Losing Patients

Just got back from a long weekend at the beach with my wife, celebrating our 15th year wedding anniversary. ALONE. Oh my gosh, it was nice.

I have a 28-year-old patient who has been a patient here for ever. Her teeth started to hurt after she hadn't been here for a couple of years. (Oh pain, the great motivator.) Turns out she needed a RCT, but was tight on cash. I asked if she would be interested in watching my kids for 5 days. She was in (she used to be a nanny and still does this...so it wasn't really that much of a stretch), so that part of the trip was set.

I borrowed a friends beach condo and we just left. We relaxed. We slept until 8am (yes, this is sleeping in for parents of 4). We did a lot of sitting on the balcony reading. I smoked some cigars. We watched Inception. We went and ate down at the pier. We took walks on the beach. And other than a couple of meals out...it was nearly free. NICE!!!

I want to talk to you about losing patients. I can't remember what got me fired up about this subject. I had a friend tell me a story last week. He had a patient call and tell him he was leaving his practice. Of course, he asked the patient why.

The patient said that his wife had a crown replaced and when she asked for the old crown, my friend gave it to her. My friend responded didn't understand what the problem was. "Well, we are upset because you didn't offer her the old crown." [For the record, I don't offer patients their crowns back. Do you?]

I was talking to a friend that owns a retail shop. He bought an existing shop, tried to make it better and just changed the name. We were out to dinner the other night and we started talking about work. He claims that he wishes he could be more like me when it came to criticism. He thinks that I just blow it off. Because really I do. I have gotten to the point that if they leave our practice, I do kind of blow it off. I will talk about this later. But back to him...

He says someone would come in and say, "You sure have made a lot of changes in this place." He is an introvert and things similar to what I am about to say just don't come as easyily to him. This statement something critical.

I would say, "How do you like those changes?" Or "What do you think of those changes?" But he won't ask those questions because he doesn't want the rejection. He said, "I know they could be saying something positive, but I fear rejection so much that I just don't want to hear it."

Wow. This is so foreign to me that I scoffed at him.

I told him that it sounded to me like this person has something to say. Now if this person has to say that she doesn't like the way you set up the X. You hear what she has to say and you can tell her that the reason you put X there is because of Blah, blah, blah. Just as long as you strike up a conversation with her. She wants to be heard and you heard her. If you never talk to her and she doesn't get heard then there is a chance she is gone. It is all about relationships. I know that; he knows that; you know that.

I mean, when people are calling your office and asking how much you charge for a crown, what are they asking? Do they really care if you are $28 more than the next guy? No, they want to know that you are going to care about them.

If you say, $1200 and hang up, you have not separated yourself from the $1150 guy. Now, if you strike up a conversation with them and ask them what is going on and ask them to tell you the story. "Just give my doctor a chance. Let's have you come in and let him look at it, because a lot of times he might not think you need a crown." BADDA BING. You have a raving fan.

But back to the losing patients thing. I am old enough to know that I can't please everyone. Trust me, I have tried. I can't do it. There are a couple of reasons someone will not like me.

They don't like my dentistry. This one really hurts me. I take so much pride and I want to do it the best. I want to wow everyone. If someone told me that they didn't trust me or they were displeased with my work, I don't know what I would do (luckily this has not happened too much, I give them their money back and let them drive someone else crazy).

They don't like my personality. You may ask yourself, "What isn't there to like?" I ask myself the same thing. In my attempt to make it fun here, in my attempt to make people comfortable, I can be loud. I can be crude. I can be unprofessional (a cuss word might slip out every once in a while). I have great intentions, but everyone is not going to like my style. And, quite frankly, I am at the point in my life where I know this and it is totally okay. I know I am going to lose patients because I "made some changes around here." I hate that it happens, but I know they are going to find a dentist that fits their style, and everyone will be happier.

Some of you who are introverts may be losing patients because you are too quiet. And you know what? THAT IS OKAY. We extroverts are losing patients because we talk too much. Some people leave because we are too tall, too short, dress funny... We have to let them go.

We have to do our best and take pride in our work. And we HAVE to care. But we have to have our own style. We have to make ourselves happy before we can make others happy.

How is it with you?

Have a great Wednesday,
john

"Would Robin Hood rob our house?"

I will tell you something that my daughter said that is going to lead up to this blog perfectly.

My daughter and I were talking about the story of Robin Hood, and she started asking me if it is okay to steal if you are going to give it to the poor (the answer is no by the way, but that isn't part of the story). She thought about it a minute and asked me, "Dad, do you think Robin Hood would rob our house?" I had a good belly laugh over this one.

I got my W-2 last week and I have been thinking of my present financial situation. For the first time in a long time I have had to some creative financing. A couple of years ago a bill would come in and we would cut a check. Now we hold off on this until we get paid next Thursday. What the heck happened? How did I get myself into this mess? And I thought about it awhile, and this is what I came up with...

I will put it in round numbers. Let's say I made $150,000 five years ago. And out of that $150,000 I put $20,000 toward debt reduction and savings. If you look at me on paper, you would say this guy is living right. He is being so smart with his money. He only spends $130,000.

Now to me, I am living right at $130,000. We go out to dinner a couple of times a week. We go to movies, we have all the kids in all sports. We go to "reward" lunches for the kids. Lunch after church. We go through the pay car wash. We have the house cleaned twice a month. Kids in private school. Vacations.
Magic games, Gator games. Broadway plays, caviar, and champagne. You know what I am talking about. I mean $130,000=the good life.

Now the next year. Okay it is a little off, but nothing to get your blood pressure up. The cleaning lady only comes once a month. No more "reward" lunches. No more caviar and no champagne. We cut more coupons, but no real lifestyle changes. Oh and we are still saving or putting $20,000 toward debt reduction.

Then the next year comes and it is off again. But this year it is more off. Hmm?!!
Well, now we have canceled the cleaning lady all together. We don't go to plays anymore. We don't eat out at all. We carpool when we can. We go to the dollar theater instead of the 3-D megatheater. No more lunches at all. No caviar, no champagne. At this point we start to save less and we are not reducing any debt.

Then the next year comes. OH NO. It is still going down. No going out. No buying nice things at all. No lunches out. Pennies are being pinched. No one is saving anything, and no debt is being reduced. We are just trying to survive. We watch EVERYTHING we spend, and I am talking everything. We understand it is not the big purchases that will kill you but the tons of little purchases.

So now, three years later, my income is $120,000 and my fixed expenses are $130,000. I don't look so great anymore. I look (and feel) like a total shmuck. Three years ago, anyone would look at my family spending and say, "That guy is doing it right. He lives in a modest house. He drives modest cars. He is tithing, he is playing, he is reducing debt, and he is saving." People were jealous of what I had going on.

Now they look at my family spending and are saying "He is way over his head." They are saying, "Tisk, Tisk, tisk."

Now, I have taken two of the kids out of private school. We don't go out nearly as much any more. Well, I can't move because my house is barely worth what I paid for it. I guess three years ago I could have saved more. I guess if I knew this was coming I could have done a lot of things differently.

In order for me to get my head above water again, I have to just to make more money.
The bills are not going to stop coming. We have stopped needless spending. I look at my practice and it is healthy, but nothing is going to change that much in the next year. It is not going to be a million dollar practice today and a $1.6 tomorrow.

I think this is what my life looks like for the next couple of years. It looks like a lot of bag lunches in the staff lounge. It looks like a lot of family picnics instead of going out. It looks like a lot of (free) Movies-in-the-Park with the kids.

Is that kind of what it looks like for you guys or am I the only one that looks like a shmuck?

Have a good weekend.

Your favorite shmuck,
john

Remember all those numbers are made up. Also, I know that I have oversimplified the story, but you get what I am saying.

Other Offices

Oh man. I have so much s!@#$%t going on right now.

Our new front desk person was totally overwhelmed and succumbed to the pressure and quit (it could have been that she saw the front desk resumes that I had on my desk, that "accidentally" fell on the floor and she "accidentally read them"). I called our local dental society (they have a placement service) and they sent me 7 applicants.

But I went ahead and put the opening on Craigslist. Have you done this? I put the ad up at 8:30am and I had 15 resumes in front of me in ONE HOUR. So far I have received over 70 resumes. Crazy.

There is a young man who grew up in our practice. I'll call him Wes. In high school, Wes started talking about having an interest in dentistry. Over the break, Wes came in.

He came and shadowed for a week or two and loved it. He then went into college thinking dentistry might be for him. So he took all the appropriate classes and continued to come by during the summer and winter breaks. As a junior in college, he made the decision that teeth was his thing.

I backed him 100%. I think the world of this young man. I wrote him a fantastic recommendation letter (if I don't say so myself), and next thing you know, he has been accepted to the greatest dental school in the nation - The University of Florida College of Dentistry.

Before he went off to dental school, I took him out to dinner. And this is where I told him that I knew he had what it takes. I told him that I really want him to consider working at our office when he gets finished with school.

Wes now is in his second year of dental school. And after many talks and him coming to the office quite a bit to shadow, we have made a handshake agreement that he is THE ONE. He wants to work here and I want him to work here. It will be perfect timing. My father is 66 years old and he wants just a couple more years. So that is Wes.

Now, I talk to Wes about once a month. When I go up to a football or basketball game, I usually try to touch base with him and take him out to dinner. We have an open line of communication. He calls when he has a practical dentistry question (that is, when he learns something in school and he wants to know if that translates well to real life).

On his spring break and Christmas break, he still comes in for a morning or two. But this year was different. Wes was not this kid that wanted to be a dentist. He now was this young man that is/or is really close to being a dentist. His questions are more meaningful for him because I can tell he is starting to see himself here. Kind of like when you go to buy a house and you like it so much you start talking about how your furniture is going to fit in the living room.

In the 6 hours he was here, he brought a lot of spunk. A lot of energy. It is amazing how new blood can energize everyone, including me. I have someone to talk to. Someone to preach to. Someone that listens.

I think being here for a couple half days really energizes Wes, too. He sees his education leading to something. He gets to see what the prize is. (I know what you are thinking. "This is a prize?" Come on, don't be so negative.)

After Christmas, he went to his girlfriend's house and hung out there for a couple of days. It just so happened that she had a dentist appointment while Wes was there, So he went with her. And soon after he called me.

He had so many questions. He told me that the office looked like a SuperCuts for teeth. He told me that his visit opened his eyes for the first time and that he was finally able to appreciate what he was getting into here at my office.

This gave me an opportunity to tell him that this was a good thing. I told him that he should go to other places - and lots of them. I even went as far as telling him that he might consider, while working here, working at other places. Why just do it the way I do it?

He should want learn what to do and what not to do. Bring a well-rounded world view back to the office. Then he can start to build HIS practice here, not build up MY practice. It has to be his and ours. Something he can be proud of. Something that is his that he can come to work owning.

That was the first part of our conversation. The second part was more philosophy. Now, you know that if there are 10 dentists in a room and they all look at a problem there are going to be more than 5 ways to take care of this problem. This next part of the blog is my philosophy. Don't be mad at me because I might be different than you.

His girlfriend had a cavity under a filling (a filling that this dentist did). The cavity was deep and I think the pulp horn was nicked. But the next thing you know, she is getting a root canal. This is a 21 year old. To me, this screams "Red flag!"

He says, "What do you think?" Wow, that is a loaded question. This is how I delicately addressed this. I told him that every young person that trusts me with their teeth becomes my child. I treat them like I would treat my own children, which means I am super conservative.

I told him that what that dentist did is totally within the standard of care. Decay and the prep hits the nerve, you do a root canal (I don't, but I think it is the standard of care). But you all know what is coming next. Then it is probably a post and core and then a crown - on a 21 year old.

Now, some of you are saying, "Yeah, so what?" To me, this sounds like this dentist is treating this person like a tooth, not their own child. If this was my 21 year old kid, I would know that once I do an RCT, that opens the tooth up for a chance of failure. And the same thing with a crown. Once they get a crown, it is suspect to fail and then when she is forty she is going to have to redo this crown and so on and so on. This tooth was going to be fine with a big, deep filling. And like I said, it is still within the standard of care.

For me, if my daughter had a deep cavity, I would avoid the nerve the best I could (and I am not insinuating that this dentist didn't), even if it was going to be a carious exposure, in which case I would be treading very lightly.

She is 21, for crying out loud! She wasn't hurting, she just had some decay. I would do a direct pulp cap with some glass ionomer. I would say, when I do this, I do it with a great deal of certainty that it is going to be successful. I can count on one hand how many root canals I have had to do on people less than 25 years of age and I am talking between 10 and 20,000 fillings. I have done so few that I can remember who they are.

I told Wes that that is how I do things. That is why people come here. They are not a set of teeth; they are my responsibility, and I take that very seriously.
So she is getting a root canal. Does at 21 year old need a crown on a deep MO filling on #19?

To me, most of the time, the answer to that question is "No." I would do a filling and go from there. If it was huge, I would do an all porcelain onlay, preserving as much tooth as I could. But I can tell you again, I do not do too many crowns on people under 25.

This was a great conversation I had with Wes. I love that kind of stuff. I love talking teeth. I love talking philosophy. I love it when the person I am talking to is just as passionate as I am. That is why I talk to you guys.

I am looking forward to Wes getting more information from school and coming back to me with it. I am looking forward to not just me teaching him, but him bringing some of his philosophy to the table as well.

What do you think? It is honesty time. Do you find yourself not caring as much? I mean people can beat you down, and I understand that. Do you still have passion and do you treat everyone like they were your family? Let me know.

It is nice to be back. Have a great Wednesday.
john

Christmas vacation - Gammichia style

Happy Friday,

Where was I? Oh, yeah. I was telling you just about the trip up to the mountains. We got to the mountains and we were basically snowed out of our house. Long story short, we rented a condo for the 4 remaining days.

I rented this condo begrudgingly because I knew they had had enough, but I had seen this house and to me it was worth the wait. If we had to rent a place for one more day then got to go to the house, it would be worth it. But they just wanted a place and I got that.

Everyone settled in and most of them went to Pigeon Forge, and the Gammichias stayed back. It would have been a 3 hour drive to get there (oh and that means a 3 hour drive back). So they did their thing, and we did ours. We went to a little town about 40 minutes away, did some shopping and had lunch. It was nice to just be with us.

On the way back into the mountains is when we found out that our kids get car sick.
Oh yeah!!!! The kids were watching a movie in the back seat and when one of them looked up it was, "I don't feel so good... [barf]."

No time to react. Oh,the joys of parenting. My wife and I look at each other and I say, "Hey, I am driving what do you want me to do?" So, we get this all cleaned up (I say "we", I mean my wife - hey I was driving), and we make another trip to see if we can get to the house.



And we got close. There is a main road up the mountain that we were able to navigate. This is a picture of the road that is off the main road that leads to the road that the house is on.

Did you follow? Main road (paved,curvy, winding straight up), another road (pictured above, paved) and then the road our house was on. All the roads were paved except for the road our house was on.



The house was down and around to the left on road in the above photo. About 300 yards. I caught up to the plowing guy and he said that this road was gravel and he was not responsible for gravel roads.

We sat at the end of this road and wondered. Can we park here and drag our luggage to the house? Man, were we in a pinch. Meanwhile, we had a snow ball fight.





Kids had a blast but ended up crying because I hit them in the face with snowballs. NOT ON PURPOSE. I swear. And we made snow angels.

(Not bad for a Florida boy, huh?)

We decided to bag the whole house thing. It was going to be a pain in the ass to convince everyone to pack everything up again for the fourth time and go up the mountain only to have to drag their luggage 300 yards in the snow. So we left it alone. The next day we went sledding.



The condo backed up to a golf course. We found a par 5 that was downhill and went to town. It was great.


I have to tell you, living in the south, I hate the cold. But when you get to see snow again, it really is great. Great to see for a week or two then go home. By the way, 60 degrees today in the Sunshine State.

That night, we went out to dinner because a couple of the folks had birthdays. Remember I invited 7 people and this was our group (one family of 5 is missing in the photo).



The next day we went snow skiing and had a ball. Noah cried and cried for the first hour and then after that was like a little champ. Luke went snow boarding and loved it. I got my bearings (it was like riding a bike) and was like a champ out there. Good powder and not very crowded. Good times.

We had our second throw up in the car but this time we had a big baggie to barf in.
We zipped it up and viola, no mess. Now the ski lodge has a plastic bag full of puke in one of their hedges (hey, it was my wife. She said, "I looked for a trashcan and there wasn't any around". Sounded fine to me).

Crazy trip. On many occasions, I felt like Clark Griswald. Remember the scene where he just loses it, the "quest for fun" scene? (If you don't like the F-bomb, don't click on this link.) Yeah, that was me a couple of times. But I apologized to the kids and we moved on.

But nobody got hurt. We got to see snow. We snow skied. We had several snowball fights. We went sledding. We enjoyed each other and the family. All in all, I think it was a pretty successful trip. Now I just need a vacation from my vacation.

Thanks for walking down memory lane with me. Oh yeah, and that "free" house I got up in the mountains cost me about $800 to never get to.

Did you guys go on vacation? Anything funny? Let me know.

Back to all dental next week.
john

The Griswalds go to North Carolina

I am going to go straight into telling you about my vacation because it is going to be long.




We had a great Christmas. As you may know, we do a big Christmas Eve family dinner. Dad comes over and cooks from about noon to about 6pm. People stream in all day and it is so awesome. Christmas morning was pretty great too. When you have kids, it is so awesome to start traditions and have memories. We open presents at about 7am, then my family comes over about 9am. We do gift exchanges and then we eat. My wife does a couple stradas and we do bagels and lox and those kind of things.

Obviously, the house is a mess after all that and it is really hard to pack for a 7 day winter adventure with all that going on. Once everyone leaves, we turn it into high gear. I clean the house (as best as I can) and my wife starts to pack.

If you didn't hear, we were going to the mountains of North Carolina to a city called Sapphire, 38 miles SW of Asheville. It is about a 10 hour drive from our house.

Oh, and I almost forgot, I invited my wife's family to join us up there. She has a cousin that is married (they are our age) and they have three children, a 16 year old girl, a 14 year old boy, and a 4 year old daughter. And her other cousin, who is a single mom of a 11 year old girl. We really love their company and we have been talking about doing this vacation for a long time. I figured this is a 4 bedroom house, it should be fine. We were very excited.

As an aside, at Thanksgiving, we met the 16 year old's boyfriend and they made the soft sell on us about him coming on the trip. What I mean by soft sell is, "Oh, he is coming with us."

And, after much discussion in the car on the way home, we were going to let it be. But two days before we were supposed to leave, they texted us (you know how I feel about texting) saying, "Our son's girlfriend is coming, too."

Now I really do love my wife's cousins. I love them more than my own cousins. And not because I have to love them, but because I really like being around them. And maybe I don't know anything about having teenagers and the craziness that goes on, but my wife had to call and talk to them about our concerns. We were going to take the two upstairs bedrooms and let the kids have the downstairs but we didn't want teenage orgies going on in front of our 11, 10 and 7 year olds. They understood where we were coming from and said it would be cool. My wife calmed down and was comfortable with the conversation.

So, at about 2pm we loaded up the family truckster and were off. We had a laptop, an iPhone, an iPad, a portable DVD player, a ton of movies, and half of everything we owned packed in that van. And we drove. We were in constant contact with the cousins, who are from Miami, because we planned on meeting in Orangeburg, GA, for our first layover.

.

We got into the hotel, where we were meeting, about an hour and a half before they did. We settled in and went to bed. By the way, we stopped in a Denny's right off the highway at about 7pm and it was PACKED. Full of folks going to Disney World and such.

We woke up the next morning to their text at 6:30am, "Ready to go." So we dragged ourselves to the free breakfast downstairs. I met my cousin in the lobby. Hugs and kisses all around because everyone was so excited about the mountains. We went in to the restaurant, and my cousin was like the mayor, saying hello to everyone. I looked at my wife like, "What the !@#$ is going on here?" How does he know all these people?

Turns out he has invited just about everyone he knows. His sister and her family and his parents are there. They got their own place together. He invited a co-worker and his family who are getting their own place. And everyone is downstairs at the breakfast place at this hotel. It was like little Havanna in there. It was a little shocking but whatever - the more the merrier. It was going to be great. Packed up the car and got on the road. And, oh yeah, it was already snowing.

Trust me this is a good thing.

We now have about 20 Floridians who have just wee wee-d themselves because there is snow on their windshields.

I am the lead car in a train of 5 cars. I have got the GPS going and my wife is following our tracks on GoogleMaps on the iPhone. Somewhere in South Carolina the directions start to get hairy. What I mean is that you have to go through some small towns to get to this mountain road. The GPS is telling me to go on this road but GoogleMaps is telling me that road. And you know that everyone else's GPS is saying something else.

I know everyone must have thought I was screwing things up so I just pulled over. "My GPS said we should have gone...." "Well, my printed out MapQuest told me we should have turned..."

Whatever. Someone else take over. I don't care. So now I am car #3 out of five. Too many personalities.

We got to Sapphire Valley just fine, without anymore trouble, at about 1pm. We drove into the "neighborhood" and there was A LOT of snow on the roads. Great to play in, but no so much fun to drive in. We got about 1/4 of a mile in (and that was about 2 miles short of our destination) and couldn't go anymore. Well, s!@#$t.

We had to turn the Havanna convoy around. We went to the neighborhood community center and asked around. They said that the neighborhood was supposed to be plowed, but that we should probably get a hotel for the night. We checked in at the Hampton Inn right across the street from the community center. One of the five families got to their home.

(This the front yard of the one house that we got in)

(this is how we chilled the booze)

We were hopeful that tomorrow we were going to be able to get to the house. The next day. we awoke to 12 degree temps. Homey doesn't play 12.

It was bone-chilling cold, but that is why we were there. They said the roads were going to be plowed that day but we didn't want to rush anything. We went tubing and tried to waste time.



At 4pm, we tried the mountain. Yee haw, the roads were plowed. Yessiree we should be in our house in an hour or two.

Okay, so I was wrong. A plowed road doesn't always mean a drivable road. We made it up the mountain about 1/4 farther before it got too steep for a minivan. One of families brought a 4x4, so we called him up. I thought if he could get us up there, we could make better decisions. Well, he got us up about a mile before he was starting to slip. We are Florida boys, what the hell do we know about mountain driving?

So we bagged it for the second night. Back to the one house that was inhabited and we all had a Cuban feast. My wife and I decided to rent at a Bed and Breakfast that night, and it was very cozy for our family. The others decided to sleep on the one available house's floor. That would be 7 adults and 9 children in a three bedroom house (with hardwood floors).

We woke up fine and they woke up ticked off because of lack of sleep. They went straight to the local time share place and rented two condos for the remainder of the time. They didn't want to risk not having a bed to sleep in for another night. They asked me if I thought this was okay.

What was I going to say? I kind of felt responsible for their misery. But I was still holding out hope we could get to this house. I was thinking to myself, "They say they are going to plow the roads again until they are passable. They are going to salt the roads. We could possibly get there today."

But then again, they can be right and they would really be angry. We checked into the condo. My family shared a two bedroom condo with my wife's cousin and her daughter. They got a room and we got a room. Our boys slept on a pull-out couch.

We went from a 4,000 square foot house on the side of a mountain with pristine views and 2,000 decks looking out to 900 square feet on the bottom of the mountain to this. We did get to the house, but I am not going to tell you anything else.

I know I sound like such a wussy. I heard on the radio that Florida is the only state NOT getting snow today. All of you have seen these photos right outside your house. But like I said, I am a Florida boy and get to see snow like every 3 years.

I have to go now and shovel about 8 inches of sunshine off my driveway (I know I am rubbing it in).

See you friday,
john

2010 in review (con't)

Before I forget, I have to say a big THANK YOU to all of you readers. I so appreciated the comments. You all have been very encouraging to me and it really keeps me going. You know what else would keep me going? Yeah, a stipend. Are you listening, AGD?

But seriously, I do enjoy writing, but I really enjoy touching people and when you comment, I know I am doing it right.

I had a chance to read the last 6 months of blogs. WOW!!! I have to say, the second half was good. I mean very good. We covered a lot of stuff.

We started the second part of the year talking about weird cases. Remember the blog about the woman who had tetracycline stains and wanted veneers? I convinced her to improve her occlusion because the final result would be exponentially better. So she started orthodontics. She had the upper braces taken off and we did the upper veneers. The cementation is the last time anyone that I know saw her. I mean, flat out disappeared and never had the lower braces removed.

Then the case that took 3 years to do, round house temps on upper and lower, bone grafting, implants. I finally finished the lower and the guy never came back. And I thought I did a really good job on the lower.

I had a blog about CE lecturers who say to email them with any questions but never write you back. I also talked about a teacher at Baylor University that spent an hour on the phone talking to me about pediatric dentistry. I called this blog "Good Dentist, Bad Dentist."

We talked about the economy a lot and how it affects our offices. We talked about internal and external marketing, which led to some talks about service and how bad service is ruining some businesses and how we should guard against bad service in our own practices.

And that led to how we dress and what is appropriate for the office. Is what we are wearing offending our patients? That led to the discussion about what are willing to give up to please our patients, what are we not going to give up, and whether or now we care if it ticks people off. We talked about The Show and how we have to forget all our problems when we are working. Our patients are paying for our best and expect our best.

I talked about 10 products I can't work without. Have you gotten a headlight yet? We talked about what a successful practice was and what is considered a "modern" practice, and I gave you my tips for revving up the WOW factor.

Dr. Ric talked about wearing cycling clothes and that started a bit of a firestorm. Better him than me. I talked about Tiger Woods and how real life affects all of our work. Speaking of Tiger, I wrote a blog on being faithful and how a trip to the adult toy store might be a good idea (and somehow related that to our dental office getting stale).

We talked about passion, and if dentistry is still your passion. Oh, and mid-life or mid-practice crisis. What if "THIS is it?" I wanted to know about your management style and wanted to know who was the boss in your office.

I helped a young lady out that worked for Dunkin' Donuts, and did a smile makeover for her. (look for those photos in the January issue of AGD Impact).

A ghost writer wrote a blog to orthodontists. And a ghost writer wrote a blog about his trip to his accountant.

We talked about sealants causing cancer (or the scare that BPA might). I talked about getting a traffic ticket, which, by the way, I am still pissed off about.
I talked about watching a CE lecture in your underwear - I have improved on my resins since then and they are looking so good. Then there was the riveting tale of me being whisked off to the medical tent after the Chicago Marathon.

I told you how I cut into an adjacent tooth trying to extract a tooth I had no business trying to get out. Then that I wrote about a person saying they were going to sue me because her back and neck hurt from getting out of the chair (luckily she has never called back), and that led to the blog about the Scarlett Letter.

I told you about my TV interview. Then basketball season started and that kid said I was being critical, which opened the door for me telling you that I am a critical person and bring it to work. Then of course we finished up with Thanksgiving and ending back where we started - at my Christmas party.

If you are not a regular, man, you have missed alot. You should go back and read; I don't think you will be disappointed. My favorite of the year was a tie between Dunkin' Donuts and The Show.

The last two weeks on vacation gave me a good breather and I am reading to take on 2011. I did a lot of thinking about blog ideas. If you have any or want to write a blog or two let me know. I am at Jgammichia@aol.com.

Have a great weekend,
john

2010 in review

Happy New Year!

I know you missed me. I missed you too. I hope you all had a great Christmas break (holiday) and a happy new year.

You know, we are starting our fourth year of the blog. That means we just finished 3 years. We have a lot to be proud of. I think it is going great (and I know those endorsements are right around the corner). Our numbers a really good. One week this year we had over a 1,000 readers (yes, I track those things).

One thing I would like to improve is the comments. First of all, I would like more comments. I write the blog so most of you don't feel like you are on an island, but without comments, I am the one that feels like I am on the island. And when I do get comments, so of them are kind of venomous. I would like not to tick people off this year. I know that I can't please everyone, but I still would like to try.

Anyway, to start the year I thought I would review what we did last year. A week ago, or so I started to re-read all the blogs from 2010. I have read through July so far and I want to talk about what I have read.

First and foremost, I definitely have diarrhea of the fingers sometimes, so I feel for you. But all in all, I was really pleased with the content. There was a lot of dental stuff talked about. There was some funny stuff and there was some good family stories/drama mixed in.

So with out further adieu, let's review. I will do this as briefly as possible...

I read a ton of books and I watched a ton of movies. It was a very average year for books but I did see some good movies. Avatar, The Hurt Locker, Law Abiding Citizen... but I have to say that the one thing that stuck out the most was the movie Precious.

Starting off the year we talked about my Christmas Party. Always a touchy subject but I think I did a nice job. And, as you may remember, I had a vasectomy over last year's break and I wrote a great blog (if I don't say so myself) on the subject. Instant classic, so if you haven't read those, you must go back. Then there were some follow ups with returning the "samples" that were quite humorous.

We had a couple of guest bloggers. We had our friend from Canada write about what it is like practicing dentistry above the border, eh. We had another guest tell us about how he went to peer review. We had a guest blogger tell us about how he had a patient say he worked on the wrong tooth and the argument that ensued. We even had a dental student write a blog on what it is like in school nowadays (I have seen her in AGD Impact a couple of times since then. Then we had a past president of the AGD write on his take on the HealthCare Bill.

I also wrote some blogs about my family. I told you that my daughter (who I think is the smartest of the bunch) came home from shopping and told me she knew what she wanted to do for the rest of her life. She wanted to be the person that gives out food at the grocery store. I am so proud. I wrote a blog about my son's basketball camp and how he learned what a virgin was (and some other key terms).

I went to a computer/parenting course and wrote a blog on the dangers looming on the computer. I wrote a blog on my crazy adventure about running the Snickers Energy Bar Marathon in Albany, GA. And I told you about my vacation to North Carolina in the summer time. Speaking of, I have lots of pictures from the mountains that I will get to next week.

I wrote a lot about the office, too. About how I hated Facebook, then how I started an office Facebook page (I knew I had some schizophrenia in me). I told you how I went to another dentist's office and talked about me buying his practice and he told me to get lost (in not so many words). I wrote a blog about Dentistry from the Heart (which is scheduled for March 4 of this year).

I told you I had a conversation with the president of a company about my troubles with one of their products. We talked about working on a drunk patient and about how I lost a family of nine because I wouldn't write off a $2.15 bill.

I told you how I have tried to market my practice with my3zips.com and marketing through a community magazine (nothing is working). I wrote a blog on a patient asking me to lie to an insurance company to benefit him. I told you that I have found out some bad things about other dentists and I was tired of being quiet and I was going to start whistle-blowing.

We talked about what mode of communication is acceptable with your staff. For example, when is texting acceptable. I talked about the ins and outs of working with your dad. I reminisced about my first associate job.

I showed you some cases, like the boxer's mother (oh, that was a good one) and my assistant's brother who got about $50,000 worth of dentistry. I also showed you when I helped that guy who was coming out of prison and wanted a new look on life, and I gave it to him.

Remember when I got my tire fixed for free? I wrote about how that impacted me. And of course the Brican America stuff (don't get me started, I am trying not to cuss).

And that was it for 2010 up to August. I have more reading to do, so I will talk about the second half on Friday. Then back to more thrilling blogs in 2011.

Do you remember a blog that you liked the most? One you thought was the funniest?

Hope you are having a good first week back. I am stressed that it is so slow. But I guess this is a topic for another blog.

Welcome back - and I really did miss you.

john