The Guidelines for the Management of Patients With Periodontal Diseases, which Dr. Michael Rethman inspired, was published well over ten years ago by Dr. Kenneth Krebs and Dr. Donald Clem and was our declaration of how the patients who need us most can be best approached and treated within the traditional referral model. It was a significant piece of work. While the approach that I take is a direct to patient approach, the goal is the same and that is to assure that needful patients have the opportunity of finding and being treated by the periodontist.
My effort here is to clarify for all who choose to read this what that entails and to give a broad brushstroke to how it can be done.  It follows the real time experience of one doctor, myself, and how I accomplish that goal. By all means, I believe that what I describe is but one way, one methodology of practicing periodontics in today’s environment. However, some of the principles that I will describe here are in my opinion universal.
This might be regarded as intended for the young periodontist only, but it is not. I put some of these lessons into practice well beyond the midpoint of my career and even today, continue to hone those principles. Hopefully, you’ll be smarter and faster than I was.
I realize that I run the risk of getting some upset. Such inevitably occurs when one takes a stand and particularly when one writes about it. I apologize in advance for any upset that I cause. Please understand that is not my purpose. The purpose only is to describe a philosophy that has worked for me for many years in order to possibly help others.
I also understand that I take the risk of writing of something of which you have no interest. Therefore, I am keeping these essays confined to a single thread so that you may choose to read or skip this as you see fit.
As I began this, I did it as a summary statement, primarily as a comment on recent posts.  But as it developed, it became more than that. For that reason, I have divided this essay into six sections. I will publish one section at a time.
I hope to show you how, within your existing practice model, you may improve your ability to provide help to that group of patients who need us most. This document will show how the existing practice model can gradually be changed if you choose to.  It will also attempt to identify and recover the responsibility that we have lost in my opinion. Finally, I will talk about the future as I see it. I hope that you find this to be logical, instructional, and possibly even motivating.
Coming up next: A way of playing a winning game