Every producer of these packages has testimonials and positive reviews on their website. They all say they do the really important stuff that we dentists need them to do. So, how can you really choose which one might work best for your office?

The answer is that each and every one of them will work for you. The pluses and minuses that each has washes out in the end if the software is continuously updated by the manufacturer. And most of the popular packages are updated regularly.

In the end, as so many things in life are, word of mouth carries the greatest impact in choosing a package. Packages that people have used or seen in other offices, that staff learned in school, and that people hear others speaking of positively will tend to generate more sales. Social media is a great way, if not the best way, to market your product with that word of mouth thought behind it.

Unfortunately word of mouth advertising can kick you in the ass and if you decide to open up the web as your mouthpiece, expect that you might have some bad stuff indelibly placed on the web for all to see forever…

When I opened my first office with a couple of buddies we had to decide on a practice management software package. There were a ton out there on the market then, and even more now. We chose to purchase Dentrix then because of some familiarity with it and the fact that it had potential to grow with the office. Dentrix back then worked very well as a clinical program but when it came to the front office stuff we found that it had some shortcomings. This was a while back so I can’t exactly remember what the issues were but I do know that they were fairly minor.

When I left that group practice to set up my solo practice I decided that I wanted to support a Canadian software company, if possible, and that it was more important for a package to work well from an administrative/accounting/scheduling/insurance perspective than for it to work well with respect to clinical stuff. I didn’t have a problem writing my patient notes by hand and we weren’t on to digital xrays. Because my office is small and we use just a small portion of the available dental procedure codes, communicating treatment and treatment plans from the back to the front the old fashioned way wasn’t a problem.

I chose Abeldent based on word of mouth, some usage at an office I had worked in, and the fact that it was used commonly enough in many offices that a large proportion of dental staff had some familiarity with it. Sure, it couldn’t do prescriptions then, clinical charting and notes sucked, and it had really minimal reporting and support that was relevant to a specialty practice. Abelsoft advertised widely, however, that they were working on all of these things — watch for them soon.

I think the package cost me about 10 or 12 grand to buy with four licences. I signed up for a maintenance package for about 3 grand a year that included fee guide updates and free software updates. Tech support cost was per use, but after setting up the program, why would I need to use tech support really? Everything that we’d need to know should be in the documentation and regular updates should fix any bugs that existed.

Really? Wrong.

Turned out that Abel updates happened once a year (for us anyway), maybe twice a year. Every update bloated Abel substantially and slowed down key parts of the package. Every update introduced random bugs in the software. Many updates changed the database so that we wouldn’t be able to uninstall the newer version of the package and revert to an older one (as far as I know). Abeldent continued to bloat. New updates added features that slowed things down even more, but never really addressed usability or fixed many obvious bugs. Customer satisfaction surveys that I filled out went unheeded.

By version 6 we had a decent balance between a stable system that we could work around bugs that we knew of, we were starting to get used to the slower modules and developed personal routines that we did while waiting for something like the prescription list to populate. When insurance companies or patients or even their lawyers wanted copies of my clinical notes for whatever reasons I resigned myself to doing screen captures of my notes page and printing them as graphic files because there was no way that I could find in Abel to actually print notes for more than one day at a time.

Abel’s solution to the slowdown was to require faster hardware for later versions. I was sent version 7 and then version 8 which required hardware beyond what I was running in the office. My patience, which had been wearing thin for years, broke and logic kicked in.

Yes I could spend money to update the hardware, but really how would I know that the software would be any more useable than it had been to this point. Abel’s software documentation was practically non-existent, changelogs were non-existent (and the documentation spelling out the major improvement or additions with each release never addressed bugs), and given their development track record I was pretty sure I’d be asked to update hardware at some point soon again. No, I had had enough.

I decided to cancel my maintenance agreement with them. We decided that we would enter fee guide updates by hand. I would keep version 6 running on existing hardware for as long as possible and just shelve versions 7 and 8. I would save at least $1000 a year, and after a few years I could look into upgrading hardware and software again. At that point, though, I would have saved enough money to allow me to buy a completely different practice management software system. It would provide me with more options.

Needless to say, Abel was quite surprised when I quit the contract. I had been paying into it for years and they probably expected that I was going to continue to do so forever.

Other offices must have decided to do the same as I had.

About 4 years ago we all received a letter from Abel informing us that they would only provide product support (which you have to pay for anyway) if we were on their maintenance contract. If not, you were shit out of luck. Of course, you could sign back up for the maintenance package for a few thousand dollars and then you’d be right back on track again.

I chuckled when I read this. To me it meant one thing only — Abel had been getting fat and lazy from money generated from these maintenance contracts instead of directing more of that money towards software development. Now that enough of their clients had smartened up, they were starting to get nervous. I chuckled again.

Fast forward to today.

Abelsoft continues to try to generate revenue by being lazy rather than innovative:

1. In order to attach my new associate endodontist to the software, we had to purchase a key from Abel. Abel initially refused to sell the key to me because I am not on their maintenance contract. After unleashing my office manager on them the issue was escalated and one of their managers eventually decided to allow us to buy the key without me having to be on retainer with them. Isn’t that awesome business practice? Making customers beg to pay for a software feature that should be a free part of any package.
2. Over the years, through hardware attrition, the computers in the office have slowly been upgraded and are now compliant with the requirements for Abledent version 8. I recently decided dust off the version 8 CD and installed it. As usual, many modules are grinding away even slower than before. There are new features, reworking of older features, and 2 new bugs. One has to do with printer dialogue issues, the other is shown in the picture above. Abel refuses to address these issues because we are not on a maintenance agreement with them. It’s almost as though they deliberately release buggy software in order to entrap your commitment to them.

So Abelsoft’s downside all stems from outdated licensing models and IT business practises. They are already feeling the effects of their stubbornness to treat their customers more respectfully. This friction to change can only lead them in the same direction as Research In Motion.

As one RIM ex-employee recently wrote, “Success cannot be borne of a 2005 status quo when the world looks a lot different now than it did even 12 months ago.”

Abel’s upside is their tech staff. Over the years, the people that we’ve had to deal with for tech support have always been exceedingly knowledgeable, efficient, and courteous.

Unfortunately that upside is not enough to keep me as a customer and where I go so will others. Online business practices and customer service have evolved in all spheres on the web over the years and consumers expectations continue to rise.

Abelsoft refuses to keep pace.

UPDATE, January 15th, 2012:

About five months ago Abelsoft offered to get us back onto a maintenance contract without charging me the restart fee. I agreed to this because they assured us that version 10 of Abeldent was more stable, less buggy, and solved many issues that I had with previous versions. I only had to upgrade the server to get it running.

I can report after using this new version for a few months that it is much less bumpy to use. Yes, there is buggy behaviour as before, but so far they have been minor issues (that I can’t even remember off the top of my head).

I’m now a satisfied customer again. I’m leaving the post above standing because there’s still a difference between a satisfied customer and a happy customer.

© Periapex for The Periapex, 2011. | Permalink | 8 comments |

From a patient that I saw yesterday for a consultation:

I’m with a new dentist now. I left my previous dentist because one day when she was drilling my tooth and you could smell that tooth dust smell she told her assistant that that was the smell of money.

© Periapex for The Periapex, 2008. | Permalink | 13 comments |

This scores your office lots of fuck you points and pretty much guarantees that if you try to refer other patients in the future they’ll probably have to wait even longer. Why not teach the specialist “a lesson” by not referring any further patients to them.

© Periapex for The Periapex, 2008. | Permalink | 15 comments |

This will actually be your next patient because all of your patients these days seem to need pit and fissure fillings for some reason. Could that reason have anything to do with the fact that you’re planning on putting your practice up for sale soon and want to show prospective purchasers high production numbers?

© Periapex for The Periapex, 2008. | Permalink | 7 comments |

Isn’t it funny how some people think that a fancy job title makes them more important? I’ve actually used this point to my advantage when hiring. There is a surplus of dental auxiliaries looking for jobs with fancy “management” titles. So much so that the best staff I’ve ever found, who are a pleasure to work with and who do an effective job, are the ones who appreciate the job for what it is and not what it’s called.

A job ad for a Treatment Coordinator that leaves out the name of the position but instead describes the successful candidate as a people-person, team-player, analytic, needing X amount of experience in a dental office, etc. will produce many different resumes than a job posting for a “Director of Treament Coordination”, who will be “in charge of”, “manage”, “oversee”.

The dental office environment demands a team approach with every member helping each other. If one person feels that because they are the “manager” they should only be telling people what to do, the system breaks down and poor morale develops.

Patients see all of this. It reflects badly on the dentist because everything in a dental office trickles down from the top. If patients pick up poor staff morale, what do you think they’ll think of your actual dentistry?

Dentistry is not the only place that works best with a team approach of course. Practically any work environment needs this.

Interviewers for potential dental school candidates often will attempt to assess if the interviewee has leadership ability. At an interview level this really just translates to confidence and past acomplishments in organisations.

I’ve never been interested in leading people and yet have been put in this role uncountable times. I can’t tell you how well I manage staff, but the success of my office on a personal level satisfies me that I’m doing something well.

There are two lessons that I learned about being a manager that will forever rule me.

The first is through a job that I had at a camera/photofinishing store when I was in my first year of university. The store manager gained my respect and my desire to help him do his job simply by doing as much of the work that was required of us himself. He would ask for help as needed. Ask not tell. He led by example to the point that we employees took on responsibilities willingly because we saw how busy he made himself as he was pulled in many different directions. We genuinely wanted to help him. Does he sound like an ineffective manager? Was his day too scattered to properly “manage” the store? Shouldn’t he have properly delegated jobs?

Nope. His management strategy was the most effective I’ve ever worked under.

The second lesson that I learned was during my endo program. The dental assistants were arguing among themselves about whose fault it was that some item was not working properly. The argument wasn’t heated but had gone on for at least 5 minutes. I needed a functional version of the same item for the case I was working on.

Practically without thinking I left my op, went over to the staff and told them to blame me for the broken item. I told them to tell their boss that they could come and talk to me about it. Then I said that I really needed a working one.

Each of them blinked at me in surprise then ran off in different directions to find me what I needed. To this day they still remember me and “what a nice resident I was”.

Good management empowers staff and helps them to appreciate the job they have. The team effort that results minimizes the actual need to “manage” and maximizes a positive, enjoyable work environment.

– Periapex, Supreme Director of Endodontic Therapy, Workland, Ontario, Canada.

© Periapex for The Periapex, 2008. | Permalink | 4 comments |

This ensures that you save money because the hygienists are not wasting prophy paste.

© Periapex for The Periapex, 2007. | Permalink | 2 comments |

Action: Throw instruments (the sharper the better) at your assistant because you are frustrated with the patient or the case.

© Periapex for The Periapex, 2007. | Permalink | 4 comments |

She: So is the patient coming back for work?

Me: Yeah I think so.

She: A pulpectomy or pulpotomy?

Me: What’s the difference–

She, cutting me off as she busily shuffles her paperwork around: One is all the way down the canal, and the other is only part way.

Me, pausing confused: Umm…yeah..thanks for the endo lesson. I know the difference that way. I meant what’s the difference in cost…?

She: Oh.

© Ameloblast for The Periapex, 2007. | Permalink | One comment |

Any shaking of the scope gets magnified a gizillion times. This is my first test shot. It’s an upper 6 showing DB and the two MBs.

© Ameloblast for The Periapex, 2006. | Permalink | No comment |

I have a digital camera (Nikon Coolpix 990) attached to my microscope. The scope is off to the left of the following picture. There’s also a video cam hooked up to the scope for my assistant to monitor what I’m doing. I’d rather have an intraoral camera than the Nikon hookup though.

I use my Canon SD500 camera for the other photos that I post.

I don’t have digital radiography in the office so I use an Epson scanner that has a transparency adapter to scan in xrays. I used to take pictures of xrays off the viewbox if I wanted them digitized. This worked decently, but requires a good knowledge of the camera’s exposure settings and some image manipulation on the computer. This was useful when I used to teach and didn’t have a scanner handy when some interesting xray came along.

© Ameloblast for The Periapex, 2006. | Permalink | 2 comments |