Am I the Only One?

HIPPA regulations are supposed to protect the patient from the GOVERNMENT collecting our medical information or from intruding into our personal medical issues.

Recently, Ebola patients have had their privacy invaded when Government, at all levels, has informed the media who the patients are, by name. This is a complete violation of HIPPA regulations and now you know how worthless the regulations are.

In fact, the Patriot Act of 1992 exempted the Federal Government from abiding by HIPPA regulations.... They can collect YOUR medical information WITHOUT a warrant and simply barge into our office and collect that information.

So let me understand this: HIPPA was designed to prevent the FEDERAL Government from invading YOUR medical privacy but the Federal Government then EXEMPTED itself  (in 1992) from the regulations and feels free to take your information and tell the world.

Just one more thing that I do not understand.

Together we Decide

Patients decide whether they want our office to take care of them and we, my staff and I, decide if someone should be our patient. In most dental practices, it is the patient that decides when to join a practice and when they are better off somewhere else. In our practice, there must be the right 'fit' and when we do not see that, we decide not to schedule a patient or that  person cannot remain in our practice.

On Saturday, I opened the door to 18 Division Street to let someone into the building who was going to take Pilates in the Studio next to our office. I quickly saw that the person was someone who I had asked to leave our practice. We of course exchanged common courtesies as would be expected.
This patient wanted to name their own fee for their treatment which was $200-$300 less than I had told her on the consultation. When this patient confronted Donna, I told Donna to accept the patient determined fee and when she left, send her a termination letter.

I do not fight over  or negotiate fees with anyone. Each of us decides how much a product or a service is worth to them and if it has value, they make the purchase. What no one can do is to go to the Lexus dealer and tell them that they want a Lexus at a Ford price.

Sadly, there are times when I have to inform a person that I cannot or will not be their dentist and more often than not....IT HAS NOTHING TO DO WITH MONEY.

I LOVE taking care of the overwhelming majority of my patients.

Listening to Words of "Wisdom" from a Young Man

My wife is in Hilton Head visiting with her brother and his wife. That means that I have been on my own for dinner this past week and last night was the only time that I actually went out for dinner.
The easiest place to go to and eat by yourself is the Indian Restaurant  (Karavalli) in town.  I always bring a hard copy of the New York Times when I go out to eat even though I almost always read the paper online.

There was a table of four behind me and I assume that it was a 3 member family with an invited guest.  The guest was 22 and a college senior and spoke with exceptional authority on any subject that was discussed. I know, I know...when I was his age, I probably did the same thing. However, I reached a point in my life in my early 40s when I realized how little I really knew about dentistry and went on an education mission which resulted in spending about $4.5 million dollars and getting almost 4500 hours of Continuing Education. ( Aside: in the early 1990s, there were VERY few dentists with a clear understanding of how to diagnose and treat the entire oral system of muscles, teeth, bone, soft tissue, salivary glands  and a finicky joint.) Once I started to study I had  a better understanding of how much I needed to learn and learn I did.

In the early days, I never tried to impress anyone with how little I knew and never spoke out in a post graduate class. I have been on many international dental websites and it never fails to amaze me how little people know but they say it with such authority.

Today, I know a significant amount of knowledge about restorative dentistry but I don't offer information unless I am asked.

The young man was a great source of entertainment for me. Speaking as an authority without much knowledge may sound great socially but ....

The word 'Wisdom' and youth cannot be used in the same sentence. (Except here, of course. lol)

The "Ah Ha" Moment

Life usually goes on in a pretty predictable way. We get up, eat breakfast, go to work etc etc. Sometimes we 'wake up' from the norm and see something that is different from we usually do or think. That moment is the "Ah Ha" moment and it is a game changer for most people.

One of my new patients has been with me for about a year and came to our office as a 'reluctant' patient calling when he was swollen and in pain and forced to ask one of his co-workers who his dentist was.  Needless to say we saw him immediately and obtained an appointment for him with Root Canal Experts for an hour later. He had many root canals, had some hopeless teeth removed in preparation for implants and I have been restoring his teeth during this past year.

My patient had a mouthful of old dentistry including root canals, fillings and crowns...all of them relatively poorly done. He was NOT neglectful in taking care of his mouth. This week my patient was in for an appointment, sat down and said to me:

 "You know, I was thinking. What is different about your work is that in the past whenever I had dentistry, I always had to go back to the dentist because something broke, something fell out or it did not feel right. Since I have been coming to you, I never have to return for you to 'fix' something that you just fixed."

It occurred to my patient that something was completely different from his previous dental experience and he understood  what that was without someone in our office telling him that we try to do excellent work.

The real difference is objective and NOT subjective: More passion, more education, more study and scheduling more time with each patient.

Isn't that different?

Technological Misunderstandings

I recently diagnosed a dental abscess for a long time patient and referred her to my favorite endodontic practice, Root Canal Experts. As most of my patients know, I am a general dentist but I limit my practice to fixing teeth and restoring implants, the things that I love to do and what I am good at so I don't perform root canals.

After the initial consultation with Root Canal Experts, the patient sent me an email stating that she wanted a second opinion and she wanted her x-rays sent to another general dentist.  My response both in my mind and in my email was, "After 30 years  if you don't trust my recommendation (especially where there is literally no money involved on my part), you need to find another general dentist to take care of you."  I never mind when a patient has a cosmetic consultation and informs me that they are going for other consultations because that patient will be able to compare my recommendations with other dentists and their work.

I sent my patient a termination letter and the following day, she called in tears stating that she did not mean to offend me or question my recommendations. What she meant to say is that she could not afford to see the best at Root Canal Experts and wanted treatment at a lower cost.

Don't you think that it would have been better if the patient had actually called Donna and explained her situation? Using incorrect words without the opportunity to explain what you really mean is a problem with emails and texts. We THINK we understood what the other person is saying to us without seeing or knowing whether the person is being sarcastic, funny or simply misunderstood what he or she heard.

A 30 year relationship down the tubes and we all lose. SAD