What a Long Strange Week It’s Been.

I haven’t written in a while… uninspired and busy with my family’s “new normal.”  But, here’s what happened last week…

“I can’t help you with any discomfort.”

strange week x-rays-8236A new patient came for a problem-related examination.  He found us through our website.  He had a four-unit bridge #28 – 31 (#30 missing) and an RCT on #29 finished about 3 weeks ago.  His complaint is that one of the teeth is very sensitive to heat.  He pointed to #31.  Overall, the bridge looked decent, except for the facial and mesial margins on #31 being shy.  The margin on #29 isn’t perfect, either.  The RCT on #29 looked good, though that tooth was still sensitive to percussion (not unusual only a few weeks post-op).   “I’ve got my x-rays.”  The patient showed up with a copy of his FMX printed on a single sheet of plain paper.  This shit drives me NUTS!

bob-newhart-stop-itAttention all digital dentists:  Stop giving out WORTHLESS plain paper copies of digital x-rays!  It makes us ALL look bad!  Patients don’t understand why we can’t use them (not diagnostic).  And, they get upset that we either have to WAIT for proper emailed images or take them all over.

My front desk called the previous dentist to get emailed copies of x-rays.  His office obliges, and we got them immediately.  The images were taken before the new bridge.  So, I ended up taking my own films of the problem area.


The patient explained that he didn’t want to go back to the treating dentist.  He said that the dentist worked alone (no assistant) and that he (the patient) had to hold the suction.  He also mentioned that the dentist said, “I can’t help you with any discomfort,” because he didn’t have a prescription pad.  He chose that dentist because of the office’s proximity to his house and that he accepted his dental plan – one of only two dentists in the area accepting the plan by his account.   It must be a great plan!

I believe the issue with the patient’s pain is of endodontic origin (#31) rather than the shy margin.  I referred him to an endodontist for this particular case.  On his way out, the new patient (despite having an HMO plan accepted by all of two dentists in the area) joined our Quality Dental Plan (in house membership savings plan).

Shortly after the patient left, my office manager answered a phone call.  The woman calling simply asked, “Do you do endo?”  Yes, she used the word, “endo.”  My OM answered, “Yes, we do.  Would you like to make an appointment?”  [CLICK]  The caller hung up without another word.  The caller ID displayed the name of the office manager who had sent us the x-rays earlier.  Whoops!  OK… But… WHY?  We thought that was very odd.  “Whatevar!”  Dentists are a strange bunch.

“I want it for free.”

Oh-Yes-its-FREEThis week, I had a couple of new patient inquiries via my website.  My office manager always promptly contacts these prospective patients.  One of them said she needs four crowns because of “decay under some old crowns.”  Yeah, baby!  That’s our kind of patient!  But, wait…  She had a special request:  She wanted them for free “or almost free,” because she “has no money.”  My OM offered to explain how our Quality Dental Plan works to save patients significant money.  Nope.  Not interested.  [CLICK!]  Maybe she should call the President and ask him for free crowns.

Yesterday another new patient (website referral) was in the schedule for a broken tooth.  She called just before her appointment to cancel… because she “didn’t want to pay for anything.” 

This morning, on the news, was a story about the latest iPhone being introduced in stores.  The video footage was of the now-familiar long line of overnight campers vying to be the first owners.  The reported price of the new phone:  $650!  That’s $650 + $100 / month data plan = $1850 for the first year of use.  I wonder if the Apple stores get calls asking for a new phone for “free” or “almost free?”  I wonder if anyone walks in and says, “I want the new iPhone 6s, and I don’t want to pay anything?”  The older I get, the more jaded (and less sympathetic) I become.  Comedian Ron White says, “You can’t fix stupid.”

Suicide isn’t painless.

Contrary to the theme song lyrics from the TV series, “M.A.S.H.,” suicide isn’t painless.  I got word this week that one of my dental school classmates committed suicide.  The pain spreads like ripples through generations of his family and friends.  By all appearances, he had a very successful and highly-regarded practice and a wonderful family life.  It just goes to show… You just don’t know.  It reminded me of a quote that resonates with my own experiences and observations:

Be kind, for everyone you meet is fighting a battle you know nothing about.” ― Wendy Mass, The Candymakers

A song by Third Eye Blind has these lyrics:

person cliff battleEveryone’s got to face down the demons
Maybe today
You could put the past away
I wish you would step back from
That ledge my friend
You could cut ties with all the lies
That you’ve been living in
And if you do not want to see me again
I would understand, I would understand


One positive outcome was that my dental school class has created a Facebook group where we can gather, share news and stories, post old photos from our dental school “daze,” and stay in touch.

That was my week.


Truckin’ got my chips cashed in. Keep truckin’, like the do-dah man
Together, more or less in line, just keep truckin’ on…

Sometimes the light’s all shinin’ on me;
Other times I can barely see.
Lately it occurs to me, What a long, strange trip it’s been.

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9 Responses to What a Long Strange Week It’s Been.

  1. “When we long for life without difficulties, remind us oaks grow stronger in contrary winds and diamonds are made under pressure.”

    Your friends and dental community are growing stronger because you have allowed us to witness your life with Lia’s Leukemia . We will also witness what the challenges not only creates in you, but also us.

    Thank you for allowing us to be a part of your life at this time. You were a strong man before and we can’t wait to see what is being created now!

    Prayers for Lia and your family!

  2. Ken says:

    Glad to hear we’re not the only office that gets calls from people not wanting to pay for anything too. Where or when did this originate within medicine/dentistry that people expect things for free?

    Keep on keeping on my friend.

  3. Susan says:

    Mike, I am sorry to hear about your classmate. Suicide is a difficult subject to grapple. Your blog entry brought up a mixture of emotion and thoughts for me. It is healthy to externalize one’s thoughts and feelings about this subject imho. Your blog is a healthy way to face these truths, imho. Too often we internalize our thoughts and feelings, pretending to be ok on the outside, stuffing our true emotions, while resorting to maladaptive behaviors for temporary relief from these uncomfortable feelings. “Maladaptive behavior” meaning unhealthy addictions, or any behavior that may temporarily relieve internal discomfort, but knowingly leads to greater distress in the “long run.” I know this sounds clinical, but I don’t really know how to speak in others terms. All of us are affected either directly or indirectly by mental illness. I don’t know the answers but I sense that a mixture of compassion/love/support, patience, “tough” love (respecting one’s own boundaries while withholding moral judgment) is necessary for emotional and mental healing. Just some of today’s ramblings that make sense to me, and but may not make entire sense to others. Thank you for your writings.

  4. Man, I thought I had strange things happen at my office. Was it a surprise to that other office that another dentist does endo? People in General are just weird. P.S. I totally agree. Can we stop with the paper x-ray shenanigans?

  5. Managing patient sometimes become hectic and take more the two to three business meeting in final treatment and during these period patient ask you to give extra attention because of dental fear and treatment doubts, and you have to do that just to make patient more comfortable before the treatment.

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