 |
 |
WestwalkOrtho.com
Home >> Newsletter
>> Newsletter
Archive >> Fall '99
|
FALL/WINTER
'99 This
is the forty-third and last newsletter of this "millennium' which is
circulated to all our patients, parents and colleagues.
'Y2K' not withstanding, we hope to enter the twenty-first century
with hope, optimism and good will toward all mankind.
It has been and will continue to be our way to keep you informed of
the latest developments in our practice and to express opinions which we
hope will stimulate a dialogue with you.
We have found that your opinions and suggestions toward improving
our services to you have been invaluable over the years as a way of
helping us to be responsive to your needs.
Please feel free to speak with any of us at any time. HEALTHCARE/MANAGED
CARE This
section of our newsletter has continued to receive popular acclaim from
our constituency. And, as I
write this, we, and probably many have received their annual
"greeting" from their insurance companies.
In our own case, as predicted, our premium has increased the cost
of what is one of the most expensive plans available.
And, as also predicted when our plan PHS Guardian was taken over by
the California based Foundation Health Plan, some benefits have been
reduced or modified in such a way that we are paying...you guessed
it...more for less. The
mighty bottom line has prevailed. It
is probably unnecessary to say, but the profit motive of all insurance
companies takes precedence over patient care.
Companies that show losses eventually fail, as was the case with
the HIP plan in New Jersey. The
Oxford Health Plans came close to failing and is currently struggling to
regain a solid footing. But,
I would predict that with costs continuing to rise for medical care faster
than people's resources to pay premiums, it is only a matter of time
before many companies fail or are taken over by larger more solvent ones.
The trend, in my opinion, is that there will be fewer and fewer
insurance companies willing to offer health coverage and as in all basic
economics, with fewer "games-in-town" premium costs will rise
while the list of coveted services will be reduced. Typical
of the persiflage of our politicians is President Clinton's position with
respect to Medicare coverage for drug prescriptions for senior citizens. Drug costs for this age group represent one of the major
expenditures. His plan would
require seniors to pay a premium of $24.00 per month that would pay for
$2000.00 worth of prescription medications.
Sounds great doesn't it? But,
drug costs are so high that this falls far short of what the average
senior is required to spend. Admittedly,
in three years, for the same premium, Clinton says that $5,000 worth of
drugs would be covered, which coincidentally is close to what the real
costs for seniors are on an annual basis at the present time.
When asked where the money will come from to pay for this, the
President claims that "projected" budget surpluses over the next
fifteen years will be close to "one TRILLION",
yes, TRILLION dollars. He
also claims that our national debt which is approaching SIX TRILLION
dollars will be retired and that the solvency of both Social Security
and Medicare will be assured through the year 2036. Former Senator Alan Simpson of Wyoming who is now a Fellow at
the Brookings Institution, which is a governmental “Think-Tank”
overseer, has expressed a very skeptical view of the President's
statements. A humorist and
senatorial "gadfly" for the many years that he represented the state of
Wyoming, he said, "For those of you who have ever seen the film, "The Day
the Earth Stood Still”, I have only one comment as to the President's
statement...Klatu Nicto Verada.
For the few of you who might have seen or remember the film made in
1950 and a personal favorite of mine, its theme is based upon a visit from
another galaxy by a humanoid creature played by actor Michael Rennie.
He comes to Earth expressing the concern of the neighboring
galactic system as to the development of nuclear weapons and warlike
behavior by Earth's peoples spreading beyond our galaxy.
This he says cannot be tolerated and threatens that unless our
petty warlike behavior is stopped, that with the aid of an indestructible
robot named "Gort" the entire planet will be,
“reduced to a cinder".
The command given to "Gort" to do this are the words
uttered by former Senator Simpson, "Kiatu Nicto
Verada". Therefore,
and I apologize for the protracted dissertation, I think that if you put
credence in anything that William Jefferson Clinton says that you should
affirm your belief in the "tooth-fairy".
Our health care system is in trouble.
Hospitals are showing increasing financial losses and physicians
are becoming increasingly discontented, leaving the practice of medicine
in large numbers. These
doctors are the most qualified and experienced and are being replaced by
many who must work in an unfeeling, impersonal environment.
Ethical behavior is declining and collegiality is almost
non-existent. The very core
of medical care is being eroded to the detriment of patient welfare that
is secondary to the insurance company "bottom-line."
How do we reverse this? I
do not have a complete solution, but as we enter this new millennium, we
must return to a society that places regard for one's fellow man and love
of family first, before any economic consideration.
A tall order by any measure, but it is possible if we all begin
with the principle that each day we will try to do something kind for
someone we know. THE
AGE-OLD DEBATE, REVISITED Having
been in the practice of orthodontics for more than thirty years, I have
been privileged to see the pendulum swing back and forth on the subject of
Extraction vs. Non-extraction of permanent teeth to resolve a malocclusion
(bad bite). At the time I
began my practice, the state-of-the-art technique was a light force
approach (common today) developed by an Australian orthodontist, P.R. Begg.
He realized that teeth move more quickly and comfortably by the
application of light continuous forces.
He also concluded that evolution has diminished the space for the
number of permanent teeth which develop and therefore, most malocclusions
which evidence "crowding or malposition” of teeth respond best to
the extraction of four permanent bicuspids (premolars).
In my early years, by statistical survey of practicing Orthodontic
specialists, approximately 80% of all case treated involved the removal of
four first bicuspid teeth. As
an aside, at that time "direct-bonding" of brackets was only in
its infancy and every patient had the typical "tin-grin' with metal
bands surrounding each and every tooth.
The sum total of band thickness plus some modest lack of space
actually created a situation where extraction was required.
The majority of treatments via this philosophy produced good
results in terms of ideal "fit of the teeth". However,
as facial anaylsis evolved, a more critical facial evaluation revealed
that in many cases, the extraction of permanent teeth had produced less
desirable long term facial morphology. Orthodontics
is a very introspective and intellectual art form and the science, or art
of diagnosis is constantly being refined.
At the same time, we better understand how faces grow under the
influence of muscle forces. By
altering those forces and tooth position, we can favorably affect facial
growth and development. The
use of "directly bonded brackets" produced a real revolution in
thinking about the need for extraction applied so frequently.
At the same time, competition for patients began to increase.
The reason for that increase could be the subject of a ten-page
paper in and of itself. The
source of the competition unfortunately was supplied by a plethora of
inadequately trained dentists who had "taken courses" in
orthodontics and were misled by the content of these courses which
philosophically trumpeted, " Extractions are never necessary"
and that "Orthodontics is really easy, a long hidden secret which can
make you wealthy in an ordinary general practice.”
The net effect was disastrous for the patient population and cast a
negative aspersion upon a respected and legitimate specialty.
The bad result; a huge number of treatments that were done by
egregious expansion relapsed back to the original conditions and had to be
re-treated by the use of extractions. The same excess expansion caused a myriad of serious
periodontal (supporting bone and gum) problems.
Therefore, common sense would probably indicate that it would be
best to seek the advice of a legitimate "specialist" when
deciding upon the individual who will render orthodontic treatment. The State of Connecticut requires that anyone who claims to
be trained as a "specialist in orthodontics" indicated by the
words, "Practice Limited to Orthodontics" must, in fact, have
completed an approved university based graduate course in Orthodontics.
And even with those having that basic "credential" one
would be wise to seek a specialist who is "Board-Certified".
We distribute a brochure written by the American Board of
Orthodontics called "One Step Beyond" which explains the value
of Board Certification. If
you haven't received this, please request it from our receptionists. SCHOOL
BELLS, A TIME TO EXERCISE EXTRA CARE With
the summer drawing to a close, as always, children will be returning to
school. Obviously this means
a change in schedules, eating habits and a host of athletic activities.
Most adolescent patients tell us that they simply can't brush after
eating lunch, but in truth, they could spend thirty seconds brushing and
rinsing in the lavatory areas. We
supply each patient with a "portable" toothbrush that can be
easily carried in a pocket and returned to its carrying case after use.
Even such a short brush and rinse can do wonders toward maintaining
good oral hygiene that is so very important in achieving a
quality-treatment result. There
are many "contact" or high impact sports that have the
potentialto create an environment where head and mouth injuries can occur. We, as most dedicated health-professionals, advocate the
wearing
of protective "headgear" and "mouth guards', even in
sports that do not require it. Field-hockey
and Soccer, for example can and have experienced quite a number of
injuries despite their being viewed as relatively "benign"
contact sports. We have
available to all orthodontic patients two types of "mouth
guards". One can be
attached to a "helmet" and the other simpler one can be carried
in a case. We urge you to make the request, particularly because these
are supplied at "no charge" For
those students who swim, we recommend that no retainers be worn in WESTWALK
JOINS "THE WEB" In
our previous Newsletter we mentioned that Westwalk Orthodontic Group would
be joining the "Information Super Highway" and now we are proud
to announce that we may be reached on the Internet.
Our internet address is WWW.WESTWALKORTHO.COM
Our website was designed by Dr. David Romeo's son, Mark Romeo who is now
in his Senior Year at American University in Washington, D.C. He is a true
"Web-Master". We
believe that you will find it informative and thought-provoking and we
will be anxious to hear your reaction.
We expect to be constantly updating the site with new information
and it will have an e-mail for questions and input.
TRADITION,
TRADITION! It
has been a "tradition" for me to end these Newsletters with a
word of "thanks". We
thank you for entrusting your children and yourselves to our care. We view that trust as an
honor and we will continue to strive to provide you with the finest
care that is within our capabilities.
But, it is not only the doctors who render care; it is our staff as
well who are a source of genuine pride in our offices.
It is they who deserve at least an equal share in what we produce.
There are no adequate words to thank them for their dedication and
professionalism without which we could not achieve the consistently fine
results that we produce. All
of us wish you and your families a wonderful fall, winter and most of all
a bright and hopeful entry into the New Millennium.
|