A Facebook Response: Re: “Disappointing GNM experience in Russia” on TMJ/TMD Discussion Group

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By Bruce Wayne Greenstein, a concerned OC GNM Trained Dentist, Miami, Florida, U.S.A.

Cheow Chuan Tan, your post caught my attention and prompted me to give one thought to your situation. Allow me to share the following perspective. “We live in a time blessed of great material prosperity…… In our personal quest for wealth, we need to make certain that we do not allow it to become synonymous with stealth – stealing our sense of morality, our personal dignity and the preciousness of our values above all additional zeros in our bank accounts.”

Rabbi Benjamin Blech

There is nothing wrong with insuring one’s own financial situation and ability to care for ourselves and families, but any model that excludes the benefit to another in that process is flawed and inappropriate. I cannot speak to all the specifics in your case as I am very far removed from this situation. While the lengthy description includes what appear to be some fair and accurate statements, others are very likely guesses as to the process by which GNM dentists perform their work. I can understand how the public might misconstrue instructions during the process of capturing an optimized, physiologic mandibular position thinking things subjective rather than objectively based on all the many parameters we’ve been taught as GNM dentists. But, there are many variables that go into determining an appropriate trajectory and the right vertical, AP and lateral position for the jaw based on ALL the data collected from scans to photos to XRs to patient’s most important contribution – their symptoms and how those help to describe what might be going on for the body’s muscles and joints and nerves let alone biochemistry.
As the patient in need, I would encourage you to discuss this further with your GNM dentist despite the few visits you’ve had as you have no doubt spent a tidy sum of money to feel better. Throwing the baby out with the bath water is JUST as wrong as a practitioner hastily trying to treat a patient and capturing hard-earned money without following through on an inherent obligation by virtue of what is clearly understood as the doctor-patient contract. I would imagine that the doctor wishes to be part of the healing process with you rather than take money from you without providing the service requested.
Admittedly, the types of pains associated with TMJD are nothing we wish on anyone. But, this discipline takes exactly that – DISCIPLINE – and time and communication. GNM protocols are not as straightforward and simple as repairing a tooth with a cavity by placing a filling.
In all walks of life, there are both good and bad, well intentioned and less caring people be they technicians, professionals, etc. Discerning who is who takes time, patience, diligence and research. Most of us want to do excellent work and make a good living. Doctors do need to appreciate that this isn’t the next cool dental course/subject to add value to one’s practice for the sake of doing some “big” cases and making a name (and lots of money) for oneself. This is something that MUST be done with a dedication to learning and progressing and refining skills, working one’s way up the financial fee scale over time based on experience, study and successful symptom resolution. But, GIVE to your patient a full measure of what is deserved and if you didn’t charge enough for the time required to help a patient, then the onus is on the doctor to eat it and do right by the patient. But, communicate throughout as effectively and honestly as possible – doctor and patient – and most likely no one will walk away upset. My apologies for the length of the post, however, you appeared to be someone who would appreciate a thoughtful response.


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