| ronredmond@orthodontist.com |
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| Thursday, April 20, 2006 |
| Sunday, October 26, 2008 11:35:59 PM |
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Lama,
I understand your concerns, I have them as well, but I characterize myself as an optomist and I believe America is strong, much stronger than all the fear mongers believe. We survived the great depression and prospered. So, the question remains, do we jump off a cliff; why not if the world is about to end?? Or, do we hold our heads high and continue to do the best we can for those we love and care for? I'll take the second choice, after all, I believe it is the only viable alternative.
Ron
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Dear Dr. Jarrah,
If you have practiced for a while, this is not the first economic crisis for orthodontists. During a crisis, you learn to adjust your terms (usually not lower your fee) to enable the fear to be pacified. I have even resorted to bartering in the past, but if you resort to this method, be very careful not to "give" you orthodontics away.
The good news is that orthodontists usually spread their fees over the treatment length, so we have a built-in buffer to temporary downturns in the economy. Many offices accept full payment upfront, and to the extent that you do this, your buffer is weakened. Usually, the payment period is 20-24 months, so you're in good shape for 12-18 months. Certain orthodontic therapies can be shorter, for example Invisalign and SureSmile, which will reduce the payment period and therefore reduce your financial buffer to 6-9 months.
The bad news for the current economic crisis is our inability to determine the length of time before recovery begins. I am speaking of the recovery, not jusr of our economy, but the fear of the general public. Time will tell what course we will need to take, in the meantime, enjoy your buffer.
Sincerely,
Ron Redmond DDS, MS
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Gerry,
I think the two genetic patterns are related. I remember hearing at a recent lecture (Dr. Bob Boyd??) that the genetic pattern for anterior cross-bite and the presence of mesiodens may be related, at least that was the observation of the speaker.
Ron Redmond
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Dear Dr. Mailankody,
I'm afraid I cannot accept your characterization of our profession as "Surgeons or Butchers". Unless you practice in an environment that doesn't require compensation, such as a government controlled health care system, or you are fortunate enough to be independently wealthy, compensation is a vital part of your practice. If you chose to view practice efficiencies as a pathway to excessive compensation, then I can take the view that practice efficiencies allow for reduced costs to the patient and a superior model for treatment delivery. There will always be those that take your view, and those that take mine, but to describe one as a surgeon and the other as a butcher is inappropriate.
Sincerely,
Ron Redmond DDS, MS
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Hi Lael,
Anterior x-bites come in a lot of varieties that require different approaches to treatment. I prefer a fixed appliance, usually posterior composite bonded to the opposite arch to prevent the tooth from closing into a x-bite position. For example, x-bite of #8 can be treated with composite bonded to the lingual of the lower central incisors to present a flat surface (table) to #8 on closure. The composite is shaped to present a flat surface at the level of the incisal edge of the lower incisors. I do not recommend this technique unless the upper and lower incisors have orthodontic appliances in place and archwires present to provide stability. Once #8 cannot "lock" behind the lower incisors, the archwire can easily move it out of x-bite. Of course, different forms of x-bite are handled with composite bonded appropriately.
Good luck,
Ron Redmond DDS
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Hi,
There are several on-line (Internet-based) orthodontic management systems. These systems do not require anything in your offices except a computer terminal and a printer. All patient data, photos, x-rays, and digital models are stored off-site. They perform all the server maintenance, back-ups, and program updates. These services usually range from $400 to $1,200 per month. I believe this is the future of office management.
Ron Redmond, DDS, MS
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Dear Dr. Low,
I have used different patient education techniques over the past 35 years, but the new systems are a "cut above". I have reviewed Dolphin's Aquarium, Solutions by Design's Screen Play, and ICE Dental Systems. The graphics and range of subject matter is terrific in all three, but only ICE is available online, so the education can take place in the office or at home. Screen Play and Aquarium are CD-based, which limits their application distribution. Aquarium is updated over the Internet. I currently use ICE Dental Systems for patient education, informed consent, and patient history collection. The benefit to me is the ability for the patient to view the animations at home, and the software stores the amount of time spent on each animation. For example, if I ask a patient and parents to view a series of animations related to oral hygiene, I know if they did it, and how long they spent on each animation. This information is stored in their permanent treatment chart for medico-legal reasons, and also to help me insure they are as informed as possible. I hope this helps!
Ron Redmond, DDS, MS
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