The 250,000 Smoked Ham

Dr. GP had just a few minutes between patients so he decided to run up to the front desk because he knew it was almost time. He was so excited!

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by L. Don Wilson, DMD

For more information on this topic, go to and search using the following key words: referrals, specialists, lasers.

Dr. GP had just a few minutes between patients so he decided to run up to the front desk because he knew it was almost time. He was so excited! It was that marvelous time of the year – you know, the first couple of weeks in December when those glorious gifts come bountifully into our offices from each of our specialist colleagues, thanking us for making their holiday especially bright...perhaps much brighter than our own! But never mind that, it was almost time for the daily arrival of the UPS Santa Claus at Dr. GP's office. I wonder what overpriced, slick magazine or Web site goody he will drop off today?

"Hey Debbie," Dr. GP shouts as he rolls around the corner. "Has UPS been by this morning? It's almost 11:30." But as the words roll off his lips and before she could respond, he saw it! Over on the desktop just beyond Debbie, that brown, pristine box so neatly packaged and not even scarred by the delivery process.

Dr. GP picks it up. "It's very heavy this year," he exclaims, as he reads the embossed foil label in the upper left-hand corner of the priceless package. Oh, how his eyes light up when he reads the words, "Slow Smoked Ham Company, 123 Main Street, Appleton, TN."

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"Good old Dr. Perio," he says out loud so that Debbie can easily hear. "He never forgets to thank me for all those patients I send his way every year. You know, Deb, today is only Monday. If tradition holds true, by the end of the week we should receive that lovely fruit basket from Dr. Endo, the smoked turkey from Dr. Oral Surg, and that big bag of shelled pecans from Dr. Ortho. What an exciting week," Dr. GP proclaims.

Sound familiar? This scene happens every year in most of the general practice offices around the country. For all of the patients we refer out to the specialists – amounting to about $250,000 in lost production from our own practices – we get a $95 smoked ham delivered to our door. And to make matters worse, we are not the least bit concerned about the $249,905 deficit!

Don't get me wrong; I am not "anti-dental specialists." There is a place in our profession for specialists and I refer patients out to them...but only as needed! There is no reason why any GP cannot provide his or her patients with "basic and beyond" perio, endo, and oral surgery treatment.

In my office, I know my limitations in these three areas, and I refer out those patients who require treatment beyond my time and skill limitations. If your personal limitations are too confining, then perhaps it is time to expand your borders.

Your patients like and trust you. That is why they come to see you. They are not interested in leaving the comfort of your office to see some stranger unless it is absolutely necessary.

Furthermore, you should not have any interest in pushing your patients out the door into the "periodontal abyss," only to have them return many months later...out of benefits, money, time, and energy. They left wanting a mouth full of indirect veneers, and they return with a mouth full of lengthened crowns and a request for only direct bonding.

"But I don't do those procedures," you rebut. Have you really thought about why you are not attempting more procedures? Is your practice so busy you just do not have the time? Congratulations if that is the case, but please understand that you are in the minority.

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Frenectomy, fee $471Crown Lengthening, Code 4249, fee $774Perio Gingival Surgery, Code 4240, fee $795

If you don't feel empowered with the skills and equipment necessary to complete these procedures, it is time to invest in the equipment and educational process to broaden your horizons. Please understand we are not talking about the exotic procedures performed by specialists; we are concerned with basic and routine procedures that we are currently referring out.

In today's economy, most dentists have either seen a downward turn in their practices or at least have struggled to maintain the status quo. If you have any signs of decline, then consider increasing the "basic procedures" in your practice with the addition of laser-assisted dentistry.

Lasers are now a part of the "standard tray" for every day dentistry. Dental lasers allow us to provide a better patient experience and increase practice production while doing common dental procedures. This would include procedures we are currently referring out to specialists. After initial laser training, most dentists feel comfortable performing basic operative, endo, perio, and oral surgery procedures.

Let's look briefly at just a few of the many procedures made easier for the practitioner and the patient when completed with lasers. Frenectomies can be completed with a laser in minutes in an almost bloodless environment with little or no postop pain.

Crown lengthening with a laser can be completed with a modified closed flap – depending on osseous genotype and visibility. By doing this, you do not disturb the papillae in the esthetic zone prior to veneers.

Perio gingival surgery can be done with a "no-cut, no-sew" laser technique. This procedure is much easier and faster for both the doctor and patient, with little if any postop discomfort. This technique – using the new radial fire perio tips – provides reattachment and is perfect for 4 to 6 mm pockets. Case acceptance is near 100% when patients learn there are no incisions and no sutures.

Highly successful practitioners use lasers day in and day out for basic dental procedures to increase production and grow their practices during the current economic downturn. Laser dentistry not only allows us to do procedures in less time with less effort and better results, but it allows us to do more basic procedures in our offices rather than referring them out to specialists.

Can you find time to add five to seven 30-minute procedures per week to your practice? If so, you can increase your production by up to $250,000 per year. That will provide you with enough extra income to buy a YSGG laser, a 940 diode laser, order several smoked hams throughout the year, and still have $175,000 left over!

Oh, by the way, you will continue to refer enough exotic treatment out to the specialists to still receive those UPS deliveries when December rolls around.

Dr. L. Don Wilson graduated from the University of Alabama School of Dentistry. He holds Standard and Advanced Proficiency Certification, as well as Educator Status through the Academy of Laser Dentistry, and the Associate Fellowship within the World Clinical Laser Institute. Dr. Wilson has conducted more than 300 laser seminars and is the director of laser education at the Nash Institute in Charlotte, N.C. You may reach him by e-mail at

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