why dont specialists respect general dentists?

[toothking]

its coming to that time of the year where im deciding if im going to be applying for residency. after speaking to faculty and other students why does it seem a good number of specaialists have little or no respect for general dentists?

although increased respect is not a reason to pursue specialist training do the extra years of learning and practicing really make this big a difference compared to just leaving school and attending CE courses? senior classmen, practicing dentists - can you learn to treat interesting ortho, perio, endo and pros cases from these events as ideally id like a wide based practice but also be fairly competant.

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[ISU_Steve]

Ego and territoriality pure and simple. Not that there's anything wrong with it, but it's not necessarily a lack of respect from what I have seen observing, it's just that a lot of specialists have encountered problems with generalists overstepping their bounds in much the way you're describing for your "wide based practice". One of the oral surgeons I know says his job would be much simpler if the general dentists (and I quote) "would know when to say; when their skills are exceeded by the demands of the patient."

I'm not saying you can't competently handle a wide range of cases, I don't know you and I do know a couple of general dentists that I would trust with all but the most complex cases, but it's just not a common ability in my opinion.

 

[lnn2]

why does it seem a good number of specaialists have little or no respect for general dentists?.

I don't think that's true! It's difficult to be a GP because you have to have a broad enough knowledge of everything! The most important thing is knowing your limitation! If you don't know how to handle complications for 3rd, even 2nd molar extractions then refer out BEFORE you do it! same thing for Endo, if you suck at locating molar canals then refer out BEFORE you perf! It's embarassing refering out a screwup case!

Remember, specialists DEPEND on GPs for referals! don't believe that "respect" nonsense stuff! If a specialist's talking smack about me then I'll refer patients to his competitor down the block, run the first guy out of town!

although increased respect is not a reason to pursue specialist training do the extra years of learning and practicing really make this big a difference compared to just leaving school and attending CE courses? senior classmen, practicing dentists - can you learn to treat interesting ortho, perio, endo and pros cases from these events as ideally id like a wide based practice but also be fairly competant.

Those extra years of training make a huge difference, of course! For example, almost all of the molar and RC retreats are done by endo residents at my school. So yes, they can handle any RC cases after 3yrs. But if you ask them to do a crown prep or a simple filling, I bet you that 8 out of 10 will suck at it! The other 2 were born with a good manual dexterity! otherwise, they woudn't be able to do it either

For GPs, everything comes with time and experience. You have to take CE courses (a requirement to practice) to stay up to date on dental materials, techniques.....

 

[drben]

I can tell you the vast majority of specialists respect the skills and abilities of their general dentist colleagues. I realize that GP's have a greater breadth of knowledge in every other dental specialty than I do because they see and treat the vast majority of dental problems.

That being said, the only time I get pissed as a specialist is when some know it all GP tries to tell ME how to do MY JOB (something I spent additional years in the prime of my life training in, and something I do exclusively in my practice). Don't get me wrong, there is a lot that can be learned from experienced GP's who have been around the block, but in the end the expertise and experience of the specialist trumps that of a GP period.

The problem becomes when a GP takes a couple of weekend courses at Howard Johnson University and then becomes convinced that their skills are no longer subordinate to that of a specialist.

It's not about egotism guys, it's about knowing your role in a multidisciplinary approach to dental care.

Ben

 

[12YearOldKid]

It's easy for specialists to get a distorted view of GPs as their livelihood consists of bailing out GPs when they are in over their heads. Of course, it would be nice if you could predict the outcome of every case perfectly and refer before problems arise, but... you can't. And so the specialists are going to get several screwups every year from even the best and most cautious GPs. It's just the nature of the job. Even specialists have plenty of cases that blow up on them; they just don't have the luxury of having someone else to clean up after them.

And of course, there are those who just have egos that need constant feeding. That's why they became specialists in the first place; to make themselves feel important and superior. Look around in your class. There are already people who can't even entertain the possibility of being a GP; it's just not glamorous enough for them. These people are generally not the most popular folks in the class.

But overall, I think GPs and specialists tend to get along pretty well.

 

[lnn2]

Of course, it would be nice if you could predict the outcome of every case perfectly and refer before problems arise, but... you can't. .

I disagree. Let's not kid ourselves, this is not brain surgery. From radiographs, patients hx...you can make a diagnosis and know whether you're capable of treating that condition! If you can't come up with a diagnosis then refer! While you can't predict post-op complications but you can certainly expect the outcomes.

It's easy for specialists to get a distorted view of GPs as their livelihood consists of bailing out GPs when they are in over their heads...

Specialists' jobs shouldn't consist of bailing out GPs when they are "in over their heads" If you're "in over their heads" then you don't know your own limits. Don't bite off more than you can chew. For example, you had done a difficult molar RC, properly! you had seated a crown with post and core. More than 5 months later, there's still PA radiolucency, no improvement. You then have to refer out to an endodontist for apicalectomy (or whatever tx the endodontist thinks appropriate) That's called unexpected post-op "complications" You provided adequate care to the patient. That's not a screwup case. You were not in over your head in this case. On the other hand, if the molar was under/over filled, the post was sticking out on the side of the root then you were in over your head. You didn't know what you were doing. Now, the endodontist now have to bail you out! You shoudn't depend on specialists to mop up your mess. Nobody wants to clean up your ****

Like my OS professor said "THINK!, Look, study the case, don't do it if you don't know how to handle the complications. don't send me the root tips. don't biopsy and then ask me for my opinion"

But overall, I think GPs and specialists tend to get along pretty well.

I agree. We have to! After all, we do need each other!

 

[lnn2]

It's not about egotism guys, it's about knowing your role in a multidisciplinary approach to dental care.

Ben

I second that!

 

[12YearOldKid]

Specialists' jobs shouldn't consist of bailing out GPs when they are "in over their heads" If you're "in over their heads" then you don't know your own limits. Don't bite off more than you can chew. For example, you had done a difficult molar RC, properly! you had seated a crown with post and core. More than 5 months later, there's still PA radiolucency, no improvement. You then have to refer out to an endodontist for apicalectomy (or whatever tx the endodontist thinks appropriate) That's called unexpected post-op "complications" You provided adequate care to the patient. That's not a screwup case. You were not in over your head in this case. On the other hand, if the molar was under/over filled, the post was sticking out on the side of the root then you were in over your head. You didn't know what you were doing. Now, the endodontist now have to bail you out! You shoudn't depend on specialists to mop up your mess. Nobody wants to clean up your ****

I think you misunderstood what I meant by "bailing out". Every dentist is going to be faced with patients and situations where his training and ability/patience fails him. Ideally, this will be recognized before he gets started on the case and the patient will be referred. But EVERY dentist - I don't care how cautious and meticulous he is with case selection - EVERY dentist will get into a case that he realizes he can't finish.

But whether the referral is made before the case is begun or on the rare occasion when it is made in the middle of treatment, the specialist ultimately makes a living by bailing out the GP. He should expect to see the difficult/surprise cases. (If you are going into endo don't expect to instrument too many #7s.) Some exceptions might be pedo and ortho; patients seek these guys out on their own and so they often get to do the slam dunk cases as well as the tough stuff. But practically nobody goes to perio, prosth or endo without a referral and so they end up bailing the GP out on cases he doesn't want or can't handle.

Assuming the GP can finish 99.9 percent of all cases he starts he is still going to have a need for a mid-case bail out once or twice a year when is seeing thousands of patients. The specialist with a referral base of about 15 GPs is going to be getting stuck with somebody else's mess just about every other week or so; it would be easy to get jaded and think that all GPs must be *****s. But the specialists who are willing to help a guy out of a tight situation without making a big stink about it are the ones who end up with a very loyal and frequent referral base. (BTW, if a specialist is only getting crap cases like that; it's usually because the referring dentist doesn't like you. )

That is the life a specialist chooses... and he is paid handsomely for it.

 

[brycethefatty]

its coming to that time of the year where im deciding if im going to be applying for residency. after speaking to faculty and other students why does it seem a good number of specaialists have little or no respect for general dentists?

although increased respect is not a reason to pursue specialist training do the extra years of learning and practicing really make this big a difference compared to just leaving school and attending CE courses? senior classmen, practicing dentists - can you learn to treat interesting ortho, perio, endo and pros cases from these events as ideally id like a wide based practice but also be fairly competant.

The reality is that specialists have to respect GP dentists because that is where their bread and butter comes from. Specialists build their practice by building a large referal base from general dentists. Instead of marketing to the general public (like General denists do) they spend their time wining and dining general dentists until they've built up a strong referal base. Basically, any specialist that bad-mouths or puts down a general dentist is cutting out part of his referal pool.

 

[toothking]

The problem becomes when a GP takes a couple of weekend courses at Howard Johnson University and then becomes convinced that their skills are no longer subordinate to that of a specialist.

It's not about egotism guys, it's about knowing your role in a multidisciplinary approach to dental care.

Ben[/QUOTE]

thanks for your opinion. thats what im concerned about, if you want to learn how to tx plan interesting ortho or pros cases or do surgical extractions is it ethical to take weekend courses at some HoJo near the airport then start practicing?

i do agree with the guys that if a specialist doesnt respect the gp he cuts his own throat

whats your field dr benn?