I took my 2 year old to see an orthopedic doctor that specializes in pediatrics last Friday. The doctor spent nearly a half hour with us, confirming the pediatrician's diagnosis of radial subluxation or Nursemaid's elbow and casting my son's arm. Prior to seeing that particular orthopedic doctor, I called two other doctor's offices to inquire for an appointment. One of the other doctors didn't have any appointments available until Monday. Apparently the doctor was only working between 2:30 and 4:30 on Friday and he already had thirty patients scheduled in that time period.
I feel fortunate that I was able to get a same day appointment with an orthopedic M.D. that was able to spend a significant amount of time looking at my son's arm. The other doctor that was so booked Friday afternoon could only spend 4 minutes on average per patient. Four minutes isn't enough time to hardly say hello, let alone diagnose and treat an injury.
Both of the doctors are contracted with my insurance company, which means that they have agreed to certain discounted fees. I am sure if you asked either doctor why they decided to go into the profession that they would say they want to help people. However, being a doctor is more than just helping people. Being a doctor is a business and there is a certain overhead to having an office, staff, and treating people. When an insurance company discounts a doctor's fees, then the doctor is forced to see a larger volume of patients to keep the business running.
The quality of patient care is what suffers when a doctor only has 4-5 minutes to spend with a patient.
As a dentist I have made a choice not to contract with any specific PPO dental insurance. I employ a hygienist that sees only 8 patients a day, or one an hour. I myself only have about 8 patients on my own schedule on any given day. If I were an in network provider for PPO insurances I would be discounting my usual and customary fees anywhere from 30 to 50% percent. At that rate, I would be unable to afford to employ a hygienist, unless that hygienist saw twice as many patients. Since doing dentistry like fillings, crowns, extractions, and root canals takes a fixed amount of time, I would be unable to increase the volume of patients on my schedule. It would be difficult to have a viable dental practice if all of our patients were PPO or HMO patients. Also, patient care would suffer if my hygienist only had 30 minutes to clean someone's teeth, take appropriate x-rays, set up the room, and have time for me to do an exam.
Kari Ann Hong, DDS
1000 Newbury Road, Suite 190
Thousand Oaks, CA 91320
www.familycaredentists.com
Monday, May 18, 2009
Wednesday, May 13, 2009
The Terrible Two's
Today was my second week back from maternity leave for baby #2. My elder son is about to turn two and he is already acting like a two year old.
I had the baby at my office this morning. He is pretty calm and easy going, except for when he is hungry. I had to take one break in the middle of crown preparation appointment to feed him. The best part of the morning though was when I called my dad to say I would be home a little early for lunch. He was having quite an experience with my two year old.
While out shopping together, my dad was holding my son's hand and my son being two and having a mind of his own, tried to walk away from grandpa while they were in a parking lot. Somehow in the process my son now likely has a subluxated radius in his left forearm. I had to cancel two hours of patient appointments this afternoon in order to take my son to see the pediatrician.
Sometimes it is hard being mom and dentist at the same time.
Kari Ann Hong, DDS
1000 Newbury Road, Suite 190
Thousand Oaks, CA 91320
www.familycaredentists.com
I had the baby at my office this morning. He is pretty calm and easy going, except for when he is hungry. I had to take one break in the middle of crown preparation appointment to feed him. The best part of the morning though was when I called my dad to say I would be home a little early for lunch. He was having quite an experience with my two year old.
While out shopping together, my dad was holding my son's hand and my son being two and having a mind of his own, tried to walk away from grandpa while they were in a parking lot. Somehow in the process my son now likely has a subluxated radius in his left forearm. I had to cancel two hours of patient appointments this afternoon in order to take my son to see the pediatrician.
Sometimes it is hard being mom and dentist at the same time.
Kari Ann Hong, DDS
1000 Newbury Road, Suite 190
Thousand Oaks, CA 91320
www.familycaredentists.com
Tuesday, March 3, 2009
Little Brothers
My son is going to be 21 months old this week. In about one more month he is going to have a life changing event with the birth of his little brother.
I have a younger brother. He is three years younger and I distinctly remember the day he was born. My grandmother was at my house that morning and I no longer had my mother's full and undivided attention. Apparently within the first week I asked my mom if we could take my little brother back to the hospital.
Growing up we would play together. Although I remember most of our play times ending in arguments. According to my mother I liked to boss my little brother around and he in turn like to do things to irritate me. It wasn't until I was a senior in high school and my brother was a freshman that we started to get along and enjoy each other's company.
My son right now can become very clingy during certain parts of the day. It seems to get worse around dinner time when he wakes up from a nap. I can only imagine how I am going to manage dealing with a cling-on toddler and an infant at the same time. On the plus side, my son is a little helper. He enjoys throwing away trash and vacuuming all on his own initiation. So perhaps he will throw away his little brother's dirty diapers.
I feel like I am in the calm before a storm. I know that our entire family dynamic will change when this new one is born. I can't wait to meet him!
Kari Ann Hong, DDS
1000 Newbury Road, Suite 190
Thousand Oaks, CA 91320
www.familycaredentists.com
I have a younger brother. He is three years younger and I distinctly remember the day he was born. My grandmother was at my house that morning and I no longer had my mother's full and undivided attention. Apparently within the first week I asked my mom if we could take my little brother back to the hospital.
Growing up we would play together. Although I remember most of our play times ending in arguments. According to my mother I liked to boss my little brother around and he in turn like to do things to irritate me. It wasn't until I was a senior in high school and my brother was a freshman that we started to get along and enjoy each other's company.
My son right now can become very clingy during certain parts of the day. It seems to get worse around dinner time when he wakes up from a nap. I can only imagine how I am going to manage dealing with a cling-on toddler and an infant at the same time. On the plus side, my son is a little helper. He enjoys throwing away trash and vacuuming all on his own initiation. So perhaps he will throw away his little brother's dirty diapers.
I feel like I am in the calm before a storm. I know that our entire family dynamic will change when this new one is born. I can't wait to meet him!
Kari Ann Hong, DDS
1000 Newbury Road, Suite 190
Thousand Oaks, CA 91320
www.familycaredentists.com
Monday, November 10, 2008
My 17 month old son, the little messer
My son is now 17 months old. We have many names for him, such as "the little messer" and "trouble." Basically, he finds any drawer, cabinet, item on the counter, clothing on the floor, or trashcan and tries to disassemble it, move it, flip it over, examine it, or place it somewhere that only he can find. Currently, his favorite vices are the spice drawer at my parents' house, spatulas, pots and lids, brooms, vacuums, and trashcans. He has become quite adept at operating electronic equipment and knows how to turn on the vacuum, the TV, the stereo system, the phone, and other electronic gadgets.
The hard part about watching my son is keeping him out of trouble. He has boundless energy and a mind of his own. For example, when we went to Disneyland yesterday, he insisted on walking himself, but didn't necessarily want to follow us. Further, even though we were right next door to a really cool ride, he wanted to climb up and down the same stairs. Mark is easily distracted, as he sometimes stops at the local planter box to pull leaves off the stems. He loves slides. At Toon Town, he went down the slide over a half dozen times. At lunch at the Blue Bayou, he insisted on playing with the salt and pepper shakers and, with a shaker in each hand, banged them on the table. When Daddy took the shakers away from him, Mark then began banging on the table with his spoon. Our neighbors were not too happy with the noise, so Daddy showed Mark how to pick up grapes with his spoon. Thereafter, Mark tried to pick up the grapes as Daddy showed him, but became frustrated when the grapes fell off onto his lap.
Mark tried his best to hold off napping. As soon as we got back to the car, he fell asleep, and we finally had a short reprieve from his rambunctiousness.
Kari Ann Hong, DDS
1000 Newbury Road, Suite 190
Thousand Oaks, CA 91320
www.familycaredentists.com
The hard part about watching my son is keeping him out of trouble. He has boundless energy and a mind of his own. For example, when we went to Disneyland yesterday, he insisted on walking himself, but didn't necessarily want to follow us. Further, even though we were right next door to a really cool ride, he wanted to climb up and down the same stairs. Mark is easily distracted, as he sometimes stops at the local planter box to pull leaves off the stems. He loves slides. At Toon Town, he went down the slide over a half dozen times. At lunch at the Blue Bayou, he insisted on playing with the salt and pepper shakers and, with a shaker in each hand, banged them on the table. When Daddy took the shakers away from him, Mark then began banging on the table with his spoon. Our neighbors were not too happy with the noise, so Daddy showed Mark how to pick up grapes with his spoon. Thereafter, Mark tried to pick up the grapes as Daddy showed him, but became frustrated when the grapes fell off onto his lap.
Mark tried his best to hold off napping. As soon as we got back to the car, he fell asleep, and we finally had a short reprieve from his rambunctiousness.
Kari Ann Hong, DDS
1000 Newbury Road, Suite 190
Thousand Oaks, CA 91320
www.familycaredentists.com
Friday, November 7, 2008
It's a Boy!
We had an 18 week ultrasound this past Tuesday, election day, and found out we are having a boy! I can't believe I am soon going to have two little boys running the house.
Kari Ann Hong, DDS
1000 Newbury Road, Suite 190
Thousand Oaks, CA 91320
www.familycaredentists.com
Kari Ann Hong, DDS
1000 Newbury Road, Suite 190
Thousand Oaks, CA 91320
www.familycaredentists.com
Saturday, October 25, 2008
New Dental Technology
I spent the last two days attending Esthetic Professionals 10th Annual Update course. This is the third or fourth Esthetic Professionals update course I have attended. It was highly informative on the latest and greatest in dental technology and materials. Also, I had the pleasure of hearing Dr. Bill Dorfman speak as well as a dental materials educater from Loma Linda School of Dentistry, Dr. Brian Novy.
The most exciting new technology presented at the meeting is 3M ESPE's new digital scanner called the LAVA COS. The scanner can image a tooth in the mouth that has been prepared for a crown. The scanner is a mix between a video camera and a still picture camera. It moves around like a video while at the same time plotting 20,000 picture points. These picture points are so accurate that the image can be used to fabricate a model that can be used to make the final crown restoration.
Dr. Bill Dorfman spoke about an electronic oral cancer detection system call VELscope. Apparently, the light emitted from the Velscope shows any cancerous or precancerous lesions as black tissue. Twenty-five percent of oral cancers occur in people that have no obvious risk factors such as a history of smoking or excessive alcohol consumption.
Dr. Brian Novy presented some convincing clinical work he has done to remove decalcified white spots caused by braces. The treatment for the white spots involves wearing custom plastic trays that are similar to bleaching trays, along with a calcium-phosphate-fluoride paste called MI paste. These trays are worn for about a month and the white spots nearly disappear.
It is always fun to learn about new technologies and procedures. The hard part is deciding which technologies to bring back to your office.
Kari Ann Hong, DDS
1000 Newbury Road, Suite 190
Thousand Oaks, CA 91320
www.familycaredentists.com
The most exciting new technology presented at the meeting is 3M ESPE's new digital scanner called the LAVA COS. The scanner can image a tooth in the mouth that has been prepared for a crown. The scanner is a mix between a video camera and a still picture camera. It moves around like a video while at the same time plotting 20,000 picture points. These picture points are so accurate that the image can be used to fabricate a model that can be used to make the final crown restoration.
Dr. Bill Dorfman spoke about an electronic oral cancer detection system call VELscope. Apparently, the light emitted from the Velscope shows any cancerous or precancerous lesions as black tissue. Twenty-five percent of oral cancers occur in people that have no obvious risk factors such as a history of smoking or excessive alcohol consumption.
Dr. Brian Novy presented some convincing clinical work he has done to remove decalcified white spots caused by braces. The treatment for the white spots involves wearing custom plastic trays that are similar to bleaching trays, along with a calcium-phosphate-fluoride paste called MI paste. These trays are worn for about a month and the white spots nearly disappear.
It is always fun to learn about new technologies and procedures. The hard part is deciding which technologies to bring back to your office.
Kari Ann Hong, DDS
1000 Newbury Road, Suite 190
Thousand Oaks, CA 91320
www.familycaredentists.com
Tuesday, September 30, 2008
Conquering the two year old patient
In the past two weeks I have seen three patients in the two year old age range. The biggest challenge with patients in this age group is getting them to open their mouths and to stay open while you look in their mouth. I asked my son's pediatrician the other day why it is that one and two year olds don't like to open their mouths. His response was that the mouth is the one thing a child that age can control. Apparently you can put your fingers in the child's ears and eventually they will open their mouth to get you to remove your fingers. While this trick might work for the pediatrician that is just trying to take a quick look in the back of the throat, it doesn't work so well for the dentist that needs to evaluate 20 individual teeth.
Back to my story... I saw three such patients recently. The first one was a girl that was turning two in a couple of weeks. She didn't want to have anything to do with me and refused to even open her mouth. The second child I saw was a girl that had just turned two. I tried a different approach with her. First, my assistant found a cartoon on television for the girl to watch. Then I had the mom hold the daughter in her lap while we counted the mom's teeth. After we counted the mom's teeth, the little girl wanted her teeth counted as well. While counting the teeth I am able to evaluate each individual tooth for cavities. By two years of age nearly all twenty of the baby teeth have erupted. If cavities are present at this age, then they are either visually evident or are apparent when touching the tooth with a dental explorer (an instrument with a pin like end).
The third patient I saw was a three year old boy. In his case both the cartoon trick and counting daddy's teeth worked. As a three year old there was a little bit more comprehension of what was going on and I was able to polish his teeth as well.
Fortunately, in all three cases the children's parents were doing a good job assisting with the brushing and none of the children had any cavities. When kids this age do get cavities the only way to treat them is to either wait until the child is older (like age four or five) or to treat them while the child is under anesthesia. The best thing for the two and three year old patient is cavity prevention!
Kari Ann Hong, DDS
1000 Newbury Road, Suite 190
Thousand Oaks, CA 91320
www.familycaredentists.com
Back to my story... I saw three such patients recently. The first one was a girl that was turning two in a couple of weeks. She didn't want to have anything to do with me and refused to even open her mouth. The second child I saw was a girl that had just turned two. I tried a different approach with her. First, my assistant found a cartoon on television for the girl to watch. Then I had the mom hold the daughter in her lap while we counted the mom's teeth. After we counted the mom's teeth, the little girl wanted her teeth counted as well. While counting the teeth I am able to evaluate each individual tooth for cavities. By two years of age nearly all twenty of the baby teeth have erupted. If cavities are present at this age, then they are either visually evident or are apparent when touching the tooth with a dental explorer (an instrument with a pin like end).
The third patient I saw was a three year old boy. In his case both the cartoon trick and counting daddy's teeth worked. As a three year old there was a little bit more comprehension of what was going on and I was able to polish his teeth as well.
Fortunately, in all three cases the children's parents were doing a good job assisting with the brushing and none of the children had any cavities. When kids this age do get cavities the only way to treat them is to either wait until the child is older (like age four or five) or to treat them while the child is under anesthesia. The best thing for the two and three year old patient is cavity prevention!
Kari Ann Hong, DDS
1000 Newbury Road, Suite 190
Thousand Oaks, CA 91320
www.familycaredentists.com
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