Alway Trying to Get Better at What I Do

I received the following email today:
wow!!!!!! that case is so incredible, every time i think you can't get any better , you do!

If I was planning to retire, it would have happened three years ago when the recession brought our practice to a screeching halt. The dental surveys show that the vast majority of dentists practicing today WANT to be retired by MY age.

I plan to practice dentistry for more than a decade and if that is to be the case, I fully expect to be much better at what I do than I am today.

I always want to try to be the BEST.

Every time I complete a really good case, I pray that this will not be my last great case. And as you can tell from the email that I received from one of my colleagues, I continue to improve and the quality of the cases gets better.

Score one for the old guys.

I Thought That You Were a Cosmetic Specialist

I have said many times that I am a GENERAL dentist with a speciality in Esthetic Dentistry (by virtue of my Certificate of Proficiency in Esthetic Dentistry, SUNY/Buffalo, 2001). This means that I do everything that a 'regular dentist' does with regards to FIXING teeth.

I received a frantic email this evening from that beautiful young model on my website stating that she went to her life-long regular dentist who started to do a root canal and broke her side veneer.
When I called her I asked her why she would go to anyone but ME to fix her teeth or only someone that I referred her to?
She responded," I thought that you were just a specialist in Cosmetic Dentistry."

I will say this again: I AM A REGULAR DENTIST WHO ENJOYS FIXING TEETH AND MY WORK STRIVES TO REACH THE LEVEL OF ART.

If you or your family is looking for a dentist who strives for excellence every time I treat a patient...You have arrived at your destination.

Young Dentists Will Tell It Like It Is

Older, established dentists are dentists who defend everything they don't know and will deny that another dentist could be better than they are. Most DENTISTS believe that all dentists are the same and if they are not the same (in quality, knowledge, etc) then that they are better than the average.

It is all a coverup because no one wants to feel that they are average and besides, how could they be 'average' and make so much money.

Young dentists have grown up in a media age and are capable of learning about dentist both near and far. They KNOW that not all dentists are the same and they would like to be like one of the top clinical dentists that they see and admire. I recently posted a challenging but wonderful case on the ACE forum and received some extremely kind comments from young dentists. This is what they said:


Hi Dr.Gerald, no words to explain, for me you are the worlds best, now i have to sit extra some more time in my office. Take care, Ashok.( From Bangalore, India)


beautiful Gerald, just beautiful!
What was your treatment plan on this case? Any mid-treatment photos?
Much appreciated. As always your posts are magnificent. (From Sydney, Austrailia)
K

Hi Gerald- Awesome case! She looks beautiful- great job! I hope one day I can send you my cases that look like that. How long did the whole case take? (Saratoga Springs,NY)

Young dentists know that there are some fabulous dentists in the world and that, because of lack of experience, they are not among them. But at least they KNOW that there are different levels of quality to aspire to.

How Do We Get There

"The quality of a person's life is in direct proportion to their commitment to excellence, regardless of their chosen field of endeavor." Vince Lombardi

Excellence has become a rare commodity in our society. A commitment to excellence is really a commitment to hard work and sacrifice. While others are out playing, some of us are working. Working not because of the money but because of a genuine desire to become the best.

In dentistry, it has become common to cut corners, seek shortcuts and perform without a proper understanding of how to do the procedure at hand. Dentists who fail to prepare to perform at a high level are full of blame when failure occurs. Blame the patient, blame the lab, blame the materials or the dental assistant.

Excellence is just not attainable by the average dentist. Few want to work hard to become superb at what they do. When it is more fun to play with a golf ball than it is to play with teeth then we know that mediocrity will be the result.

Some patients KNOW that there is something better out there and with the help of the Internet and some effort, excellence can be found.

A Very Special Day

April 23 is a very special day for my very good friend and colleague Dr. Francisco Banchs. Francisco is joining a large group of very special folks called AMERICANS; he is becoming an American citizen. We welcome him into our family.

Francisco already has all of the attributes of a natural born citizen in that he is hard working and strives for excellence. His sense of fairness and compassion means that he fits right in with the best of how we think.

The American Dream is to strive for personal success but only in so far as it make the nation better for all of us. One of the best dentists in the world joins the best nation in the world.

We wish Francisco all of the best as he becomes one of us. Our toast tomorrow will be: Health, Wealth and Happiness.

Reputation and Ethics

"Lose money for the firm, and I will be understanding. Lose a shred of reputation for the firm, and I will be ruthless." This is what Warren Buffet told to management and employees of Salamon Brothers when he rescued the Wall Street Firm in the early 1990s.

We had to ask a patient to leave our practice. This doesn't happen very often but occassionally, it is necessary because the patient doesn't want excellence. As I have told you before (and what Warren Buffet believes in as well) maintaining my reputation by pursuing excellence in clinical dentistry in an ethical dental practice is paramount to our practice.

When a patient asks me to compromise my standards which can only lead to mediocre results, it is time to ask that patient to find a dentist that believes in the same approach to dental treatment.

I cannot compromise my reputation by producing mediocre dentistry. I will not lower my ethical standards by charging you a fee for less than excellent dentistry.

Deception

Your insurance company wants you to believe that all dentists are the same and if they are correct, then all dentistry should LOOK the same and dentists should charge the same fees. Let's look at insurance companies as an example and ask if THEY charge the same price for life insurance for all 47 year old men? If you are a non smoker, there is a different price and if you have a pre-existing heart condition or diabetes, there is yet another price for life insurance. So what the insurance company is telling you is that not all 47 year old men pay the same price for life insurance.
If a dentist treats 3 patients at the same time or allows 10 minutes for a filling, and would rather be playing golf than fixing teeth should they charge or get paid the same fee as the dentist that treats ONE patient an hour, uses a rubber dam and tries to do their very best? I don't think so....But your insurance company does.

Let's understand something...Ford does not charge the same price as a BMW or a Lexus because Ford KNOWS that BMW and Lexus make a better car and they charge more to own one of their vehicles.

When patients claim that we charge too much it is because they do not understand that all dentists do not have the same education,knowledge, skill, talent and passion as the dentist down the street. There are different fees for different dentists because some dentists are 'Fords' and some are 'BMWs.'

Who do you want working in your mouth? The dentist who would rather being playing golf or the dentist with a passion for what they do?

It really IS your choice....Choose wisely.

What My Patients are Saying

All of my patients KNOW how much I care about you and how I want to do my very best work so that I can make you happy and your mouth healthy.

I am honored to receive letters and emails from my patients expressing their thanks and appreciation for how well they are treated.

This is a note that I received today from a patient that I have cared for since 1998:

You are the best dentist I've ever been to!
I tell everybody!
I'm so happy Saratoga is coming in....don't you go and get too busy for me, ok!
Thank you again for agreeing to join the honorary advisory board. You make me proud.
Have a great weekend

Nothing makes me happier than when we recieve your notes and I thank you .

I could not be happy without you.

My Perfect Thought

Actually, I did not say my 'perfect thought.' Maureen Dowd, the Pulitzer Prize winning columnist for the New York Times said what I am always thinking. This is what she said:

"The minute you settle for less than you deserve, you get even less than you settled for."

Isn't this the essence of excellence? And isn't this the thought that I have been trying to convey on my blog in every post that I write?

I am not perfect and I would not try to convince you that EVERYTHING that I do in dentistry is perfect but what I would tell you is that every time that I begin treatment for you, my goal is to do the best possible work that I can with the goal being excellence.

The departure from EXCELLENCE is mediocrity. If a dentist starts with the goal of mediocrity where will he or she end up?

The minute you settle for less than you deserve, you get even less than you settled for...I just love the way Maureen thinks.

My Patients

If you are a dentist in the Capital District, you might not want to read this post.

I treated four patients this week that are staff members in other dental offices. Two patients worked for specialists and two worked for general dentists. I take care of folks that know what good dentistry is about and select ME to be their dentist.

Does that surprise you?

I also take care of a lot of DENTISTS.

Perhaps you should think about going to the dentist that other dentists go to for THEIR dental treatment.

Looking Good from a 1000 Miles Away

I consulted with a young Navy Man this week who wanted some cosmetic dentistry to fix the spaces between his front teeth. As is our protocol, I asked the young man how he selected our office for his consultation. He informed me that his mother is a dental hygienist and lives in Michigan and that she had spent HOURS investigating many dentists in the Capital District and that she was happy with the work on my website and my credentials.

Can you imagine that? Selecting a professional for his or her COMPETENCE and Credentials. The old fashioned way to find a physician or dentist to take care of you or your family.

I guess it should be easy for folks in the Capital District to find my office if a dental hygienist 1000 miles away can find me.

Compromising Excellence? No Way

I went to dinner with a good friend of mine and he said to me, "You may not say this in so many words and you probably don't want to hear me say it but you are telling your patients that if they don't want to do treatment your way, that you don't want them as patients."

Excellence is a gold standard. There is not good, better or best 'excellence.' Excellence is exactly what it says that it is...The best possible treatment that I am capable of doing without compromising.
I am not nor have I ever been motivated by making money. I want to do the kind of dentistry that I am not ashamed to place on my website or in my new TV commercials. Another way of saying this is that I will not do treatment that will embarrass me or my office.

I am not an average restorative dentist; I earned a Certificate of Proficiency in Esthetic Dentistry (SUNY/Buffalo 2001) which means that I am not only competent (or capable) but that I excel in the area of fixing teeth.
Excellence cannot be watered down...It is the way that we do dentistry. So I say to my friend, "If a patient wants mediocre dentistry, there is a list of hundreds of dentists to select from."

I just don't want to be on that list....even if it were to make me a wealthy man.
Sorry, I don't do mediocre excellence

The Big Mistake

I received the following email from a patient that I have met with twice. The first visit was a consultation in which I persuaded her that orthodontic treatment rather than cosmetic dentistry was the BEST method of treatment and the second appointment was to take x-rays and do a thorough clincial exam. This is the email that I received:
Dr Benjamin, I'm sorry to inform you that I might need to switch dentist! I enrolled into the Fidelis care health insurance because, paying out of pocket for doctor visits were becoming too much financially. I work 35 hours a week and you need to work 37.5 to be considered full time to receive the health benefits so, with that being said I don't have insurance. I signed up with fidelis care but, I have to be seen by a Doctor that is on their list. I would love to stay with you! With all the work that needs to be done I'm afraid that I won't be able to afford all of it out of pocket with all the ortho care that needs to be done as well. I hope you understand! Actually I know you will, your a great person! I'm not sure yet who I'm going to go and see but, as soon as I do I will have them contact the office if they need any information. I'm sure they'll need to see the x-rays so they can start work on my cavities. I'll stay in touch and let you know what's going on, also if in the future my job has an opportunity for full time, I'll have the right insurance to come back to your office! I'm truly sorry to have to leave your wonderful caring practice!
Thank you for everything!
Yours truly,

The problem is that this young lady believes the INSURANCE INDUSTRY propaganda which is that all physicians and dentists are the same and that the treatment outcome is going to be the same if you select the cheapest 'health care provider.' [Aside: the health care provider is really nothing more than a clinical insurance agent which has little or no resemblence to a DOCTOR.]

I can pretty much guarantee what this young ladies mouth will look like in 5 years but I would rather keep it to myself. Suffice it to say, I believe that this young patient will have a better outcome in my office....And for one simple reason: I am passionate about what I do.

Rejection

A young woman wrote an op-ed piece in today's New York Times about being rejected from some of the most elite colleges in the United States and that she tried not to let those rejections threaten her self esteeme.
The TIMES has a blogging section and I wrote the following in response to the article:

I have the distinction of being rejected by almost every dental school in the United States at least once, three years in a row. I decided to become a dentist at age 9 and refused to be dissuaded by rejection.
All of that said, I won the AACD Smile Contest in 1998, I created the world’s first esthetic center within a dental school, am nationally recognized for my work and am up for promotion to associate clinical professor.
Rejection is not easy nor does it make us happy. Failure is the beginning point on the road to success and with some persistence and determination, that journey will result in the desired outcome. I have used my repeated rejections as a way to motivate myself to pursue excellence to demonstrate to those that rejected me that they were wrong in their decisions.
And I am a better dentist for those rejections.

Some of us are very fortunate in that we have the personalities to turn negatives into positives as a force for moving forward. I have no idea whether this is because of genetics or parental upbringing. All I know is that I am happy to have the ability to pick myself up off of the canvas after being knocked down. As my Father used to say, "You have to roll with the punches."

If this is the result of parenting......"Teach your children" as the Crosby, Stills and Nash song goes.

15 Months

There is no question that my Troy practice was in decline for the past 10 years. I was doing my very BEST clinical dentistry in my career but the number of patients that I was treating had been in decline for a decade. How was this possible? Many of the local folks around my office left our practice to have insurance dependant dentists treat them. That said, patients were travelling from fairly great distances (Buffalo, Syracuse, Lake Placid, Connecticut, Massachusetts and Vermont) to be treated in my office. When the recession began for us in July, 2007, our travelling patients became nervous about the economy, stopped spending money and delayed dental treatment.

We thought, we thought some more, we discussed, we adapted, we planned and responded. We acted on our thoughts and opened our new and beautiful office in Saratoga Springs, NY in January, 2009.

This past week was the first week in almost a decade that we had a full schedule of patients after 15 months in our new office. I am not able to state that we are out of the woods and will be eminently successful but what I can say is that our PASSION for what we do, our incredible training and education, skill and knowledge and finally our endless dedication to the pursuit of EXCELLENCE is becoming recognized by patients throughout the Capital District.

And one of the best parts of being in our new Saratoga office is that I never hear the words from Billy Joel's song Piano Man when out of town patients arrived at my Troy office. No one asks, "Man what are YOU doing HERE?"

I am thrilled to have taken the incredible risk to start all over again in the worst possible economy...Most consultants would say that what we are doing, at my age, cannot be done. We are doing it.

Congratulations to us!

EXCELLENCE

It is my job to care! It is my job to take care of each one of my patients in the best possible way that I can. Excellence is NOT an option in my office. Excellence is what we choose to do and how we treat our patients. What patients do not understand is that by selecting EXCELLENCE, the patient will pay more and receive better care but Excellence also has a high price for the doctor as well. Doctors that decide to dedicate themselves to EXCELLENCE will usually earn less than a mediocre, high volume doctor.

By selecting excellence, the doctor can see fewer patients and earn less income than the doctor who participates in an insurance plan and treats 3 patients at the same time. This is a prescription for mediocrity and a significant percentage of failure.

Patients also have a choice; When excellence is the choice, patient satisfaction should be high, patient care should be superb and the initial cost will be higher.

If paying less for care is the chosen option, then mediocrity will be the final outcome which means that sometimes patients will be happy with their care but often the results will be less than expected and the patient experience will be compromised.

So what do you want for yourself? The fee for excellence is higher but the PRICE of excellence is far less than for mediocrity.

Think about this.

"I Never Had a Dentist That Cared as Much as You"

I just got off of the phone with a patient who I have known for about 5 years. His treatment was complex and the results were not what would have been expected or predicted. Yes he has a fabulous smile that my staff and I created for him but the orthodontist was unable to move his teeth into the position that would have yielded perfect results...This is real life and not everything occurs as we plan or hope.
I am re-establishing a more comfortable bite for my patient that was not provided by the orthodontist. I treated my patient yesterday (Friday) and asked him to call me Friday afternoon or Saturday morning so that I could make any refinements in his new bite. I called him this morning and he preferred to wait another few days to see how his bite feels. At the end of the conversation, he thanked me for my call and said," I never had a dentist that cared as much as you."

Every single one of my patients MUST feel and believe that I care passionately about taking care of you. Your dental health and MY happiness depend on it.

The Perfect 10

I have always believed that it is my job to try to be the best clinical dentist, the best employer,the best teacher and the best person that I can. All human beings fall short of perfection and that is both factual and perhaps by design.
In February, I gave a lecture at the Root Canal Expert's Education Center on Excellence in planning and treating the cosmetic patient. Yesterday, I recieved the final results of the lecture evaluation from the course participants. Unfortunately, many who attended (and enjoyed) the lecture didn't bother to complete the form but for those that did, here are the results:



The PERFECT lecture.

I am thrilled by the survey results as were the Course Directors, Dr. Francisco Banchs and Dr. Allyson Byrn. This means that we are doing everything right in helping our colleagues select EXCELLENCE in how they treat THEIR patients.

I spent at least 100 hours in preparing for my lecture that I was to receive no monetary benefit. Those that select EXCELLENCE as their modus operendi (how they do things) do not do so for the money. They do it for the personal satisfaction that they receive and for the professional respect that we recieve from our colleagues.

It was great to see that I had done everything RIGHT during my lecture.

Integrity Gets in the Way of Making Money

NO IT DOESN'T!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
I have taken care of three generations of one family for quite some time. The grandfather,the son and his children. The grandfather came to me a few weeks back looking for help on improving his smile. Everyone knows of the scandals that take advantage of the elderly and separate them from their money. I spoke with the son and asked him how much dentistry did he want me to perform for his dad (80+ years old.) I informed him that my relationship with his family was extremely important to me and that violating that trust in exchange for making money was unthinkable and just would not happen. The son told me that he trusted me implicitly and knew that I would always take care of him and his family. Ultimately, the son told me that it was up to his father as to what treatment he would have.
I saw the grandfather yesterday to discuss options and told him that his teeth were healthy and needed little treatment but if he WANTED to improve his smile, it could be done. I cautioned him that it would take many hours of treatment and that he needed to proceed carefully.

Integrity or $15,000?

NOT EVEN CLOSE! I would never sacrifice my integrity to earn a buck. And everyone that reads this or knows me and my office should know that.

I don't want your money if I can't earn my living ethically and with integrity.