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by Barry F. Polansky, DMD
I allow young dentists to observe in my practice from time to time. One day, not too long ago, I had a dentist shadow me around the office. Throughout the day, at certain junctures, I would point something out and say, "My father taught me that." After about four or five times, the young dentist asked me where my father had practiced. Without missing a beat, I said, "Oh, my father wasn't a dentist ... he drove a taxicab for 40 years." The young man looked stunned. He was expecting dental answers to dental questions. Most dentists, especially the younger ones, think dentistry is about teeth rather than life. After a fulfilling career in dentistry, I think all of the trials and tribulations — the tough cases and techniques — taught me more about life than anything else. Maybe it was what my father was trying to tell me so many years ago.
There is a lot more that goes into our work than the concrete commodities. It may appear that patients come to us for a crown, a filling, or a bridge, but what they really come for is our expertise, and that expertise doesn"t begin or end with a crown, a filling, or a bridge. Our expertise consists of our skill level, our care, and our judgment. Skill, care, and judgment. The tangible components, it seems, are what we get measured by, but I believe it"s the intangible factors that add the value.
It's the intangible components that separate the mediocre from the very best. It's the intangible components that transform a dentist into a physician of the oral cavity. It's these intangible values my father taught me that have made all the difference. What I was conveying to the young dentist that morning was that to become a physician of the oral cavity, one has to become a master of the intangibles.
Modern dentistry places inordinate emphasis on the physical attributes of our work. From the minute we enter dental school, we are inundated with the idea that dentistry is a "hands" profession. Dentistry is an art, they tell us. It's almost as if a hierarchy is set up from the moment we go to our first class. We all look over our shoulders to see what the other students are doing and then rate ourselves.
This hierarchy plays tricks with our minds. Unless you had those "great hands," you constantly wondered where you fit in, especially on that day the instructor crushed your wax molar. Well, relax, because I"m here to set you free. Great hands are overrated … always have been. Only those with truly great hands will tell you how important they are. After 35 years in practice, as someone who was never really endowed with exceptional manual dexterity, I completed some really nice dentistry, and most of my success came from those extra added values — care and judgment.
Hold on a second. I am not saying dentistry is unskilled labor — just that you don't have to be Leonardo to get great results. Of course, great artists have great habits, not unlike some of those my father taught me, like "measure twice, cut once." My father was a great planner. It took him forever to start a project. He used to say what so many instructors in dental school told us: "If you don't have time to do it right, how will you get time to do it again?"
Let's go back a few years and read what a couple of the really great artists said about their work. Michelangelo said, "Trifles make perfection, and perfection is no trifle," and "A man paints with his brains and not with his hands." Leonardo once said, "People do not change as they get older. They just become more of what they are already."
These thoughts and ideas have led me to conclude that, through our experience, we get better skilled by taking our time, planning, and really caring about what we do. I once heard someone say that our manual skills do not change after our first five years of practice. I agree.
After my first 12 years in practice, I was lucky to have a master show me how to prepare teeth. Amazingly, just like Michelangelo said, I started prepping with my brains rather than my hands, and that made all the difference.
So the physical or skill component of being a physician of the oral cavity is, as I said, overrated compared to the emotional component … care. Because I realized that my physical skills had a set-point didn"t mean change was impossible.
By taking the time to develop a passion for work and people, improvement is inevitable. But "care" is a tough one for many dentists. It"s that intangible that is hooked to so many other parts of our lives.
Let's be honest, how many really happy dentists do you know (not including yourself)? How many do you know who go through every day in total joy and bliss, completely engaged? I know many who say they"re happy. I was in that category many years ago. I didn't want the world to know I was really indifferent. Is there a correlation between happiness and the amount someone can care? I think so.
In his bestselling book, How Doctors Think, author Jerome Groopman tells us that how we feel about our patients can have a positive or negative effect on our diagnosis. In other words, we can actually misdiagnose based on how we feel about our patients. Maybe how we feel about our patients begins with how we feel about ourselves. Think about that. Can you treat sweet little Mary Jane and Joe the Jerk with total equanimity? Can we go through our days without prejudice? Or do we prejudge?
People are paying us for our care and judgment, the intangibles, and like I said, the physical stuff can be highly overrated. All of this has led me to a chicken and egg conundrum. In becoming a physician of the oral cavity, what comes first — a successful model of practice or happiness? In other words, does success lead to happiness, or does happiness lead to success?
I believe it's the latter. In order to become a successful physician of the oral cavity, the dentist must work on becoming happy first. The happy dentist is fully engaged, growing in his capabilities because he enjoys his work and is able to treat those people who appreciate him for his care, judgment, and skills. All others need not apply.
I believe, like the king of Bhutan, the last Buddhist kingdom in the Himalayas, that happiness is so important that he has made it his goal to increase the well-being of all of its citizens. Bhutan focuses its economic development on the GDH, gross domestic happiness rather than the GDP. What would a dental practice look like that measured its success in happiness instead of production?
So on that day when I was showing the young dentist how I practice, I was really trying to show him the lesson that my father tried to convey to me, and the same lesson that I always tried to teach my own kids: The most important thing is to be happy in your work, and everything else follows from there.
Barry F. Polansky, DMD, practices in Cherry Hill, N.J. Author of the book, The Art of the Examination, and publisher of "Dental Life," he is on the visiting faculty of the Pankey Institute. Send an e-mail to Dr. Polansky at [email protected].