Date: Tue, 21 Nov 2006 05:58:05 -0600
From: "ESCO automatic digest system" <LISTSERV@LISTSERV.UIC.EDU>
Subject: ESCO Digest - 15 Nov 2006 to 20 Nov 2006 (#2006-43)

There are 4 messages totalling 560 lines in this issue.

Topics of the day:
1. Hiring office manager
2. Respect
3. Re: Invisalign


Date: Sun, 19 Nov 2006 11:20:35 -0500
From: atogrye@AOL.COM
Subject: <No subject given>

I like to know if any of my colleagues have an office manager and if so what function do they serve? When should one consider adding this position to their ever growing payroll? Thank you for your input in advance. Anthony

Date: Thu, 16 Nov 2006 19:42:00 -0600
From: "SCOTT SMORON" <scottsmoron@COMCAST.NET>
Subject: Respect

1) I think it is interesting to hear all the JUDGEMENTS being thrown
about...from one ortho to is shameful and that may be the
reason for the degrading image our profession perceives and why so many

would vote to spend $4M through the AAO to re-establish it.

2) Align was granted patents it should never have been given. We all
**KNOW** this and Ortho Clear made some headway here. Once patents are

granted, they are expensive to overturn. There are behind-closed-doors

issues that are not talked about, but Align has engendered hostility by

going out and sometimes claiming to have invented the obvious. Ortho
challenged them but both parties realized it was just not worth the
litigation and settled. Align is not in any way innocent in this
Better capitalized and having the advantage of some questionable patent

approvals, they bullied OC into submission. We should all applaud
willing to fight for our profession! Aligner-type appliances in a
were made before Invisalign (I am a former part-time lab tech). Some
these patents are akin to one supplier arguing that any fixed appliance
corrects a Class II falls under their patents. So the Jasper Jumpers,
Bite Correctors, the MARAs, the Herbsts, the Forsus, the Saife springs,

would all fall under the same patent. AND THANK GOD PATENTS EXPIRE.
have some balance about the roles these companies played and played
Both companies did things which do not benefit all stakeholders,
employees, shareholders, patients and customers. Neither is innocent.

3) This is an extension of the #1 reason above, but ESCO is a
tool that brings together some pretty bright people. So why don't we
discussing everything with a little more balance. For those who stayed
Align and never strayed, don't act like you did not benefit from all
Your lab fees are now $100s lower than were before. Are you passing
savings along? I honestly doubt that is the case. I did lower my fees
OrthoClear and I thought I was delivering a superior product.

4) Why do some still disparage aligners? You cannot convince everyone
wear braces. Or headgear. Or do orthognathic surgery. I have worked
those who draw a line in the sand and say "Do it right and perfect or
do anything". How many of your cases are perfect board results? If
all are, I applaud you. I make compromises in treatment. Stop telling
me I
need to educate the patient better; I educate them about much more than
can only fully correct this with braces". I discuss treatment options,
discuss compromises that are produced by each approach, and then listen
my patients. It is not delegated. I am not seeking out money. I am
providing care. You may educate the patient about what is ideal, but
they never return and improve what they have. It is a difference of
and I know this; I simply prefer to improve the dentition of everyone
comes to me than pick and choose only those willing to commit to
You would rather stick to perfection. We do not need to disparage one
another. You have consistent board cases, I have periodontists who
appreciate my willingness to discuss multiple options and find a fit
their patients who have compromised dentitions. You get everyone to
their headgear and elastics, I have patients who choose to wear a
to improve a gummy smile or use aligners to straighten out that one bad

tooth but still has Class II relationships and 4mm of overjet. We both
happy patients and we should be happy for one another.

My experience with the Align corporate operation was often atrocious.
a patient's rebate did not come through, I called my rep. When a
never showed, yo Matt. So when Matt, my rep, switched, all I knew was
the person who took care of me and my patients was recommending
new. And the product delivered...great fit, liked the software.

I did pass the savings along. No longer did I have to charge $5k+. I
doing simple cases for parents of patients for like $2k. They were
thrilled. I was thrilled.

My patients will be alright. I will continue to enjoy using this
technology. My poor rep got VERY screwed.

But why the judgements and the disparaging comments? Maybe someone
and wiser could just tell me that pre-adjusted appliances caused the
hostility amongst otherwise bright people. I know there was a time
when it
was believed that pre-sized bands with attachments could not work, and
the sentiment became that you were short-changing the patient if you
them. And I know one orthdontist who still believes this!

Let's try to get along and respect each other!

Scott Smoron


Date: Thu, 16 Nov 2006 22:44:32 -0500
From: "Barry Raphael" <alignmine01@CONVERSENT.NET>
Subject: Re: ESCO Digest - 10 Nov 2006 to 15 Nov 2006 (#2006-42)

< I suggest if you are doing so many Invisalign cases that you are afraid of reprisal by the company, you may want to reexamin your criteria for starting your cases.>Anthonyt

Anthony, You may be surprise to hear me say this, but perhaps you have not done enough cases to find out that aligners can be superior to fixed appliances in certain situations, and easily equivalent in others. And well appreciated by patients when given an appropriate choice of treatment options. I'm not looking to throw out the baby with the dirty water.

<Yes, I own Invisalign stock and plan to buy more; Sue me> Elliot

Elliot, I am suing you in the court of higher conscience. You really surprised me with your invective. You have always been the voice of reason for me. But as I was reading your paragraph, I was thinking..."oh no. He owns stock." So tell me, you ownership does not influence your opinion on this issue? And what about your choice of the appliance for your patients? You don't even think with each enrollment, "This case will benefit me in two ways now".?

Funny how I find myself advocating for the appliance and against the company? No, I won't buy stock. So I'm idealistic. Sue me.



Date: Thu, 16 Nov 2006 16:21:50 EST
From: BPovolny@AOL.COM
Subject: Re: Invisalign

In reference to the thread in which several doctors complain that Align is manipulating them with it's "Patients First Program", let me get this straight:

-You doctors chose to start treating your patients with Orthoclear.

-Orthoclear went out of business.

-Align offered to finish those Orthoclear patients' aligner treatment at no cost, but requires new records so they (Align) can fabricate their aligners for all these Orthoclear patients.

-And you are mad at Align, because .... because .... because .... ?????????

Could someone help me out here? I can't see why you wouldn't be thrilled if Ford would give you a replacement car when your Chevy quit running. Sure, it's great PR for Ford, but come on now, are you seriously complaining about Align's offer? Align has no responsibility to do anything at all for Orthoclear patients and doctors. Why not just manufacture your own clear aligners and finish the case yourself? Then evil Align would be entirely out of the picture.

If Align weren't getting something out of it's offer why would it make the offer? You Orthoclear doctors are lucky that Align feels there is something in it for them, because if there weren't you'd be up the creek without a clear aligner!

And it is sounds positively silly to hear orthodontists sit around and talk about what should or should not be patentable. Patents are issued by the US Patent Office, not by chat rooms full of orthodontists. Anyone can challenge a Patent. Orthoclear based their entire business strategy on challenging patents. They failed, but hey guys, have a go at it if you think the Patent Office is wrong. You'll find plenty of patent attorneys who'd be happy to take your money to help you with your challenge

I use Invisalign but am not a partisan in their camp. In my view Invisalign is a tool with rather limited applicability. Align is the emperor with no clothes. They claim their product can do all sorts of things it can't. Any experienced orthodontist who uses Invisalign knows how limited it is. Once GP's start using it many will overreach due to Aligns' absurd claims about what Invisalign can do. They'll discover that, despite Align's claims, Align has not in fact repealed the laws of physics or the biology of teeth and occlusion. And those GP's will get in trouble on more difficult cases. Then we orthodontists will come riding in with the bugles, banners and white hats. Right now, however, for you Orthoclear doctors, Align is the cavalry, like it or not.

So relax guys. You are responsible for decisions you make. If you back a losing horse admit it and get on with taking care of your patients. And if Align offers to treat your patients for free, for God sakes, stop complaining about having to take some records!

Brian Povolny