Wow,
First I want to say that I was directed to this site by a few people and I was trolling the mill forms and came across this fun-fest right off the bat.I would like to direct this to Jake Dobbins and what techs may catch it. Though I may not have much street cred within the site, I feel I might be better qualified to mediate doctor to tech interactions here. I am unique because we get to work in-house with our doctor, we co-caseplan most cases, and take custom shades on all. And we get to play cleanup when things go wrong.
I think both sides here are right. But I would like to help with perspective before we create more enemies out there.
Sometimes when techs don't step into the clinical office often enough, we tend to get caught up in our work as artists. Which is good, our job is part science, part art.
But we forget that we need the dentist "legally", he does not need us "legally". Though I do not claim this is always right, it is the legal facts of the USA, and we need to remember that. In the US the dentist acts as general and he subs out the work to everyone else. And he has the right to go ahead and do his own sub work if he wants. Weather its the right call or not actually varies and there is lots of debate constantly on which is right. But you "the tech" need to remember that you cannot go hang a sign and start prepping teeth no matter how good we are as techs, "legally".
You also need to know that your doctor needs patients, and he generally has way more debt than you. Right now the average dental student graduates with 375K school debt. Not to mention startup debt runs 200-500k, and family mortgage and an industry thats getting more and more popular so there is lots of competition. So anything we can do to help dentists stay in business is more important than our talents as an artist/tech. Just the facts.
Guys like Jake are some of the good ones. They went to school when they taught technology (they don't now). He has to wade the sea of crap that gets thrown at him by salesman and flyers, probably daily. The best way for any dentist to navigate what is the right call on material and processes will always be the technician. So hang in there Jake, I would like to help you out. I believe to have a growing practice, you DO need to offer some type of same day crown to be competitive. It does not mean you need to Only offer that, but todays millennials won't walk in your door without some stupid internet hook. Although the crowns "by my standards" are not good. They are competitive when compared to crappy labs, and slightly more reliable. The trick is to know when to use chair-side CAM and when its better to outsource. Many lab guys are sore because the good old days of getting every single tooth from a dentist are gone. When I see it work is when a dentist offers his patients options, and lets them choose which way to go. Although that takes personality, you seem like you can handle that. Some guys choose when to use CAD by quality, and some by time. When your schedule is full, you are worth 4X as much as me when I am busy. So in the case of our doctor, its more economical to have us do as much as possible. I would look at 3 things when looking at chair-side CAD. 1) speed, time is not only money, its a big deal to the patient. If you get a sweet 5 axis mill, it might equate to a 2-3 hr chair-side e.max case. 2) support, talk to other dentists who use the CAD. Word of mouth is the only reliable way there. 3) open source, though closed source systems may simplify things a little. You need the option to send your files to anyone anywhere. You don't want to be fenced into a single restorative protocol.
Before anyone gets upset, here are the real bad guys screwing things up. Insurance and Salesman. There is always an aception and so on........ But insurance is completely killing new dentists coming out of school. And making them feel like they need to cut every corner just to stay open 3 days a week. If patients new what quality insurance offered them, they wouldn't have dental insurance, its a joke. Now salesman, we have many great guys we work with and so on....... But more and more are going for an "80 grand and adios" sale. They are pressuring labs to buy equipment telling us we are going extinct, and telling dentists the same day to buy the same equipment and eliminate the lab. These guys are scum - out of all the mills purchased for chair-side CAD, only about 25% are being used. The rest are collecting dust, so be careful Jake. And most of us labs can't afford to make a bad purchase that size, so we partner up or get hired by a large operation (accounts for some of that 50% decline in labs). In short, we need to have more open dialogue between lab and dentist, because thats the only way to figure out what is best for the patient. We are the only two who can correctly evaluate what is right for them and the practice. Even though the legal end falls on the doc, there is no way he has the time to keep up with all the new materials and processes.
