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Do you know where Cherokee Place is in New York City?  Don’t cheat by going to Google Maps.  Fifty years ago NYC cab drivers would sit around their favorite eatery, The Belmore Cafeteria on Park Avenue, and quiz each other on the little known streets in the Big Apple.

Cherokee Place is an alley between 77th and 78th streets between York Avenue and the East River.  The Belmore, by the way is long gone; it was a cab driver’s hangout made famous by Martin Scorsese in the movie Taxi Driver.  I know because I drove a cab while going to dental school.

My point is that cab drivers back then had to have a certain knowledge about the city’s geography.  That and a license to operate the cab, known as a medallion, were the only barriers to enter the field.  In London, cabdrivers have to take a test called “Appearances” to “Acquire the Knowledge” of over 25,000 places in that city.  That’s a barrier tho entry.

Today things have changed.

First there were 2 way radios, then gypsy cabs and those black cars would roam the streets, unlicensed, picking up passengers.  Today there is Uber and Google maps.  The barriers to enter the taxicab industry have all but broken down.  The prices for medallions are falling by the day.  All industries get disrupted…books, music and even healthcare.

In the cab industry guilds were formed to protect the independent drivers.  Taylor Swift recently spoke up about protecting artists.  In dentistry I wonder who or what protects the fee for service dentists who are seeing similar disruptions in dentistry.  And the forces are quite formidable.

Adam Smith one of the original framers of capitalism warned of “pirates” entering a marketplace for their own self-interests.  We have seen the age of dental insurance and now we beginning to see the age of the dental service organizations.  Corporate dentistry is moving quickly to become the predominant force in dentistry…as providers and educators.

Prominent practices owned by some of dentistry’s finest educators are being swallowed up by dental service organizations.  The smaller practices are being bought at discount prices and young dentists who have spent a fortune to become independent practitioners will soon have no choice but to work in corporate dentistry.

Who is protecting them?

Who is the voice of fee for service dentists?

Not the ADA.  Not dental schools.  Not the state licensing boards.

Really, they paid a heavy price to enter dentistry…in time and money.  Okay, I know that dentists will still be able to make a respectable income, but what about the ability to learn and grow through autonomy…doing the kind of dentistry they enjoy rather than selling out to corporate forces.

Really, what’s at stake isn’t money as much as it’s well- being, autonomy and independence—the real reasons for becoming a dentist.

Unlike driving a cab, dentistry is a complex job.  Today’s complete dentist must know more than “acquiring the knowledge.”  He must be able to “apply the knowledge.”  The application goes way beyond technical dentistry.  Today’s complete dentist must be expert in leadership, business and communication in addition to diagnosis, planning and treatment.  The dental service organizations will compete with economies of scale that the fee-for service dentist cannot match.

Cab drivers could not see Uber coming.  Dentists must learn how to become “Complete Dentists.”  The answer lies in the dental education system…training dentists to learn just how complex their job really is and applying that knowledge.

 

 

 

 

 

 

 

 

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3 Knots

 

I am a big believer in study clubs.  Our club, the Three Knots Study Club has existed for ten years.  We meet yearly at a different location for educational and social reasons.

In the past few years we have fished the Everglades, explored the coast of Maine and hiked the hills of Asheville North Carolina.  This year one of our members hosted our meeting in Lancaster Pennsylvania…the heart of Amish country.
We certainly got a good look at how the Amish live…this trip was way beyond the typical tourist experience.

I had seen the pretzel factories, eaten enough funnel cake and shoo fly pie and sat behind many buggies in traffic to satisfy my curiosities but actually meeting and spending time with the Amish was a true learning experience.  It was truly a close up view into a culture that stands in direct contrast to the way we live in America today…and even without the modern amenities there’s a lot to learn from these quite progressive people.

Progressive?  Let me explain.  Everything is relative isn’t it?

The one thing that stood out while visiting the Amish farms and observing their family life was a great sense of moral responsibility and empathy for one another.  The lack of modern amenities blended in after a while.

What was really noticeable was the how they worked and related to one another.

Everyone working on the farms were craftsmen.  The animals were well taken care of, as if they were part of the family.  Mostly though what stood out was the care they placed in making sure everyone was taken care of…in the family and the extended family.

Progressive?  Or has the rest of society redefined progress as nothing but more and more material wealth, say as measured by the GDP (Gross Domestic Product).  When does it stop?

Of course the Amish aren’t the only ones who measure success by other standards than material wealth.  In Bhutan the new economic paradigm is Gross Happiness Product which uses natural and social capital values to assess the true costs and gains of economic activity.

I remember first being introduced to the Pankey Philosophy many years ago.  In the center of Dr. Pankey’s Cross of Life was three words…Reward…Material and Spiritual.  Through the years I continued to see our culture lose it’s balance with way too much emphasis on the material…at the total expense of the spiritual (if you have an issue with that word…think ephemeral or intangible—think purpose and gratitude).

As a matter of fact it was through Dr. Pankey’s original philosophy that I heard the term “moral obligation” in relation to dental practice.  It was a driving force in my writing my first book about the examination.

Morality and character are the drivers of a sustainable career in any profession…are we losing it?  Observing the Amish shows that we differ in more ways than air conditioning and electricity.

I am not suggesting anyone give up all material possessions…just to take a step back and realize that as an old movie title said…“The Best Things in Life are Free.”

This weekend we didn’t run the rapids in Montreal, see a Broadway show or ride horses in the Texas hill country…we just ate some really good home cooking and watched another way to live that could hold promise for our future.

 

 

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Mark Twain Said…

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        “This is going to be a rough flight,” my wife said as we took our seats on a recent trip to Tampa.  She was nodding across the aisle where a grandmother was placing seat belts on her terrible two-ish grandchildren.  The two little boys looked back across at me, and for […]

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