This editorial brought forth countless negative memories about this pejorative, yet true statement. It prompted me to write a few of my experiences with not only the public but also our fellow medical colleagues.
The first incident occurred during my first year in dental school. For those who are unfamiliar with McGill’s dental program, students spend their first year-and-a-half in medicine. We follow the same curriculum and are held to the same standards as our med-school counterparts. After completing this portion of the program, we finally go on to study dentistry for the remaining two-and-a-half years. At the end of one of our study meetings, a group leader, a gastroenterologist, made the following comment: “Oh! You’re only a dental student! I shouldn’t have been so hard on you!” This not only left me feeling inferior to my medical colleagues, but unworthy or privy to their level of knowledge. I felt cheated because there was to be no distinction between a dental or medical student; after all we would be writing the same exam. I thought this highly qualified and intelligent doctor to be incredibly condescending. Then I remembered something my undergraduate anatomy professor once told our class, a bunch of would-be future doctors and dentists; he said: “The more you are specialized in a field of medicine the more you know nothing”. He was completely right because when you think about it, a cardiac surgeon, for example, is incredibly knowledgeable about the heart, but not much else. Therefore, this gastroenterologist’s knowledge is only limited to the GI tract and nothing else, pretty narrow-minded seen under these circumstances.
It is truly unfortunate that this great profession is quite frequently belittled by our medical colleagues and the population at large, who don’t understand that we are not just treating the mouth but the person as a whole. Very frequently, we are the first medical and regular contact that a patient has. I can recall countless times when I had to refer a patient to a doctor in order to be treated for high blood pressure or the beginnings of diabetes, first diagnosed orally.
As a dental resident and now supervising clinician at a hospital-based dental program, I have seen numerous consults asking for miracles because medical programs do not teach their students what dentists do. Two examples come to mind, the first is a consult from either geriatrics or neuropsychiatry, where a patient, either severely demented or incapacitated had their dentures lost by the attending staff and is now no longer capable of eating. I have often asked myself whether these doctors realize that our clinic walls are not stocked with dentures of all shapes, colors and sizes and that our jobs don’t consist of trying one pair after another until we find the best fitting. Even with the best and most skilled of all dentists, the fabrication of a brand new pair of dentures requires at least three appointments if not more, not to mention a lucid and cooperative patient.
My second example, although again only applicable to dentists who have worked in a hospital setting, some of you might be able to relate. Ever get called to the ER in the middle of the night because a patient has sustained a severe trauma? The patient is in a c-collar, half comatose, intubated from every orifice possible and imaginable and the consult reads: “Please assess avulsed tooth #1.1”. Surprisingly some doctors do know some dental lingo, like numbering. However, when the tooth in question is nowhere to be found except at the scene of the accident, the patient has a great potential of coding on you as you conduct your assessment; one cannot help but think that the patient has more pressing issues than his lost tooth. And under these circumstances, the evaluation of the patient on our part can take place at another and better time.
Now we cannot only blame our medical colleagues for their ignorance, some of our patients must also be held accountable. How many patients have we come across expecting miracles at bargain-basement prices? Most patients don’t realize that our fees are the result of not only our level of experience and education but also the fact that we have a huge overhead to deal with. Dentistry as a business is expensive; we are not socialized like medicine, for which services the patient in Canada never sees a bill. We are expected to provide our patients with the latest of technologies, the best available dental products, all for a very reasonable fee. I cannot help but remember the time in dental school when we would be separating from the med-kids and finally pursuing dentistry. But before we could do so we had to buy our equipment, only $18,000.Imagine how infuriating it was when we heard our med colleagues complain about their $1,000 worth of equipment they needed and would keep for the rest of their professional careers?
So, unlike the Seinfeld joke (Season 8, ‘Yada Yada’ episode), dentists are not doctors who failed out of med school. We earned our doctor title just as much as our doctor colleagues. We are just as valuable and an integral part of this country’s medical system. We should be proud to call ourselves doctors and ignore those who don’t know any better. Take heart, some may be called doctors but know little beyond their training.
Dr Jennifer Forsprecher, B.Sc., M.Sc., DMD
Montreal, Quebec
