Saturday, July 31, 2010

A Root Canal, But I Digress

Yesterday at lunch with a good friend the subject of root canals came up. She said that while on a trip to Mumbai, India, she had to have a root canal on a painful tooth and she had it done in Mumbai. I sensed a tone of surprise when she said the dentist used the same modern equipment, was just as skilled and just as caring as she experienced in the US. She was thoroughly satisfied. And, the shocker? It only cost $150.00, total. "It paid for my plane ticket," she said.

What! My contribution to the discussion was that the cost of my root canal, in progress, is $1,350 and my share of that, after insurance, is $855, and that may not be all I pay. My dentist says I may need a "post," to firm up the tooth, that will cost another $345 out of my pocket since my insurance has capped out for the year. So, now that he has prepared me for another pocket-shock, I will probably "need" the post, since he suggested it, whether I really need it or not, primarily because I don't know any better and I've been sold on the idea for as long as I remember that dentists are "special," held to higher standards, expected to know the complexities of the human body (and teeth) and from all of their very expensive eduction they know what they're talking about. And, from there, the conversation digressed into why the cost disparity between a dentist here and a dentist there and why our costs in the US of A are so much higher.

I guess that you can guess how many turns the discussion could take, but I think dentists in America are overpaid. Can we say that "our" dentist are better trained than those in India? I don't think so. In Japan, a dentist's standard of living is middle class and not at all extravagant. Are they somehow not as good as ours? From the cost in India, it must be the same there; an Indian dentist must not have a high, extravagant standard of living because, if they did, the cost would be higher. I'm sure there are other reasons for the disparity, high insurance administrative costs for example, but US dentists do live extremely well, drive expensive cars, have the nicest homes and pretty much live the "good life." It is not a very hard job. It isn't "back breaking, laborious" work. The fact is, being brutally honest, I have to ask the question: just what is it that makes them "special?" How complicated is a tooth?

When all is said and done, a tooth is a pretty simple structure with a few layers of various materials, held in place by roots embedded in bone and a firm grasp of skin and tissue. That's it! Nothing more. One tooth is pretty much like the next. Google search for tooth structure and only one picture is returned; a crown, neck and root composed of enamel, denture, pulp, gum, bone, root canal, nerve, blood vessel, etc. Know one, know them all. What's the big deal?

I'd say that a dentist isn't much more than a glorified auto mechanic, and maybe, in terms of intelligence, less is required. An automobile is a complex piece of equipment, with new designs and technological improvements every year. A mechanic must never stop learning, or else they become obsolete in a year or two. What is there that a dentist must study every year? A new drill bit? A new digital x-ray machine? Nothing hard about that.

And, an automobile can't touch the complexities in computer programming! Try defining an "object," for example. Webster says an object is "anything that has a fixed shape or form, that you can touch or see, and that is not alive." But, that's not true! In the ephemeral and ambiguous worlds of cyberspace and programming, an object doesn't have a fixed shape or form and you can't touch or see it. But, a huge contradiction is that you can "know" it! It is true that it isn't alive - until you make it live. Try to wrap your brain around that definition! Talk about Zen Buddhism of unreal reality! This stuff will drive a programmer nuts and a non-programmer bonkers! Because in object-oriented programming, a programmer must "use" other "objects" that may or may not exist on your computer. There are hundreds of thousand of objects on your computer, maybe millions, and all could be at the beck and call of a programmer - if he or she knows they are there. If there isn't, or he/she doesn't know they are there, then the programmer has to "create," like a god, an object to use in the program. If that idea hasn't confused you, then try this one. Not only does the programmer have to create objects for the program to function, the object should be "polymorphic," able to take on numerous shapes and forms and "uses" yet still remain process specific, i.e., built to do finely defined functions, AND reusable in other programs if possible. Ha! That ought to make your head spin. Try to do that, Dr. Dentist!

All of this takes me back to another root canal I had done by Dr. Fry in early 2001, around the time I started my full-time computer programming job. Since it turned out that I have a knack for programming, I love the challenge and the logical thinking required and the infinite puzzle solving and especially the group of people the job put me with, and I was thinking of "after-hours" contract programming (I was, in fact, doing that for my previous company to help them transition to the new guy after I left), Dr. Fry asked me while I sat in his chair what I would charge to create him a web site. "$125 an hour," I said, the going rate for programming at the time, and in fact the rate I was charging my previous company. "Oh no!" he said, going nearly apoplectic, "that's way to much!" That just showed how much he knew about programming, i.e., very damn little. In fact, he was so disturbed by my quote that he broke off one of those mini-files in one of my root canals that finally, a few years later, caused an infection and I had to have the tooth pulled. That's why I'm seeing a different dentist for my latest root canal. Dr. Fry not only didn't know anything about programming, he apparently knew very little, or not enough, about dentistry.

So, what's the bottom line? It would likely surprise Dr. Fry that the average run of the mill programmer is worth four or five times their salaries to successful software companies. Microsoft and Oracle, for example, earn over three-quarters of a million dollars per year for each of their programmers, although they don't pay the programmers nearly that amount. Most programmers don't know that either. If they did, they would start forming unions to demand better wages. But, Bill Gates and Larry Ellison know it. What do you think made them so rich? How much do those brilliant programmers, such as Vaishali, Phil, Shivani, Mark, Dan-the-database-man, Namrata, Jeyasree and Barbara earn for their companies? Maybe two or three million each per year or more. They can make your iPhone talk while it does the Polka and your credit card safe and secure as it passes through those ambiguous secure socket object layers. Absolutely phenomenal!

We pay dentists way too much. Is there any other conclusion? They are only glorified technicians. Nothing more. Let's have them drive Chevies instead of BMWs. 


1 comment:

Dan said...

Very thought provoking Dave. Maybe 'you' need to check on flights to Mumbai.