says if I pay more money I will get more hits and more calls.
He even has a different phone number on his website so the company can keep track of how many people are calling (because they call a different number, get it?).
This company even records the calls. The company can only guarantee a call not an appointment, so they record the calls. My friend can go to their website and listen to all the calls that were made to his office at this special phone number. So he can see the kind of person calling. He can see how his staff is handling this call.
Are you ready for this? Are you ready to delve into this kind of world?
I don't know if I am ready.

Now you know why people made a site and never touch it again. It is too much work. I was fine without it.
They had no idea how this industry was going to move, and they couldn't keep up or didn't want to.

I will have ours up and running in about two weeks I will let you know.
Remember this is only my temporary website until the $5000 one...NOT.

Have a great weekend,
I will talk to you next week.
I am going to Long Boat Key and staying at a resort called the Colony. Beach, fun in the sun, Hilda and I have our own room, reading, movies, it is going to be great.
Then it is back home to the Swan and Dolphin.
See you next week,

Wednesday, July 9, 2008


I have a funny story to tell you.
I was working yesterday and one of my administrative assistants called into my room and told me that someone from Dental Economics was calling me.
Now to you non dental people this is a dental magazine. I would say the circulation is probably around 40,000-60,000. A free magazine but every dentist knows this magazine.
I have written a couple of articles for this magazine in the past.
I was very busy at the time and couldn't not break away. I asked my administrative assistant to ask them if I could call them back.
So my mind started to wonder. What could they want?
I thought to myself they have read the blog and want to do an article on me. Or I thought maybe they had read some of my articles and they wanted me to submit something for their magazine.
Then I started to remember how difficult it was for me to get an article published in there magazine.
I continued to think how far I have come and now it is so cool to have them start calling me.
The word was out about this guy in Apopka, FL.

So I finished with my patient and asked my admin. assist. if she had the name of the person who called and where was the number so I could call them back.
She said they didn't leave a number they were just doing a phone survey on how liked their magazine.

WOW!!! was I wrong. See what happens when you let my mind wonder.
My assistant and I got a real belly laugh out of this one.
Then I started to think what an ego I have. I still laugh thinking about.

So here I am talking to you with my egotistical tail between my legs.
I know you like me and if you had magazines you would let me write in them.

Anyway, I saw Cloverfield on Monday night. I thought it was pretty good. I don't know how I liked the Blair Witch Filming method but the movie was pretty good.
I watched Vantage Point last night. Pretty good also. My wife liked it more than I did but still okay.

I wanted to write to you today about websites.
I have been wanting a website for about 6 years now. I just don't know.
I have been quoted from $0-$5000 to do one.
Now if you know me I don't want to do something if it is going to suck.
So I have talked to a ton of people about how we can make a website that is awesome.
That is when they start talking about how much it is going to cost.

Now before I spend all my money I start asking around about other peoples websites.
I think a while back I was doing a lot of DentalTown and I threw out there a question on whether I needed a website or not.
Of course these are all web people and an overwhelming majority of them said a website is a must.
Then I started asking my friends if they had websites and none of them did.
And if they did have one it stunk to high heaven. I could of made these websites.
They had old pictures, old fonts, old everything. I would ask them questions about there sites and they would say that I haven't touched that thing in a couple of years.
So if you do have one, you just don't have one. You have to update it. It is a living breathing thing.
So I started to think...who is going to do all this updating?
If I get one (and remember it can't suck) I have to be committed to it.
So am I ready to commit the time and the money it takes to have a website?

Now why would I have a website. To get new patients? To teach people about our office?
To have downloadable forms for people to get before their first visit? Directions?
Show off?
Are these good enough reasons for the time and money commitment?
New patients...I don't know. Is the Internet the new yellow pages? This year for the first time have not paid the yellow pages. All we did was bold our name but it was so expensive.
Also the people we get from the yellow pages was always hit or miss (and more miss than hit).
They would have a problem and we would fix it but this would never lead to a long term relationship.
So you say, how do you get your patients? Well word of mouth has always been the best. A friend or neighbor tells a person how great our office is.
Now could they tell them about our office and then the person look us up on the Internet? YES.

This is where a person can tell something about our office.
Now what does it tell a person if you have a boring website?
That is why I don't want a boring site. So for me it is better to not have a site then to have a boring one.
Can it save time with forms? Yes
But when I think about it, if I wanted to find a dentist in the area I just moved into... I would go to my computer and Google "Apopka Dentist". Wouldn't you?
I know at least some people are.
Because more and more people are telling me they found us from the internet AND WE DON'T EVEN HAVE A WEBSITE.

Now I just had an endodontist call me today and ask if his staff could come to our office and have a lunch and learn with our office. I asked what are they going to be teaching us? They said they are going to come here and teach us how to use their website.
Apparently, they have some mack daddy website that if very interactive. We as a general dentist office can make appointments for our patients.
When my patients are getting work done and the endodontist takes an xray it instantly gets put on the website (I guess there is some password stuff we have to learn about) and you can watch and follow, through the xrays, your patient getting a root canal.

Now I have enough problems already with time. Is this something I really want to take on.
I know how much time it took to get digital x-rays going. I know how much time it takes to have computers in every room and right up all our charts on the computer.
I know how often the computer guy has to come out here to fix a glitch in the system.
Is this something else we want to tackle?

Because once you start with, "Thank you for making you New Patient Exam appointment, feel free to go to our website and download all your new patient forms" and your forms aren't downloading for them...problem.
Or if you are telling people to go to your website to get directions to the office and they can't find directions on your site...problem.
What about this? You have a site that you have committed to and you have spent a crap load of time on and money on and you get no hits.
People are typing in "Apopka Dentist" and you are like the 12th one down the list.
You know no one ever goes to the site that is 12th on the list.
Then you have to pay a search engine person to make your site first.

I want you all to think about this until Friday.
I want to hear from you. If you have a site I would like a comment about your can be anonymous. How big is your site.? Is it just a template or is it the mack daddy one?
If you are bold enough put your website address on the comment and we all can check it out.
If you are thinking about one...tell me your thoughts.
On Friday I will tell you what I am doing.

I am on vacation next week but I am going to bring my laptop with me (so I will probably write).
I have to prepare for the lecture on Thursday. Lots going on in my life.
I want to hear from you about your website. JUST DO IT.

I will talk to you on Friday.

Monday, July 7, 2008


Oh my gosh. It has been so long since we talked.
You secretly missed me, didn't you?
It is okay, I missed you too.

I did not watch any movies this weekend. I am sitting her stunned. I have Cloverfield and plan on watching it today.
My queu is empty so I have to add a whole bunch. I did however run across a movie I saw in the theater that I must mention. 3:10 to Yuma, have you seen this movie? It was Awesome with a capital "Awe". If you have not seen it is definitely a "move to the top of the queue movie" (I am assuming you all have Netflix).

You know how I felt of this book Operation Instructions by Ann Lamont (it sucked). But I had nothing to read and I am a reader. Readers must read, so I went to my bookshelf and looked for a book I haven't read.
Turns out I borrowed a bunch of books from a friend (shout out to Eli) who is a book addict.
I usually like the books she likes and found a book she gave me that I never read. One was by Ann Lamont.
I gave it a whirl...I had to, I need to read. I am going to go to the library this week (this is a new thing for the Gammichia's going to the library for books. Did you know they have books you can read there FOR FREE. Are you kidding me?)
Anyways, it is book called Traveling Mercies. I am about half way through and it is not bad.
She is a bleeding heart liberal (not that there is anything wrong with that) and also a Christian.
It is refreshing to me that people can believe the same thing but come from so many different backgrounds. I am almost 40 and I am still learning about people. This is good.

I am going to write on Websites this week but I decided I wanted to tell you one thing (that has nothing to do with websites) first.
I want to tell you about the Gammichia's money situation.

It is not bad by any stretch of the imagination. But it is not that great.
We can't seem to pull out of our month to month bill paying.

Let me take a step back.
5 years ago...
We were in pretty good shape financially. No debt except our house and school loans.
Our family was getting bigger and our first house (I bought for $176,000) which was a 3/2.5 bath was getting too small.
So we sold our first house (for $305,000) and bought another house. We bought the new house for $280,000 and then gutted it. We ended up putting about $90,000 into it. So we basically bought our new house for $370,000. Now in today's numbers this was a complete steal.

At the same time the whole house thing was going on. I was buying into the practice and I won't tell you how much that was but it was enough.
Now I was hoping that my dad would say, "John, I just love you so much, I have enjoyed practicing with you for the last eight years so much that I want you to have the practice." NOT.
We worked out a fair price that we both could live with and I bought half of the practice.
So although I didn't owe that much when we went to borrow all that money, it was a big convoluted mess. But when the smoked cleared I had only two and a half loans.
So we have a mortgage, an office loan, and a equity line (which we pay interest only).
Our mortgage is normal, our office loan gets paid with quarterly bonuses and we try to pay down our interest only loan.
Its this equity line I want to talk about.
We began 5 years ago with $95,000 of debt in this account. We have been paying it down steadily for 5 years. Oh, we also dip into it when there is a need that is not part of our monthly budget. Like our mini-van pooped out a couple of years ago. We needed $14,000 to buy another one, we went straight to that account.
So it is always a little give and take. When we get a bonus we drop the number down, when we there is a windfall need we go to it. Also I never really worry about our monthly bills because if we spend too much we just dip in "the account". When we get a bonus we pay it all back.
This is not very good stewardship.
This system is in lieu of changing our habits. Changing the way we live to get rid of debt.

We now owe $84,000 in this account. Five years we have paid it down $11,000. Not very good.

So I came home last week and said (more like screamed), "Moratorium on all spending". We had a family meeting and everyone agreed.
This lasted about 4 hours.
I decided I wanted Luke to go to basketball camp-$165
-don't forget we are still paying tuition. Come to find out we pay on a yearly basis not just when they are in school. What a racket.
Hilda needs maternity clothes- $ a lot.
The pool pump pooped out -$299
When I mean pooped out I mean pooped out. It was smoking and not running. I mean if it was smoking and working I may of just left it.
I was having sprinkler problems in my yard-$135 (don't get me started)
I took my kids to a matinee movie (Kung Fu Panda)- $50. Yeah I said $50. Did you know a matinee movie is $8.50 per kid. WHAT?!!
I had a kid come over (who was working in the blazing hot sun for $10 per hour to raise money for a mission trip) and he worked for 3 hours - $30.
I have another kid mowing my yard for $20 a week (let me tell you it is the best $20 I ever spent. He works very hard and I don't have to do it).
Breakfast with grampi (even with coupons) -$45
We had a going away party for our babysitter/friend/children's ministry person at our church--$ don't know (but worth every penny. Love you Debbie).
We went to a fourth of July party that we contributed to.
...and the list goes on.
These are not extravagant things.
But they are not things that are in the fix budget.
They are not things that cost a lot but if you add them all together...guess what?
We start dipping in the rob Peter to pay Paul account.

It just takes a lot of money to run the Gammichia household.
I don't think we live very extravagantly. We live very very comfortably but I am thinking maybe a little too comfortably.
I don't think it is the big purchases, I think it is the one hundred little purchases.
These are the hardest things to cut back on.
The trips to Chick-a-filet.
The regular movie theater instead of waiting for it to come to the dollar theater.
Breakfast with Grampi at Perkins instead of the little country kitchen.
$5 here, $12 here, $21 here.
You know what I mean.
Its like going on a diet.
You don't just have to cut back. Because cutting back is just getting back to not gaining weight. But if you want to lose weight you have to go into the negative.

Oh and I have a $4000 medical insurance deductible. Yeah, I have one of those real inexpensive principle insurance plans but high deductible. Now the 8 ultrasounds come along at $250 a piece.
I blame it all on Hilda, it is so much easier that way.
I will let you know how the diet is going.

I went golfing with my nine year old today. I had two free coupons, YEAH. It was blazing hot.
There are only three water fountains on this nine hole course that we WALKED.
After the third water fountain, he said, "Dad, I have two best friends on the golf course."
I said, "Oh, yeah, who are they?"
He said, "The water fountains and you."
At least I made the list.

See you Wednesday.

9 days until the AGD annual meeting. You are going right?
If you don't come, who will go to my little lecture. I am counting on you.


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