Ortho Applicants Beware!!!

[kctoothdr]

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You guys are right...I have no right to complain about trimming models. Scores of guys did it before me. Thanks to all of you for your feedback...it helped to give me some perspective. A friend reminded me tonight of how I felt as an otho applicant a few years ago. I would have ABO trimmed 140 dog terds for a spot in an ortho program back then. I guess I've lost sight of how bad I wanted to do this. Nothing worth doing is easy and though being a resident at CU is stressful, it is very much worth doing!

I bashed a lot of good people with my posts and for that, I am sorry. There are many passionate and dedicated people in the CU program and I am grateful to them for giving me a shot.

 

[dragonteeth]

Well if they didn't know you were unhappy before, they do now. Not sure how they will respond to being trashed in a public forum, but probably won't be unicorns and rainbows....

Why models? Lack of patients, staff doesn't do it, they are making you redo them or..?

You said you were getting a good education, but you also said the program was outdated. These two statements seem to be at odds. Are they teaching older techniques, not using ortho software, or..? What makes you still say after ranting about all the rest that you're getting a good education?

Finally, have you and the other residents gone to the director with your concerns as a group? Did you offer constructive suggestions for positive change or simply express your displeasure as you have here?

It's nice to warn others away from a terminally bad situation, but I doubt your post will do much more than throw them into an angry defensive for airing their dirty laundry in public. I hope things go well for you.

 

[kctoothdr]

I am deleting this post because of it's unfair portrayal of my program.

 

[charlestweed]

At my ortho program, not only did I have to trim 100+ initial and final casts, I also had to make all ortho appliances and hand trace all the ceph films. I didn’t like doing these nonsense things but there was no reason for me to complain since the tuition was so cheap there. Now, I am so glad that my director made me the lab work. At my private practice, I’ve saved lot of money for not sending cases to the outside lab. I hire a full time RDA and make him my lab tech by teaching him what I learned at my ortho program. When I have patients, he assists me and when I don’t have patients, he does the lab work.

 

[gryffindor]

You're complaining about trimming models? 😱 You don't have anything to complain about there. I also went to a program where we did nearly all of our own lab work and it was treacherous but just part of the price we paid to be residents.

I don't know what IMS software is and I hate redundancy so generating word documents is probably a waste of time. However, are your directors used to paper systems? I've seen several older practitioners struggle a lot in using practice management and charting software so they may feel some comfort in having word documents than searching on a computer for patient information.

Not being able to attend GORP or other meetings is lousy. I attended a lot of meetings as a resident and am really glad I had the opportunity because I certainly don't have that kind of time or flexibility in private practice. I'm also glad I got the chance to become familiar with all different kinds of ortho companies out there at these meetings because again, there is no time for exploration or research when you are working with borderline incompetent/lazy staff members and have 10 patients waiting with 40 more on the way.

Isn't your program a mere two years? Sorry, but suck it up and deal. I remember acting interested in the specifics of the various ortho programs I visited and interviewed with, but deep down inside, I just wanted an acceptance to any program and didn't care about what kind of bs I had to put up with to get that certificate.

 

[OG1]

If I were paying $50,000 tuition I'd be ticked off about having to trim models. Why not just tack on another $5,000, a drop in the bucket, and let you send that stuff out? We're all going to be 5 bazillion dollars in debt and begging pedodontists for work anyhow.

 

[amalgamator42]

We weren't even given time to attend GORP until this coming summer until McNamara himself confronted our director as to why our residents were not at the conference. Voila...we were granted time to go this summer.

FYI- GORP is going to be awesome this year, so you picked the perfect year to go!!!

My favorite part of residency is having guest lecturers, and going to meetings. I always pick up some tips that I can use the next week in clinic...

Sorry to hear your troubles, but know that no program is perfect. Every program has weaknesses. Hopefully, the faculty care enough to always strive to improve. It would be nice if they at least explained why things are how they are and why they are reluctant to change it. A dialog with the residents is so important.

Unfortunately, they know that most residents just end up going where they match and that they can do whatever and charge whatever and they will still fill their class...at least they went match now. I specifically didn't apply there b/c they weren't match and I didn't want to get put in the position of being forced to drop out early.

That being said, I think you should do a few models, but once you are competent you all should send them out. We have to do our own start models, but finishes are sent out, which saves ALOT of time. It is useful to learn how to make retainers and appliances. But this also has a limit. Again once you are competent, sending them out saves a ton of time that can be better spent on thesis, reading, ABO boards study, etc.

With as many residents as you have, I bet you all could hire a person pretty cheap and keep them busy full time with just models. Just charge the patients $100 more per case and send out the models and Hawleys after you do a certain number!

 

[charlestweed]

....I've seen several older practitioners struggle a lot in using practice management and charting software so they may feel some comfort in having word documents than searching on a computer for patient information.

That’s me. I am clueless about the practice management software. I don’t want to change to paperless because I think paper charts are much more efficient. Patient’s photos, health hx, tx plan, tx progress note, pan, ceph etc are all in one chart. Everything is right there. It takes me a second or two to pick out an x ray from the chart. It takes my friend, who runs a paperless clinic, at least 30 sec to do the same task. I write faster than I type.

 

[ortho lurker]

My favorite part of residency is having guest lecturers, and going to meetings.

Meetings are even better as a practioner as they are a tax write-off for vacations (cruises, ski trips, family travel) and serve as class reunions for c.e. units that you need any way. The information at these meetings may not be as applicable in the working world as you will not have the unlimited budget as a residency to try all the latest and greatest stuff.

Which brings me to my other point: there are literally 10 ortho practices for sale in So Cal right now. The obvious remark is to get out of a saturated market (which these selling owners are trying to do). However, this might be the start to a disturbing trend for everywhere else. I think Dort-ort and Charlestweed were right when they said that ortho is a dying specialty and that the only way to be successful is to run a low-overhead office. After visiting a few of these selling offices, I noticed that they all used expensive supplies and technology. Do more expensive brackets and computer software really get you better results? Does more expensive equipment convince more people to spend more money when the gap between rich and poor is getting wider? Also, you can forget about relying on GP referrals because GPs are doing Invisalign or are hiring in-house specialists. I spoke to a few ortho business owners and they said that the taking out to lunches and dropping off of fruit baskets resulted in nothing. It looks like you residents can only look forward to working for pedodontists after all.

 

[kctoothdr]

You guys are right...I have no right to complain about trimming models. Scores of guys did it before me. Thanks to all of you for your feedback...it helped to give me some perspective. A friend reminded me tonight of how I felt as an otho applicant a few years ago. I would have ABO trimmed 140 dog terds for a spot in an ortho program back then. I guess I've lost sight of how bad I wanted to do this. Nothing worth doing is easy and though being a resident at CU is stressful, it is very much worth doing!

I bashed a lot of good people with my above posts and for that, I am sorry. There are many passionate and dedicated people in the CU program and I am grateful to them for giving me a shot.

 

[gryffindor]

That's me. I am clueless about the practice management software. I don't want to change to paperless because I think paper charts are much more efficient. Patient's photos, health hx, tx plan, tx progress note, pan, ceph etc are all in one chart. Everything is right there. It takes me a second or two to pick out an x ray from the chart. It takes my friend, who runs a paperless clinic, at least 30 sec to do the same task. I write faster than I type.

I love paper. However in this increasingly digital world, I can't start my office with paper charts. As much as paper charts are convenient for me, they are a nightmare at the same time. I've lost count of how many times I write a detailed consult note or succinct and informative progress note, only to have the staff tell me "Doctor, we can't find the chart, here is a blank progress note for you for today." 😕 (This happens at EVERY single office I work at.) The most irritating part is that whenever I seem to scour the chart shelves after the chart has been declared lost, I magically find the misfiled chart each time. "Oh doctor, you're so smart!!!" 😡

Besides not having the square footage to store paper charts, my number one reason for wanting to go digital is to eliminate as much human paper mishandling as possible and to never ever hear the words "Doctor, the chart is lost."

 

[S Files]

That's me. I am clueless about the practice management software. I don't want to change to paperless because I think paper charts are much more efficient. Patient's photos, health hx, tx plan, tx progress note, pan, ceph etc are all in one chart. Everything is right there. It takes me a second or two to pick out an x ray from the chart. It takes my friend, who runs a paperless clinic, at least 30 sec to do the same task. I write faster than I type.

30 seconds to pull up an xray on a computer? ehhh?? don't know what your friend is doing, but any reasonable software system can do it by just double clicking on an icon. i don't want to market any program in particular, but there are several good systems that are all inclusive (images, notes, charting, billing, etc). less duplication of tasks in a paperless practice.

 

[charlestweed]

30 seconds to pull up an xray on a computer? ehhh?? don't know what your friend is doing, but any reasonable software system can do it by just double clicking on an icon. i don't want to market any program in particular, but there are several good systems that are all inclusive (images, notes, charting, billing, etc). less duplication of tasks in a paperless practice.

Actually, he still uses paper charts. He only uses computer software to store his digital pan/ceph images. Man, it took a while to load the x ray images and it requires more than just one mouse click. I draw Palmer notation and elastic vector (class II, class III, vertical etc) on the chart a lot. I wonder if you can do Palmer notation with the paperless management software? Or do you have to specify the side and quadrant by typing UL5 or LL5 or ?

Another advantage of using paper chart is it lets the RDA put his/her initial right next to the doctor’s signature. If the RDA makes mistake, I know exactly who he/she is.

 

[S Files]

I wonder if you can do Palmer notation with the paperless management software? Or do you have to specify the side and quadrant by typing UL5 or LL5 or ?

Another advantage of using paper chart is it lets the RDA put his/her initial right next to the doctor's signature. If the RDA makes mistake, I know exactly who he/she is.

1. of course you can. just go to the picture of the teeth and click and drag with your mouse.

2. most ppl who use electronic charting include a mandatory input of initials for whoever is typing in the information

 

[S Files]

Actually, he still uses paper charts. He only uses computer software to store his digital pan/ceph images. Man, it took a while to load the x ray images and it requires more than just one mouse click.

oh so he does use paper charts? ok because in your post above, you wrote that this "friend of yours runs a paperless clinic."

in any case if someone is trying to use combo paper charts and digital images, it doesn't seem very efficient at all.

i suggest at the next AAO you visit some of the vendors. you won't worry about having a problem showing vectors of elastics, etc.

these systems can be made so efficient it's ridiculous. i have my patients fill our med, dent history and demographic info online, and it automatically populates our electronic chart. another thing i like is we send our referral letters automated. template pops up, with pt name and DOB and their DDS name, with pictures and xrays and i just tweak it accordingly. as said above, none of this info can potentially be mis-filed or lost.

 

[charlestweed]

No, he told me he still uses paper charts. I thought his office is completely paperless when he showed off his digital x ray machine on the grand opening day. There is no reason for me to switch to digital right now because we only have about 700-750 active patients (all 3 offices combined), which can easily be managed by paper chart system. I don't think we'll get busier in the future because of the slow economic recovery and an increase in number of ortho grads. I consider myself to be lucky if I can maintain the current number of active patients and new starts. After we see the patients for a 6-month retainer check, my staff put their charts in a separate "retention" file cabinet so we have fewer active charts to deal with.

Right now, I use an old (and probably discontinued) PhotoEze software to import photos into an 8x11 sheet. This software also allows me to import patient's photos into word document so I can type report and send it to the referring GPs. I am getting lazy. I no longer send out report for every patient like what I used to do when I first started.

A day before we see patients, my office manager pulls out all the charts, calls patients to remind them the appointment, and then files the charts according to appointment time. So when the patients show up the next day, we have the charts ready for them. We don't usually have problem with mis-filed or lost charts. I encounter the problem of mis-filed and lost charts at the chain clinics but it is still very rare.

Btw, I stopped joining the AAO a long time ago for I saw no benefit of being a member. For CE units, I just take classes with the GPs.

 

[amalgamator42]

Btw, I stopped joining the AAO a long time ago for I saw no benefit of being a member. For CE units, I just take classes with the GPs.

Can you elaborate? I thought that the idea of AAO was to look out for our best interests and the strength of a professional organization comes from the fact that most of the professionals are members. Perhaps there are intangible benefits? In the grand scheme of things I think the AAO does a lot of good compared to to the ADA...

If I'm not incorrect, aren't the vast, vast majority of orthodontists members of the AAO? Plus the journal isn't half bad...

What CE do you do? I have found the AAO meetings to be pretty good...besides isn't most of the best ortho CE not available to the GPs?

 

[charlestweed]

Can you elaborate? I thought that the idea of AAO was to look out for our best interests and the strength of a professional organization comes from the fact that most of the professionals are members. Perhaps there are intangible benefits? In the grand scheme of things I think the AAO does a lot of good compared to to the ADA...

Then the AAO should stop the new ortho programs from opening and the current ortho programs from increasing their class sizes.

What CE do you do? I have found the AAO meetings to be pretty good...besides isn't most of the best ortho CE not available to the GPs?/QUOTE]

Mostly general dentistry topics….endo, restorative, cosmetic stuffs.

 

[charlestweed]

If I'm not incorrect, aren't the vast, vast majority of orthodontists members of the AAO? Plus the journal isn't half bad...

I know plenty of orthos who are not the AAO member. The AAO recently dropped the ADA membership requirement (you must first be an ADA member before you can join the AAO) to encourage more orthos to join.