Invictus

One of my favorite quotes is from the famous William Ernest Henley poem "Invictus." Invictus is a Victorian poem that was published in 1875, but what many people don't know about Henley is that he actually had one of his legs amputated just below his knee at the age of 17. Henley contracted tuberculosis of the bone at age 12, and when it progressed to his foot, physicians felt the only way to save his life was through amputation. Surprisingly, Henley remained active until the age of 53. I won't copy the entire poem here, but the quote that I'd like to elaborate upon (especially based on Henley's life circumstances) is:

"I am the master of my fate

I am the captain of my soul."

Let's put this in perspective. William Henley suffered a serious "life-event" that would normally result in complete immobility, compromised lifestyle, and self-pity. We must remember that, especially in this time period, we did not have efficient ways to mobilize and restore function to people that suffered amputation. However, Henley remained positive and took ownership of his problems. He knew that he was the only one who could choose his life direction, and did not blame others for his ailment.

So, what's your point?

In dentistry, as with many other professions and businesses, we as practitioners choose how we want to practice, and develop our own philosophies to create a practice that represents our true values. When I first graduated from dental school, I imagined that I would enter into the "real world" and be equipped to solve the most complex of issues that my patients faced. What I didn't expect to find over the first two years was a great lack of personal fulfillment when I would see (way) too many patients each day and try to solve all of their issues myself. I began to think that it was just my patients that weren't owning their own problems, and that if only they would change, then I would be happier. I couldn't be any further from the truth.

Like Henley, I had my first "ah-ha" moment of my professional life. I was failing as these patients dentist. I needed to change. That is not an easy thing to realize and admit, especially coming from someone who has always strived to do and be the very best. I wasn't failing because I was doing anything technically incorrect, but because I was not spending enough time with my patients. I was too busy, and I couldn't get to know them---the most fundamentally important thing that I should have been doing.

Enter: The Pankey Institute (http://www.pankey.org).

The Pankey Institute for Advanced Dental Education in Key Biscayne, Florida has provided a place for dentists to explore the meaning of excellence and renew their commitment to the kind of dentistry they want to be doing. L.D. Pankey's basic tenet to successful practice was: "Know yourself. Know your patient. Know your work. Apply the knowledge."

With the constantly changing healthcare system, many dentists tend to forget that we are the masters of our fate: not an insurance company or government mandate. It is our job to create an environment that harbors our own personal values. So, I felt it necessary to make a change.

I started to take more time---a lot more time---with each individual patient. I couldn't believe how much I got to know about so many interesting people. More importantly, I couldn't believe how much easier I could assist these patients in achieving their goals after thoroughly understanding their values, beliefs, and perspectives. I committed myself to an extraordinary amount of high level continuing education, and surrounded myself with some amazing practitioners in various study groups. I started to practice interdisciplinary dentistry utilizing extremely talented and knowledgeable specialists to help coordinate optimal patient care. But does all that really matter? No, of course not. We all know that people don't care about how much you know until they know how much you care.

Other dentists (often seasoned dentists who want to mentor "the kid") will often ask me why I spend so much time with each patient. They tend to mention that "time is money" and that my time would be better spent seeing more patients and therefore doing more "work."

I will hear comments such as:

  • "What do you do for an hour with a new patient?"
  • "Aren't people too busy to come and see you?"

I like to remind them that we are not treating a set of teeth, but people. We must address our expectations, goals, and desires. We must understand each others paradigms. Our goals for a patient may not be the same goals that the patient has for himself or herself. Arguably, an hour is often insufficient time for us to accomplish these tasks together. It is, however, a way to begin building a mutually beneficial relationship with each other based on trust and respect. Would you give up an hour of your time if it meant preventing losing teeth in the future? Taking a comprehensive approach also provides the baseline information that we need to do our work in the most predictable and optimal manner---with specific goals in mind. This, in my opinion, is the only way to create true value in the services we, as professionals, provide.

So, I remembered Henley, and that only I was the master of my fate. Do I take a chance and begin reflecting my values and philosophies into my work and my practice, or do I remain a technician of the mouth? If a patient called me on a holiday after breaking their front tooth, would I know who they were? Would I know what they expected of me as their dentist? In the beginning, probably not. However, now I have chosen to practice how I would like to be treated, and after a few years in, I can tell you that I am much happier both professionally and personally. I truly know my patients, and I don't need to scribble notes about their children, jobs, and hobbies on the front of their chart to remind me who I am treating. That in itself is personal fulfillment. I can now truly help my patients simply by understanding them as individual people living busy lives and dealing with unique and complex problems.

I fully recognize that we are living in the era of digital downloads, text messaging, fast food, and quick service, but there are many times when we need to rely on old-fashioned human relationships. It is important for us to get to know each other. It is important for the future of our journey together.

Embark upon your journey the same way, and remember, only you are the master of your fate.