Endo, Know when to say when......

Discussion in 'Dental' started by suffolktri, Dec 6, 2008.

  1. suffolktri

    suffolktri Junior Member
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    This is a simple plea to all my fellow colleagues in dentistry who are about to join the workforce.

    Know when to say when.

    I am a current endo resident and couldn't be happier doing what I do, but it's been harder lately for me to stomach what I see come to my office from referral/dental school.

    I'll be the first one to say that we need good general dentists doing good endodontics. You've all heard the number (70-80%ish) of endo that is done in this country by GPs. There are in fact a group of GPs out there who are more skilled at endo than some specialists. These guys along with our specialty give Endodontics a good name and do our patients some good with quality care. Unfortunately there is another larger side of endo done by GPs (and sadly a few endos) that is really just boot-leg crap.

    Someone here on SDN said something I'd like to quote.

    "It's really hard to know what you don't know"

    I fear sometimes that dental students get either a cringingly small amount of endo experience (the usual) or sometimes a deceptively/dangerously larger amount of endo experience in school and these roads lead the overwhelming majority of students onto one of two separate paths. One is that path of " I hate endodontics, who would ever want to be a "micro-masturbator", endodontists are zombies" path which is perfectly fine with me. Work with us and we'll work together to help your patients and make everyone happy.

    The second path is the dangerous path of "endodontics is monkey-proof, all I do is put file 1 in the hole, file 2 next and finally this warm thermafil crap in the now bigger hole and the case is closed" This attitude spills onto most of the other areas of dentistry as well and alot of the time these are the kinds of GP's who are also doing braces every thursday, popping some implants in on Tuesdays, doing full mouth rehabs and wondering why in the sam heck dental school took 4 yrs, they could of mastered this drivel in 6weeks.
    ......It's hard to know what you don't know..........

    To all those future GP's out there who are committed to (1) offering the standard level of care and (2) KNOWING WHAT THE STANDARD LEVEL OF CARE IMPLIES AND IS , I say welcome, we need you, patients will need you, and you will be successful in many ways beyond the monetary.

    To all those future GP's who are already becoming cynical and complacent about their knowledge and plan on doing "everything", get a good lawyer.
    Just this month alone I've had several referring dentists in the second group and when you perf, overfill, underfill, don't use RDI, NaOH accident, miss canals, overflare, transport, zip, etc... it's alot harder for me to get your back when talking to the patient and ALOT harder for the same to the lawyer.


    Know when to say when, that when is when you know you don't know.
    How's that for a tongue twister
     
    #1 suffolktri, Dec 6, 2008
    Last edited: Dec 6, 2008
  2. ou_jay

    ou_jay Junior Member
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    What is a sodium hydroxide incident?
     
  3. suffolktri

    suffolktri Junior Member
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    don't you know, it's the same as the baking soda incident.:)

    sorry, good call man, that's what happens when you type entirely too much after 12.

    It's sodiumhypochlorite, NaOCl, and I think it's worse than a NaOH accident, (I wouldn't know yet actually, thankfully we don't pour lye down the canal so I guess I don't know what I don't know)
     
  4. doc toothache

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    Sounds like you should be thankful they are coming to your "office". Without referrals you may end up having more time twiddling your thumbs than practicing endo.
     
    #4 doc toothache, Dec 10, 2008
    Last edited: Dec 10, 2008
  5. OceanDMD

    OceanDMD Rather be fishing
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    I just love the 'reprimanding all knowing' tone from specialists, let alone resident specialists. It really makes me want to refer them my business.
     
  6. Awara

    Awara Member
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    This residency in school is the NUMBER ONE reason we GP's don't know or don't learn enough about ENDO. There are people in the class ahead of us who have done 0 root canals and they will graduate in 5 months. Every single god damn endo goes to grad programs for their resident. This sucks when you are paying all this money to learn. We GP's have to start somewhere and I think dental school does really poor job of teaching us anything in endo. It is all referral for ENDO.

    If I was recommending to any predent I would tell them to go to a school without Graduate Endo program if they have a choice. I didn't know that and I am getting really frustrated as a dental student.

    Also, I have heard the same arguments from Ortho and Prostho people that you shouldn't do any if you haven't done a residency. I say BS. You have to start somewhere and I think knowing what you can and can not do is important but it is not nice when your specialist or resident specialist tells you that you should refer all out or dosn't like troubleshooting some of the problems you encountered. Dentistry is not fun if you don't expand your horizon and learn different aspects of it. Number one reason I am not specializing because I like all aspects of dentistry except PERIO.

    Also, you telling me than all the problems such as overfil, underfill, NaoCl or perf etc. doesn't happen by Endodontists. I am in complete support of taking all the CE's and learning so you can do a good job in endo. I would need help of the doc I am referring to when I am in trouble and If I don't get it then well too bad.
     
  7. ptrianon

    ptrianon New Member
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    I have never wanted to do all my own Endo more than I do right now.
     
  8. Guy Smiley

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    I really think this depends on where you go to school. At our school we had to do at least 2 molars start to finish and we have an endo program there. I would have to say ortho is the specialty your least likely to see a lot of as a dental student. Even at schools that do a lot of ortho, the most anyone will get is 2, maybe 3 cases as a dental student.
     
  9. Rube

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    All the more reason your feelings should be directed towards your board. Think of the numbers involved here...If we referred 15% more of GP cases to you, you (endos) couldn't handle the increased numbers. The problem is poor experience in dental schools and that is where endo needs to take the lead in getting cases to us.
     
  10. TomBosley

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    You are a total badass. You show those endodontists you dont need them!
     
  11. aphistis

    Moderator Emeritus 10+ Year Member

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    Jeopardizing your patients' welfare to show another dentist how big and tough you are? Now that's what I call professionalism.
     
  12. doc toothache

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    Of course, berating gps, the hands that feed you, is so much more professional.
     
  13. UKdent

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    We don't have an endo grad program at UK and still don't get any endo cases. I guess that is probably because many patients are electing for implants and since we can place an implant and crown for $873, it is roughly the same price for endo and crown. Oh well at least we get practice with implants....
     
  14. aphistis

    Moderator Emeritus 10+ Year Member

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    You seriously call that "berating"? Have you never been criticized in your life? If you think he's being unnecessarily critical, that's fine and I respect your opinion, but geez, get some perspective. I've never understood people who insist, whenever possible, on going out of their way to get huffy and indignant. If you do good endo, the OP isn't talking to you. If you routinely turn out crap, you should take their comments to heart. Neither option leaves much room for getting as personally offended as you seem to be.
     
  15. aphistis

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    DrJeff has suggested making your fee for molar endo equal to your fee for implant placement. I like that idea a lot.
     
  16. ptrianon

    ptrianon New Member
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    I think its fairly obvious that I was making fun of the OP's condescending tone in the original post and that I don't actually plan on doing all my own endo. I find it interesting that your questioning of my professionalism also reads as condescending.
     
  17. aphistis

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    Condescending to you, perhaps. I admit I can't substantiate it, but I have a hunch you consider most people who disagree with you to be "condescending." To quote a favorite of mine...
    Further, *I* think it's fairly obvious that any two people can have wildly differing ideas of what constitutes "fairly obvious" on an internet message board.

    Finally, with regard to the rest, I'm not trying to condescend to or patronize you; beyond that, though, if you want to feel patronized, neither I nor anyone else can stop you.
     
  18. KOM

    KOM Senior Member
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    :laugh: Aphistis...are you ok?

    It appears that you are the individual getting "all huffy and indignant" at anyone who calls you out. Perhaps you may want to work on a particular theme from this thread and "know when to say when."

    Continuously attempting to back up your snide remark may be the exact reason why some, myself included, do perceive you as condescending in this thread.

    You can dish it, but apparently can't take it.
     
  19. aphistis

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    Nah, I can take it. :) By now it's pretty obvious I'm the minority viewpoint in this thread.

    The OP showed a lot of audacity to come in here offering those criticisms to a bunch of (mostly) general dentists and dental students, and s/he wasn't very diplomatic about it (which, as others have correctly noted, is likely to cost the OP some referrals out in practice), but that doesn't make them wrong.

    Sarcasm can be a tricky, but useful tool, but it's going both directions in this discussion, and I reject the implicit assumption that being sarcastic and/or candid automatically equates to being condescending. If you disagree, I respect that and more power to you. As long as you stay within the TOS, you can pile on me and the OP as much as you like.
     
  20. KOM

    KOM Senior Member
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    That's the spirit!

    Now...time to wrap up this semester!
     
  21. lotexigeus

    lotexigeus Master Member
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    am i the only person that thinks aphistis is a tool?
     
  22. aphistis

    Moderator Emeritus 10+ Year Member

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    Definitely not.
     
  23. dheav005

    dheav005 keepin' it movin'
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    duh, his avatar clearly indicates that he's a hammer.
     
  24. lotexigeus

    lotexigeus Master Member
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    k, just making sure.
     
  25. doc toothache

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    Notwithstanding an unabashed acknowledgment that we like to think of ourselves as the best clinicians that ever walked on this earth and at worst, we are first among equals, the "boot-leg crap" that Dr. Endo refers to may, in general, be work we have done ourselves but never to be seen again since unsatisfied patients will move elsewhere to have our problems rectified by our fellow practitioners.
     
    #25 doc toothache, Dec 15, 2008
    Last edited: Dec 15, 2008
  26. PERFECT3435

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    good thread. i'll be doing my endo comp tomorrow and will keep this thread in mind.
     
  27. verticalbite

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    actually, im goin to be a GP so you should kiss my ass so i will send you referrals, otherwise ill go and get some CE and do all of them!
     
  28. Deltron 3030

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    873$ for an implant and crown at UK? And you place them as an undergrad?
     
  29. HuyetKiem

    HuyetKiem Senior Member
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    The OP has his/her point. If you're planning on doing "everything" after dental school, be prepare and know your limit. You should take as many as hand-on CE classes as possible , volunteer most of your free time in specialty clinics, free clinic, or community clinics during 3th &4th yrs. Always feel guilty when you're not doing or learning dentistry during those 4 yrs.

    It had worked out great for me in my 4 yrs of dental school because I was an oldest person in my class and had no life other than dental school and family :D:D
     
  30. DCRedskinsRule

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    In my INEXPERIENCED opinion as a first year student, I seems to me that all the OP is saying is that GP's are given a lot of power and freedom with their practice, but need to know the difference of what they CAN do and what they SHOULD do. A GP (with or without certain CE courses/certificates) CAN place all implants, do all molar endo, and perform all complicated ortho...but SHOULD s/he? I actually whole-heartedly agree that no GP should do all of the work. The way I see it, if the cases could not get complicated beyond the realm of understanding that a GP can obtain with 4 years of education, then why would we have specialties to begin with?
     

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