I don’t know about you, but desserts are my favorite part of a meal. I don’t eat them often, but when I know I am going too, I look forward to it as a reward. I have even been known to eat my dessert first. After all, life is short and there are no guarantees.
The world is full of stress and while we cannot predict the future or always control what happens to us, we certainly can try to control how we react to challenges. As a dentist, I follow 7 or so Facebook dental groups. I tend to read lot of newsletters and articles, as well as spending a lot of time every day speaking to doctors one on one. It seems that over the last ten or fifteen years there has been a trend in how these same doctors view life, react to challenges, and face life in general. Without a doubt, stress seems to be rising in every corner of dentistry. Is this new or are we just verbalizing this feeling more? Is there more stress or are dentists just not realistic about their expectations in a competitive consumer driven business? I would have to say there has been an obvious move toward entitlement and doctors with “victim” mentalities. You could even call it a “neurosis of doom, gloom, and doubt”. As I look around, and while things have certainly changed, the types of challenges as well as their prevalence has not changed. So, what’s going on?
I asked one of my best friends to read the postings and threads on Dental Town, 5 Dentist only Facebook groups, and two issues of Dental Economics and then get back to me for a debriefing.
Two weeks later, I asked him for a summary of what he read when it came to the attitudes, actions, challenges, and advice he was exposed to. Kind of an outsider’s view when we pull back the curtains on what dentist do, say, and their concerns. No preconceived ideas, just a frank discussion of how a non-dentist thinks about what is said when no one but another dentist is listening.
Now this person is 30 years younger than I am, is an attorney, has a family and owns their own business. It is a dual income family with three kids. Kind of an educated “Leave It to Beaver”, all American family from Texas. What I was looking for was an unbiased perspective on the question of how dentists see themselves: mature, educated, average, challenged, stressed, financially secure or something far worse.
Stay with me a moment and let’s pretend we, the readers of this article, are not dentists or part of a dental team. Secondly, let’s assume we stumbled across three or four of the largest Facebook dental sites along with some articles and websites specializing in dentists and their businesses, and became intrigued about how dentists think, what they focus on, and how they feel about their profession. Don’t forget, you know nothing about dentistry except what you are reading or hearing for the first time. Kind of a spotlight on dentistry, a topic which you have no real interest in or knowledge of.
Before we start, and this may just be me, an old dentist that tends to have a little more history in dentistry, life, success, and failures, but if I were this uneducated, uninitiated voyeur of dental sites, I would probably come to some startling conclusions about dentists, dental employees, and dentistry as a profession. Here is what came out of my debriefing with my friend. In a quick bullet point format, these are the results, words, and opinions of my non-dental friend.
- Dentistry must be really stressful. Based on the comments from over two thirds of the “posters”, most of the dentists’ comments indicate a level of stress far beyond what you would expect from a profession that usually works less than a 40-hour week and is in the top 10% of incomes for a professional job. This non-dental person was wondering if dentists ever worry about not being able to pay their rent on their apartment each month, whether their kids were involved in a gang or drugs because this same non-dentist person knows people who have to work two jobs to support themselves and two kids. I have to wonder as a dentist if we really know what stress is. I mean real life threatening, can’t afford a doctor, can only qualify for minimum wage jobs, and find it difficult to pay for three square meals a day kind of stress.
- Dentistry must not pay very much. Remember we are looking at dental posts on social media from the perspective of a non-dental person. These same dentists seem to create threads about the cost of everything: equipment, staff salaries, benefits, interest rates, cost of ownership, etc. Based on this non-dentist potential user of dental services perspective, they feel like dentistry is almost too expensive for them to do anything but emergency dentistry. Forget cleanings two times a year, cosmetic makeover work, or even more than a couple of fillings. It seems to most non-dentists that dentistry has become all about selling them something they don’t feel like they need. My friend, who makes a great living, felt like every time he went to the dentist (and he has gone to two different ones in five years) he was being manipulated like a used car salesman would do. When I asked him if there was a time when he felt that things were different, he went on and on about this great dentist he had twenty years ago. He used words like “caring, compassionate, great communicator, not pushy, seemed to want to help and always made sure that he allowed me to make the final decisions. He just wasn’t pushy or needy.”
- Dental seminar topics sounded like a used car salesman closing tactic sessions with bigger and better services thrown in. Based on the ads running on some of these Facebook group sites along with the seminars being pushed, this non-dentist is thinking that healthcare, or at least dentistry, is all about ripping off the public. Topics taken right off the internet included: creating the multimillion-dollar net practice, how to get more patients to say yes to bigger cases, take them out and do all-on-four dentistry, hire me and my marketing company and we will double your new patients and closing percentages, don’t miss this never before seen trick used by only the biggest most profitable dentists in the US to make millions, don’t sell to a DSO become your own DDSO and make multiples of what the rest make, and on and on and on. Yep, can you imagine what the average non-dental potential patient might think about the hype and smoke and mirrors that the most popular writers, speakers, and marketers are saying? On the other hand, I can only assume there might have been an equal number of clinical seminars that our non-dentist critic knew nothing about. But overall he was surprised at the hype and carnival barkers that seemed to steer dentists to what he considered less than he would have thought. He did admit that attorneys had their own high rollers pushing shady strategies that conflicted with his perception of the type of culture he wanted in his own office. He then said, “but no one likes an attorney”.
- How can I find an honest caring dentist that will not try to take advantage of me? This surprised me, but I guess when a non-dentist pulls back the curtain on our profession and takes a moment to look a little deeper, there are areas that we as dentists might not want the public to know. For my part, I feel like a majority of dentists are trustworthy and care about their patients. With that said, I would also say that 90% of the practicing dentists would not be my first choice to actually work on my teeth. What I told him about finding a good doctor is that good doctors and really good offices are busy. Real busy: 40 plus new patients per doctor, more than one hygienist, consumer hours, great reputations, up to date facilities, spend time in their communities, have strong families, and donate their time to help others while serving in leadership roles in the community. Surprisingly, I admitted that what I was describing was an “average dental practice”. His reply of, “Yea, I don’t want an average dentist to work on me or my family” was revealing.
- Dental schools must be pretty poor educational institutions based on comments from dental students and dentists. Dental students seem to be stressed about their dental school, cost of an education that they feel they will never pay off, and the lack of a well-rounded curriculum. From the questions posted on many sites, it sounded like the dental schools were only interested in making money while at the same time falling short on their curriculums and clinical training. As an aside, he mentioned several times that it sounds like from the questions from students and young dentists that most dentists were definitely incompetent both as businesspeople and as clinicians. In fact, the comments on Facebook were so scary to him, that I bet he would never go to a recent graduate of young doctor. He couldn’t understand why there would not be practice management/business training in dental schools that would prepare doctors to run their own businesses. I admit that I took the time to tell him some of the horror stories about dentists graduating with very little clinical competence as a direct result of poor dental schools with even poorer curriculums.
- It sounded like insurance companies were a huge problem in healthcare and dentistry in particular. It sounded to him like insurance companies cared nothing about the insured and tended to create a system that was flawed in medicine and dentistry for the doctors. (NOTE: I tried to make sure that I let him talk from a list he created and did not encourage of discourage anything he said. I wanted to hear just unbiased views from a person clueless of our industry challenges.) He went on to say that while he wasn’t surprised about the negative things he read concerning the dental insurance industry, he did feel like most of the dentists who asked the questions, made statements, or gave advice, sounded a bit like little spoiled kids with an entitlement complex. (He is an attorney and uses bigger words than I do, so often times I had to make sure I understood what he said). Because he had handled cases in the medical field and litigation involving insurance companies, I could tell he had a bad taste in his mouth when it came to this area. He did mention that he was a little surprised at the attitude and even actions of dentistry as a whole when all we needed to do is look at medicine, pharmacies, chiropractors, vision, and see the path and ultimate result of big business and for-profit groups that have consistently targeted our professions. His point was that it seemed we had not done our homework when it came to taking actions to stymy the progress of managed care in an industry crippled by supply and demand and the commoditization of health care.
- He was surprised at how many dental school graduates never became owners of their own practice. He did his own research on DSOs and corporate dentistry. He felt that a majority of grads really only want a job and not long-term ownership. It sounded to him as though there were some generational causes for this, but mostly he felt that this trend in dentistry to lifelong employee status was the same as in the legal profession. These doctors, or in his case attorneys, didn’t want to deal with staffing, client acquisition, and ownership issues. These same doctor/lawyer employees felt that they didn’t want to take the risk or want to be accountable for building a profitable fulfilling business.
- It appears that many of the doctors posting had questions about legal/malpractice occurrences. I almost stopped him here, with him being an attorney and all, but he insisted and was curious as to my opinion. He went on to say that while he is totally ignorant about many things dental, he was surprised at the naivete of dentists when it came to legal questions. Based on the questions and comments from other dentists (no attorneys responded), he was surprised at how far off all of the answers were. It was about this time that he emphasized that none of the answers were even close to a true legal statement of fact. He was amazed at the suggestions made and the attempt by the answerer to sound like some type of expert. His final comment: these doctors are getting their information from an unreliable source and nothing but a lawsuit will result if the advice were taken as legal fact. He cautioned me not to listen to solicited input from those that have not a scintilla of education to share or answers that would hold water.
That, my friend, was the summary of how a non-dentist might perceive our profession when given the opportunity to take a peek at our private discussions, articles, social media, and general dental topic threads on social media. Pretty lack luster but an honest overview that each of us should take seriously. Before I go, I want to leave this article with a positive thought.
Just last week I flew to Phoenix to speak for a couple of days with 15 dental students about dentistry. It was so refreshing to see the “yet to be dentist” so excited about our profession. They were hungry for knowledge, sought the truth, and wanted to hear about how to stage their dental school experience in a way that would ensure their practice success. They all knew it would not be easy to be successful, but all were certain they would do whatever it took to work hard, give more than others thought wise, and were sure that they would face both short falls and successes on the road to becoming successful at dentistry. Each and every one of these students wanted ownership and knew the weight of debt they faced at graduation. They had a realistic view of dentistry and did not feel entitled to anything just because they would soon have a diploma and be called doctor. I could see there was stress and uncertainty. But more than anything, I saw they considered just the opportunity to step onto the field of a new career and ownership a blessing not to be squandered. Maybe I, like my non-dental friend, have read too many complaints, victim mentalities, and doctors claiming that everything is unfair for them. I think that perhaps I should cut back on following those sites where the vocal minority enjoy their pity parties and instead follow those that have decided that life doesn’t give you what you want, it gives you what you deserve. This fear of stress is really the symptom of those who fail to truly own their performance and results. This lack of accountability coupled with blame shifting creates excuses that in the real world creates limiting beliefs that will forever shape your future and doom most to mediocrity. Sure, dentistry is difficult. Yes, insurance companies are bad. And consumers are difficult to work with and team members are hard to find. It has always been this way. It is time to put on your big boy panties and deal with it. Turn from being stressed to eliminating your excuses and finding your results: the desserts of hard work, adapting to every changing circumstance, and getting up every time you fall down. In this way you will never fail.
I snuck out and my wife and I just saw the new movie called Air about the marketing of Michael Jordan. One phrase really impacted me. While trying to get Michael Jordan to sign with Nike, when Adidas and Converse were light years ahead of them and were offering more money, one of the employees of Nike, after designing a shoe just for Michael Jordan, said this to him and his family: “When it comes down to it, a shoe is a shoe, until someone steps into it.” A dental practice is a just a dental practice until ___________________ steps into it. Put your name there. See yourself as a legend. Leave a legacy. Define your future.
Michael Abernathy, DDS