…on the other hand, life can be good.

A contrast from yesterday’s blog where I said that many people who work as clinicians are not suited to the job, have made decisions for the wrong reasons and are unhappy.

Dentistry is rewarding in many ways, if you get the design of your job right – and I’ll talk about that tomorrow. It pays relatively well – especially in early years, it is challenging both intellectually and physically, has social kudos, it provides ways of stimulating your interest in different areas as time progresses. There are opportunities to be your own boss, to build a business or businesses, you get to work as part of a team and above all you get the thanks and respect of your patients who you are able literally from cradle to grave.

Take a look at this recent survey from US News about highest paid and “best” jobs and see where a dental degree might take you. I am aware that most of my readers are in the UK (& Ireland) and the reason that I have used this link to help you to see what might, could and should be possible for you to achieve with your degree.

But, and its a big BUT, and at the risk of using a cliche, you must think, look and act outside the box. The climate of fear, in the UK especially, is dividing the profession, helping to keep people down and constantly looking over their shoulder for the next problem. Those who want to serve their patients, who get involved in successful clinical and therefore, business relationships will flourish. Of course there is a need for personal and business resilience to safeguard yourself. Of course you need strong and effective systems to ensure that you can serve your patients to the best of your ability.

Personal and business success is achievable in any country, any jurisdiction and any health system but it will not be delivered on a plate, it takes time, dedication and hard work – if you’re willing success will come, if you’re not then prepare to be disappointed. 

 

You don’t have to do this…”Things They Didn’t Teach You at Dental School”

An excerpt from the forthcoming book, “101 Things They Didn’t Teach You at Dental School”

“This above all: to thine own self be true, And it must follow, as the night the day, Thou canst not then be false to any man.” Polonius. Hamlet, Act 1, Scene 3.

Is Dentistry really what you want to do? You don’t have to.

Many dentists made the decision about what to study at university in their mid-teens. A time of life that is short on maturity, experience and insight. Parents, teachers and career advisers see dentistry as a well-remunerated, socially acceptable profession with a good secure future. 

Unfortunately a number of dentists are ill suited to a profession that makes extensive physical, mental and emotional demands. How many of us have the nerve to say that it’s not what we want?

After 5 years as an undergraduate and carrying a large student debt it is a very brave new graduate who would dare tell their parents and family that they have chosen the wrong subject to study. Humanities and pure sciences graduates would be fortunate to continue with their subjects. It is only the vocational degree where the graduate is able, or expected, to follow the career pathway without a second thought.

Socially, to turn away is akin to leaving your fiancée at the altar, yet an individual is to be admired for admitting that they don’t feel the commitment needed to make a happy marriage. 

Turn things on their head, if you know in your heart of hearts that you are unfulfilled and unhappy being a dentist isn’t it better to say so sooner than later? How many more miserable years do you want to tolerate? How much stress and heartache can you endure once you have admitted to yourself that you’re in the wrong place? 

There are far too many dentists who have plodded on through their BDS and Foundation Training then on to associate posts and partnerships without considering the future or an alternative.

They think this is the way that it has to be, it will get better, easier, less of trial to get out of bed in the morning – next year. Living from holiday to holiday they get little fulfilment from the work they do or the people for whom they are supposed to care. 

Often these are the ones who succumb to the stressors. The use of alcohol and other drugs, gambling or other addictions along with failed relationships are commonplace.

I have attended funerals of apparently happy and successful dentists who have taken their own lives because they could only see that one way out.

These problems are not unique to dentists and many people as Thoreau put it “live lives of quiet desperation”. 

What else is possible? 

Answer – anything that you want to be. There are ex-dentists who are successful architects, writers, lawyers, and musicians. I know a former orthodontist who now builds dry stone walls (and will teach you how to build them too). The discipline of your training means that you are suited to re-train.

Stuck in a government-devised rut, which rewards quantity not quality?

If you want to change then say so, and do something about it. This isn’t a rehearsal; there is no second chance at life, no re-run. If you want to be better, nobody else can do it for you.

 

The Natural Order of Things

John Naughton posted this quote from Douglas Adams on his Memex blog HERE.

“Anything that is in the world when you’re born is normal and ordinary and is just a natural part of the way the world works. Anything that’s invented between when you’re fifteen and thirty-five is new and exciting and revolutionary and you can probably get a career in it. Anything invented after you’re thirty-five is against the natural order of things.”

I agree with the principle but not necessarily the exact ages. It made me think of the “Bell Curve” or as one person in audience corrected me, “It’s a Gaussian Distribution Curve” I have since discovered (stats not being a subject of which I retained any knowledge) it’s also known as normal distribution – or extra normal if you wish. In this case it shows the Diffusion of Innovation Theory.

As Jim Lovell (of Apollo 13 fame) said, “There are people who make things happen, there are people who watch things happen, and there are people who wonder, ‘what happened’?.” In Dentistry I think that most new graduates tend to be to the left of the midline – they are curious, learners, enquiring about the world into which they have been released so they become Early Adopters and Early Majority. As time passes, excitement is tempered by experience in many who want a “simple” life, they get into groove, which becomes a rut which is of course only a grave with the ends kicked out. They slide gradually to the right of the curve and settle into the Late Majority (watching what happens) or eventually The Laggards (what happened?).

Others get a handle on things and hit their straps later on, often realising that their jobs with businesses on the right of the midline are taking them nowhere and so they head in their own direction, start enquiring and looking into alternatives, revelling in their curiosity and enthusiasm. The tide can carry you to the left but it can be hard work and it can sweep past you and, as your energy wanes, you find yourself drifting backwards to the right being passed by “the bright young things”.

I have seen this happen with dental societies that are started with energy, flourish and then consolidate and eventually wither, plus contemporaries who finish up putting in the years until they can take their pension and get out. Other dentists I know have kept striving, looking over the edge, investing in themselves and their businesses loving what they do right until they hang up their handpieces.

  • I love working with Early Adopters and Early Majority people because they keep me on my toes.
  • Innovators tend to burn me out, but that’s fine because it’s a great ride. a blast whilst it lasts.
  • The Late Majority can be fun to push and often convert into “Earlies”.
  • Laggards just can’t see the point of anything.

 

09/2020

“We are providing oral care, not just dentistry, for individuals…”

Stephen Hancocks’ Editorial British Dental Journal 22nd November 2019

“We are providing oral care, not just dentistry, for individuals not just a homogenous bunch plucked from the general public…”

“….One is left in little doubt that the current UDA system of remuneration in England, for example, fails utterly to address such important shifts in emphasis. While it is difficult to foresee a model other than that offered by a private route which would provide an obvious solution it cannot be outwith the wit of clever people to devise systems to allow quality over quantity whilst also enabling livings to be made….”

LINK

 

Come and work for Smile Direct!

The advertisement on indeed.co.uk looking for staff, or should that be “new team members?”, has some interesting comments from the people who have experienced the fun of being part of The Smile Direct community. Take a look and make your own mind up but it smacks to me of a sales driven, under trained, workforce with a high turnover, who have been over promised rewards which are difficult to achieve. Did I expect anything else in 2019?

What amused me most was one of the images on the site, not this typed one:

Rather the one that reminded me of an examination I was taught about but, thankfully, never had cause to use during my long and varied clinical career. I’ll let you imagine why they chose it.

Do dental patients know what they want?

Do (Dental) patients know what they want?

A recent article in the British Medical Journal discussed the instruction from Health Education England that patients and public should be consulted on ‘What they need from 21st century medical graduates’.

I’m reminded of Henry Ford: ‘If I’d asked customers what they wanted, they would have told me – “A faster horse!”’.

Steve Jobs, added: ‘People don’t know what they want until you show it to them.

‘That’s why I never rely on market research.

‘Our task is to read things that are not yet on the page.’

Prevention

If we’d asked people 50 years ago they wouldn’t have mentioned prevention and treatment of dementia in a reply.

Indeed, it is likely they would not have considered prevention at all.

Would they have suggested smoke-free workplaces, public houses and restaurants?

If the same question is asked of dental patients, ‘painless’, ‘free’ and ‘always available’ might be high on the list.

Two decades ago, a desire for straight white teeth without much ‘drilling’ would probably have been included as desirable.

But not considered possible by most dental patients.

The revolution in general (dental) practice driven by a desire to deliver an alternative to disease-driven repair care with minimally invasive, patient centred, cosmetic care was not anticipated.

Similarly, putting dentistry at the heart of general medical care would scarcely be an expectation or demand from most of the population – were they even to be asked.

Yet we know that the future must embrace the concept of ‘putting the mouth back in the body’.

Dentistry’s task is to take Job’s words and not only read but also write things not yet on the page.

Who knows where that might take the next generation of dentists?

First published in Dentistry.co.uk

Oh the places I will go – Part 3 – Bounceback

Part 1 – The World at my feet

Part 2 – The World at my feet – in pieces

18th March 1993

My 40th birthday and a very significant date in the life of my practice. In the wake of the 1990 NHS contract and subsequent clawback of fees a group of dentists in Gloucestershire “held hands and jumped” to remove our dependence on the NHS. Several of us had things in common, we were of similar age, had big loans and couldn’t see how we could square the circle of carrying on providing our best for patients and continue to make a living.

With the assistance of the fledgling group, Gloucestershire Independent Dentists (GID) and supported by each other, in the words of Judith Cameron, we leapt and the net appeared. Some practices changed overnight, I was more cautious and transitioned over a 12 month period, giving all my adult, non-exempt, patients one last NHS course of treatment. This enabled me to have a conversation about the why, how, when and who of the changes. In those days Denplan was just about the only game in town and Gloucestershire became “Denplan county”.

I dreaded making the change, I anticipated wholesale rejection, arguments, insults and my hard work unravelling in minutes. I couldn’t have been more wrong. Because I changed gradually, and every patient received a letter ahead of their next visit plus good PR from GID, the word had got round. I allowed time to talk to explain my motives and to offer alternatives. The overwhelming feeling was one of acceptance, some begrudging, some cancelled their appointments “on principle”, some disappeared and then reappeared. More patients that I expected just said, “I’m surprised it has taken you this long, you have been giving private service since you opened.”

Instead of it being a catastrophe it was a tiny bump in the road. At the same time I started studying with the Open University on their MBA course which was really useful but due to circumstances beyond my control I was never able to complete. I also enrolled with Dr Mike Wise’s year long restorative course which also made me raise my game.

So I found myself with a largely private practice. There was still a significant NHS commitment because of the number of children we had attracted, which took a lot of management but worked extremely well and became a model for others to follow.

Things were looking up, I had managed to get a mortgage after a couple of years of banks not wanting to touch me with a bargepole, had remarried and our son was born in early April.

Life was good and the challenges were under control. The work was no less hard but the road was looking smoother.

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