A Few Good Men immortalized the scene between young Jag officer Lieutenant Daniel Kaffee played by Tom Cruise, and the crusty older marine Lieutenant Colonel Matthew Markinson played by Jack Nicholson. Nicholson, while on the stand in a military court room, is being cornered by Cruise when Nicholson asks: “You want answers?” Cruise fires back, “I think I am entitled. I want the truth”. To which Colonel Markinson (Nicholson) yells: “You can’t handle the truth”.
Too often, I patiently listen to owner doctors describe new graduates as entitled, lazy, incompetent dentists with the work ethic of a 10-year-old and the commitment of ferret. Young associates describe owner doctors as a borderline criminal, deceitful, greedy liars that pay pennies while they take home all of the profits. I might have taken a little liberty in the adjectives to leave out four letter words, but I think you get the idea. Both point their fingers at the other along with 100% of the blame for any failed associateship. When this happens, the profession of dentistry is broken into two different camps: The owner vs the employee dentists. A “we vs they” situation that sours associateships from both perspectives. Can you handle the truth?
Add to this poor, out of proportion perspective of associates and owners, the choreographed result of “learned hopelessness” and we see the result of victim mentalities in young dentists appearing in almost every post on social media. The topic of unfair student debt, poor preparation from dental schools that have lost sight of what it takes to get hired after graduation, and job opportunities gone bad. I want you to take the time and view this psychology experiment with a class of students to understand the long-term harm and innocuous way that too many young doctors view their situation.
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Learned hopelessness or helplessness is when an individual continuously faces a negative, uncontrollable situation and stops trying to change their circumstances, even when they have the ability to do so. What compounds this hopelessness is social media and print media where the only stories you hear are about successful practices with doctors your own age. I mean, anyone would walk away feeling like a” loser” or just stupid or confused. Bottom line is that dentists are in the top 1% of intelligent and talented people in the world. Even the average practice produces profits that put your take-home in the top 1-3% worldwide. There is not one challenge that the current group of young dentists cannot easily overcome in a span of 5-10 years in a career lasting well over 3-4 decades. You have already won. It takes only a commitment to continued learning and never backing down. Be the person that always goes for two points instead of one. As a perspective, when you have a 50-year dental school reunion, you will be surprised at the doctors who as students couldn’t walk and chew gum have successful dental practices and a wonderful life. Once you leave dental school, grades mean nothing. It is a whole new ball game. Your prior performance doesn’t have to be an indicator of present and future success. Generally, it just takes the right mentors, a change in attitude, losing your excuses, and being persistent. Stop comparing your success to that of some other dentist. You get to define what success in dentistry is for you.
While walking through the stables of the Fort Worth Stock Show, I noticed a pen with a beautiful horse and surrounding the stall were about 40 trophies and ribbons along with a sign saying: “Put on your big girl panties and deal with it”. If, and certainly I would suggest you have already read the four articles prior to this one, you will know that I am not a fan of giving you a pass or a participation ribbon. Stand up and take responsibility for your results and lose those tired excuses and start finding the future you always thought you would have. Anything is possible. That is the real truth.
Since we have spent several articles about what an associate should look for in an office they would consider working in, let’s agree that neither perspective is correct and that both aggrieved parties have some truth but each lack the knowledge or view from the other side. It’s a case of the old “pot calling the kettle black” (keep in mind that both the kettle and pot sat over the same fire that discolored their metal). There is always blame enough to share. If in fact something does not work out, a great attitude to take is that it is at least 50% your fault. When discussing associates and their employers: Sometimes you win and sometimes you learn. Make every job, every failed situation a learning opportunity to not make the same mistake twice. In life, I have found that there really were no mistakes, just lessons. It seems the world allows you to have these “lessons” repeated until you actually learn something. You will know that you have learned something when you change your actions and attitude.
In no particular order, I would like to bring up some facts and perspectives that you need to use in order to successfully apply the list of red flags we have already discussed. Like it or not there are some hard to accept lessons in this article. Get ready, here comes the TRUTH.
I mentioned this once before, but it bears repeating: There are no perfect jobs. Every job opportunity has the potential for greatness but will probably fall short of actually being perfect. You get to decide to roll with the job, fix it, or leave. The challenge will come down to those of you who think the next job will solve all of your problems. This is kind of like that old country song about a guy who has failed at every relationship and blames everything on the women he married and ended up divorcing: No Matter Where You Go, There You Are. The funny thing about doctors that seem to keep striking out at finding a good job: the only constant was that they were present in every case. Just makes you wonder. Even in a poor result, the winners in life learn from their missteps.
Your dental schools did not have the curriculum or the training to give you a successful start in real world dentistry. With very few exceptions, dental schools are failing at training competent dentists for the real world of dentistry. In most cases, the cost of your education did not actually give you the ROI you deserve for four years and hundreds of thousands of dollars in school costs. You need to ask yourself why in the world would anyone need to take a GPR or post graduate training after dental school unless dental schools failed you in the four years, they had to train you to be a dentist? Certainly, money and profits have nothing to do with this. Surely the professors that taught you were competent at the practice of dentistry. But if they were, why were they now teaching? Surely, some are trying to give back to the students what they themselves had learned. Maybe some found that the practice of dentistry was too stressful, not profitable, hard to get started, so they went to work for the dental schools at $20/hour to share their lack of expertise to the student body. Maybe it’s just me, but I just don’t understand why dental schools are blind to their own results. Surely, in the real world, most dental schools would not survive the lack of results they continue to proffer. I’m sure it’s more difficult that revamping the curriculum, requiring some of the useless classes we took in dental school to be a college requirement for medicine and dentistry. Maybe academians don’t understand the importance of the business of dentistry or there would be competent professors teaching practice management. I just don’t know. Maybe the fact that dental schools are failing their graduates being commonplace, makes no common sense to me. Maybe you should strike this second truth. I will try to do better with the rest of them. Then again, can dental schools handle the truth? There has to be a better way to create a better result for the money we pay for our education. Just saying: accountability goes both ways.
In life and in work, you get what you deserve, not what you want. Wanting is never enough. Man plans and God laughs. Shift happens year to year. Any relationship or job depends on what you put into it. Hopefully, if you have read and reread the previous articles, you will do a better job of weeding out the poor choices and taking a job with as many positives as you can find. The stage is set, and now it depends on you to make it work or to quickly realize your mistake and move on. Hopefully you don’t become one of the recidivistic failures I see on every dental social media group. If you have done your homework, you need to step up and be accountable for your success or failure. The trick for me is to take the attitude of “ready, fire, aim”, instead of “ready, aim, fire”. Too many of us get stuck at aim, aim, aim, and never take the shot. You miss every shot you don’t take. The trick is to fast track the learning cycle while learning something every time you fall short. An expert is someone who has failed at something more than anyone else. Learn from those that have been where you are, so you don’t have to reinvent the wheel. Take the knowledge of others and thank them for the head start.
Lose the “victim” attitude. Nothing is worse than the person who always puts their failure on the shoulders of everyone else. It was that owner doctor, that poor staff, the lack of patients, poor systems – you get the idea. These folks act like everyone is out to get them. When things are not going well, always look in the mirror: It is usually you. Too many set themselves up for failure and are surprised when it happens. Wake up. If you find yourself constantly falling short of the results you desire, remember that everything you do is precisely designed to give you the results you are getting. If you don’t like your results do something different. In fact, do everything different. Some truths are bitter to swallow. Do it anyway.
Every day you need to show up early, ready to work, with a self-motivated attitude regardless of the challenges, and know that this will be a great day. No one wants to always be your cheer leader. Gold’s Gym has a sign over the free weights: “Pick up your own weights, you mom doesn’t work here”. Live in the moment. In the poem The Station, by Robert Hastings, he makes an incredible but true statement: “It isn’t the burdens of today that drive men mad. It is the regrets over yesterday and the fear of tomorrow. Regret and fear are twin thieves who rob us of our today. Regret is reality, after the facts. So, stop pacing the aisles and counting the miles.” This is the foundation of hopelessness. There is rarely anything that persistence cannot overcome. Are you handling the truth yet?
Positional authority can kill your career. When you graduated from dental school, you were given a diploma that gave you the title of doctor. “Doctor” is a title that gives you positional authority that you have not actually earned. If you walk into a new job and speak down to the existing team while lauding your doctorate and limited knowledge of clinical and dental management, you are guaranteed a job failure. Your position in life, even with that Dr. in front of your last name, is to learn from others. God gave us two ears and one mouth, use them in that order. Listen twice as much as you talk. An attitude of serving the patient while learning your trade will carry you a long way. Many doctors, too often, have a great self-image for no apparent reason. As graduates of a dental school, you are just barely not dangerous. That diploma is just a learner’s permit. A great attitude is to consider your team as partners rather than underlings. You stand side by side with each team member you interact with to serve your patients. Take and share ideas and use their counsel to grow in your knowledge. This is the team’s truth.
Sad but true, no one wants to hire a recent graduate from dental school. Most, even DSOs, would rather you have worked somewhere else before they hire you. They, the hiring office, consider previous job experience as a wake-up call and attitude adjustment that they don’t have to deal with by hiring you. They want you to understand your place in the dental community. They would prefer that you have already made a lot of rookie mistakes and learned to adjust your expectations and attitude to adapting to different situations. They hope someone else has smoothed your rough edges, allowed you to realize that 70% of what you learned in dental school was worthless, and that you really did not get a real-life education before you graduated. Dental schools are decades behind having a curriculum that would ready you for ownership or practicing dentistry. If you are reading this and still in school, try to double the requirements in clinic. Spend time going the extra mile and get more deeply involved in endo, pedo, ortho, perio, oral surgery, and advanced clinical techniques. Spend your evenings taking inexpensive but priceless classes online from Dentaltown and Dental Economics to broaden your education on everything. Start in your first year to seek out training on practice management because you will get “0” in dental school. Graduating from dental school and being a useful addition to most offices is a myth. Be the 1% that go far beyond what you are taught and search out a deeper understanding of the basics you are afforded in school. The truth is that great offices to work for are busy, and they expect a certain level of competency from you the day you are hired. Certainly, they want to help. But they rarely have the time to onboard you in an ideal way when we look at basic clinical dentistry. That ideal way does not include teaching you the basics of clinical dentistry and improving your case acceptance and people skills. This is the hard truth for those graduates with a great self-image for no apparent reason.
The team in an office you work for can end your time there. While the culture of the office should be the result of an owner doctor with vision, it is far more likely to be driven by the team. The process of being hired should be a shared responsibility of the owner and the team but is rarely done this way. If you have been hired without the go ahead from the team, you may face a daunting task of survival. Often times, if done incorrectly, your hiring can become a bone of contention with the staff. They will put you under a microscope, compare you to their owner doctor, and unless you exceed that difficult comparison, your job will be in jeopardy. Hygienists will see the aftermath of your work and be very critical. If you don’t meet their expectations, they will direct patients away from your schedule and on to the owner’s. If patients complain or need things adjusted or redone, the front desk will be the people that have to clean up your mistakes and they too, can end your time at the office. It is like death from a thousand paper cuts. All at once or a little bit a time makes no difference, you will not survive if you don’t meet or exceed the expectations of the team, and this is often times a moving target. Consider your time in dental school an opportunity to get to that point of competency in all you do so that later when you are on the real job, you will look good. Thinking someone else will want to hold your hand is a hit and miss type of perspective. It is rare indeed.
Patients can end your job. Most, if not all, of the patients that you will see would rather see the owner doctor, not you. That is one huge strike, maybe two, against you and you haven’t even worked on them yet. The good news is that most practices you work for don’t have very good associates or owner doctors anyway. The bottom line is that you have to appear “remarkable” to any patient you meet or work on. Admittedly, in most offices this is a rather low bar to exceed, but you have to be different in a good way from the perspective of the patient you work on. Maybe you could make a pre-appointment call just to introduce yourself and ask if there were any questions you might answer for them before their appointment. Add to this a post visit call that you make for every patient you worked on that day. I did this for every new patient I saw, even hygiene new patients. I never had a patient that did not comment on how special this made them feel. How about writing a terrific patient card to every patient you stuck with a needle every day you work. I did this for 37 years. Can you image what it feels like when your dentist sends you a short, handwritten card praising them for being a good patient and asking them to refer their friends and neighbors? In a world of texts and emails along with automated AI calls, a card like this makes you look remarkable. If you are thinking that you don’t have time to do this, you certainly will never have time to have a super general dental practice with 80% direct referrals. It takes a different mindset to be successful in dentistry. Odds are, you have never heard of doing something like this because up to now you have learned the basics from doctors who were never successful in the real world of dentistry where there is a dentist on every corner and patients vote with their feet and wallets. No one needs another “average” dentist and average dentists are challenged to make it in a great office and rarely do. Commit to being remarkable in the eyes of every potential patient. With two strikes against you from the start, it only takes one little snafu and both that patient and your job is history. The truth hurts but sugar coating this is worse. Like being voted off the island by the team, patients can also short circuit an otherwise great opportunity. Your title of doctor only allows you a time at bat, you have to earn the respect of everyone around you. It isn’t a given, it requires staging everything to be successful in a consumer driven business.
You will most likely have to go through a formal interview, follow up interview, and a working interview. There is a tsunami of opinions of refusing to do a working interview on social media. Knowing what I know about recent graduates when it comes to a lack of clinical competency, I would absolutely demand a working interview. But I would not have a doctor work on an actual patient. I would have them triage a couple of emergencies which might include x-rays, exam, diagnosis based on findings and conversation with the patient, and an assessment of the patients dental IQ, budget, and “wants”. I feel that having a trusted assistant or hygienist observe and give me their feedback on how the candidate did would help me make a final decision.
I would also have them assist at the front desk by booking some patients, seeing how they did with new software, checking someone out, etc. I don’t expect much but I do want this young doctor to interface with as many team members as possible so that I can get their opinion on how the candidate’s personality, attitude, people skills and ability and desire to learn fits our culture.
I would also have sent the young doctor a copy of The Super General Dental Practice (free at www.supergeneralpractice.com) and ask them what they thought about it. It includes 90% of the foundations and culture in my practice. If they have issue with this, they are not really a good fit for the practice.
I might have them do a few checks in hygiene after being briefed on our systems and what this might look like. I find that having multiple hygienists spend a little time with the candidate makes a huge difference in finding the right person. Remember that my team has final say on the ultimate hiring of a new team member, including a doctor.
Finally, I would have as many of the team as possible take the doctor at the end of the day and go to Chili’s or some casual restaurant and have a few appetizers and drinks to get to meet them in a social setting. I would not attend this last step myself. Later, everyone would meet and decide if this candidate was the right one. My team always had final say on any employee hiring. I found that when they chose someone, they also committed to making sure they would be successful in our offices.
Success in dentistry comes down to three important things that, sadly, cannot be taught. The first is that the successful, fulfilled, happy doctors I know, all have great people skills. When I look to hire someone for any position in my offices, number one is an obvious talent with people. They like people. They enjoy meeting people. They immediately connect with people. If I don’t see this in any candidate, I will not go any further with the interview. For the most part, people skills, along with the next two attributes, you either have or you don’t. Certainly, you can compensate for this if you were in a solo practice and were the owner and in control. But we are talking about you, the doctor, being an employee or perhaps even a future partner. I have to pretend to be interested in people and learned how to do this pretty well, but it is exhausting when it is not your nature. I hired team members who not only complimented our culture, but also could help me by compensating for the areas I was not good at. I actually considered or had the mindset that I never hired employees; I hired partners in my practice. That’s why, in the Super General Dental Practice book, the culture was based on a Purpose Driven, Doctor Led, STAFF OWNED mentality. We all stood shoulder to shoulder as a team.
The second trait that is the foundation of success as a dentist is being self-motivated. Again, candidates either walk through the door with this attribute or they don’t. I only consider those that are self-motivated. Legendary football coach Vince Lombardi said it well when he stated: “It’s not my job to motivate my players. It’s my job to keep 11 motivated players on the field at all times”. Self-motivated job candidates seek to be better; they strive to improve; they demand to work in cultures that create commitment and not just compliance. They seek a better future in all they do and will almost always pressure you to do the same thing. It’s as if they constantly raise the bar on their own performance, as well as those they work with.
The last trait is to structure your life as a constant learner. These candidates understand they don’t know it all and covet learning. They know that their degrees are just learners permits. It’s great working beside others that are constantly becoming experts at all they do. They never settle for average. They never allow others to settle either. These types of people will not allow mediocre performance from themselves or others.
Perhaps this last truth along with the three attributes of people skills, self-motivation, and lifetime learners is the hardest to swallow. Perhaps the most difficult to accept. While I believe there are no challenges that cannot be overcome, this last truth, if you don’t already have these traits, will play the greatest part in becoming successful in dentistry. Success in dentistry is all about relationships with your patients. It is not just great dentistry. You don’t get to do great dentistry unless your patients like you. It’s kind of funny when you look back from a 50-year career and you see the outcome. Where students that could barely make the grade in dental schools became incredibly successful in dentistry. How some of the highest-grade makers in dental school struggled their entire career. Who dropped out and who weathered the course in dentistry. How dentists in general, defined success in their careers financially, family, where and how they lived. Each of you are making the changes and actions that will re-write your future success in dentistry. My hope is that this series of articles give you the perspective to help make those actions a positive step in your careers.
Michael Abernathy DDS
[email protected]
972.523.4660 cell