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Wor$hiping Fal$e God$

December 29, 2014

Filed under: Art of the Examination — Tags: , — Barry @ 10:43 PM


Breaking rules always comes back to bite us.  All patients come into my practice through my new patient examination process.  Except this one time!

The patient wanted a cleaning and then have her teeth bleached.  She had a baby at home and time was a big issue…so we allowed it.  Her first appointment was for a cleaning.  When I did my examination I noted significant wear for a thirty two year old.  I backtracked and told her I needed to do a complete exam, which she scheduled.

On the morning of the exam, I overheard a conversation between her and my receptionist.  The talk was all about insurance.  If I’ve heard it once….

This time however I saw the image of that Gary Larson cartoon of a dog owner explaining to his dog Ginger what she should and shouldn’t eat (no porkchops Ginger – they cause pancreatitis), and what Ginger hears (blah, blah, blah, Ginger, blah, blah, blah…Ginger).

In other words, it’s hard to train dogs and it’s even more difficult to lead people.  The information my receptionist gave to the patient about dental insurance was just perfect.  All she heard was what the insurance covered…next to nothing.

So I did my examination.  It was great.  A wonderful opportunity for the patient to understand her own mouth and good dentistry.  Everything went as expected: sore tight muscles, a centric slip, clicking on opening, significant wear.

Then I noticed something on her x-rays.  She had no fillings, but she did have four crowns and two root canals.

I asked her, “How did this come about?  You have no history of decay and yet these four teeth have been maximally restored.”

She said it was because of the grinding and the wear.  Then she put two and two together…the slip, the clicking, the wear the sore muscles…and now the history of pain.

The ravages of occlusal disease!

No one had ever done a comprehensive examination for her.  I felt she really appreciated the diagnosis.

She got it and I felt fulfilled.  Then she turned and asked, “When can I get my teeth bleached?”

This is what dentists are up against these days.

When I thought about the insurance conversation and the examination I thought of the The Ten Commandments…you know the scene in the movie in case you never read the Bible, where Charlton Heston (playing Moses) comes down from the mountain with the two tablets.  Do you remember when he raises the tablets and smashes them out of frustration because the people were worshiping a Golden Calf?

Well, at that moment I felt like Moses…frustrated, alone, trying to convince yet another patient of the principles of dental health when all they’re interested in is the false gods of insurance and cosmetics.

Leadership is a lonely line of work. 

But it is the most important work we do.  The definition of a leader is a person who has followers.  People will follow when they get to know, like and trust…that you will lead them to the promised land…instead of the land of four crowns and two root canals.

I wish our education system put more emphasis on leadership instead of trying to get these lessons out of watching old movies.  Maybe then the idolatry will end.






  1. Excellent. It’s always been a hard task to accomplish, specially with our training in dental school.

    Comment by Fred — December 30, 2014 @ 11:16 AM

  2. Fred—this is dentistry’s biggest problem. This is the biggest problem that each dentist faces everyday and there is no leadership in individual practices as well as in the dental community. Any leadership I see is coming from those who wave shiny new toys at dentists and the public. Leadership must be based on values and principles—not idols, not $$$.
    Even the wonderful CE programs who teach amazing technical skills, miss the leadership point…they try to teach it but they are mostly, what Peter Drucker used to call “technical arrogance.” Dental schools, CE programs, MUST take this more seriously or the entire profession is at stake. Even worse than medicine because at least medicine is life mandated.

    Comment by Barry Polansky — December 30, 2014 @ 11:50 AM

  3. No one ever said being a dentist will be easy. We know it really is not. Maybe that is why it is not talked about much. As for the leadership? Well, ummm, errrr, ahh, ummmmm.
    Happy new year Barry Polansky!

    Comment by Roger — December 31, 2014 @ 9:53 AM

  4. Yes Roger–I guess through everything that is what I am saying—that being a dentist is not easy. It saddens me when I hear dentists speak about how easy it is…but they never really see the big picture.
    If you have a better word than leadership—I would love to hear it because these days that word has lost its meaning.

    Comment by Barry Polansky — December 31, 2014 @ 10:22 AM

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