Professional Courtesy: 6 Years and a Whole Lot of Humble Pie by Dr. Thomas Giacobbi

Professional Courtesy: 6 Years and a Whole Lot of Humble Pie

by Thomas Giacobbi, DDS, FAGD, editorial director

In preparation for this special edition of Dentaltown, I thought about the most meaningful advice I could share after 27 years of practicing dentistry. That sparked a memory of one of the best bad dental jokes for times when something doesn’t go to plan: You can tell your patient, “They call it practice for a reason.”

There is a shred of truth in that joke: The dental profession is one in which experience has tremendous value. The time spent in practice has a compounding effect on your speed, decision-making and clinical success.

In his book Outliers: The Story of Success, Malcolm Gladwell presents the concept that one can achieve true expertise by practicing a particular skill for at least 10,000 hours. If you apply this concept to practicing full time in dentistry (40 hours/week, 50 weeks/year), you will need to work five years to reach 10,000 hours.

Most dentists work fewer hours than that, so let’s peg the goal at six years. When young dentists ask when they’ll get faster, better or when will things get easier … the best answer is “about six years after you graduate.”

The other great teacher in this profession is a big, fat slice of humble pie. You’ll experience this more than once in your life. The important lesson is to know when your pie is ready to be served. Many times, dentists get themselves into trouble because they couldn’t recognize they were in over their heads or were unwilling to admit they didn’t know what to do. A story from the early days of my career illustrates this point.

I opened my practice from scratch after completing a GPR and working as an associate in a few different practices. I had achieved my 10,000 hours, and my previous experiences helped me determine what I wanted in a practice of my own.

As many of you will see, when you first start as an associate or you start a practice from scratch, things are slow. You will be ready and willing to do any reasonable procedure that walks through the door if the alternative is staring at the wall. In the early days of my scratch start, we might see only a few patients the entire day, so I was happy to do a root canal or extraction when needed.

On a particular Friday afternoon, I had decided to tackle the extraction of #3 on a patient who was in some pain from a badly decayed tooth. The procedure started well, with good local anesthesia and progress on the extraction. However, the decayed tooth broke unfavorably, and the difficulty level started to climb. At one point, I was struggling with that last bit of root. This procedure had taken longer than I wanted and become more difficult than I had expected.

The voice in my head said, “Danger! If you do this next bit wrong, you may wish you hadn’t done it at all.” I had to be careful of the sinus—losing a root tip in the sinus would be a terrible thing. I stopped to collect myself, and had the assistant take an X-ray to assess the situation while I went down the hall to my office and made a humbling phone call to the oral surgeon up the street.

I told him I was stuck and needed help. He told me to send the patient right over and he would be happy to have a look. I knew my patient was the last thing he needed in his busy day, but deep down I knew it was the best decision. I went back to the patient and explained that the procedure was not done but I didn’t feel it would be wise for me to press on. I told him I had a colleague up the road ready to see him that day.

The patient appreciated my candor and went to the oral surgeon to have the extraction finished. I called my patient later that evening and he was very appreciative of the referral and my desire to make sure it was done right.

There are many lessons I took from that experience. First, be humble and honest with your patients about your abilities and expectations. Second, while you can’t predict everything that might go wrong, you can always have a backup plan to address complications. Third, specialists are there to do the things outside of your comfort zone.

The beauty of practicing dentistry is the ability to define your comfort zone and to change that definition over time. You will have more than one slice of humble pie in your career and it will go down easier if you leave room for the lessons learned.

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