Worry

Robert E. Horseman, DDS

      We all entered dental school with a certain amount of worry and apprehension. Compared to what came out four years later at the other end, though, we were insouciant youths, rank amateur worriers at best. To become a really world-class worrier normally takes longer than four years, and in any other academic pursuit this still holds true, but dentistry is an exception.

    Through excellent and unrelenting tutelage, entry-level worrying is elevated to a fine art in a relatively short time; the whole essence of a first-class worrier distilled and refined until at graduation the new dentists emerge to start their worry-intensive careers with their degrees and a portfolio of concerns more comprehensive than they could have imagined.

     In the past, much has been made of the fears and worries of our patients. Many practice management lecturers would be out of business and reduced to actual laying on of hands if it weren't for these patient worries. Yet, little or no attention has been focused on the worries of the dentists, probably because the patients won't ante up $195 to learn how to overcome their dentist's worries

     Dr. Arthur Moronia sent in this query: I worry a lot about full denture cases. Sometimes my stomach hurts. Is there any reason for me to be so uptight?

     Us: You bet there is, Art. When it was decided years ago that dentists instead of blacksmiths should make dentures, we lost the ability to relax from that time forward. The opportunities for worry about dentures are manifold: 1) They don't fit. 2) They do fit, but the patient's wife doesn't like them. 3) Neither one of them likes you after a month and have taken a sacred vow to harass you until the end of time or until you have given all their money back plus the pink slip on your BMW.  They have told all their friends the blacksmith could have done it better.  How unhappy could anyone possibly be if he never had to make another denture?

     Dr. Fabiana Montrose writes from San Andreas: My office lies directly over a well-known earthquake fault and I worry about this, especially when there is a ring around the moon. I have a headache THIS big more often than not! What should I do other than wear a football helmet and reduce all my cabinetry to a height of 18 inches?

     Us: Remember that if you are 30 or over and have never had a major operation or a dreaded disease, you've about reached the limit of what the gods will allow.  Worry about that instead.  If you insist on concerning yourself with the earthquake, which, by the way, the Earth First people say will happen next week around 4 PM, you should definitely move immediately to Krakatoa where there has not been a disturbance for ever so long.

     From Leftover, Nebraska, Dr. Albee Withsee complains that his main worry is compliance with anti-infection orders. He thinks it would be a relief to finally get cited for noncompliance because he wouldn't have to worry about that anymore.

     Us: you are absolutely justified in your worry, Doctor, especially when you consider that there are unspeakable things in your cuspidor quite beyond the reach of plumbers' tools and immune to the flushing of cleansing agents. It's only a matter of time before they slither out, destroying everything in their path. You should fight fire with fire and after the purifying heat of combustion has subsided, worry about beating the arson rap.

     Occlusion is what has Dr. Sandeep Bhattpathy agitated. Dr. Bhattpathy, you will remember, discovered the patented method of converting a barndoor hinge to a sophisticated articulator. He sold this innovation to the Denar Corporation in 1936 and has been living like a rajah ever since, although Denar never capitalized on his patent. Today he is worried that his knowledge is insufficient to manage some of his more difficult cases.

     Us: Well, Doctor, ever since we tried to set up teeth in the prosthetics lab in 98 degree temperatures, occlusion has remained a thorn in dentists' paws. You should always be aware that there is a maniac or two in everyone's practice just waiting to have a minor alteration made in his bite so that he can present you with a subpoena. These people can be readily identified when they refer to you frequently as the "defendant." It would be a nice gesture if you would refer them to your orthodontist friends so they can share your concerns.

     Following are some common worries you may have overlooked, but are important enough to prevent you from becoming a Senior Worrier if not observed:

v    There is a good chance that you will have to take out every amalgam you have ever placed and restore the tooth with something very costly and white. People who have moved away will have to have their airfare paid for and if they have died in the meantime, you will owe their survivors at least a million dollars apiece. 

v    Resin restorations almost certainly have something toxic in them. Just because the components taste bad doesn't necessarily mean they are good for you. The fatal element just hasn't been discovered yet, but you can bet they're working on it.

v    You should worry about why you never could start your day at 9 AM like most civilized businesses. If you can't begin your work at a reasonable hour, you would be justified in assuming that you have lost control of everything else as well.

v    You should avoid as long as possible men wearing hats. Sooner or later a blue-jowled citizen wearing a topcoat, a dark grey fedora and black high-top shoes, will appear at your office.  Claiming to be from some government agency, and possibly accompanied by large black dogs, he is going to demand things from you that you can neither comply with nor understand. Rolling your eyes upward in martyrdom and feigning injured innocence will not lessen your sentence.

v    If two or more successive orders from your supply house turn out to be correct, you must realize that you're being set up for some epochal error that will take more than 6 months to rectify.

v    As a general practitioner you should have noticed by now that all the specialists you refer to have a more opulent life style than you do, take more time out of their offices and indulge themselves with vacations costing more than your annual net. It would be wrong for you to sleep soundly, knowing that, on average, they are 10 years younger than you.

v    There are very few things in your office having sharp points that will not have stabbed you almost to the bone on the days you're out of peroxide and only have Band-Aids in red, white and blue with the word "Owie" printed on them.

v    The requirement that you go mouth-to-mouth with the resuscitation dummy for your CPR certificate is likely to be dropped. It will be replaced by the necessity to prove your proficiency in placing a Class III foil every year on your birthday, plus reciting correctly the enervation of every major organ of a dead frog.

v    You're better off with a tarantula in your skivvies than having three unattended kids under 5 on sugar highs left in your reception room with Crayolas and a bag of Milk Duds.

v    If you have a computer in your office, you're really asking for it. When you least expect it, an asteroid with a magnetic field larger than Jupiter's is going to pass within 20 miles of your office and put you out of business. It happens all the time.

v    The CDC and OSHA are afraid that by your inattention to barrier techniques, lethal bacteria in your office are going to bite somebody and all parties will then blame you for encouraging this attack.  Like the bacteria wouldn't consider infecting you just for the hell of it. To practice really safe dentistry, you must seriously entertain the idea of  staying home and conducting your practice by Federal Express.

v    While you're at it, you might worry about what the world of potential patients is doing between your first appointment in the morning and the long wait for the last one in the afternoon, and if a lunch hour extending between 10 and 3 is really in your best interests.

v    You need to start worrying if, after 3 decades, all x- rays begin to look pretty much the same. 

v    If your curing light is powerful enough to turn something soft into something hard as a bowling ball in 20 seconds, what else can it do?

v    You should be alert to the fact that wearing your mask for 30 minutes is the equivalent of being in a closed garage with the car running for an hour. You should never put on a mask without leaving a note.

v    It would incorrect for you to go to sleep at night without understanding clearly that at least one of your staff is at that very moment getting pregnant or writing you a letter giving 2 weeks notice.

v    Out of every 10 patients at least 3 of them believe they are not getting their money's worth unless you do it twice.

v    People who are allergic to antibiotics and every kind of pain killer known to be useful, will make a bee line for your practice the second they are in trouble.

Originally published in the Journal of the California Dental Association 11/91.

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