Friday, December 25, 2009

Friday, December 18, 2009

I Can't Stop.

Hi all,
As an aside this will probably be my last blog of the year. I am working Monday and Tuesday of next week and that is it for the rest of the year. So I probably will not be able to have time to blog next week, considering I have lots to buy and I don't have all my lights up on the house. I mean I did it all but then I went to Lowes yesterday and they had all their Christmas stuff HALF OFF. I bought about 10 boxes of lights. $3 for a box of C-9 lights...are you kidding me. $3 for a strand of those tubes light, oh I had to get 5 boxes of those.

So I want to say Merry Christmas and Happy Chanukah to all of you. Have a great New Year. It has been a tough year for some of us, but let me remind you how blessed we are.

I hope you all of you get some good family time this year and some good eatin'. I will see you next year.

My daughter said a Madisonism this week that I thought you would get a kick out of.
After Thanksgiving, I play nothing but Christmas songs at the house, in the car, and at work. I want to get in the mood.
Well we are in the car and the song Angels We Have Heard on High starts to play. So the lyrics are Glooooooooo-ooooooooooo-ooooooooo-ria, In Excelsis Deo.
So we are singing and Madison says, "How are we suppose to know what we are singing when they write the song in German?" . My wife and I totally busted a gut.

In my book Tim Keller is talking about how Success can be a god, which I can relate to.
Some of us are driven by success and we find our identity in success. Success becomes our god.
He also says that as he had counseled people in life he hears things from the affluent that he never would hear from the less affluent.
Things like, "Life isn't suppose to be this way."
He says he never hears this kind of talk when he is around the poor.
Why do we think that because we have money and we are "successful" s!@#$%t isn't going to happen? Do we think because we work hard and have some means that we are not going to have issues? No, but I think it does mean that we will work hard to persevere.

Okay about our topic.
I have to tell you that I only got one comment from yesterday's blog. I am not going to take it personally. I am not going to think that no one is reading. I am not going to thing that no one likes me.
I am chalking it up to too much eggnog on your behalf.
The one comment....
Word is getting around about what a great guy you are John and people are starting to take advantage of you. I do help certain people out in my office but only the ones I know, not people off the street. What I do to prevent the flood gates of what you are describing from opening is to volunteer at a clinic that is set up to help people in need. This way I help people who need it but it has nothing to do with my office.

I do agree with some of this commentor's comments. I especially like the "great guy" comment. But I get an e-mail (I don't know how they get my personal e-mail) and it asked me to help. What do I do ignore their request? It is 20 minutes out of my day, a day that I might add is NOT stocked full of paying patients at the moment. Maybe I won't help everyone "off the street" but I might help everyone that at least asked me.
Now this person says he helps "the one's he/she knows" but I have to tell you I am helping people I know from church that I don't really like.
Sometimes if you know them, you know that they are in a position that they are in, not being able to pay, because of their lack of drive. They are adults that are stupid and have been fired from their jobs and then their kid falls down while ice skating. Do you punish the kid because their parents are lazy asses?
See sometimes knowing people is worse then not knowing them. You just fill a cavity and let them go. You don't have to know why they lost their job, you don't have to see what kind of car they drive, you don't have to see their new blackberry with the data plan and cringe.

I have told you that I think of my talent as a gift from God. I told you that Jesus talked about us multiplying our talents and he talked about what it would look like if we didn't multiply our talents...not good.
He talked about Feeding the hungry, clothing the naked, visiting prisoners, and if you read between the lines, you might see fix or pull the teeth of the decayed.
"Whatever you do to the least of my brothers you did unto me."
My problem now is I can't stop. I can't say NO.
I know it is terrible business. I know in the long run it is not really helping me (meaning I don't think all of my patients that I don't charge are running out and telling their rich friends all about the gentle dentist they just went to).
I guess what I am going to do is go with the flow. As the economy is crappy, people are going to need me. If the economy gets better then people are going to need me, but this time they might be able to pay.
I will continue to help people with reckless abandon, and I am not going to think about it. If I have openings in the schedule I can either walk around the office and get pissed about seeing my staff huddled around the front talking and laughing and doing nothing or we can help someone in a bind. (This is not a jab at my staff, sometimes there is just nothing to do).
I think this is just how I would wanted to be treated if I was in a bind.
Will some people take advantage of this? Absolutely. Do they take advantage of me? Absolutely. But I try to not think about it. I don't want to not help the masses because one person is a total mooch. (At my Dentistry from the Heart free dental day, someone rolled up in a current model S500 Mercedes).

I know it is crazy. It is a terrible business model: to just help someone without any questions, to do it and never think about it again, and go home and feel God's pleasure.
It is in my genes. I just can't stop.

I am glad we had this talk (I feel like it was kind of one sided)

Have a great holiday,

Tuesday, December 15, 2009

Freebie Dentistry

The weather here in Central Florida is crazy.
It was 85 degrees here yesterday. Unbelievable.
Football is over.
In the fifth grade league, we had our best game I have ever coached on Saturday only to be followed by our worst game of the year on Tuesday. It didn't help that our quarterback couldn't play. So we played with our second string quarterback but in this league every kid can't play every quarter so for one quarter we had to play with our third string quarterback. One problem we don't have a third string quarterback. So we tried one play with this kid and he said to me in the huddle, "I don't want to play quarterback anymore."
The kindergarten/1st grade league...well it was definitely a challenge. Fun but a challenge.
But it is over. I am sleeping again.
Just to let you know we have already signed up for basketball.
The saga with the unhappy patient is over.
Spoke to everyone I could think of to ask advice. I have to tell you the advice was very polar.
I would say 30% of people whose ear I bent said, "Tell him to stick it and don't give him any money back."
The other 70% said to give it all back. Not just the $950 but ALL of it.
Here is my train of thought.
I want it to go away. If I give the guy $950 back it has an 80% chance of going away.
If I give it all back to him there is a 99% chance of it going away.
I have told you in the past I am sensitive. I am probably a lot like most of you.
I am a people pleaser, and I will do anything, even at my own peril, to please people (my wife may disagree).
After much deliberation I decided to give him the whole thing back, yes all $1700 back.
It f@#$%^!ing kills me to do it but I don't ever want to think about it again.
So I called him and told him that I have decided to give him the whole thing back.
But here is the kicker, he said, "Thanks, this is really going to help me with this credit card statement." Then he added, "I hope I can come to you for my future dental needs."
I said, "This I am going to have to think about." Knowing this was the last time I was going to talk to him or see him in a professional capacity EVER.
I wrote the check and the dismissal letter at the same time.
In the letter I told him that I wrote the check not as admittance of guilt but in my last effort to make him happy. I told him I thought the product was superior and my effort was over and above what the average dentist would give.
Good riddance.
I told you I am reading a book called Counterfeit Gods.
It is about how we substitute things such as money, woman, children, our house, etc, for God.
But the funny thing is that we are not the first generation to do this. He backs all the stories about us with stories in the Bible. Stories of people 2500 years ago doing the same thing.
It is short book, but it is intense.

Okay topic,
I have this patient that has really bad teeth. He had gum disease and crowding and his midline was off over 5mm.
I have him go to the periodontist to see what teeth could be saved. The periodontist and I came to the conclusion that the best thing to do was make him a denture. We did and he looked fantastic.
A couple of months later his wife came to me.
Let me back up...this is a working family. She is a businesswoman and he is a works for Universal Studios. They have a couple kids.
A normal working-class family. This is my wheel house. These are the people like me.
She comes in. She has some missing teeth in the back and some decay, but in the last 5 years she has been trying to reel in her dental problems.
She had her front 6 teeth redone with all porcelain crowns. She had more than 3 root canals in the same teeth. So from what I gathered, she spent more than $7,000 to have this done, which to their family was A LOT.
She came to see me because one of the crowns came off.
One first look, her crowns really looked good. I went in her mouth and oh my goodness.
The lingual (tongue side) of her crowns were so open. Some almost a millimeter. Now you non-dental people, a millimeter in dentistry is a huge number. Me saying a crown margin is open a millimeter is telling dentists how poorly this work was done.
I basically had to break it to her right then that the work was not very good (I said it professionally, but basically got my point across) and I said that all of this work was starting to fail.
So I didn't hear from her for a while but about a year later another of the crowns came off.
I put the crown back on and reiterated my concerned about the other teeth.
She knows she has to do something but just can't.
Recently she has written me a letter telling me how much she likes me and begging me to go on the dental plan that her company pays for.
There is almost no way out for her.
Okay so what do WE do? I am talking about you and me. I am talking about the patients you see that have a need and you know they can't afford it. I know this scenario is not just happening to me.
I have to tell you that this stuff kills me. I have such a hard time thinking "I can't help everyone. Everyone has a story, and if I helped everyone with a story then I would never work for money again."
Or, "I hate it that they have this problem but what am I going to do?"
My thing has always been that everyone is not the one sitting in front of you.
Meaning this person is the one with the problem. Not everyone else. We will deal with everyone else later. Right now let's deal with this person with this problem.
This year, by leaps and bounds, I have given away more dentistry than any other year.
I probably did more free work this year than I did in the previous three years put together.
I don't know if it is the Dentistry from the Heart day that I do or people have heard about me through word of mouth (maybe I am getting a reputation), but I have received requests from so many outlets this year.
I have received so many e-mails from people I don't know.
"I have a husband that is out of a job and his tooth is hurting so bad. Can you help us?"
Am I the only one getting this?
Then people at church start asking me. Then friends of people at church. Then it is neighbors.
Friends of staff that are down and out. Friends of patients.
It is coming from everywhere.
I have to tell you that I have a heart for people. I want to help people.
What do I do?
Do I just treat everyone that needs something?
I have to tell you, up until now it has been all fillings and extractions but the problems seem to be getting worse and worse.
Does this thing continue to pick up speed and the next thing you know I am seeing everyone?
Do I have to regulate who I take? Do I put in a spot in the schedule for freebies?
Tell me what you are doing.
I will finish up our talk on Friday. I would like some input from you first.
Have a great day, I just keep thinking, 4 more working days left. Then it is 3 days of 24 hours a day shopping (I told you I am a complete failure at Internet shopping, see last Wednesday's blog).
See you Friday,

Monday, December 14, 2009

Christmas Party Marathon

Your mission, should you choose to accept it, attend 4 Christmas parties in 4 days. You must exude the yule-tide spirit at each.

Yep, that was Ric's mission, although Ric doesn't recall Ric having a choice about whether or not to accept the mission. Thursday night the Bunco ladies were over to the house for their Christmas festivities (if you have not experienced the suburban dice game, you are really missing out guys). Friday was Ric's office Christmas party at our house, Saturday was our Sunday School Christmas party and Sunday was a Christmas party for the Venue Band (a praise band Ric sings in at church).

In between, Ric met with his banker and accountant for end-o-the-year planning. Ric doesn't want to give it away but Ric thinks Uncle Sam is getting a nice present from Ric this year. But it is on backorder so he won't get it until mid-April. Nonetheless, still a pretty nice present if you can wait for it.

Ric also saw a couple of emergency patients at the office over the weekend. That seems to come in waves. Ric can go months without one and then go several weekends in a row with one.

After all of that, Ric believes he is now ready for the holiday to begin. The air is cold and crisp, Christmas music is playing in the office and the procrastination on buying the kid's presents is well into its 50th week. Aaahhh, Ric loves the prospect of again filling the tree with presents that are purchased from the in-stock leftovers of area stores during frantic lunch-hours and the Friday remaining before the big day. We do it every year and, quite honestly, it is fun. Our kids all have birthdays in November and December so we are getting those presents early and Christmas presents just seem to get put off until later.

Well, today is one of those rare days where Ric is busy but his hygienist isn't so Ric better get back to prepping crowns.

Have a great week.


Thursday, December 10, 2009


Nothing going on except for flag football.
I am not even watching TV anymore. This is bad because I love watching TV. It is mindless. It helps me decompress.
If I do I put the TV on, I am asleep in about 10 minutes. I think I am getting old.
Okay I have a couple of short stories that I will turn into a blog.
One is about a patient.
Nice guy about 70 years old.
I did a bunch of restorative to the tune of $1000.
Then he is missing his posterior teeth on the lower. I went through all his options, and he decided implants were not for him.
I told him that I am not a big fan of the traditional removable partials. #1 because I don't do a lot of them. #2 is because I am an aesthetic guy and I don't like putting in clasps where you can see them. I told him that people say they don't mind and when they get them they wish they didn't make that decision. (Now I don't want all the removable guys ticked at me, that's just how I feel. Partials are fine.)
He said he wanted one so I told him I would come to a compromise with him. I decided to do a cast Valplast partial. So we would make a framework and the teeth and clasps would be in Valplast.
So I made the partial. Well it was easy to say, but not easy to do. I sent the framework back because I was not happy with the fit. So this first step took a long time and a lot of visits.
I finally was comfortable with the framework. We did the framework try in and bite registration. Then we did the wax-up and the processing.
We delivered the RPD. I was thrilled. He didn't like it. I adjusted it and he said he would try it.
He came back in two days and said, "this is not going to work."
Hmmm. Well let me do some adjusting. I am sure I can make this fit good and make you happy.
I can't remember but I think he let me adjust it and came back the next day.
He said, "This is not going to work."
I was a little disappointed in the lab and the way that they did the partial. I don't do these very often, but I can tell sloppy work when I see it.
Maybe, just maybe I said out loud, "I hate this lab and this is for sure the last time I am working with them." (I know this is a big no no but what can I say, I did it.)
He suggested, "why don't we try a different lab?"
Okay, I was thinking to myself, "He is not completely pissed, he is willing to do what it takes to do this."
I said, "Okay, let's do that"
I spoke to the new lab man and told him my dilemma. He was willing to take this case on.
We used the same metal framework. We decided to scrap the Valplast because it is hard to adjust. Quite frankly, I was thinking I just wanted it to be comfortable for this man. I started to lower my expectations because I just wanted him to be happy...not me.
I went through the next five steps again. I pulled the framework in a impression. Bite registration. Wax-rim. Teeth wax try-in. Then another wax try-in to make the occlusion perfect. The processed teeth came back, and I was thrilled when I put them in. The second process went so much smoother.
One problem. He wasn't happy. You know the kind that is shaking his head the second you put it in. Kind of like last time, it was the "this isn't going to work" shake.
I told him that sometime partials don't feel perfect the first time you put them in. I did some adjustments and he said, "Well I guess I will try them."
The next day or the day after he called and asked to "speak to me".
I was think to myself, "Son of a #$%!@*, you have got to be kidding me."
So we sat down and talked. I look over and he has the teeth in a ziplock in his shirt pocket. Now for you non-dental people...this ain't good.
He said, "This thing is not going to work."
Now I am a The Customer Is Always Right kind of guy. I take the posture of I will do whatever it takes to make this work even though I have done most of it already.
I told him that usually it takes time to get use to something foreign in your mouth, and I didn't think he was giving it time to work. If he does wear it, then we adjust it and he gives it another chance.
He was convinced he gave it enough time.
I told him that I am willing to do whatever it takes.
I asked him if he didn't mind me sending him over to my dad (down the hall) and see if my dad could see something I didn't see. He said, "No, he wasn't interested in that."
I said that I could refer him to a prosthodontists and see if he could make this thing work. He said he wasn't interested in that.
I said, well then if you want to get teeth in the back and you want to go away from the partial you can get two implants and I will give you the $1700 credit toward the abutments and crowns.
No he wasn't interested in this.
He said, "I don't want anything. I like you. I like your office. I want my wife to come here. I just don't want this partial and I want my money back."
Now usually this would be no problem. But what are we talking about here. I have probably seen him, and I am not exaggerating, 15 times.
I have paid the labs (between the two of them) $721.50.
So it is not as easy as giving him his money back. I told him this and I told him that I wanted to think about it and I would call him.
I thought about it and I thought about it. I wanted to give this guy his money back and rid myself of him, but I couldn't get passed all the work I did all the money I paid and how this guy was impossible.
So I called him and I told him that I was willing to give him back all his money minus my lab bill.
So I told him I would give him back almost a $1000.
He said, "What?" he goes on to say, "I am sitting here looking at a $2700 credit card bill and you're only going to give me back a $1000?"
Well of course I said, "Well let's not forget that you had a New Patient Exam with X-rays and you have 5 new beautiful fillings."
A couple of times as I was trying to explain how much I have spent on this. Time and money. And he would even go on to say, "Yes, I recognize how hard you worked and how you really tried and were doing everything you could and you have to be paid for your work."
But something was not computing in his mind.
He went on to say, "Someone is getting screwed here."
I could feel the steam building up in my head.
Remember I am still The Customer is Always Right kind of guy.
So I told him, "I am starting to hear a theme here. You were not happy with the first partial, you were not happy with the second partial, you are not happy with me giving you your money back. I am starting to think that it doesn't matter what I do for you, you are not going to be happy."
Then he is like, "No, no, no. I am not that kind of person."
Uh, well, yes you are.
Then he says, "Just send me the money and that will be that."
I said, "Okay."
Well, I guess he had time to think about it. So he called me back.
He started again with the, "I have a $2700 credit card bill to pay and you are only giving me back $1000."
Calgon take me away.
What the hell can I do for this guy?
I can hear his wife talking to him in the background. And we are going round and round.
We were getting ready to hang up and I could still hear his wife. So I said does your wife want to say anything, he said "she is saying something about getting a lawyer but just send me the money" and we hang up.
Oh, I was having such a good day.

Next story,
I was in Atlanta last Saturday. In the FanFare event before the SEC championship game there was tables set up for a silent auction. Now to me silent auctions are ALL for charity. The tables were filled with autographed memorabilia. I got all excited. I am a sucker for charities, and I am a sucker for autographed Gator stuff.
I went straight up to a Percy Harvin jersey and put a bid on it.
As I was leaving the table I asked the attendant what charity the money was going to. He said this is not for charity.
So they are having a silent auction to benefit the memorabilia company. Are you kidding me?
So I was walking away and I was thinking of erasing my name but I realized that I was the first bidder and what are the chances that I would be the only bidder. There was still half a day and someone is bound to out bid me.
Well I get the call yesterday saying I won the damn thing.
I had to break it to the guy that I would have been happy to pay but I thought it was going to a charity. I would be happy to buy it if he was willing to work with me on the price.
I told him I would have to bring all my son's x-mas presents back if I was going to buy him this jersey. He said he was not willing to budge on the price. I said, "Thanks, but no thanks."

Last one,
I want to get my wife a David Yurman bracelet for Christmas. "Want" being the operative word. I have been looking. So I went on e-bay yesterday. The first item was a bracelet for $50 and it was up in 45 minutes.
Wow, so I put my bid in for $55, what the heck. Now this bracelet would probably retail for about $600. So of course I thought the price would go from $55 to $555 in the last 10 minutes.
Just in case I e-mailed the seller. I asked if the bracelet is real.
I had a patient and when I came back to my computer, she had written me back and said it WASN'T. Only one problem...the auction was over and I had WON.
So I am pissed.
I now have a bracelet that I don't want.
Let's go back. I got to ebay. I type in David Yurman bracelet and this is the first item up.
After this is all over I look at the title of her item and it was this...
David Yurman .05 perfume with a free gift of a bracelet.
So she was selling the perfume and giving the "knock off" bracelet as a free gift.
It was a total con.
I wrote here and told her my story. I told her I was looking for a bracelet and I had no idea it was not real. I felt a little mislead by the whole process.
I told her I didn't want it but realize I am obligated to buy it but do I have any recourse.
She wrote me back and was very very kind.

Hi There,
I completely understand and I'm sorry about the confusion. There are a lot of people out there who can't afford the real thing so I give them a chance to own a similar item for way less. I would never think of tricking a buyer, that is why I put in my listing that the free item is not a David Yurman. I will retract your bid and all will be fine. Thanks again,

My faith in people restored. I wrote her back telling her I applauded her integrity and I appreciated her letting me off the hook.
What a week.
I hope yours was better.

Tuesday, December 8, 2009

Designs for Vision

Hey all,
Before I say a word I wanted to have a shout out to Dr. Ric for Monday's blog. Just awesome. The economy is real and is affecting a lot of dentists. I spoke to my Patterson rep and he talked about having to put a "hold" on seven of his dentists (meaning he is not allowed to sell them products anymore because they are so behind on their bill).Now he wasn't saying it like his profits are being cut, he was saying it like, "Oh, my gosh how bad does it have to be for these dentists if they can't pay the supply bill."
I appreciate Dr. Ric's transparency, and I hope you all liked it as much as I did. Great job Ric.
Finally I can talk about it. Gator football.
I know you all thought of me this weekend as the Gators were getting there asses handed to them. You were either all saying, "Oh my gosh, John is there, and he spent all this money and time and effort go and see the Gators play and man are they getting killed."
Or you might have said, "Ha, finally someone beat the Gators. Thank goodness I won't have to hear ESPN and John talking about them anymore, and I won't have to hear Tebow this and Gator that for at least 6 more months."
Either way I appreciate you thinking of me.
Well if you do care, I had a pretty good time in Atlanta. We went back to our favorite bar with the beer taps on the tables (Hello friend. Where have you been all my life?"). But really when you lose that night, the ride back is a bit of a drag.
We had a great run and you really can't be that upset.
Talking about being upset, there were two Gators in my section that almost came to blows twice during the game. When you mix alcohol and testosterone and a good butt whoop'n someone is bound to want to punch someone else (regardless of what team they root for).
It rained like crazy here in central Florida so the flag football games I was going to miss were rescheduled. So this week between the two teams I coach I have six games in 6 days.
Game tonight, Thursday, Friday, two games on Saturday, and the last game is on Monday.
Are you kidding me?
I wanted to talk about loupes.
In dental school I got this awesome deal on loupes. I bought the Designs for Vision 2.5.
I looked like Elvis Costello, but I could see like I have never seen before. And if you knew what kind of student I was you realized that I needed all the help I could get.
Before I go anywhere else I want to say that I am a big backer of loupes (or all types of magnification). I think they make people better dentists, and I think that if you don't have loupes you need to look at yourself in the mirror. Do you want to be the best dentist for your patients? If the answer is YES, then you need to get loupes.
I had those 2.5 for about 8 years. About 7 years ago I thought it was time to jump up in magnification, I think at my dad's pushing.
I was concerned about the decrease in field. But I made the jump to 3.5.
I have tried to go back to the 2.5 for a procedure or two, and it is like looking in the wrong end of binoculars, things are so small.
So last month I am finishing up a routine exam and I was taking my loupes off to just rap with the patient and they broke.
Mayday, mayday, we have broken loupes in room four.
The whole office stops what they are doing to help me because this is a major thing.
Because I have been using loupes for so long I just cannot work without them.
I occasionally try to do an exam on someone without my loupes, and I have to get so close to them to try to see it gets uncomfortable. "Can you please open more I need to just climb into your mouth so I can see?"
So we all realize how I rely on these things and they broke.
See the frame and the earpiece came apart. They are pretty well built and there is a cool piston on the earpiece so you can bring the earpieces out to get them around the ears when you take them off.
So you have a $1600 pair of glasses hanging on these pistons.
I tried not to panic. I have a patient in my chair.
I bust out my resin cement and put the piston back together. I put this fire out pretty quick.
I started to think about what I am going to do.
I called the company and told them that I needed my glasses repaired.
I told her the problem. She said it was my lucky day and that the frames had a lifetime warranty. See all the pistons and arms and everything were covered. So all the repairs will be free.
I said, "Awesome, so I am going to send them in."
"No problem," she said, "It will take about 7-10 business days"
"No, I don't think you understand. I use these glasses every day. I need you to rush the repair and get them back to me as soon as possible.
"Oh", she said, "in that case it will be 7-10 business days."
You see, everyone who wears these glasses is important. Surgeons, dentists, periodontists, urologists, OBGYNs, etc. Everyone who owns these glasses makes a lot of money.
There is no such thing as a rush order.
Okay so you have a product that is totally backed by the company but it doesn't do you any good because they can't repair anything fast.
So I was thinking to myself, I am going to have to go on a two week vacation before I have these things fixed. (Oh, that is going to happen real soon I would imagine...NOT).
In the meantime, I will just live with my self-repair for awhile. Just as I was thinking this the other side of the glasses broke. The other ear piece broke off the piston. This time the resin cement didn't hold. We tried it again. No luck.
So I did what any desperate person would do and cemented the pieces together with Superglue.
Don't we all laugh at our patients that Superglue their teeth together. Well I am sure the glasses people will laugh at my redneck butt when they get the glasses.
What was I suppose to do?
So I called my Design for Vision rep. She said she could send me a loaner pair.
Sounds like a good idea right?
Well the problem with that is that each pair of glasses is fitted to the individual. So the ones they will send me will be close but I wouldn't be able to see that great with them.
Does not sound like a good alternative?
So my choice is to work without them, use my 2.5's that are also glued together, or use a loaner pair, or go on vacation long enough to get these things repaired. Or the last choice was to buy a new pair.
I started to think about it. I need these glasses more than anything else in this office. If my suction wasn't working, would I think about doing anything else but fix it or replace it PERIOD. There would be no discussion.
I need them. My thought process was that if I have two pair I would never have to worry about them again. I would never have this decision to make again.
I would never have to think about vacations and glasses repair. I would never have to Superglue my eyewear ever again.
But factoring into this problem is that they are $1600. No the decimal point is not in the wrong place. Did I tell you that I am tighter than two coats of paint?
I kept saying to myself as I was dialing the reps number, "This is the best thing to do, this is the best thing for your patients, this is the right thing to do. I would like to order another pair of loupes please, this is the best thing to do. I know how much they are please just take my credit card number fast, this is the best thing for my patients, yes I know that it will take 3 to 4 weeks to have made, this is the right thing to do. Thank you, good bye."
Once you have loupes they have you by the you know whats. They should call you a month after you get your first pair and tell you that they will give you a discount on a second pair.
Because when these things break, full warranty or not, you are in big trouble.
As I sit here, it has been three weeks since I ordered my second pair. The Superglue is working like a charm (you have never seen a man be more gentle with anything in your life). And every day I tell myself, "It was the only thing you could have done."
Thank you sir can I have another.
Have a great Wednesday,

Monday, December 7, 2009

Jeremiah 29:11

Hello depression, welcome back.

I swear I wasn't like this before starting my business 3 1/2 years ago, and I have never been diagnosed so I don't mean to offend anyone with diagnosed depression ("what's the deal with cancer").

However, the voices are back.

Not the fun happy sarcastic voices.

The "YOU SUCK" voices.

Ever get those? Ever have one of those weeks where you are just worn down? One of those weeks where you are a walking panic attack. An actor who walks around the office smiling but has to hurry back to the privacy of my private office before the true emotions come through. A week where you know you have snapped at your kids and wife when they didn't deserve it. A week where you had unfounded, random fears of being diagnosed with cancer or having a family member die (yeah, I have those voices a lot). Then to cap it all off you hit a weekend where instead of relaxing and recharging you spend 6 hours rebuilding a hard drive in one of your operatory computers (can't wait to get that bill) and then spend Saturday seeing a patient in severe post-frenectomy/extraction pain who can't wear his new denture because of the inflammation.

I don't even know where to begin so if this is stream-of-consciousness and you don't like it - fine, skip to Wednesday. I'm lying on the couch now, ready for the healing to begin.

November was one of the worst collections months in the brief history of this office. It was a month where I am still juggling bills so that everything clears on time. It was a month where you realize that there is no such thing as a "profit margin" in a dental practice with the start-up costs we have. It was one of those months where I felt like Bernie Madoff - is this really a successful business or simply a fancy maxillo-mandibular-ponzi scheme.

It was one of those months where I had to expend all my energy juggling bills and fighting the pressure to "diagnose to help the bottom line". I don't know the technical term, but I don't think non-dentists can appreciate that pressure. Is it only me?? I am extremely conservative on my diagnosis. If a practice manager came in I'm sure the 1st thing they would say is to cut 2 staff members and the 2nd thing they would say is to start diagnosing more crowns. BUT I WILL NOT COMPROMISE, I WILL NOT SETTLE, I WILL NOT STOP FIGHTING. I hate the pressure of having a stack of bills on my desk and still diagnosing as if I am Bill Gates. I don't like leaving an operatory frustrated because the tooth isn't cracked a little more to justify a crown.

It is the holidays, I want to be generous and happy. I love giving things to people - that is my gift and my curse (thanks granddad). I employ a single mom, a young woman putting herself through college, and 2 new moms (one of whom's husband recently lost his job). I have a responsibility to these people. They have each worked so hard this year, and we are growing but there is just nothing extra. How do you do Christmas bonuses?? I am not going to be able to do much and that just bugs me.

There is an analogy that I use all the time in situations like this. If you enter a strange room and the second after you enter the room all the lights go out, if you continue moving across the room your mind will retain the brief image of the furniture in the room and you can navigate across the room without hitting anything. If, however, you stop, you lose that image and it is more difficult to make it across the room. I can self-diagnose and give myself that advice. It seems dark now but remember your vision, just keep moving forward, stay the course. I know we are doing fine (Mr. Banker if you are reading this - believe me, we are doing fine - promise). That said, it is a hell of a lot easier to cross the room with a freaking light on.

Well, I can't put it off any longer. I have to go through the stack of mail on my desk and start figuring out what bills to pay. Time to put on the iTunes and just do it. Hopefully next week will bring back some of the mania that everyone enjoys so much more.

Have a good week,


Friday, December 4, 2009


Hey all,

I haven't done a thing this week. I have had 3 flag football games this week. I haven't even watched TV. I am too tired to read, so nothing.
All my flag football teams are getting rolled on. The first grade boys are kind of having a hard time focusing (imagine that). We have practice one day, and all we do at practice is this ONE play. Then the very next day, at the game, we go to run this play and half the kids are looking up in the sky doing pirouettes and the other half has no idea where to go. One kid starting running the wrong way with the ball.
My fifth grade team is going pretty good. I think most of the kids are having a good time. We played an undefeated team yesterday, and I think we held our own pretty good. We were down 18-7 at halftime and on the last play before halftime it was our guy running all by himself and somehow got caught from behind. That was a game changer. We lost 38-7, but it was much closer. They scored two quick ones at the end.
Well the other coach got the "why isn't my kid playing" speech from one of the parents this week. It is so difficult coaching. You have to try to manage the game. You try to put kids in a position in which they can succeed. You tell everyone their pass patterns, and at the end of the game you get three kids coming up to you and telling you they didn't catch the ball today.
We played a team last week that practically gave it to the same kid almost every play. It's tough... and you are wondering why I can't sleep.

I am not going to tell you that I am leaving today to HOT-LANTA to watch the team I am not talking about in the SEC Championship game. And that is all I am not going to say about that.


I am a watch guy. I look at everyone's watches. I don't know what is about watches. I know some people are shoe people. My wife, she is a ring person.
Are we all like this in some way? Is there something you check out on people? Shirts, necklaces...tell me your thing, it's anonymous.
Anyway, I look at everyone's watches, and really I don't know much about watches. I recognize a nice watch, but to be honest with you I wouldn't know if it was $15 or $15,000.
Okay, I will be honest with you, I look for Rolexes. I don't know why. I heard one time by someone, "They make a statement," and I think this is true for me. For me, I think watches tell me volumes about people. I just know they are easy to spot, at least for me.
That being said, I am not much of a watch guy myself. But I have been. My father had a Rolex, when I was in high school, that I have always liked. So when I got out of dental school I wanted a nice watch. I was hoping he would give it to me, but that was not going to happen.
But one Christmas, my wife bought the watch from my father and gave it to me. I think I was 31 years old. I was thrilled.
About a month after the gift giving I went to change the date and the stem pulled right out of the thing-a-ma-jig that turns the hands.
Usually if you have a watch that breaks you throw it away. This watch is too expensive to just throw away. So I had to find a jeweler that is a Rolex certified guy. Well you know what I found out about Rolexes...they have to be serviced.
Yeah, they recommend that every year you get the watch tuned-up. So 10 years ago I paid my father $1000 for a 15-year-old watch. Then I had to have the thing serviced and put the stem back in the thing-a-ma-jig for the low low price of $650.
Isn't it great to have a Rolex?
I told you they make a statement.
So after a couple of years of having this thing (no, I never did service it again. Did I ever tell you about how cheap I am?) I didn't like the watch.
No, I said that wrong. I loved the watch. I didn't like who I was when I was wearing it. It made me feel like I was somebody.
So when I went out I would want people to see it. I found myself pulling up my sleeve so people could see it. "Does anyone need to know what time it is? No, well let me tell you anyway." I wanted for people to see the statement that I was trying to YELL.
When I am at work it was the total opposite. I didn't really want people to see it. I would be bringing someone up to the front, while saying goodbye and filling out the router (this is the form that I use to tell my front desk personnel how much the procedure is going to cost) and I know the person is really going to struggle to pay my bill. I know they have a bunch of kids that come here and they are just scrapping by to be able to afford my dentistry. Meanwhile, I am rolling around in my phat watch.
So there is a lot going on in my head when I wear this stupid watch.
First and foremost, the money doesn't make any sense. I mean who in their right mind is going to have a watch serviced for $400. I could buy 8 Timex running watches for the same price as the SERVICE on this watch. It made me feel more special than I deserve. I mean, if I need a watch to fit in or feel a certain way, well...I know, I totally need therapy.
And I didn't want my patients to feel like they are paying my high prices just to fund my luxury.
The reason why I am bringing this up today is there has been an episode that I want to tell you about. I want to wear a watch again. I use my cell phone to tell me what time it is and I hate it. I have to go in my pocket and pull the thing out to tell me what time it is. It is too much effort.
So I wanted to pull the Rolex out again. It is the only watch I have.
I stopped wearing it about 5 years ago because of all the stuff above and because the band was breaking. Turns out the band is silver and gold. Well as you know the gold on the band is soft.
And as I told you the watch is about 20 years old. The gold links have stretched out and they are starting to break. I have had them soldered and soldered and now I think I just need to have the band replaced.
I took the watch out of the jewelry box and sent it to the guy I have work on my watch.
He calls me and tells me that I indeed needed a new band and they cost...wait for it.....$1800.
He then goes on to tell me that they make off-market Rolex bands that will look just like a Rolex band and they are much cheaper. I was still having a hard time focusing after the above mentioned price so I asked him what the off-market bands cost. Just $850.
Now this is just plain ridiculous. We are talking about a 20-year-old watch. I just want to wear a watch.
"Or" he said, "I can repair the broken link for $50."
"DONE, now you are talking my language"
How do you think a gold Rolex with a black face with diamonds on every number would look with one of those Velcro bands on it? Trust me I thought of it.
I think spending that kind of money in any economy is foolish. I think maybe when my kids are gone and I have money to just blow I might pull the old Rolex out and buy a new band (in 15 years what do you think the price of gold will be? The band might cost $5000 by then) but for now I think it is back in the jewelry box again. I think for now in this stage of my life, the Timex Triathlon is looking real good.
Have a great weekend.
Hey does anyone have the time?

p.s., if anyone has a old Rolex band sitting around and wants to sell their favorite blogger a band...I thought I might as well check.

Tuesday, December 1, 2009

That First Phone Call


Hope you all had a Happy Thanksgiving.

Mine was great. We decided not to have it at our house because it was too much of a burden on my wife being that the baby is only eight weeks old (and very needy I might add).

So my sister volunteered.

Her house is not quite big enough for everyone so we did it outside.

It was great. The weather was perfect. Food was great. Company was great.

We finished dinner, and we all went into the living room and watched Willy Wonka and the Chocolate Factory (the old version). It was a great movie to just veg out on the couch.

I got in a little nap. The kids loved it.

The Gator Basketball team (I am not talking about the other Gator team) beat #2 Michigan State on Friday night and then beat Rutgers on Saturday. So we moved into the rankings yesterday at #13. We play #5 Syracuse next Thursday. I'll let you know how it goes.
About the other team that I am not talking about, if I was talking about them I would tell you that I just got my tickets to their SEC championship game on Saturday.

I just finished a book called Crazy Love by Francis Chen. It was recommended to me by a friend (shout out Ethan). It is one of these books that makes you think about life a lot and how we probably should be doing this a little bit better (or in my case, a lot better).

See this is why I don't read these kinds of books. Ignorance is so bliss.

I like to read about how other people are screwed up so it makes me feel a little less screwed up.

This book looked at me and I didn't like it.

I just started Counterfeit Gods by Tim Keller. I will let you know.

Okay about the marathon. I have put off talking about it for as long as I could.

This race was called the Space Coast Half and Full Marathon.

So this was my first half and full marathon together.

It is a small venue. The weather was perfect.

I wanted to run a sub 4 hour marathon.

So my running buddy and I decided to start with the 3:50 guy and see how long we could hang with him.

Bang it started, and we started going and we were going fast.

I was first thinking that people are running fast because it was the beginning of the race and they will settle down.

Well it didn't take me long to realize that this was the 3:50 pace.


It took me about 2 miles to realize that I couldn't keep this pace. About mile 5 we took our first walk break for about 30 seconds. Keep in mind that we train in a way that there are drinks every two miles. We stop and get drinks and then go. Sometimes waiting for everyone to get drinks will take about 2-3 minutes.

Mile 8 I was really struggling. Mile 11 I told my friend to go.

This is where my mind started to go. The 4 hour guys started to pass me. I didn't have a watch or an iPod or anything. I was all by myself and struggling.

I could have sworn I saw the 4:30 group pass me. Now I was pissed, and I was annoyed with myself.

I thought now, if I go on, I am going to come in at 5 hours. I was walking at every mile, sometimes twice a mile.

Then I started seeing the 13 mile signs.

I started to think I could just finish now. Now the sign was getting bigger. Half marathon go this way and full marathon go this way. Hmmmm? This is definitely not my day so why don't I just end the torture now? If I run the full marathon and it takes me 5 fricking hours, my friend, who I drove with, would be sitting around for an hour waiting for me.

I went to the half marathon path.

I finished in 2 hours and 1 minute.

Wait a minute, how then did a person with a 4:30 minute sign pass me? Either she was 30 minutes faster than her group or I was delirious and read her sign wrong.

Anyway I was done. I was so disappointed. I don't know what to think.

I guess I will be back at it next week. Maybe I will catch a later marathon and give it another try.

Next time I won't blow it in the first 5 miles.

I am still kind of depressed about it.


I wanted to talk to you about the phone call. In case you missed the first blog about this call, let me refresh your memory. Well because I am running out of time in the day let me just give you a link to the first blog.

This is something you have to talk to your phone call answering people about.

I know sometimes you go in your office and isolate yourself from the phone calls. You isolate yourself from the collecting money. You isolate yourself from conflict up at the front.

Well at least I tend to be this person.

So, because I know I tend to NOT want to get involved, I force myself.

I schedule meetings with my front desk staff once a month. It may be 20 minutes on the first of the month first thing in the morning.

We talk about procedure, we talk about patients, we talk about how they answer the phone. (I do the same thing with my hygienists. To talk about things like toothbrushes, fluoride, how they are handling certain patients, sealants, you know stuff like this). Constantly opening the lines of communication.

So in our front desk people meeting we talk about this conversation.

I ask them if they get this phone call and of course their answer is "all the time," and we talk about what they presently say.

Well this is what I tell them to try to accomplish on this phone call.

I want them to know the difference between our office and other offices. I want them to talk to this potential patient about the good in a new patient exam. I want them to spend time, for lack of a better phrase, getting to know this person on the phone. I want them to hang up the phone and say to themselves that that was an unbelievable phone call. That person was so awesome on the phone.

Now does this mean that everyone is going to want our type of dentistry? NO. You think that you are setting yourself up for so much failure. BUT, what it might do to that person is plant a seed for that kind of dentistry. They may go to another place and not get treated very well. They may go to a place that they feel like a number. They may go to a place that makes them start second guessing their decision. So when they do second guess themselves and they get tired of feeling like cattle, what do you think is the first place they are going to come back to? Hopefully, the office that treated them the way they wanted to be treated.

Now real quick about the CEO that has his/her administrative assistant call...

A couple of reasons why they have their people call, they don't really understand the type of office we are or they don't know what kind of dentistry they need. So you have to first get this person on the phone. If they don't want to come to the phone, well then you are better off not seeing this one. If they come to the phone there you are right back to the above paragraphs.

How do you get the person to realize they are calling the Ritz-Carlton of dental offices. I am not talking about stick your nose up Ritz-Carlton. I am talking about the five-star service Ritz-Carlton. And if the person is a CEO or some high-flooten job like that it shouldn't take them long to figure out this place is special.

We had our meeting today and one of my people said a couple of times she has had to say on the first conversation, "I am sorry Mr. Jones, maybe this is just not the kind of practice you are looking for."

I don't mind this. Trust me it is better to let people know up front. I have plenty of patients that I wish I would have told them this before the first appointment. (If you are my patient and you are reading this...that last sentence was definitely NOT about you).

Am I making sense? Am I rambling?

I would like to know if you have meetings with your staff. Do you have a full staff meeting and then have separate meetings as well?

Do you isolate yourself?

Do you know you should get involved but let your staff do it (trust me you are not alone)?

Let me know,
Have a great Wednesday,



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