Circle of Life

Being a Disneyholic can have its positive and negative aspects and the one that comes to mind for me most recently is the movie, The Lion King in which there is a substantial emphasis on the “Circle of Life.”  I have had that occur to me and my family several times in the very recent past.  I recently returned from Los Angeles where my mother-in-law who is 98 years old is getting Hospice care at the end of her very long life.  That same week Dr. Naten’s wife gives birth to a new little baby girl, is this the “Circle of Life” from The Lion King? In that same time frame we had a terrible tragedy in my household.  My 15-year-old Morgan horse passed away suddenly due to a rupture of his abdomen into his thoracic cavity which was untreatable. In accessing our sudden loss Karen and I decided it would be best to rescue a mustang from the Bureau of Land Management, who was destined to be euthanized. Once again, part of the “Circle of Life”. These types of situations certainly give me pause to wonder about our place and how we fit into the grand scheme of this “circle of life”. It probably is not dental but I find myself taking a lot of time to contemplate these issues and to appreciate our time together with friends and family as I hope all of you do. Thanks for reading my blog.

My Father's Sayings

I have had several staff members ask me to spend some time writing down some of the sayings that I use all the time when dealing with a variety of patient issues. Many of them have been refined over a period of years but the vast majority of them are based on my life’s experiences both with my family as a child and with my substantial experiences in dental school. With that in mind, I thought I would do several blogs regarding some of those old sayings. I think I will start with several of my father’s old sayings who was an engineer and not a dentist but several of his sayings are applicable to dentistry.

The first one and probably my favorite is that “You pay for the inadequacies of your youth as you get older.” This is very true in dentistry.  If you have cavities when you are young and you have to have fillings done, most likely you will eventually have to have additional restorative procedures accomplished on those teeth as you age. If you have gum problems when you are young those will definitely haunt you in older age as your ability to heal decreases and gum problems become more progressive.  This reminds me of the 2^nd saying which was “the Lord wastes good healing on the young as they don’t appreciate it”.  Once again, if you have gum problems when you are young the healing capabilities that you have as you get older decrease and periodontal problems increase. You can certainly deal with this problem with great oral hygiene but it is always going to be an issue. The next quote which I oftentimes find humorous and I relate a patient at least once a day was my father’s comment to me “Mark, you can have one or two things in life. You can either have children or almost everything else you ever wanted.”  Fortunately, my father and mother picked children otherwise I would not be here. I chose children and I think for our future children are an extremely important portion of our lives and the future of our country. I will be doing more quotes from my father and from my dental school experiences in future blogs. See you in my next blog.

Let's Face It, Being a Dentist Isn't Easy

Make no mistake about it, I love my job.  I have been doing it for over 40 years and hopefully anyone who has done a job for 40 years really loves it.  However, let's face it, being a dentist is not easy.  You are not just running a small dental practice, you are running a small business which is also your families' livelihood.  You are running a small business that requires you to stay-up on all the latest procedures and techniques, hire and fire staff who are an extension of you and your business, all in the effort to improve the lives of your patients even though they don't really want to be in your chair.  It is a tough gig that is demanding and can be draining.  Between the government and its companies, I spend about 40% of my time making them happy.  I came out of dental school wanting to help people have a better smile and better oral health, yet we battle every day with patients that don't want to come in and some days it seems like I care more than they do.  In addition, as with every small business we have staff who don't exactly get along and patients that think I act too much like Steve Martin in "Little Shop of Horrors."  It is an interesting profession in which I have to hear several times a day "it is not you doc, its just that I hate dentists."  Fortunately, I really love my work and I look forward to it everyday, coming in and dealing with all the nuances of a modern dental practice and I plan on doing it for years to come.

See you at my my next blog.

Tooth Fairy Part 2

In our last Tooth Fairy blog I indicated surveys regarding how much the tooth fairy leaves children in the United States. Since the average in 2015 has gone down 24 cents from 2014 to $3.19. This would be the 2nd consecutive year the tooth fairy has reduced what she leaves under pillows. Surveys found that 32% of respondents reported that $1.00 was left by the tooth fairy the most common amount while nearly 20% of the respondents said the tooth fairy left $5.00 under their pillows and 5% of the household reported that the tooth fairy left $20.00 or more. On the other end of the spectrum 10% of survey respondents said their child received nothing from the tooth fairy. Interesting enough comparing moms to dads, the survey found that for the 2nd year in a row fathers reported to be far more indulgent as the tooth fairy, saying she left nearly 30% more than moms did, $3.63 versus $2.87.  Additionally, if you take it down by regions in the northeast of the United States 25% of the children received $5.00 or more while almost 10% got $20.00 or more bringing the average amount in that area to $3.56,  substantially higher than the overall national average. In the Midwest the tooth fairy left an average of only $3.13,  while the west got $3.09 and the south $3.07.  All this is obviously extremely interesting from my perspective. There are certainly differences in the way different parts of the country view tooth fairy issues and it is certainly something interesting to ponder. Hopefully with improvements in economy the tooth fairy can reverse this recent trend of decreases time will tell.

See you at my next bog.

Corperate Dentistry

Since graduating from UCLA in the mid-70s I found Dentistry going through many transformations as far as its delivery of dental care to our patients. In the 70's there was a fear among all private practitioners that HMO style insurance would take over (similar to Kaiser.) That never occurred.  HMOs are still in the 5-6% range of overall Dental Services in our area, primarily PMI for the state, which is a division of Delta Dental. The current challenge in Dentistry is corporate dentistry or DSO's or Dental Service Organizations. These large corporate practices have huge money backing them up and can provide services at decreased costs, but not without risk. While almost every one of my graduating class dreamed of owning their own practice I do believe that percentage is drastically lower today for a variety of reasons and one of them is corporate dentistry. Many of the corporate players are offering different financial packages and continued education opportunities. They are finding ways to reduce staff and doctor turn overs that plagued the industry in the past and corporate dentistry will continue to grow over the next several years because of what I believe are 3 primary reasons.

11.      Generational differences between myself and the new graduates. There are happy just “working for the man” and getting their paid holidays and benefits. They value their time off and do not dream of creating their own “empires.”

22.      My class only had 3 females out of a class of 106. At UCLA in Dr. Naten's class 3 years ago, it was 60% female. Because of differences between men and women dentists which I have blogged about before, women desire to work part time only, for family reasons compared to male dentists and therefore there is a complication in buying their own practices compared to their male counterpart.

33.     Lastly, the debt load of current graduates can be $300,000.00 compared to the $50,000.00 debt load that I had in the 70s. While this may be consistent with the increased costs of housing in that same time frame it certainly is a daunting factor in setting up your own practice.

These three factors will  undoubtedly help corporate dentistry to continue to grow over the next several years.  Hopeful for all of us at private practices, its growth will be limited, and not affect the way we provide services for our patients.

OPPS!

To all you bloggers!  I just had a patient in today that reminded me why they call my job "Practicing Dentistry".  We did a fairly minor tooth color filling on this patient’s lower right bicuspid to replace an old broken silver filling.  I placed the new filling with no apparent problem but he called up about a month later complaining of recurrent pain with the very same tooth.  He was going to Maui next week and wanted to have it looked at ASAP.  An X-ray quickly showed the problem.  I had a margin problem between the teeth on my brand new tooth colored filling.  Now this reminds me off an old saying of Dr. Jennet's, my operative instructor at UCLA in the early 70's.  One of his favorite sayings was, "The only dentist that never had an overhanging margin, is the dentist that never did a filling."  Much to my dismay, it actually took me 2 additional tries to get the margin down on this extremely interesting situation.  Relying on our radiographs to verify the edges.  And that is indeed why they call my job "Practicing Dentistry."  You never know what is around the next corner or where future surprises may lay.

Dynamic Duo

The other day we had a long time patient “visit” for the prep and impressions of a new crown on a tooth he had broken. He humorously noted that he looked forward to his visit to see how the “dynamic duo” was doing. I rarely have patients come in for treatment with such enthusiasm and friendliness. He obviously made Edison’s and my day. Edison is originally from the Philippines and came to us here in Sacramento after transitioning with his family on Oahu for five years. He then ended up here in Elk Grove. He is actually a dentist in the Philippines and due to the educational cost for retraining here in the states he opted to continue serving the public as an extremely confident RDA in our office for the last 14 years. In a field where most of his contemporaries are female he stands out as an outstanding example of a caring and sympathetic RDA. In fact, in our office of 19 staff members Dr. Naten, Edison and I are the only males which is not typical for most dental offices. However, the way we work together it’s probably the reason for the dynamic duo compliment. We all strive to do the best that we can for our patients and do dentistry to the highest quality standards possible. And with that thought in mind, Edison and I as a "dynamic duo" will go on to service our large family of patients and I do feel that our new name is a compliment of the highest order and we really appreciate it.