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Dentistry Then and Now

November 30, 2015

Filed under: Business of Dentistry,Leadership — Tags: , — Barry @ 2:30 PM



In 1973, while in dental school I read the influential bestselling book, Working⁠ by Studs Terkel, the late Pulitzer Prize winning author.

In that book Terkel reveals a well-founded conviction, that our universal search is the one for meaning, the subject of Viktor Frankl’s classic book Man’s Search for Meaning.

Terkel calls our jobs a search as well; “for daily meaning as well as for daily bread, for recognition as well as for cash, for astonishment rather than torpor; in short, for a sort of life rather than a Monday through Friday sort of dying.”  The book is composed of interviews of people with many various jobs.  The common attribute in all of the interviews is “meaning to their work well over and beyond the reward of a paycheck.”

I recently re-read parts of Working.  I was particularly interested in the dentist, Dr. Stephen Bartlett who at that time had been practicing in a Detroit suburb for nineteen years.

The interview could have been done today.  Bartlett’s complaints about dentistry: that it was physically demanding (he stood all day and refused to change to 4-handed sit-down dentistry), that most patients were under stress, that he had to deal with cancellations and mostly that only he knew when he did a good job.

He also spoke about what  was appealing to him:  that he could practice dentistry as he liked (autonomy), that he had the opportunity to play a role in the lives of his patients by changing their appearance (meaning), that he was his own boss and could make his own hours.  I thought how similar the job is today…but like Viktor Frankl during his life—something happened…beyond his control…World War II.

In other words the landscape has changed. The human factors have remained the same.  Our jobs provide us with a sense of meaning and purpose.  No matter how much technology has made dentistry more pleasant…people still have fears and cancel.

The more things change, the more they stay the same.

Some might say, and I agree, that the sixties and seventies were the Golden Age of Dentistry.  It was a time when a dental practice offered as much autonomy as a dentist wanted.  It was the the ultimate in free enterprise.

We knew the score, graduate, specialize or open your own practice, hang up your shingle and go to work.  Easy-peasy.  If you were a people person, even better.  If not, no problem, just work some nights and weekends.

There have been many changes since those years.  The effect of insurance and third parties, as many dentists know, is not a simple equation.  Insurance has had the effect of lowering the standards and quality of dentistry by discounting fees and creating their own networks—no matter what the insurance companies tell us.

Pay peanuts—get monkeys.

Advertising may be the holy grail of the free market economy, but under the guise of “educating the public,” it has been abused to the point of bringing out the worst in dentists…and once again creating conditions that force (too strong? I know) dentists to work for less.

Then there is the economy and the shrinking middle class…and the expense of opening a practice.  Yes…there was a price to sitting down and doing 4 – handed dentistry, Dr. Bartlett.

Enough with the bad news.

There is good news—those things that appealed to Dr. Bartlett?  They still exist.  They’re timeless…and just like Frankl’s response in the death camps of WWII…it is up to us to respond to our present conditions.

It has become more difficult to practice with meaning and autonomy.  We must make our own meaning.  Leaders are meaning makers that is why I feel leadership needs to be emphasized in this profession.


Spirit- Body- Mind The Natural Order of Things

December 16, 2014

Filed under: Philosophy — Tags: , , — Barry @ 10:38 AM


Breathe. Think. Move.  Three simple words repeated over and over again by Leo, my Yoga teacher.  There is no better instruction for Yoga than those three words…in that order.  The first step or the starting point is to breathe, followed by a thought and finally a movement.  The Latin word for breath is spiritus.  Thinking is carried out by the mind, and finally movement is carried out by the body.  I repeated the three words to myself in silence.  “Why?” I asked myself, if the key to Yoga is spirit, mind and body, do we get it wrong by telling ourselves that it’s all about body, mind and spirit?  We get it backwards and that could make all the difference in the world.

The breath is the starting point, without the breath there is no rational thought.  The mind cannot think straight when there is a lack of oxygen.  The breath is the spiritual energy of the Yoga…the foundational component.  Everything is built on the breath yet we tend to put the most emphasis on the physical…the tangible…the material components.

The edict,  form follows function applies here.  So many of us want to look good but we fail to apply the fundamental principles to get it right…whether that be in in Yoga class or at work or in life.

Most of us get the order of things wrong…we want to start every meal with the desert. 

At Yoga I am pretty good at focusing on the breath, but on this day I was even better because this new insight allowed my mind to  focus even more acutely.  After all what are we, but our minds?  I felt as if the roof had been lifted.  My postures were better…I looked better, I felt better.

At the midpoint of the class Leo started to speak more about a stable base.  I thought more about a secure base.  How wonderful it would be to go through life knowing I had a secure base.  Would that make a difference in my life?

Dentists who practice with an understanding of occlusal principles know that the masticatory system is built around a secure base…so is Yoga, and so is life.

Mindfulness is all the rage these days, yet how can we apply mindfulness without the energy to overcome the distractions of our monkey minds…our comparing minds.

Comparing minds?  Like when you are watching someone else’s postures rather than your own, or looking at someone else’s dentistry on Facebook, or just constantly counting everyone else’s crayons.

In order to slow all that down we need a secure base.  That secure base is the breath…the spirit.  That’s why it comes first.

Viktor Frankl said:

“Between stimulus and response there is a space. In that space is our power to choose our response. In our response lies our growth and our freedom.”

 It is in that space that we get to use our minds…our rational minds rather than our monkey or comparing minds.  That’s mindfulness, and that is where form follows function…but it requires a secure base…the spirit.

Society teaches us to envy those with great wealth (great postures too)…but I have always wondered about the man who doesn’t have any invisible means of support.

Take the time to build the foundation in everything you do.  Use the spirit, the breath to take control of the mind.  Reap the external rewards by paying attention to the natural order of things.