Paul H. Henny, DDS 

Trust is commonly thought of as a firm belief in the reliability, truthfulness, and capability of another. But trust is about vulnerability . 

The more a person trusts, the more they are willing to allow themselves to be potentially hurt. They make a risks-benefit analysis, and when they feel they are ready, they decide to throw the dice.  

Conversely, when a person isn’t willing to trust, they have strategically chosen to minimize their vulnerability.  

Think about the times when you were personally unwilling to let someone into your life—when you were feeling too vulnerable. 

It’s easy for us to project our values without sensitivity to others’ often hidden concerns. When a patient says no to x-rays, to allowing us to proceed with a proper restoration, or other appropriate procedures, they don’t trust us enough right now. And when that occurs, it’s easy for us to instinctively respond by projecting our values onto the situation.  

A better strategy is to empathetically explore why a person responded to the situation the way they did—try to understand the situation from their perspective, and then focus on finding common ground in shared goals and values. Hopefully, with the right questions and empathy, we can build a bridge of trust and help our patients cross over to a place of more information on which to make the appropriate decisions for themselves. 

“No” often means “not yet,” as in “You haven’t convinced me yet that I should allow myself to be that vulnerable around you.” 

Co-Discovery requires a leap of faith on our part—a belief that most people will eventually do the right things for themselves. If we are unable to trust our patients on that level, then we’re going to struggle emotionally, demonstrate frustration, and to some extent inadvertently manipulate patients into doing what we want them to, a behavior that drives emotionally sensitive patients away. 

We need to trust our patients will make the leap as well. We need to willingly take the time and energy to continue in and trust the Co-Discovery process during which the patient starts to believe that we are the best resource to help resolve their problems and achieve their goals. When we allow our patients the time to make decisions based on what they think is in their best interest, they usually make healthy choices and appreciate the services we provide. This is how we succeed in helping them (and us) have a healthier, happier life. 

For an in-depth look at Co-Discovery and multiple essays on patient-centered dentistry, you are invited to read my recently published book: CoDiscovery: Exploring the Legacy of Robert F. Barkley, DDS, available at The Pankey Institute and on Amazon. 

Charlie Ward, DDS

In this article, I’ll share how I save my Dental DSLR photos and choose between the file formats of RAW versus JPEG. There are specific reasons why we might need one format or the other, or perhaps both. I’ll also share how I store and protect my ever-growing collection of images. 

The Difference Between RAW and JPEG Format 

We have a choice when we’re shooting with our DSLR about how we want to save our files. On the menu of our camera, we see that we can choose between RAW and JPEG, and the quality of JPEG. When RAW is selected, all data that hits the camera sensor is saved. A JPEG is a processed image resulting in a compressed (smaller) file size.  

The data stored in RAW images can be 3 to 4 times more than in JPEG images, depending on the quality of JPEG you select on the camera menu. The processor in your DSLR camera will remove data from a JPEG image that it perceives to be imperceptible to the human eye. The greatly smaller size of JPEGS makes them universally preferred, not only for storage but for quick upload, download, and opening for viewing online. I routinely shoot high-quality JPEGs for diagnostics and routine lab communication.  

(If you are wondering what JPEG stands for, it’s for Joint Photographic Experts Group. Once JPEG images are in your computer, they can be saved as different file formats ending in different extensions such as .eps, .pdf, .jpg, .jpeg, .bmp, .tif, and .tiff.) 

If I take an image in both RAW and JPEG format, at first glance, the JPEG and RAW images may look the same, but on closer inspection, I may see that the stain on a tooth’s enamel or surrounding skin tones appear lighter in the RAW image. The camera itself has processed the image and determined that some of that data is unnecessary.  

When to Shoot RAW Images 

For most of what dentists do with our DSLR cameras, JPEGS are fine. There are three situations when we should choose to shoot RAW images. 

1. When we want to edit images like a professional photographer. 

1. When we shoot images for accreditation for the American Academy of Cosmetic Dentistry. The Academy requires images in raw format so they can tell that the images have not been edited.  

1. When we are using a digital shade matching system like eLab or Matisse that requires RAW input. 

Why Shoot Both Versions When You Want RAW 

If you are storing CBCT and RAW images on your server, a lot of data can accumulate quickly. I shoot JPEG versions of the images I shoot in RAW format so I can delete the RAW files from my server when they are no longer needed and still have a case record with the JPEG files. 

Storage Tip: In my practice, we download the patient’s or the day’s images from the SD card on to our server in a patient folder. We have one main folder and within it a subfolder for each letter of the alphabet. Inside each alphabet letter’s folder is another subfolder labeled with the patient’s name for each patient whose last name begins with that alphabet letter. Inside each patient’s folder are appropriate subfolders, labeled for example, “Name-Prep-Date.” 

Charlie Ward, DDS  

Whether you want to use a digital SLR camera for documentation, patient education, lab communication, making presentations at dental events, dental publications, or accreditation in the American Academy of Cosmetic Dentistry, you have choices to consider in multiple price ranges.  

Dentists can spend $1,800 and get a good system for documenting cases, patient education and lab communication. Dentists can easily spend $3,800 or more on a setup to equip themselves to take higher quality images. 

Camera Body: Most dentists shoot with a Nikon or Cannon DSLR camera. These are comparable brands. My experience is with Canon but my lab technician uses Nikon and gets wonderful results. I am shooting with the Canon EOS 90D. The comparable Nikon is the D7500. More entry-level models are the Nikon 3500 and the Canon Rebel T8i. 

Lenses: We can get a third-party Sigma 105mm or a Tokina 105mm lens that gives us decent quality, or we can purchase the Canon 100mm or Nikon 105mm version at twice the price. When I upgraded to the finer Canon lens, I noticed a huge difference in image quality. I recommend an upgraded lens for the highest-quality images you need for accreditation. 

Flashes: The ring flash is a great entry-level option and significantly less expensive but there are limitations to what you can do to control your light. I’ve been using a dual point flash for some time. I can pull a flash off and shoot from a different angle. By changing where the light is coming from, I can accentuate the angle lines for more depth and visual clarity.  

Sometimes, I’ll take one of my flashes off, hold it on the opposite side of what I am shooting, and shoot the flash back into the lens of the camera. When I do this, I get an ethereal-appearing image or an image with a white background. I appreciate the versatility of using the dual point system.  

For my best-looking images and portraits, I’ll use softboxes. This gives smoother, more diffuse light and a beautiful appearance. These are necessary for everyday dentistry but make a huge difference in showcasing aesthetic cases.  

Consider the Long Term: When dentists invest in cameras and lenses, they typically use them for a long time. If you are on the fence about how much you want to invest, my own experience might be helpful. I honestly wish that I had upgraded sooner than I did with the Canon EOS 90D and the Canon 100mm lens. After taking photos for 12 years, the upgraded equipment has only increased the joy I have for photography and pushed me to take more pictures! 

Financial literacy is the foundation of our relationship with money, and it is a life-long journey of learning. The earlier we start, the better off we will be, because education is the key to success when it comes to money, and our financial life is likely to become more complicated as we get older.

Becoming financially literate involves learning and practicing a variety of skills related to budgeting, managing, and paying off debts, and understanding credit and investment choices. Personally, we have more energy around creating an effective spending plan, than a budget! Basic steps to improve our personal finances include creating a spending plan, keeping track of expenses, being diligent about timely payments, being prudent about saving money, periodically checking our credit report, and investing for our future. Financial literacy is the ability to understand and effectively use various financial skills, tools, and processes; including personal and business financial management, spending plan creation, and investing, while learning to live on less than we make!

We believe financial literacy is one of the most important things we can learn and help others learn, and the learning never ends. We believe the subject qualifies as a mandatory part of primary education. Yet presently, it is only a required course in public schools in just 17 states in the USA.

Given that college students graduate with an average of $32,000 in debt due to student loans and credit card debt, and on average, a graduating dentist in 2020 reported close to $300,000, in dental school debt (ADA).

Therefore, we believe, it is imperative that young people learn the basics of credit, debt, spending plans, saving, and investing before they face that burden. It is never too late to become financially literate, and the earlier we start, the better.

We are adding some basic financial literacy lessons into the intentional design of our coursework. Come join us and devote appropriate time and energy to really getting on top of personal and practice finances.

2021 Pankey Financial Course Offerings:

• Mastering Business Essentials (MBE) – April 29th – May 1st

• Creating More Financial Freedom – August 20th – 21st

Seth Godin recently asked, “What are the symptoms of a marketing problem?” and continued… 

We have a ‘marketing problem’ when: 

• There are people who would benefit from your work who aren’t engaging with you. 
• There’s a change you seek to make in the culture, but it’s not happening. 
• You’re having difficulty persuading other people of your point of view. 
• The service or product you make isn’t resonating with those you seek to serve. 
• You’re fighting in a race to the bottom, and it’s wearing you out. 

If you have a marketing problem, how much time are you spending working on a marketing solution? …You can’t solve your marketing problem tomorrow by simply repeating what you did yesterday. 

At the Root of Your Problem

Broaden your thinking and consider what is at the root of why you aren’t doing more of the dentistry you want to do and building a larger base of patients you enjoy. There are two primary reasons why dentists fail at meeting their desired practice goals: 

1. They’re not very good at delivering on the promise, and therefore aren’t getting very many internal referrals and excellent digital reviews. (Marketing doesn’t solve this. Other things do. This isn’t really a marketing problem, is it?) 
2. They are not well known in their community for being the genuinely caring and “honest” type of dentist that patients crave most. And they are not well known for being the perfect fit to compassionately and predictably solve complex oral health problems to significantly improve quality of life.  (Marketing can help solve this, but how?) 

Resolving Your Problem

Most dentists naturally focus on developing their skills and then struggle in the shadows with an amazing skill set that few people seem to appreciate. How do you best approach resolving issue #2? That depends on what it is that you’re trying to achieve. What is your purpose? And what are the principles and philosophy that stands behind that purpose? Because it’s your principles and philosophy that you need to be promoting and projecting out into the public sphere, not just the flash…not just the “how to”…and certainly not the doctor dancing around the office and bragging about how great he or she is.  

Patients need to be genuinely impressed and more than satisfied so they spread high praise in your community. You and your entire care team need to give them things to talk about…what it is different about your approach….the relationship they have with you…the experience they have in your office…how well they are informed…the excellent results they enjoy…  

Clearly speak about your principles and philosophy in mindful, emotionally intelligent conversations with patients. Clearly write about your principles and philosophy of practice on your website. Listen and read “well” what patients say about you. What do they love? This is significant content for your website, blog and other external marketing.  

It comes down to: What is it that you can do that is deeply significant to your target audience, and how can you best convey that information and feeling to them on a consistent enough basis that they want your care?  

The foundational, solid relationship you build with them using highly attuned emotional skills will support treatment acceptance congruent with what they value and congruent with what you explain is in their best interest to meet their oral health and smile objectives. 

That’s what marketing is about, and it is both an internal and external process that must be constantly fine-tuned and consistently evolving within yourself, within your interactions, and within your messaging inside and outside of your practice walls. 

Dental graduates frequently say they chose dentistry because they liked science and working with their hands. Many thought medicine was their path, but in medicine, they saw the lack of control and time away from family. Dental graduates also say they were attracted to dentistry due to the monetary return they could get for their efforts.

When practicing, profitability can be elusive. You can feel like your child’s hamster trying to outrun your overhead. You can feel like dentistry is #1 in your life and there really is no other life for you, but you are frustrated because your dream was to be farther along in your debt reduction and wealth growing. You are putting in the hours but not receiving the return.

Many things and decisions can get in the way of profits.

We want to convey positivity here, not rehash the problems. You can have a profitable practice. A larger net return can be yours.

Let’s have a frank discussion about you, the leader, THE one who wants very much to win in the game of profitability. The keys to profitability involve YOU–your attitude, your team’s attitude which comes from you, and systems you need in place to be more efficient.

YOU are the key to opening the profitability gate. What is your current attitude about life, your success, and your situation? This is a challenge as you are slightly prejudiced. Do you have a family member or a really good friend who can assess your attitude (your positivity about yourself)? Years of negativity can be a challenge.

How do you feel about the future?

Here are some questions to help assess your present attitude about yourself:

• What are your goals five years from now?
• What are you looking forward to?
• What do you want most out of life?
• What do you like best about yourself?
• What do you feel motivates you?
• Do you have any personal power in your life?

At Blatchford Solutions, when we work with dentists and teams, we ask them to assess various life choices, such as the place they choose to live, and the friends, marriage partners, courses and schools they choose, even cars, vacations, restaurants and more. We all have a Comfort Zone for each of these areas and when pushed out of your comfort zone, you reply, “I would never go there, do that, try that, spend time on that”, and more. Our comfort zones have a floor and a ceiling.

You need to know if your “Deserve Level” allows you to be profitable. You can sabotage your success if you feel you deserve less. You can modify your Comfort Zone (Deserve Level) with a clear vision, strong determination and possibly some outside help.

What is profitability to you?

Put some numbers down; spell it out for yourself at this time. Is a net of $500K unreasonable for you? Do you deserve to have 60% overhead on $1.2M collection? Is a net of $750K unreasonable for you? Is a net of $1M something you deserve? Do you deserve to be debt-free? What would change in your life if you were debt-free?

Your Deserve Level also affects the quality of team members with whom you choose to work, the building and area in which you choose to practice, the continuing education courses you take, and so many non-dental activities, too. Our goal is to help you realize you can be as profitable as you feel you deserve. Dentistry is not just about your clinical excellence. It can also be about your excellence in the business of profitability.