After 3 months in practice, I now know why some Dentists Commit Suicide!

[HighTechDentist]

Sorry for the over-dramatic title. I myself am not suicidal, so no worries there. I've been out in "the real world" for about 3 months now, and for the most part it's been great. But, the last 2-3 weeks have been awful for me. I've lost a few patients and had some issues with a pedo patient. Furthermore, my production has slowed down greatly this month. Also, I service a fairly low income population of patients, with poor dental education (poor education in general), many of whom I can't communication with because I don't speak their language. This can frusterate me at times!

Never mind the fact that the majority of my patients are happy. I am the type of person who doesn't let myself relish in the good news, and blames myself for anything bad that happens. I beat myself up, and like dominos, or a virus, I let any negative news chip away at my self esteem, confidence, and the results are exponentially bad.

I'm only 3 months into "real world" dentistry, and it's already starting to effect me. I'm starting to loose sleep. I'm starting to get emotional. I occasionally snap at my assistants. What will it be like 3 years from now? 30 years? Will I make it that long? I have to nip this in the bud NOW.

Are there any practicing dentists out there who have a similar personality? How have you refined yourself to deal with the inevitable negatives that come with such an "up and down" kind of profession?

Is there a book I can read? Something for inspiration?

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[ItsGavinC]

Check out this recent thread: http://forums.studentdoctor.net/showthread.php?t=773873

 

[charlestweed]

Also, I service a fairly low income population of patients, with poor dental education (poor education in general), many of whom I can't communication with because I don't speak their language. This can frusterate me at times!

I actually have more pleasant experience treating these low-income patients (95% of my patients). They respect and trust the doctor. They don’t ask a lot of questions. They don’t read things on the internet and dictate the treatment plans.

Have you ever thought about going back to school to specialize?

 

[yappy]

Do people often "get close" with their internet research? how has it impacted how you do dentistry. It seems like it would be difficult to deal with somone with a large amount of facts they dont really understand and no clinical experience to guide them - yet they're pressuring you to do what makes sense to them... OR win them over in some logical battle that is going to take alot of your time.

 

[DrJeff]

Do people often "get close" with their internet research? how has it impacted how you do dentistry. It seems like it would be difficult to deal with somone with a large amount of facts they dont really understand and no clinical experience to guide them - yet they're pressuring you to do what makes sense to them... OR win them over in some logical battle that is going to take alot of your time.

After a while, if YOU understand the science behind what you're talking about, it becomes a non-issue 99% of the time. Sure, every now that then you'll get someone walking in with 10 pages the printed from some random site that popped up from a Google search that you can't have a RATIONAL conversation with, but those also tend to be the patients that you can't get to leave your practice quick enough.

One of the key things to learn is that when discussing things with patients theres the logical component and the emotional component. If you can keep the emotion OUT of the conversation, then your usually fine. It's when emotion gets thrown into the mix that things often get out of hand.

 

[ItsGavinC]

I actually have more pleasant experience treating these low-income patients (95% of my patients). They respect and trust the doctor. They don’t ask a lot of questions. They don’t read things on the internet and dictate the treatment plans.

Amen to that!

 

[BenDentalMatrix]

It sounds to me that this is more of an "inside" problem (emotions, motivation, self esteem), as opposed to an "outside" one (your office location, dentistry as a profession).

It would be the same even if you were working at a high-end clinic with rich patients.

I suggest you check out some Bob Proctor stuff. He has an amazing program called "Born Rich,' but if you're on a budget, the books Psycho-Cybernetics by Maxwell Maltz, and the Law of Success by Napoleon Hill would also serve you very well. On a purely emotional level, I recommend The Sedona Method (book or course), by Hale Dwoskin.

Be kind to yourself, it does get a lot better.

 

[options13]

The one thing I have learned is that you will have good days and you will have bad days. The more you focus on the bad days the more negative energy there is around you, and not only can your assistants feel it, but your patients as well. Instead focus on the positive. Past 2-3 weeks have been rough for you, but before that it was doing good. I have learned that patients comes in spurts, many months are great but some months can be bad. December is around the corner, and watch you will be so busy you won't know what to do! I suggest learning a way to cope with stress, whether its Yoga (which helps me) or just talking to someone to vent out anger or stress. If you feel like practicing dentistry is not in your cards then try teaching! There are many options out there you have to choose whats right for you, because you have a whole life ahead of you! Just relax!

 

[GTFOOMICT]

Sorry for the over-dramatic title. I myself am not suicidal, so no worries there. I've been out in "the real world" for about 3 months now, and for the most part it's been great. But, the last 2-3 weeks have been awful for me. I've lost a few patients and had some issues with a pedo patient. Furthermore, my production has slowed down greatly this month. Also, I service a fairly low income population of patients, with poor dental education (poor education in general), many of whom I can't communication with because I don't speak their language. This can frusterate me at times!

Never mind the fact that the majority of my patients are happy. I am the type of person who doesn't let myself relish in the good news, and blames myself for anything bad that happens. I beat myself up, and like dominos, or a virus, I let any negative news chip away at my self esteem, confidence, and the results are exponentially bad.

I'm only 3 months into "real world" dentistry, and it's already starting to effect me. I'm starting to loose sleep. I'm starting to get emotional. I occasionally snap at my assistants. What will it be like 3 years from now? 30 years? Will I make it that long? I have to nip this in the bud NOW.

Are there any practicing dentists out there who have a similar personality? How have you refined yourself to deal with the inevitable negatives that come with such an "up and down" kind of profession?

Is there a book I can read? Something for inspiration?

You need a reality check and see where your position in the world is and how great it is, AND how much it is nearly 100% in your control.

Inspiration? You have a job that can not be reached in terms of income, quality of life, and job satisfaction by a majority of americans, let alone the world.

This sounds like a YOU problem and not a problem with dentistry. Own your problems and decisions.

 

[KHE]

Sorry for the over-dramatic title. I myself am not suicidal, so no worries there. I've been out in "the real world" for about 3 months now, and for the most part it's been great. But, the last 2-3 weeks have been awful for me. I've lost a few patients and had some issues with a pedo patient. Furthermore, my production has slowed down greatly this month. Also, I service a fairly low income population of patients, with poor dental education (poor education in general), many of whom I can't communication with because I don't speak their language. This can frusterate me at times!

Never mind the fact that the majority of my patients are happy. I am the type of person who doesn't let myself relish in the good news, and blames myself for anything bad that happens. I beat myself up, and like dominos, or a virus, I let any negative news chip away at my self esteem, confidence, and the results are exponentially bad.

I'm only 3 months into "real world" dentistry, and it's already starting to effect me. I'm starting to loose sleep. I'm starting to get emotional. I occasionally snap at my assistants. What will it be like 3 years from now? 30 years? Will I make it that long? I have to nip this in the bud NOW.

Are there any practicing dentists out there who have a similar personality? How have you refined yourself to deal with the inevitable negatives that come with such an "up and down" kind of profession?

Is there a book I can read? Something for inspiration?

I'm an optometrist. The only reason I'm posting here is that the thread title caught my eye.

I would suggest a therapist. And I"m not saying that glibly or in a sarcastic way.

You're dealing with a discrepency between what your expectations were and what you're getting. That is preciesely what makes people "nuts."

People don't get angry or upset when bad things happen. If my car is making a clunking noise and I take it in and the guy says I need a $3000 job to fix it, I'm not upset because I expect it.

If I take it in for a routine oil change and they tell me it needs $3000 worth of work, then I'm pissed off.

So again....people get upset not when something bad happens to them but when something bad happens to them that they are not expecting. I think that's what you're dealing with and a therapist can help you redirect your thought processes in a way that makes your life and career work better for you. Try it.

 

[bigstix808]

I'm an optometrist. The only reason I'm posting here is that the thread title caught my eye.

I would suggest a therapist. And I"m not saying that glibly or in a sarcastic way.

You're dealing with a discrepency between what your expectations were and what you're getting. That is preciesely what makes people "nuts."

People don't get angry or upset when bad things happen. If my car is making a clunking noise and I take it in and the guy says I need a $3000 job to fix it, I'm not upset because I expect it.

If I take it in for a routine oil change and they tell me it needs $3000 worth of work, then I'm pissed off.

So again....people get upset not when something bad happens to them but when something bad happens to them that they are not expecting. I think that's what you're dealing with and a therapist can help you redirect your thought processes in a way that makes your life and career work better for you. Try it.

i completely agree with you about stuff happening unexpectedly... but how do you deal with the high number of px's that come in for a "filling" just to find out they need a RCT (root canal) costing extremely more than that "filling"?? not from a tx perspective, but explaining THAT to the px ... over and over again ...

im only a student so im curious of how a provider deals with this on a regular basis...

[and yes, KHE, i do realize you're an optometrist ... my question is just a general inquirey]

 

[KHE]

i completely agree with you about stuff happening unexpectedly... but how do you deal with the high number of px's that come in for a "filling" just to find out they need a RCT (root canal) costing extremely more than that "filling"?? not from a tx perspective, but explaining THAT to the px ... over and over again ...

im only a student so im curious of how a provider deals with this on a regular basis...

[and yes, KHE, i do realize you're an optometrist ... my question is just a general inquirey]

For something like that, you'll probably have plenty of opportunity to practice giving that "speech" before you graduate and I'm sure you'll come up with something that is highly effective and minimizes the shock and pain.

I guess the only advice I can offer is that whenever you have to give someone bad news, whether it's about an expensive root canal, or about someone dying, or firing someone, or anything in life really, the best way to do it is to just look them directly in the eye and as calmly as possible, just say it.

 

[Edentulator]

I'm at the same point in my career as you are, and I can relate a bit to how you're feeling. I have also had ups and downs ranging from the endo treated tooth I tried to extract, which ended in referral to an oral surgeon, to the broken endo file, to the pedo patient who started to trash the office while screaming profanity...Then there was the geriatric patient with dementia who kept trying to punch me. I've had days where 60% of my patients have cancelled/not shown up, and hated myself for feeling so bitter toward them.

On days like that, sometimes I go home and feel like I don't deserve to be a dentist, because there are so many dentists out there who are much more skilled than I am, and I wonder why I thought that I'd enjoy dealing with some of the more awful patients. Then I remember the patient who couldn't stop crying at her first appointment, and after her third or fourth, told me that I had given her the best experience she had ever had and her fear was gone. Or the pedo patient who was so interested in my explanations that she told me she wanted to be a dentist...Or the patients who like me so much they refer their children, friends and relatives to me. Then I remember that I must be doing something right, and while nobody is perfect, you can't control absolutely everything and there are always going to be challenges to get through.

I also make a conscious effort to leave the stress at work. When I get home, I remind myself that being a dentist is my job, and what I do in my personal time is my life, which I'm in complete control of even if things go wrong at work. Sometimes I have to tell myself "I'm not going to think about this right now," which can actually work quite well with some practice.

You may also want to keep a journal. Sometimes being able to pinpoint what you're feeling and what the triggers are can help to keep things in perspective. I find sometimes if I write about something, by the time I'm finished, the bad feelings have started to fade. And sometimes rereading entries and trying to look at them objectively helps me to put things in perspective and lets me learn from my experiences, forgive myself for things I could have done differently, then move on.

If that doesn't work, I browse SDN or volunteer for events at the dental school, where there are a lot of people who would give anything to be in my place. I remember all the hell I went through to get to this point, and remind myself that compared to most jobs out there, being a dentist is pretty darned good. 🙂

 

[DentinBond]

It will help to mentally divide your challenges into three areas:
-What is within your control (mostly your own reactions to things that happen; also to some extent technical aspects of dentistry).
-What is within your influence, but not completely within your control. This is a far larger area than what is within your control! You can influence patients, staff, aspects of your business, but you cannot control them completely. This is even true of technical aspects of our career. You can minimize the chance of a rotary endo file breaking, for instance, but you cannot fully control even that.
-What is outside of your control and influence. Like, the larger economy.

Being realistic about this ahead of time makes it a lot easier to gracefully accept outcomes that are less than we desire, and to manage our emotional reactions to them.

Books? Well, at just 3 months out, you're probably right in the middle of "The Dip", the part of learning something where it just begins to get really hard because you realize how far you have to go to become really excellent, really superb at whatever it is. In Malcolm Gladwell's Outliers, he makes reference several times to the well-established fact that it takes 10,000 hours to become truly excellent at something- anything. This is how human beings are, there are no shortcuts. It's a great book.

And Seth Godin wrote The Dip to deal with this exact challenge. Short, very readable- great stuff.

His Linchpin is the most inspiring book I can think of in recent years though. I was at his book launch and the Q&A session afterwards, I've studied with him a bit- he's onto something very important with Linchpin. I believe that it would help you prevent this damage to your self-esteem that you mention by showing you the larger picture of what you're doing, what your role is in society. What you're capable of accomplishing, and what kind of difference you can make.