Oral Health Group

Re: Thankfully We Have Each Other, January 2014

March 1, 2014
by Dr. Nathaniel (Nat) Podilsky

Dear Dr. Nouri,

Thank you for your editorial. It was very enlightening. I couldn’t agree with you more that we are fortunate to be a member of this great profession of dentistry and even luckier that as a profession we have the privilege of being self-regulated.


In the 90’s, I am one of those dentists who was involved in “corporate dentistry” as a business model. I managed and/or owned nine dental practices with six or seven owners with multiple associates and hygienists. The focus was never shifted from ethical patient-centred care to increasing profitability in order to keep the owners (dentists) satisfied.

Later on, I was on the board of a publically traded dental corporation that was expanding into Alberta. This corporation had a CEO at the helm that knew nothing about dentistry and yes the focus was more on profitability than on patient centered care. I refused to stay on board with an organization with the wrong values and vision, and so I resigned. Yes, I can strongly agree with you that over time the integrity of profession will be questioned. The end result will be the loss of self-governance.

On a bigger and growing concern is the number of dentists that own more than one dental practice. Their resources are often stretched (time and money to name a few). How can this dentist be “patient focused”? When the dentist is in one of his practices, patients want to be seen in his other practice. I know. As mentioned before I used to be one of those dentists hopping between more than one practices. The dentist is often tired, stressed and working five if not six days a week. Weekends and nights are often open to accommodate patients. Does this promote quality work?

I also agree with you that very few universities incorporate a comprehensive dental business management courses in the dental curriculum. It is because of this that I have developed my own business courses in Edmonton which I teach to individual dentists often on a “one-on- one “basis. Dentistry, as a business, is becoming more and more complicated as time passes.

I agree that Social Media can be great for the dental profession. It allows us to share info, techniques, etc. and allows the dentist to feel less isolated. Social Media, if used by wrong individuals can also destroy the reputation of a dentist or office. Every dentist should monitor “their profile” on this public domain.

I must disagree with you on your comments about “hasty adoption and introduction of modern” technology. And then you go on to use the Cone Beam CT (CBCT) as an example. 3D technology does enhance our diagnostic capabilities. I remember the days when the Panorex was introduced. The Panorex increased our diagnostic capabilities and we were able to eliminate full mouth radiographs which not only took a lot of time but exposed the patient to high dosages of radiation. No opposition was raised when the Panorex was implemented. No special legislation was implemented by the governing bodies. Why are dentists still using full mouth surveys on a lot of patients? Cone Beam CT has allowed us to diagnose pathologies, endodontic lesions, wisdom teeth angulations, fractures of teeth and jaws, airway obstruction, bone quality and quantity for implant placement to name a few. Implementing modern technologies “raises the bar” for the entire profession and should enhance “our professional stature in society”. Adopting modern technologies does come with a price, often a hefty one.

I really enjoyed your comment that “I try to practice dentistry by believing that if I take care of my patients well, my patients will take care of me.” This is so true, and yet I have seen overheads go from 40% to 60% in twenty or so years. I believe that dentists have to become more business minded and that finances will not take care of themselves. Twenty or thirty years ago that may have been the case. Times are changing and we as dentists must also change. In your overall picture, yes patients do take care of us if we only spend the time and commitment to take care of them.

I do strongly agree with your overall editorial and yes I strongly believe that every dentist must work with integrity to maintain our professional and ethical status in the eye of the public. I again thank you for your article. I find your editorial very inspiring and thought provoking.

Dr. Nathaniel (Nat) Podilsky