Friday, April 30, 2010

I have this specimen

I have two words for you.....Fri and Day.

Hope you have had a good week.
Things going okay here.

My son Noah had another beauty yesterday. My wife had her best friend from high school and her family over to the house yesterday. She has two kids. Her son is 4 and her daughter is 2.
Her and her family are from Miami, and, for now, their first language is Spanish. So the boy is bilingual, but it is apparent that he struggles more with English.
So we are all outside, and I am throwing the football with Noah (6 years old). And I start talking to Paulo but either he doesn't know I am talking to him or he doesn't understand what I am saying. So Noah says, "Dad, he is half-deaf."
I said, "What?!!!"
And he says, "Yeah, I think he is half-deaf because I have been standing real close to him and talking and he doesn't do what I am telling him to do."
So Noah is saying this to me and Paulo is standing about 2 feet from him, and he is serious as a heart attack. He has fully deduced that if he doesn't do what Noah is saying or turn when he is talking to him that he is "half-deaf".
I have to try to not full-on barrel laugh right in front of him and try to explain to him that Paulo just probably doesn't understand what he is saying.
Oh my Gosh, when I told Hilda and her friend, we laughed so hard. That Noah.....hilarious.

I had a funny/awkward thing happen to me this week that I thought I would talk about because I can always bring funny/awkward stuff back to what we do at our offices.

Remember my vasectomy story. Well if you didn't, here is the link.... , instant classic. And it would have been worse if I now didn't have an editing department telling me "You can't say that."
I believe in being real. But I digress.

After the vasectomy blog was the "post-op" blog in which I told you that they wanted me to bring in, let's call them "progress samples", #21 and #30. They give me two sample jars and said see you soon. Easy right?
Seemed fine at the time. But this week was somewhere around #21. Actually I lost count, and I didn't tell them. I found it hard to mark on the calendar every time me and my wife...well you know.
So anyway, I am not going to tell how challenging (and fairly anti-climactic) it was to get the sample in the jar. (I told you I believe in being real, and I told you that the editing people believe in editing). But this isn't the funny/awkward part of the story.

Now, they tell you to just put it in a bag and bring it in, "The people up at the front know what to do."
So here I am with my sample in a brown bag, and I am going to bring this in. I park and walk up to the front door. Now this urology office is big - 14 urologists. So the reception area is real big. I walk in the door and there are at least 10 people at this desk. I am not talking about staff, no I am talking about patients and the people with them.
I wait my turn and the nice young lady (about 24 or so) asks if she can help me.
I said, "Yes, I have a sample to give you."
Now, you realize I am trying to make this as not weird as possible. I am saying to myself, "We are all adults here. They do this all the time. It is not weird for them so why would it be weird for me. So walk right up and talk normal."
So she proceeds to say (it kind of seemed that she yelled), "Is it urine or semen?"
Did she just ask me, out loud, in front of all these people if I have urine or semen in this bag?
Again I say to myself, "This is very normal, everyone does it."
I say, as calm as possible, in a much softer tone than she used, "semen".
Now, I hope all of you reading this are thinking....AWKWARD?
I am flat out dying in that room. I don't look around, but I am sure everyone has just taken one step away from me.
I give her the sample and fill out the paper work and walk out shaking my head. Thinking, does everything at this office have to be like that?

So I started thinking. Do we do this at our office?
Do we do something everyday and lose the fact that it could be weird for our patients?
Do we make people say what is hurting them at the front desk or in the reception area where it could be weird?
I mean this lady at the front could have found out my name, punched it in the computer, and realized I had a vasectomy about three months ago and could have figured out what was in the jar.
I guess, also, she could have taken the bag, look in it and figured out real quick what the sample was.
She could have said something like, "Is this a sample after a vasectomy?"
I would have said, "Yes", and she would have known what it was.

Do people drop off their denture to be repaired in the front or do we take them discreetly to the back? Or do we say out loud, "We will call you when your denture comes back from the lab."
And they leave shaking their head saying to themselves, "Does it always have to be weird at that place."
I think where I fail is when I am talking to a parent. They have a teenager so they don't come back with them when they come back to get their teeth cleaned. I go out to where they are sitting, in the reception area, and talk to them about their kids. Sometimes it is, "They look great, they need to see an orthodontist" or it could be "your kid is just not brushing his teeth, and he has five cavities".
I try hard to put myself in my patient's shoes. Some of them don't care, and I try to read them as we start to talk. If I feel like they are uncomfortable talking out in the open, I will bring them in the back.
But you never know, they could be saying to themselves, "Act normal, they are talking like it is normal so let's try for this not to be awkward."

Is your staff doing the same thing? Are they respecting people's privacy up there?
Or are they saying or even YELLING, "Urine or semen"?

Do a little looking in the mirror this week. Remember that it is always a good thing to make you and your office staff better. Let's start there.

Have a great weekend.

I am halfway through my first book on my Amazon Kindle. The book is called Water for Elephants. I have to tell you that it is weird reading from the Kindle but I think I will get use to it.
One thing that I always do is I forget who the characters are. So I flip back and find out who this person is. This is hard to do with the Kindle. There is a way of making I might do this with the next book.

Tuesday, April 27, 2010

Perfection, Well Almost

Hey all,

We all have demons, some of us more than others (i.e., Dr. Crowder), but we all have them.
And mine is perfection.

I think I strive for perfection in everything. So much so that I am not so fun to be around sometimes.
"Honey, yeah the kitchen looks clean, but I think the counters could have a little less smootz on them."
"Kids, I said, clean your room and yes, your drawers are part of your room aren't they?"
Can you see how fun I can be sometimes? A real ball of joy.
I put this s#!@$t on myself, too.
I have this thing about the lawn. I am not happy unless the edge is a perfect line.
And with the pool. If there is one leaf at the bottom I get kind of uneasy.
But when the lawn is edged and when the pool is spotless, I can't wait to come home and see the fruits of my labor.
I have this weird feeling of peace when I see that edge. I get that same peace when I see the counters shiny clean and when I go to put my kid's clean, folded clothes away and their drawers are in order.

And this genetic disorder carries over to my dentistry. I think it is a product of a lot of different things.
First and foremost, it is in my genes. I think my father was highly critical, and it kind of made me try to work harder for his approval (We can blame our parents for everything can't we? Now everyone that hates this about me...don't look at me. Look at my dad.)
Okay, along with all the baggage I bring from my childhood, I go see these gurus and their work is as close to prefect as you can get.

So put these two things together, and it is a deadly combination.
I finished two big cases last week, and you would have thought someone had shot my dog.
I walked around here moping, and I went home moping.
Let me tell you about these cases.
One was my assistant's brother. He lives in Maryland and has had a partial for most of his adult life (about 40 years). He realized that things were not going so well because the teeth that he had were starting to move.
She convinced him to come down and have us take a look.
Well the next thing you know, he is getting four implants. After the four implants were integrated, we were able to take out his partial and remaining teeth and make him a round house temp.
Then for the other upper four implants he needed bone augmentation and sinus lifts on the top.
I will save you the details, but about 14 months after we started, we began the impressions for 3x4 unit bridges on the top and a 5 unit bridge (unit is what we call one tooth) on the lower.
Last week is when we finished the case.
The case was sensational.

He was thrilled beyond belief. I have to tell you that he went through some major stuff and he told my assistant how this week made it all worth it.
And, oh yeah, it was over $50,000. And to hear him say that is was worth it is like music to my ears.
Then why do I feel like I am walking around with a splinter in my foot.
I haven't stopped thinking about that one margin that I thought could be better.
See I don't know if one of the bridges sat down all the way.
It is one of things that has so much going on. When I tried them in, they were tight. A good tight.
I cemented them in with Temporary cement and after all the cement was taken away, you see that this one was a bit shy. The weird thing was the incisal edges lined up.
Then we went to try in the lower bridge and the occlusion was way off.

I sent it back.
When he returned the bite was totally better, but instead of five points of contact there were four.
Since he didn't live here, every time I had to send this thing back to the lab made for another night or two in a hotel.
All this is weighing on me, and it is heavy.
I cemented it in.
Now don't even get me started on the exposed implant on the upper left, and I know he is going to come back to finish the lower left and do his lower anterior but....
I still feel like I am walking with a limp.

The next case.
This guy has never been one to clean his teeth.
He has never been one to come to the dentist regularly either.
But one day he came in, on an emergency (what a surprise), and he had broken #9 (upper front tooth) 2/3rds down the root.
It needed to come out. So this was going to force his hand a bit. He was going to have to do something major.
He said I have $10,000, what can I do?
Oh, before I forget, he has 22-27 on the lower, and he wants a partial for the lower, #22 and #27 were decayed to the gum line.
I agonized over it for a week or two, and this is what we decided.
We were going to do a temporary bridge from 3-14 on the top. I had Glidewell temps made and told him that it would last until he could come up with the funds to finish off the top.
Then we were going to make him caps/ERA on #22 and #27, cement them and then make a precision partial for the bottom.

I prepped the top all in one day. Cemented the upper temps and scheduled to start the bottom.
When he returned in two weeks for the bottom, it looked like he hadn't brushed since we put them in.
To back up, I really laid it on hard how important home care was to the success of the treatment.
I told him that plaque will make this thing fail.
We went ahead and prepped the lower and it was definitely not the most ideal, and I explained this to him.
One the try-in of the crown/ERA, it seems that the temps had come off, and he decided it didn't matter and he didn't come in to have them put back on.
There was plaque all over the already weak teeth.
Do you ever have this patient?
Last week I cemented in the crown/ERAs, and it was a mess. The tissue was so unhealthy. I am mad at myself for his lack of homecare. I continue to reiterate the need for good home care (like a broken record). The crowns went in and the partial went in so smoothly....except for all the blood and stuff.
But the turned out so nice. You know the kind when even the pink acrylic on the partial matches the color of his tissue where you can't see it.

This was one week post-cementation. Please note the crap around the crown/ERAs.

But you know I can't stop thinking about how this guy still, after all we have done, doesn't care about his teeth.
So most of us would say, "I did everything I could for this guy." I talked to him til I was blue in the face about home care. But somehow I take his lack of concern to be my problem.
I blame my father.

This job is tough. There is no doubt about it. I spend 10 years of my career trying to get these kinds of patients. They finally are starting to seek me out, and now I don't know if I can handle it.
And then when you do feel great about it. You feel like the esthetics are good and the occlusion is good. You worry about the case breaking or failing.
So every time you see this patient for a cleaning, you mumbling to yourself, "please don't find decay, please don't find decay."

I have reserved my room at the funny farm in about 10 years. And just for good measure, I went ahead and paid in full for my heart surgery.
I blame my critical father.

Have a great Wednesday.

Monday, April 26, 2010

That movie gets 2 snaps up

OK, so I did it.

I broke down.

weak moment

I apologize if I let you all down.

I saw Avatar.

Yep, its out on DVD now but I went and saw it in the theater. In fact, I had to drive 20 miles to find a theater that was showing it in 3D.

So anyway, Susan has been telling me I need to see this movie — in 3D. And, of course, I am not going to see it because . . . well, because everyone else has seen it. I mean, come on, you're talking to the guy who went to college in Memphis and never even drove by Graceland. The guy who spent more time on the Paris Sewer Tour and Euro-Disney than the Louvre (yes, it can be done in 10 minutes & yes the Mona Lisa is quite fetching).

But I needed an excuse to eat salty popcorn and Milkduds and going to "How to Train Your Dragon" by yourself is a short slide from pathetic.

So I saw this movie that has collected a bajillion dollars and, to paraphrase the late, great Tommy Callahan, "it was AWESOME." Visually stunning, clever modern retelling of Dances with Wolves. Gave me warm feelings as I remembered my childhood fascination with Smurfette. . .

Big complaint — the implication that the United States Marine Corp are cold-blooded mercenaries seeking only to kill and the conflicted emotions that you feel at the end when they are defeated. It would not have changed the plot at all to let them simply be a private corporate security firm. Otherwise, nice cartoon.

Now, to finish with my normal tenuous link to dentistry. The movie asks, "what is real and who am I?"

You tell me. It seems to me that as a business owner I get caught up in lots of things that consume my life — so they must be "real problems". But when I stop and think about it, when I have moments of clarity that allow me to separate perception from reality, I realize that much of what I do as a small-business owner is fantasy-land stress. My reality is that I am a husband and father, son, brother and friend. The stress of running a business, being involved in organized dentistry, and being a dentist are all secondary to my true being. Hours of boredom between patients will get you a little topsy turvy on this one. Who would have thought a James Cameron movie would have helped me right the ship.

Well I better go, the voices want to do the NYT Crossword.

Have a great week.


Thursday, April 22, 2010

Kids These Days: Part II

Hey guys,
Is it Friday already?

I just saw a disturbing YouTube video on "Unschooling." Have you seen this stuff?
I almost wrote a real mean blog on the subject, but I am going to calm down first and then maybe write something about it next week.
I am going to give you the link at the end of the blog. I don't want you side tracked.
Focus on me.

Okay, we spoke on Wednesday about all of things that are lurking on the Internet that are a real danger to our kids (and for adults for that matter).

So let's have a quick talk about how to fight the good fight.
I am going to take a four-step approach.
1) work on the kids
2) work on your computer
3) get accountability software
4) stay informed

First, as I alluded to you Wednesday, talk to your kids.
Tell them the dangers of the Internet. Work on their hearts. I guess the talk would go something like this:
"I recognize that pressing that button to see naked boobs is so easy, and when you see it, it makes you tingle all over (is it hot in here), but these kind of things are not good for you in so many ways. That tingling feeling is good, but it is something you should have for your wife some day (honey, I still get tingly when I see you). This woman is made in the image of God and should not be being naked for a picture. She is someone daughter. Son, I can go on forever about how not all woman look like this, and we are getting a false impression of sex and what woman are suppose to look like. This objectifies woman. You know how I have talked to you in the past about the Magic Dancers and women on beer commercials..." (someone turn down the air in here, what is it like 90* in here)
Okay, maybe this talk in not going to be easy, as you can see I am fumbling over my words and I am writing them.....try saying them.
How about "talk to your mother"?

Now let's talk about getting stuff on your computer that can help.
There are some FREE downloads that you can get on your computer that are so easy. is the old standby. Download this file, and it won't let your kids go on bad sites.
Net Nanny has some patented software that knows the difference between "breast" and "chicken breast". So it is not oppressive.
The site has video of how to set this stuff up. It is simple even for non-computer people.
Another one is K9.

This one is just as easy. Staying accountable is another good way of protection.
This is another downloadable program that you put on your computer. It will let another computer know what the first computer is doing.
Say you insist on having a computer in your kid's room, which I don't recommend, whatever site your kid goes on gets emailed to your email account.
You will always be knowing what is going on in there.
What is good about this stuff is that they can be downloaded to your kid's iphones too.
The fact that your kids are protected on their computers at home with all your filters but can just go on their phones to get their freak on is a serious issue.
Now they can't.

We can stay current by going to websites that are all about tech stuff. and are both websites that only talk about tech stuff....bbbbbbbboooooooorrrrrrrrinnnnnnnnnnggggggggggggggg. But you have to do it.

That's it. Just one less thing you have to think about it.
Because of The Daily Grind.
Hope it helps.

Okay, now that you have read this blog your reward is that link to this "Unschooling" video.
Warning: very stupid people that might make you very mad in this video.

Watch at your own risk.

Have a great weekend.

Wednesday, April 21, 2010

Kids These Days

Hey all,
No comments on the Drunk Patient blog. I am very surprised. I thought it would elicit some funny stories from you guys. But nothing.

Today's topic.

I went to this seminar called "Technical Pitfalls" given by Defender Ministries sponsored by my kids' school. This is an organization that educates teens and parents separately on the dangers in our computers.

This organization is made up of two techies that have children. And in their lives they were both challenged by the "devil" lurking in their computers. They are at their computers every day and negative influences are a mouse click away. Both of these guys admitted to getting involved in this temptation and vowed to try to help their kids.

I want to back up a second and tell you that if you have children or plan to have children and you don't want them chewed up and spit out, it is time to wise up. The computer is a dangerous place for kids and teens (and adults for that matter, but we know better).

Okay, you are a pretty tech-minded dentists just like me.
You read blogs, you can fix the minor problems on your know how to back up and you think you are the shiznit.
I have some bad news...You don't hold a candle to the sex industry.
I am here to tell you that the porn people are WWWAAAAYYYYY ahead of you.
Just when you thought you got everything taken care of, industry invents more things.

Let's talk about a couple things we know about...

Facebook.....I got that.
Problem with FB is that it opens up so much stuff for a teenager. We had a kid expelled at our school last year because he told someone he was going to kill him on FB.
Turns out this other kid was bullying this kid and he had had enough.
The kid came from a great family just trying to do the best they can. problem.
I don't think you can get adult movies on Netflix, but you can get everything but...
Just something else you have to watch out for.

Blogs....dude, I know about blogs.
Did you know there are more blogs about sex than any other topic?
Dentistry a close second.
Do yourself a favor and do NOT Google sex and blogs together.

I have a Twitter account. I don't know how to use it, but I have it.
I know there is a potential for this instant messaging stuff to get HUGE, and we have to be aware of how kids will use it.

How about Hulu?
Do you know what this is?
Starting to get a little more obscure? This is a site on Internet that is basically a hub for all TV shows. You can go on this site and watch any TV show ever played on TV.
That is cool if you want to watch old What's Happening episodes but again it is something you have to be aware of. I don't know if you have ever seen Nip and Tuck or any other FX shows but....

Let's talk about cell phones for a second.
Sure cell phones are good for our teens. You can get GPS systems on them. You can get a hold of your kids right away. They can call you when they are in trouble.
Cell phones are great, but they open up a whole other world of trouble they can get into.
The guys says, and I quote, "What is it with kids? When they get a cell phone and they want to take pictures of themselves naked?"
It seems we have been hearing so much lately of girls taking pictures of themselves naked and sending it to a boy that they like.
Now when this boy gets this picture, according to this guy, if he doesn't report this to the authorities he is committing a crime.
Now again, if he is like any other teen-aged boy and send this picture to all of his friends, he has just committed a FEDERAL offense of distributing porn. This is a big deal.
So you are 13 years old and you send out a picture to your buddies and all of a sudden you are a labeled a sex offender for the rest of your life.

Then of course to a lesser level there is sexting. I do it, but I am an adult and I am married to my girlfriend. But I don't want my 14-year-old getting all hot and bothered by his girlfriend's texts.

Okay how about these things.....

BitTorrent. Ever heard of it? Me neither.
How about Phishing?
How about ChatRoulette?

BitTorrent is a file sharing system on the Internet.
"The result is a better digital entertainment experience for everyone."
For everyone, that is clever. But what about if your kid is sharing porn with someone else?

Phishing....Well according to Wikipedia....In the field of computer security, phishing is the criminally fraudulent process of attempting to acquire sensitive information such as usernames, passwords, and credit card details by masquerading as a trustworthy entity in an electronic communication. Communications purporting to be from popular social web sites, auction sites, online payment processors or IT administrators are commonly used to lure the unsuspecting public. Phishing is typically carried out by e-mail or instant messaging, and it often directs users to enter details at a fake website whose look and feel are almost identical to the legitimate one.

Apparently what this is, is that you put yourself into this pool of people and the computer randomly hooks you up with someone else and you chat.
This sounds like fun if you are a sound adult. But it is just another way that weird people can get a hold of your unsuspecting kids.

Unsuspecting....that is a good word.
Because most of this stuff is used for good. But like I said before, porn people and weird people are on the cutting edge of taking something that has been invented for mainstream stuff and making it porn-friendly.

Mostly the issue is the relationship we have with our kids. We all know that this kind of thing with kids is a hard issue to discuss, but they have to be educated about this stuff. You have to know what your kids are doing on the computer. You have to have filters that won't let your kids stray.
I am going to talk about this on Friday. How do we talk to our kids? Can you talk to your kids? You have to. I have to.
I feel like if I can give them the sex talk, I can give them the porn talk.

I hope I didn't stress you out.
I know when I left this meeting I was totally stressed out. But we have to educate and then pray. What else can we do?

Have a great Wednesday.

Monday, April 19, 2010

Tales of Monday Morning Nothing

Sometimes less is more, more-or-less.

Less stress = more happiness

Less weight = more health

Les Nesman = more humor ("oh the calamity")

Less war = more peace

Less debt = more opportunities to give

Less commitments = more time with family

Less brushing = mo' money, mo' money, mo'money

Less TV = more time outside

There is a balance in life. Taking from one side of the balance sheet adds more to the other; for better or for worse. These past few weeks I have been on the "more is less" side, and that has to change. More free time, less revenue; More bills, less money to pay them; More stress, less sleep. . . .

You get the idea.

I hate being the repetitive blogger, but after 9 months hopefully you are seeing what I first told you - with me you get the highs and lows.

By the way, today and tomorrow 30 or 40 of you AGD brothers and sisters are in Washington D.C. to lobby Congress on legislative issues. I want to send a quick shout-out to each of them to thank them for taking time to go. I have been there the past couple of years, and it is a great meeting.

That's it for me today, for some reason the voices are speaking Spanish today so I need to find a translator.

Have a great week


Thursday, April 15, 2010

This Patient Has Been Drinking

Man the weeks just fly by.

I had another tough week.
All my teeth this week were hard. Lots of decay. I had a 16-year-old who had big time decay. One of these cases in which her teeth looked fine just looking at them, but after we took x-rays I could see she had some bombs. So we did 6 on the left side in one sitting. They were so deep, and I was trying to avoid doing root canals on her. I ended up having to do electrosurge around one of the teeth just to get the band around it. By the end of it, my hands were sweaty (you know when the glove looks see through), and I had sweat running down my back to my butt. I hate that.

Every impression I took this week was tough. I found decay under this dude's bridge, and after I took it off, it was like-BOOM-decay everywhere. I had to stop and tell him that both of the mesial abutments were decayed to the gumline and they were going to need root canals and post and cores just to get another bridge. I had to tell my front desk to call the next patient and ask if they can come a little later.
That was for #20 and #21.
Now #18 (non-dental people: This is a tooth that is way in the back and really tough because of the tongue) had decay under the crown on the lingual, deep. So when I was done with #20 and #21, I had to tackle the lingual of #18. Can you say butt sweat?

That was every day this week I swear.

But I wanted to talk to you about a patient I had. He had old crowns, I want to say 30 years old, from 6-11 (for you non-dental front teeth). And he wanted to have them replaced.
He is a bit of an odd fella. I think his wife died a couple of years back, and he hasn't been doing that well since. He has been a patient of mine for a couple of years and hasn't stopped talking about "the settlement".
I know we all have patients like this. If it is a loss of life claim or a divorce or an accident, we all have patients that aren't living their lives any more because a lawsuit is consuming their lives.
But this guy apparently lost his wife in a medical malpractice situation and "plans" on getting a couple of million dollars and it is coming "soon".
So he was thinking that since the money is coming soon that he wanted to get started.

This person had lots of questions.
Not that I have a problem with questions, but I am a big fan of "let's do it, who do I pay?" and it gets done.
His questions were, "What are you going to do first? Are you going to give me shots? How are you going to make the temporaries? Will it hurt? How long is it going to take?"
Not in a "I would like..." kind of way, but in a "I'm nervous and I just feel like I should ask a bunch of questions" kind of way.
"Why are you going to send them to Glidewell? What do you mean the temps will stain?"
So, I remained calm and answered all his questions and took all his phone calls.
(Let me back up a sec. It sounds like I have a problem with answering questions. I don't. But this is the kind of patient that has said that he wants new crowns in the front for years. He has been telling me he was going to do it, and we would schedule and then he would cancel. So some of my reluctance to answer all his questions is due to the fact that I have answered them all before. That's all.)

So this time he scheduled. And I know he was serious because he paid the money to retain the appointment.
We did all the preliminary stuff. We did a wax-up. We sent the models to Glidewell, and they made some temps. I went with Glidewell this time because I knew this patient was going to be one of those people who say they will probably have the money for the final restorations in about a month, but it might take over a year. You all have those patients. The ones that you tell that it is imperative that they follow through to the final step and you don't see them again after the temp phase for a couple of years.
Glidewell makes the type of temps that they guarantee for 2 years. When I am working on this kind of person, I always go with the guarantee and charge the patient the $50 extra.

Anyway, the day of the appointment comes. It is like 11 am.
He is jacked up nervous. He is asking a bunch of questions again and is sipping on a coffee-type container. And he puts it down on the counter and every time we go away from his mouth for something, he is jumping up to get this mug.
Then he alludes to the fact that he is running out of "comfort drink".
Then I ask him what he is drinking and he replies, "Well, you know, a little of this and a little of that."
And as he is hitting the bottom of this thing he is acting a bit more relaxed than at the beginning of the appointment.
And we figure it out that this guy is drunk.
Now I am not talking about 85% through the appointment.
I am just finishing up the shots, and he is flying high.
So here is the dilemma.

Do you work on a drunk dude?
Do you send this person home?
For me I am going to be totally honest with you. HELL YES, I worked on a drunk dude.
But I can see how some of you would not agree with me. Do I think in a perfect world I should send this guy home? Yes.
But if this world was perfect, this dude wouldn't be getting drunk IN MY CHAIR.

So my assistant and I are in the backing saying, "He is totally drunk."
And I brainstorm about it.
If I send him home I waste the appointment time. If I send him home you have to say, "Dude, you are drunk. I can't work on you." Then you run the risk of him saying, "Well, if you won't work on me I am going to find another dentist." I also can't put a guy who has been drinking back in a car and send him home.
I am totally not running that risk.
So this brainstorming lasted about 5 seconds.

I mean what am I suppose to do?
Now I know there is some risks of working on a patient that is under the influence, but I don't know the extent. I have to tell you that I have some experience with being drunk and I have some limited experience with marijuana (sorry dad, I love you mom) but I have no experience with anything else. And if some came in high on coke, I wouldn't know it.
I might say, "that person ain't right" but I wouldn't know if they were geeked out (I know all the drug lingo).

I have to tell you that working on crazy messed up people is totally part of the job. I just have to laugh about it and do my job the best I can.
Every day it is something else.
Now I just come to work expecting someone to be drunk or something like that.
I think some day soon that drunk person at work might be me. JK

Have a great weekend.

Wednesday, April 14, 2010

Oh Man is He Ticked

Hey all,

It is time for Orlando Magazine's "Best Dentist" issue.
In November, or something like that, we get a survey. I don't know if they actually look at this but I know I got at least one vote (You are dang right I voted for myself). But needless to say, one vote was not enough.
I don't think it is a big deal not to make the magazine, but it always stings to not make it.

Talk about friend was so ticked that he wanted to write a blog about it.
Well I will let him tell you.

Springtime in Orlando is a happy time. You can’t beat the weather. MLB has spring training, the azaleas bloom everywhere, and Orlando Magazine puts out its list of Orlando’s best dentists.

For years I’ve come to look forward to the issue where many of my colleagues are recognized for their excellence. Our local dental society frowns on the notion but according to the publication, it is based on surveys sent and filled out by local dentists. It has to be legit, right? I’ve filled out the survey myself many times. This brings me to last Saturday.

As I waited to get my haircut, I started flipping through the April issue of Orlando Magazine. The table of contents immediately led me to the section on the “best” dentists. Within seconds of reading this year’s list, I became physically ill and disgusted. Certain names were included that had NO business being mentioned among Orlando’s “best.”

As dentists, we see other dentist’s work. It is a small community. Sometimes we see firsthand if someone is good or not good. And in a small community there is a lot of talk. (John has always talking about his reputation and how dear it is to him, and this is why). Yeah, I know what you’re thinking. John’s ghost writer is a behaving like a little whining crybaby. Yes, it does sound like it, but allow me to give you a profile on one of Orlando’s “best.”

Here goes…One of the “best” works in my building. While he/she drives a $100,000 convertible Benz he/she doesn’t offer staff health insurance. In fact, this dentist shaved hours off their paychecks several times. I’ve seen staff members storm out of the building in a rage. The dentist hasn’t invested in any meaningful innovation to the practice since the 1990s, unless of course you believe a Zoom lamp is “state of the art”.

Laser dentistry? No way. He/she won’t even purchase an electrosurge unit. An office assistant comes over and borrows mine. And last time it came back broken—oh, they didn’t even follow through on repairing it properly. Instead he/she hoped an assistant’s husband could fix it. When the husband couldn’t, I wound up getting it fixed myself.

Digital camera? Doesn’t own one and actually has the audacity to fancy the office as a cosmetic dentist and a “smile maker” because they do PFMs. Wouldn’t want there to be evidence of the work, I guess.

Loupes? Heck no. I’ve been in the building 3 years, and there has been the same pair hanging from the same hook in the office collecting dust. You would think that seeing the other guy in the building using 3.5 powered loupes with an LED headlight would motivate someone to “up” their game. Not this dentist. Then again wearing loupes might open this dentist’s eyes to some of the poor dentistry he/she is doing.

Extractions? Forget it. I’ve heard the horror stories. I am not even going to touch that one. Implants? This dentist doesn’t know what a freaking analog is. The office constantly borrows my hex drivers and torque wrenches whenever they restore an implant. Did I already mention this dentist drives a 100K Mercedes. Buy your own hex drivers! Invest in a wrench!

iCat, Invialign, and IPR are foreign to this dentist. He/she doesn’t even own resin cement. I could go on forever. I don’t mean to imply that you need to have the most expensive, high-tech equipment and products to be the “best” dentist, but you should at least know of new innovations in the field.

You may be inclined to find a silver lining somewhere. You may be thinking this person is an older dentist who just does what he/she likes and is probably awesome at it. I know dentists like this who do just crown and bridge and yes, they are awesome. This isn’t one of those dentists.

This makes me wonder about the other dentists on this list. Obviously I have a problem with this particular dentist being on this list because I am very familiar with his/her work. But maybe there’s another dentists out there who flipped through the same pages of this magazine and found the name of a colleague that is not deserving of the distinction of the “best.”

You might have guessed, I’m not on that exclusive list. Jealous? Seems like it. But I really don’t believe I should be on there yet. You see, I feel I still have a lot to learn. That’s why I’m active in a couple study clubs. That’s why I’ve bothered to see Spear, Dawson, Strupp, Buchanon, Morin, and Misch. (Not to mention continuums and countless weekend courses.) My underachieving colleague doesn’t belong to a study club and doesn’t participate in CE unless it is mandated by the state. So I have to wonder, how does this magazine determine who is the “best”? From what I can tell it doesn’t seem to be based on CE hours, office innovations, or patient satisfaction. So what is it based on? I’d prefer not to dwell on it. Instead, I’d rather let the quality of my work be judged by my respected colleagues and patients rather than a magazine.

In my career I’ve had the honor of treating several dentists, employees, hygienists and their families and even an ex-employee of mine who now works for other dentists, etc. I’m particularly proud of the work that I do for them and their satisfaction with my services. I don’t need to be told that I’m the best; I just need to know that I am doing my best for my patients.

So you may wonder why I’m so upset about this “best dentist” list if I don’t care that I’m not on it. Well I think it is a disservice to the public who may take this list too literally. I personally feel that my neighboring dentist is a pretender. This dentist isn’t someone who sees any value in continuing education. Never has. It’s downright embarrassing that someone has a license to treat people but doesn’t take personal responsibility to treat someone well. It disgusts me….obviously. So that fact that a patient may see this dentist’s name in the publication and visit this office based solely on this recommendation is upsetting, and not because I want the patient to come to me. I just want the patient to go to another dentist—any dentist—that takes pride in their work and treats patients with respect.

I’ll finish with a few thoughts. There are many excellent clinicians and people on that list, individuals who I would go to and send my family to. But the inclusion of this particular dentists and the omission of some marvelous colleagues is a shame. The list used to mean something. Now it doesn’t.

I guess as a profession we have to decide for ourselves what makes a person the “best” dentist or what puts a person on the road to becoming the “best” dentist.

I told you he was ticked.
I talked about how it stings. Well if the dentist down the road gets all these accolades and you see his/her work all the time and you are cleaning up after them, it stings even worse.

I think in our town the dental society tried to get a cease and desist against the magazine from doing this. Saying that it against ethics and stuff like that. But it appears the magazine won that battle.

Any thoughts? Do you have this in your town?

Have a great Wednesday.



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

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