Daylist or Duellist?

I was provoked into writing this because the WordPress editor’s spellcheck doesn’t like “daylist” as a single word and kept substituting “duellist” until I got the message that I should write about them both.

One of the most difficult things that I found in making the shift from working with patients to a more fluid, desk based, set up was losing the day list. This creation often had the power to make or break your day. It might leave you on the crest of a wave or crushed by it. It could deliver patients in a comfortable manner who were pleased to see you, or make you feel as if you had been run over by a Springbok scrum.

When it worked well, and when I was a practice owner it usually did, then days were profitable, pleasant and stress was kept to a level that was sufficient to stimulate but not enough to exhaust. This was because the team and I invested time in discovering and experimenting with what worked best for all concerned. It took skill, practice and the ability to learn on our feet, to acknowledge success and failure and knowing that the perfect day was the holy grail of scheduling. Most of theme we scored around 90% satisfaction and I was happy with that.

When I left my own practice and started to work with others it sometimes felt like a throwback to the bad old days of my amalgam bashing youth. There was no control, the gates opened and the day just happened. It is easy to blame front desk people for this and many dentists do, but a team can only do as they are trained and allowed to practice. When they understand that things can be different. Often unfortunately there is no two-way conversation, no comprehension of the others’ point of view and little will change.

Ken James, from Seattle, taught us great lessons in how to make the day pay, for which I was always grateful. Ken was a former olympic basketball coach and it was he who made me think of the combat like element of the day.

If you are letting the day beat you, get some help, it doesn’t have to be that way.

 

 

Gold Crowns, Onlays and Inlays

I was taught to do my own “wax ups” for gold crowns and inlays when I was a student and didn’t enjoy it very much at the time. It was hard work to hold the inlay when trying it in without dropping it, not to mention running the risk of the patient swallowing what had taken hours to make, shape and polish. 

Later on I found that gold inlays and crowns were ideal ways of restoring molars & premolars without further damaging the teeth. It’s a lovely material and, in the hands of a good technician, fantastic to use.

But, and there has always a but, patients weren’t sure about having gold in their mouths. So I used to make two statements and then ask them one question. “Gold is a great material for use in the mouth. You find most gold crowns and onlays in the mouths of dentists, their spouses and their team members. Why do you think that might be?”

My father always taught me that if you had confidence in what you were offering you didn’t need “sales techniques” all you had to do was show the purchaser the path and then get out of the  way.

The Monday Morning Quote #652

Travel changes you. As you move through this world & this life, you change things slightly. You leave marks behind, however small. And in return, life & travel leave marks on you. 

Anthony Bourdain

A Supper Party. A Poem by John O’Donnell

This tickled me this morning. A poem by John O’Donnell

Heard on the ever interesting Sunday Miscellany. LINK

 

 

 

Our house, with two cats in the yard…

 

 

 

 

 

 

I first heard this song nearly 50 years ago, I was hitch hiking from Cardiff to London at the start of a trip that eventually took me to the Greek Islands via Yugoslavia (as it was then). I got a lift in a mini and the driver played Crosby, Stills, Nash & Young’s album Deja Vu on cassette. (I could not imagine anything cooler than having a mini with a cassette player!) All these years on we have two cats in our yard and I whistle the melody of CSN&Y’s song every day…

 

The Weekend Read – Can Medicine Be Cured? by Seamus O’Mahony

Can Medicine Be Cured? : The Corruption of a Profession

I have an instinctive leaning towards any O’Mahony from Cork because my maternal grandmother, Catherine O’Mahony, was Cork born and bred. Stories of, and meetings with, members of the extended O’Mahony family have been some of the highlights of my life. 

This book examines modern medicine through the lens of an experienced physician, researcher and sceptic. This last is defined as, “a person inclined to question or doubt accepted opinions”, and shouldn’t we all, even we idealists, be doubters and questioners?

Dr. O’Mahony writes beautifully, his arguments are clear, concise and well supported. I am a retired clinician but  still very active in what I consider to be still a field of medicine, although I occasionally have my doubts. It was refreshing to able to read what at first appears to be bad news, especially as I get older, that I am not going to live forever and modern medicine will not sustain me into a glorious old age where magical medical interventions will carry me through the vicissitudes of my decline to a point of rapturous departure.

My suspicions are that like every generation before me I will become gradually, possibly embarrassingly, infirm and medicine will do little to reverse that decline. 

One of the author’s conclusions are laid down in the epilogue, “The medical industrial complex is not some vast, organised sentient conspiracy; it is as fallible, messy and irrational as the people who created it. It has become so powerful, however, that medicine has passed the *Illichian tipping point where it is doing more harm than good to the people it is supposed to serve. There are two simple questions to ask of any new development, treatment or paradigm in medicine: first, who benefits? Cui bono? And second does it make life any sweeter? Ask these questions of genomics, digital health and awareness campaigns and the answers are obvious.

*Illichian. 

My thanks to reestheskin, whose review goes into far greater depth than my superficial skim,  for his recommendation of this excellent book. Fine picture from ReesAcres on his web page too.

Book Depository

 

40 Years On….

Today,  April 1st, I have been classed as self-employed for 40 years. That means that I have taken responsibility for ensuring that I keep a roof over my (and my family’s) head, that I acknowledge when times are good and acknowledge that times will not be so good. I have had ups, downs, made mistakes, learned from them (eventually), met some great people and a few, a very few, “less than nice” individuals.

I have tried to ensure that I have worked with people who understand me, care for me, take the time to know me and support me these include accountants, lawyers, financial advisers, insurance people and very occasionally banks. Of course I have encountered dentists both as colleagues, clients and some who even called themselves competitors and who sadly behaved as if we were in a fight for business. I have always believed that there is plenty of work to go around and that if your offering is good, you are straight with people, tell them the truth and don’t try to rip them off you will succeed. You need a team that you can rely on and I have been blessed in working with some marvellous people. My thanks to my teams in practice, nurses, hygienists, practice managers, front of house people, behind the scenes people, laboratories who dug me out of messes and the specialists and consultants who did the same. 

I’m writing this in my studio/office/workroom at ReesAcres (approx 2.6 acres fact) in West Cork where we moved permanently in 2013. For the past twelve months I have rarely left home and can think of no better place to be. Work continues to be interesting and whilst I do miss meeting people and speaking in public, travel itself can get tiresome but I’m looking forward to getting acquainted with Cork Airport again in the foreseeable future.

Most of my contemporaries have retired but I enjoy what I do and, whilst there are people to help with their businesses, careers and challenges, editors wanting copy and all that goes with this life, I’ll keep going. Do I regret 40 years of self-employment? Not in the least. The hills, valleys and roads less travelled continue to keep me in their thrall. When I started out in coaching we had to do an exercise and choose the five values that would guide our lives. After much deliberation and thought I opted for Integrity, Independence, Co-operation, Communication and Curiosity and of all I think Curiosity has guided me most.

Communication has dropped below the level I would like so I resolved this week to write a blog post every day, starting today, if I don’t make the effort nothing happens, one of things that I learned very early on. IADOY It All Depends On You.

The Monday Morning Quote #651

“Most runners run not because they want to live longer, but because they want to live life to the fullest. If you’re going to while away the years, it’s far better to live them with clear goals and fully alive then in a fog, and I believe running helps you to do that. Exerting yourself to the fullest within your individual limits: that’s the essence of running, and a metaphor for life — and for me, for writing as whole. “ Haruki Murakami

Chosen for today because, after a month off my (active) feet with what I hope will be the final attack of Gout*, I hope to renew my relationship with the roads and hills of Castlehaven about the time that this blog is published.

The CQC post-Covid

Quote of the Day. “There is nothing I can think of that the CQC can bring to a post-Covid NHS, other than irritating everyone and wasting their time.”

From Roy Liley’s regular blogpost, I often disagree with what he writes, probably because my experience of working in large organisations is so small to be non-existent. When he talks about the pointlessness of inspections as he does here, he is spot on no matter what size of organisation.

Lilley continues:

“I can’t think of a single thing that anyone, serious about managing a chip-shop, never mind a hospital, could imagine that inspection brings to modern management… neither a jot nor a tittle.
Even before Covid, turning up and inspecting was generally agreed to be futile. 
  • Turn up and it’s good, you wasted your time. 
  • Turn up and it’s bad, it’s too late. 
Everyone knows, page one, chapter one, paragraph one of the dummies guide for managers, says… don’t waste time on inspection.
Dare I quote… again… the grandfather of management gurus, Edwards Demming;”
‘Quality cannot be inspected into a product or service; it must be built into it.’
If you don’t know about Demming, and you should, start here.
My take. The ham-fisted, wrongly targeted, imposition of compliance, in all its forms, has done more to reduce morale, eliminate joy, and distract from the ideals of patient care. It has contributed to making the practice of Dentistry a far more miserable existence than any other single thing over the last 50 years.

The Monday Morning Quote #650

“If you do not tell the truth about yourself
you cannot tell it about other people.”

Virginia Woolf