Parenting 101

Hi all,
I thought Mondays blog is going to be a classic. If you missed it you have to go back.
But when you are talking about kids all you can do is laugh.
My mom and my younger sister were over yesterday, for dinner, and we were just having a ball talking about growing up.
My sister says, "Mom, I remember you always being late to pick me up from things."
(as an aside, I have 4 brothers and sisters. 40,39,37, 27,25. So there was 3 then in 10 years there was 2 more)
I said, "Oh yeah, well when we were in summer camp, on time, mom dropped us off and then took off. You know, "Bye, I love you. Be back at 3:30 to pick you up."
Only one problem...there was no camp that day.
Back in the day when I was 8 years old, you could just drop a kid off and not see an adult. You just told your kid to get to his classroom by himself. And there were no cell phones to tell your mom to come and get you.
At this point we were screaming into an empty building for the janitor to help us.

It is funny sometimes how ill equipped we are to parent. And we are the ones really trying.

I did want to get to this story...I am leaving for Mexico at 1:30 today so I hope I can get through this.

You are not going to believe this. I usually get to this throughout the day.
I started this early in the morning and I never was able to get back to it.
Here it is 2 minutes before I have to leave to the airport and you remember the last time I went to the airport. I am trying to not go through that again.

I have to go.

Adios, I will talk to next Monday.
I swear I will get to this story.
john

Raising children

Hey all,
Hope you had a good weekend.

Mine was very eventful. We had a leadership thing at church. That is dinner and some stuff Friday night until about 9pm. Then up at 8:30am to get on a bus to go to a remote site to talk church stuff. This ended at about 10pm.
Then church the next morning at 9am.

Only one problem.

This Saturday was my long run day. We are getting up there in miles and scheduled to run 20 miles. That means wake-up call at 3:30am. Get to the meeting place at 4am. Then running for 3 hours and 45 minutes. Then I have to crawl back to my car and get home at 8:15, shower and get on the bus at 8:30.
So getting home at 10pm meant a very long day for yours truly.

As far as the weight loss thing...I think I am moving in the right direction but it is not that fast. I told you last weekend I was 192 on Sunday. Well, I was 196 by the end of the night.
So I was frustrated.
Saturday after the run I was 190. But of course it is all water weight. But this morning I was 194.5.
So a good trend but I don't know if it will be fast enough to win the money.
It might be time for some more guerrilla tactics.
The worst is that the weight loss is suppose to make it easier to run but it is not happening.
I am getting creamed out there.

Today's topic is about raising kids.
This is a tough one. What a special job the Lord has given parent.
It is by far the toughest job in the world.

You love this kid to death. I mean crazy love.
But as I speak this week don't ever think I know what I am talking about.
I kind of live by what Kevin James said on King of Queens, "I am just a stupid man just trying to do the best I can."
I am not an expert I am just a parent. A parent just trying to "raise up a child in the way he should go". (Proverbs)

I would never judge someone by the way their kids are.
This is kind of how some people parent, (present company included) we parent out of fear of the way our kids will act in public. Are you crazy? When I see a kid acting up in a store, I just think, 'been there, done that."
But the only time I will judge someone if they are not trying. If you are gone all the time you can't parent.
My wife and I have no idea on how to parent. You know what I mean. I mean we try. We take classes, we read books but we really are flying by the seat of our pants most of the time.

One thing we do try to do it study kids and see if there is a common trend between successful kids.
Things like...did the parent micro manage the kid?
Were they strict?
Did they have an open relationship with the kids?
Did they make the kids their "friend" and not their kid? (I don't recommend this one)

I have three awesome kids but I continue to pray that they turn out okay. I pray that they will grow up loving the Lord and being a productive member of society IN SPITE OF ME.
That they will see the stuff that will make them great and forget about all the crappy stuff I have unintentionally done to them.
Let me make something very clear...I don't care if they go to college. I don't care if they make a lot of money (although it would be nice it at least one of them will buy me a house or something like that).
I just want them to be happy. I want them to make others happy.
This means to me, not being in jail. Not being addicted to drugs and not having kids before they should. And I want them to have a job they love.
I don't care if they care if they are janitors as long as they love to do it and do it in a way that honors our King.
Pretty simple right? NOT

I have read a ton of books on raising kids (okay, maybe my wife has and she told me about them) but as you might imagine they all have different opinions on the way raising kids should be done.
Its like anything.
IN my opinion is it is all about time.
Spend time with them. Spend time loving them. Just being there.
But wait...the more time you spend with them the more opportunities you have to screw it up.
See what I am saying...it ain't easy.

My wife (and she will say it herself) she parents out of fear.
She has seen people in our family self destruct. She fears this happening to her kids.
So she will not allow this to happen to her kids. But we all know that even great families have some kids that self destruct.
And you know what you can do every thing perfect and they will self destruct. Sometimes it has something to do with the KID.
I mean if you ask anyone, "How was your family life growing up?" Most people will say it was moderately screwed up.
I am a pretty stable guy but I can say that we sit around the Christmas table and laugh about the dysfunction in our family as we were growing up.
"Remember the time you were chewing gum loud and dad told you to be quiet? You decided to not be quiet and then dad took your gum and squished in your hair? That was so funny."
"Remember the time dad made you eat ice cream with your hands because you put your fingers in the quart of ice cream?"
"Remember the time dad smacked me in the mouth for yelling the F-word at you when he had guests over? Yeah, that was classic"
We have five kids so the stories are endless.
Sometimes my dad gives it back to us but most of the time he just laughs along with us.
Now we all reacted differently to our up bringing. 5 kids, all the same parents and all very different.
I know what you are goin to say, "you shouldn't parent all your kids the same."
Yeah right, that is real easy to do (sarcastic tone).
You did something wrong and I am going to have to discipline you.
Let me go over to the discipline chart. Okay you did X offense, I discipline you this way. Wait you are a girl so I have to change it. Oh wait you are a second child so I can't do that so I have to do this. Wait you are my sensitive one so I will just do this.
Get it...NOT EASY.

I like my wife have many issues in my parenting skills.
Lets say my kid does something wrong. Yes, my little angel went and kicked over the older boys Lego building.
Now in the grand scheme of things, this is not a big deal. BBBUUUTTT it is.
But I just sat down from a hard day of work and I really don't give a crap about the Lego's.
Tonight the older one is going to have to put all the Legos away anyway so do I have to get up off this couch and beat the crap out of someone right now?

Well according to my wife, and all her books, I must act. Because it will reinforce bad behavior...blah, blah, blah.

But he is so cute.
Do I have to discipline (spank) him?
This is hard stuff. You have to take the spoon, tell him to meet you in the room.
"But Daddy, how many spankings is it going to be?" (he is four years old)
"Son, I will meet you in the room."
Now he is in the room and you are suppose to be calming down in the kitchen so you don't hit out of anger.
So I say to my wife, "You do it."
So said, "No, be a man, you do it."
"I promise not to ask you for sex for a whole week if you do it."
"No, you do it." (I have to discipline, but this allowed me to beg for loving all week).
Then it is into the room.
Man I hate doing this.
I tell him to pull his pants down and lean over the bed.
He has such a cute "tooshie" (this is what my mom called it so this is what we call it).
But don't forget you can't hit him to hard so that he is scarred for life and you have to hit him hard enough to make remember not to do this again.
Did I tell you I hate doing this?

Now I know there might be a bunch of non spanker blog readers.
Here is my thought process....
The Bible says to do it.
Simple as that.
One of the verses is, "Spare the rod, spoil the child."
Or in some translations
"Spare the rod, hate the child."
So when I have to discipline my child, I keep saying this verse over and over in my head. I love him or her and that is why I am doing this. I am being faithful.

I am going to stop here. I know I was rambling but I have all these thoughts and my fingers don't type fast enough.

I will tell you more stories on Wednesday.

Have a great Monday,
Don't forget How I Met Your Mother is on tonight. CBS 8:30 (I think).
john

I started another book...It is called Why They Hate. It is from a woman who was a Christian brought up in Lebanon. She escaped the violence in her country and now is writing an autobiography type book about her growing up and explaining to the reader about the fundamentalist Islamic person. It is about the fifth book I have read on this topic.

Rain, rain, go away.

Okay the Olympics.
First and foremost, it was brought to my attention that I might have offended some people with my hoodlum and punk comment about track stars. I can assure you I was not thinking of color at all when I said that. I am sorry if it came across that way.
I hope to be more sensitive to this in the future.

Okay I thought the track and field in general sucked. On my way home I would hear the results of the nights events that actually happened 12 hours before. Then I would go home be forced to watch the events that I already know the results from. Then I would wake up and get to read about it in the paper.
Passing the baton. Is this a big deal? I guess so. What the heck?
I mean it is passing the baton. You are ahead by 10 yards, you don't even have to do it fast. It was a heat race. its just passing the baton, come on.

Hey has anyone seen Greg Louganes? Because he needs to make a come back. Our divers stunk and stunk bad. At least they stunk next to the 40 pound Chinese "women". They all went into the water and it was like the splash was being sucked in. It was hilarious. But we redeemed in beach volleyball. That was AWESOME. I loved it. Now these guys (and gals) have to play like 100 games to get 1 medal. But Phelps swims 17 times and gets 8 medal. Swimming is so much more bang for the buck.
Three more days of the Olympics...what am I going to do with me time.
It is almost time for America's Got Talent and some new episodes of How I Met Your Mother.

I almost forgot, I watched Definitely, Maybe last night. I did not like it. It was like a romantic comedy that wasn't funny and not romantic. Don't waste a spot on your Queue for this one.


Okay when I was making fun of this "Hurricane" I didn't realize that I could upset someone upstairs.
Man oh man. It has been raining here for 4 straight days. I am not talking about rain stop for a while and then rain again. I am talking about non stop rain the whole time.
So far this morning I have talked to 5 people that have water in their homes.
One of them is ME. Last night water started coming in my living room through a recessed light. Drip, Drip, Drip. So we had a bucket in my living room. This is not good.
My pool is overflowing.
Now that is just at my house.

Now my office is another story. It is like a disaster area.
I am pretty sure my office was struck by lightning over the weekend. My vacuum system was not working and we were having all sorts of electrical issues.
All the computers are on the fritz. Probably in relation to the lightning strike.
Oh, by the way, if you are all digital and your computers go out...this is bad. REAL BAD.
You can 't look at xrays, you can't look at a treatment plan. You can't look at an letter from the periodontist. You don't know what you are doing on the patient sitting in your chair.
NOTHIN.
Then you call the computer guys and they are not working because of the weather. Again, not good.
So deep in our Rolodex we find the cell number to one of the repair guys and he came right over (after he got dressed).
This was a big deal to us. We were very thankful to the tech. We ran down the street and bought him a $50 gift certificate to Home Depot (everyone loves Home Depot). It was a tender moment when we gave it to him.
The computer guys have been here about 5 hours a day for the last three days.
They send out the Dell people (because we are still under warranty).
You are going to love this one. The Dell guy shows up (not a Dell guy but someone hired by Dell to do contract work) because he has been called by my computer guys. He has strict orders on what computer to take and repair. We told him that the one that he is taking is not the one that is giving us the problems. He says the numbers match up so this is the one I have been told to take from you.
He says if you don't want me to take this computer you are going to have to call Dell.
Okay, then what is the number we can call so we can straighten this out?
He says, "I don't know."
WHAT?!!
He reiterates, "I don't work for Dell, so you are going to have look it up yourself."
I started to look around for the cameras because I thought I was on Candid Camera or something.
Has the world gone crazy or something?
Okay so you don't directly for Dell, but you are being paid by Dell. You don't have phone with your employers number programmed in it. You don't have it memorized. You don't have a sticky note with it on it.
ARRRGGG.
Needless to say it has been wet around the central Florida area. And yes we have been working.
I don't know about your collectors but they don't care about the weather and they still want their money. So when the weather is bad we still work.
But it seems that patients don't feel that great about driving and coming to the dentist in the rain.
Although the patients in our Apopka dentist office have been great and it hasn't been that bad here but I have spoken to other dentist that said their offices have been like a desert (A desert with their parking lot filled with water).
And all this because I said this hurricane wasn't going to be a big deal. Who would of thought?


Have a great weekend,
john

Confirming appointments III

Olympics.
I am having a hard time getting into Track and Field.
One of the problems is is I can't tell if they are all hoodlums or not.

I know they are all college graduates, I know they all have determination and drive like no other. I know they have discipline and they are fine tuned athletes.
But when the NBC guy interviews them they sound like bunch of street punks.
Is it me?

Now when the woman fell last night in the hurdles, that broke my heart. She came to be interviewed and was very gracious and then they showed her in the tunnel just breaking down.
I hate that for her.
And if she doesn't fall, we get Gold and Silver. That sucked.
Now what I am following more than anything is the medal count. If the communist China beats us in the medal count I am going to boycott the next Olympics.

I finished my book Two Wars. It was okay.
I watched the movie In Bruges. This is a movie with Colin Farrell in it. I am not a fan of his but I really liked this movie. If you can stand the F-word about a million times, I would recommend this movie.
It is in Irish English so I had to watch the movie with English subtitles. They speak with such heavy accents and they use words we don't (like arse). It is really hard for me to follow with out the subtitles. Man, am I getting old.

Okay about our topic for the day.
I have told you we, as a service to our patients, we confirm about 50-70 patients a day.
So instead of having one staff member confirm all day we now work with a company called Televox.
This is an automated confirmation system. We like it a lot.
But today I wanted to tell you about the issues we have had with it.
It is not the system itself that we have problems with, it is usually some human error working with a computer.
The confirming with the automated system is pretty easy. If people are home and they get the message and "Press 1" to confirm. We are golden.
If they are not home the system will leave a message.
Then as you know they have the option of leaving a message or not being being called by Televox ever again.
So the system is set up to call people at 7pm.
In the morning, usually two days before the day, the staff gets an email of all the things that went on the night before. 24 people confirmed (and it lists the names), 11 people got the message but didn't press any button, 12 left messages, and 14 people we were not able to get a hold of. So the staff usually only has to call 14 people.
Not bad. And I think this number is going down. Another cool thing is on our EagleSoft system you see a "C" on the patient for confirmed (the system does this). Or an "L" for left message or "U" for unconfirmed. If the patient is set up to get an email it will send an email and put a "E" on the patient.

Okay, here is the deal.
The system leaves a message. It is a computer. It doesn't know if it is calling the right house. If you have the wrong number for Anne Smith and she has an appointment on Friday. She gets a call tonight. But you could be leaving a message for Bill Adams (who is not a patient).
But next to Anne Smith's name on the schedule says, "L".
A false sense of security.
So leaving a message is like a virtual message. You don't know if they actually got it.
Or the system may have left a message for the correct person but they didn't get there messages. Not our fault or the systems fault but guess who is sitting on there butt NOT working on a patient.
So I told my staff that I had my reservations about the leaving message stuff. But the record shows that we are about 95%. But it is the 5% that kills me. I come up to the front and ask if my patient is here.
They say, "No, but the patient was confirmed."
"What kind of confirmed?"
"It says, Left Message". So I get turned off by the Left Message.
I asked couldn't we just keep calling until it talks to a real person. Tell it not to leave a message.
But then again this is changing something that works 95% of the time.
It can do this but it costs you everytime the system calls. Its minimal but....

I guess we are having about the same results with Televox as we have with a real person calling.
It is the same stuff. We don't have the right numbers for people.
We left a message and they don't get it.
No one was home and we don't have another number for them.
Same stuff.

One thing we are doing as a practice is collecting emails.
Most people now a days like and use email.
This is going to revolutionize the way we confirm. It is going to be great. Also we are going to start doing some sort of e newsletter. I know, I know this is old news for some of you but...
Like "Introducing our Associate" or something like that. It is in the works right now and is real close to happening.

So that is it for confirming.
There is a lot that goes into just getting butts in the chair.

I hope you liked it and I hope it was informative to the way we do things.
Write me if you have any questions Jgammichia@aol.com
Have a great Wednesday,
john


PS I almost forget...I am going on a missions trip next Wednesday. It was kind of last minute.
By the way, what is up with me having to pay $1200 to go and serve people.
I am going to remote parts of Mexico City and doing dentistry for 4 days.
It is kind of a medical trip. A pediatrician goes. A dentist goes. A internal medicine guy goes. A pharmacist goes and an optometrist.
One big happy family.

Confirming patients II

Okay now that Michael Phelps is the greatest Olympian of all times, I might be able to get some sleep. That 100 butterfly was enough to stop your heart.
But now what, track and field. The problem with the track and field coverage is it is not LIVE.
Meaning I am watching it on TV and want to know something about an athlete, I come to my computer and look something up. And out of the corner of the welcome page is the results of the event I am looking forward to watching that night. It is not the same.

I have good news, I was down to 192 pounds today. This is 8 pounds. I am two pounds from winning the bet. I have been playing it cool and not leading on that I have been losing weight. He has no idea I am close. I also think the MandM's worked.
On my marathon training. We are going strong. Last week, I ran 10 on Saturday and 7 (hill work) on Sunday.
I did 12 on Saturday and we are doing 20 this Saturday. Starting at 4am. That means getting up at 3:20am to get there on time. That is the worst part, sleep deprivation. So not only do your legs hurt but you are totally worthless the rest of the day.

No movies this weekend.
Almost done with my book Two Wars.

Well lets get right to our topic of the day.
I am talking about confirming our appointments. (if you missed Friday's blog you should take a gander at it).
I did want to mention that this is vital to the success of our office. It is good for us and it is good for the patients. My father when he started about a million years ago did it and we still do it today.
We have always loved doing this because it is a service that patients appreciate. But it also gives us an opportunity to call patients, say hi. We get to tell them we are looking forward to seeing them...building relationships. And, last but not least, it is to make sure their butts are in the chair.
But.....this was getting too much. As I eluded to on Friday was we have an average of 50-65 patients a day in our Apopka dentist office. This was involving ONE full time staff member to confirm patients.
So we had a company called Televox give us their shpeel at our office. What Televox is is the automated confirmation service. You know the "Stacy has an appointment at our office at 2:30 on Monday...Press 1 to confirm, Press 2 to cancel this appointment and Press 3 to have someone from the office call you."
This system will call, it will email, it will text message, it will leave messages on answering machines, it will leave voicemails.
It will send birthday and anniversary messages, it is limitless.
My front desk people called some references and they were excited about it.
It was $699 to set up and about $300 a month.
This is a bargain, if it works. Also it is going to free up one whole staff member to do something else.
We decided to pull the trigger on this one.

One problem...I had my own ideas of how we would use it.
Don't forget our office is all about personal relationships and needless to say speaking to Max Headrum on the phone is not very personal.
How can we use this technology and not lose what our office is all about?
Usually there is almost no set up for this system. You link Televox with your EagleSoft or you Dentrix and it almost takes it from there.
One option that Televox offers you can put your own voice to the message.
So what we did is I had my front desk person work with Televox and create our own message.
For the first 6 months (I thought if everyone is on a 6 month recare they will hear it only once) our message is going to be something like this...
"Hey, this is Samantha from Dr. Gammichia's office (in our very own Samatha's voice). We are so excited about the opportunity to use Televox, the newest technology in confirming your appointment."
Now can you imagine what a pain the badonkadonk it was to program in all the names in Samantha's voice. She didn't have to prerecord every name but what she had to do was prerecord every sound. So the system then puts all the sounds together and creates the name.
So our message is prerecorded and it is someone from our staffs voice.
A couple of things I did with the message. On our message they were not able to cancel an appointment, that was not an option. So it was "Press 1 to confirm, press 2 to have someone from our office call you, and press 3 to leave a message for one of Dr. Gammichia's staff."
One other thing I wanted to do is give our patients an out. I added another thing to the message. I had them add "Press 4 if you would prefer speak to a real person instead of Televox in the future."
This is giving people an out. They hate the impersonal touch of technology and I can understand this.
So with this system there is something you can put in someones virtual chart that will not allow Televox to contact them.
So we did it. That was about 7 months ago.
I would say all in all it was a success. It turns out that this day and age it is all about speed. If they can get reminded about an appointment and it only take 2 seconds, they dig this.
If they don't have to talk to someone. As much as people like relationships, they like convenience better.
That is going to be it for today.

But this is not over...there are some glitches. I will tell you about them on Wednesday and finish this topic.

Have a great day,
john

Ps I know you must be very concerned about me living in Florida and having a hurricane coming right at us. But have no fear it is only a category 1 hurricane. Pa-lease. I am yawning as I am writing this.
It will be okay, you see central Florida doesn't have any trees to get knocked over...they all came down 4 years ago.

Confirming appointments

Olympics are killing me. Come on Michael you can do it!!! But could you just do it before 11:30pm?
Funny thing.
I was talking about the Olympics and my assistant asked who is Michael Phelps?
WHAT?!!!
I said are you kidding?
No who is Michael Phelps?
Just forget it.

Anyway, the guy is a complete stud. I did do some research on him. I found out a couple of things.
First I was wrong... and he did go to college. As much as I like Michael (yes we are on a first name basis) I hate the fact that he went to the University of Michigan. I will forgive him.
Oh this is why I hate Michigan (for now). Also, they play in a weak conference. Yeah, I said it. I think the Big 10 is a weak conference and so does the national media so don't just blame me. SEC baby. Can't you just smell college football season. 2 weeks. Smells like victory.


I just can't get into gymnastics either. I don't like watching 12 year old girls that are 4'6 and 78 pounds.
But I did see that Japanese guy fall off the rings...SPLAT... that must have hurt.

I watched the Bucket List on Wednesday. I liked this movie. They picked the perfect two actors for this. I thought it had a good message. And I loved the assistant character. I will always call him Jack, from Will and Grace.

I wanted to talk to you about confirming appointments.
This may be a 12 part series because there is so much that goes into it.
Let me remind you that we are a two and half dentist practice and we have 3 full time hygienists.
Each hygienists will have 9 patients a day in our Apopka dentist office.
And the doctors will have anywhere from 4 to 12 patients in a day. I mean if someone is having a suture removal it is still considered a doctors appointment. It may be on the assistant column but for this exercise...work with me.
So we have about 50-60 patients a day.
Now we are a fee for service practice. So having the people here is affects the bottom line directly.
So I am going to talk about how to schedule and how to remind.
Now I am going to tell you how we do it and you can tell me how you do it.
I, by no means, know how to do this. We basically reinvented the wheel with this one. We spoke to a number of people and asked them how they do it.

It all starts with the New Patient Exam. After this appointment the person is suppose to get another appointment.
The rule is that no one leaves the office without getting an appointment.
So the New Patient leaves the office with at least one appointment. If the patient says something like, "I don't have my schedule book, can I call you?"
"Sure" we say, "But if by chance I don't hear from you, I will make it a point to call you tomorrow."
This does two things; one they know how important it is to us and two, that if we do have to call because they "forgot", we are not bugging them, they knew it was coming.

Okay, lets say they get their cleaning and get put on a 6 month recare schedule. Well, what then. They leave with an appointment for 6 months from now.
I think this is crazy because I will forget a haircut appointment in the afternoon and I just made the appointment in the morning.
But luckily not everyone is like me.
Okay so, in our office, we like to help people remember their appointment. So a month before their appointment we will send a postcard. It has a funny picture of a penguin or a bear with teeth on it, and it says your appointment is Sept 14 at 9:30 and we are looking forward to seeing you.
Then 2 days before their appointment they get a reminder call from us.
We use a system called TELEVOX (I am going to tell you about TELEVOX on Monday), this is an automated confirmation system.

Now this all sounds great and it works about 90% of the time.
The problem is that 90% means 10% of your patients didn't show up.
So out of every 10 hygiene patients 1 is not going to show up.
Lets add this up...Every day you will have 3 no shows (three hygienists, remember).
4 days a week is 12.
50 weeks a year times 12 no shows a week is 600 a year.
If every hygiene patient averages $100 a visit, that is $60,000 a year.
Wow!!!
For the doctor, not only do I sit around because I only schedule one patient at a time. I sit and steam because of it.
And while I am steaming I am looking for someone to blame.
99% of the time it is the patients fault. We did everything we could do to make sure they come to their appointment. We give them a reminder call. We tell them how long they are going to be at the office and tell them how much it is going to be.
Now don't forget how many man hours it takes to do all this.

But if I go one hour a day without a patient, it really hits the bottom line.
I am not saying I am busy all the time or anything like that, but that is the goal.
So lets say we try to produce $350 an hour off the doctors column and I am open one hour a day.
$350 time 4 is $1400.
Times 48 weeks is $67,000.
Times that by two doctors and that is $134,000 a year.
So the potential is there but is 100% to much to ask.
So lets say you have a practice like mine and if you can reduce the doctors and hygienists and doctors no shows in half you would make $100,000 additional dollars. Would you hire a new employee to do it.

I am not a micro manager but I might see a hygienist at the front desk. Text book sign they do not have a patient. So I will say, "What is up?"
This is how I can tell if our systems are working or not. It did seem to be working but at what cost.
At our office, come to find out that one of the three front desk people was devoting the WHOLE DAY on confirming appointments.
This is what we did for about 12 years of my practice, 6 months ago we integrated Televox into our office. I will tell you the challenges we are having with this system.

I will continue this on Monday.
All you non dental people will be bored out of your mind but it could be interesting to see the ins and outs of what your dentist does.

Have a great weekend,
Remember to rest on Sunday,
john

Patients, convenant or consumers

I can't stop watching the Olympics. I have to sleep drill because I am so tired but I can't turn it off. I have DVR so if I wanted I could just watch it the next day...but that is not acceptable. If Michael Phelps can win two gold medals in 54 minutes I can at least watch it live.

My wife is so confused about what Michael Phelps is going to do for a living.
It all stared when she asked what college he swam for. I said he didn't go to college.
She said, "What do you mean?"
I said, "He swims."
"What the heck does that mean?" she said.
I said swimming is like a job. He does it 8-10 hours a day. People go to college to get a job. He has a job and his education will have to wait, colleges will always be there.
She said, "What is he going to do after the Olympics?"
"Well, he is going to continue working." I said.
I told her I think there are meets all the time. The TV people kept talking about the "Worlds".
But if he wanted to retire after this year I think he would be doing okay for himself.
(I even told her maybe, he can afford some orthonathic surgery with his endorsement money).
I have heard $50 million dollars is what he is going to get from this little diddy of his.
Who needs college when you have all that kind of money? Just ask all the NBA stars. Yeah the ones living under a bridge 3 years after there last paycheck.

But the people I wonder about is the one time bronze medalist. I don't think the endorsement deals are that lucrative. I mean they will make money but not career money.
Do they quit school and devote the next 4 years of their life trying to get the gold (and the career money) or do they get a scholarship to go to a Division I school? Get there education and maybe make the team again in four years.
They really don't talk about these guys.
Or what about the fourth place guy or in 7th place. Yeah you are the 7th best athlete in the world at this event and you get this really nice USA swim gear for your efforts.

Okay, today's topic...
At church this weekend the preacher was talking about are we Covenant Christians or Consumer Christians.
I thought a lot about this and how it relates to my life. I brought it back to my work and thought about my patients.
Are they Covenant patients or consumer patients?

Let me explain.

In the Old Testament God made a covenant with His people. I will be your God and you will be my people.
This "covenant" meant that whatever we do, as crappy as we are, as sinful as we are God will always uphold His end of the bargain and continue to be our God.
The "Consumer" Christian is like it sounds. We are consumers. The relationship is very volatile.
If you are not living up to your end of the bargain I am going to go somewhere else. If God is not meeting my needs I am out of here.
I have a "Consumer" relationship with Publix (our local grocery store, I guess it might be Kroger or something in your area). If they have a clean store, if they sell me food at a fair price, if they do everything I want out of a grocery store, I will continue to shop at Publix.

Now lets bring this home to Dentistry (if you are not in the dental field...add in your profession).
I want Covenant patients.
I know this is a pipe dream but...I want a patient that says, "I love it hear and I am never going to leave."
I want patients that think I am all that and a bag of chip AND I am not perfect.
I want them to like me and my office and all its faults. I want them to believe in the stuff we are doing and have a relationship with us that is stronger than "what have you done for me lately."
Am I making sense?
I want to be able to be human. Where does it say in my brochures that I am the PERFECT dentist. Where does it say that we will be able to fulfill all your needs all the time and do it a price that you think, "wow that was cheap"?
I want them to know that I want the best for them. I want them to know that I try my best to do on them what I would do on my own family.
But it seems like people are so consumer oriented, myself included.
They lack commitment.
You are not perfect so I am going to go to the next new thing.
We do this with mechanics. We do this with stores. We do this with churches. And I sorry to say that people do this with Dentists.

Now I understand people leave my practice (man, I bet they are sorry now). I understand that I am not perfect and we make lots of mistakes. But the problem is that no one ever tells you that they are leaving and why they are leaving.
We make mistakes but we can't improve because we don't know which screw up was the back breaker.

So this is what I do. I try to make it relational.
At the first visit the first thing I do is go to a room that is not a operatory and talk to them.
And we don't talk about dentistry. I want to create something more than a dentist/patient relationship. I want them to see me as someone who cares about them. I am not saying that this is always a big hit but this is all I know how to do.
I talk about there work and their family.
Then I get into teeth questions. Then I get to educating them on stuff about teeth.
"WOW!! This guy is not your run of the mill dentist. No one has ever spent this kind of time with me. "
Does it equate to, "Man, they really screwed up my bill, but I like him and I will over look it"?
I don't know.

I have been pondering this all week. Now I want you to ponder it.
Do you have a patients that love you for you?
Do you have covenantal patients or consumer patients?
If you have covenantal patients let us know how you do it.

Have a great Wednesday,
john

Drug addict call

I don't know about you but I love the Olympics. I love sports and I love the USA. So this together with the chance of beating communists is ... the ultimate in TV.
So with 12 hours of non stop Olympics and 5 channels to choose from...I am like a kid in a candy store.
I watched the Olympics last night with my wife.
The men's swimming was on late but every time Michael Phelps is on my butt is going to be watching it.
The men's 4x100 freestyle was AWESOME.
No, it was more than awesome it was...well something better than awesome. Like the awesomest.
So if you didn't see this race you missed out on one of the most exciting 4 minutes of sports of all times.
The stage was set by the French being the best in the world (in a sport that the Americans have dominated since the beginning of time) and then they were talking smack. They told the newspapers that they were going to smash the Americans. The FRENCH of all people.
Some of the other things going on was Michael Phelps was in this event and this was one of the 8 events that he was in and if he was able to win gold this would keep the possibility of him winning 8 gold medals. The record is 7 by the the Lance Armstrong of swimming, Mark Spitz.
If he wins eight he would be vaulted to one of the greatest athletes of all time. Oh and he is only 23 years old.
But the commentator was saying he doesn't think the Americans (on paper) could win.
The stage was set. "Take your mark...beep."
They were winning after the first leg of the relay, then it was close, then the French got a lead just before the last leg. Oh... and then the last leg for the French was their best guy. He was winning by more than a second. But the American was holding his own and then started to gain on him...OMG, a half a lap to go and the American is gaining. 10 yards to go and he is still gaining...OMG...2 yards to go and they are neck and neck.
Americans won by .07 seconds.
Hilda is jumping up and down in the living room, we are slapping five.
It was the awesomest.

So all my movies are waiting for me and they are going to have to wait until after the Olympics.

Now to my unbelievable story....

Last Saturday I got a call.
Let me digress a second. I get about 5 calls a year on the weekends. I almost never have to go to the office (dentist office in Apopka). I am up to it though. I leave my cell number on my answering machine at work.
I work 4 days a week but I am a dentist 7 days a week. If people need me I can spare the hour.

I got a call while I was sitting on the couch watching baseball. I couldn't get to my phone in time so I called the person back (they left a message but I just called the number back before I listened to the message).
She introduced herself as a patient and told me that had a son that got some teeth knocked around.
Usually it is a kid and an accident. At this point I would jump in the car and meet them at the office.
This was a different scenario. I could hear the son in the background. He was a son but he was a man.
I could hear him in the background yelling at his mom, "Tell him the black people (he used the N word, but I don't even like saying this word) kicked my ass!"
We are trying hard to have a conversation and he keeps yelling, "Tell him the black people kicked my ass."
I told her I would call my associate and see if she could help. She lives a half a mile from the office and I live 15 miles (also she wants this kind of stuff).
I told the mom I would call her back.
My associate was going on vacation and I was thinking she might still be in town. She was not.
At this time I listen to my voice mail.
I saved it...it was hilarious (hilarious in a sad way). He says, "Yeah (in a voice like you just woke up from a huge night of drinking) , your message at office says if you needed emergency dental care to call you. Now I am calling you and you are not there. My mom is a good patient at your office and you are no where the f--- around." Real nice.
Needless to say I am not thrilled with this dude at this point.
I called the mom back and I told her if his teeth are all messed up they could go to the emergency room and there would be an oral surgeon on call. He or she would put his teeth back together.
She asked if I can tell him that.
He got on the phone. I told him that. He says, "Why can't you do it?"
I am really bad at confrontation. I mean really bad.
My father is worse than me so I blame him.
But as I get older, I am really trying to be loving to people but tell people how I feel.

I said, "Look, I just got your message and it I was offended. I can tell you if it was me and I needed someone to help me I would certainly be a lot kinder on the phone."
He said, "Look dude, (still in the way hung over voice) if I apologize will you come in and help me?"
I said you don't have to apologize but in the future you should be nice and sure as hell more respectful to the people who could possibly help you."
Well, I guess he was holding it in as long as he could.
He starts with the, "My f---ing mother has spent f---ing thousands of dollars at your place and you won't even f---ing help us."
I told him I never said that.
He kept going, he said, "I know what it is you... have too much money."
Yeah, you make too much f---ing money that is what it is. You don't need my mom's f---ing money."
I said, "See this is what I am talking about."
He said, "F--- you, f--- you" and he hung up.
WOW!!!

This was unbelievable. I went back to watching baseball.
But you know what... I feel bad.
I don't feel bad for the son/man. I feel bad for the mother. I am sitting here still feeling bad for the mother.
The mother who has a drug addict adult son.
He probably went to buy some drugs and talked to the drug dealers the way he spoke to me.
Now he gets beat up and then calls mommy.
The mother that he probably has stole from. The mother that he has probably has spit at. The mother who has dropped thousands of dollars on his habit and and thousands more trying to get him in to rehab, hoping one day that he will stop.
What an awful situation.

We all have someone like this in our family.
Maybe not immediate family, like me, but extended family, and it always the same story.
Have you ever watched that show Intervention. It is an unbelievable show.
Some of the drug addicts just don't want help. They still don't recognize a problem. They haven't hit rock bottom enough to want to get helped up.
The families are in misery and the addict is spinning out of control.
I had 4 minutes with this family and I have not stopped thinking of the mom. I still haven't called her back yet.
I don't want to get involved. I am not trained. I could get sucked in. I have my own problems.
These are the excuses I use to justify NOT calling.
I think they are pretty good ones.

I could go on for days on my thought on this, but this blog is getting long, thanks to Michael Phelps.
I will talk to you on Wednesday.
john


Ps There has been a comment wanting to know about my wife. She is doing pretty good. It hase been about two weeks. We went to church yesterday and this was a big step because you know you are going to have to talk to everyone about it. The people at our church have been great. Time has been healing this wound, as well as a lot of prayer.
We went to the doctor today and he said everything was fine with us and it was just a freak thing.
This has given her some closer.
Thanks for asking. I so appreciate you all, even though you didn't come to my lecture.
I have not forgotten about that.
I have to go this is too long as it is.

Alot about nothing

Only three days left on my vacation.
I have been a media fiend.

I saw the movie with Diane Lane called Untraceable. Very good.
I saw a movie that was given to us, Take the Lead with Antonio Banderas. Not bad but very predictable.
I saw P.S. I Love You (also given to us) a total chick flick. Not bad though.

I finished To Kill a Mockingbird.
Okay here is my opinion about this book (Patti, please do not reach through the computer and kill me).
I loved the book.
But you know this is mandatory reading for all ninth graders (this and Catcher in the Rye) so I tried to read this book through the eyes of a ninth grade young man. The book is about a lot of things but you can tell the book is going to be about this court case. Yeah, you read a lot about this kid Dill and all of Scouts neighbors and this spooky guy living next door.
But its about the court case... and the court case didn't start until page 177. The book is 280 pages long and the action started on 177. Now if you are a young man and you are trying to see if reading is going to be your thing, you want action. You want action from the first word. I can understand setting up a plot but 177 pages.
Now that I am almost 40 and I love to read (in spite of reading the mandatory reading in high school), I can pick and choose the type of book I want to read.
I can see how this book might have been misery to someone just starting out.
I understand that this book is awesome literature and has stood the test of time but we are trying to pull young people away from the video games and the television and from My Space and Facebook and you are not going to do it with 177 pages of setting up characters.

That being said...
The book brings up so many issues. The book was set in 1935 and copyrighted in 1960's. The book is about discrimination against black people, but the funny thing is the author weaves in the same type of discrimination of the poor, the illiterate, and people of different religions. The book was about people knowing it is wrong but not having the cool-yones to stand up against the popular way of thinking.

I know we have come a long way but don't we still do this now.
And as we get older we get worse. Jews, blacks, Muslims, Hispanics, poor, rich.
Being in the people industry you hear a lot and sometimes it is not loving. And sometimes you catch yourself not being loving.
These are all the feelings I was feeling from this book. Now this is what a book is suppose to do to you. I spent an hour running thinking about if I still judge people for all the wrong reasons.
I mean one of the most impactful lines in the book was as when Jem was describing the different types of folks to his little sister Scout and Scout said," why can't they all just be Folks."
Aren't we all just Folks?
Very powerful book.

I have started to read a book called Two Wars. It is another first hand account of the war in Iraq.
I will let you know.

Oh, I almost forgot. I have been meaning to tell you something for a long time.
I have a new favorite TV show. It is... How I Met Your Mother.
I love it.
I have DVR so I don't know exactly when it comes on. I think it is 8:30 Mondays.
You have to give it a try. You have to give it a couple of episodes. I laugh a lot when I watch the show... I mean belly laugh. Sometimes I have to pause it while I am laughing, rewind it and watch it again and then laugh again.

Did you watch the videos on Monday and Wednesday's blog. I think the second one on Wednesday did not link so cut and paste it and then it will run.
Very funny.

Last thing...it is so hot in Florida. I almost dread going outside. I instantly sweat going outside.
Now you know that I am a runner... it is either early morning or late in the evening when I run. Last night at 9:30pm it was 90 degrees. Are you kidding me?
I ended up running at 10 with short shorts and no shirt (I know bad imagery, but imagine seeing it live...not pretty). It was like breathing steam.
I felt like the cyclist in China. I run and look for sprinklers that are on and try to run through them.
"Honey, I just saw a naked guy running through our front yard."

I hate to leave you with that picture but...
Have a great weekend.
Talk to you Monday,
John

Amazing videos

Sorry this is a little late.

I was basically traveling today.
I just got home late but wanted to write you.

I hope you liked Monday's video. If you didn't cry you have a heart of stone.
I know the AGD people must be in the works in getting the Hoyts at the next annual meeting (if they are not...then....I don't know what I would do).

Today you are in for a treat.
I am not a YouTube junkie but I do enjoy a good video now and then.
This video I saw last year. It is amazing. Over 35,000,000 have viewed this video.
Yes I said thirty-five million!!!
It is about 6 minutes long but you have to watch the whole thing for effect.
Christians have used this video in church asking who are you, the buffalo, the lions, or the alligator?
http://www.youtube.com/watch?v=LU8DDYz68kM


I have to give you one more...
This one will plain make you laugh. This is the new craze at weddings.
http://http://www.youtube.com/watch?v=YT56YizyR2o
The there is only one person that knows something is up and that is the DJ.

I hope to talk to you on Friday.
Let me know if you liked the videos or if they were old news.
John

ps I am almost done with To Kill a Mockingbird. I have my opinions...Patti I will let you know them on Friday.

Inspiration

Today you are in for a treat.

I am on vacation this week. We came to the beach at St. Augustine. We feel every time we leave our house it is like moving our chaos elsewhere. We feel we have the most control at our house. So if we have to surrender it is not that hard to just come home.
We go to the beach but inevitably we just make it back to the pool. I mean we have a big pool at our house. Why do I need to pay $200 bucks a night to cram into a hotel room and swim in their pool.
But anyway, the place is pretty nice. We went out last night and got the lay of the land. It is very nice. We walked around and had dinner. It was quaint and the prices were fair (not like Long Boat Key). The shopping district is perfect and I am sure we are going to "conquer" this area.

I am loving To Kill a Mockingbird.

I have this awesome story from this weekend but it is going to have to wait.
Today I wanted to inspire you.


This video broke about 4 years ago. It is about Dick and Rick Hoyt, a man and his son (who has cerebral palsy).
His son claimed that his disability went away when they ran together.
So they took up running together. This story makes me weep every time I watch it. His training culminates with them participating in an IRONMAN.
I watched a bunch of these videos trying to find the best one and one video it shows some of his early marathon with Rick. On the clock as the two of them was 2:57:00. I am assuming this was a marathon. This was only about 1 and a half hours before me. By the way dad Hoyt is in his SIXTIES!!!!!

http://www.youtube.com/watch?v=YTUSB6eBoFs&feature=related

If that was not enough, go to you tube and press in Dick and Rich Hoyt or go to the Hoyt Team website.

By the way Team Hoyt are now motivational speakers and I think they would love to speak at the AGD annual meeting.

Also watching this video makes my 17 mile run this week look pretty puny.

I will talk to you on Wednesday.

John

Fellowship

Hey,

Just another week in paradise.

I finished watching Black Hawk Down. They did a very good job with the movie.

I just picked up the book To Kill A Mockingbird. We all have read this in high school but I don't know about you but I don't remember anything from high school.

I had a kid come into the office this week and he is reading a book for school (you know, summer reading) and it was (something like) How to Read like a Literature Professor.

I said this is just like our schools. Lets make all the high school boys HATE reading by forcing them to read a book like this. Reading is suppose to be fun. This is why I never got into reading as a kid because I had to read books like Catcher and the Rye.

(by the way, as an adult I got back into reading and decided to pick it up to see why the uppity ups like this book. I hated it.)

But there are books that are "Literary Masterpieces" that are just not fun to read, and if you are trying to get a young man to read then try to make it fun for them. I understand these books are important but if kids hate reading it is much harder to appreciate literature.

And I talk about boys and young men because I was one of them (and still act like one of them and we all knows boys and girls are different. Let's face it...girls are just smarter.

Anyways...I am going on vacation again next week. I know, I know..."Didn't you just go on vacation?" Yes, I did.

I take two weeks off in the summer and two weeks off at Christmas time.

Then I mix a week in here or there around the year. Yeah, it is good to be the king.

So anyone want to write a ghost writer blog?

As promised I wanted to write to you about the Fellowship Award I received.

It was pretty good. The ceremony was well done. I felt like such royalty.

One of my teachers and mentors got the main award, Dr. Henry Gremillion.

Just a note about Dr. Gremillion. The guy is wicked smart (I bet he didn't like to read as a kid).

But he was so good at teaching. At taking the time to come (way) down to your level to make you

understand.

I remember as a young dentist I would call him up. He would either come to the phone or call me back. Now that I am a mature dentist I realize how busy he must of been and I just thought calling me back was the only thing on his schedule. Luckily he did call me back and I am a better dentist because of him.

Fellowship...did you know that only 7% of all dentist get this award. Huh?!!

I am so high brow now.
But the ceremony gets you pretty pumped up to keep up the fight for your profession. You are sitting next to people that really care. The ones that have taken the classes, have taken the test, that ones that put up all the money it takes to move forward. They are paying money to make this profession just a little bit better.

And I think the AGD does a great job promoting this kind of dentist. That is what the

organization is all about. It is not about just paying your money to be part of an organization (I am not saying who I am talking about). They have a purpose and it is to educate their peeps and

make the profession better.

Now this ceremony is the culmination of the organizations successes and individual successes.

There are mature dentists their getting there fellowship and real young guys getting their Mastership. It is a celebration.

Speaking of celebration there was some party afterwards. It cost $85 to get in (Ouch, don't they know we are all cheap dentists and it was a cash bar. You could get a beer for the low low price of $8. Yes I said EIGHT. That is $50 to get a buzz on, he did not just say that).

But I have to say we had a really good time at the party.

I ended up seeing a couple of my friends their and we had a blast.

They had three HUGE rooms set up, all connecting but separate. One was an 80's room. This room had billiard tables, Foosball tables, video games, air hockey and a band and a DJ when the band was taking a break.

The next room was a Jazz room. It was simple and it just had a Jazz band in it.

The middle room had all the hours de vors in it and it had "Dueling Piano's".

There obviously was a ton of thought and work put into this party. When I tell you it was huge I mean it was huge, my wife and I were very impressed.

Outside all the rooms was a dessert stand. Also outside there was this karaoke studio set up where you can sing a song and they would make a DVD of you singing. Problem was there were speakers so everyone could hear you sing. I love singing in the shower but I don't want anyone hearing me.

So when you think about it $85 doesn't seems so much. I am not backtracking because I still think $85 is alot...but you are getting alot for your money (but $8 for a beer, I am bringing my flask next time).

Great time had by all. It was a huge deal and I felt pretty honored to be a part of it.

Here is a couple more pictures.

Isn't my wife beautiful?

Have a great weekend.

Remember I am on vacation next week and if you want to write something you can

just send it to me Jgammichia@aol.com

Faithfully,

john