What a Profession!

by Elliot Mechanic, DDS

For more than 20 years, I looked forward to viewing the last five minutes of CBS television’s 60 Minutes to watch Andy Rooney. This cantankerous old relic (dinosaur) would always be bitching and complaining about something. I thought he was usually right on the money! He would tell it like it is, expressing and verbalizing what other people would be thinking, but were too polite to express out loud. Andy Rooney had the ability to convey the realities of life.

Dentistry is a great profession. However, in my opinion, it is a really tough one. Tough for both the patient and the dentist. Today’s dentistry can provide meticulous exacting procedures using advanced materials and techniques. By reading publications such as “Oral Health” and obtaining readily available continuing education dentists are able to fine tune and advance their skills. I have always felt and publicly stated that the actual clinical work is the easiest part of our profession. Dealing with people is the most difficult, whether it be our patients, staff, or others we interact with.

In 2012, my world of dentistry often seems like an obstacle course. I have to perform exacting procedures in a tiny dark orifice (the mouth), with a moving large muscle (the tongue), and in a Jacques Cousteau underwater environment (saliva). And if all this seems to be difficult enough, my patients do their best to make delivering their dental work even more challenging.

Some patients try to talk continuously during their appointment, distracting me with jokes and asking countless questions about things that have absolutely nothing to do with the procedure we are doing. Others try to help and guide me by trying to impress me with or teach me information that they have read on the Inter­net. I have news for them…the net is not dental school! Often it can take the first twenty minutes of an appointment just to get the patient to sit still and clam up. It amazes me how people try to talk and joke while a drill is in their mouth spinning at 300,000rpms.

Have you ever noticed how some patients always have to go to the bathroom the minute they are seated in our dental chair? With plenty of time to pee beforehand they somehow wait to be seated before having to excuse themselves. With the exception of Gérard Depardieu I have never heard of passengers running to the bathroom at the moment an airplane is taking off. During the actual dental procedures, why do patients choose the most inappropriate times to suddenly have to go? I have just removed the retraction cord, mixed the impression material, and are about to place the final impression in their mouth and my patient begins to frantically motion that they must do their thing.

Do your patients signal to you hysterically to suction the tiniest drop of saliva from their throat? Why don’t they don’t just swallow it? I have had patients, grab their cell phones and attempt to text while I am in deep concentration performing exacting work in their mouth. What can be so important? Are they communicating with the Prime Minister, the Queen, or President Obama?

How about the patient that is constantly grabbing their bib and wiping their lips while my handpiece is in their mouth? Better yet, the person with a handkerchief in their hand, frequently dabbing their face because heaven forbid I should see them in a messy state.

People tend to enter my treatment room throughout the day as if I have an open door policy, even if the door is closed, which in any other environment means, “do no enter!” Whether it be family of the patient, or other members of my team, I am disturbed throughout the day.

I am constantly being rushed! Patients tell me they only have twenty minutes for an appointment which they know has been scheduled for an hour. Would these patients rush their surgeon performing a heart transplant or even their hairdresser for that matter. Why can’t I just sedate everyone like my friend the oral surgeon ?

The patient’s right to privacy, in my opinion, is also sometimes out of proportion. Some provincial licensing bodies prohibit dentists from placing notations or medical alerts on the outside of a patient’s chart where they are clearly visible. We have to search for concealed hieroglyphics on the inner pages because on the remote chance that someone snoops through our filing cabinet at night, there is nothing prejudicial showing. However, if we miss something we are legally liable. As I previously stated, practicing dentistry is like running an obstacle course.

If a patient confides in me that they have a contagious disease with a high risk of cross contamination, am I still obligated to treat them? Am I even allowed to express shock or concern, or is that discriminatory or prejudicial? If they instruct me not to inform anyone, should I inform the staff who are treating this patient? Where is the line drawn? Do we have to expose ourselves and our team members to the risk of contracting a disease that can ruin our lives? I am a firm believer in a person’s right to privacy, but why is it that all over the internet, on Twitter, Facebook, Blogs, etc people expose and broadcast every aspect of their personal and private lives? “Had sex with Bob last night…yummy,” or “I’m tweeting from the toilet.” Heaven forbid I note that a patient has a penicillin allergy on the front of their chart. Ridiculous?

At 57-years-old I sometimes have a hard time with today’s vision of being politically correct. I grew up going to Chinese restaurants. Today I get reprimanded for not saying Asian. I have been criticized by some patients for having a Christmas tree in my reception area. All right, I give in! Let’s call Valentine’s day and Halloween our most important holidays.

I love dentistry and have learned to accept and put up with a lot. When patients arrive late for their appointments I try to excuse them. When they behave like two year-olds in the dental chair I just bill them more. When they say “nothing personal doc… I hate dentists,” I just answers “That’s ok Fred, I hate patients.” The dental profession, as do most service professions puts up with drama, drama, and more drama!

Dentists are conscientious, honest, extremely hard-working, and highly-educated health professionals. Just as we cater to and respect our patients, we deserve the same courtesy. As Rodney Dangerfield, the late comedian would say “ I don’t get no respect.” Some patients really take advantage of us by not paying their bills promptly, missing appointments, etc, etc, etc (you all understand). As my late mother Bernice would say “throw them out the door!” However it is not that simple as we must follow the guidelines set out by our regulatory bodies before refusing to treat a patient.

I have tried to express in a humorous manner some of my observations after more than three decades in the dental profession. These may not be your personal views.

I hope everyone enjoys this year’s esthetic issue of Oral Health with the usual eclectic mix of Canadian and Inter­national authors contributing original manuscripts (no reprints). Canadians are the world’s secret weapon in dentistry. We are a quiet people. Others may talk big but Canadians know how to actually do it. OH