Wednesday, February 6, 2013

Five Things They Didn't Teach You in Dental School

You don’t know what you don’t know. I wish someone had told me that they call it “commencement” for a reason. Here I was, walking across the stage, donning that famed lavender cap and gown, thinking it was all finally coming to an end. Four years of blood, sweat and tears were finally at a head, and four-day work weeks with voluptuous paychecks were right around the corner. I had given up my twenties for the hum of fluorescent lights in the quiet nooks of the area’s most desolate libraries. But my thirties? My thirties were going to be good.


My first two years in private practice consisted of long, spotty workdays, five to six days a week. Accessing pulp chambers with a quivering hand, one eye closed, and a “Hail Mary” under my breath wasn’t an uncommon occurrence. Exiting the room to grab “another instrument” to buy myself just enough time to run a radiograph by my boss was the norm. Feeling my heart racing under the self-inflicted pressure of thinking I was taking far too long for the patient’s comfort to perfect my crown margins was standard. Sleepless nights and elevated blood pressure readings were more common during the first two years out of school than they had been while I was still in school. Hmph.

The first two years were hard. Really hard. Now in my third year out, I’m in a routine, feeling confident and doing some great dentistry. Here are five things they didn’t teach me in dental school that I wish they had. They might have saved me some of those sleepless nights my first years out.

1. Family, friends, and family friends can be some of the most difficult patients you will ever treat. While it is initially tempting to build a practice off of people you already know, it’s a slippery slope. It is difficult to be objective. I always feel extra guilt that there are standard fees and copays associated with their treatment. While I enjoy treating some family and friends, there are others that I’ve learned are better served by the dentist I work for.

2. Look and act the part. Your chairside appearance and demeanor will gain your patient’s trust far more easily than your excellent hand skills will. The dentist I work for wanted me to try wearing scrubs to work. For the two months I tried, patients either questioned my age or asked when the doctor would be in. A quick transition to business-casual, a white lab coat and a set of heels, and the patients open without hesitation for me to work away. Professionalism isn’t something they spend much time on in dental school, but patients can sniff it out from a mile away.

3. Contrary to popular belief, you will not be buying a yacht your first year out of dental school. But your patients think you will. The only voluptuous paychecks I had anything to do with were the ones I sent to the banks in the form of student loans each month. At the end of each day, I’d reflect back on how hard I had worked, how much I had sacrificed to be where I was. I would question what I had done. My first paycheck (for a two week pay period) was for $213.16, BEFORE taxes.

As scary and frustrating as it is to watch the bills roll in each month when your pay seems nominal, be patient. I’ve learned that it takes time to improve your hand skills, improve your patient rapport, and become generally more efficient. Worry about the treatment you provide and the money will come on its own. Your patients think you are buying a yacht with their crown copay. You have to have confidence in the quality and service you are providing for your patients, because many of them won’t understand the education, training, lab fees and overhead associated with the care you provide. In their minds, that $1,000 check is directly deposited into your personal account.

Don’t let patients discredit your work. Don’t allow finances to sway the treatment options you provide for a patient. It is your responsibility to give patients all of the options and it is their responsibility to decide which option best fits their overall situation.

4. Dentists are your friends. Never put another dentist’s work down. When a patient comes to you complaining of a previous dentist, don’t indulge in their disdain. Unless you were in that dentist’s shoes at the time of treatment, you don’t know the entire situation. Offer condolence that the patient had a displeasing or unsatisfactory experience and move on. Let your own work speak for itself.

5. Unless your friends and family members are in the dental field, they will look at you like you are speaking a foreign language when you tell them that dentistry is stressful. Don’t you get paid well to work a few hours and golf the rest of the week? What’s stressful about that? This career can break you down. The rewards are immense, but not without normal, everyday bumps in the road. Treatment decisions are difficult and patient management can be nearly impossible. Lean on your fellow dentists to work through the normal stresses of the career. If I didn’t have colleagues to vent to and lean on, I don’t think I would have made it through those first two years.

Courtney Lavigne, DMD


Lilya Horowitz DDS said...

Great post! I am a firm believer in the No Scrubs policy. I tend to get the "how old are you?" occasionally but the heels and nice clothes make a big difference.

Pamela Waterman said...

I had so many of the same issues in my first career as a beginning engineer, from confidence to clothes. I have friends and relatives who are dentists, so I hear you on the hard work element. I'm also really psyched there are now so many women dentists and orthodontists - I tend to choose them first, as I know how hard they will work to do a great job. Thanks for these tips I can send to a next-generation dental student I know.

Diana Nguyen, DDS said...

So true! Great post.

Jon said...

Thank you for writing!
Respectfully Yours (always wearing a tie)
Jon Hardinger DDS MAGD
Communications Council

Jared B. said...

As a graduate of less than a year ago, I always enjoy reading and learning from those that have shared their experiences before me. I will take any tips and words of advise I can get. Thank you for sharing!

Anonymous said...

eloquent :)

Unknown said...

Great post Courtney! So many true points! I ordered a snazzy white coat from a Japanese designer and Bam I felt an immense increase in my patients confidence!
Also, how about the fact that treating friends and family sometimes causes us to under treat!

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