"Affordable Luxury Is an Oxymoron"

Who said this?

Consumer Reports in the January issue discussing cars.

Whether most folks know it or not, the word 'affordable' is a marketers word for 'cheap' or 'poor quality.

"Quality" is a word describing excellence and excellence cannot be delivered for pennies...for anything.

There are commercials on TV for 'Affordable Quality Dentistry' or 'Fidelis (medical) care."

I have told you many times that overhead in a dental practice averages between 71% and 75%. What does 'overhead' in a dental practice include?

The rent of the office at 18 Division Street
The HOA fees
Taxes
All Dental office supplies and equipment
Laboratory fees
Electricity and gas, telephone and internet
Insurance
My valuable staff (The best trained and loyal staff in the Capital District)
All the Continuing Educations costs
New Carpeting in the office
New Painting of the office

So my personal income is (to keep the numbers easy but not necessarily accurate) 30% of collections.

But wait!

Government at all levels took ONE HALF of the 30% that was left or said another way: Government took more than 50% of the income that I earned.

So is it possible to have excellence in dental care delivered inexpensively????

Not possible...Again...NOT POSSIBLE.

Overhead is too high for dentistry to be both inexpensive and be excellent.

A patient can have cheap dentistry but it will be average or less.

A patient can demand excellence and the cost will be commensurate with the quality...

Consumer Reports told you what I have said for 20 years: Affordable Luxury is an Oxymoron.

Cheap dentistry is NOT quality dentistry; And "Affordable quality dentistry" is almost a dishonest statement.

My Job is to Take Care of You

A patient who has been in my practice for 35 years called our office early this afternoon telling Tricia that she had a terrible toothache...On a scale of 1 to 10 with 10 being the most severe pain...the patient WAS a 10. We saw her immediately and determined that she had an infected tooth and required a root canal.

What would be the right thing to do??? It is 2 days before the Christmas Holiday and few professionals will be working tomorrow... We called Dr. Banchs at  Root Canal Experts and asked him if he would be so kind as to see my patient...

Now Dr. Banchs is no 'regular root canal guy.' He is one of the best in the world. We are going to get one of our long term patients an appointment with one of  best endodontists in the WORLD within ONE HOUR?

Yes!!!!!! Because that is how we try to take care of OUR patients.

Go ahead and try to get a Park Avenue physician in Manhattan to give  you an appointment just because you are in agony....Not going to happen unless you know someone who knows someone.

But YOU  do know someone...You are our patient and we will always try to do our best to take care of you.

When I left my office, I stopped at Dr. Banchs' office to see how my patient was doing...She was having a root canal by one of the best in the world...without experiencing a second of pain.

That's how we do it. (Thanks Dr. Banchs for making our office look good.)

Just Incredible

I receive many Christmas and New Years cards from patients, friends and colleagues. The vast majority of my patients always include a personal message in their card.
I am so honored by your kind words telling us that we are more than 'just' your dentist.
Thank you so much .

(This person has been my patient for almost 20 years)
 

We Thank YOU

Our office thanks all of you for your caring and concern for Donna. As luck would have it, Donna had a toothache during her course of chemotherapy and needed a root canal and a new crown.  At the crown appointment, I asked Donna about her root canal and she said, "Dr. Banchs is amazing. I never felt a thing."

Donna looked well and she said that her current course of chemo is easier to tolerate than the last drug that was used. She still says that her treatments make her very tired.

We all thank you for your cards, notes and your expressions of concern for Donna and our office.

It is deeply appreciated.

International Week at Dr. Benjamin's Office

This is a pretty special week in our office. We will see three patients who will travel hundreds or thousands of miles to have dental care in our office.

We saw our new patient from Singapore today and probably every day this week. Also, a long time patient who dated one of our staff's sons. Her Mother lives in NYC and she lives in Japan. Every time she comes 'home' to her Mother, she drives up from The Bronx to have a dental appointment. I have treated this young lady for more than 10 years and she refuses to go to any other dental practice. Lastly we saw a young Lady from Toronto, Canada. Her Mother recently became our patient after she married a man that I have cared for for 30+ years. Her Mother insisted that she become our patient after learning that tooth decay was left under her new bonded fillings.

Someone just told me that our office was ME and that if and when I retire, the office will be 'just' a regular dental office.

WRONG!!!!!

OUR office isn't ME...Our office is a dental practice dedicated to excellence  and as long as the dentist in our office is continuing the legacy of excellence, our office will survive and prosper.

People are coming from all over the world to have care in our office because WE CARE...and we dedicate ourselves to taking care of YOU and YOUR Family.

That is our reason for being.

A Christmas Card

It is my belief that I have taken care of more patients for 25,30 and 35 years than virtually any other dentist in the Capital District. Last week we received a Holiday Card that said:

"Thank you for all you do for me and my family. I didn’t think I would get through my first appointment back some 30 years ago.

But here we are! I consider you one of my best friends!

Signed  “With Love” "

I am so honored and thrilled to receive cards and notes from my patients expressing their concern when I am injured, their appreciation to us for helping them keep their teeth  and lastly for  their expressions of love and friendship.

I know that we are 'only a dental office'  but we have taken care of people for sooooo long that we are a part of their family.

Thank you to everyone for your kind notes and cards now and throughout the year. It is a privilege and an honor to care for you.

Tomorrow

Tomorrow Dr. Banchs and I will treat a patient who is traveling to the Unites States from Singapore  to have dental treatment in our offices.

How can that be????????????????

There are many fine physicians and dentists around the world but the chance of receiving the best health care is still in the United States. Most  American citizens will NOT get fabulous health care for a variety of reasons:

1. They feel that all doctors are the same
2. They will only go to doctors that participate with their insurance
3. It is not important to them especially when teeth are involved (Just take it out)

I am so honored and so flattered that an individual would fly around the world to have dental treatment in our office. My new patient must see something that we are doing right.

Social Security...Here we go again (NOT political)

My Father paid about $15,000 into Social Security and between his Social Security monthly payments and Medicare he was given hundreds of thousands of dollars in benefits...And I have NO problem  with that. Every generation pays for the generation that went before: brilliant!

In 2004, the first legislative act proposed by  President George W. Bush after his re-election was to attempt to privatize Social Security. That meant that you would be free to invest your own money in the Stock Market and you would no longer get a monthly benefit from the Government. It generally doesn't matter which party a voter belongs to, they don't want their Social Security touched. Mr. Bush's attempt to end Social Security failed miserably.

But that did not stop Sam Johnson of Texas who  just introduced a bill (http://samjohnson.house.gov/uploadedfiles/social_security_reform_act_bill_text.pdf) to slash monthly Social Security benefits except for the very poor.

Susan and I both worked more than 40 years and we have contributed much  more than $500,000 into Social Security and Medicare. It's OUR MONEY and not the Governments.

Do you really want YOUR benefits cut or YOUR Elderly Parent's benefits to be slashed?

Call your Congressman or woman and tell them how you feel. It is YOUR MONEY.

Nice Compliment

I post many of my cases on one of the premier  international dental forums: DentalXP

This forum has many world class dentists especially in the field of implant dentistry. As you know, I do not surgically place implants but I do the restoration of the implants. That means that I place the actual teeth onto the implant roots. That said, I feel that I need to know many of the preceding surgical steps that go before I place the crowns, bridges or dentures.

The hardest part of implant dentistry is making the gum tissue around the implants, healthy and in the right place so that the implant crowns look like teeth.

In the case that I posted yesterday, a new patient came to my office after the implant had been placed; she was very unhappy with her treatment. One reason was that she had the 'infamous' black triangle between her teeth. I asked the advice of many on the forum so that I could determine how to close the black space. Most of the suggestions involved orthodontic treatment but I thought that I had a better way to close the space.

I decided to place restorations with ideal shapes that would encourage nature to do what I wanted and my treatment was successful.

Note that the black triangle is filled in with pink, pointed gum tissue. Believe it or not, closing that space is one of the most challenging things to do in all of dentistry.

So what did some of my colleagues say?

 Manuel De LA ROSA says on 11.29.2016 07:07 PM

Gerald, congratulations on your treatment management and results. It really takes a lot of details to manage this great combined perio-ortho-pros to achieve such a great result. I agree with Maurice on the CTG for the future of the soft tissue margin, specially thinking on the long run. As Jorge says, most of times the simplest option results the most favorable....and some times difficult to achieve. Beautiful case and result!
Thanks for sharing such a nice case.
Best regards,
Manuel 

Do you think that the fact that I have almost 6500 HOURS of post dental school education has anything to do with my clinical success? 

Please find THE BEST health professionals to take care of you. Your happiness and your life depend on it.

Interesting

I am able to see how many of my blogs are read. I don't know WHO is reading this but I know how many people have read it. My average blog is read by about 16 folks.

Would you like to know which blog was read the most? And would you be interested to know which blog was read 3 times more than all the other blogs?

The blog imploring you to VOTE!

In a way, I am thrilled that more people read that post than any other...

We need to be good citizens.

Something Is Bothering Me (NOT POLITICAL)

I do not care how you voted and it should not matter to you how I voted. That said, I expect our politicians  to be honest with us when they want our vote.
This is what our President-elect said that he would do upon winning the election:

1. End ObamaCare
2. Have a Special Prosector to investigate his opponent and hopefully lock her up
3. Build a wall between America and Mexico
4. Reverse the Executive Order on opening up Cuba
5. Deport illegal aliens immediately

Word has it that he will not keep one promise...NOT ONE.

I don't care how you voted but do you think it is right for a politician to lie to us in order to be elected.

What happened to integrity...

I told you that this blog would not be about politics.

Standards of Excellence

A few days ago President Obama gave the Freedom Medal, the nation's highest civilian award to an incredible group of Americans. Each of them represented the best, most talented and most respected individuals in their respective fields. If you haven't seen the entire presentation which lasts about an hour, I suggest that you go to YOUTUBE to view it.

When the President presented the medal to Michael Jordon, he commented that it is often heard of a surgeon being referred to as "the Michael Jordon of Surgery."

Why?

Because Michael Jordon represents the absolute best at what he did...

Michael Jordon is THE STANDARD by which  all basketball players will be measured.

Who cares? And why is this important?

It is important because almost everything we see in America today involves lowering our standards or expectations so that we are not disappointed.

(Aside: Do you REALLY think that Donald Trump or Hillary Clinton represented the BEST that America has or did we settle?)

To me, STANDARDS matter.

Don't you think that I would just love to be called "the Michael Jordon of Dentistry?" It is not going to happen but I hope, dream and strive for that every single day that I treat a patient.

My new favorite saying is:

"If we lower our expectations sufficiently, everything becomes acceptable." *

Don't lower your standards. Seek Excellence. Yes it will cost more...but you are worth it.


* When I googled my favorite saying, I found reference to ME as the person that said it.

Distance is NOT an Issue

The day before a holiday tends to be a very easy day because many folks are traveling or too busy planning for festivities the following day...After being in practice for 40 years, I understand this and never get upset or concerned that our schedule is not full.

Yesterday, my patient from Connecticut cancelled her appointment and for good reason. Instead of taking her 4 1/2 hours to get home it could have taken her 8.. Wise move.

When I checked my schedule though, the Connecticut patients time was filled with my patient from Boston who was killing two birds with one stone by having dentistry and visiting her family for Thanksgiving.

My last patient of the day flew in yesterday morning from Phoenix so that I could repair his front teeth which he chipped while lifting weights...Yes he will also stay with his family for Thanksgiving.
The day before, he called our office to make sure that we would not be closing early on Wednesday (yesterday) because he was specifically coming home to have his teeth fixed.

I am so honored that patients will make the greatest effort to remain our patient even when they leave the area.

Whether you live next door, in the Capital District or out of State...I sincerely appreciate having you as my patient.

Thanksgiving

We wish you you and your family a Happy Thanksgiving.

Every patient that I treat is thanked for being our patient.

At the end of the day, I thank each of my staff members for their hard days work.

I am so grateful for having the knowledge, skill, talent and ethics to take care of you the best way that I can.

Susan and I are thankful for our health, our family and our friends.

Everything I have is because of you, my patient....And I thank you.

3=100

Now what does 3=100 mean?

My first three patients yesterday have been my patients for a total of 100 YEARS.

Is this surprising?

Not to me.

Many of my patients have been with me for 25,30 and 35 years and I believe that I have more long time patients than any dentist in the Capital District.

On Monday, I went out to the waiting room to chat with my first  patient who has been with me since 1980. When he told his son that he was driving (from Berlin, NY) up to Saratoga to go to the dentist, his son ask, "Now why would you drive that far to go to the dentist?" My patient responded to his son, " Because everything he has ever told me has been true."

Trust in those who take care of us is suspect these days. It is hard to know whether the doctor is looking out for their own best interest or the patient's best interest...

What we are seeing today is a decline in civility, in ethics, in integrity and doing the right thing.

Everything in our office is about YOU, our patient. I will never hurt you for money. I will never take your money and not give you value.

Now do you understand how 3 can equal 100?

There Are Some Things That Need No Comment Or Explanation

This just appeared on the CNN website:

CNN)The mayor of Clay, West Virginia, has resigned and another county official is out following their exchange over a racist Facebook post that compared first lady Michelle Obama to an "ape in heels." 

The county employee, Pamela Taylor, worked as director of the Clay County Development Corporation and wrote on Facebook: "It will be refreshing to have a classy, beautiful, dignified First Lady in the White House. I'm tired of seeing an ape in heels," according to a screengrab obtained by CNN affiliate WSAZ.

Mayor Beverly Whaling commented on the post saying: "Just made my day Pam," the screengrab shows.

Clay County Commissioner Greg Fitzwater confirmed to CNN that Whaling resigned, but did not know if Taylor was terminated or resigned her post. But he said that she was no longer working for the county.

CNN has attempted to reach both Whaling and Taylor for comment and have not heard back. (End of CNN post)

Whatever happened to our decency?

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VOTE!!!!!!!!!

In life, adults rarely get the opportunity to make the perfect choice and we frequently grumble that  we are not going to get what we want.

Get over it!!!!

Nothing in life is perfect...Never was and never will be.

The right to vote is precious and we should remember this. People died so that we can vote.

If you don't like your choices...you can sulk and in three years demand better choices.

Hold your nose if you must...

BUT VOTE!!!

And Who Made That Decision (Not Political)

I often wonder, " Now how did a supervisor approve that choice?"

Today Susan and I went food shopping at Hannaford's and one of the items on our list was Death Wish Coffee in the K Cups. This is not our usual coffee but we indulge periodically.

We went down the Coffee aisle looking for bags of Death Wish but no Death Wish...Oh well, we can get some during the week.

At the check out counter the cashier asks the usual, "Did you find everything?" I always think, "Why do they ask when they really don't care?" One of the store managers was helping pack groceries and she immediately responded with, "I think Death Wish Coffee is in the Cereal aisle."

Susan and I said at the same time, "That is exactly where I would put it" in a half serious tone. No one got the humor in our statement.

Now really...Who approved placing Death Wish Coffee in the Cereal aisle, one aisle over from the coffee aisle? I want to talk with that person to learn the logic in that decision.

A while back Senator Schumer agreed to extend the Hedge Fund Mangers Federal Tax Exemption for BILLIONAIRES which allowed a manager who earned $4.2 BILLION in one year to pay NO FEDERAL TAX, NO MEDICARE TAX AND NO SOCIAL SECURITY TAX...He did pay %15 Capital Gains taxes, however.

My question to Schumer is, "What were you thinking when you agreed to let a BILLIONAIRE pay no Federal Taxes? Who are you working for? The People or special interests.

Senator Schumer: "How did you make that decision?  Would YOU  be the one who made the decision to put Death Wish Coffee in the Cereal aisle?

In our office, major decisions are made with everyone's input and sometimes I am over ruled. I am not always right and I may not be seeing all sides of an issue which is essential for good decision making.

"Capital Living Magazine's List of the 'BEST DENTISTS.'

I am always  happy to be selected by other dentists in Saratoga Springs to be on Capital Living Magazine's list of 'Best Dentists.'

Unfortunately, the list is meaningless...Better to be on it   but................

So what is the problem?

This same magazine lists the 'Best Doctors' in the Hudson Valley for each specialty in medicine.. The magazine supposedly surveys many doctors and asks who they feel the best physicians are in each specialty within an 80 mile or so radius.. The Best Dentist List asks dentists in EACH SMALL TOWN who the best dentist is in that small area.

I was not selected as the Best Dentist in the Capital District. I was not selected as the Best Dentist in the Hudson Valley....Only one of the best dentists in Saratoga Springs....

Big Deal!!!!!

I saw several dentists on the list and I was not impressed.  In fact, I would rather not be on a list that included mediocre dentists.

Oh well...I made it on the list..."Ho Hum."

"I Just Saw One of Your Patients."

Six dentists from the Capital District attended an implant course in Boston recently and when chatting with one of the young dentists, he told me that he recently saw one of my patients.

In MY MIND, someone who comes to my office, has a tooth fixed and then leaves is NOT one of my patients. These individuals usually are shoppers who believe that all dentists are the same and if you can find 'a good one,' for a cheap price, then that is where you  go.

So what did the young dentist say to me?

" I saw one of your patients recently and you did a resin bonded filling on an upper first molar  and it was  the best and most beautiful filling that I have ever seen."

I am always honored when another dentist sees my work and calls or emails me to congratulate me on the fine work.

This should make, YOU, my patient, very proud.

Learning Never Stops

I attended a two day implant educational program in Boston this past weekend.
30 dentists from around the country attended the program and the vast majority had never seen any of the treatment presented. The course entitled TeethXpress involves the removals of all remaining teeth (Most of the teeth are not savable even if money is no object.), placement of 6 implants in the top of the mouth and 6 implants in the bottom jaw and finally the placement of screwed down dentures so that the patient has teeth and will never be without teeth.

This level of dentistry did not exist five or six years ago and is really a miracle.

The other miracle is that Dr. Bulford, my surgeon and I are already involved in treating 6 of my patients. I have completed many cases like this but they have not been treated in one day.

If you know of anyone suffering to wear dentures and they are at their wits end, they should know that help is available. Yes this level of treatment IS expensive but when money solves a problem, it is worth spending the money.

You can go online and enter: "TeethXpress.com is you or your family wants to learn more about this amazing treatment option.

Why do I study so much??? To take care of YOU. Taking care of you is my life's work.

Wells Fargo

The culture of many large companies are corrupt. Usually these same companies rail against government regulation which makes sure that they obey the rules and laws.

This past week we found out that Wells Fargo, America's largest bank was opening millions of fake accounts for people that did business with WF but did not want to have those accounts. The accounts generated millions of dollars in fees for the bank.

We also learned that WF was repossessing cars financed through the bank of soldiers who were overseas fighting in Iraq or Afghanistan. This is a violation of Federal Banking regulations designed to help soldiers who many not be in a position to send a check to the Bank.

Wells Fargo paid over $100 million in fines to get Government to leave them alone.

This is not American Capitalism...It IS fraud.

Just so you know: In the almost 40 years that we have been in business, we have never hurt a patient for money or took money from patients that we did not earn honestly.

Donna

If you have called our office recently, you sometimes have Donna answering the phone and other times Tricia answers your call.  Donna has recently been diagnosed with breast cancer and has been having many doctor's appointments both locally and at Sloan Kettering in Manhattan. Donna began her chemo this past week and has suffered the usual complications of the medications.

Donna will be out for a while during her treatment. We are all concerned for her and are hoping for a complete recovery.

We love Donna and wish her well.

Another Loss

I took care of David since he was about 12 years old. His family, one of my favorites, has been my patient since about 1981 or for 35 years.

About 13 years ago, David developed a neurological disease which forced him to stop working and to, once again, be dependent on his parents. None of his family ever missed a 6 month dental check up but a few years ago it became evident that David was declining as he would have to be helped into and out of my dental chair. Several years ago, David received his health care through Medicaid and his Mother told me that he would have to go to another dentist because I did not participate in that program. My response was: "ABSOLUTELY NOT!!!!. I have always taken care of David and I would continue to do so AT NO CHARGE. This is how you take care of people when they are down on their luck.

I received a one page letter last week informing me that David had succumbed to his disease.

I was heartbroken to learn the news. At the bottom of the page was a long list of people that the family wanted to thank and my name was mentioned.

I was honored to be David's dentist almost all the days of his life.

"You Have the Best Dental Patients"

The is how Dr. Francisco Banchs describes MY patients.

Why does he say this?

Because he calls YOU: intelligent, engaged and involved. He also says that you are aware that neither his office, Root Canal Experts, nor my office is interested in taking your money unless we give you value. This means that you KNOW that we are sincerely interested in taking care of you.

Every dentist: the good, the bad and the great receive letters and card of thanks and appreciation several times a year. In our practice, we receive cards and letters  as often as several times a week.

This is a "Thank You" card that I received this week:

 

 

 

 

 

 

 

 

 

The World is Flat

16 years ago Thomas Friedman, a renown international reporter for the New York Times wrote a best selling book, "The World is Flat." His point was that the entire world was becoming interconnected and that we had better learn to compete with people from around the globe.

My favorite dental form is the highly regarded international group called Dental XP. Many members of the forum are world class and leaders of my profession. Trust me when I tell you that the best dentists in America are among the best in the world but the best dentists around the world are far better than the Average American dentist...Sad, I know

There is a very fine clinician who is an MD, DDS, Oral Surgeon and Periodontist on the forum who happens to be from Croatia. She posts some of the most spectacular dental implant surgical and restorative cases for critical comments. I am one of the non implant surgeons on the forum and I am highly regarded for my knowledge and ability in restoring teeth and implants.

Dr. Snjezana Pohl posted a case yesterday and she asked for comments and I was happy to make restorative suggestions prior to her case being completed. This is how she responded to my comments:

 snjezana pohl says on 09.18.2016 02:23 PM

Thank you, Gerald. I appreciate your knowledge, sharp eye, your advices and taking your time to help me to make better dentistry! I understood each point and agree with you. Technician and prosthodontics colleague will receive it.
Thank you again (actually, I decided to post more cases with provisional, hoping for your comments).
Best regards
Snjezana 

I am honored by Dr. Pohl's comments; her comments she make you happy as well in that you KNOW that YOUR DENTIST is recognized both inside and outside the United States.

"This is the First Time that I Have Been in This Room"

People constantly think  (and say) that I am a very expensive dentist. I tell people that it is my job to help you keep your teeth all the days of your life. That means that I do not routinely cut down your beautiful, healthy tooth structure for a crown to "save your tooth." Crowns ARE expensive and most other dental treatment is considerably less costly.

Today one of my long-time patients...35 years...was in to have some fillings placed because she developed tooth decay. This 78 year old patient had EVERY SINGLE TOOTH that had when she became my patient more than 3 decades ago....She also had only one or two crowns placed in all of those years.

As soon as Mrs. G sat down in my chair she says,"Wow, I have never been in this room before."
Mrs. G came with me from Troy and we see her at least once a year for a cleaning and checkup which means that she has been to my "NEW" office more than 10 times during the last 8 years.

She has had NO dental treatment  except for cleanings for almost a decade...

Now really, if you don't have to pay ME to fix your teeth for almost 10 years, how can I be expensive?

PS: Most of the treatment done for this patient was placed 18-25 years ago....That's good dentistry

The Corrupt Sugar Industry

In the 1960s, The Sugar Research Foundation  paid Harvard scientists  the equivalent  (in today's dollars) of $50,000 to convince the country that it wasn't sugar that was causing heart disease but rather fat. This just came to light in the most recent issue of JAMA INTERNAL MEDICINE. (JAMA is the Journal of the American Medical Associate and one of the most influential medical journals.)

This means that for the last 50 years we have been told that we must reduce our intake of FATS if we want to keep our hearts healthy.

Once again, we get misinformation because honest people were willing to sell their integrity for money.

Is this any different than the employees of Wells Fargo opening fake credit card accounts and loans in our name so that they could earn more money?

We tend to see the corruption around us as something new but the reality is that unethical behavior by business has been around for quite some time.

May patients must be sick of me saying that I am not interested in your money if I do not give you value. On Tuesday morning a staff member's relative came into our office with a toothache and after examining the patient and taking an x-ray I informed the patient that he could ask Dr. Banchs, the root canal expert and I to save his tooth BUT the reality was that despite the fact that we could save the tooth for a year or two, it might be better for him to remove the tooth and not waste his money because the the tooth was so badly destroyed by tooth decay.

Am I crazy??? I could have made $1700 for doing a crown after the root canal was completed and instead I made $125 for the consult. How could I do this?

Integrity.

Ethics.

Do the right thing.

I do not hurt patients for money. I will not take your money unless you benefit from my treatment.
I took an oath to do no harm and after 40 years.....I still believe in that oath.

'Her Passion Was Taking Care of Her Patients'

As many of you know, I love reading the obituaries in the daily New York Times because I get to read about the accomplishments of many people that most of us have never heard of.  Since most of us never brag about what we have done in our lives or the other people that we have gone out of our way to help, it is nice to know that someone will learn what our lives were about.

Today, I read of the passing of Dr. Jody Ross Birns, a pediatrician  who practiced in White Plains, NY and who succumbed to breast cancer at age 60. In the obituary we read:

"She loved family and friends. Her passion was taking care of her patients with who she developed a very strong bond. This was attested by the large number of second generation patients who brought to her by parents that she took care of when they were children."

There is no greater appreciation shown to a doctor than having multiple generations of patients to treat at the same time. In our office, we have seen THREE GENERATIONS of patients which is something that may never happen again because the oldest generation is passing on and the younger generations often do not return to their parents geographic location after college.

I am most honored to have taken care of my patients for a very long time...many for almost 40 years.
As I have said many times..... The doctor/patient relationship is one of the most special of human relationships. It is not husband and wife or parent and child but it is right up there when a patient asks you to take care of them and TRUSTS that you will do so.

Sadly, for most patients this relationship  is coming to an end with my generation of physicians and dentists. Patients move around between dental offices to 'find the best deal' which is often not the same as 'find the best care.'

This ,like many things in American life, saddens me a great deal because taking care of you has been my life's work and not just a job.

The Game That Our Congressman Play (non political)

I have tried to email both of our Congressmen (Tonko and Gibson) many times and every time I attempt to send them an email, an error message appears.

"You have an invalid email address"

Don't you think that I know each of my email addresses?

This what the Representatives of both Parties do when they don't want to hear our complaints or suggestions. This has happened to me many times when I have tried to contact their offices.

Perhaps you can answer the questions that I wanted to ask our Representatives:

1. Why do I have to begin taking Social Security payments  at 70 years old when I will still be working full time? What difference does it make to Government and aren't I saving the taxpayers money?

2. Why do I have to begin to start spending my retirement savings at age 70 when I will still be working full time? Why does the Government care?  Why doesn't Government leave us alone to make decisions that benefit both the individual AND the Government.

Ask the ole cheer goes: Time to throw the bums out.

"Dentist Shortage in 12 States"

If you believe this headline which appeared in "Dentist's Money Digest" (a publication that I never heard of) then I have an oversold bridge in Brooklyn that I can offer you. New York, which was one of the 12 dentist shortage states listed has 58 dentists per 100,000 citizens. In fact, Long Island has 106 dentists per 100,000, the highest in the State.

So what does this mean?

We do not have a  dentist SHORTAGE problem but an ACCESS to dental care problem. The less fortunate in our society do not have access to great medical care, dental care, great schools or safe neighborhoods...This is nothing new and should not be the a headline in a 'journal.'

So why do we have an access to dental care problem?

NYU Dental School charges dental students $125,000 a year for education. For anyone counting, that means that a young dentist has a 'Ferrari payment' of $3,000-$4,000 a month as a student loan. Medicaid pays a very small percentage of a dentists usual fee and therefore it is virtually impossible to provide care for those on Medicaid except in a government sponsored health care facility where physicians and dentists are on a salary.

As I have explained to you before, the surgical fee for my reverse shoulder replacement was $16,500. MEDICARE (not Medicaid) paid my surgeon $1425. While older folks have ACCESS to medical care, they lack ACCESS to the finest physicians and surgeons because the government will not pay their fees.

We don't have a shortage problem and we don't have an access problem but rather a 'don't want to pay problem.' Government....both Medicare and Medicaid does not want to pay those providing care.

Something to think about.

The Decline of Culture in America

I went to see the Philadelphia Orchestra, one of the best orchestras in the world, at SPAC last night.
The vast majority of the audience was composed of the retired set which is probably par for the course at cultural events like jazz, opera, classical or live theater.

The program last night began with Brahms, then Beethoven and lastly Tchaikovsky. There were three young girls near our seats and they were totally bored by the first 58 minutes of the Brahms music as was this old dentist. The last two minutes  of the music before the intermission  was loud and fabulous.

If we want young people to become excited about culture, don't you think that it would have been wise, on the last performance of the season, to present vibrant, loud, and engaging music? Something memorable?

I have been to performances of classical, opera and jazz and everyone  had gray hair unless they took "preventive measures." Young people have grown up in a digital world and whether we old folks like it or not, we have to give young people a reason to enjoy classical music...and I agreed with the three young girls that the music from Brahms was less than enjoyable.

I am Offended (Not Political)

Many years ago, billionaire Leona Helmsley was widely quoted as saying:

"Only the little people pay taxes."

How do you think the little people on the jury voted when ole Leona was tried for tax evasion?

GUILTY!!!! and sent to jail.

In last weeks New York Times, billionaire Donald Trump was quoted as saying:

"Only stupid people, very stupid people, pay a lot of taxes."

Am I the only middle class person offended when very rich people insult the rest of us when we pay taxes?

Very wealthy people defend themselves by saying, "I pay everything the tax laws require."
While that is technically true, it is worth noting that the wealthy BUY the Congress and tell them how much  (or little) they want to pay.

"Back in the day," the middle class controlled the Congress and we had a fairer, though ridiculous, set of tax laws.

I don't know about you but I am offended when rich people call ME stupid when I pay the taxes that my accountant tells me to pay.

"I am a Cosmetic Dentist"....Really????

Why would a dentist claim to offer cosmetic dentistry and then not even have ONE case on his or her website?

If you Google 'Kitchens' you will find 100 Kitchen specialists who will have lots of kitchens that they have redone and probably just as many testimonials  from happy clients.

So why do so many dentists say that they offer 'cosmetic dentistry' as one of their services and not show any of their work?

Do you really think that they are exceptional at performing beautiful, appearance related dentistry?
Do you think that they even OWN a camera?

For the last 20 years, every fabulous cosmetically oriented dentist can show you many cases that they have personally treated.

Every plastic surgeon and every cosmetically oriented dentist has understood that if you don't have a photo of your work, that you haven't done it.

Don't be fooled by dentists who have no work to show you.

No photos= no work

It is ALWAYS About Trust

My wife Susan was diagnosed with cataracts recently and required lens replacement in both eyes. I noted that Susan could not follow a golf ball even when the ball was hit straight down the fairway.

So who did I send Susan to?

Dr. N became my patient as a young teenager and still is my patient even though he travels 45 miles each way to see me.  Seven years ago I had an eye problem and I became his patient.

You already know that when I have need shoulder and knee surgery, I traveled to New York City for my care. But I know and TRUST Dr. N to treat both Susan and me and that is where she had her cataract surgery.

Yesterday, we traveled 50 miles each way so that Susan could have her surgery and today we made the trip again for her post op check up.

Susan did great and can finally see clearly again...Dr. N. and I treat each other like it matters because it DOES.

Always find great people to take care of you.

Doesn't Anyone Look? Or Care

I saw these prints in an office  and I was wondering whether anyone in the office ever looks at their surroundings.

When I walk into my office (and I am almost always the first person to open my office) I stop and take a look around to see what patients or visitors will see when they enter the door. Is my office neat? Is the carpeting clean? Are the magazines current and neatly placed? Are all the light bulbs working? Is the artwork straight and in the correct place.

Who hung the artwork in this office?

Who walks by the artwork everyday?

What do their clients think?

Am I the only one who thinks that artwork should be presented well and hung straight and in a straight line?

Or does it even matter?

My office, our office, was designed so that you know that we care. We care about treating you the way you expect to be treated. We care about making you comfortable. And we care that you receive the best possible care that we can provide for you.

Of course we are not  perfect but none of us, human beings, are. And we will not tell you that we are 'The Best' although we wish we were.

(Aside: When you hear the vacuum cleaner on a Wednesday or Thursday morning and no one but you and me are in the office...it is because I...yes me...am vacuuming the carpeting near my lab. It is our office and I care.)

Do you think it would be rude to walk into the office and straighten the artwork?

Trust, the Immeasurable Component in Health Care

I have blogged about the fact that intelligent people want to trust their professionals who take care of them but unfortunately, that feeling of trust is not being felt in today's health care environment. And really, why should their be? Physicians and dentists have their health care options controlled by either Government or insurance companies which means that they can no longer practice or offer THE BEST POSSIBLE health care to their patients.

If you talk to physicians and dentists, they are generally not happy and at best, disappointed in their jobs and job satisfaction. Do patients feel their disappointment and lack of job satisfaction?

YOU BET!

And how do I know that? Well, I actually asks my friends and acquaintances who are physicians if they love what they do...The older guys respond that "they used to." And younger Docs do not look at their job as "A Calling" or "a passion."

More importantly, I can look at my schedule to see all of the 'out of town' patients in my schedule.
Last Monday, I had patients from:

Connecticut: new patient:
North Carolina: someone 28 who has been my patient all of her life
Manhattan: someone 27 who has been my patient all of her life
Ticonderoga, NY: a dentist's son who wanted my restorative expertise
Woodstock, NY: a long time (15-20 years) patient

Why are these patients traveling to our office?  In a word, TRUST.

These patients know or have heard that they can trust me to do the best work that I can to take care of them.

(Aside: The Connecticut patient came to my office because I successfully took care of his daughter when she fell while a student at Skidmore. When I asked the patient, "Why did you come to our office?" the spouse answered, "Because my husband wanted dental treatment and we knew that you would do it right."

I truly do LOVE my job...and I don't care who knows.

A Social Experiment

A few years ago one of my patients received the bad news that he was going to lose a front tooth because it was dissolving (called internal resorption). He took the news well and would have the tooth extracted and after a few months have an implant placed and then a crown placed on the implant about 5 months later. The total time without a tooth would be 8-10 months.

I, of course, informed the patient that I would make him an Essix appliance which would provide a fake replacement that would look, but not feel, like he still had all of his front teeth. But to my amazement, my patient declined to have a replacement tooth because he wanted to see how people would treat him when he was missing a front tooth...This is a great social experiment but one that comes at a very high cost socially and professionally. There is ALWAYS a fee to make an Essix because it usually takes me 2-3 hours to fabricate. However, after I saw my patient toothless, I offered to make his Essix at NO CHARGE because I was uncomfortable  seeing him without a tooth.
Offer DECLINED and the social experiment would continue.

My patient is in a management position at New York State and came into contact with many people on a daily basis. So what do you think that my patient learned by walking around toothless?

He learned that people to DO have minimal standards of appearance for their boss and co-workers. People were upset to see someone that they knew, liked and respected missing a front tooth.

Think about that: teeth, dental health and one's general appearance DO matter. Even if a person doesn't care how they look, everyone else cares because WE have to look at you.

It is Interesting

The business professionals in dentistry consulting tell us that the majority of new patients in a dental practice are derived by direct referrals from happy existing patients in your practice. For whatever reason, the majority of our new patients find their way to our office  from one of two ways:

Google or other search engine and from there they will visit our website.
Our extensive direct magazine advertising in HerLife or Saratoga Living.

It is very rare to learn that 'so and so' referred me to your office. Why is this? Are we not making enough of our patients happy? Do our patients not feel appreciated? Do our patients feel that their friends  aren't interested in the quality of dentistry that we provide? Or perhaps people think that I am not a "Real Dentist" and only provide cosmetically oriented dentistry...which is what my marketing in magazines implies. The majority of our patients have only their 'regular dentistry' done in our office and do not have ANY  cosmetically oriented dentistry. We ARE a 'regular dentist' despite being recognized for our cosmetic treatment.

Please consider referring your friends and family to our practice. Ultimately they will thank you.

Funny

There has been a lot of controversy in medicine and dentistry about over prescribing antibiotics  either because antibiotics are not effective for a particular problem OR we are making antibiotics less effective by their overuse.

The American Society of Orthopedic Surgeons believes that it is not necessary to give patients antibiotics for those that have had joint replacements after a certain length of time. And the American Heart Association has reduced the number of heart conditions that require antibiotic coverage.

Last month, I sent about 75 patients a letter stating that I would no longer be prescribing antibiotics for medical conditions and that those patients who do take antibiotics prior to their dental appointment should call their physicians to make sure that they still need antibiotics and if they do, they have the doctor prescribe it.

I saw a patient yesterday who told Tricia that when she received my letter, that she was nervous to open it because she thought that I was announcing that I was retiring.

The patient repeated the same thing to me afterwards..

I found her comments funny.

I am NOT retiring in the near future...but just in case, you might want to have treatment performed sooner rather than later. lol

Don't worry.

Doing the Right Thing and what the Godfather of Cosmetic Dentistry Says About YOUR Dentist

A 12 year old boy fell while skiing and broke his two front teeth. Unfortunately, the teeth developed pain and root canals were needed. I met the young man when he was referred to me by Root Canal Experts to restore his teeth.

I restored his teeth by bonding resin and creating 2 full teeth while  removing only a very small amount of healthy tooth structure. And remember....I could have made 2-3 times the amount of money if I HAD placed crowns instead of bonded resin!

The final result !

So what does the Godfather of cosmetic dentistry, Dr. Ronald Goldstein,  say on an international dental forum about how I managed the treatment for my young patient?

Reply

 Ronald Goldstein says on 08.10.2016 02:19 PM

Perfect result, Gerald, This is exactly the technique and rational I presented in "Diagnostic Dilemma: To Bond, Laminate or Crown?" The Intl. Journal of Periodontics and Restorative Dentistry May 1987. It is just so sad that Endodontists continue to refer patients back to the general dentist telling them to crown the tooth after the root canal was completed.

(Please note that the renown Dr. Goldstein says the same thing that I always do: don't cut down teeth for crowns unless you absolutely have to.)

It is a sincere honor when one of the finest  restorative dentists in the world  says:

                                                "PERFECT RESULTS, GERALD"

It certainly makes me feel good to have Dr. Goldstein's comments...More importantly, it should make
                                                                 YOU
feel good as well knowing that your dentist is highly regarded by his peers.

 

I am Always Surprised

I am always surprised when a wealthy, world class, and media savvy individual has less than attractive teeth. I am  watching Kerry Walsh/Jennings play Women's Beach Volleyball in the Olympics this evening and I noticed that she looks like she has no teeth...This 37 year old world class athlete appears to be 20 years older than she is because you cannot see her teeth...

Firstly, why does she appear not to have any upper teeth  (she does have teeth) when she is so young?
Now many dentists will tell you that she is a (tooth) grinder and that is why her teeth are so short and worn down... My guess is that she had orthodontics as a child and  her upper teeth were moved too far back to close spaces...It is NOT that she grinds her teeth but that rather she wants to have more room to move her lower jaw...

Where is her agent that gets her commercial endorsements? Where is her manager and most importantly, why doesn't her dentist tell her that her teeth can be fixed so that she can regain her youthful appearance? Her dental problem is fixable  by either redoing the orthodontic treatment or by having a bite adjustment and porcelain veneers. ( If you Google her wealth you will see that money is not an issue.)

Why do famous people not have an attractive smile??

Beyond my level of understanding.

No Need to Floss?????

You can get that idea right out of your mind.

Your Mother told you things that had no basis in science but they were absolutely the truth.

I don't care what you heard on last nights NBC Nightly News...Flossing is an absolute must.

Just ask Trish what the difference is to clean the mouth of a patient who flosses all the time and those patients who never or rarely floss..


Blood and smell

Listen...if you don't want to brush AND floss every day, you might as well send me a monthly check because you dental bills will be sky high... It is YOUR money...

Don't floss if you don't want to...But I have for the last 45 years and I will continue to do so...

". Hard work, heart, taking chances — that was always my philosophy.”

No, those are not my words in the title of this blog. These are Barbara Streisand's words in a long article in today's New York Times.

However, they might have well been my words because it is exactly what I believe. I am at the point in my career that I could 'coast' if I wanted to...But why would I? I have always worked harder and longer (more hours per week, per month or even per year) than any other dentist that I know. Studying, learning, expanding my knowledge and understanding, and finally, trying new treatment modalities is what I have done for the last quarter of a century.

I owe this to you, my patient; to be the best that I can be.

I am not a fan of those who see taking care of others as merely a job rather than a passion or a 'calling.'

For those of us who love what we do, hard work, having a heart and taking chances is what defines us. Why would you want to have someone taking care of you who only sees you as a means to buy something that they want.

Very sad.

[Read the entire interview of Barbara Streisand in today's Times.]

Another Honor?

I just received notice that I have been selected by my peers to be included in the Top Dentists group.
Just me  and a few hundred other dentists...

I am not a fan of all  of the kids getting a trophy just for 'participation' or showing up. I am also not a fan of groups like 'Top Dentist' because there are no standards of any kind for selection. I don't know a lot of dentists and a lot of dentists don't know me but some of them selected me to be included in this group.

If I am going to win an award, I want it to be meaningful and for something that is special about me, my staff or our work.

Top Dentists??? Really??? What did I do to 'deserve' this? And what did the other 100-200 dentists do to deserve inclusion in this group...

Are they on the faculty of a dental school?
Do they have thousands of hours of study with the majority of it being with world class clinicians?
Do they post their work for other dentists to see and criticize?
Are they nationally or internationally known?
Have they had one or more articles published in a peer reviewed journal?

I want to be selected for an award that is given because my work is an example of excellence.

Visit many dentist's office in the Capital District and you will see their plaque for 'TOP DENTIST."

I hope that you see me as an example of an excellent clinician...Now that is something that I would be proud of.

"I Have Been Looking for You for 15 Years"

Susan and I take a walk around town virtually every evening to see the tempo of the town during racing season in Saratoga. This evening ,as we left 18 Division Street, a couple approached us and the man introduces himself as a retired dentist who has always used a rubber dam during his 45 years of dental practice.

He told me that his wife was looking at the current issue of HERLIFE and she saw my "Ask the Expert" column. The question asked was, "How do I find a good dentist?" and one of the things that I mentioned was to find a dentist that always uses a rubber dam during treatment.

The dentist congratulated me for being conscientious  by using a rubber dam. He  told me that he wouldn't be treated by a dentist unless the dentist used a dam and that I was the first dentist in 15 years that he could personally visit.

Maybe that's why there are so many dentists in my practice. A dentist that uses a rubber dam is a dentist that cares about quality and no one will dispute this.

"I Couldn't Believe It"

One of my long time patients had an appointment yesterday and was telling me about her experience with online dating. This patient was actually in my chair on September 11, 2001 at 9 AM as the planes were attacking the World Trade Center.   It was the same year that I placed her 10 veneers and she has always looked fabulous.

My patient has been single for a while and decided  to join one of the sites like Match.Com or eHarmony.com. Within a very short time she received 180 notices from men and EVERY one of the 180 men commented on her beautiful smile. She told me that she didn't think that men would pay attention to her smile....

Oh Really?

Every cosmetically oriented dentist will tell you that one of the largest group of people seeking cosmetic dentistry are recently divorced individuals, both men and women. Many people, realize that in order to attract another quality person, they might have to lose some weight, dress better and finally get their dark, chipped, crooked and worn teeth taken care of by a quality dentist.

Maybe it is time to look in the mirror and evaluate whether you are happy with your smile. People ARE looking.

"Thank You! You Changed My Life"

Many times I see a patient with worn, broken or chipped teeth. And many times a patient complains about headaches. My first reaction is that the patient's teeth are not lined up correctly and teeth are colliding.

I strongly suggest that a patient consider an occlusal equilibration or bite adjustment. The cost is $400. I explain what the treatment is and why I recommend it. But understandably, some patients, especially new patients, are reluctant to have the bite adjustment.

I met a new patient 2 months ago on a new patient exam and after chatting with the patient suggested a bite adjustment. As usual, the patient resisted but ultimately decided to follow my recommendation.
A month ago, the patient had an occlusal equilibration and last week she had a cleaning with the hygienist, Trish. After the patient left, Trish told me that the occlusal equilibration had changed her life by eliminating her headaches and she asked Trish to tell me how grateful she was.

I called the patient a few days later to thank her for her kind remarks. First she thanked me for the phone call and then she told me how thrilled she was with what I had done for her...

This is not the first time that a patient has told me how much better they feel after a bite adjustment. Why don't other dental practices offer this??? I don't know but I will  tell you t hat it is one of the most  significant treatment options that we offer.

My job is to take care of you and your family the best that I can. Having my patient's trust is the MOST important aspect of patient care. I will do my very best never to abuse your trust.

Don't Tell Me What I Said

Someone told me today that they referred a patient to me but when they read my blog the discovered that I did not support the Second Amendment to the Constitution. For those who did not read the original blog, I will repeat it here:

 We Tried It This Way

We have tried having a 2nd Amendment with no restrictions.

And how has this worked for modern America?

From my standpoint: miserably.

The unlimited access to assault weapons, designed for rapidly killing the enemy by the military, is unworkable.

Perhaps if all 350 people in the PULSE Nightclub had been slaughtered, we would see some change in our laws on assault weapons.

Perhaps if 1000 children had been murdered in the Newtown School we might think differently.

There is no unlimited, unrestricted right in our Constitution EXCEPT the 2nd Amendment. Even our right to practice our religion is not unlimited. The Supreme Court has ruled that marijuana is not acceptable for use in religious ceremonies. The Court has also limited the use of  'magic mushrooms' during American Indian celebrations.

This also reminds me of the stop light that was installed in 'downtown' Cropseyville, NY.  Cropseyville was a farming community in the middle of no where (but where my office was for 10 years before moving to 'Uptown' Cropseyville). Unfortunately, three downstate residents died in car accidents at the junction of Rt. 2 and 278. Nobody wanted a stop light installed but that didn't matter because the reality was that more people would die if a light wasn't installed. The reality must always dictate what our reactions should be.

We have tried the 2nd Amendment without limits. Now reasonability must prevail.

Teeth are very important to me but so is human life.

What I said and what I mean is this: THERE IS CURRENTLY NO UNLIMITED RIGHTS IN THE CONSTITUTION EXCEPT THE SECOND AMENDMENT...

Speech is regulated and the freedom of religion has limitations. And what I ASKED is after 240 years of having no limits on the Second Amendment, might it be time to limit automatic weapons? It seems that not everyone is responsible in the use of military style weapons.

Now did I say that I opposed the right of American Citizens to bear arms???? Not one word.

Reading is fundamental.

There are many reasons to select my office for your dental treatment. The only valid reason is that you want quality restorative dentistry.  If you don't like the fact that I wear a red tie every day, then please find another office for your care.

Our office exists to provide the best possible dental care that we can....And when I am working, that is the ONLY thing that concerns me.

I apologize for my rant.

How Sad

I recently spoke with two older gentlemen who have been retired for 13 years and 9 years respectively and each was thrilled to be done with work.

How sad...

As someone who has always loved their job, I cannot understand how or why someone would stop working by choice...Do they have another 'calling' in their lives like music, art, philanthropy or teaching that they did not have time for while employed? Or did they spend  3 or more decades working at a job that they did not enjoy or worse.....hated?

Many of my colleagues view dentistry as just a job which enables them to do or buy what they really want to have. Dentistry "done right" is interesting, exciting and never boring. For me, it is about trying to use all of my knowledge (6200 hours of post dental school education) and all of my skills attained over a 4 decade career to produce the finest level of dentistry that I can. Dentistry would be boring if it was only about 'doing another bonded posterior direct resin.' It is ALWAYS about trying to do the BEST possible bonded posterior direct resin that has ever been done in the history of the world. That is the goal despite the fact that the goal is virtually unattainable.

But I am ENGAGED in what I am doing for you.

If someone doesn't like their job...move on...If their job is boring, find a way to make it exciting...
But not enjoying going to work??? Very sad.

8 1/2 Years and 800 Blogs Later

I just checked  to see when my blog started...2008.

Back in the day, 2 or 3 people would read my blogs; today 25 people read each of my postings.

My 'best' blog was read by 51 people and several are read by 30+ readers.

Sometimes a new patient will tell me that they have been reading my blogs for a while before they decided to switch dentists. They became a patient in our office because they liked our office and the kind of people that we are.

I don't know of any other dentists who have been blogging for as long as I have. The vast majority of dentists who blog actually pay a company to produce a 'canned' blog that many dentists purchase....And they only talk about teeth and nothing about the people who 'own' those teeth.

I doubt that my blog will last another 8 years but then again, who knows...Dr. Ronald Goldstein of Team Atlanta and one of my earliest mentors is 83 years old, works 2 days a week and still produces world class dentistry.

We will aim for another 400 and see where it takes us.

Not Everyone who Is Doing the Job Should be Doing the Job

Tom Fuentes, former Assistant Director of the FBI and currently a Homeland Security analyst for CNN was asked about the shootings in Minnesota and Louisiana. What he said was, "Not everyone who has a uniform and has a gun should be wearing a uniform and having a gun."

200 teachers in NYC sit in the 'Rubber Room" and receive their full pay despite the fact that they have been deemed unfit to teach...And they get summers off like all teachers...The cost to NYC? $20 million.

Many physicians and dentists refuse to study, have minimal skills and hate what they are doing but continue to show up for work.

Three examples of three different professions and yet the indifferent and the inept continue to do what they are doing?

Why do we continue to tolerate this as a society? This is not a problem like cancer...This IS fixable.

Is it time to reconsider who protects, the public, teaches our children and provides our health care?

That is for you to decide.

Have We Lost Our Reasonability?

We have to come to an agreement on something.

If a policeman pulls someone over for a broken taillight, he should run a report to see if the person has an outstanding warrant for his arrest. If not, a pre-printed ticket should be handed to the driver and the policeman should say, "Please get your light repaired and have a good day."

Period.

End of Story.

If a policeman pulls ME over, that is exactly what I would EXPECT  to happen...No lecture, no sarcasm, no harassment.

Be civil...give me the ticket and get back in your car and do your job.

Do you really think that this is what happened in Minnesota?

Either the policeman had an 'attitude' or the driver had one. Doesn't matter...someone became unreasonable.

"The Best Thing That Happend Was When I Lost My Dental Insurance."

I have been treating a patient for 7 or 8 years and she recently remarried. Her new husband was told that he needed 4 or 5 crowns and his wife told him that perhaps it was time to visit her dentist in Saratoga.

As is usual, I disagreed with my colleagues about when it is NECESSARY to place a crown on a tooth. Prior to 1992, a back tooth with a large mercury filling or a large new cavity was deemed to be a weak tooth and required either a crown or an onlay. I observed these rules for the first 15 years of my career. In 1992, we learned how to bond to the inside layer of a tooth, dentin, and that meant that we no longer had weakened teeth that required protection of a crown. I was not the smartest guy in the my dental school class but I clearly recognized  that dentinal bonding was a game changer and would save many teeth from being destroyed for crown placement.

That was a QUARTER CENTURY ago and I have been proven correct. My patients have fewer crowns placed on their teeth than any dental office that I know.

When my patient's husband presented to my office, I did agree that his 25-35 year old mercury fillings did, indeed, require replacement but my recommendation was to restore the teeth with a direct resin restoration (a white filling) placed under a rubber dam. My new patient accepted my recommendation and last week I completed the replacement of his old mercury fillings. When my patient got up from my chair, he told me how grateful he was to be my patient and that "the best thing that ever happened was when he lost his dental insurance because he would have stayed with his old dentist."

I am always honored when a  (new)  patient recognizes that our reason for being is to take care of you and that we will always place your best care above our own (financial) well being.

UPTOF8

I was driving on the Northway today and saw a car with the license plate: UPTOF8 or Up to fate.

I have never lived my life in the HOPE that something good would happen to me to ensure my success (both personally and professionally.)

When I had my car accident (I was a pedestrian)  back in 1976 and had  my right leg was amputated and reattached, I always KNEW that if I worked hard enough, I could still have a successful life. In fact, I worked so hard that after 18 months and 4 surgeries later, I was out running 5 miles. (Was it fate that one of the great trauma surgeons, Dr. Roger Seible (now deceased) was my surgeon..Possibly?)

When I fractured my shoulder 18 months ago, was it fate that I had access to a great shoulder surgeon? Or was my recovery and return to work the result of going to physical therapy for 4 months, 3 times a week?

Is it fate that I have an international reputation for being a quality restorative dentist OR perhaps is it the result of taking more than 6200 hours of Continuing Education and much of it with the best in the world?

Yes it is true that no one becomes a success without the help of someone else along the way but the fact of the matter is that an individual must work incredibly hard to reach the upper echelons of their profession. Success is not an accident (or fate). It is always the result of hard work with 10,000 hours being the bare minimum for success.

(An Aside: President Obama said that no one is successful all by him/her self and he was roundly criticized by his opponents. Trust me, we all have gotten some help by someone along the way and I have blogged several times how my broken tooth and a visit to Susan's family dentist helped me get accepted to dental school. Lots of people are accepted to dental school but few work hard enough to become recognized for their abilities.)

We Tried It This Way

We have tried having a 2nd Amendment with no restrictions.

And how has this worked for modern America?

From my standpoint: miserably.

The unlimited access to assault weapons, designed for rapidly killing the enemy by the military, is unworkable.

Perhaps if all 350 people in the PULSE Nightclub had been slaughtered, we would see some change in our laws on assault weapons.

Perhaps if 1000 children had been murdered in the Newtown School we might think differently.

There is no unlimited, unrestricted right in our Constitution EXCEPT the 2nd Amendment. Even our right to practice our religion is not unlimited. The Supreme Court has ruled that marijuana is not acceptable for use in religious ceremonies. The Court has also limited the use of  'magic mushrooms' during American Indian celebrations.

This also reminds me of the stop light that was installed in 'downtown' Cropseyville, NY.  Cropseyville was a farming community in the middle of no where (but where my office was for 10 years before moving to 'Uptown' Cropseyville). Unfortunately, three downstate residents died in car accidents at the junction of Rt. 2 and 278. Nobody wanted a stop light installed but that didn't matter because the reality was that more people would die if a light wasn't installed. The reality must always dictate what our reactions should be.

We have tried the 2nd Amendment without limits. Now reasonability must prevail.

Teeth are very important to me but so is human life.

When the Pain is Unbareable

Last week a patient sent me one of their employees who was in agony. He had had a toothache for two days and was directed to my office.

I was able to get him an immediate appointment with an oral surgeon to have his tooth extracted. While Donna was on the phone with the surgeon, I saw how much pain the young man was in and offered him Novocain to immediately stop the pain. and of course, he accepted.

The young man was put on the phone to speak with the surgeon's office and when he hung up, he told us that he could not keep the appointment because he had no money and no credit card. He left our office before we could tell him that my staff made an 'Executive Decision" that WE would pay for him to have his tooth extracted. Unfortunately, he did not have a cell phone and we could not reach him to tell him to go to the surgeon's office for treatment.

I don't care about what someone's political or philosophical beliefs are about poor people but when someone is standing in front of you IN AGONY, it is hard not to want to help another human being.

[Aside: You might be thinking, "But your office does not accept Medicaid." Correct and I never will. The ONLY people that bear the burden of Medicaid are physicians and dentists. Their reimbursement will not even pay the hourly wage of a top notch assistant."]

There has to be a better way to care for those that cannot care for themselves. The inability to solve this problem speaks more about who WE are than about those who are helpless.

What would you do with another human being with intense pain standing before you?

Mick Jagger Told Us 50 Years Ago

"You can't always get what you want but if you try real hard, you will get what you need." So goes the song.

Maybe it is me..........People are becoming more unreasonable all the time.

I tell my new patients (my long term patients already know) that I believe that I am a very good dentist BUT I cannot change:

1. The laws of physics
2. The rules of biology
3. Your DNA

When a patient presents with a problem and I provide the options for treatment, it is often unreasonable for a patient to say that they don't like their options. Frequently, when I tell a patient who has been in pain that they have two options for eliminating the pain. They can have the tooth removed or have root canal therapy. Sometimes a patient will say, "I don't want either option."

Kindly refer to rules 1 through  3 above.

I cannot change your options nor can any other dentist.

Period...NO EXCEPTION.

I know that this is America in the year 2016 but 50 years later, "You STILL can't get what you want."

Find good people to take care of you and let them do what they do to take care of you.

The Young Guy

A young man in his 20s presented  to my office with a fractured edge on his upper left front tooth.  The tooth had been previously bonded in the Midwest but the young man would not let the dentist remove part of a lower tooth that was sticking up higher than any other lower tooth and was responsible for chipping the tooth in the first place.

I had read the previous dentist's notes and he noted that he refused to let him adjust the lower tooth which is commonly done.

I informed the young man that in High School he was taught a principle in his physics course:

"Two things cannot occupy the same place at the same time." Most of us intuitively know this to be true but some just do not believe it...

Trust me: It is 100% TRUE.

I gave the young man two options:

1. Shorten the lower front tooth
                        or
2. Have Invisilign treatment (Clear othodontistics) to realign the lower teeth...

The patient informed me that he didn't want his lower tooth touched nor did he want Invisalign.

That's nice but the patient cannot dictate treatment that is not in his best interest. Period, No exception.

The patient also said that he would never submit to treatment without having a second opinion.

Really?

So if a patient goes to the BEST dentist in the world but does not like his options, he   believes that it would be ok to get a second opinion from a dentist ranked  2000 in the world??

REALLY????????????

It is absolutely necessary to go to the best clinicians in the world and then listen to their advice.


Yes ,  Really.