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It can be tempting in a dental career to cut corners to make life a little easier, especially when it pays off. At other times, it hurts more than it helps. Here are four instances from different facets of dentistry where taking the quick route will come back to bite you.
In dentistry, time is our biggest limiting factor. We do not have the luxury of increasing our work productivity on an economies of scale level. We cannot service 17 patients at once, the only way we can increase income is by performing more complex expensive procedures or becoming faster, and even speed has its limitations if you still intend to do quality work.
I have found many dentists trying to create ‘more’ time by cutting corners in manufacturer’s instructions. Etching for 5 seconds instead of 10, curing for 20 seconds instead of 40. The amount of time ‘saved’ is negligible and the quality of work produced is far lower than the patient deserves. Post operative complications, such as sensitivity from incorrectly cured composite, will also eat into any ‘time’ that you saved by not following the instructions. Notwithstanding the fact that the treatment will likely fail prematurely.
I am of the mindset that it is someone else’s entire job to figure out the most efficient amount of time for their product to be effective. If they say etch for 10 seconds, do it. If there was the ability to etch for 5 seconds, they would have found it and that’s what the recommendation would be.
The most tempting part of dentistry to cut corners are clinical notes. 99% of the time the only person to ever see them will be you, but that 1% is where it counts.
Over time you become more concise with clinical notes. When I first graduated, notes for initial exams would be the length of a small novel, but over time I learned what is important and what is fluff. It is vital not to cut down to the point where you are missing key elements by simply stating ‘medical history, diagnosis, risks and treatment options discussed’ and thinking this is sufficient information to record. To think you will have a career spanning decades without a single complaint or complication is naïve. Rock solid records will help your case at any point. Training staff to record every phone call, every grievance, every gift is crucial as it all helps cover your bases should you ever need to. While indemnity insurance is there for a reason, it cannot undo bad record taking.
A colleague of mine was taken to court over a complaint, he had such impeccable records that not only was the case dismissed immediately, the judge was so impressed with the notes presented during the case that he became a patient of the very clinician on trial. If that isn’t a win, then I don’t know what is.
This is a topic I have mentioned in previous articles, and I will continue to harp on about it without shame. Dental practitioners rely on physical fitness to be able to do their job, especially if you want a career that’ll see you to retirement. Cutting corners with posture and ergonomics is something we are all guilty of, I am not holier than thou, I have used direct vision with my spine contorted and we always think ‘I’ll do it just for this one spot’. But it’s the cumulative effect of ‘just this one time’ that can lead to debilitating ailments with the potential to end your career. Having discipline to position yourself in a way that is suitable for you is the most important take away. Of course, some patients have physical limitations preventing them moving in ways that aids your work, but for the most part, you can get the patient to move or tilt their head to ensure you are not compromising your posture. At the end of the day, they aren’t the ones holding those positions for eight hours daily.
Look after yourself both mentally and physically and you will have a much longer and more prosperous career.
Although this may not be applicable in your first few years as a new graduate, it’s something to keep in mind or even keep an eye out for, as you gain experience working at different practices. Approximately a third of your week is spent at work and in most cases, you spend more waking hours with your colleagues than your own partner. Ensuring you have great staff (dental assistant and reception alike) is critical not just to the smooth running of a practice but overall stress and happiness levels.
There is a spectrum of how a practice can be run, some opt for a ‘family’ approach while others keep it a professional space. No matter how you choose to operate, the key is to have reliable processes and skilled and kind co-workers.
The life of a dental practitioner is already stressful, our work can drain your social battery; looking after patients and having staff that make your life easier, rather than adding to the headache of a day, are worth their weight in gold.
I have worked with fantastic staff and not so fantastic staff. The difference to how you feel at the end of each day cannot be put into words. Training up staff can be tedious but if you treat them with respect and pay them well you shouldn’t find yourself having to do it too often. Both my parents ran their own specialist clinics and had the same staff for over 30 years, this is a sign of a happy workplace.
I have found some organisations lose sight of the individual person and have ‘award systems’ for payment tiers, this is often not reflective of the value of that person. Practising within this system can be tricky to navigate and can flow on to impact your staff. People can enjoy their work and like working for you, but if this is not reflected in their pay because the clinic hasn’t met their target, they are likely to leave. You cannot begrudge your staff for leaving if they are not fiscally valued because at the end of the day it is their livelihood. Many practices believe they ‘own’ someone after training them and this can be a toxic mindset, often resulting in high staff turnover.
It is also essential that staff feel valued. If they have developed skills, learned how you work, ensure the smooth running of the practice, then reflect that in their pay. Trying to hit the bottom line on what you think you can get away with paying them is a quick way to lose valuable staff. That $2/h they were refused at the pay review, resulting in losing them to another practice, will cost you a lot more when you’re forced to find new staff who just aren’t as good, and you’ll lose much more in decreased productivity.
Dentolegal Consultant perspective Don’t be disheartened if it takes you a few tries to find the right practice environment. You will learn something everywhere you go, even if some of these lessons are hard to go through. Critically, always ensure that your ethical compass points north, and if pressure is being placed on you to do something that doesn’t feel right – then don’t. Remember, the overwhelming majority of practitioners are practising happily and safely – that’s where you should be aiming; always aspiring for best practice. The rest will fall into place.
