Columbia Winibtv&itpLo^oZ. intijeCitpofi^eto^orfe College of pijj'giciansi anti burgeons l^titvmtt llihvaxp rX^^^^ -^^ipf. ^"'^'' ^^ational Iiank\ Date. NO. DB ^. 3 (£. a^i %. y. 4 1 ! « 6 / ^ J ^. /z. — u (^ 2 '/P ^2*.*. > - 1 - - 1 1 1 1 ■ ' 1 — a 1 DATE. 1 Cr. a 6 /o 1 i: 1 RECORDS AND BOOK-KEEPING 93 tion or by the hour, to indicate the length of time spent in such work as cleaning or treating, in case of any question arising regarding fees. People in general have not yet been sufficiently educated to a just appreciation of the effort ni- volved in cleaning and treating teeth, and they are inclined to look upon it as a trifling service. A filling is something 'tangible to them, and they are willing to pay for it, but an adequate charge for cleaning or treating is sometimes resented unless the dentist can show them the actual time spent in such work. On October 6 a gold filling was inserted and a treatment made, — fee twelve dollars. The number in the third column of the ledger corresponding with the number on the diagram shows the precise filling which was m- serted on that date. On this same day the patient paid ten dollars on account, which is duly entered in the credit column. On October 13 the roots of the lower molar were filled and amalgam in- serted in the cavity, — fee seven dollars. Thus the record and account may be carried on down till the work is finished, and when more work is done for the patient at a subsequent date it is entered on this same page and the record 94 SUCCESS IN PRACTICE of the mouth kept complete in one place, to be referred to at a moment's notice. There is always room at the margin of the diagram or at the foot of the account column to record any- thing special about a given tooth, so that the entire history of the mouth may be kept in the most compact and convenient manner. By the use of abbreviations to indicate operations and fillings as here illustrated it is possible to con- dense a vast number of records and a very exten- sive series of accounts in one book, thus giving a ready reference under one cover for a great many patients. Mailing-Sheets. — To facilitate the monthly rendering of accounts it is necessary to have some plan whereby the operator or his book-keeper is not obliged to go through the entire ledger or series of ledgers each month in search of unpaid accounts. This is readily managed by having ruled mailing-sheets printed, as shown on page 95- These sheets should be about eight by eleven inches in size ; and when a patient's work is com- pleted and the last entry made in the ledger, the book-keeper should place the name on this RECORDS AND BOOK-KEEPING 95 ?i: s- • ^ •z "-., > 5^ ^ f^ s (o ,<^ W to > s- « a s> ?a ^ in ^■ v> ^ ^ >*. •^ ^ > ■ft. o M s o .^O O <^ > s r». H !^V< M S ^ > • 5- 2 i'S ^ ^ CO JS. W ^1 JO RpS n ;^' > > n Z 0) H ?? a *• n p 0) o I20 SUCCESS IN PRACTICE dissatisfaction, and so it is best to render the account " For professional services." But there are very many worthy individuals whose educa- tion and experience in professional matters have not progressed far enough to enable them to accept such a bill without considering it arbi- trary and high-handed. They want to know something more about the service they are pay- ing for, and it is for the benefit of these people that the foot-note is printed. It at once dis- arms suspicion, and if for no other reason than this, the keeping of diagram records is a very profitable procedure. In cases where work is done for the various members of a family, and the bills are sent to the head of the family, it is well, in view of the fact that he is not supposed to know the amount of service rendered to each member, to indicate this on the bill. Every precaution should be taken in rendering an account to disarm pos- sible criticism in advance, and this is particu- larly true in dealing with new patients. After patients have been coming for some time and have become accustomed to the dentist's methods, and have gained confidence in him, he can take COLLECTING ACCOUNTS, ETC. 121 greater latitude without misunderstandings, but he should make sure of his ground at ever}- step. A bill such as just indicated may be made out in the manner shown on page 122. A discriminating practitioner will soon learn by his experience with the individuals who come under his care just how to approach them with bills to the best advantage, and if he makes this matter a study he will eventually be able to conduct this department of his practice with very little friction. But in order to accomplish this he must first establish a reputation for absolute honesty in all his professional dealings. With this as a basis he need have no fear of conten- tion; and if contention does occasionally arise, he can face the result with perfect confidence that whichever way the issue goes he will have no compunction of conscience in the matter and nothing of serious import to grieve over. But unless he is fundamentally honest he will never have any assurance against suspicion, and no real resource to fall back upon in case of contention. If men were far-sighted enough to see the results of doubtful dealing, surely all men would be honest for policy's sake if for nothing else. 122 SUCCESS IN PRACTICE E Q ^ U) 6 6 1- u u „ cc ^ 1- (0 z u < 1- < _i .t m (/) 10 . (D o o h S ^ 00 5r> •>!*. ^ j> i!^ s ^ • i ■« '^ « s ^0 1 1 1 * E E S s 8 COLLECTING ACCOUNTS, ETC. 123 Paying Bills. — In intimate conjunction with the close collection of acounts must go the prompt payment of bills. No dentist of any self-respect will ignore his business obligations to the extent of gaining the reputation for being poor pay. Carelessness in this respect is almost criminal, and in a profession like dentistry-, where the invested capital is small and the obligations not necessarily large or numerous, it is inexcusable to form the habit of not paying legitimate bills. It is usually not of necessity that dentists are poor pay, but merely because their business methods are lax generally and because they allow them- selves to drift into shiftless and irresponsible habits. A legitimate business obligation should be held as binding and as sacred as any other obligation in life; and if a man plans his affairs properly, it is as easy to pay a bill at one time as another. It is largely a matter of habit and self-discipline. Many a man who is not at heart dishonest carelessly allows himself to get behind, and, through sheer lack of decision and self- restraint lets matters drift along month after month and year after year till it all ends in a 124 SUCCESS IN PRACTICE total loss of credit, and then such a man wonders why the world is hard on him. The desire to have things without the ability to pay for them is a disease which when chronic becomes as fatal to the ultimate self-respect and happiness of the individual as does tuberculosis to his physical system. Many of the things we buy in our modern civilization are luxuries in- stead of necessities, and while it is true that in the constant change of customs and tastes the luxuries of yesterday seem to become the neces- sities of to-day, it is yet a fact that many of the items of expenditure in the life of the aver- age individual are wholly unnecessary. It is well and proper for a man to have some of the luxuries and to indulge his taste for the sublime and the refined in the modern amenities of life, but it is not well, neither is it proper, to do this until he can afford it. To indulge in luxuries at the expense of one's business credit and repu- tation and to buy luxuries that one is not cer- tain of paying for is equivalent to downright dishonesty. Let the young man starting out in life be cautious about contracting bills, and particularly COLLECTING ACCOUNTS, ETC. 125 in those cases where there is the shghtest doubt about his abihty to pay. Let him look ahead very carefully, and if there is not in his mind a positive assurance that he can meet his bills when due, let him resolutely deprive himself of the things he otherwise would buy and wait till his circumstances so change that he will be justified in the purchase. There is nothing so discouraging or disheartening to a young man as to have a load of debts hanging over him. It may be necessary under certain circumstances, in fact it frequently does become necessary with a young dentist starting out in practice, to go in debt for his equipment, but it should be his constant aim backed by the closest economy to discharge the obligation as early as possible and get even with the world. To be out of debt and able to look every man in the face is a wonderful satisfaction to any right thinking individual, but for a young dentist to attempt to conduct a prac- tice with the collector calling at his office every few days is to travel an uphill road filled with rolling stones and paved with briars. It is not within his power to do the best service for his patients while he is harrassed by debts. 126 SUCCESS IN PRACTICE To gain a reputation in the community for the prompt payment of accounts estabHshes a man's credit and adds immeasurably to his self-respect. A man under these circumstances can confidently ask for credit in time of need, and people are only too glad to accommodate him. There is so much innate goodness in humanity even in business relations that there is never lacking the desire to help those who attempt to help them- selves, and the surest way to gain friends is to prove one's self worthy of them. IX FEES There are two principal plans for arranging fees in a dental practice, — by the hour or by the operation, — and there are arguments for and against each. To charge wholly by the hour is in some respects an equitable arrangement, but there are objections to it as an invariable prac- tice. It is true that a dentist's time is his chief stock in trade, but it is also true that his ex- penditure of energy is an important element in the case, and there are some operations which tax a practitioner far more than others. To have a set fee then for each hour's work is not just to the operator, and to have a sliding scale according to the character of the operation is practically charging by the operation. Then again, while as a professional proposition the cost of material should never enter into con- sideration in arranging fees for professional ser- vice, yet it is undeniable that in some cases it 127 128 SUCCESS IN PRACTICE becomes a factor. For instance, the difference between an hour spent in removing deposits and poHshing teeth and one spent in condensing gold in a cavity would amount to something in the way of actual cost, to say nothing of the dif- ference in nervous tension. To work by the hour is to be constantly watching the clock, par- ticularly if the operator is conscientious and has his patient's interest at heart, and there is always a feeling that he is working on time which belongs to somebody else instead of himself. Any diversion from the real work in hand or any interruption in an operation seems so much of a direct robbery of the patient, and this fact always being prominent in an operator's mind, makes him more or less a slave to his surround- ings. Another inequitable feature about the case is the fact that no operator is able to give uni- formly good service at all times. There are days when he is not up to the mark and when matters move slowly despite his best effort, and there are other days when he is in the highest perfection of physical, mental, and nervous balance, so that he is able to accomplish twice the work in a given time that he can on other FEES 129 occasions. To charge the same fee per hour for service rendered on two days so different in accompHshment is not equitable, and an opera- tor cannot well say to a patient : " I am not in condition to-day to do the class of service I ordinarily do, and so I must not charge you my regular fee," no more than he can say : "I am feeling so well to-day that I must charge you more than ordinarily." A fee should be based on the amount of ac- complishment more than on anything else, and this fact also illustrates a frequent injustice where, on the other hand, charges are made solely by the operation. To charge a set fee, for in- stance, for an amalgam filling is wholly wrong, because it may require three or four times as long to insert one amalgam filling as it does another, and the limit of accomplishment in the one case is vastly different from the other. The element of time in an operation cannot therefore by any means be ignored, and the most equitable arrangement is to have a combination of the two systems of charging. There should be a mini- mum fee for each kind of operation, and the charges should run upward from this minimum 9 I30 SUCCESS IN PRACTICE according to the time and energy required in its performance. As to the size of an operator's fees the mat- ter must of course be regulated to some extent by the customs in vogue in the locaHty where he practises. It is suicidal in every particular to make one's fees lower than the regulation fees of the neighborhood, as it is also usually inju- dicious to make them very much higher. This applies more particularly to practices in smaller towns, where an operator's fees are a matter of common gossip and where the precise fee for a given operation becomes well known. If an operator varies in any way from the regulation fees, it is always safer to raise the fees than to lower them. This may seem a strange state- ment, and yet it is amply borne out by obser- vation. If a man's fees are lower than his neigh- bor's, there is always a suspicion that he is not so capable a practitioner, and invariably the cheap man draws around him a class of practice which at best is very undesirable. He gets the shoppers and the misers and the financially irre- sponsible. His is the patronage of the " great unwashed." FEES 131 To establish in a neighborhood the reputation of being the highest-priced dentist in the place is often a sheet-anchor of strength. It may drive some people away, but if the fees are at all within reason it will not drive very many worthy peo- ple away, and for one such who leaves a dozen others will come. In fact it is the very rarest thing imaginable for a dentist who is capable of giving good service to ever lose his patronage on account of high fees. Of course he must be sufficiently skilled to justify himself in charging well, and he must have some sense of honor in making his charges ; but where there is one den- tist who has failed on account of high fees there are ninety-and-nine who have failed from other causes. In many instances high fees are made the scape-goat of a man's failure when the real cause was something else. The mere fact of de- manding and maintaining good fees tends to establish confidence in a man and draws to him the most desirable people. . When a young man starts out in practice, par- ticularly if it is in a large city where fees vary greatly among practitioners, he cannot expect to get as high fees as the older and better estab- 132 SUCCESS IN PRACTICE lished practitioners; but as he gains patronage and experience he should gradually raise his fees till he gets them up as far as his capabilities will justify. To do this requires some tact and judg- ment. It will not do to make too prominent a display of the fact that his fees are being raised. He should quietly go about it, stiffening up here a little and there a little, and from time to time as the opportunity seems propitious he should advance his minimum fees till the volume of his income is perceptibly increased. In this way his practice will gradually undergo a process of evo- lution without any serious protest on the part of his patients, but with an ultimate weeding out of undesirable patronage and the establishment of an adequately remunerative fee system. Estimating Work. — In some instances pa- tients make a request to have the cost of their work estimated in advance, and while this seems to them a perfectly legitimate and natural thing to ask, it is in many cases a very difficult matter to comply with it, and under certain circumr stances the request is wholly unreasonable. It is often quite impossible to predict by a mere examination of the teeth the extent of service FEES 133 it will require to put them in a healthy condi- tion, and the patient might with equal propriety ask a physician what he would charge to carry them through a case of illness where the exact nature of the disease was unknown to him. This feature of the case should be fully explained to patients, and most individuals will instantly rec- ognize the situation and see the justice of the dentist's contention. And yet it is necessary for patients in many of the exigencies of life to know something of the obligations they are about to assume, and the dentist should give them as accurate an idea as he can. In esti- mating work in this way the operator should in- variably explain the contingencies of the case to the patient and should emphasize the fact that it is only an opinion he is giving as to the prob- able cost and not an agreement to perform the service for a stated amount. Anything in the way of bargaining over a dental fee should be frowned upon by a self-respecting practitioner, and yet this has no reference to a cordial con- sideration of the question of cost with a worthy but impecunious patient. With those who are so situated in life that they are obliged to plan 134 SUCCESS IN PRACTICE their expenditures in advance it is well to esti- mate work by placing the probable cost between two sums, — a minimum and a maximum amount, — with considerabile leeway between the two to allow for discrepancies of judgment. But while it is ordinarily best — as has been in- timated — to avoid giving estimates on work in advance, it is occasionally the case that the den- tist may wish to force a consideration of fees on the patient before the work is undertaken. Sometimes irresponsible people, or those who may not be familiar with the dentist's fees, make appointments for work without sufficiently con- sidering the obligations they are assuming, and with such individuals it is always well to have some sort of understanding. The time to bring this about is, as has already been stated, when the examination of the teeth is made at the first sitting. A little precaution in this respect will frequently avoid subsequent complications and unpleasantness. .. Other instances where it is sometimes well to broach the subject of fees before the work is be- gun is where a child or ward is sent to the den- tist by a father or guardian and the mouth is FEES 135 found in a much worse condition than has been suspected, and also in those cases where the pre- vious dentist has been one whose fees are very- low. Under either of these circumstances the amount of the bill may be much greater than had been anticipated, and there is likely to be dis- appointment and sometimes even serious dis- satisfaction when it is rendered. In such cases it is well to drop a polite note to the father or guardian informing him of the condition of the teeth and stating that the practitioner deems it a duty to him to apprise him of the facts before doing the work. One of the greatest abominations connected with obtaining legitimate fees is to have patients come from a man whose fees are notoriously low, and whose patients are therefore not edu- cated to a just appreciation of the value of den- tal service. When a responsible practitioner gets a patient under these conditions he must exercise rare judgment and tact and see that the patient is by some means made to understand what his fees are in advance. Precautions of this sort often protect the dentist against charges of extortion and dishonesty. 136 SUCCESS IN PRACTICE Disputes Over Fees. — But it occasionally arises in the conduct of a full practice that diffi- culties occur in adjusting fees, and patients sometimes dispute a bill or complain of its size. The only safe way for a dentist to avoid trouble of this sort is to be perfectly equitable and just in his charges at all times, and then if a con- tention arises he is in a position to say to the patient that his bill is in strict accordance with his regular fees. If the patient still persists in complaining, it is in order for the dentist to take the ground in a gentlemanly and cour- teous manner that it is his province and not that of the patient to set an estimate upon his ser- vices, and that while people are not obliged to patronize him, when they do come they must let him say what his services are worth. Above all things he should talk reasonably and good- humoredly to the patient and never allow him- self to give way to ill temper. The moment a man gets angry or the least bit abusive he jeop- ardizes his case and loses his advantage, besides branding himself as a man unworthy to be classed as a professional gentleman. If patients are so ignorant or overbearing that they will not FEES 137 listen to reason or explanation, it is better for the dentist to excuse himself from their presence and refuse to have anything further to do with them. It is better even to lose a bill entirely than to stoop to an unseemly quarrel. Make it a rule with patients and let them so understand it that you will have no contention over accounts, and when this is well established as a tenet of your professional faith you will have little cause for contention. Not only this, but it will be found that in the course of a year there will actually be fewer accounts lost by pursuing this plan than by continually combating people. The Ideal Status of the Fee Question. — But in the broadest consideration of fees and the best means of regulating them the whole matter sifts itself down to the fact that the ideal condition in the conduct of a practice is where fees are never discussed at all. To be continually talk- ing fees to patients is degrading and smacks too much of commercialism. It emphasizes the sor- did side of life and does not comport with the dignity of true professionalism. There should be eventually established between patient and operator such a stable confidence and such a com- 138 SUCCESS IN PRACTICE munity of interest that it is never necessary with long-standing patients to mention the subject of fees from one year's end to another, and this very condition can be largely brought about if the operator sets himself to work along that line as he is building up his practice. But it cannot be wholly accomplished at the outset nor till the practitioner has demonstrated his integrity to the satisfaction of patients and established a firm conviction in their minds that he can be depended upon for equity in all his dealings. When this has once been attained, patients simply come and have their work done, say nothing about fees, and expect a bill on the first of the following month. A check is then mailed to the dentist, who receipts the bill, or has his book-keeper do it, and returns it to the patient, when the finan- cial part of that transaction is forever closed. To maintain a practice on this basis is the acme of professional success so far as relates to the material aspects of the comity between patient and practitioner, and such a condition leaves the dentist's mind free from the baser influence of financial bickering and gives ample opportunity for the closest possible attention to the higher FEES 1 39 development of his professional skill. It is not only better in a financial way, but better men- tally and morally in fostering the loftier impulses of honor and confidence and placing human in- tercourse on a more exalted plane of mutual equity and harmony. Charity Work. — In the exigencies of profes- sional life It becomes the duty of every prac- titioner of dentistry to do more or less charity work, and this should be most cheerfully done whenever the merits of the case warrant it. \Mien it comes to the relief of pain the question should never arise as to the patient's ability to pay. There are many unfortunate circumstances occurring in the lives of individuals which fre- quently throw them on the mercy of others, and when reverses happen among his patients the dentist should never be remiss in his duty so far as exercising charity is concerned. He should adopt the golden rule in this matter as in other affairs of life. But there is another side to the question which must be faced with resolution and carried out with judgment. The dentist should have a care that he does not do more harm than g-ood with I40 SUCCESS IN PRACTICE his charity. In anything he does beyond the mere relief of pain for a patient he should first make certain that the object of his charity is worthy, and even then he should not carry his benevolence too far. This is not so much be- cause of imposition on himself as for the possible injury to the object of his charity. There is nothing in all human experience more demoral- izing to an individual than to voluntarily accept unlimited charity, and the moment a man holds out his hand and receives aid from another with- out return that moment he sinks in his own self- esteem and loses an appreciable segment of his character. With all the laudable intentions be- hind our various systems of charity to-day, it is fast becoming evident to thoughtful people that more injury than good is being done by them. Many of them are merely helping to cre- ate a pauper class and are making people irre- sponsible and dependent who otherwise would develop some self-reliance. After giving a man a certain amount of aid in time of need he should be thrown on his own resources in order to bring out the best there is in him. Those who aim to be the best of friends to man are often led FEES 141 through mistaken charity to be his worst ene- mies. Reach down your hand willingly to lift up a fallen brother, but when he is once firmly set upon his feet let him stand alone. Gtiaranteeing Work. — The request is some- times made by patients to have their work guar- anteed. This, as every practitioner knows, is an unreasonable request, and the only guarantee a dentist should ever give is to guarantee that he will do the very best he knows how for the patient's welfare. He may say to the patient, and in fact he should say, that if his operations fail through any fault of his he will cheerfully make the failure good. But he should never under any circumstances guarantee, for instance, that fillings will remain in for a certain number of years nor that a set of artificial teeth will wear a given time. Unless a patient has suflEicient con- fidence in a dentist to know that he will remedy any defect in his work without a guarantee, the attitude of the patient to the practitioner is not such as to make their professional relationship harmonious and satisfactory, and they are better apart. A physician might with almost equal propriety be asked to guarantee that when he has 142 SUCCESS IN PRACTICE once cured a patient of an illness the patient will never get ill again, as to ask a dentist to guaran- tee his work ; and no practitioner who is honest will ever be led to do so unreasonable a thing. EMPLOYING AN ASSISTANT In the conduct of a practice which is at all extensive the dentist will consult his best inter- ests by employing a young lady assistant. No office is ever kept in quite the pink of perfection without the ministrations of a feminine mind to supervise its care and smooth over the rough excrescences left upon it by the average male habitant. There are so many useful services for the assistant in a dental office that an oper- ator who has once employed one will never be found without her. She stands between him and many of the pett\' annoyances which would otherwise fall to his lot. She saves nearly one- half of his time by dexterously assisting him in his operations and by attending to the clerical work, such as making appointments, notif>*ing patients to come for examinations, keeping books and records, sending bills, and the hundred and one little routine details of an office practice. She H3 144 SUCCESS IN PRACTICE protects him from the ubiquitous book-agent and the perennial Hfe-insurance man. She accepts the blame many times when he is himself at fault, and to have some one to do this is most delightful. She remembers things that he for- gets and attends to all his memoranda. She looks after the linen of the office and keeps the instruments cleaned and sterilized. In fact to have a competent assistant is to re- lieve one's self of many of the small cares of conducting an office, and no man in full prac- tice can afford to do without one. It is economy in every way, financial, physical, and mental. XI ECONOMY IN PURCHASE AND IN AVOIDING WASTE Purchasing Instruments and Supplies. — If all the folly of dentists in purchasing material they do not need were represented by an aggregation of the stuff so bought it would create a pile that would reach to the moon, and if another pile were made of the material they should buy but do not it would reach equally high. This might be construed into an intimation that they do not always use good judgment in their purchases, and an examination of the average dental office will amply corroborate the inference. It is sel- dom that one sees an office which is too well equipped, but it is quite common to see offices sadly lacking in the essentials and strewn about and lumbered up with a mass of material of no practical utility. A certain amount of such accu- mulation seems inevitable in years of experience, as it is impossible for a dentist to judge accu- lo 145 146 SUCCESS IN PRACTICE rately with regard to the probable utihty of every instrument or appHance he examines, but that a man may come much nearer it than most dentists do is certain. The young dentist in par- ticular should form the habit of studying care- fully the instruments he buys, and should ordi- narily see a practical test of every instrument or appliance before he purchases it. This plan of procedure will not only save him many dollars in the course of a year but it is really of great advantage to the dealer who sells him his sup- plies. To purchase an instrument that proves inefifective in the buyer's hands is to create dis- affection, and it frequently brings about the re- quest to have the instrument exchanged for something else. This is always unsatisfactory to the dealer, because of the accumulation of second-hand material for which there is very little market. The irresponsibility of dentists in not knowing just what they want and in pur- chasing what they do not need is proverbial in our supply-houses, and the evil is so great to all concerned that it should be remedied if possible. The dealer is not in a position to remedy it, be- cause he cannot predict whether a certain appli; ECONOMY IN PURCHASE 147 ance will appeal to a given operator or not. There is a great variation among men as to their adaptability to instruments, and one operator may find an instrument invaluable to him in his work while another will pronounce it useless. No one can judge of this matter but the indi- vidual himself, and it is high time that dentists made a more discriminating study in regard to the purchase of their supplies. This does not infer that they shall be nig- gardly or penurious about their equipment. No man can serve his patrons in the highest degree of excellence without having the necessary ap- purtenances to do it with, and it is economy both of time and patience to have the most perfect equipment. A well-appointed dental office ap- peals to patients and inspires a certain amount of respect, while it gives the operator a greater d^ree of confidence and satisfaction. A consideration of this question cannot be complete without a word as to the paying of bills for supplies. There is altogether too much laxity among dentists in regard to obligations of this sort, and it is a serious reflection on the profession as a whole that many practitioners 148 SUCCESS IN PRACTICE shirk responsibility in this particular as long as possible. They seem to imagine that because the dealers make their living on the patronage of dentists, the latter are thereby privileged to take all sorts of liberties and ask for all sorts of favors. Some of them accept it as almost an affront to have a regular monthly bill presented to them, and if a draft is made for a long over- due account it is construed as the very acme of imperiousness and high-handed usurpation. They forget that business is business and that dealers are simply business-men with business methods. It must of course be taken for granted that this imputation does not by any means apply to all dentists. There are many in the profession who pay their bills promptly and are in no wise open to the charge of irresponsibility ; and even with those who are derelict it is many times the case that it is due more to carelessness and pro- crastination than to any real desire to escape their just obligations. But the legitimate way is to pay bills when due, or rather the best way of all is to have no bills to pay. The cash buyer is always at an advantage over the one who asks ECONOMY IN PURCHASE 149 credit, and in dealing with dental-supply houses an appreciable saving may be made. Most houses have a rule that by depositing ninety dollars with them the depositor is given credit for one hundred dollars' worth of supplies to be obtained from time to time as the dentist re- quires them, and there is no rate of percentage that pays better than this. It is a profitable ar- rangement in every way, and with responsible houses it is a perfectly safe one. As soon as a dentist begins to take advantage of this offer his relations with that particular house may be said to be on a very satisfactory basis, and if any favors are to be shown in the courtesies of com- mercial relationship he is most certain to be the one to receive them. Avoiding Waste. — In a world where the genius of a man is constantly being taxed to util- ize the by-products of civilization there should be a universal sentiment against undue waste, and in the commercial world this is true. The waste of yesterday becomes the staple article of commerce to-day, and fortunes have been made and saved by preserving the rejected. In the practice of dentistry, where the precious metals I50 SUCCESS IN PRACTICE are largely used, an operator may gain much in the course of a year by carefully saving the dust and scraps. Little particles of gold falling to the floor during the operation of filling should be picked up and kept in a bottle. Disks or strips used in finishing gold fillings should be preserved and sent to the refiner. The platinum pins in broken teeth, the dust from the lathe in grinding gold crowns, bridges, or plates, all of them should be carefully gathered and saved. It requires little time to do this, and the aggre- gate of accumulation from this source in a life- time of practice would make the average man independent. It is never well to be penurious about anything, but it is always well to be saving, and if all the wanton waste of the world were carefully utilized there would never be the need for deprivation. XII BANK ACCOUNT AND INVESTMENTS A YOUNG man should establish a bank account as early in his career as possible. The moment he gets a few dollars ahead he should put it in a good bank, and so far as convenient he should pay his bills by check. It creates a favorable impression in the community and gives him a more stable standing. Besides this, a check paid for a bill and duly endorsed is a receipt, and the cancelled checks accumulating month after month are a vivid object-lesson and a con- stant reminder of his expenditures. He has more confidence in himself when he has a balance in the bank, and it gives him a greater incentive to save. If he has much currency in his pocket there is always the temptation to spend it for anything which may catch his eye, but if his money is in the bank he is likely to think twice before drawing on it. A bank account brings him in contact with business people and 151 152 SUCCESS IN PRACTICE establishes a relationship which is frequently ad- vantageous to him in the way of profitable investments by the time he has a sufficient accumulation to seek investment. This matter of investing one's earnings profit- ably is a very important consideration for the professional man and should be studied with the same care that is given to other material factors of life. A man's professional usefulness does not continue unabated to old age, and unless he saves something in his palmy days he is likely to face want in his declining years. There is no more pathetic spectacle than an old, broken- down, penniless dentist, worn out by years of service at the chair or the bench, his patients slipping away one by one, till finally the last loyal patron seems to have abandoned him for a younger man, and he left with nothing but re- grets, to face a meagre existence eked out by charity. That this has been the lot of many a practitioner who in his day was capable and active is only too apparent, and it should prove an object-lesson for the young men of the hour to so shape their affairs that when the hand be- gins to lose its cunning and the brain to be less BANK ACCOUNT AND INVESTMENTS 153 alert they will have something laid away to en- sure their independence. How doubly sweet it is for an old man to be able to dispense charity in his latter years instead of being obliged to ac- cept it. As to the kind of investments suitable for a professional man he must be governed largely by the nature of his surroundings, and no ex- plicit advice can be given ; but there is one fea- ture of the case that every young man should be warned against. The frantic craze to become suddenly rich has wrecked more men than any other one factor of commercial life, and the ten- dency for speculation is largely backed by this desire. It is the most alluring of all phantasies, and there is little wonder that young men fall by the thousands in its pursuit. The young profes- sional man, of all others, should avoid this siren. Even if speculating were a profitable and legiti- mate procedure he is not so situated that he can expect to excel at it. When men who are con- stantly studying the stock exchange and the grain market frequently find themselves on the losing side, how can a young man who never gets more than the merest occasional glimpse of 154 SUCCESS IN PRACTICE the inside expect to speculate successfully ? The moment a young professional man begins play- ing the stock exchange or the wheat pit on mar- gins, that moment he begins to lose a grip on his practice. A speculative procedure diverts attention from professional matters and unfits a man for the closest possible attention to his work. There are of course exceptions to every rule, but it is the rarest thing imaginable for an out- sider to ever make a competence in speculation, and if the vast sums of money put into specula- tion by professional men were placed beside the amounts they have made thereby, the former would bury the latter so deep that it could never be detected. The young man should studiously avoid all the myriad glittering schemes for making money rapidly, and should content himself with slower but safer investments. First mortgages or good bonds are preferable to flyers on the Board of Trade, and a safe dividend-paying stock bought outright and placed in the vault will beat a mar- gin speculation nine times out of ten. Of course interest on mortgages or bonds is not high, but BANK ACCOUNT AND INVESTMENTS 155 it is one of the most marvellous things in all business experience to watch how interest will accumulate as the months and years go on. A few hundred dollars put out at interest each year during the time of a man's greatest earn- ing capacity will secure him a competence when he is old. The dentists to-day who are inde- pendent are for the most part men who have saved little by little and invested it safely, rather than those who have speculated. XIII PROFESSIONAL RELATIONSHIP AND CITIZENSHIP No consideration of a dentist's success in life would be complete without reference to his pro- fessional relationship and his status as a citizen. To be successful in the truest sense of the word a dentist must have intimate association and the most cordial relations with his fellow-practition- ers. Whatever else he may get out of life in the way of money or friends there is always a void unless he numbers among his most intimate asso- ciates the members of his craft. There is some- thing wonderfully sustaining in the true friend- ship of those working along similar lines, and it is perfectly natural that a mutual interest should develop between the members of a com- mon profession. He who holds himself aloof from this kind of association misses much in life in the way of enjoyment and professional prog- ress. No man can advance as rapidly alone as he can by the aid of those interested in the same 156 PROFESSIONAL RELATIONSHIP 157 pursuits, and when a man refuses to fraternize with others of his profession he injures himself more than any one else. Everything pertaining to professional welfare should have his hearty support and loyal endorsement. To hang back and be an odd sheep brands him at once as being possessed of qualities that are undesirable, and this judgment is passed on him not only by the profession but by the public at large. There is nothing more unprofitable than a self-imposed ostracism. The dentist should join the various dental societies of his locality and take an active interest in their welfare. He should write papers for them and should contribute to the periodical literature of his profession. He may not be able to write a brilliant paper, but every man has it in him to say something that shall be of benefit to his fellow-practitioners, and he has no right to withhold it. And even if he cannot write, he can be useful in other ways and thus leave his impress on the profession in such a manner that he will be a distinct personality instead of a nonentity. In short, he should consider himself part and parcel of the profession and not a mere 158 SUCCESS IN PRACTICE excrescence waiting to be wiped off by the breath of progress. Not only this, but he should take a vital inter- est in affairs aside from the profession. A man who wraps himself up in any one pursuit and thinks of nothing else is prone to become nar- row-minded and self-opinioned, and in all hu- man relations there is no one more illiberal than a narrow-minded dentist. If a dentist is at all active in mind he needs some outside interest or some fad as a diversion from the grind of professional life, and if he is not active, he needs it all the more to create activity. He should aim to be broad in his sympathies and his interests, and should remember that he is a man first and a dentist afterwards. This involves the obligation of good citizen- ship, and to be a good citizen is to take cogni- zance of public affairs. It means that the indi- vidual should vote at all municipal. State, or national elections, and in order to vote intelli- gently he should make himself familiar with the leading questions of the day. This does not im- ply that he shall be offensively obtrusive with his political beliefs nor that he shall consort with PROFESSIONAL RELATIONSHIP 159 ward-heelers or unworthy politicians, but that he shall look upon it as a duty to take an interest in the proper administration of government and to lend his aid towards the election of worthy officials for this purpose. To sum up the factors which enter into the making of a successful dentist, a man should not only develop his professional attainments to the highest state of perfection, but he must aim to provide for those dependent upon him by strict adherence to a sound financial policy in the conduct of his affairs, and in addition he must hold true to his obligations to the profession of his choice and to the commonwealth in which he lives. A dentist who fulfils these requirements to the best of his ability may be considered to have attained all in a material way which his particular lot in life permits of him, and of such a man it can never be truly said that has lived altogether in vain. THE END RK58 Johnson Success in dental pra€tice. J63 Copy 2 -^uiBiuNlVERSlTVUBRARiESlhsLsU) RK 58 J63 C.2 K' dental Kact|c.. 2002306328