It is Telling

Tricia, my office manager,tells me that I should not brag so much. I tell her that I am from New York (City) and bragging is what kids would do in NY. My patients are very grateful for what I do for them and I am fortunate that they freely express their appreciation.

My local colleagues are very reserved in what they say about me and I understand that because dentists in the same geographic area tend to be very competetive. Dentists throughout the country have seen my work and do not feel challenged in the least to express themselves about my work. Our discussion on the ACE forum yesterday was about dentists who are bored or tired with the work that they do. I posted a comment that older dentists should only do the treatment options that they love to do which is what I have done for the last 10 years.

This is what a 68 year old dentist from GA, who I regard as a top clinician, wrote about me:

How can an old guy who loves what he’s doing NOT get excited. I haven’t felt the down turn many have and maybe that’s because I like to do so much stuff. Gerald is world class on restorative and could be on anything he wanted to but, hey, he can make a choice without declaring a specialty…and abide by it.

He also said: Now, I’m no Gerald Benjamin with direct composite but that was less than thirty minutes including the photography. If I could get Gerald’s fees for directs I could take longer.

I am so honored when my peers place me in the same group of dentists that I consider to be MY MENTORS. There is no confusion about the term "World Class." It does not mean that someone is THE BEST dentist but rather in that elite group that that my colleagues look up to and want to be like.

I love my work and all I have always wanted to do was take care of my patients in the best possible way. I am in awe when my peers consider me world class. It really is just another way of saying that I do, indeed take care of YOU, my patients in the best possible way.

Incredible to say the least. And I thank you for being or becoming my patient.

July 24, 1971

Thirty nine years ago Susan and I were married in Niagara Falls, NY. We met in our junior year at SUNY/Buffalo. None of our parents went to college and we both grew up in families with a very limited budget. Our wedding was austere by today's standards but it was exactly what we wanted. I started dental school two years after we were married and it was an extremely challenging part of our lives in every respect. (One day I remember going to dental school with exactly a quarter to buy a cup of coffee.) My accident on July 18, 1976 when I was about to start my senior year did not make things any better as everyone could imagine. We celebrated our fifth wedding anniversary in the intensive care unit at the then EJ Meyer Hospital in Buffalo, NY.

As we sat in front of Starbucks this afternoon, we realized how few people who attended our wedding are still alive. We think that our parents would be very proud of the adults that we have become.

Susan and I think that we have done all right.

(Aside: Susan used to always joke that even if we got divorced, she always wanted ME as her dentist)

What is Wrong With Us?

Lots of folks complain about our wonderful country and blame the Government for what is wrong with us.

This week a representative from the CABLE Company and a representative from the POWER Company scheduled appointments to sit down with us to discuss ways to improve their services for our new office.

The problem is: Neither one showed up for their scheduled visit.

I think we need to look in the mirror when we are looking for someone to blame for why things don't work all that well any more...HINT: It's not the government

The Quest for Knowledge

Last night was another evening of learning at the Root Canal Expert Learning Center, the institute started by Drs Francisco Banchs and Allyson Byrne at 18 Division Street in Saratoga Springs. The Center has national and local experts present relevant and current information about a wide range of dental subjects including, implants, root canals, cosmetic dentistry and implant restoration. This has been cutting edge learning.

Probably the most important part of the Learning Center has been to bring together a group of progressive dentists from our area that comprise the present and the future of dentistry. It is not surprising that we see the same dentists at these courses time after time with only an occassional new face showing up.

Where are the other 50+ dentists that have easy access to the Learning Center? Why don't THEY want to learn? Oh they have their excuses: My patients would never want any of those treatment options, It's my golf league night, My wife asked me to take out the garbage.

How did we as a profession (or a nation) get to be in this situation where the majority of professionals no longer want to learn so that they can take better care of you and I, their patients?

Why don't you ask YOUR DENTIST why he or she wasn't at the Root Canal Learning Center on July 22? And while you are at it, why don't you ask YOURSELF why you still WANT to be treated by someone who was not learning when they should have been?

Thanks Francisco and Allyson for another great evening of learning.

(Aside: My next learning experience will be in Scottsdale, AZ in August with Dr. Frank Spear, one of the best restorative dentists in the world..Why would anyone want to be in the desert in August?...... TO LEARN)

Cosmetic Dentist?

We are, thankfully, building our new practice in Saratoga which means that we see many new patients. I am starting to see patients from one or two dentists who market themselves as 'cosmetic dentists' and from what I see of their recent work, they are anything but a 'cosmetic dentist.' Patients that seek esthetic dentistry have a very clear idea of what they expect to look like after their treatment is completed. They are not expecting to be a movie star but they understand esthetic principles and have expectations that are very high. These patients show up at my consultation appointment very angry, frustrated and disapointed because their results are nothing what they expected and, in fact, the results reminded me of the work that we used to see in the 1980s that passed for 'cosmetic dentistry' because our profession had not yet formulated principles of esthetic dentistry.

Part of the problem is that the dentist has not bothered to master the very demanding and rigorous area of dentistry that is called cosmentic dentistry and as such, has almost no chance of meeting the expectations that some patients have. On the other hand, the patients that arrive at the office of a 'cosmetic dentist' must understand that their insurance will cover little if any of this kind of dentistry and if they do have high expectations, they cannot expect to pay the fees of the average dentist. The more luxurious or performance oriented a car is, the higher the cost of the car and the same concept is true in dentistry.

Every dentist advertises that they are a 'cosmetic dentist' and that is because all of our licenses give us the ability to do 'cosmetic dentistry.'

The New York State Board of Rengents has certified that fewer than 40 dentists in New York State can legally and ethically state that, "they are a general dentist with a specialty in Esthetic Dentistry. All of those dentists have earned a CERTIFICATE OF PROFICIENCY IN ESTHETIC DENTISTRY from the School of Dental Medicine at SUNY/Buffalo.

I am one of those few dentists.

You have a greater chance that you WILL be disappointed in your esthetic dentistry if you select a dentist without a Certificate of Proficiency in Esthetic Dentistry.
And that is a fact.

Let's be perfectly clear about one thing. It is illegal and unethical for a dentist to advertise or claim that they are THE BEST. Earning a Certificate of Proficiency does not mean that you will do the best when you treat patients. It DOES mean that you have been TAUGHT what you need to know but whether that translates into excellence speaks to the integrity of the individual.

July 18, 1976 9:30 pm

A very special night indeed. Special not because it was a happy night but it was the night that I found out that I was 'The Right Stuff."

Exactly 34 years to the minute, I was crushed between two cars and had my right leg amputated and reattached. My surgeon, Dr. Roger W. Seibel, was one of the few trauma surgeons in the country and I was most fortunate that he treated me. Dr. Seibel was 37 and had been a surgeon in Vietnam. Shortly after my surgery I told him that I wanted to be as good at what I was going to do (I was a senior in dental school) as he was at what he did.

Anyone that has suffered a significant traumtic injury will never be the same again. It will take years to recover from the wound and a lifetime of enduring and managing the chronic pain that is ever present. Some humans are not born with the ability to get past these injuries and can become addicted to pain medications and are not happy human beings. Others are fortunate enough to have the ability to get past their injuries and go on to accomplish wonderful things. I am lucky enough to be in the second group.

I barely survived the accident but I had the benefit of a great surgeon and the support of my family and friends. There is no doubt that my life would be much different had I not suffered my injury. I did learn of lot from my accident. I learned that I could be tested by life and still go on to be successful as a human being.

I would not have survived treatment by a mediocre surgeon and I definitely would not have my leg today. I learned first hand how important passion, talent, dedication and skill are.

I don't think that there are many Dr. Roger Seibel's around any more because mediocrity is in demand and excellence is not.

Thanks Dr. Seibel for being a fabulous surgeon and setting an example of excellence during my career. (Unfortunately, my hero and first mentor passed away in 2007.)

The Adelphia: Excellence From a Bygone Era

My friend Dr. Banchs called Susan and I up at 5:15 today (Friday)and asked us if we would like to go to The Adelphia Hotel on Broadway in Saratoga for a quick drink. We haven't been in the Adelphia before and it appeared to be a beautiful old hotel from an era of grande old hotels. The lobby and the gardens were stunning and reminiscent of a British Hotel. As we sat with our drinks, we commented on on how things such as SPAC, The Adelphia, or fine restaurants like 8 Tables or Dine could simply fade into the night because we have not enculturated our children to appreciate excellence.

I have written before about the fact that excellence in medicine and dentistry could easily evaporate before our eyes because patients would rather pay a co-pay for mediocre health care and dental care than be taken care of by superb physicians and dentists.

Many things that represent excellence in our nation will simply fade away because no one really accepts or wants a superb experience at the Ballet or a fabulous physician or dentist that puts his/her heart and soul into taking care of their patients. We need only watch Mystery Diagnosis on TV to know how frustrating it must be to go from doctor to doctor until the patient finds a world class doctor who easily discovers what is wrong with the patient. Invariably, the patient asks, "Why didn't any of the other doctors know what was wrong with me?"

That superb physician, fabulous hotel or the ballet is coming to an end for a lack of appreciation. Use it or lose it...I promise you.

Another Dentist Gives Up

A friend of mine is a dentist in New Mexico. He is a very good dentist and was extremely honest and ethical. He always made sure that when there was corruption or unethical behavior any where in the country, that he would present it on the ACE forum so that everyone knew when the profession was being impacted negatively.

He told me today that he had given up the fight to remain a fee for service dentist and would now begin participating with dental insurance companies. There were not a sufficient group of patients who wanted excellent dental care and would rather have a lower quality of dentistry than pay for treatment out of pocket.

What does this exactly mean? And how will his patients be affected?

1. The quality of care will decline because he will lower his fees.
2. He will spend less time with each patient.
3. He will use a lower quality of dental materials.
3. He will use cheaper dental labs.
4. He will see twice as many patients in a day than he usually does so that he can earn the same living that he is used to earning.

How will his patients be better served by paying less? They will lose more teeth and have more tooth structure removed so that he will be able to earn more by placing more crowns.

This is how this game is played. You pay less and you get less.

Every time a physician or dentists gives up and becomes, in effect, an agent of the insurance company, we all lose because excellence is one step closer to extinction.

The day that I am forced to become an insurance dentist is the day that I will close my office. And everyone will lose.

Be Careful What You Wish For

Managed Care in health care began about 1980 with what was referred to as HMOs or Health Maintenance Organizations. My father was very excited when HMOs first started because he thought that it would be a good way to contain medical costs. I warned him (by repeating what President Reagan said, " There is no free lunch.") and that while HMOs might seem like a good idea, it would lower the quality of health care that the patient received. He ignored me because I was young and had been a dentist for 3+ years. My dad had Crohn's Disease and periodically would have to spend a week or so in the hospital. The nursing care was excellent and when a nurse was called for help, it usually arrived quickly. Fast forward 20 years and on one of his last hospital stays related to Crohn's Disease, it would take THREE HOURS to have a bed pan picked up. Three hours??????

HMO's arrived with great fanfare and created expectations that care would be great and costs would be contained.

Have you been to a hospital recently or waited in a doctor's office for 2 hours?

Be careful what you wish for.

Can You Imagine This?

I received the following email from a relatively new patient that has rapidly become one of my favorite patients because she is intelligent, funny and loves the fact that I truly want to take care of her. I am posting only the first part of her email.


Dear Dr.-I value your opinion above any of my care providers. You are
extremely knowledgeable and informed, you care and you engage and involve
your patients in their care. Why can't everyone be like you?

Can you imagine this? In the eyes of my patient, her dentist cares more than her primary physician or her gynecologist. How can this be? And what does this say about our medical system EVEN BEFORE MR. OBAMA'S changes take full effect in 2014?

I grew up in the 1950s and 60s where doctors cared so much about their patients and teachers were on a pedestal with regards to stature and respect.

I am honored that my patient KNOWS that I truly want to take care of her but I am terribly disappointed that many doctors no longer care about each and everyone of their patients.

I care...I always have and as long as you place your trust in ME, I will do my best to treat you the best that I can.

I Am Truly Honored

When I post my work on the ACE forum, I never ask my colleagues to send me nice comments about what I have posted. Sometimes I recieve a lot of public and/or private comments and emails about my work and sometimes none of my peers are moved to say anything. What is truly amazing, is that my work has become the absolute standard of excellence in the field of direct anterior direct bonded restorations (or white fillings to repair front teeth for those reading this who are not dentists.) Dentists make reference to my work as THE standard even when they are not discussing work that I have posted. Tonight a dentist made reference to ME with this post:

Right before Spring break I did 4, 4 surface anterior restorations on a young college student who is definitely one of those “never satisfied” people who would find something wrong even if it was Gerald Benjamin or Newton Fahl did the work (no I do not include myself in that group-I wishJ!) She called 2 weeks ago to try to get an appt to “touch up” the tooth. Since our office is closed, I am supposed to call her if I am able to see her.

Newton Fahl from Brazil is the undisputed BEST resin dentist in the world. I am truly honored by my colleagues to be mentioned in the same sentence as MY MENTOR, Newton Fahl.

And to think that I was rejected from almost every dental school in the United States because they did not think that I could do this job.

--

I Made a Mistake

I made a mistake last week. I forgot to send out a denture to the laboratory to be finished and therefore we had to cancel the patient's appointment last Monday afternoon. We told our patient that as soon as the denture was returned to our office that we would see her EVEN if it meant that I would return to my Troy office over the July 4th weekend. On Saturday at 11:30, I met my elderly patient at my Troy office to insert her new denture.

I made a mistake! I travelled a total of 80 miles to correct my error and tell the patient that I was sorry.

This is the way it used to be in a kinder and gentler America. If you made a mistake, you accepted responsibility for the mistake, you corrected the problem and you told the person that you were sorry.

Where did we go so wrong that few accept responsibility and apologize?

And What Do My Patients Think About My Work

I often blog about what my colleagues, both local and national, say about my work; They know dentistry and recognize which dentists perform at an exceptional level and those that are average. When I tell you what other dentists email me, I post the exact words on this blog...No exaggerations and nothing out of context.

I receive many notes of appreciation from my grateful patients and I would like to show you an email that I received today:


Hi Dr. Benjamin,
Just wanted to thank you and your staff for my wonderful new style. I felt completely comfortable with the procedure, with you, and your staff. Everyone is so surprised on the different look that it gives me. My fiance is especially blown away. My parents also wanted me to say thank you for working with us. Have a great 4Th and thanks again!!

My patients pay me to do what I love to do and then they take the time to tell me how much they love my work...

70% of dentists would not select dentistry as a profession again. I love my job...How could I not?

I Am Amazed and Honored

I always strive for excellence. I have spent the last 20 years of my career studying with some of the best restorative dentists in the world because I WANT TO BE LIKE THEM!!!!

I am now amazed and honored when other dentists want to be like ME. For 31 years I practiced in a rural setting doing the best possible dentistry I could without any of my colleagues throughout the country taking note of me. Today, a dentist from Pennsylvania posted a case on the ACE forum using a technique that I have perfected.
This is what he said:

Not sure how long these 'build-ups' can last, but if economically the
patient cannot afford an onlay, I think it's prudent that we restore as
close to what nature originally had, as possible. The DB cusp of #19 was
gone here, pre-op, and when we 'hand build' these types of restorations,
putting a cusp back is quite a challenge. These take time to layer up,
and Gerald Benjamin's work makes me strive to really RESTORE a tooth,
and not just fill it.
Thanks for the inspiration, Gerald!
Ray

He did NOT send this message to ME, but rather he posted it on an international forum where other dentists have either heard of me or seen my work.

I hope that it makes you proud to know that other dentists respect and learn from YOUR DENTIST.

It certainly makes me proud.

'But You Don't Accept My Insurance As Full Payment'

A new patient asked to speak with me at her cleaning appointment. After cordial greetings were exchanged she told me that I was the first dentist that did not accept her insurance as full payment. I told her that dentists that offer a higher quality of dentistry never participate with insurance companies. "But all of my previous dentists participated and I never had to pay anything." I really should have been more diplomatic but I wasn't and responded with, "I am sorry but your previous dentists must have been mediocre and I am not."

The public MUST understand that when a dentist is a participating dentist, there must be compromises in the amount of time spent with the patient, the quality of the work by the dentist, the number of patients that the dentist treats at one time,the quality of the materials used, or the quality of the dental laboratory that the dentist hires to make the crowns or veneers.

Some aspect of quality MUST be lowered if the fee is going to be lowered.

It just makes sense...The less you pay the less you will receive. And this is not news to anyone.