What's your take on how the profession has changed in the last 20 years? How do you feel about it?

Replies to This Discussion

Permalink Reply by Cary Feuerman, DMD on September 12, 2010 at 10:33am

Suzan, I would have to say that my experience as a periodontist who has maintained a private practice for over 25 years is vastly different from what you have outlined above. Our motto is to always "do the right thing" for our patients. Most successful dentists and practices, in my opinion, always outline and follow a comprehensive, health-centered, ideal treatment approach for patient care. Patients will make educated, well-informed decisions about their care. Dentistry is a wonderful profession that has the ability to vastly improve the quality of life, health, and sense of well-being for our patients. Regarding dental school applications, are they not at or near an all time high? At least the institutions in the Boston area are certainly not struggling for enrollment. Admission to dental school remains highly competitive. Thanks for generating some discussion.

Permalink Reply by Suzan Bekolay on September 12, 2010 at 12:36pm

Thanks for your perspective Cary. I should have made it clear that I was referring to general practice. I'm pleased your experience is completely different and offer an explanation as to why. Specialists contend with a different behavioral paradigm from general dentistry. They are largely insulated the need to influence choice since people go to specialists with a readiness to change. They know what a specialist does and make the appointment with a more committed intent for services often directly corresponding to the efforts of a GP. You have another advantage in a referral based practice; the transference of trust. I trust my GP therefore I trust to whom I am referred; at least at the start.

The general dentist has a considerably different challenge in competing for the investment of discretionary income. Their need to influence choice beyond insurance is often the agenda and frequently is about cosmetics. Many patients subscribe to the no pain:no problem paradigm which presents a behavioral complexity in itself; to shift the behavior to one of pro active choice. Others have a heightened sense of "buyer beware" subsequent to the now very public view of opinion in social media venues for one. The "informed" consumer is, I would suggest, a different consumer from days gone by. Generally people do not respond well to pressure tactics some of which include over teaching; well intended or not. To be clear, your philosophy does indeed exist in the general dentist population and some are thriving. The questions are which philsophy is more predominant and why; what explanations are there for the rise in GP failure: why are people reporting feeling "sold" more than before; why are a number of general practitioners disenchanted?

The institutions I refer to are post graduate institutions. It would be interesting to have data on the motivations of student enrollment in dentistry. We know there is a rise in female numbers.

Of course, we have no stats on any of the above; only anectdotal evidence and that's why I opened the discussion.

Thank you for helping me clarify my meaning. I honour your approach. I believe the picture is not bleak and dark. There is huge opportunity and I would offer this may be a time of accountability and reckoning. It's a very exciting time for all of us who share your commitment to health centered, client centric paradigms.

Maybe I'm full of bologney and all is well, better than ever before but some of us veterans have a different take. I hope to hear from others.

Permalink Reply by Don Deems, DDS, FAGD on December 25, 2010 at 11:29am

Hi Susan,

That's a good lead-in for discussion.

I have been in general practice for nearly 25 years, and indeed there have been a lot of changes.

However, I agree with Dr. Heurman on his approach to dental care, which is very similar to mine. 

From my perspective, the majority of "marketing" (by that, I'm assuming you mean some type of external marketing) is done by a minority of the profession. It's my opinion that what's driving this "marketing and sales" is primarily marketing professionals and dental consultants who have found an easy target with dentists ... the pitch is easy, and to find those dentists who want more money, well, that's not hard.

The dental profession is missing great philosophers and great teachers of dentistry. A select few are around, but they are old and retired. The new "gurus" have put too much emphasis on money - not that it is all of their emphasis - but it is a lot. Further, much of what dentistry is experiencing is only a reflection of our materialistic culture. As you said, long-standing institutions are struggling for enrollment ... and part of that is because the potential teachers, philosophers, and leaders have taken a back seat to those with money who look to place ads in journals, which in turn give them "article space", which then fills the journals with mostly articles geared towards making more money and making it faster.

Make no doubt there are great teachers out there ... but they choose to quietly go about their teaching rather than make it a money-making scheme. It's their passion.

Older generations have always felt younger generations were on the wrong path, but it's just evolution in progress. It's neither good or bad. Change is inevitable.

What is needed is a solid foundation for change, open discussion in the profession, and responsible teachers, leaders, philosophers who can help re-focus the profession on its core principles.

Permalink Reply by Suzan Bekolay on January 4, 2011 at 12:04am

Happy new year all and thanks Don for your thoughts on the subject of what's changing.  We're on the same page.  A man I deeply respect has a web site called "in the spirit of caring" which houses many writings of the masters.  He and 8 other masters joined me and another great master in a conference call in late 2010 as we ran the idea up the flag pole so to speak.  We are slow at it but working towards a summit where the "best of the best" come together under one roof and park the self promotion and clinical approaches or biases at the door.  We have all been in the profession many years and have at least one major thing in common.  We're committed to relational - health centered care which we believe to be core principles of which you speak.  We recognize there are many parts to great practice and there are masters of particular areas. 

Pulling off the "Light My Fire" summit is no small undertaking and I still remain optomistic that it can become a reality.  Members of the group share my enthusiasm but for a variety of reasons we got stalled in the late fall.  2011 we begin again.

I'm no more than a strong believer and like you, feel there needs to be a venue where THE GREATS are made available affordably, with effectiveness and keeping in mind that even 3 days of intensive needs follow up and support for those interested.  The intent is to light the fire where there has been so much noise around new technologies and technique.  We all share the belief that dentistry remains a behavioural art.  However, the efficacy of the summit remains questionable to many of the Greats who believe that too many are pulled in the opposite direction with as you say marketers galore.

I confess I'm reluctant to broadcast since some might misunderstand my commitment to the profession that has given me so much and be suspect that I am self serving in my motives.  Nevertheless, there's a link on my web site only because we needed some place to begin where interest can be expressed.    We have the notion that PERHAPS and it's a big one...a "by demand" summit is possible and relies upon word of mouth so to speak; in other words, via blogs like this and others that a "viral" marketing may occur.

Are we nuts is the question?  Is it possible that there might be enough demand; where the audience drives the agenda?  We're all called for some strange reason to want to contribute and give back to the profession that has had tremendous positive impact on all of us with a very unclear line between professional and personal growth.  Would love to hear thoughts from others.  ARE WE NUTS?

Permalink Reply by Don Deems, DDS, FAGD on January 4, 2011 at 9:02am

Nope, not nuts, but I feel a voice of reason. As a dentist, practicing coach, and international speaker, I have been in touch with many dentists who feel similarly. I for one, am all for pulling together as large a group as possible, having a loose agenda, and a multi-day discussion, pulling together resources, ideas, energy, and interests to see what's possible. One woman doing it alone can't make it happen (unless you're really God). Thoughts?

Suzan Bekolay said:

Happy new year all and thanks Don for your thoughts on the subject of what's changing.  We're on the same page.  A man I deeply respect has a web site called "in the spirit of caring" which houses many writings of the masters.  He and 8 other masters joined me and another great master in a conference call in late 2010 as we ran the idea up the flag pole so to speak.  We are slow at it but working towards a summit where the "best of the best" come together under one roof and park the self promotion and clinical approaches or biases at the door.  We have all been in the profession many years and have at least one major thing in common.  We're committed to relational - health centered care which we believe to be core principles of which you speak.  We recognize there are many parts to great practice and there are masters of particular areas. 

Pulling off the "Light My Fire" summit is no small undertaking and I still remain optomistic that it can become a reality.  Members of the group share my enthusiasm but for a variety of reasons we got stalled in the late fall.  2011 we begin again.

I'm no more than a strong believer and like you, feel there needs to be a venue where THE GREATS are made available affordably, with effectiveness and keeping in mind that even 3 days of intensive needs follow up and support for those interested.  The intent is to light the fire where there has been so much noise around new technologies and technique.  We all share the belief that dentistry remains a behavioural art.  However, the efficacy of the summit remains questionable to many of the Greats who believe that too many are pulled in the opposite direction with as you say marketers galore.

I confess I'm reluctant to broadcast since some might misunderstand my commitment to the profession that has given me so much and be suspect that I am self serving in my motives.  Nevertheless, there's a link on my web site only because we needed some place to begin where interest can be expressed.    We have the notion that PERHAPS and it's a big one...a "by demand" summit is possible and relies upon word of mouth so to speak; in other words, via blogs like this and others that a "viral" marketing may occur.

Are we nuts is the question?  Is it possible that there might be enough demand; where the audience drives the agenda?  We're all called for some strange reason to want to contribute and give back to the profession that has had tremendous positive impact on all of us with a very unclear line between professional and personal growth.  Would love to hear thoughts from others.  ARE WE NUTS?