Lifeguard Sunset Catalina Turtle Orange County

Practice Philosophy.....

Even Though I have Retired from Clinical Practice I Continue to Refer Other Dentist Anesthesiologists Who Mirror My Philosophy...

I was born in Pasadena Callifornia and split my time growing up between Arcadia and Newport Beach, sailing and surfing. Our family still maintains a home in Newport Beach. Locals might recognize the pictures that I took above. I have lived in Orange County for 25 years, married, and have raised two wonderful daughters. I graduated both undergraduate and dental school from USC.

During dental school at USC, I realized that many patients were underserved because of special needs, anxiety, failure to acheive profound local anesthesia and a myriad of other reasons. When Dr. Stanley Malamed arrived at the dental school to teach Nitrous Oxide sedation and local anesthesia, I signed up for his very first class. He was instumental in instilling in me the desire to continue to learn throughout my career.

Irealized that there was a need for dentists with exactly the same amount of anesthesia training as physicians, so I applied and was accepted into the Harbor-UCLA Medical Center Anesthesiology Residency. I functioned fully as a medical anesthesiologist, delivering babies, on-call, working up and clearing patients for surgery, performing the anesthesia for open heart surgery and for patients as young as two hours to 105 years old. During the two year residency I only treated a handful of "dental" cases, all of which were emergencies. My training was not "similar" or "equivalent" to medical anesthesiology, it was the same. My name tag read "Physician Post Graduate, Anesthesiology". There are only a handfull of dentists in California who have trained this way.

During that time the chief of Anesthesiology told me "You can teach a monkey to intubate, paralyze the patient and put them on a breathing machine for anesthesia. That is potentially more dangerous for the patient, has a lot of unpleasant side effects, and takes a long time for induction and recovery from the anesthesia. But since your plan is to go back and to serve dentistry, why don't you focus on intravenous techniques and local anesthesia that allow some co-operation, with no memory, but the patient awakes much faster?"

I took his advice to heart and began doing as many spinals, epi-durals, Bier Blocks, and other regional blocks as possible and perfected my sedation techniques to eliminate nausea and memory but acheive a pain free state with a rapid recovery.

When I graduated from the Residency I realized that I could provide hospital services at a fraction of the cost of even Surgi-Centers and I offered my services to dental offices throughout the State. As the only full-time anesthesiologist (non operator-anesthetist) I discovered that the demand was high and widely spaced. I learned to fly and was eventualy rated Commercial Mulit-Engine Instrument and delivered anesthesia everywhere from San Francisco to San Diego and in-between.

As more dentists and physicians came to realize the need for quality anesthesia care in the dental office I no longer needed to fly and have restricted my practice to Orange County. I was a founding member and President-Elect of the American Society of Dentist Anesthesiologists, the American Dental Board of Anesthesiology and the California Society of Dentist Anesthesiologists (first President). I have taught at USC, Loma Linda University and UCLA. I have lectured at both State and national meetings. I continue to teach courses in Medical Emergencies, local anesthesia, nitrous oxide and the history of dental anesthesia. I am also a General Anesthesia Evaluator for the DBC Permit examination.

I have a reputation of having too many rules which I am proud of.   Just like flying and the six years I spent as a Professional Services Reserve for the Orange County Sheriff's Department, I go by the book and follow the rules. For ethically challenged dentists practicing "overhead dentistry", I'm "hard to work with" because I strickly follow safety procedures which takes a little more time.

I believe that the patient's overall health and well being come before the dentistry. I work up my patients pre operatively, consult with their physicians when indicated, do extensive consultations by phone and call my patients postoperatively to check on them. I won't allow the operating dentist to leave the room for hours on end to work on other patients. I won't allow a dentist to leave me alone with a patient. Sometimes in my consultations I discover issues about the patient's health that may delay treatment. I have scores of patients in which I discovered a potentially lethal underlying health problem. All those patients are grateful for my attention to their care and needs. Some dentists see my thoroughness as being too careful, one even told me I had to "learn to take risks".  Rest assured I will never work with that dentist or learn that skill.