The Grass Was Always Greener

Another posting from an angry / disillusioned middle aged dentist on a bulletin board.

The usual content – I can’t wait to get out, I’m only holding on for my pension/next new contract/someone to buy me out. As ever there was the associated blame game GDC, BDA, CQC, Government, politicians of all hues, patients, banks, Dental School overproduction and so on. Along with this comes the hankering after the Golden Age when things were good, when you could make a good living without intervention and so on.

So when was this Golden Age was when the grass was greener, the days were sunnier and the sea warmer?

Tobias Smollett’s Humphrey Clinker felt the same in 18th century, “was the world always as contemptible as it appears to me at present?” he exhibits the common vice of old men “tiresome, complaining, a praiser of past times”.

According to Horace the middle-age have always been moaning about things. My mother, like many mothers, used the litany “I don’t know what the world is coming to” from the first day I can remember, until her mind finally went.

It made me wonder about “Dentistry’s Golden Age”. It strikes me that the Golden Age of Dentistry (or of anything) took place in the years just before you joined it. So depending upon your age that will be just before the last new contract (2006), the contract before that (1992), the last hike in patient charges or the last change of government.

The principals in my first practice (who were 5 – 10 years my senior) told me that, everything had changed for the worse but the dentists before them had had it pretty good. They in their turn no doubt could point to the generation that flourished when the high speed turbine was introduced circa 1960. Of course in the years just after the introduction of the NHS it is fair to say that dentists were faced with an ocean of disease and had little choice but to fill their boots. That particular Golden Age ended in 1951 when, to raise funds for a war, the government introduced charges for prescriptions and dentistry.

I think you can get my point here.

To those who came after me let me tell you about the Golden Age that I lived through:

  • General Anaesthetic sessions in practice where 20 or more children had anything from 1 to a dozen teeth removed in a “sniff and snatch” session at the end of which would be 3 or 4 Dental Clearances and the delivery of approximate, “fit where they touch” full dentures.
  • An acceptance that the route was a filling, a larger filling, a crown, then root treatment, extraction and denture.
  • Periodontal disease was something that could be neither cured nor treated.
  • Where composite fillings were mixed from two pastes and set before you got them to the mouth in summer and seemingly never in winter.
  • Where occlusion was only about straight up and down movement.
  • Where orthodontic treatment for the majority was, upper fours out and a removable appliance to retract everything else – hence the ‘British straight down the throat’ appearance.
  • Where one serious option for a cosmetic solution was extraction and a plastic denture.
  • Etc

Not so much Golden as Silver (Amalgam).

Then that all changed for me. In the space of 12 months I had a turn around, a paradigm shift or whatever you want to call it and refused to accept the lessons that I had been given. So I wouldn’t take teeth out that didn’t need to be removed, I did believe that people were given teeth for life and it was my role to help them keep them for as long as they wished and that gum disease could be controlled.

I learnt to take a long view of my patients dental health and that the relationship was between the patient and me and not a third party.

A few short months later I realised that I would have to remove myself and my patients from the shackles of the NHS which was being increasingly driven by political fad and dogma. It took courage but it wasn’t impossible. My friends who hadn’t, didn’t or wouldn’t convert said the usual, “they wouldn’t have it round me”, “they don’t value what I do” or “I’m committed to the NHS”.  I was never convinced by their reasons but I made my own Golden Age and I see others enjoying their own Golden Age now.

So where is this going?

It’s up to you to create your own future, to build your own Golden Age. Companies like Shell build their businesses by looking 25 years or more ahead, politicians rarely look further than the next election. Which model will deliver you greater success and happiness? Yes you have to be agile as a business, you must know which way the wind is blowing and learn to respond to trends both social and economic. But you must also decide on how you will live your life and run your business.

Ask yourself, “If I wasn’t starting from here what would I do? What would I want to achieve? How would I go about it?”.

Take out the politics. Look at your patients, their diseases, their elective needs and wants and what would you do that is different from the way that you live your professional life now? Is that the right thing to do? Or not?

What’s stopping you from creating your own Golden Age?


Published by Alun Rees

Dental Business Coach. Analyst. Troubleshooter. Consultant. Writer. Presenter. Broadcaster.

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