Thinking Ahead, Looking Back

July 1, 2012 | Dental |

Being semi-retired has its perks, and the main one, as of late (besides trying out the many flavours of coffee, leisurely walks or of course shopping) has been… reflection.  Looking back on life and career can be an arduous, caffeine-consuming task.

The main question I ask is:“Would I have chosen to become a dentist again?”

It is a bone-crunching question that has kept me up many nights.

What were my goals for career and life?

All those nasty days at clinic putting on a rubber dam for the first time, or breaking, separating a cusp on a tooth or missing that damn canal on the upper first molar and perfing, or not getting paid by a really nice patient… were these moments really worth it at the end of the day?

Let me begin at the beginning. First, let me confess that I became a dentist because my roommate went to see his dentist who was a female and pretty much cajoled me into writing the DATS… and lo and behold, I was accepted to dental school.  So i don’t have any ‘white knight’ stories of becoming a dentist because i wanted to help people or that I wanted to become a medical doctor but did not get accepted to medical school.  I became a dentist because i had to become something and my horribly, nice, parents would really have been aghast, if i didn’t make something of myself and earn a proper education.

My skin still cracks slowly and painfully, when i think of my fond memories of dental school.  From being screamed at in front of my patients at various times for not clamping the right tooth for the rubber dam, to putting phosphoric acid on the dentin (yup, that would really kill the nerve), to having a yelling match with the chairman of the restorative department for not revealing the name of the instructor who had given me permission for taking an impression of two teeth at the same time!  What a load of crap!

Freshly out of dental school, and my A.E.G.D., I sent out over five hundred resumes back in 1993 and kept getting the response that i needed more experience.  At a crossroad,i finally decided to use my education and hard work to buy myself a job. I bought the cheapest dental office i could find.

That was my first mistake and definitely not my last. For the next five years, even though i worked like a dog, I just couldn’t see myself getting ahead.  I wasn’t in dentistry for the money.  Dentistry was something I went to school for and something for me to have success in.  Success is a funny thing and every year, my definition of it changes with my
new experiences in my aging life.   Success for me at the time meant keeping my schedule busy, making a bit of money at the end of the year and ultimately keeping my patients happy by doing a ‘kick ass’ job on the dentistry.

The next five years were terribly difficult because although I was skilled at dentistry, my business and people skills were non-existent.  As dentists we love to do the techno dance,
bouncing around from one new gadget to the next latest one, or the latest and best technique to the most advanced one.  The lesson of the business of dentistry is the hardest for us and unfortunately we all go into it stupidly naive.

The biggest problem was that i did not understand that your expenses have to be lower than your production.  According to Tim Brown, of ROI Corporation, the total expenses
for dental practices have gone up from 40% – 60% now.  My operating expense was about 60-70% as a new dentist who bought a good patient base but poor equipment and
outdated office furnishings.  Every year, there was an unexpected costly surprise and although my practice was growing, and my dentistry was getting better and better, I was the second poorest paid employee after my hygienist.

This certainly was not the life i had imagined.where was the glamorous life of the dentist jettisoning in my new BMW and enjoying life?  I had stress, stress and more stress.  The leases on the new equipment plus the loan for the practice were eating me up.  Staff turnover was an infection.  Collections were poor, as I didn’t want to discuss the money
aspect of it and let the patients pick how they wanted to pay me.  The funny thing is that when you pick up your $1.68 coffee at Tim Horton’s, they make sure they have
your money before giving you the java.

The average dentist makes slightly more than what they did twenty years ago when the cost of inflation is adjusted into the factor.  I do believe personally that the stress is much
much more so.  With our ever-increasing larger dental offices to more expenses to more staff to more spa-like dental offices, there should be a bigger payback.  If i had not made
changes to myself, my dentistry and my business of dentistry, I would not be telling you that dentistry has been absolutely enriching to my life.

Dentistry is not worth the hassle to be to able to just do an average job with average pay.  I would rather fail than be average.  Dentistry is a very difficult and unappreciated profession that requires very difficult technical skills and relies on the least informed individual, the patient, to make the final decisions.  I firmly believe in patient education but we are competing with that particular patient’s needs and desires.  It is difficult to say no to the cardiologist who recommends an angioplasty and say,“well, I don’t need the heart, just take it out.”  The angioplasty procedure by the way has about a 40% failure rate
within two years* if the patient does not change their lifestyle.

Dentists should work hard, they should plan hard and subsequently earn what they deserve.  Don’t buy yourself a job, but work hard to make a rewarding career out of dentistry.  I would choose dentistry again as a career but without the first bumbling ten years where i was learning to walk. I crawled miserably and fell more than i want to remember.  The most important changes that i made focused on leadership
skills, having set goals, creating a winning team of staff, organizing every minute that I spent in the treatment room, and making my patients feel like they were at home.  It is most important to have a healthy dental office that at the end of day makes you leave with a smile on a job well done and have the ability to drive what you want.

*Data from clinical trials and statewide registries of percutaneous transluminal coronary angioplasty (PTCA) show that between 30 and 40% of angioplasty patients experience recurrent angina, myocardial infarction (MI), death or repeat procedures by 2 years of follow-up.

John P. Allegrante, Mary E. Charlson et al, Improving health behaviours and outcomes after angioplasty: using economic theory to inform intervention, Oxford Journals volume 17 issue 5, p606-618.

Bottom Line:A heart felt account of a semi-retired dentist who looks back on her life and career as a dentist.