If you know me you are very aware of my belief that dentistry is way less about teeth and procedures than it is about the patient. In fact, I extend that to say that it is much less about any of those three than it is about YOU.
If you know me you are also aware that Atul Gawande is one of my favorite authors. His last book, The Checklist Manifesto, is on my personal all-time best list, but then I am a little OCD so I like lists.
His latest, Being Mortal, is an observation about the way in which medicine and health care have changed the way we think of and treat people as they approach the end of life. It becomes incredibly personal when he shares his experiences with his wife’s grandmother and his father. I recommend the book very highly.
The reason I offer it as something that is worth your time is that I believe it has the power to change the way in which you interact with others. Not just OLD others, all others. It turns out that Atul becomes highly aware of something that I have been aware of for a long time.
EVERY Medical (dental) Procedure is Elective.
As dentists we were trained to tell people what they need, to solve their problems before they knew they had them, to be the experts regarding what is and what should be. Most of us learned rather quickly that method did not work as well in practice as it did at school. (there is a good reason for this but that’s another digest) We quickly adapted to the new normal in one way or another. Some of us became slick and polished in skills of selling, some of us learned to only tell people what we believed thay would say yes to, some of us got angry and depressed, some of us learned to listen and wait until the patient had a reason to ask, yet each of us realized that everything we had to offer is elective.
This lesson is one that is not yet clear to medicine and not yet clear to most physicians. Every procedure is elective. The reason this becomes so clear to Dr. Gawande is that the decision about a medical possibility makes that procedure much less “necessary” when the outcome that every patient eventually arrives at is close enough to see and feel. The truth is that the same freedom, the same decision is always owned by the patient when we (health professionals) give it to them.
This does NOT mean giving a patient a list and saying “do what you want” just as much as it does not mean saying “You will do this.” It means treating the person rather than the disease. Freedom is given when we become the advocate for what the patient wants, for what they see as their preferred future, for what they want to be who they are and want to be. Sometimes this means our best dentistry is not the right treatment for this person at this time.
I know that we at Spear Education spend a lot of time helping you be the best technical dentist you can be, and I am very proud of that. I also know that we realize that teaching you to do that exceptional dentistry will be less than rewarding if you can’t help patients see it and want it. I believe that happens when you can let go of the need to be in charge, when you can listen to the person in the chair, when you can ask the questions that help them talk and learn what they are really after. This book helped me see that more clearly than ever.
Have you read this book? What are your thoughts?
Gary DeWood, D.D.S., M.S., Spear Faculty and Contributing Author