Why I’m not fazed by COVID-19

I first posted this on my personal Facebook feed.  I expected a lot of negative feedback.  But, the opposite happened, for the most part.

I am not fazed. And, this bothers a lot of people.

It seems the new measure of a person is his or her capacity for righteous indignation, pandering for “social justice,” and public virtue-signaling. Keeping up with the Joneses is no longer a material pursuit. It’s an emotional attention-getting pursuit. And, hoo-boy… has this “crisis” provided that opportunity in spades.

I’ve had some friends extremely upset at me for not being as “worried” as they are. I’ve had to “un-friend” some on social media for being rather nasty. One long-time (~20 years) friend and colleague gleefully admonished me for having my practice still open and that I’d be “shut down soon.” He had missed the fact that my state had already shut us down except for emergency patients. But he was apparently happily anticipating the impending shutdown of my business. That’s not cool at all.

I’ve been chastised for being “cavalier” in my posts about this Coronavirus. I’ve been excoriated for not demonstrating the proper amount of fear and dread. I’ve endured the derision and contempt of colleagues even for being open to see emergency patients. Many dentists, incidentally, have run for the hills, ignoring their training and expertise in infectious disease control. They’ve closed their offices and are referring emergency patients to the ER. Or, they’re not even answering the phones at all.

But, I’m the bad guy. According to some… a really bad guy. For seeing emergency patients. My own colleagues are PISSED that any dentist would see patients. Some have accused the dentists who are open, of “stealing” or “scooping up” their patients. You know… the ones who they’ve left in a lurch, refusing to see them.

Perhaps my position and lack of alarm is due to perspective. So, here’s my perspective:

Consider that I came into Dentistry at the time when

Continue reading

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A “Simple” (but not easy!) Cosmetic Bonding Case

Taking a brief break from the Coronavirus hysteria (I’m not done!) to post some dentistry.  A friend just boldly posted on Facebook:  “Stay home. Close your business. Don’t go out. Live in fear….  No thanks!”

Me, neither!  I did this case today.  It had been planned for months.  Patient is a young woman who has some congenital dental issues.  She has had cosmetic bonding done twice before.  Her chief complaint was the appearance of teeth #s 6, 7, and 10.

#6 is mesially tilted and rotated.  #7 is a peg lateral (as you’ll see).  #10 is actually #11.  The tooth in position #11 is a retained deciduous canine. 

We talked about all options including ortho and veneers.  She wanted minimally invasive and “minimally expensive” treatment.  She asked if I could JUST re-do the bonding.  I sure can!

Here are some side views:

Here’s a close-up of #s 6 and 7.  Pretty, eh? Continue reading

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And one last thing about the Corona hysteria…

I’ve stayed out of posting on social media like Facebook, though I’ve been lurking a bit.  It’s a good thing I’m staying out of the fray, as I’d likely make a lot of enemies by calling out people specifically.

So, I figured I could post my thoughts here in more “generic” form without calling out any particular person.  🙂 

First… if you read my last two posts… it’s working!  Today was pretty full.  Not a banner day, but decent.  Tomorrow’s schedule is even better.  Next week is even better. 

A few of today’s patients told me they appreciated my email, and it made them feel better.  Booya!

I sent a third email out today to reinforce the previous two.  But, that’s it… no more emails.  I don’t want to bug them.

<rant>

To those dentists who are caving to the hysteria….
 
I’m an adult.  I’m a free American. I’m a trained doctor, well-versed in infection control.  I’ve dealt with HIV, H1N1, Hep B, Hep C, and other bugs far more virulent than this one.
 
I don’t need “guidelines” from a gov’t lackey looking to score political points.  I have all my training and over 30 years of experience.  My patients are also grown-ass adults who can make their own decisions with my professional input, for which they’ve trusted me for years.
 
If “universal precautions” didn’t work, we’d all be dead by now.
 
We are OPEN.  My patients are coming.  And, we’re all going to LIVE happily ever after!
 
If you choose to discard your own training, experience, and the exercise of critical thought in deference to the edicts of government lackeys… and then leverage your weakness as delusional “virtue signaling,” knock yourselves out.  I’m not doing it.  I’m going to work and living my life. 

No doubt, those who are reflexively shutting down because they were told to are subject to the pervasive guilt complex that has long-infected the dental profession.  It also goes to show that dentists are prone to the herd mentality.
 
As I like to say, “your mileage may vary.” 
 
</rant>
 
I shall now don my asbestos suit.  😎  Contrarians unite!
 
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Bad News = Opportunity… Part 2

OK… So, by now most of us have witnessed the full-on panic in America.  It’s crazy.  If I’m honest, I will say that I don’t suffer fools well.  I admit that I am contemptuous of those who adopt the “herd mentality.”  And, man are we seeing that!

Like many practices, mine has seen a lot of cancellations or simply delaying scheduling planned treatment.  Next week’s schedule is full of holes.  Big holes.  What to do?

First, I sent out a mass email to my patients to allay their concerns as it pertains to Coronavirus and dental treatment.  You can see that email here.   I also posted it on my practice Facebook page and my practice blog. 

Then it occurred to me that I might incentivize scheduling next week.  So, I sent out another email yesterday: Continue reading

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Bad News = Opportunity

Coronavirus is all over the news.  The resulting unjustifiable panic is the real “pandemic.”  Perhaps we should call it “pande-MONIUM?”

The news offers many opportunities to communicate with our patients with context that can be leveraged due to hyper media coverage of a topic. 

I just posted this on my practice blog site, my practice Facebook page, and sent it as a mass email to my patients. Continue reading

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Walmart Dentistry – It’s for real!

I wrote about Walmart Dentistry a few years ago.  In the previous iteration of “Walmart Dentistry,” it was my understanding that it was a DSO renting space in a Walmart retail location.

This time it’s different.  Walmart opened a new health clinic in Georgia.  It has a medical and a dental side.  Run BY Walmart.  They also published their fee schedule, with costs that are notably lower than the “average” out there in the real world.

Cheaper than a haircut!  Click on image to download their full fee schedule.

OMG!  OMG!

So… is it time to panic?  I submit that this could be GOOD for our industry.  Well… good for PART of our industry.  Mind you, I am a solo fee-for-service private care practice.  I am “out of network” for all insurance plans and don’t generally even accept assignment.  The vast majority of my patients are self-pay (cash).  I won’t get into the merits vs challenges of such a practice.  But, I’ll simply say, “It ain’t easy!  But, I’m the captain of my own ship.”  🙂

Race to the bottom!

Should private care practitioners (even those participating “in-network”) be worried about competing with Walmart?  I say NO.  Not a bit.  Who should worry?  Corporate Dentistry, that’s who.  Click the link to see evidence of that.  The DSO industry (aka McDental) has taken notice!  I’ll admit to looking forward to indulging in some sweet schadenfreude while Walmart and the other McDental chains (Corporate Dentistry) race to the bottom!   The only problem for DSO McDental:  Walmart is already at the finish line.

Both McDental and WallyDental are targeting the same audience: Continue reading

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The Power of Photography (and a quick mock-up)

A quick blog post here.  A recently new patient has had some basic restorative treatment.  I asked him about his front chipped teeth.  The initial chips were caused by an accident when he was a kid.  He never had them repaired.  But, they are chipping away even more in recent years. 

He was reluctant to repair them, because he felt that the “imperfection” was part of his “look.”  He also mentioned that he did not want perfectly straight edges on his teeth.  He liked the imperfect look.  On the other hand, he was concerned that they may break even more.  His initial reaction was to put it off for now.

Today, he was in for a composite restoration of a cervical “abfraction.”  After I was done with that, I asked him if it would be OK to do a mock-up on the two front teeth.  It would give him an idea of what is possible with bonding.  I also told him we can “characterize” the edges so that they’re not perfectly straight. 

I did the mock-up in about 2 minutes.  I intentionally made the incisal edges “imperfect.”

I took before and after photos and gave them to the patient.  He was impressed!  He’ll be back to have it done!

For the final restorations, I’ll spend a bit more time on the central incisal embrasure. I like them a bit smaller and sharper.

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Gold is still the Gold Standard!

Today, I had a patient scheduled for a crown on #3.  The tooth had a couple of deep occlusal amalgams with some darkly stained cracks on the marginal ridges.  Oh sure… we can debate, “to crown or not to crown” or “when to crown” until the cows come home.  I submit it’s a judgement call, based on experience and leave it at that.

Would you crown it? Ha! Never mind. I don’t care! 🙂

Once seated in the chair, she asked if we could do gold instead of porcelain.  Her husband had recently gotten a gold crown on his 2nd molar, and he remembered well the advantages I presented to him.  He had relayed that same information to his wife, my patient today.  Admittedly, I had not offered gold, as #3 is usually near what I call the “cosmetic transition zone.”  Given that, in my experience, so few people will consent to gold, I generally limit the option to 2nd molars.  In those cases, my “pitch” on the advantages of gold is compelling. 

Perhaps, this experience was a reminder to start offering it more often for other teeth.

She said, “I can’t see it anyway, and I like the idea of less tooth being drilled away.”  Of course, I agreed with her!  Oh… she’s a bruxer, too.  After a bit more discussion, it was a done deal… gold it is!  There was no reason to prep the facial and lingual surfaces for full coverage.  The plan was for a gold onlay.

I began by removing the amalgam and cleaning up the “schmutz.”  I wanted to visualize the extent of the crack before prepping. Continue reading

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Today I Met a Real World War 2 Hero!

Today was just another regular day at the office.  I went out to lunch by myself at one of my usual places.  I sat in a booth, facing the front of the restaurant.  As I was finishing up my lunch, I noticed an older couple being seated in the booth right in front of me.  They sat next to each other facing me.  The older gentleman was wearing a hat that said, “Purple Heart – World War II.” 

Being a patriotic veteran myself, I felt compelled to buy the couple’s lunch.   I’ve never done anything like that before, but I just wanted to do it.  There aren’t many WW2 veterans left alive today.  They are a very special group of people!  I previously wrote about another WW2 hero, Army dentist, Captain Ben Salomon.  When my server dropped off my bill, I asked him to put their lunch on my card, too.  

Since I was done eating, I got up and stopped by their table and said, “I just wanted to thank you for your service, and lunch is on me.”  They were quite surprised.  They asked my name and then asked me to sit with them.  A lovely couple.  Married 61 years!  He’s now 97 years old.

John and Mary Katsaros and me.

We chatted, and he was quite eager to share his story with me.  He was a waist gunner on a B-17 Flying Fortress (bomber).  Hard core stuff!  His plane was shot down over France.  Three of his crew were killed in the aerial gunfire.  The rest bailed out of the plane at 27,000 feet!  He said at that altitude you pass out from a lack of oxygen and hope you wake up in time to pull the parachute ripcord.  His right arm was shattered by a bullet when his bomber was shot down.  He broke several ribs and both ankles when he hit the ground. 

B-17 Flying Fortress

He was captured by the Gestapo.  Escaped.  Captured again.  And escaped again with the French Resistance.  A Jewish doctor hiding in a cellar Continue reading

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Neil Peart – Legendary Drummer Passed On

A Tribute to Neil Peart, the “Professor.”

Earlier today, I watched some Rush and Neil Peart videos.  Then I dozed off on the couch for an afternoon nap.  I heard my phone text notification ding… and then ding again… and again.  Someone was blowing up my phone.  It was a combination of several text messages and Facebook messages.  Several friends were telling me the news:  Neil Peart died.  My friends know how much of a fan I am.  He was 67 years old.

Here’s the weird part…  Just a couple of hours prior, before I dozed off, I was indulging in some Neil Peart videos, which I had not done in a while. 

I’ve liked plenty of other bands over my life. But, Rush is the one that truly resonated with me.  The music.  The lyrics.  The members’ personalities.  I felt connected to them on a philosophical, if not spiritual, level.  I did not know Neil was sick.  It turns out he had been battling glioblastoma (an aggressive and incurable brain cancer) for three years.  But, some “cosmic connection” must have compelled me to listen to Neil’s percussive magic earlier today. 

I first learned about Rush in college from a friend, with the album, “Moving Pictures.” 

If I could pick a soundtrack for my life, it would be Rush.  I’ve often described Rush as “rock for intellectuals.”  If you’ve attended a Rush concert, you’d agree it’s a “nerd-fest.” 

The depth of the talent of all three members of Rush is stunning.  If you’ve seen the documentary, “Beyond the Lighted Stage,” you’ll remember all the OTHER musicians interviewed… looked up to Rush as the “gods.”  They are the musicians’ musicians.  What are the chances of THREE virtuosos coming together in ONE band?

Neil was a poet, who wrote most of the lyrics for Rush.  A voracious reader, he was also a prolific author of many books.  Of the three band members, he was the most private, who rarely gave interviews or attended fan events.  Alex and Geddy were the “PR” guys.  Neil kept to himself. 

Neil incorporated a lot of different styles in his performances, but Jazz was a major inspiration for him.  He was a big fan of Buddy Rich and Gene Krupa.  He performed at a Buddy Rich tribute with Buddy Rich’s band.  Watch the video and be blown away at his talent that went beyond the world of Progressive Rock.  There is a reason he was nicknamed, “The Professor.”  His solo starts at about 3:50.  Watch the reactions of the band members behind him at about 5:40.

His concert drum solos were legendary and considered by many to be the highlight of the event.  Here is a solo performance in Frankfurt.  If’ you’ve never seen him before, prepare to pick your jaw up off the floor. Continue reading

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