Several years ago my office team and I spent some time attempting to redefine what we do and how we do it.  We had a general idea of what we felt was important to our patients and to us in terms of the care we deliver but felt we needed to better define our core values and become more focused.

 At the time there was a lot of press related to “cosmetic” dentistry and “spa” dentistry (whatever that is).  In an age of “Extreme Makeover” and almost instantaneous gratification, we chose another path.  I never wanted to be just a “cosmetic” dentist.  I felt our patients were entitled to more than just cosmetic care.  I felt comfortable based on my training and experience providing a more comprehensive kind of experience - one that was patient centered, relationship based, and that fully integrated health, comfort and beauty.

Two articles I read in the last week helped confirm that in a world that is rapidly changing my team and I are on the right track.

In New York Magazine, week of June 1, Beth Landman wrote in her article “Nipped & Tucked” about the changing reality of medical and dental practices that were only recently, cosmetically oriented.  She wrote about “lifestyle” medicine losing some of its allure as the result of changing economic times and the trials and tribulations of doctors who now have to provide more health centered treatment.  I apologize if I appear naïve here, but shouldn’t the health aspects of care have been considered all along? 

As I’ve said before, as dentists we’ve been trained to be scientists, biologists, clinicians, and artists.  But concentrating exclusively on the “cosmetic” aspects of care often times neglects the health and comfort of the patient.  Shouldn’t these clinicians have been addressing health issues all along as part of the “cosmetic work” they were doing?  Now they’re getting back to basics because the revenue stream from these cosmetic procedures has slowed to a trickle.

In the New York Times Business Section, June 7, 2009, Julie Weed wrote an article entitled “If All Doctors Had Time To Listen”.  She talks about changing models of health care delivery; new methodologies that allow physicians to spend more time with their patients, emphasize prevention, and decrease the number of referrals to specialists.   Ms. Weed  states that these “patient centered” practices are popular and growing.  That shouldn’t be a surprise.  Patients are looking to re-establish a more relationship based personalized kind of care where they feel cared about and cared for.

All in all, a good week that made my team and I feel comfortable that we are on the right track, trying to remain relevant in the lives of our patients.

As always, thanks for listening.

RMS

This week I presented a lecture to the Oral Surgery and General Practice Residents at New York-Presbyterian Hospital where I am on staff as a voluntary attending dentist.  I was asked to speak about implants and aesthetic dentistry- certainly an interesting topic. 

I had an opportunity to speak to them about the changes I’ve seen in implant dentistry over a 25 year time frame as the result of scientific frontiers that have been continually pushed outward.  But just as importantly, I had the opportunity to speak to them about what I call, “The Psychology of Beauty”.

We live in a society where more of us than ever before want to look good and feel good.  And for many, feeling good about themselves is tied in to feeling good about the way they look. We live in a society where baby boomers want to look better than their parents did at a similar age and where, right or wrong, it takes but 15 seconds for an observer to make decisions about who we are based on visual images (note the Susan Boyle phenomenon).  I tried to educate the residents about the psyche of the patients they are treating; about their expectations based on what they see on TV and in the media, and how their self esteem can be affected by our results.

 We spoke about the origins of plastic surgery and the first documented procedures in 600BC; the evolution of plastic surgery from an art and science dedicated to making disfigured patients fit into their society to one trying to make patients look better than others in society.  I spoke about the phenomenon of TV shows like “Extreme Makeover” and how programs showing significant improvement in body image impact on the self-image of the individual.  And I discussed with them how this evolution, indeed revolution, in technique and social thinking impacts on their successful delivery of aesthetic implant procedures. 

Studies by  Ellen Berscheid, at the University of Minnesota, and books such as “Survival of the Prettiest”  by Nancy Etcoff, PhD  cite the importance our society places on “good looks” and the “raison d’être” of the beauty industry.  After all, the eyes and smile are the first two features someone looks at when they meet you for the first time.  And many have come to realize the importance of a pleasing smile in both their personal and professional lives.

Of course I also addressed dental technique and process, and aesthetic and diagnostic criteria so essential to being successful.  But I think the idea of presenting information on “the psychology of beauty” and how this affects our patient’s expectations is another important consideration in the learning experience.

As always, thanks for listening.

RMS

In December of last year, Thomas Friedman wrote an Op-Ed article for the New York Times entitled “While Detroit Slept”  In it he says  “ I can’t help but reflect on what, in my view, is the most important rule of business in today’s integrated and digitized global market, where knowledge and innovation tools are so widely distributed. It’s this: Whatever can be done, will be done. The only question is will it be done by you or to you. Just don’t think it won’t be done.”

I’ve spent a lot of time thinking about this because if I have a choice, I’d prefer it to be done “by me” instead of “to me”. How does this apply to dentistry, how does this apply to my patients, how does this apply to me?

 As dentists, we wear many hats; we are scientists, biologists, clinicians, psychologists, and artists.  And yes, as small business professionals we are also entrepreneurs.  I’m trying to better understand how we can continue to maintain outstanding patient service and customer care, as well as provide our patients a comprehensive approach to dental health that fully integrates health, comfort and beauty.  And how do we do this in a world that is changing so rapidly in terms of social interaction, economic turmoil and technological change? 

What got my attention today (May 25, 2009) is a posting in the New York Times entitled “Webcast your Brain Surgery?  Hospitals See Marketing Tool” by Pam Belluck.  It addresses new ways health care providers are using social networking to get the message out about what they do and how they are doing it. In the article, the author writes about a patient at Methodist University Hospital who allowed the webcast of her brain surgery from the operating room.  It seems as if education was not the only goal of the webcast.  Evidently the concept of webcasting the operation, even though it was done on tape and played later, was also used as an advertising and promotional tool by the hospital; the hospital monitoring how many watched the operation, how many YouTube hits the webcast got and how many people called for an appointment.  The competition is so great hospitals are trying unconventional methods to attract perspective patients to their facilities.

In other hospitals individuals are Tweeting directly from the operating room to describe what’s happening.  According to Ed Bennett, Web strategy director for the University of Maryland Medical System, more than 250 hospitals now use YouTube, Facebook, Twitter or blogs in an effort to reach a wider audience (patient population).

According to Ms. Belluck while some ethicists and physicians raise questions about privacy issues and hospitals painting an overly positive picture, the hospitals feel they must use unconventional, even audacious methods in order to connect directly with the public. 

In a world that is changing so rapidly in terms of how we connect to patients, the question I have is this-is the utilization of the new social interactive technology like Twitter, webcasting, and YouTubing in the patients’ best interest or the providers best interest?  For sure, if the new avenues of social interaction work to educate and comfort patients, they are wonderful new tools to demystify medical and dental procedures.   But if they are utilized solely for advertising and self-promotional reasons, then maybe they need to be rethought.  Maybe the best way to answer the question is to ask.  That’s something my team and I intend to do.

As always, thanks for listening.

Robert Sorin

I attended a most interesting lecture in conjunction with my monthly staff meeting at New York Presbyterian Hospital last week.  Dr Greg Chotkowski, an oral surgeon who trained at New York Presbyterian, presented information on harvesting stem cells from teeth.  Yes, from teeth!  Greg is the founder and president of StemSave , an innovative organization that has developed the capability of storing stem cells from children’s teeth.  I’ve taken the liberty to share information from the National Institute of Health and some of Dr. Chotkowski’s thoughts from an article he has recently published. 

What are stem cells?

According to the National Institute of Health:

“Stem cells are distinguished from other cell types by two important characteristics. First, they are unspecialized cells capable of renewing themselves through cell division, sometimes after long periods of inactivity. Second, under certain physiologic or experimental conditions, they can be induced to become tissue- or organ-specific cells with special functions. In some organs, such as the gut and bone marrow, stem cells regularly divide to repair and replace worn out or damaged tissues. In other organs, however, such as the pancreas and the heart, stem cells only divide under special conditions.”

“Stem cells have the remarkable potential to develop into many different cell types in the body during early life and growth. In addition, in many tissues they serve as a sort of internal repair system, dividing essentially without limit to replenish other cells as long as the person or animal is still alive. When a stem cell divides, each new cell has the potential either to remain a stem cell or become another type of cell with a more specialized function, such as a muscle cell, a red blood cell, or a brain cell.”

Stem cells are unique in that they are the only cells in our body that can regenerate. They are the repair and maintenance cells of the body and are the key to unlocking the promise of regenerative medicine.  Another unique feature of certain types of stem cells is their ability to differentiate. They can turn into a broad range of specialized cells. This enables stem cells to regenerate organs, tissues, bones, specialized cells, and much more.  There is hope that stem cell therapies may treat diseases and conditions such as Parkinson’s, Alzheimer’s, diabetes, MS, arthritis, heart disease, spinal cord injuries, joint replacement, and other genetic diseases.

Recently, scientists have discovered stem cells in the baby teeth of children and in the developing wisdom teeth of young adults.  The stem cells that exist in teeth are very compelling for a number of reasons. Most notabel is their “plasticity”, or ability to differentiate into other types of tissue such as muscle, neurons, bone, organs, insulin-producing pancreatic beta cells, skin and cartilage to name a few. This means they could potentially be used to treat a wide range of diseases and injuries. 

The second  interesting thing about saving the stem cells from your teeth is they are your own- this is referred to as autologous tissue. Once they are reintroduced into the body during a treatment, they will not be rejected as foreign tissue.  Recovering stem cells from baby teeth also ensures the stem cells are young, strong, and vital.

In the StemSave program, patients enroll directly with StemSave and provide the name of their preferred dentist. The dentist is contacted and provided with the necessary tools and instructions so the tooth can be returned to the StemSave lab. In the StemSave lab the stem cells are processed, tested for viability and cryo-preserved.  All registered StemSave dental practices are provided with materials that are both informative and visually compelling. StemSave works closely with the dentist to offer training so that patients can be made aware of the option to save the stem cells from a tooth that is scheduled for extraction.

According to Dr. Chotkowski, growing new tissue and organs from stem cells is no longer science fiction. It’s happening now!   Recently, a new windpipe was grown with tissues developed from a patient’s own stem cells. The new windpipe was transplanted into the patient without the need to take any rejection drugs.

It’s both exciting and gratifying to know that dentists are now on the frontlines of this emerging medical technology. We are now at a point where a trip to the dentist could potentially change a life.

As always, thanks for listening.

RMS

In January of this year I leased a new Infinity when the lease on my old one was up.  Drove the old one to the dealer, picked up the new one and drove away.  Simple.  Or so I thought.  Seems like the dealer arm didn’t communicate well with the financial support arm.  Now the financial arm of Nissan thinks I still have the old automobile and keeps calling me every evening, telling me I am 60 days in arrears on the old lease.  Countless phone calls and faxes have possibly resolved the problem but what a waste of my time.  What wasn’t really my problem became my problem.  The point of all this is that nobody on the other end listened; no one cared enough about a loyal customer to try to solve my problem.  Didn’t leave a good taste in my mouth.

In a healthcare world that has become, at times, very depersonalized, I still believe that patients want to feel cared for and cared about.  It’s the personal connection between doctor and patient that is so important.    My team and I believe in a very individualized, personal approach to patient care.  It’s important for us to understand our patients concerns, listen to their stories, and help them meet their treatment goals.  And while we think we are providing great customer service we are now about to initiate an in- office project to see if this is truly the case.  We are going to begin looking at how our patients are treated, and what their perception of treatment is, starting with the first phone call and proceeding through each phase of the patient experience.  We are going to ask our patients to provide us with feedback about how they feel they are being treated; are they comfortable, are their expectations being met, and are we creating a quality care experience that makes them feel comfortable returning for care and referring other who may need similar kinds of care.   Are we listening and responding appropriately?

 So if you are reading this, and you are a patient in our practice, feel free to respond in kind.  Send us an e-mail or call us in the office.  We’re anxious to include you and hear what you have to say.  It’s the only way we can get better!

As always, thanks for listening.

RMS