CONTACTS 
0201 - Steven K. Olsen, DDS.              415 398 4400
020101 - Dr. Steven K. Olsen

SUBJECTS
Cavaties, Fillings, Crowns

0403 -    ..
0404 - Summary/Objective
0405 -
040501 - Follow up ref SDS 25 0000, ref SDS 22 0000.
040502 -
040503 - Curt feels there may be a cavity that was missed in prior check ups,
040504 - which could have caused the tooth to break off.  He recommends an
040505 - examination within the next day or so.
040506 -
040507 - Steve is going on vacation starting on Thursday, so should try to get
040508 - this done before then.
040509 -
040510 - Talked to Jacki.
040511 -
040512 - She set a meeting for 1230 today.
040513 -
040514 -
040515 -
040516 -
040517 -
0406 -
0407 -
0408 - 1230 visited Steve
0409 -
040901 - Curt initially examined the problem.
040902 -
040903 - He advised that some porcelean has chipped off from a crown.
040904 -
040905 - He showed xrays of the crown.
040906 -
040907 - Steve examined the problem and reported that the crown is structurally
040908 - intact.  He suggested grinding off a sharp segment, rather than a
040909 - major repair.
040910 -
040911 - This was done, and the condition seems to feel normal.
040912 -
040913 -
040914 -
040915 -
040916 -
040917 -
0410 -

SUBJECTS
Grinding Requires Retainer, 000613

050301 -  ..
050302 - Grinding Teeth Requires Retainer
050303 -
050304 - Steve reported there is increased wear of specific teeth, since my
050305 - visit just a month ago on 000502. ref SDS 22 0001
050306 -
050307 - He feels this reflects grinding during sleep, and explained a
050308 - retainer can be provided to reduce damage.
050309 -
050310 - I mentioned business issues the past few months that has caused
050311 - emotional tension arising from efforts to develop new technology.  I
050312 - have been aware of frustrations which cause physical reaction,
050313 - including grinding teeth.  This may contribute to the problem.
050314 -
050315 - Steve took some time to point out patterns of teeth wear, which he
050316 - feels are more reflecting of grinding during sleep.
050317 -
050318 - As a result, we will try a retainer to see if this can manage the
050319 - problem of grinding teeth during sleep.
050320 -
050321 - Curt prepared an impression mold of my teeth that will be used to
050322 - build the retainer.
050323 -
050324 -
050325 -
050326 -
050327 -
0504 -
0505 -

SUBJECTS
Medical Practice Requires Records
Medical Management Needs SDS
Bumbling TQM Cut Corners Faster Better Cheaper
Mistakes in Medical Practice Reduced by Com Metrics
Seeing Patient Obviates Need for Medical History

1108 -
110801 -  ..
110802 - Support for Medical Practice
110803 -
110804 - Follow up ref SDS 24 0001
110805 -
110806 - During our visit discussed inquiry from Clarence Braddock on 000611,
110807 - requesting a report on progress at Kaiser to implement requirements
110808 - for doctor, patient communication. ref SDS 24 5538
110809 -
110810 - We discussed briefly the cause of medical mistakes, similar to
110811 - mistakes in other sectors, arises from...
110812 -
110813 -
110814 -           Communciation is the biggest risk in enterprise
110815 -
110816 -
110817 - ...due to an innate feature of mental biloogy called meaning drift,
110818 - explained in the letter on 990924. ref DIP 2 1680, shown in the
110819 - record. ref SDS 18 5576
110820 -
110821 - We reviewed Richard Popejoy's point that Communication Metrics is less
110822 - helpful in dental work, because a dentist deals directly with the
110823 - cause of problems.  A dentis can visually inspect to accurately
110824 - identify problems, whereas a medical doctor is more dependent upon
110825 - explanations of symptoms and correlation with history, because to see
110826 - a problem often requires invasive procedures, which is costly, time
110827 - comsuming, and causes discomfort. ref SDS 2 0866
110828 -
110829 - Steve noted that even in dental work, communciation and understanding
110830 - the record is helpful, which reflects other trades like auto repair
110831 - reported on 990507. ref SDS 15 0001
110832 -
110833 - He suggested a good solution to meaning drift is writing things down,
110834 - and noted having adopted a code system to get more done in less time.
110835 -
110836 - I noted briefly that writing things, traditionally called literacy, is
110837 - helpful.  A meeting at Intel on 000517 showed this method worked well
110838 - for an engineer once on a project in Texas. ref SDS 23 2064
110839 -
110840 - But, many doctors, CEOs, engineers and managers feel they do not have
110841 - time to write things down.  It seems faster at the moment to avoid
110842 - this step, and to defer extra cost and delay because responsibility is
110843 - often transferred to others.  These social pressures and self-interest
110844 - dynamics cause people to move away from literacy through the course of
110845 - a career, as reported on 991108. ref SDS 19 7380
110846 -
110847 - Steve feels the medical profession is particularly reticent about
110848 - improving work practices, which reflects the tension that occurred in
110849 - changing the paradigm from orality to literacy beginning about 400 BC,
110850 - reflected by legend of Prometheus, reviewed on 991108. ref SDS 19 5368
110851 -
110852 - Steve said he would take a look at the letter to Clarence on how to
110853 - move the ball forward to improve medical practice. ref DIP 1 0001
110854 -
110855 - Steve suggested contacting Sequoia Hospital, because unlike Kaiser,
110856 - which is more of a follower, the Administrator and Chief of Medicine
110857 - have sufficient authority to evauluate new methods.
110858 -
110859 -     Thought Sequioa Hospital is where Millie's son Steve, nearly died
110860 -     last year because of mis-diagnosis, but the record on 971107 shows
110861 -     that occurred at Penninsula Hospital. ref SDS 4 0001
110862 -
110863 - Steve referred me to Jacki for an email address,
110864 -
110865 - Jacki advised that Steve does not have an email address, but there is
110866 - one for the office...
110867 -
110868 -
110869 -                    jzelnik@embarcaderodentristy.com
110870 -
110871 -
110872 - Submitted ref DIT 1 0001 linked to this record and to the letter to
110873 - Clarence discussing cause and solution to medical mistakes.
110874 -
110875 - Next day got correction on email address....
110876 -
110877 -                     admin@embarcaderodentistry.com
110878 -
110879 -
110880 -
110881 -
110882 -
110883 -
110884 -
110885 -
110886 -
110887 -