Back in the early 70s when I took the Board, we were required to perform the tasks on live patients. This is something that many modern-day dental students would probably consider barbaric and would never even be considered as an option. These days, board exams are conducted on mannequins.
Not only were our ‘mannequins’ living humans, we had to procure them ourselves. The days leading up to this board examination were fraught with anxiety and concerns that our chosen dental patient might not show up. In my case, this is exactly what happened. My scheduled 8 o’clock patient called me late the night before with some excuse.
Of course, I was frantic because by that time it was too late to obtain another patient. I had no choice but to call Joan, who I remembered—having been to the dental clinic for a tooth cleaning—had x-rays taken at that time. These had demonstrated evidence of the requirements necessary as a patient for the dental board examination. I explained the situation, begging her to show up the following morning which she dutifully agreed to do, instantaneously dropping my stress level ten notches.
The morning session required all candidates to perform a filling on a front tooth and a filling on the back tooth or what is called a Class III gold foil. This is a procedure rarely done these days and has a very difficult and intricate restoration—the tooth needing to be prepared to exacting specifications, and the filling composed of 24-karat gold being annealed into the cavity preparation with the use of heat and pressure.
I chose the gold foil because, as part of the requirements at Northwestern, we had to complete twenty of these Class III gold foil fillings. I was done in less than an hour and did not have to return until 1 o’clock in the afternoon. The remainder of the required procedures, including the next day, all went smoothly. I was confident that I had passed with flying colors, which I did. I guess Joan had a little bit of usefulness left in her.
I headed for Honesdale, Pennsylvania, to a waiting associate’s position arranged by my mother-in-law.
It was my first day, and my first patient seemed nervous. Maybe it was just my nerves bouncing off them.
The room was tiny, and I felt cramped. It contained only a dental chair—a definite upgrade from the equipment we had in dental school—a bright, shining light which hung over the patient, and various pictures on the walls. The most prominent of these was a St. Bernard, with a mournful look and slobber drooling from its jowls.
The high-speed whine coming through the doorway reminded me that my employer had upgraded to the new air handpieces (dental drills) that recently been developed.
The patient explained that she had a toothache, so an x-ray was taken to assess the issue. While it was being developed (x-rays were analog back in the day, as digital x-rays had not been invented as yet), I thought about my present position and somehow knew it wouldn’t last.
My little muse had a tendency to be very annoying at times and, at that moment, she reminded me of my sworn oath of sorts. This oath, of course, was that I would not, could not, be happy working for another person.
Only a few weeks later, it came to pass that I was out on the street wondering what I would do with the remainder of my life.
It seemed that the wife of my employer had felt threatened by me, worrying that I would ‘steal’ all of their patients, and had switched all the patients I had to another doctor. Upon discovering this, and not having anything to do at work, I walked out and simply never returned. At this point, I was somewhat used to leaving things and not looking back.
Many years later, I discovered a common factor in the dental world. A great many dental wives feel threatened, their husbands working each day with several cute, little females who sometimes dress to resemble a bunny from the now defunct Playboy club. As a result, they station themselves at the front desk, answering all calls and following all movements in the office like a house mistress, under the guise of saving money.
Anyway, here I was, a diploma, a license but no office let alone patients. I had no idea what to do with a practice anyway. In all my years of training, I had never given a moment’s thought to the fact that I would, in fact, one day be running a business. Somehow this made sense to me, even though I didn’t want to work under anyone. I guess I was used to things just either working out for me or not working out for me.
Back then money was easy to get and I was fortunate to get a line of credit for 200K. With that I bought a building and my brother-in-law, who was a contractor , remodeled it . However , frp, day one, I had no idea about patients and how to get them to accept treatment. I thought I would just tell them what they needed and they would accept it. Of course as we know, it doesn't work tat way and I soon found myself almost bankrupt.
I muddled along trying different approaches but things did not improve abd I was working six days a week!
Fortunately, Karma stepped in once again and I found myself at a continuing education course presented by a dentist in Texas. During one of the breaks, I was able to explain my problem to him and he suggested that we meet for a beer after the day’s presentations were done.
Later, after explaining how I felt in greater detail over drinks, his answer frustrated me in its simplicity. He set his beer down, turned to face me and said, “it’s very simple, just get in step with the patient.” He stood, thanked me for the beer, said he would see me at tomorrow’s presentation, and then departed—much to my annoyance.
I ordered another beer and sat there thinking about what he said.
“What did he mean by ‘get in step with the patient’?” I said out loud to myself, trying to make it make sense.
Dental school had taught me that I was the doctor and the patient should accept my recommendation. If they did not, they should be told to find another dentist. This, however, was apparently not very good advice, because it certainly was not working for me. People, as it turned out, didn’t like being told what to do.
When I returned to the office, I was eager to discuss this with my two favorite ladies because, thankfully they knew how to interact with people much better than I did. I admittedly was never great at reading emotions or being sensitive to what another person wanted over what I wanted. They suggested that perhaps it might be a good idea if, instead of telling patients what to do, I might try asking them what they wanted to do.
That started to make sense to me as it satisfied the doctrine of getting in step with the patient.
Well, long story short, I did what Earl had shown me works and things started to change. Slowly at first, but definitely improvement.
This was great because we started to have some breathing room.
I visited Earl again, spending some time in his office and was amazed that he only was in the office about 25 hours per week because he was on the golf course at least five times per week.
I loved golf so when I returned to my practice, I immediately closed the office on Saturday. This worked well because most people did not show on Saturdays anyway and besides production increase a bit.
Soon there after I closed on Friday. This was scary but in a short while we saw that production actually went up! In addition our patient skills were getting better so this helped also.
About six months later I wanted to play golf so bad, we closed at twelve on Tuesday and Thursday. The result of this was that production went up even further. In addition, we were seeing many new patients and treatment acceptance was through the roof.
The final result was I was working only 25-26 hours per week with plenty of free time. The staff loved it and went around town telling everyone what a great dentist they worked for. Life was good.
I finally sold that practice and we moved to Florida where I opened another practice from scratch. This was much easier because I know what I was doing.
I sold that practice in 2004 and took a job working on a remote Indian reservation in South Desakota. I wanted to give back and show other dentists who might be struggling just what I did so for the last ten years I have been working on this and that is the short version of my story.
If you need some help or just want to chat, give me a call.