Trouble in Paradise

Alot of this column’s focus is a reflection of my general practice in Massachusetts.

Alot of this column’s focus is a reflection of my general practice in Massachusetts. It is a simple, old-fashioned practice, covering a range from sealants to dentures with generations of patients - some of whom I inherited when I purchased the office. It is not a Taj Mahal, ultra-slick, Star Wars environment. I am a putterer - wires and devices are scattered across the office. Since I constantly change things, some of the computer wiring is fished through foam pipe insulation that I purchased at Home Depot. The wiring snakes along the bottom of the cabinets. While not “pretty,” it is practical for my constant access, and creates a “bargain basement” conduit. If this was new construction, I would have PVC pipe throughout the walls that would allow easy maneuvering of the wiring and a much cleaner setup. Note that you need sufficient diameter in the pipe to allow passage of larger-end connectors, such as video, or lesser-used parallel if you have technology requiring this connection.

Although I have seen and tried most of the products reviewed in this column, my office currently does not have every single one, nor do all things run flawlessly. I recently decided to upgrade four treatment room workstations. There were a few “blips” in appointment scheduling, causing the staff to look at me assuming that I had done something wrong! They expect the tech side of the office to be top of the line and perfect in light of their boss’s avocation. These things happen. Computers running Windows must be rebooted on occasion. Programs sometimes have to be reinstalled, and new programs can cause havoc with old ones. Then there is the fear of upgrades that appear from companies such as Microsoft and Symantec. I often wonder why I should bother installing an upgrade from version 2004 to 2005 if the programs are running fine. While the majority run smoothly, some cause problems. I usually search the Web for “issues” before I install an upgrade. For example, in Google, I enter “Windows XP service Pack 2 problem reports.” (I waited months before I had the courage to hit “Enter,” with nothing of note to report.) Using a search engine like Google, you can usually find message boards on most errors and problems. Inevitably, someone has had the same problem you just encountered. Granted, with some time, a few Web lookups, and even a few support phone calls, the problems get resolved. But, in my position, I have to put on that special grin and - with clenched teeth - tell the staff members that I actually expected that crash. Then I run back to my office and hide until they all leave for the day. I then spend the night fixing problems so everything looks fine when they arrive the next morning.

With regard to the new workstations, my oldest ones were still running Windows 98. They could have been upgraded to XP Pro, but we needed more RAM and power for all of the graphics. I assumed data could be easily transferred to the new computers along with the programs. I have used Aloha Bob ( with decent success. But not all programs traverse Windows platforms, and some do not transfer at all. It is a good thing I have all of the installation disks. I recommend doing an inventory before installing upgrades, and, of course, research any programs that don’t work in the new operating system. For instance, I cannot use my WinFax Pro program in WinXP unless I buy the upgrade. This also was true for a few other programs. In addition, I had some favorite old programs that needed activation codes. When I tried to contact the companies, I learned that two are now out of business. I can only use these programs if I leave them on the old machines, which is not really practical.

Once I resolved the technical problems, other issues came to light at a recent staff meeting. I proudly announced that the four new computers were installed in the treatment rooms. My office manager stood up, with a raised fist, and said, “I’m soooooo glad the treatment rooms are working fine, but what about our computers at the front desk? And what about this software? Can’t you get an upgrade for the insurance handling? Don’t you have connections, Mr. Bigshot?” As a result, I have decided to get a few more computers. I will do a more thorough investigation of the practice-management software marketplace for my personal information as well as for this column’s readers and for my course attendees. My thanks to Jean, who brought this situation to my attention, and who put me in my place. Jean will be with me at the ADA and Yankee Dental meetings, looking at the latest software. You can refer all questions to her!

Dr. Paul Feuerstein installed one of dentistry’s first computers in 1978. For more than 20 years, he has taught technology courses. He is a mainstay at technology sessions, including annual appearances at the Yankee Dental Congress, and he is an ADA Seminar series speaker. A general practitioner in North Billerica, Mass., since 1973, Dr. Feuerstein maintains a Web site ( and can be reached by e-mail at

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