By: Dr. Joe McEnhill
I want to raise a glass to the general practitioner! We live in a world focused on becoming more and more special, but where does that leave the generalists? Does that make them just run of the mill? A bit lackluster? Less sexy? I for one think we should celebrate the role of the GP.
When I consider how many of my peers have lost their love for dentistry, I wonder how it happened. The challenge of overbearing regulation, litigation and patient demands is a mine field. In an effort to avoid the attention of the over-officious regulators and ambulance chasers, there seems to be a trend toward defensive dentistry. This leads to a downward spiral of clinical ability.
Is it a fear of failure and the resulting adverse sequelae, or lack of confidence in one’s ability, that has led to this defensiveness? Probably a combination of both, and it’s resulting in patients being referred even for relatively simple procedures. A specialist referral was not a luxury my father (a dentist) had when he started out. He was in at the deep end and just had to get on with it. And now, more than a decade past what many consider retirement age, he still practices and loves his career. So, what is the difference?
Meeting Your Potential
I remember setting out as a newly graduated dentist and being told by an older chap that he was a much better clinician. He explained this was because he had made many mistakes in his career, as opposed to being a fresh-out-of-the-wrapping, wet-behind-the-ears dentist cub.
This was not meant to be a put down; the point was to show me you cannot progress without reflecting on your own failures. If a pervasive no-win, no-fee claim culture leads to a cover-up mentality, then how can the next generation of dentists thrive and progress and realize their full potential?
I love my job. I think dentistry can be great fun and, specifically, I think general dentistry is fantastic. I might sound like a geek, but I’m sure I’ve been called worse! I do of course have my preferred disciplines and I gravitate toward oral surgery, implantology and esthetics. I also have plenty of weaknesses and, like most dentists, there are some disciplines I prefer to avoid.
The General Dentist’s Role
It is worth making an effort with specialists who work in your weak areas, as my orthodontist and endodontist will attest. But I see the general dentist as the conductor of the symphony orchestra. They need to know the whole score and make each section come together and ultimately wow the audience, in this case the patient. The conductor of this dental orchestra needs to bring each section in on cue and blend them seamlessly. As an “implantologist” and a generalist, I do this every day.
Some would argue implantology should be a specialty in its own right. Whichever way you look at it, any implantologists worth their salt must have a broad range of abilities. They must be capable of doing oral surgery, perio, occlusion and esthetics to a high standard, as well as understand the material science and have the ability to manage anxious patients.
But how do we define the standard of treatment that a reasonable body of clinicians would accept? Prosecutors rely on the evidence of expert witnesses, so realistically, our work will be compared to specialist standards. Maybe a dangerous precedent to set but also a not so gentle stimulus to become better, or as we might say in Ireland, a good kick in the arse!
Given that surgery, prosthodontics and periodontics are all specialties, there’s a lot of knowledge the implant/generalist must be clued in on. The acquisition of this knowledge is a journey, and one’s confidence changes along the way. What’s more, this knowledge evolves and progresses at what seems like an ever-increasing rate. It is still a requirement for specialists to keep up to date within their own specialty. That’s a lot of pressure for generalists.
Evolving In A Digital World
Aside from the expectation of being a talented clinician, none of us can escape the rapidly evolving digital world. Those who don’t embrace digital dentistry will be left behind. But, of course, as soon as you figure out one software, you need to learn another. And another.
Then there is social media. As a 40-something-year-old, I got my first mobile phone just before leaving university. That’s a stark difference between the youngsters of today who are getting their first mobile phones on entry to secondary school. So, whilst I am trying to shake off my Luddite ways, today’s youth are fluent in any and all apps. Facebook now seems to be for the older generation; then there is Instagram and Snapchat, and now I need to learn TikTok!
The converse of this situation is new graduates have a lot of manual skills to learn. As a profession, we can all learn from each other. I follow a lot of young dentists on Facebook and Instagram and am frequently inspired by how they put their stories together. They present their personality and skills to the world via a shiny new medium.
This, in turn, is open for all to see, giving patients access to a lot of information. But when you think about it, this can only be good in terms of transparency. A large photo of retracted anterior teeth on a 40-inch screen leaves very few hiding places. Every blemish in that nice new composite veneer or implant soft tissue profile literally (or should I say figuratively) screams at you. And so, we can reintroduce that proverbial boot to your derriere! The school report that informed you there is room for improvement springs to mind. The point: Continual education and reflection on your own mistakes lead to your own evolution.
What Makes GPs Special
I love my profession, but I am not willing to focus on only one thing. I want to be a general dentist who can manage a patient holistically and not just treat teeth. I love taking out wisdom teeth and optimizing the patient experience of an unpleasant treatment. But I do not want to miss those tears of joy when unveiling a newly rehabilitated smile.
Taking those shrinking violet patients on a journey that leaves them brimming with confidence is a privilege and makes all the hardship worthwhile. It means years of never-ending study and massive personal investment for more strings in the bow, but ultimately, this is what makes general dentistry so special.
