JACD 71-4 - American College of Dentists

Issues in Dental Ethics
56
was a consistent or telling pattern to
their behavior or their psychological
makeup. I was looking for something
that would explain how they made such
terrible decisions and got them into
trouble, something that I could share
with others to keep them out of trouble.
It turns out there is a pattern. In my
experience, the majority of these dentists
got into trouble because of a lack of
assertiveness in some way, shape, or
form. Some were not able to say “no” to
inappropriate patient requests. Others
were unable to say “no” to demands
from their own families. Some could not
stand up to staff members who did
things that were wrong. Then, in most
cases, once the dangerous bad-decision
ball was rolling, they could not step up,
take the hit, and stop the process before
it became a juggernaut that rolled over
them and crushed them.
Dentists need to teach themselves
(beforehand) what to say in difficult
situations, especially in uncomfortable
ones. And then they need to say it. This
means learning to say “no” appropriately,
A dentist should not
work on patients, but
rather work with them.
and learning to face difficult conversations
instead of avoiding them. This is a
skill that can be learned. Few are born
with it, few possess it naturally, but a
dentist absolutely needs it to practice
ethically and, in fact just to survive in
practice. And if you cannot figure out
what to say ahead of time, at least take
time to reflect afterwards on difficult
conversations you have had and then
rehearse for the next time they come up.
Principle 7: Consult
Another way to avoid the professional
failure is to stay connected with your colleagues
and the professional community.
A dentist who isolates himself or herself
in a small, individual practice is making
a real mistake.
There are many ways to stay
connected with other dentists, and some
dentists are very good at this. Join or
form a study club, become active in the
local professional organization, take
extra continuing education courses, read
widely in the field to remain energized
and creative, and, most of all, find a
couple of colleagues to trust and talk to
when you are not sure what to do. Call
them on the phone, lunch or jog with
them, and when you get stuck, ask them
for an opinion. Be sure to speak with
them if you find yourself faced with a
challenging ethical problem. Talk it over.
Consult. Make this a regular thing in
your professional life.
Principle 8: Manage Your Stress
and Your Life
Dentists have chosen a career that is full
of promise, but it is not an easy career.
Some dentists find the work to be too
taxing after a certain number of years,
so they leave it, or if not, they grow to
resent it, or they use drugs as an escape.
The duty to remain fresh and energized
is every bit as important as the duty to
learn about new scientific developments
or technical innovations. It is neither
wise nor fair to treat patients when you
hate your work or are numb to it or are
just going through the motions.
Dentists need to learn how to manage
their responsibilities, opportunities, and
energies productively, so that they can
enjoy the entire span of their careers.
They need to figure out, each according
to his or her own values and vision of
life, where the profession and the work
fit into the big picture, and then create a
work style consistent with that vision.
They also need to be aware when their
personal resources are not up to this
task and seek advice and support when
they need it. Dentists are typically
“hard-chargers” who can “work like a
dog.” They would not have made it
through dental school otherwise. But to
work yourself into the ground without
knowing what you are working for is
asking for trouble. This means pacing
yourself intelligently so that you can
really appreciate your practice and the
people around you. Your patients, your
family, and your friends count on you
to be sane and fully present. This is a
lifelong challenge.
What Principle 8 does is remind you
to pay attention to your life and your
consciousness, along with the other
seven principles, each time you put on
that coat.
The white coat is a symbol of all
this. It is a symbol for the members of
the dental profession, and it is also an
important symbol for patients, their
families, the whole community that turns
to the dental profession for technically
expert and for humane, respectful, ethical,
attentive care. When you put your coat
on each day, remember these eight
principles and the responsibility that
comes with wearing that coat. Then
wear it with pride. ■
2005 Volume 71, Number 4