Commodity: A basic good used in commerce that is interchangeable with other commodities of the same type… The quality of a given commodity may differ slightly, but it is essentially uniform across producers.
Q: When is a patient like a bushel of corn? A: When they're treated like a commodity!
I recently made an appointment to have an esophageal scope procedure done. I have GERD pretty bad, and it’s finally my turn to have a GI specialist take a look. I got a referral to the specialist from my physician, whose opinion I really trust. I had to change the date of this procedure and when I called to change it the receptionist told me, “Dr. X won’t be in that day, so I’ll schedule you with Dr. Y.”
For the most part, I’m O.K. with that. I was sent to have a procedure by my regular physician and the procedure is a commodity. The procedure will be done more or less the same way no matter which trained specialist does it. Or at least that’s what I’m assuming. I have found no positive or negative reviews of my specialist online and I don’t know anyone else who has seen this particular doctor. I don’t expect to have much of a relationship with this doctor as I’m not going to go back to see them unless I need specific follow up from the procedure. Also, they’re going to put me to sleep soon after I meet them!
I would be upset if I went to my regular doctor for an appointment and someone I didn’t know walked into the exam room, but I have no expectation for my upcoming appointment, because I’ve never met this doctor, nor have I ever been to their office.
Let’s be honest…medicine is more or less a commodity. Or at least procedure based specialty medicine is. The medical establishment as well as medical insurance companies see the procedure that I’m having is the same thing wherever it’s done. The service will be O.K., probably not great. I will receive a mystery bill some time later for an undisclosed amount which will not have been discussed with me prior to the procedure. My primary care physician will receive a report which she will discuss with me. Perhaps we’ll change my medications. I will be a cog in the machine. How I feel about the process isn’t important to the process. At all.
The procedure is a commodity. And yes, I (the patient) am a commodity.
I don’t mean to sound so bleak, but that’s been my experience with medicine. There have been a few bright spots. Certain docs or nurses that were amazing because they were amazing. Not because the system is amazing. For the most part medicine tries to get you through the process quickly and efficiently, but it’s not so worried about the experience.
Welcome to our dental family!
I’m not O.K. with that. Acceptable service isn’t good enough. As a general dentist, I feel that it’s important that I provide the best in dental care along with the very best experience possible. Most dental patients in our office see us at least twice per year, so the experience you have as a patient is really important! My goal is to develop a relationship with each patient so that we work togetherto keep your mouth healthy. But don’t take my word for it. Check out some reviews that our patients have left for us on Google (and leave one for us while you’re there!). Or, better yet, come experience the office for yourself. I promise you won’t feel like a commodity. You’ll feel like family…a very well taken care of member of our dental family!
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So I had a patient in the chair earlier today. I got a look at his teeth and said, “you have heartburn, don’t you? You suffer pain in your chest and throat after eating Italian food.”
He got this look on his face. It was kind of scared but also kind of amazed. It was as if Sylvia Browne had told him about a relative of his from beyond the grave!
The difference is, Sylvia Browne uses cheap parlor tricks and I’m for real!
What’s my secret? Was I born with this amazing power? Have I trained under experienced psychics?
Nope. I’ve just seen a ton of gastric reflux patients. They have telltale acid erosion spots. They show up most often on lower molars. Once you realize they aren’t necessarily from bruxism (a.k.a.”night time tooth grinding”) I see them a lot. The amazing thing is that 25% or more of patients with gastric reflux don’t have any symptoms! No heartburn, no itchy throat, no noticeable bad breath. On top of that…these erosion area on the teeth usually don’t hurt. They’re often only detectable by a dental exam. This is particularly scary because untreated gastric reflux is a leading cause of esophageal cancer, and esophageal cancer is particularly bad!
This Saginaw dentist is trying to impress you with his amazing powers. But have no fear…there’s nothing supernatural here!
Do you have questions about your teeth? Would you like more information about gastric reflux or other topics I’ve talked about? Feel free to email me at email@example.com (I answer my own email) or call the office at (989) 799-9133. I’d like to be your Saginaw dentist!
“How would your dentist know that you have acid reflux?” asked the physician.
Actually it was physicians. I heard back from two patients this week who went ahead and told their physician that their dentist strongly suspects that they have acid reflux or GERD (gastroesophageal reflux disease).
One patient told me about the esophageal endoscope procedure he had. Good times! Actually, not to make light of the situation but the scope showed positive findings for acid induced damage of his esophagus. This kind of damage can lead to esophageal cancer. His doctor put him on two different medications and recommended a serious diet change.
The second patient told me about the testing he went through. Apparently there is some kind of barium x-ray that can be taken that shows places in the esophagus and stomach affected by acid reflux. He was also put on medication. He told me today that if he misses his medication it makes for a long and painful day from heartburn.
So what’s my secret? Do I have mystical powers? Am I psychic? How can a simple dentist know about medical problems in the stomach and esophagus?
As disappointing as it might be, it’s a relatively simple observation and some health history questions. As I’ve mentioned before, acid affects teeth. If you put teeth in an acidic solution for a long enough time it’s going to destroy some tooth structure.
Simply stated, acid reflux is a leaky valve at the top of the stomach that lets digestive acid leak out into the esophagus. This acid can actually make it’s way all the way back up into the mouth. Symptoms of acid reflux include:
persistent cough that never seems to turn into a full blown cold
chronic bad breath
chronic sore throat
chronic bad taste (not the kind of bad taste that includes ugly Christmas sweaters and wearing white after Labor Day.)
The damage that acid reflux does to teeth appears a bit differently than a regular cavity. First, is the location.
It’s almost always on lower molars, which are the closest to the esophageal opening. Secondly, the damage is rarely in between teeth, but on the biting surface of these molars. It appears as pitting on or near the tips of the cusps (bite surface bumps) of the molars. Affected teeth have a dull and smooth surface with a loss of gloss. Tooth decay from oral bacteria tends to be more localized and more often found in the bite surface grooves or in between teeth than cusp tips.
When you look at teeth all day long, this pattern becomes very noticeable. I mention it to each patient that I see it on and recommend that they have it evaluated by a physician. The problem is that up to 25% of people with gastric reflux have “silent GERD” and have no noticeable symptoms.
That’s where I come in!
I’ve you’ve got reflux with no symptoms it’s pretty likely that you’ll have some evidence on your teeth. Unfortunately, sometimes the tooth destruction can get pretty advanced before we catch it when the patient doesn’t have any other symptoms. This patient has eroded all of the enamel off the biting surfaces of the molar teeth yet the premolar teeth in front are relatively unaffected.
The bottom line is that dentists can sometimes be the first line of treatment for GERD. If you have any of the symptoms listed above or just wonder if you might have gastric reflux troubles I’m happy to help. Give us a call at (989) 799-9133 or email me at firstname.lastname@example.org. I’d be happy to take a look!