In my position at Spear Education I have the privilege of spending a lot of time with some of the best dentists in the world.Â Dentists who devote a large portion of their time, their energy and their money to pursuing excellence in our chosen profession.
When concerns about the dental practice are being discussed among our participants, one of the most commonly recurring themes is the difficulty experienced in having patients want the best care â the care they say they want.Â This is most certainly not a new concern for dentists.Â I recall being told in dental school by some instructors that âout there in the real worldâ dentistry is not about whatâs best, itâs about what patientâs are willing to pay for.
Having practiced for more than 30 years in that âreal worldâ I understand the frustration that comes from seeing a different future for patients than they see for themselves.Â I was left wondering why this great rift continued to exist as my technical abilities and the science of dentistry grew ever more sophisticated. Â I also wondered what, if anything, dentistry in general and I in particular had done to create and maintain it.
The Great Divide in Dentistry
The divide between what is known (optimal care) and what is practiced (accepted care)Â is after all a direct result of my attitude and beliefs about the services I provide for patients.Â I have heard dentistry described as an elective service, explaining the reason for the reluctance of many patients to request my best.Â I liked that.Â That meant that if told them about their options I had done everything I needed to do and the patient could elect to act on what I knew was in their best interest or not.Â I had, after all, fully educated them.Â If they declined to take action on my recommendations I had done my duty as a professional.
But had I really?
Free to choose, they chose the easiest, the least costly, the least whatever selection as they saw it?Â But is a blind, though fully informed, choice what they desire?Â Of even greater import, is it what they deserve?Â As a professional do I have a duty beyond that of giving my patients options and saying choose?Â When I see all the options as a cafeteria plan of electives, have I created a self fulfilling prophecy for patients who choose other than the best I have to offer?
Stay tuned for Part II of this article; I will go over a specific case of a Vietnam vet that I treated that will further analyze this topic.
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