Sorry TanMan, likeable alone does not cut it. And why waste an education by simply making a blanket statement that basic science is irrelevant? You paid for that education after all.
As for your thousands of patient visits...not sure that is relevant. Perhaps your vast experience of treatment with ASA 1&2 patients has made you nonchalant. Brushing off patients who question you is a sign of arrogance driven by bottom line mania. Yes, I am all for making money, but not by ignoring patients and risk factors. High end patients with complex treatment plans and medical issues deserve our time. If you only wish to do simple treatments on healthy patients, your protocols may serve you. But spouting that the education we receive in school should be forgotten is a recipe for future disaster and may influence to many young students who read this website. Only someone practicing a very short period of time would ascribe to this line of thought.
Likeable alone does not cut it, but being liked by your patients plays a larger role than most other factors. The most successful dentists are the ones that are also well-liked by their patients. I think this is where we've disagreed quite a bit before.
I may have paid for the education, but unfortunately, I am not going to use all of it. I can relate an experience of "getting my money's worth" and when it's totally not worth it. My gf booked us on a kayaking trip of 20 miles. By the end of it, I asked, why did you book it for such a long route when there was one that was a lot shorter and didn't kill the whole day and my arms. Her response: I thought it's something you would do... "getting your money's worth". I don't want to pay more to get tortured more. I was in it for the experience (4 miles v. 20 miles), not feel like my arms are going to fall off. It's a stretch, but I did not go to dental school to just learn, I went to learn everything that's needed to be a good dentist. Do I need histology? Probably not because I'm not going to look at slides. I have a pathologist that will evaluate and make recommendations for me. Biochemistry... am I going to diagnose any hidden metabolic disorders that the patient may have? Nope, for biochemistry all that matters is that if there's any metabolic issues, I know if there's any dental relevance, contraindications with rx or administered anesthetics/medicaments, management issues, effects on salivary glands, etc... You have to draw the line in to the extent you are going to treat your patient.
Edit: The basic sciences that you learn will eventually be replaced by it's more applied counterparts. One example would be biochemistry gets replaced by pharmacology. Much more relevant, but even then, it's not all relevant. You need to know what medications you are going to prescribe and any contraindications. All you really need to know is what meds they are on, any contraindications to what you prescribe, any metabolic issues, route of excretion/eliminations/pharmacodynamics. Rarely do you have to do any dose adjustments because you're not taking plasma concentrations of these medications. Bad Liver? Avoid APAP or CYP3A4/2D6 meds, Bad kidney? adjust dosing for medications excreted by the kidney. Pregnancy? Avoid medrol and ibuprofen. As a dentist, you don't prescribe that many medications. These mental flowcharts allow you to make decisions on the fly without hesistation. When in doubt, call their physician for the recommendations. Pharmacists will act as your protector most of your time. Good pharmacists will not make you look stupid in front of the patient.
For aspiring students and current students out there, the better way of thinking about your education is: Is this, in any way, relevant to the practice of dentistry that I pursuing (GP, ortho, etc...)? Yes, no, or maybe/I don't know. If the answer is a definite no, forget it after exams. If the answer is yes, then remember it. If the answer is maybe/IDK, then you should ask without offending your instructors. If they are evasive about giving you a clear cut answer, then most likely it's not relevant in clinical practice and only in their academic world.
If there's a chance a patient might die in my chair, I'm not going to see them. Always tell the patient that you care more about their systemic health and safety than getting a procedure or two done. Punt it to the specialist for management. For future GP's out there, the majority of your patients will be relatively healthy and the ones that require advanced management, you should leave that to the trained professionals. In my optimistic first year out, I would try to be more accomodating for medically compromised. There are GPR's out there that are more hospital based. If you want to see those types of patients, you should strive for additional training under those settings. However, as a regular GP, you should not be touching those cases unless you have the passion and training for it. There is definitely a deficiency in dental school training for medically compromised patients, but there's also a bit of a paranoia when it comes to any medical conditions. Some things that come to mind is HTN, DM, and pregnancy.
I always have to remind future dentists out there that it's not just about mouth. Think about the quality of life of your patients. I had a patient who had stage 4 metastatic lung cancer with 4 months to live (according to her physician). She had an asymptomatic broken tooth #30 (needed rct or ext). How would you approach this? I told the patient, if it's not hurting you, just leave it be, if it hurts, we'll deal with it then. Without saying it directly, I said you have bigger things to deal with than this asymptomatic broken tooth. Spend time with your family, get your affairs in order, etc... Life's literally too short for you to spending with me in this chair. I could've done an RCT or EXT, but am I making the patient's quality of life better? I assume she's in a better place now since we haven't been able to contact her.
I'm not saying forget everything, but you will forget a lot of irrelevant subject information. Don't think everything is relevant, it's not. If you can remember it, great, if not, at least remember the important and clinically relevant subject matter. As I've said before in some far off post, I aim for the low hanging fruit of dentistry.
