Dr. Von Bulow's Articles

So if you go to Webster’s and look up “insure” and “ensure” the words are virtually interchangeable. And when I’m paying premiums these days I’m seriously wondering exactly what’s been made secure, certain, or safe.

And I also totally realize it was only a couple of weeks ago that I last went on and on about insurance. But that was before I got jumped on the Internet. And I didn’t even call the other guy a bruin.

I’m proud to be part of an awesome E-mail network comprised of leading-edge dentists throughout the country and I love participating. Of the truly engaged component of our Molar Jockey Internet crew, about 80% would probably fist pump Rush (some are on a first name basis) if he were only a little more conservative and slightly more self-expressed. Sometimes it gets a little weird.

After spending way too much quality time on the network I actually start getting kind of paranoid. Suddenly, I’m looking for Socialists everywhere. On TV, in my gym bag, even behind the crummy fence lining TC’s “The Piazza (coming soon.)”

Seems like government doing anything these days is Socialism. And I guess if you’re one of the 47 million with no health insurance or one of 25 million with not enough insurance maybe you’re looking for some “security” or “safety” wherever you can find it. Think you’ll find relief from caring, sympathetic insurance companies? In the health insurance industry, relief is spelled P-R-O-F-I-T.

Between 2000 and 2007, the top ten health insurance companies increased profits by 428%, mostly because they could. Premiums for employer-provided health insurance (that’s me) have doubled since 2000. Even in dentistry, the annual maximum benefit that was $1000 in 1971 remains $1000 today in spite of inflation that makes everything 7-8 times more expensive now than almost 40 years ago.

So I dunno; some key reasons I’m a healthcare provider today and an employer who provides full health insurance for my co-workers go to my public school education K-12 and later at Cal State LA. And without my “socialized” education I could easily be one of some 72 million folks who are one banana peel away from losing everything. As it is, I’m just another small businessman ensured of getting hosed by insurance.

Maybe I’m crazy but the public sector was there for me when I wanted an education. The private sector dropped my worker’s comp coverage after 15 years because a dental assistant hit her elbow on a counter top while cleaning up a treatment room.

Funny thing is, not having dental insurance actually keeps folks away from the dentist when the tab for x-rays and exam are the investment equivalent of a microwave oven. And the preventive value of a visit to the dentist can be tens of thousands of dollars in terms of quality of life and even years of life.

So part of dealing with healthcare is being responsible and doing what you know you oughta do to take care of yourself. We’ve worked to encourage folks by offering complimentary x-rays and exam (or if there is dental insurance coverage, a rebate of similar value for future care.) Now if we could just get a similar commitment from a few health insurance companies. Or maybe some decent competition and competitive prices.

But see ya; gotta run. I’m off to the public 210 and the public driving range; might even listen to some public radio coming from public Pasadena City College on the way. Just hope I’m not getting a lesson from some freakin’ socialist golf pro…

Please accept my apologies for being such a dang grump a couple of weeks ago; my bad. Seemed like even “virtual” Coach Pete couldn’t interview me out of a bad attitude. And I even called La Polla Loca an “old broad” (means she must be less than ten years younger than me.)

So if you really do have any paid-for dental benefits available between now and the end of 2009, do take advantage of them. Why lose funds that would have helped provide better oral health, not to mention additional smiles and quality time to smell some more roses?

And please do use dental floss. Users really do live an average seven years longer and that data includes the Derby State of Kentucky (the same place that gave us “tooth” whitening and drive-thru denture franchises.)

A few things happened during the last two weeks that got me to thinking an apology was definitely in order. The experiences produced some endorphins that are nowhere to be found during spin class where my going 90mph (an estimate) on a stationary bike in a roomful of mirrors is way less euphoric than the air conditioning.

I was daily reminded about what was so special about my career choice. Wasn’t all the new gadgetry or the cool title or even working indoors with A/C listening to music or even a schedule my Dad would have considered part-time. Wasn’t even the Trojan shrine…it was the people.

I basically get to work with family I can choose and I get to make new friends every day. And all I have to do is be interested. Who wouldn’t?

It’s always fun meeting new patients and catching up with old friends because the conversation is never the same twice. Considering the vast expanse of what I don’t know I don’t know, my just being with people is a continuing, continuing education available to me 8 hours/day Monday through Thursday. Plus research shows you retain stuff better when you’re having fun so why not have fun?

Today I opened up a letter from one of our former in-service training students from PCC. Abe has sent us updates during the last three years and this time proudly announced his passing the Boards, paving the way for his chosen career as a Physician’s Assistant. I don’t think we scared him out of dentistry (maybe Singing Dental Assistant Kolleen…)

Well Abe is just the kind of person who will make a difference for folks in healthcare; he’ll save some lives and add quality to countless others…because he cares. And I’m beyond being flattered that he shared his great news (with test scores and resumé included.) One reason I start so many sentences with “so” goes back to all the questions Abe used to ask, most of them starting with “So…?”

Also received an e-mail from the daughter of one of my classmates. Inger shared she hadn’t been to the dentist since the passing of her Dad, an awesome dentist and an even more awesome guy who saved some lives by making dentures that transformed weakened, starving senior citizens into Jack LaLanne look-alikes. Inger wondered if we would accept her as a new patient. Made my month.

Next week I’ll be landing at O’Hare for the annual thumping of the Irish and I’ll have a ride into Chicago…courtesy of a great patient and friend who actually has more Trojan gear than me.

So if I come off as a grump in the future feel free to drop-kick me some feedback. “It’s the people stupid!” would be more than appropriate.

So I know it hasn’t been that long since the least Coach Pete Carroll virtual interview. Readers, Editor John, and even Judy Wong might object but guess what? I don’t care (especially the Judy Wong part.) We lost to the Huskies!!!

And this week I’m just not in the mood to babysit folks who oughta know enough to drag their butts into a dental office maybe twice a year and stay healthy. Lord knows, I’ve got better things to do than listen to “…are we human or are we dancer…la-la-la, la-la-la” everyday after work but if riding a stationary bike in a roomful of mirrors and listening to lousy music keeps me healthy, so be it.

When stats show that you live seven years longer when you floss your teeth whaddya want from me? And if you know you’re gonna waste hard-earned money by not using dental insurance benefits or flex plans by the end of the year, maybe throwing a grand away here and there to the rich and infamous is just your thing. Me, I’d root for the Bruins even if they were playin’ a co-ed swimsuit all-star team…if the bikinis were representing the insurance industry.

And dang it, now I’m sounding just like some cranky old geezer who just had his veggies overcooked, huh? But much like my senior citizen buddy Coach Pete Carroll, I’m taking full responsibility. Yes it’s my fault and my fault only. Nobody made me turn on the TV, no one kept me from sending my Carroll-autographed helmet right through the middle of the 48-inch 3-hour nightmare, and I wasn’t under house arrest. Watching USC lose while impersonating the Raiders was totally my choice. And that’s why I invited Coach Pete over to El Pollo Loco for a little powwow over how he screwed up so bad and gave me such a lousy attitude (I might add that if La Polla Loca shows up offering a senior discount, I might have to drop-kick the old broad.)

As usual, the opinions expressed here do not reflect those of the NCAA, the BCS, the Pac-10, TCDC, or even the City Council and the Gang of One.

“Coach Pete, as usual it’s great having you here in Temple City, the city of vacant store fronts, large cement slabs and larger dirt lots; hope you took Baldwin.”

“Doc V, of course it’s totally awesome bein’ here and your astute mentoring is totally special but what’s up with your attitude; it’s really jacked-up?”

“Coach, we lost to the freakin’ Huskies. I haven’t slept for a week, Thursday I snapped at Singing Dental Assistant Kolleen just because she was humming a Bolton tune, and yesterday, I couldn’t even stay focused long enough to eat a steamed artichoke. How could we lose to the Huskies; they lost all their games last year (I wipe away a tear)?”

“Young Jack, we declare high goals like being great forever, but there are no guarantees. Each setback we experience is an opportunity to look within and become even more powerful if we leave that setback in the past. To err is human; to create new possibilities is transformational. And it’s totally awesome and it’ll be a total blast when beat the living hell out of those dudes next year in the Coliseum!!!”

“Dang it Coach, you had me scared there for a minute or two when you were talkin just like a fortune cookie. All that Zen garbage might play really well on the Westside but over here in the real world, my Armenian dry cleaner is disrespecting me just because you lost to Sarkesian.”

“J-Dawg, just remember you’re still the foremost elite athlete/dentist/scribe in the San Gabriel Valley…and also remember revenge is totally awesome; it adds texture, flavor, and even romance to athletic dominance. IT’S A BLAST!!!”

“Coach, that makes sense. I feel better now; I could eat an artichoke. Did I tell ya I was Half-Sicilian? So is that really white hair or do I see some dark roots?”

“Bite me Molar Jockey!”

So I guess I’m supposed to write about stuff like oral health, health insurance, and the impending national healthcare transformation but what about my health? What about me? What about my mental health?

Without Trojan football, I’d probably kick the cat and that’s no good because I don’t have one. And without Salute to Troy, I probably couldn’t get through August and everyone else’s vacations…or even last weekend.

And you try writing this column every week for going on twelve years and see how you like it. I have this ritual where I write the thing the Friday before the Wednesday deadline, the actual column coming out on the following Monday. Like I said, you try figuring out the method to that madness.

This Friday was totally out of the question because it was bookkeeper visitation day. No way to be even slightly creative when someone is interrupting you every five minutes reminding you how much it costs to be a dentist (“Was this bill for marketing or continuing education or equipment? Is this for Worker’s Comp; thought you paid that one with the really big one you send into Anthem for everyone’s health insurance? Is this a new consultant or is it the old one with a new company name?“)

Back in the Day, when ole Mel Gibson used to ride a horse and paint his face all blue just like some re-caffeinated Seahawks fan a few years before he bought Malibu, didn’t he used to scream something all the time? Wasn’t it something like, “FREEDOOOMMM!!!“? Bet he meant freedom from insurance.

Never thought I’d say this but Mel, I understand.

Oh, Friday also means a chance to go across the street to the bank and squeeze in one final deposit for the week. Imagine my elation on seeing six insurance envelopes in the mail. Imagine my dismay when the contents of the six messages from the folks in the tall buildings Downtown revealed payment delays, a missing detail, or the lack of coverage for a given procedure. Not a single check.

And Friday, at least three different people told me they don’t go to the dentist because they don’t have insurance. Hmmm, I was wondering if that was sort of like living forever because you don’t have any life insurance.

When I finally made it to Friday night CNN, I saw a bunch of knuckleheads calling the President a Nazi because he wanted to mess with health insurance. Thought maybe they had him confused with the guy who wire-tapped citizens, tortured folks, and invaded a sovereign nation posing no threat to the U.S. But let’s leave the past in the past.

Turns out, the leading cause of bankruptcy in the U.S. is a health-related catastrophic event. Turns out, half those bankruptcy folks have health insurance; just not enough.

Friday night, I tossed and turned, somewhat stressed over my concerns for another fat monthly check due to Anthem Blue Cross, team members ill or on vacation, and the uncertainty of unchartered economic waters.

But on Saturday, I took a mega-dose of life’s best medicine. And what else would you call exercise, laughter, and the company of friends and family? Did I leave out the Salute to Troy, another year of USC Trojan football domination, and a whole fall season of Saturdays that take you back to being a kid again?

And a few days in the sun…with absolutely no thoughts of freakin’ insurance.

Okay, can anyone out there help me with this one? So I don’t know much about the alternative rock band “The Killers” except that their song “Human” sounds more like mainstream but that could be due to my hearing it every single day in spin class (For the uninitiated, spin class is aerobics on stationary bikes in a room full of mirrors. Really.)

“…la la la…are we human or are we dancer?” now plays in my head all day long. If it weren’t for my trusty dental drill and the loud sucking sound our vacuum makes I’d probably be borderline bruin by now.

Have you ever wanted to ask just one question of someone to clear things up? Like, did you really pay someone to sit down and write the “Five Dollar Foot Long” song? Or, why do you keep on playing those “Clipper Loud!” commercial spots (wouldn’t it be a little more merciful and human to just let the Clips slip out of town around 3AM by Greyhound?) Or, which one of you knuckleheads said, “Sarah Palin, what an awesome idea!!!”

So are we human or are we dancer? I guess if I can’t ask lead singer Brandon Flowers what in the Sam Piazza (coming soon) he’s singing about, I’ll just answer the question myself. Okay Brandster, but first I’ll just pretend you’re in my dental chair and ask, “Why dancer; why not dancers?” “Are we dancer?” sounds more like a bunch of dentists wondering if they’re a reindeer.

Anyway, I must be human because I dance sort of the way the previous City Council played nice with the School District, the Chamber, and business development.

And another one of those questions comes up. Ms. Mayor, we were actually in the movie Viola together so why can’t you guys help out the School District? If you have $37 million in reserve on a rainy day, why not hand over a measly $2 million to get the schools out of the red? Why not preserve the quality of the one local institution that’s the glue for stuff like property value and community pride? So congrats and I hope the new guys are more human than dancer.

And finally back to spin class and one last question; I’m still smiling.

So I know Woody Allen would opt for solitary confinement over lunch with an insurance agent but shucks, I like most of my insurance guys and Woody never met Alvin.

I totally respect the insurance business; to prove it, I’ve been paying them through the nose for around thirty years. And I never even knew Alvin from the gym was in the premium game until he started groaning away about some recent dental care. I think his words were, “Wow, you guys really run a scam.” Turns out, Alvin had had root canal care from a specialist and was now having a crown made to protect the treated tooth. Alvin smelled conspiracy.

“So Alvin, you wouldn’t have an internist do your bypass would you?” “

Jack, you’re the fastest spinner on the planet so you’ll understand I’ve used up all my benefits on one tooth. I actually had to pay out of pocket (whimper.)”

“So Alvin, what do you do anyway?” “I’m in insurance.”

“So Secret Agent Alvin, did you know annual maximum benefits for premium payers are basically the same now as they were in 1970? Wonder who set up that scam?”

I’m still smiling. Even though I’m still hearing “…or are we dancer?” And the answer is: Yes, if you sell dental insurance.

So I realize things are a little tougher to figure out these days. And there are times when I swear I’d rather be represented by Manny, Moe, and Curly Joe than the Governator, the old TC “Gang of Five,” and whomever it is who keeps leaving out my contact info at the end of these columns. Then again, sometimes you never know when help is on the way.

Like I knew there was a Bailout of some sort going on (I read about it in all the papers.) I just didn’t figure it would be limited to some hard luck CEOs. And I’ve always been uncomfortable judging folks who weren’t bruin fans. But how do y’all feel about being judged by banks? Don’t know about you guys but to me it feels like having the Crips and Bloods jump all over my case just because I have a few parking violations.

And just when I was prouder of my alma mater than Joey Chestnut can eat hot dogs on the Fourth of July the school goes totally ghetto. The USC president, athletic director and basketball coach clam up like a bunch of Watergate defendants, undoubtedly following the sound legal advice traditionally reserved for cheats and liars. If somehow Coach Pete Carroll is implicated in the death of Karl Malden, I’m gonna give up following organized sports and spend most of my leisure time watching the Clippers and bruin football.

I guess in an attempt to get away from it all, I went out and played some golf this morning. And I say “some” golf because according to patient/foursome member/tool collector Steven D., during my eighteen holes and somewhere around 4 hours at Santa Anita, I only played 3 holes of golf requiring some 23 minutes. The rest was just a long angry walk in the park spiced up with some dark blue dentalesian soliloquies.

Then, out of the abyss, a miracle.

After several decades of my hiding, I ran into Mr. Robert Low, my Government teacher from Mark Keppel High. And I guess I’m insufferably Old School. I’ll never text and I know you’re never supposed to say never but I’m also never gonna tweet (I am on Facebook.) I use my cell phone the way the bruins win BCS championships and I know one day I’ll get hauled in for verbally and physically abusing my computer. And even though I met him around the time the Beatles landed, it will never be Bob. It will always be Mr. Low.

Mr. Low was my all-time toughest, most memorable and best teacher during my 4-year stint at Mark Keppel. I did more Government reading the summer before my year with Mr. Low than I did during the year with all my other classes combined. Our group of about 20 or so students in “Accelerated” Government included a few National Merit Scholars, assorted future doctors and lawyers, and maybe the best sportswriter this side of Jim Murray. So in that select company, who wouldn’t try handing in a book report, having scanned only the inside cover? Oh, and the book? Pretty lightweight stuff; only Senator Fulbright’s Old Myths and New Realities, his landmark commentary on “The arrogance of power.”

“Mr. Von Bulow, would you mind stopping by for a word before leaving class?” And later, “Mr. Von Bulow, should you choose to return a book report in the future, I suggest you first read the book.”

Years later, after I’d been practicing dentistry in Temple City for a while, I opened up a “City of Covina” envelope (another parking ticket?) It was correspondence from then and now Covina City Councilman, Mr. Robert Low. Mr. Low had spotted one of my nasty little notes to the Times’ Sports Viewpoint; he recalled the halcyon years at Keppel with classmates pediatrician Bill Visser and sportswriter extraordinaire Scott Ostler.

I still have the note.

And what better time to re-read Senator Fulbright’s views on “The arrogance of power?” Think I’ll pass a copy forward to the next hard luck CEO I meet.

So I’ve been a Celtics diehard since I was a little kid. And that takes me way back to the good ole days when Bill Russell and Bob Cousy used to use and abuse the Lakers on a yearly basis. Kobe Bean Bryant wasn’t even a glimmer.

You’d think somewhere along the school days line some big ugly Lakers bully would have set me straight. But since “Lakers” and “bully” are close cousins to military intelligence and bruin football and my probably adopted DNA includes a deep streak of sneakiness, nothing happened.

Last week, OM Dalila and I hopped on an early AM flight to Bean Town. We were hoping to learn a few things about internal practice systems, Little Italy, and small business strategies for a challenging economy (you’d think setting up shop on Las Tunas would have taught us that lesson long ago.) We battled through LAX and said goodbye to Dr. Tooth from 28,000 feet.

By the time we got to Phoenix, fellow Friendly Skies traveler Marilyn said hello, shortly followed by, “Why would anyone wanna be a dentist?”

So I hate myself when I knee-jerk a wiseacre proctologist/podiatrist comparison. And Marilyn had a soft, warm, inviting voice so I went about explaining why I love my career.

Folks really don’t answer a calling or live passionately because they fix pieces of anatomy or really understand human body zip codes. Learning, perfecting the implementation of knowledge, and sharing it is pretty exciting stuff; even comprising some of the tastiest spices of life. And gaining results that weren’t even on the radar when my parents were my age? Wow.

But pie hole, culo, or size 11s, the real reward and fulfillment comes from giving out some human gifts…like discovery, hope, and renewal. Transforming quality of life and building lasting relationships in the process is way bigger than any small business. And, it’s addictive.

So when I looked at Marilyn I was reminded of one lovely lady who got out of the house and drove somewhere alone for the first time in twenty years because she finally felt so comfortable going to the dentist (I think Singing Dental Assistant Kolleen came back with the Martinelli’s.) I thought about all the trusting folks who would live longer, happier lives just because they loved our hygienists. And I remembered a beautiful young woman who shared a full out, no holds barred smile…for the first time since 2nd Grade.

Sometimes it’s the journey. Einstein said, “Out of difficulty comes opportunity.” Especially when you’re looking for it.

So what I learned on the way to Boston and what I took away from some 30 hours of my continuing, continuing education was this: We may have absolutely no control over stuff like the U.S. economy but we are totally in control of being responsible for the choices we make and the opportunities we find.

And for patient and practitioner alike, why not be happy about both?

Okay, so a few weekends ago I went to a convention. And how would you like to be this close to the Magic Kingdom only to wind up being surrounded by thousands of dentists and tens of thousands of sales reps?

The California Dental Association presented “The Art and Science of Dentistry” in Anaheim on May 14-17 and I just couldn’t help but reflect.

First thing I noticed was my official convention On-Site Guide. It was sealed by a wrap-around ad from the Bank of America. The headline proclaimed, “WE HAVE MONEY TO LEND.” Hmmm.

Then I noticed what should have been first (and would have been first without our uncertain economy and my warped sense of humor;) all the women. When I was a kid-DDS and attended the CDA convention I was way overwhelmed by the wealth of womanly riches in the profession I’d so astutely chosen. Today, my appreciation has more of the depth you’d expect from someone who’s practiced dentistry since Disco.

But early on, for me, going to the convention was like spring break from four years in a boy’s Catholic school. My dental school class of 120 students included all of two women. Today, the men-women ratio goes to 50:50. These days, my perception of all the women in oral health is a little different than spring break (but not totally.) Experience has taught me women make all the difference in dentistry.

Hate to sound arrogant but you just have to respect a profession that gets it. In dentistry, the practice vision comes from the owner and its development and reality comes from team members (code for women.) Women create the culture. And it’s probably no accident that 2/3 of the folks who are smart enough to find a happy dental home are women too. Why not? Don’t women also make about 80% of important family choices?

So I just might be the living, breathing, grunting epitome of the typical surface-polite male. I can read a map so who needs to ask for directions? Show me a picture; I don’t need to read any instructions. Sarcasm used to be a hobby. And I did use the past tense.

I’ve been a total project. My Mom made me a life’s work. My dental family away from home has provided on-the-job training for years and OM Dalila, Dental Assistant Extraordinaire Dani, Singing Dental Assistant Kolleen, and Twin Towers of Hygiene Jen and Peg should all get medals. And I’ve even had formal training in active listening for cryin’ out loud!

So if I’m a functioning adult with perception and organizational skills that succeed on a level at least comparable to Shaq foul shots or former-VP Cheney’s grasp of reality, it’s only because of the women in my life.

I’m surrounded by caring folks who relate to others the way Picasso related to scratch paper. Talk about making a difference in the health care experience.

As I toured the convention floor, one by one, I ran into four of our own sales reps from Patterson and Pearson Dental Supplies, Invisalign, and Care Credit. They each complimented me on my practice but saved special praise for my team. They used words like “warm,” “family,” and “happy.”

A beloved mentor once shared, “We’ve got the best job in the World. All we need to do is show up, empower our team, give some direction when you know you should…and then just stay out of the way.”

And these days I’ll often ask for directions even before panic sets in. I remain a work in progress.

The CDA presented “The Art and Science of Dentistry” last weekend. And women provide about half of the science and almost all of the art. So I’m a male but even I know when to stay out of the way.

Today I sent in my re-licensure paperwork and a check made out to the State Board of Dental Examiners.  And when I print out the ole P&L report and scan the cost of doing business with dental labs, dental suppliers, and the Tax Man (Did I actually leave out insurance expense?), the tab for my now nearly classic license looks like a pretty sweet deal.

But trust me; I won’t be making too many “sweet deal” remarks around recent grads who qualify only because they’ve already spent hundreds of thousands for school and hundreds of thousands more if they’re ready to roll the dice on opening a new business. 

Yeah, $335 isn’t half bad.  Shucks, what with the value of gold these days, you could almost pay the lab fee for one crown with three bills and change.  And I hope you’ll forgive some dang cynicism creeping in; think maybe I’ve been watching a little too much Doc House Monday nights.

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So I realize I’m getting a little older because I don’t wake up in the middle of the night any more, totally convinced I’ve been removed from dental school for calling Doc “Wrath of” Kahn a little weenie.  I guess birthdays do have some advantages.

For the most part, I loved being a student.  Shucks, the only times I remember being under the classroom gun were during Catechism and dental school; everything in between was pure hot fudge sundaes.  My teachers always had my unconditional attention and respect; with the exception of dental school, I always felt the feeling was mutual.

Of course, my family always took a personal interest in what I did.  Sometimes it was almost embarrassing.  If my brother had only known I could actually use dental floss in grade school, he’d have told the world.  And today, I always view patients in the context of family.  I kid around with the family thing during a patient’s first visit, sharing most of my relatives are Sicilian (the Familia never forgets and they’re bent on revenge.)  Not a bad guarantee for my best clinical effort.

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