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I am going to miss my target date of April 1 to return to work. Nobody wins all of the time especially when it comes to health and healing. My new goal will be in two weeks. Trust me I will work very hard at physical therapy and my home exercises so that I can meet my goal. My physical therapist, Tony DeMatteo constantly reminds me that I suffered a very serious injury and in addition to healing, I must strengthen my muscles.
Yesterday, I was working with Tony and all of a sudden he said, "Did you feel that?" He had been moving my arm but it had not gone beyond a certain limit until the muscles relaxed and my arm had moved further than it had. At the end of my visit, Tony said, "Now I am encouraged. We made significant gains today."
Before I left his office, I said to Tony, "You have 2 weeks."
I ask for your patience during my healing process. I know that some of you may be thinking that you need to find another dentist soon. I would encourage you not to do that. Like everything else, things take longer than we want and expect.
I will come back and I will continue to strive for excellence. I just need more time.
Thanks!!!
Monday, March 30, 2015
Sooner of Later Someone Says the Truth
I truly believe that someone, somewhere always knows the truth about what happened or why something happened. Many times however, we the public are left to profession speculators i.e. the media to form our own conclusions.
This morning I heard one of the aviation analysts for CNN and himself an active commercial pilot, talk about the recent murder/suicide of the co-pilot when he intentionally crashed the plane. What the analyst said (and I will paraphrase here):
"One of the issues for budget airlines is that they pay the pilots significantly less than the full service airlines and therefore they do not attract the best or most talented pilots to fly their planes.
Put another way...You get what you pay for.
How many times have I told you that when you select a dental office that participates with many insurance companies or advertises cut rates there MUST be significant differences in quality between that office and an office that does not participate with many insurance companies.
Let me explain HOW and where those differences will be:
1. The quality of the materials will be lower. The dentist cannot afford a $100 a tube for resin for front teeth and will look for a 'no name', low cost $50 a tube resin.
2. The staff turns over constantly, is not motivated and lacks full understanding of the work being performed.
3. The dentist is a recent graduate from dental school with limited experience.
4. The dentist is older but takes the minimum amount of continuing education which is just enough to keep his or her license.
5. The dentist would never consider taking a continuing education course costing $10,000 and closing their office for a week but instead takes a $99 course on a Friday morning.
6. The dentist uses an off shore dental lab, mainly in China so that they can pay less than 1/2 what a mid-level American lab charges.
As you can see from what the aviation analyst said and from what I just told you, you must EXPECT that there will be significant differences in quality when you select a low cost service or product.
We have known this for 100 years but is nice to hear it from an expert just to remind us.
This morning I heard one of the aviation analysts for CNN and himself an active commercial pilot, talk about the recent murder/suicide of the co-pilot when he intentionally crashed the plane. What the analyst said (and I will paraphrase here):
"One of the issues for budget airlines is that they pay the pilots significantly less than the full service airlines and therefore they do not attract the best or most talented pilots to fly their planes.
Put another way...You get what you pay for.
How many times have I told you that when you select a dental office that participates with many insurance companies or advertises cut rates there MUST be significant differences in quality between that office and an office that does not participate with many insurance companies.
Let me explain HOW and where those differences will be:
1. The quality of the materials will be lower. The dentist cannot afford a $100 a tube for resin for front teeth and will look for a 'no name', low cost $50 a tube resin.
2. The staff turns over constantly, is not motivated and lacks full understanding of the work being performed.
3. The dentist is a recent graduate from dental school with limited experience.
4. The dentist is older but takes the minimum amount of continuing education which is just enough to keep his or her license.
5. The dentist would never consider taking a continuing education course costing $10,000 and closing their office for a week but instead takes a $99 course on a Friday morning.
6. The dentist uses an off shore dental lab, mainly in China so that they can pay less than 1/2 what a mid-level American lab charges.
As you can see from what the aviation analyst said and from what I just told you, you must EXPECT that there will be significant differences in quality when you select a low cost service or product.
We have known this for 100 years but is nice to hear it from an expert just to remind us.
Friday, March 27, 2015
It Doesn't Seem Possible
There is a story in the current issue of Dental Economics in which financial figures are presented that no dentist will refute:
"Since 2005, real income for general dentists has not kept pace with inflation and has fallen by 16.2%."
I know what you are thinking, "But your fees are the highest they have ever been and we are paying more than ever."
AND YOU ARE RIGHT!!!!!!!
But none of the rise in the fees that you are paying has gone to me personally.
ZERO!!!
What you are paying more for is rent, electricity, my dental supplies, higher taxes, lab fees, staff cost increases.
My PERSONAL income as Dental Economics has reported declined since 2005. I pay MORE for everything in the office and I earn LESS.
Think about that when you ask me why things cost so much...Because I want to know the answer as well.
"Since 2005, real income for general dentists has not kept pace with inflation and has fallen by 16.2%."
I know what you are thinking, "But your fees are the highest they have ever been and we are paying more than ever."
AND YOU ARE RIGHT!!!!!!!
But none of the rise in the fees that you are paying has gone to me personally.
ZERO!!!
What you are paying more for is rent, electricity, my dental supplies, higher taxes, lab fees, staff cost increases.
My PERSONAL income as Dental Economics has reported declined since 2005. I pay MORE for everything in the office and I earn LESS.
Think about that when you ask me why things cost so much...Because I want to know the answer as well.
Wednesday, March 25, 2015
Setting Goals
I have always been a goal setter and for good reason. I don't have a lot of natural talent in any anything that I have ever done. I am not good at math (to say the least), I can't draw or paint, I'm not musically inclined and I was not a natural athlete. But I am a very hard worker when I put my mind to it. And I discovered when I was very young that if I set a goal for myself that was months or years away, I will probably succeed at any particular task. I could also succeed when someone told me that I would never succeed or attain a particular goal.
In the picture, I have succeeded at every goal that I have ever set which again indicates that drive beats brains any day of the week.
When I ran into my best friend's father a week before the Queens (NY) Cross Country Championship he asked me what I was up to. I told him that I had been practicing a lot because I wanted to try to win a medal in the Championship the following week. He looked at me wide eyed and said, "Not with those short legs." I won a team medal for being one of the first five runners from one school that took first place.
When I purchased my first camera in 1972, I set a ridiculous goal of winning a contest within one year of owning a camera. Now mind you, I had never even TOUCHED a camera in my life and knew nothing of the technical aspects of photography but I set the goal. I won first place in TWO contests within the first year.
Shortly after my horrific car accident in which my right leg was 99% separated from my body but miraculously reattached because of the talent and hard work of Dr. Roger D. Seibel I asked Dr. Seibel if I would run again. He must have thought that I was in a drug induced stupor because he never thought that I would WALK AGAIN. Within 18 months of my accident, Susan and I went out and ran 5 miles.
Despite missing 2+ months of classes in my senior year of dental school because of my accident, Dean Powell reluctantly agreed to let me return to school but told me that I would never graduate with my class because he would not reduce any of the requirements for me. I stood on the stage at graduation to a standing ovation from my classmates who understood that they had witnessed 'the impossible.'
Six years after taking my first course in Cosmetic Dentistry, I told my staff that I was going to enter the American Academy of Cosmetic Dentistry Smile Contest in San Antonio, Tx and I was going to win one of the five first place ribbons. Mind you, in 1999, the AACD contest was THE MOST prestigious and challenging contest that a dentist could enter. And there were a lot of REALLY good cosmetically oriented dentists in the country (and world.) I selected the hardest division of the contest so that I would have the least number of dentists competing against me and you already know how that came out.
I have selected April 1 as the day that I want to return to work and treat patients. My fracture was the worst shoulder fracture and the Reverse Shoulder Replacement is a challenging surgical procedure. And I will be 67 in a few weeks. I hope that I make my April 1 goal but I won't be crushed if I don't. This won't be easy but if you look at the list that I just presented to you, were any of those goals easy?
It will be good to take care of you again...It is what I have done for almost 4 decades. See you soon.
In the picture, I have succeeded at every goal that I have ever set which again indicates that drive beats brains any day of the week.
When I ran into my best friend's father a week before the Queens (NY) Cross Country Championship he asked me what I was up to. I told him that I had been practicing a lot because I wanted to try to win a medal in the Championship the following week. He looked at me wide eyed and said, "Not with those short legs." I won a team medal for being one of the first five runners from one school that took first place.
When I purchased my first camera in 1972, I set a ridiculous goal of winning a contest within one year of owning a camera. Now mind you, I had never even TOUCHED a camera in my life and knew nothing of the technical aspects of photography but I set the goal. I won first place in TWO contests within the first year.
Shortly after my horrific car accident in which my right leg was 99% separated from my body but miraculously reattached because of the talent and hard work of Dr. Roger D. Seibel I asked Dr. Seibel if I would run again. He must have thought that I was in a drug induced stupor because he never thought that I would WALK AGAIN. Within 18 months of my accident, Susan and I went out and ran 5 miles.
Despite missing 2+ months of classes in my senior year of dental school because of my accident, Dean Powell reluctantly agreed to let me return to school but told me that I would never graduate with my class because he would not reduce any of the requirements for me. I stood on the stage at graduation to a standing ovation from my classmates who understood that they had witnessed 'the impossible.'
Six years after taking my first course in Cosmetic Dentistry, I told my staff that I was going to enter the American Academy of Cosmetic Dentistry Smile Contest in San Antonio, Tx and I was going to win one of the five first place ribbons. Mind you, in 1999, the AACD contest was THE MOST prestigious and challenging contest that a dentist could enter. And there were a lot of REALLY good cosmetically oriented dentists in the country (and world.) I selected the hardest division of the contest so that I would have the least number of dentists competing against me and you already know how that came out.
I have selected April 1 as the day that I want to return to work and treat patients. My fracture was the worst shoulder fracture and the Reverse Shoulder Replacement is a challenging surgical procedure. And I will be 67 in a few weeks. I hope that I make my April 1 goal but I won't be crushed if I don't. This won't be easy but if you look at the list that I just presented to you, were any of those goals easy?
It will be good to take care of you again...It is what I have done for almost 4 decades. See you soon.
Monday, March 23, 2015
Lee Juan Yew 1923-2015
Mr. Yew was the founding father and first prime minister of Singapore.
Singapore as you know is one of the most orderly societies on earth as well as one of the wealthiest nations and most of that is because of what Mr. Yew accomplished.
I don't know a lot about this man and I am sure there are things that I would not admire about him if I knew more. That said, let me tell you what I do like about him.
He said the following:
"We are ideology free."
"Does it work? If it works, let's try it. If it's fine, let's continue it. If it doesn't work, toss it out and try another one ."
This is how I run my office. We make a change..Is it working or not and if not how are we going to change again so that it will work.
The CEREC machine was a perfect example. Looked good in the ads; looked good in the courses that I took. We bought it and it failed to perform. It's gone. Next.
Digital impression taking is NOT the future...It is the NOW...So we will keep looking.
When we gave up paper forms for iPads, some people didn't like the change. Now most understand it and like it because no one likes filling out all those paper forms...(Ask me how I know these last 3 weeks with all the doctor's offices that I have visited with my shoulder injury?)
I want a leader who defines the problem...doesn't have a preconceived belief about how things should be...and thinks and studies, incorporates and refines...How refreshing a Congress would be if this is how it operated?
Singapore as you know is one of the most orderly societies on earth as well as one of the wealthiest nations and most of that is because of what Mr. Yew accomplished.
I don't know a lot about this man and I am sure there are things that I would not admire about him if I knew more. That said, let me tell you what I do like about him.
He said the following:
"We are ideology free."
"Does it work? If it works, let's try it. If it's fine, let's continue it. If it doesn't work, toss it out and try another one ."
This is how I run my office. We make a change..Is it working or not and if not how are we going to change again so that it will work.
The CEREC machine was a perfect example. Looked good in the ads; looked good in the courses that I took. We bought it and it failed to perform. It's gone. Next.
Digital impression taking is NOT the future...It is the NOW...So we will keep looking.
When we gave up paper forms for iPads, some people didn't like the change. Now most understand it and like it because no one likes filling out all those paper forms...(Ask me how I know these last 3 weeks with all the doctor's offices that I have visited with my shoulder injury?)
I want a leader who defines the problem...doesn't have a preconceived belief about how things should be...and thinks and studies, incorporates and refines...How refreshing a Congress would be if this is how it operated?
Yes I Am Feeling Better
I think that the worst of my recovery is over. I am starting to sleep 7-8 hours a day and the pain is not as constant as it was in the recent past. And I think most of the general anesthetic is out of my body...All of these are really good things.
I started Physical Therapy today with my long time physical therapist, Tony DeMatteo. I like Tony but I don't like to see him. The simple shoulder and arm stretches are painful and this is just the tip of the iceberg. Don't worry, I have to do this in order to get back to taking care of you. I promise to work very hard at my recovery despite hating every minute of it.
I started Physical Therapy today with my long time physical therapist, Tony DeMatteo. I like Tony but I don't like to see him. The simple shoulder and arm stretches are painful and this is just the tip of the iceberg. Don't worry, I have to do this in order to get back to taking care of you. I promise to work very hard at my recovery despite hating every minute of it.
No More Pretense
My foot on my gravely injured leg from a car accident 38 years ago was swollen a few days ago so I thought that it would be wise to make sure that I had not developed a clot in my leg secondary to recent shoulder surgery. Fortunately, the swelling resolved itself without a diagnosis or further treatment.
I went to the oncall center associated with the hospital and when we entered the building there was a big sign which said, " Dear Customer" which made me so upset that I never read the rest of the sign.
Can you imagine? The health care system no longer treats us as PATIENTS but just customers to sell us something.
I am sorry. I am offended by being called 'a customer' and I have good reason to feel this way.
When I was in dental school, I was taught that I was always to put my patient's best interest ahead of my own and that making money was secondary to taking care of my patient. I believe this with all my heart and soul.
I have always believed that the doctor/patient relationship is a sacred relationship and one of the few "special'" human relationships. It is not the same as husband/wife or parent/child but it right up there when someone asks you to take care of them and then TRUSTS that you will do everything that you can to do just that.
Could I have been wrong for almost 40 years? Are you just my customer?
I am sorry...you will always be MY PATIENT until the day I stop doing this job.
I am offended and I hope that you are as well. Customers are a dime a dozen. Patients are special....at least to me.
I went to the oncall center associated with the hospital and when we entered the building there was a big sign which said, " Dear Customer" which made me so upset that I never read the rest of the sign.
Can you imagine? The health care system no longer treats us as PATIENTS but just customers to sell us something.
I am sorry. I am offended by being called 'a customer' and I have good reason to feel this way.
When I was in dental school, I was taught that I was always to put my patient's best interest ahead of my own and that making money was secondary to taking care of my patient. I believe this with all my heart and soul.
I have always believed that the doctor/patient relationship is a sacred relationship and one of the few "special'" human relationships. It is not the same as husband/wife or parent/child but it right up there when someone asks you to take care of them and then TRUSTS that you will do everything that you can to do just that.
Could I have been wrong for almost 40 years? Are you just my customer?
I am sorry...you will always be MY PATIENT until the day I stop doing this job.
I am offended and I hope that you are as well. Customers are a dime a dozen. Patients are special....at least to me.
Saturday, March 21, 2015
Teeth Really Do Matter
Hospital administrators in Alabama needed to find a way to explain discharge instructions to patients but they could not be sure that the instructions could be understood because of low intelligence. They did a study which correlated the number of tattoos with the number of teeth a person had and they have been able to draw conclusions from this. For those patients UNDER 60 years old:
The conclusion they found was the more tattoos a person has and the fewer teeth that person has...
the lower the intelligence. The hospital knew that it had to spend more time explaining instructions to these individuals.
If you would like to see the article yourself:
http://www.gomerblog.com/2014/03/tattoo-tooth/
To you and I, this is no surprise.
Thursday, March 19, 2015
My First Post Surgery Visit to My Surgeon
Yesterday I had my first check up for my shoulder in New York City at Hospital for Special Surgery. Dr. Gulatto was delighted my results after viewing the new x-ray. One more week in my sling, start Physical Therapy now and perhaps back to work in two weeks... We can't ask for more than that.
Many of the advancements in shoulder repair/replacement are the result of research performed by the surgeons at Hospital for Special Surgery. They learn, compile the information, evaluate information and then determine what treatment or techniques work well and what can be tweaked to make things better. In order to show my great appreciation for my surgeon, I made a sizable contribution to the Hospital for Special Surgery for Dr. Gulatto's research. I would encourage others to support improvements in medicine by making contributions to Hospitals, Universities and private groups (Smile Train, etc) so that we all can have great care like I have had.
Again, I want to thank all of you for the cards, calls and prayers. I know that I have a very special relationship with MY PATIENTS which goes beyond "fix my tooth, doc." I want you to know how much I appreciate having YOU as my patient. It is a privilege to take care of each and every one of you. Your comments in the cards are overwhelming and bring me to tears...THANK YOU.
Many of the advancements in shoulder repair/replacement are the result of research performed by the surgeons at Hospital for Special Surgery. They learn, compile the information, evaluate information and then determine what treatment or techniques work well and what can be tweaked to make things better. In order to show my great appreciation for my surgeon, I made a sizable contribution to the Hospital for Special Surgery for Dr. Gulatto's research. I would encourage others to support improvements in medicine by making contributions to Hospitals, Universities and private groups (Smile Train, etc) so that we all can have great care like I have had.
Again, I want to thank all of you for the cards, calls and prayers. I know that I have a very special relationship with MY PATIENTS which goes beyond "fix my tooth, doc." I want you to know how much I appreciate having YOU as my patient. It is a privilege to take care of each and every one of you. Your comments in the cards are overwhelming and bring me to tears...THANK YOU.
Monday, March 16, 2015
Healing
Healing can be divided into several equally important areas, some are measurable and some are not.
1. pain
2. bone healing around the new shoulder
3. sleeping
4. ability to concentrate/anxiety
Pain is tolerable during the day without any pain meds. Night time is a different story. My shoulder just aches and the pain meds never last as long as the period that they are prescribed for.
Bone healing is something that will be evaluated on my first post op check, Thursday in NYC after an x-ray is taken.
Sleeping remains a problem partly because of pain and partly because it is difficult to get comfortable
All anesthesia lingers in my body and makes me feel lousy. I can't concentrate on one thing for any length of time.I just get bored quickly which makes me anxious that I am not doing anything.
I hate the concept of retirement with each passing day. I need a purpose in my life and readingnewspapers, the internet and TV just don't do it for me.
I thank you all for the thoughts, prayers and kind words.
1. pain
2. bone healing around the new shoulder
3. sleeping
4. ability to concentrate/anxiety
Pain is tolerable during the day without any pain meds. Night time is a different story. My shoulder just aches and the pain meds never last as long as the period that they are prescribed for.
Bone healing is something that will be evaluated on my first post op check, Thursday in NYC after an x-ray is taken.
Sleeping remains a problem partly because of pain and partly because it is difficult to get comfortable
All anesthesia lingers in my body and makes me feel lousy. I can't concentrate on one thing for any length of time.I just get bored quickly which makes me anxious that I am not doing anything.
I hate the concept of retirement with each passing day. I need a purpose in my life and readingnewspapers, the internet and TV just don't do it for me.
I thank you all for the thoughts, prayers and kind words.
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