Are you healthy enough to provide health care?

Re-examine four important areas in your life that could be contributing to your frustration with dentistry and begin the process of renewing your perspectives.

Gregory L. Psaltis, DDS

I often consider how fortunate I am (and we are) to be in the dental profession. Not only do we see the tangible results of helping people, but we also earn a substantial income in fewer work hours and enjoy prominence in our society. Unlike our medical colleagues, we are able to maintain a high degree of independence from the control of outside influences. I tell people that I would not hesitate to enter dentistry again. In fact, I look back on my career decision and find delight that I made such an intelligent choice when I actually understood so little about it.

As a result of my own biases regarding our profession, I never fail to be amazed that some of my colleagues maintain negative attitudes about dentistry. In considering why this might be, I have listened to comments from other dentists to see if their complaints might shed light on the dilemma. There are, indeed, some areas of unhappiness. These comments make me believe that they may not be healthy enough themselves to provide the health care they espouse to their clients.

I have separated these areas of unhappiness into four general groupings, each of which could weaken a professional and create a negative attitude. Reviewing these areas may help frustrated practitioners to begin the process of renewing and revitalizing their perspectives. For those who enjoy the profession as I do, this article should make perfect sense.

Without your own good health, you cannot provide, teach or encourage good health in others. I am not referring to daily flossing and brushing, but rather the sum of how you conduct your life and the result these decisions have on your own outlook. I believe that a private practice is the tangible reflection of the dentist who owns it, and I would encourage everyone in private practice to consider this simple thought.

Is your practice organized, laid back, productive, one big headache, positive, money-driven or any other description that might come into your mind? How would you describe your practice? How do others, including your clients and co-workers, describe it? Chances are that these characteristics of your practice also describe you! Let`s look at the principal areas where unhappy practitioners` lives are out of balance with their own good health.

Debt

Two of my long-time professional consultants told me they were surprised by the number of long-standing, successful dentists who confided that they "have to work another 10 to 15 years" despite being 50+ years old. The usual reason is debts of one kind or another. The debt may be children`s college expenses, a condo in the mountains or, worse yet, uncontrolled credit cards that have spiraled upward into the stratosphere of financial burdens. Anyone with debt that is a part of his/her conscious life probably is affected in a negative way by that debt. In short, it forces you to be in service to the debt when at work, rather than in service to the patients.

It is not the intention of this article to suggest what is a good expense and what is not. But, I certainly would invite anyone with significant debt to simply ponder the following question: How different would it be if you went to work because you wanted to be there rather than because you "had to be there" to pay off a debt? In my mind, the healthy practitioner is one who is at work to provide a service and enjoys doing it, rather than someone who feels it is a burden and/or a necessity to be there.

Just which expenses are really justified if they alter your own perception of why you are at work? It seems that some debts, such as school-loan repayments, mortgage payments and equipment purchases, hardly can be considered to be detrimental. They are all a part of life and seem unavoidable. However, it may be helpful to consider if that 7,000 sq. ft. house or a second Mercedes is worth all the amalgams, composites or root canals it will take to pay it off.

Another aspect of this topic is retirement-funding. I am hardly the first to suggest that Social Security is unlikely to be available by the time I am eligible for it. I decided long ago to assume that future benefits would be minimal, at best, so that I would need to prepare my own retirement. If Social Security still is paying out when my time comes, that`s all the better. But I`m not counting on it.

If you are 50 or over and are not well on your way to funding your retirement, I would think about the advisability of those condos, cars, boats, planes or other expensive toys that may be blocking you from securing your future or postponing your retirement.

Physical health

We place an expectation on our patients that they will take our advice regarding home care, fluorides, treatment and all things related to oral health. I don`t feel it`s reasonable to expect anyone to follow the recommendations of a doctor who is overweight, out of shape, a smoker or in any way physically or emotionally not a model that deserves being followed. I am not referring here to being Arnold Schwarzenneger - I am referring to looking and feeling good in your own body. I am referring to being energetic and positive, which is a model that others will want to follow.

Regular exercise need not be a health club nightmare. Many forms of exercise can be made more fun by finding a partner with whom to do it (like racquetball), creating a family activity (like bicycling or walking), turning television time into exercise time (on an exercise machine at home) or taking a book or audiotape along (on a Stairmaster or treadmill machine).

The key is making the commitment to regular exercise by finding a plan that is effective for you, rather than a bother. Simply walking and stretching can make a tremendous difference. The result of feeling better about yourself cannot be overstated - the higher level of energy and, perhaps equally important, the model of positive healthy behavior that the professional displays before his/her patients and team members.

Attitude toward co-workers

In our media-driven society, sound bites and buzzwords abound. Among those words stands one that lives at the core of our practices: teamwork. If this word strikes you as "New Age," only for "weak managers" or has any other negative connotation, I suggest you revisit the concept. As insurance coverage has made dentistry accessible to more people, our practices now hold the potential for incredible growth. From my own experience, I know that an ever-growing practice cannot be managed well alone. Your co-workers are integral parts of your practice.

I view the front-office personnel as the ears and mouths of our practices, hearing what the patients` reasons are for coming to us and then beginning what we hope will be a long relationship by talking to them and introducing the office philosophy. The chairside personnel are the hands and feet of the practice, accomplishing a myriad of the critical tasks with their hands and controlling the flow of patients through the building. The dental hygienists are the eyes of the practice, more trained to notice how things are going so they can be helpful in seeing things that we, as busy dentists, might conceivably miss. The dentist`s role is to be the soul and the brain of the practice, guiding it with the professional knowledge and the compassionate philosophy that makes your practice what it is.

Some dentists try to "do it all" because they either feel that "nobody can do it as well as I can" or they fear that others are trying to usurp their authority. My experience has been that a healthy team can conduct the business of the office more effectively than I ever could by myself. You only need to experience some type of personal emergency to discover how effectively the dental team can handle the practice.

The team only needs your support and permission to do it. This step certainly can relieve the dentist of a tremendous amount of pressure and anxiety and enhance your personal health.

Patient communication skills

Another current buzzword is communication. We see seminars and articles, if not books, on this topic. Yet, I still hear from my patients that the dentists who refer children to my practice "didn`t explain anything" and "never seemed to understand me" (their words, not mine). Like every human being, patients come into our practices with a wide variety of agendas, only one of which is their dental health.

A shortcoming in our profession is the penchant for overkill in the dental-lecturing mode. Many patients simply want to be heard. Until they sense that the office personnel is genuinely hearing them, they will not be able to take in the information being given them, no matter how compassionately or accurately it is delivered.

If parents principally are feeling guilt over the decay in their child`s mouth, no amount of information will open the lines of communication with them until the over-riding guilt can be compassionately addressed. The same is true of financial concerns. To be sure, we are teachers and our principal area of expertise is, of course, dentistry. If we genuinely believe we are healers, however, the process must begin with something other than a high-speed handpiece or a dissertation. The degree of satisfaction and the sense of well-being that springs from the facial expressions of grateful patients can go far toward filling our souls and facilitating our success with technical procedures. This is a payoff for us as practitioners that never will appear on a balance sheet.

The elements discussed here easily can be expanded far beyond the range of this brief discussion. Many books (see suggested reading list) and courses are available. They can assist any dentist in achieving greater satisfaction, if not profitability, in a practice.

Some colleagues who focus their attention on the "bottom line" of their practices may fail to notice that the old question, "When is enough money enough?" is a cornerstone for frustration. If the goal of a practice primarily is financial, it may never be achieved, since nobody seems to ever have enough money.

The goal of the practice should be firmly footed in:

- A genuine commitment to quality.

- The agreed-upon commitment to make the practice a place where participants (team members, patients, vendors, etc.) are all treated with compassion.

- The belief that the doctor is the role model for all ways of being in the practice.

The result of meeting these goals will be financial success. I can`t help wondering to what degree focus of dental practices has been set in the wrong place. If we are centered on our wallets as our goal, we may be imitating a dog chasing its tail. On the other hand, if our focus of attention is closer to our hearts, the magical and remarkable result is an abundance of financial success that will exceed any previously hoped-for goal.

The health of our practices is very much dependent upon our personal health. The influence we have on our patients and co-workers is more profound in our actions than in our words.

It is my firm belief that we must be healthy to provide health care to others. If we are saddled with debt, not physically well, at odds with our co-workers or providing the wrong help to our patient, the depth of satisfaction we can find in our practices will be compromised. Recognizing these factors and taking positive steps, even one at a time, inevitably will lead to our own improved health and our ability to provide it.