Even Some of My Friends Don't Listen

One of my good friends in Buffalo sent me the following email:

"I went to the work holiday luncheon yesterday and ate a candy cane which I didn't really even want. There was his one little piece that wasn't melting in spite of sucking on it for 15 minutes, plus there seemed to be a piece stuck in my gum. Finally I gave up and threw away the piece that wouldn't melt. At dinner, I still felt some roughness on the gum/tooth area, checked it out and found that a piece of my tooth was gone. Damn candy cane!

Sorry for the quality of the pics, but can you give me any advice on repairing this before I see my dentist?"

So what do you think that my response to him was?

"Well I now have proof that you don't read my blogs. I have been imploring my patients for years to remove their old mercury fillings because EVERY single tooth will suffer the same fate...fracture of the natural tooth. Unfortunately, most dentists will insist on a crown instead of placing a well done bonded resin under rubber dam. 

High school science: all metals expand when heated...hot coffee, tea, pizza etc. teeth are made of glass and expand very little and develop micro fractures instead. At some point, every tooth with an old metal filling will suffer the same fate as yours. I have a quarter century experience with posterior resins and they are fabulous. Unfortunately, dentists make 3-4 times more by doing a crown instead of a filling. In fact, they will tell you that what I do will fall because the material is too weak. No they just don't have the talent or skill (or ethics) to do resins well. This tooth now needs a crown. 

Be well and thanks for checking in."

No tooth with a large silver mercury filling will survive indefinitely intact. EVERY SINGLE ONE will ultimate fracture the tooth just like in the above photo.

Everyone of my friend's teeth can be restored with a bonded resin filling if he so desired. The likelihood is that he will have 4 crowns placed by his regular dentist.

Let's do the math: 4 crowns @$1650= $6600

                              4 Direct resin bonded fillings in my office @$400=$1600 (These are the most
                               complex resins and cost the most)

Does anyone want to argue with me that $1600 is a lot less than $6600?
Dr. Benjamin is so expensive. Really?
Think about this!

And for the sake of your bank account....Replace your old mercury fillings before they split your teeth.

This is How We Do It

All reasonable people know that no one is perfect and that errors of commission or omission happen....And that is why we are human.

Several weeks ago I was working on a large implant case for a patient that travelled to me from NYC. Unfortunately, everything that I had done perfectly was undone by a company that my laboratory was working with. Heather, the owner of the lab  is a friend of mine for almost a 25 years and she apologized for the role that she played and for the company that she had used. I was very willing to accept her apologies but the mega million dollar corporation was not owning up to their role in the case failure which meant that I lost 10 hours of chair time.

Today, one of the executives from the company personally called me to offer their apologies and took responsibility for my problem with the case. The executive informed me that he his company would like to send me a beautiful gift basket for the Holidays to make up for my challenges with my case.
I informed the executive  that hearing his apology was all I needed and that I prefer that his company make a contribution in my name to SmileTrain so that children around the world can have their cleft lips and palates repaired. The executive was stunned by my request but agreed to make the contribution rather than sending me the basket.

Everyone who has any relationship with me or my office knows that things are NEVER about the money and always about doing the right thing. I wanted to hear the executive apologize and that was sufficient for me.

I am thrilled that my very unpleasant experience with my case will result in one child having a chance at a normal life. This is a great day for me and a very lucky child.

This is how we do it...It is never about the money....NEVER.

Nothing Surprising Here

I just received and read the January, 2016 issue of Consumer Reports. There was a report on the Most Satisfying Cars to own and the Least Satisfying cars to own.

Before I give you both lists what do you THINK is common aspect among the cars in each group?

THE COST

Most Satisfying:

1. Testla Model S
2. Chevy Corvette
3. Porsche Cayman
4. Porsche Macan
5. Porsche 911
6. Acura MDX
7. Ford Mustang
8. BMW2 Series
9. Subaru Outback
10. Volkswagen Golf

Least Satisfying:
1. Kia Rio
2. Nissan Sentra
3. Jeep Compass
4. Jeep Patriot
5. Hyundai Veloster
6. Dodge Journey
7. Nissan Versa Note
8. Nissan Juke
9. Fiat 500
10. Nissan Pathfinder

Most intelligent folks believe that you get what you pay for and the more you pay for something, the more that it performs as expected.

Not unexpected...the same can be said for almost all goods and services including medicine and dentistry.

Something to ponder.

More on Yelp, Google and HealthCare Reviews

You know that I do not place much value in professional reviews because a majority of them are bias and corrupt.

What does that mean?

Many dentists REQUEST that their patients write a review and sometimes while they are still in the dentist's office with the staff finding the site to make the review. Who is going to say 'no' to the nice dentist who just took care of them?

I have never asked a patient to write a review or to 'vote' for me as 'the best' dentist in town when one of the local weekly papers has a 'contest.' And I never will.

Do not pay attention to professional reviews...Read them all, look at the dentist's website with their gallery of their own patients and make your decision.

Do I read restaurant reviews or reviews of new cameras...sure...But I still make my own decision.

For the Third Time

We are about to paint our office for the third time in 7 years...(On January 13, we will be starting our seventh year in our Saratoga office.)

Why am I painting AGAIN?

Because of YOU.

 I never want my patients to think that my office is getting old and dingy and that I no longer care. Our office is just another reflection of the quality of the dentistry that happens within our walls. If the walls are looking old perhaps my dentistry is becoming second rate as well.

I cannot let  you think that.

I am doing the best dentistry of my career at this very moment. You don't have to worry that perhaps
(God forbid) I don't care as much as I used to. Actually, I care more today than ever...

Just as it is supposed to be...You pay us for excellence and we do our very best to deliver excellence. (Understanding that nothing is perfect and no one is perfect.)

You deserve a beautiful office, a great staff and fine clinical dentistry and we try very hard to meet your expectations.

We Used to Understand ...Today We Are Unreasonable.

I like my blog to reflect things that are going on in the world, in America, in our local community, and sometimes,  how it relates to my own little world and dentistry (my favorite thing.)

The children of our friends were in the Capital District for Thanksgiving. They live in a rent controlled apartment in NYC. Rent control means that the GOVERNMENT is going to tell the owner of a building what he or she can charge.  In practical terms, this means that the building will stay in a high state of disrepair because the landlord cannot make a penny if they do repairs. The children complained that the building was almost a fire trap with the insulation around electric wires disintegrating due to old age.

If we don't want to pay for something why would we expect that we will receive more than the minimum?

In another aspect of our lives:

Everyday, I hear my patients tell me about a serious misdiagnosis by a physician for themselves or a family member... How is this possible and why is it so common? Because doctors are allowed to spend only minutes listening to their patients and developing a diagnosis.

I know that you believe that you pay a lot for health insurance...and you do. Unfortunately, the vast majority of what you pay does NOT go to the doctor...It does go to 'administration' of health care which eats up the majority of health dollars.

We didn't want to pay doctors for taking care of us so now we pay the insurance industry to do it...And I think that we are are no longer getting the great care that we deserve.

Thanks and Giving

I have recognized for a very long time that I live a life that is better than 99.999999999999% of all humans that have ever lived...in the history of the world..
99% of that is due to the fact that I was born in America and to my parents, Mildred and Larry Benjamin,  and for those two facts, I am most grateful.

And to Susan...who has been with me almost half a century.

I am also grateful for my health, my family and friends, the best job in the world, a great staff and to YOU, my patients.

For those that have, we must give. This year either through our office  (or  I personally)  have donated to:

Smile Train
Dana-Farmer
Roswell Park
Hospital for Special Surgery
The Grafton Library
St. Judes Hospital for Children
The ASPCA
Our House of Worship
Universal Preservation Hall (Saratoga Springs)
The Dance Museum
School of Dentistry, SUNY/Buffalo
SUNY/Albany

This morning we went to Compton's for breakfast and a homeless man walked in and ordered breakfast... I have no idea whether he had any money or whether the restaurant would just provide him his food on Thanksgiving. Many of us tell ourselves that if we KNEW that the money that we would give to  street people would go for the purchase of food rather than alcohol or drugs, that we would give them money.  So I asked our waitress, Lisa if we could have his check but that she should not tell him who paid his bill. You give because it is the right thing to do.

Be Thankful.

Give to those that need our generosity.

How We Get Things Done

We usually close our office on Veteran's Day but since I took last Friday off to see our good friends in Boston, I decided to work last Wednesday instead of having the day off. I saw one patient on that day to finish a large case which took 51/2 hours to complete. At 3 hours into the case, my cell phone rang and a voicemail was left. Jeanine called the patient who said that he had  pain in his tooth on Monday night and it  had been severe but it was only a dull ache the following day. Unfortunately the pain returned with a vengeance on Wednesday and Jeanine told our patient to come to our office as soon as he could which was 3:30.

I have taken care of my young patient for most of his life and I also take care of his Dad and his Grandfather. The family are all long time patients and one of our practice's favorite. I took an x-ray and saw that his tooth was infected and I requested that he grab his jacket and keys because we were taking a walk up to Root Canal Experts on the 4th floor. I spoke with Jenny the office manager and she told me that Dr. Banchs would see my patient at 4:50 that afternoon for an evaluation. My patient went out for coffee and I returned to my office to straighten up my office.

My patient and I returned to Dr. Banchs' office and a scan and evaluation was performed. Dr. Banchs informed my patient that he had to be home by 5:30 to take care of his young children but after looking at the scan and x-ray and doing some clinical tests, he got up out of his chair and left the room. His top notch assistant told me that he is going to call his wife because he NEEDED to start the root canal that moment.

Dr. Banchs successfully got our patient out of pain by 6 PM. I walked out with my patient and said to him, "Where else could you have access to one of the best root canal specialists in the world with one hour notice?" My patient responded, "No where else."

This is how we take care of our patients. You need me and my team of specialists when you are in pain and our office will do everything that we can to arrange for you to be seen THAT DAY if at all possible.

We care about YOU and we need to tell you that.

When Patients Want More from a Doctor than They Can Deliver

Recently a new patient was referred to me by a dental specialist so that I could fill a very deep original- ( tooth without a prior filling) area of tooth decay. I told my patient that she could see Root Canal Experts for a root canal OR, I could remove the decay and she would have a 50-50% chance that the tooth would not need a root canal until sometime in the future.

What did the patient hear? That, "I promised her that she would not need a root canal for many years."

Now really...Can any dentist or physician make a promise if we don't have a crystal ball to see into the future?  Do you really think that I would make such a promise to a patient?

The patient stormed out of our office after speaking to Tricia and Donna claiming that I promised that she would avoid a root canal by having the filling.

When a dental problem involves bacteria or infection, patients cannot decide what the outcome can be..They cannot WILL themselves to be better.

When a patient has cancer, having surgery does not guarantee that they will be cured
When a patient has triple by-pass surgery, that does not mean that they will not die of heart disease.
If a patient has a very deep cavity in their tooth, having a filling does not mean that an infected tooth will not need a root canal.

I am not sure that I need to explain this but obviously I do need to explain this to some people.

In a world where every kid gets a trophy we  begin to feel that every option results in the outcome that we desire.

Sorry but The Rolling Stones told us 50 years ago that "You Can't Always Get What You Want."

I never promise anything to a patient that I can't keep. That means if you have a filling in a deep cavity, you still may require a root canal.

Physicians Love Being a Doctor but They Hate the Job

There was an interesting story on CNN Money today about physicians who are leaving Medicine not because they don't enjoy being a physician but because Insurance Companies tell them how to practice and how much money they can earn.

If a doctor can't earn a living to have a good life and pay back $300,000 to $500,000 in student loans why would anyone stay in that job?

Remember a few blogs back I told you that the surgeon who replaced my shoulder was paid $1433 by Medicare (Medicaid for the old) which was below the cost of doing business. In fact the parts in my new shoulder probably cost more than what the doctor was paid. Now why would anyone want to become a talented surgeon when you can't earn a decent living?

I gave up participating with insurance companies about 25 years ago because I can listen to one master: YOU.

I don't care what an insurance company says but you can bet that I listen to each and everyone of my patients.  My job is to take care of you the best way that I can and I will not let an insurance company with a CEO earning $40 million a year tell me that I have to work faster (sorry 'more efficiently'), use cheap materials, hire an inexperienced staff and have an old dingy office.

As long as I continue to practice dentistry, I will do what I have always done...Give you my very best effort.

I feel sorry for young  physicians and dentists who have no idea how wonderful medicine and dentistry can be.