Too young for this? Advice from other dentists

[HighTechDentist]

Dear colleagues,

I am a relatively new Dentist (completed my residency and I'm out in private practice for < 6 months). But I feel like I'm already grappling with things like burnout, obsessiveness, and lack of empathy for some patients.

Don't get me wrong, most of the time I love my career, and get great satisfaction out of helping my patients. I am satisfied with the work that I do, and find my profession to be rewarding.

However, I do have plenty of days like today. I work in a mostly Medicaid practice, and the patients come fast and heavy. I can see up to 20 patients in a day, sometimes more. I feel my standards are pretty high, however I prepared a few PFMs today, and allowed myself to send out "less than acceptable" final impressions for two. I was extremely backed up, fatigued, and the patient was irritated that it was getting late. Whenever I do anything that isn't up to par, I usually beat myself up over it, but today I let it slide and now I regret it.

I have somewhat OCD tendencies (as many Dentists do), and can often obsess on the shortcomings of a day, as opposed the the greater number of successes.

Am I too early in my career to be having feelings like this? I want to wake up each and every day with a sense that I will always do the best that I can for each and every patient. But...I am always going to have bad days, frustrating cases/patients.

Do other young dentists have these feelings? How do you deal with them?

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[ItsGavinC]

Do other young dentists have these feelings? How do you deal with them?

I've been out of residency for 16 months. Pedo. I see 65-80 patients many days.

You deal with those feelings by understanding that you are there to help. You didn't cause the cavities, you aren't part of the problem. You are utilizing your training and natural abilities to make life better for people. Your work won't always be perfect. It probably won't be perfect most of the time. That's fine. Patients will prefer a nice personality over perfect work. Do good work but leave everything at the office. Being a dentist isn't who you are, it's just what you do when you aren't doing other stuff.

 

[HighTechDentist]

I've been out of residency for 16 months. Pedo. I see 65-80 patients many days.

Do good work but leave everything at the office. Being a dentist isn't who you are, it's just what you do when you aren't doing other stuff.

Thanks, this is very insightful. Four things I have not yet mastered:

1) Leaving the baggage behind at the office every day.
2) Learning to realize that some cases will go better than others.
3) Realizing that patients have different expectations, tolerances, and one patient's cakewalk is another patient's nightmare. (This can frustrate me sometimes)
4) Not letting a bad day bleed into the next. (like dominos, I let a bad day lead to a bad week, month, etc. Suddenly things that were going WELL are not anymore as a result)

I go through such extremes with my profession. Dentistry can be such a source of pleasure in my life...and at times, I think "what did I get myself into?"

-HTD

 

[DrBYoung]

Dear colleagues,

I am a relatively new Dentist (completed my residency and I'm out in private practice for < 6 months). But I feel like I'm already grappling with things like burnout, obsessiveness, and lack of empathy for some patients.

Don't get me wrong, most of the time I love my career, and get great satisfaction out of helping my patients. I am satisfied with the work that I do, and find my profession to be rewarding.

However, I do have plenty of days like today. I work in a mostly Medicaid practice, and the patients come fast and heavy. I can see up to 20 patients in a day, sometimes more. I feel my standards are pretty high, however I prepared a few PFMs today, and allowed myself to send out "less than acceptable" final impressions for two. I was extremely backed up, fatigued, and the patient was irritated that it was getting late. Whenever I do anything that isn't up to par, I usually beat myself up over it, but today I let it slide and now I regret it.

I have somewhat OCD tendencies (as many Dentists do), and can often obsess on the shortcomings of a day, as opposed the the greater number of successes.

Am I too early in my career to be having feelings like this? I want to wake up each and every day with a sense that I will always do the best that I can for each and every patient. But...I am always going to have bad days, frustrating cases/patients.

Do other young dentists have these feelings? How do you deal with them?

You have asked some important questions here (there are actually more than one). I've been practicing dentistry for over 30 years and have treated patients in the military, in dental school environments, private practice as well as short term mission activities. Here are a few recommendations:

1. Pick your working environment carefully. Don't just go somewhere for monetary reasons. If in your gut you don't like the way a place is treating patients, then leave. If you can't leave immediately, then plan your exit as soon as you can.

2. Your attitude should not be determined by the behavior of patients. If it is, it means you have forgotten what it is like to be a patient. Remember that patients who are angry are attempting to exert control in an environment where they feel powerless. Respond calmly and gently.

3. Treat all assistants with great respect. Remember they can sabotage you and you will never know it. You want your schedule to work smoothly? Be kind to the person who appoints patients. (I'm assuming here you are not the owner). If you are, or ever become the owner, the rules really don't change that much. It is easier to treat staff with kindness and respect than it is to always have to be looking for new hires.

4. As a member of the office team, understand that you and the others who work there must get along. This is how you are able to cope with the difficulties patients bring. Your job is to treat the patients and solve specific problems for them, it is not to get them to necessarily like you. If they do, great, if they don't, then at least they should leave knowing you gave them your best.

5. Don't worry about the imperfections of procedures past. They will likely come back and then you must have the fortitude to make obvious corrections. To do otherwise is a big mistake. One of the quirky things about dentists is they often believe because they work in small rooms on little objects in dark mouths that they can get away with schlocky dentistry. The reality is that because patients, assistants and laboratory techs all move around and talk that it doesn't take long for all the dentists in your community and beyond to know what kind of dentist you are.

6. New dentists graduating from dental school basically go in two paths. It's the Robert Frost poem of the two roads diverging in the wood. The one less traveled by that makes all the difference is the one to pursue good quality continuing education. And I don't mean taking a few lightweight courses just to get the CE hours. Of course the problem is it is expensive -- at a time when you have bills, but consider this. If you continue to attempt to treat patients from your basic dental education, soon you will not be able to attract higher quality ones. Also you must quickly move toward developing relationships with specialists. Find nice people who are willing to mentor you within their specialties. This means find endodontists who will help you do better endo and periodontists who will help you do better perio. What is in it for them is that you will quickly learn what to when to hold em and when to fold em (ie refer). You see, there are some patients where it is not worth you treat them. They will suck life out of you -- but then you must be a good enough dentist to keep most of them with you for most procedures.

7. Speed is over rated. If you do more for one patient in one appointment that goes longer you can work out of fewer chairs with fewer assistants and less down time. This means you have to plan your procedures. In other words, when you do your examination, you are not there to find something to do. You are there to establish as comprehensive an examination as you can. Then from this examination you should establish the diagnosis or diagnoses. Next you must explain your findings to the patient along with all reasonable alternatives. Forget what something costs the patient. It is up to him or her (assuming we are talking about an adult with ability to make his/her own decisions) to determine what the treatment will be. Don't diagnose a person's wallet. Some people walk in with old clothes because they like them. Some people dress up with their best jewelry on. It shouldn't matter to you. Treat them all the same and sleep well at night. Organize your treatment plan for efficiency and write yourself real clear notes.

 

[ItsGavinC]

Thanks, this is very insightful. Four things I have not yet mastered:

1) Leaving the baggage behind at the office every day.
2) Learning to realize that some cases will go better than others.
3) Realizing that patients have different expectations, tolerances, and one patient's cakewalk is another patient's nightmare. (This can frustrate me sometimes)
4) Not letting a bad day bleed into the next. (like dominos, I let a bad day lead to a bad week, month, etc. Suddenly things that were going WELL are not anymore as a result)

I go through such extremes with my profession. Dentistry can be such a source of pleasure in my life...and at times, I think "what did I get myself into?"

-HTD

1) You've got to come to terms with this. There are some things you can do to lessen the load. If you really screwed up a procedure then you probably should be thinking about it and what you can do better. Who can mentor you? Where can you get good CE to better yourself? If it is a procedure that you just despise, then consider referring it out. But realize that there are VERY few things you can do to help your practice when you are at home.

2) That's life. Think of it as being an athelete. The top golfers in the world have days when they dominate the course. Those same golfers can play the same course a couple of days later and really blow it. To be a top golfer you simply have to have more good days than bad days. Think about baseball. Awesome hall-of-fame hitters only connect on 3/10 pitches. Seriously! You aren't perfect and your work doesn't have to be. It needs to be good and your attitude with patients and staff needs to be good.

3) Learn to read patients. Some patients you are better off referring. So what if you lose $3k in production if they are a headache the whole time? What would you rather have? Get rid of those 5-10% that suck the life out of you.

4) You are stressing too much. Give yourself a break. Work a shorter day or change up your schedule (alternating between late days and early days) to help you gain new perspective.

Great advice in the post above this one.

 

[ItsGavinC]

One other thing: financial stress will ruin your day no matter how great a dentist you are. If you are in a massive financial hole, try to find something better. If you focus on the bottom line all of the time, your perspective becomes tainted and you don't see things how they really are.

I'm working in an office right now that is NOT glamourous and gorgeous. It's nice and clean, but very sparse. The one thing we didn't skimp on was computer equipment and materials. Everything else (dental chairs, etc) was purchased on the cheap. I treat my patients very well. My overhead for each day (rent, materials and supplies, staff pay) is around $500. That allows me to have freedom. It's a new office and some days aren't busy (5-6 patients for $1000). Other days are busier (15 patients for $3000). But even on those slow days my world doesn't end because I can pay the bills.