An Honest Discussion About Fees

I went to a gathering a few weeks ago to watch a documentary about the gas industry and water polution. An older woman sat next to me during dinner and we began chatting and after she discovered that I was a dentist, she began complaing to me about how much her dentist charged her to fix a tooth. She told me that she was not going back to him because it was $500 to repair her tooth. I did not respond to this person's complaints because it did not interest me to do so. But I think this might be a good time to discuss the cost of dentistry and why fees are what they are.
The average overhead (the cost to operate a dental office) for a dentist is 70%. A few dentist have a lower cost of operation but 70% is about average. The lady I mentioned was charged $500 and the cost of operating a dental office is 70% which means that $150 is left for the dentist. But the average dentist is in the 50% tax bracket (federal, state, social security, sales tax, property tax etc etc etc) so that the dentist takes home $75 out of the initial $500 fee. SEVENTY FIVE DOLLARS!!!

Please remember this when you think that dentistry is so expensive.

My Patient for Thirty Years

Trish, our hygienist who joined our office 6 months ago, has been amazed by the number of patients that I have cared for for more than thirty years...THIRTY YEARS!!!
We have grown older...and in some cases, old together. How many professional relationships last 30 years?
For those patients who are above 65 and who have their own teeth, the overwhelming majority of these folks will verbalize their feelings about being my patient for all these years. It is not uncommon for a patient to say, " I would not have my teeth if it were not for you." These words deeply affect me at this stage of my career.
I am honored and humbled to care for my patients all of these years and I sincerely thank each and everyone of you for the privilege of letting me take care of you.

The Professor

As most people know, I am an assoicate clinical professor (visiting) at the State University of NY at Buffalo and I lectured at the school a few weeks ago. Tonight is my night to demonstrate to my young colleagues what I do for you, my patients. I want them to totally change how they think and consider moving in the direction of not only excellence but also conservative, strong bonded direct restorations instead of cutting down teeth for crowns.

Will I be successful in changing minds of young dentists? Probably not but success will come one dentist at a time. The old dentists that trained me taught me to ALWAYS put my patient's best interest above my own financial interest. I am trying to do that for the next generation. You and I both need to hope that I am successful.
This is a photo of me lecturing at our opening session of our course.

Like No Other Course

Last night, the Root Canal Expert's Education Center for Dental Excellence began our 2-3 year course in earnest. We are going to treat one patient, at no expense to our patient, utilizing the best knowlege that we have regardless of time or cost for the benefit of educating our younger dental colleagues; We are trying to infect dentists who have about 10 years of experience with EXCELLENCE.

Last night we had our first LIVE surgical session to remove a mini implant that was misused to replace an upper front tooth in our patient.

Most dentists think of other dentists as their competition but in a room full of young dentists who truly want to provide excellent dental treatment for THEIR patients, we were truly a group of colleagues. If our class learns nothing about the clinical excellence that we will provide for our patient, they will learn that there are other local dentists who are like minded in their pursuit of dental excellence and this will please me and the other dental specialists teaching the course.

It is an honor to be a participant in the course in the role of teacher. I do not believe that there is another dental course like this anywhere in the country. The four teachers who are giving the course are donating our services to the patient and we are paying for all of the expenses which will be almost $20,000.

We all thank Francisco Banchs and Allyson Byrne for their foresight in establishing a Center for Dental Excellence.

The Internet Makes the World Smaller

A young lady in England is studying to be a hygienist and she sent me an email after finding my blog on the internet. She found my work to be very well done and my blog very interesting. We sent emails back and forth because she was interested in how I started blogging and how did I become interested in doing fine restorative dentistry for my patients.
Last week Vanessa Clegg told me that her blog was going to have an online interview with dentists every week and would I consider being the first dentist that she interviewed. I was truly honored to be asked to tell the world about the profession that I love.

If you would like to read the interview, please copy and paste this into your browser:

http://www.dentist-truro.co.uk/dentist-of-the-week-gerald-benjamin-interview/

The internet makes us all next door neighbors. I correspond with dentists all across America on a daily basis and many dentists from around the world.

Respect Of One's Peers

For a professional, the respect and admiration of one's peers is among the greatest indicators of success.

One of my colleagues on the ACE Dental Forum sent me the following email today:
"I love your posts !!! Keep the high standards coming..............."

As I begin the last decade or so of my career, I have slowly become recognized as a dentist of uncompromising standards.

Making money has never been a sign of professional success for me because I learned very early in my career that some of the wealthiest professionals lacked both talent and ethics.

I am honored by my peer's comments.

You Have Heard This Before

I like Paul Krugman the Pulitzer Prize winning columnist at the New York Times and a Professor of Economics at Princeton.

In a recent column he was ranting about some in Congress wanting to privatize Medicare and how some also want folks to be consumers rather than patients.Dr. Krugman writes about the very special doctor patient relationship and how it is almost a sacred pact between two people. The patient trusts the doctor to take care of him or her and the doctor will do so selflessly.

I have spoken about the sacred relationship that I have with you, my patient, on several occasions and now others are starting to say the same thing.

The patient CANNOT be a good 'consumer' of dental services because dentistry has become very mediocre and you cannot expect to pay an average dentist the same fee that you would pay a superb dentist..You can't buy a Ferrari for the same cost as a Ford even though they are both cars.

Read Paul Krugman's article:
http://www.nytimes.com/2011/04/22/opinion/22krugman.html?_r=1&partner=rssnyt&emc=rss

A Surprising Comment

A dentist on the ACE Dental Forum sent me the following email:

Thanks Gerald. I love your posts !!! Keep the high standards coming...............

Perhaps I can change some minds of other dentists about providing excellence in care to their patients.

Dentists cannot change until they care about their patients first and their economic well being second.

Other dentists know what I do but they are unwilling or unable to provide excellent care to their patients...

I guess I just will never understand.

I Knew It Would Happen

There is a front page story in today's New York Times about a 63 year old physician who is a family doctor in Maryland. He can't sell his medical practice or, for that matter, even GIVE it away.Why? Because the old time doctor is no longer valued or wanted. Young doctors don't want to work the 60-70 hours a week to take care of their patients like us old timers do. They want a paycheck and time off to be with their families...And who can blame them? Also, no one wants to pay a doctor to spend time with them listening to their concerns. Today's physicians spend minutes with their patient and send them for tests instead of listening....REALLY LISTENING, to their patients...

I know that I am also the last of the old time dentist who knows their patients, cares for them as people and will always do what is in their PATIENT'S BEST INTEREST.
I have a distinct advantage over most physicians in that dentistry is always invasive and has the distinct possibility of causing pain. My patients KNOW that I will do my very best not to cause them pain.

I went to dinner with one of the orthodontists that I send my patients to for braces and during the course of the evening he said, "You know that your patients really love you." I know that and it makes me extremely happy.

But someday this level of caring and concern will come to an end and dentistry will only be about making money and not taking care of our patients.

That is sickening!

My Legacy

Several people recently spoke to me about having a LEGACY after my career is over. Last weekend the Chairman of Restorative Dentistry at SUNY/Buffalo, Dr. Carlo Munoz,who I like very much, asked me to give some thought to my legacy. To be honest, I am at the top of my career and it is hard to even think about not taking care of you.

Dr. Munoz wants me to consider lecturing around the world to infect other dentists with the concept of EXCELLENCE. I am not that interested in lecturing to other dentists as I would rather be taking care of you.Dr. Munoz asked me to give this some consideration and invited me to accompany him to Spain to lecture.

In 4-5 years I will start my serious search for my successor so he or she will have 8or 9 years studying with me so that you will have a high quality dentist to take care of you.

You, my patient, are my LEGACY...and that legacy matters a great deal to me.