Dona W. Prince, DDS, FAGD
The physicians were too busy to wake up. They let the insurance companies take over because it was too hard to run a practice and provide care. They were busy with "busyness." They used technology for the answers. "Let`s run another test, let`s use the latest equipment," they said. "Let`s fix this problem."
Where are they now? Some still are enamored with busyness because it makes them feel important. The more patients they see in a day, the better the doctor must be. Some couldn`t take off their masks and be human or see the holy in the person before them. Some believe in the system, and the system pushes technology without ethical examination.
Some physicians refuse to acknowledge the pain they inflict. The good doctors left the system, a few are struggling to make it better, and many are disillusioned. The oxymoron continues. It isn`t a health-care system; it`s a disease-care system.
We need to waken to the physician`s plight before it becomes our own. We can be different. But we need to express our differences to the people we provide care for - our patients.
We can provide health-care services. Private care does provide us with alternatives; but we need to be talking about them. We need to talk to our colleagues. We need to tweak them and make them uncomfortable about what could happen to them. Most of our colleagues are unconscious about their work. It is a means to an end, which, for the most part, is financial.
Technology has separated health care from disease care. It is easy to use technology to diagnose a problem. It`s not so easy to diagnose with our senses. It takes more time and it takes relating to the patient. But in naming the disease in this fashion, it makes the diagnosis part of the healing process.
Cure is a treatment in which the patient is not involved, except for being physically present. Healing doesn`t always mean that the disease is gone, but it does imply a deeper understanding of how it happened, as well as a feeling of wholeness. Our challenge is to give up on the results of curing the disease and allow our patients to heal.
The balance is tenuous. Technology is too easy because it produces almost immediate cures in the dental world. It is easy to get sucked into the power of curing. We feel important and powerful when we cure people. We must let go of the power and let the patient guide us in correct treatment.
Insurance companies pay for cures and patients want cures. It is the easy way; it is a way of not accepting responsibility. A married couple in my practice could not conceive children, but their insurance company paid for fertility treatment. Both were heavy smokers and continued to smoke throughout the wife`s pregnancy with twins.
Where was the doctor`s conscience? Did it matter to him that the lives of these infants were in jeopardy because of the addiction of the parents? Did it matter that the insurance company paid for fertility treatment and yet it did not pay for a smoking-cessation program?
Dentistry cannot lose its higher connections to the dignity of human life. We must consider the ethical responsibilities or lose the privilege of providing care. Do we place crowns or implants in an unhealthy mouth because the patient can afford these services? Or do we do the hard andsometimes unrewarding work of trying to facilitate growth towards health and wholeness in another human being? Our work often falls onto barren soil or soil choked with weeds as the Biblical parable states. Sometimes we are inadequate; other times, the problem lies with our patient. Do we know the difference?
Private care is not the easy road. It is an awakening to the potential gifts that we can bring to our patients. It means that we have to change; we have to do the hard work of becoming. It is a distillation of self through wrestling with the hard questions. It changes us so that we can never be that earlier unseeing, unspeaking, and unfeeling self again.
Dr. Dona W. Prince maintains a private practice in Sioux City, Iowa. She is active in promoting private care through small-group interaction, evolved through the Center for Professional Development. She also is developing a high-tech, high-touch practictice.