Dr. Mommy Dentist

Thursday, August 03, 2006

argh...

so i've been at the office in the 'burbs now officially for two months. i make damn good money and the staff is phenomenal and the patients are terriffic, but the place is not without it's kinks. no place is perfect, of course not. but did some things ever just rub you the wrong way, even if when you break it down mentally and there's no rational or logistical reason for it, you kind of just get a hunch or an unsettled type of feeling? that's kind of how i feel about my (newest) boss.

it's great to have a colleague there to bang ideas around with, consult with, ask questions to when you're completely lost, and she's great for that. but every day i'm reminded, both intrinsically and sometimes literally verbally, that it's her practice and she's got the final word. "don't use a new silicone polishing point for each composite and don't throw them out when they become nubs, this is my practice and i decide when things get thrown out." "i don't agree with this treatment plan, it's too aggressive/not aggressive enough, this is my practice and we all have to be on the same page." "i'll be doing this crown on this patient because it's my practice and i'm not familiar with your work." "these aren't your patients (even though you treatment planned them), they belong to the practice." ummm, okay, i get it. really. i'll just crawl back into my cardboard box now...

i've only been out about three years, so i know i'm still the low man on the totem pole. at the same time though, it's like, dang i've been out for three years now, am i ever going to stop being the low man? i've worked for people before, people who have invested a lot of time and money into their offices, and of course when i have an office of my own i'll be a bit of a megalomaniac myself. it's only natural to want to protect your business. and i completely understand where this person is coming from. but why is her particular approach and her constant reminding me of my place just not sitting well with me? am i being hypersensitive and should i just accept this as the way things are until i've "proven myself" and/or it's my turn to be in control? or do have enough experience under my belt at this point to warrant a little more trust and respect, and is this really not the right kind of environment for me?

and the icing on the cake of the day: geting scratched on my hand by a composite finishing but that had just been used subgingivally on a Hep C positive patient. gotta love the health professions!

9 Comments:

  • Hey Manda! Hopefully since the boss is newish, she's just proving herself. Sounds like she should take a course on staff management, though!!

    By Anonymous Anonymous, At Sunday, August 06, 2006  

  • I agree, two months is not that long to allow someone to trust you enough, especially if they are a control freak (which lots of dentists are).

    Are there other associates that you can speak to to see how they feel about the boss?

    By Blogger Unknown, At Sunday, August 06, 2006  

  • hey amleoblast, thanks for visiting my site!

    i guess for the time being i'm just going to deal and see where things take me. as for asking the other associates, i don't want to get into that at this point in time because i don't want to seem even remotely unhappy. as far as everyone at this office is concerned, things on my end are just dandy. i do know that the other staff members find her controlling and sometimes difficult to deal with, as you correctly say that most dentists are (myself included, which is why i'm even having this internal dialogue to begin with) but when does the line to megalomania get crossed is my question. who's being over-sensitive, who's being unreasonable, and how can you tell the difference?

    i do appreciate your perspective, though, thank you!

    By Blogger Dr. Mommy, D.D.S., At Sunday, August 06, 2006  

  • In my opinion, regardless of the office policies, there needs to be decent chemistry between you and the owner and staff. And most importantly, the dentistry needs to be ethical. An ethical megalomaniac is going to be better to work with than an unethical megalomaniac, of which there are many, many more.

    Time will help you to answer these questions and decide whether you should move on to another office.

    Hygienists and dental assistants deal with these issues to a much greater extent than we do and have to find ways to cope...Can you believe that some dental assistants will stay at a practice even though the dentist has thrown instruments at them?

    By Blogger Unknown, At Sunday, August 06, 2006  

  • there's no question that the dentistry is ethical. i haven't been out that long, but i've walked in and straight out of several places because some of some shady practicing, like re-using disposable materials, cutting corners.

    as an endodontist, this scenario will probably turn your hair white: one place i worked in NEVER used rubber dam for endo, despite the fact that her brother-in-law was an endodontist. i asked her to provide me with the equipment, and she gave me the oldest, crappiest latex she could scrounge up from her years in dental school over 10 years ago (latex doesn't last forever, you know). needless to say, i didn't do any more root canals at that office and i left after 5 months.

    in a nutshell, it goes without saying that i only associate at places where things are done properly. and i don't claim to be the best dentist there is, but i am always honest and i always try my best.

    i happen to really enjoy endodontics and would love to pick your brain sometime! i also enjoy your posts about treatments. i'm always looking for ways to improve my technique.

    thanks again!

    p.s. i have a separated file in my own tooth, the MB of my #46. RCT was completed about a year and a half ago, no problems.

    By Blogger Dr. Mommy, D.D.S., At Sunday, August 06, 2006  

  • Gosh, that seems awfully heavy handed. I think she's going overboard. You aren't a student for heaven sakes. I hope she tones it down otherwise no one will stay with her long. I don't think you are being overly sensitive at all. She'd piss me off big time.

    By Blogger MomEtc., At Sunday, August 06, 2006  

  • You're welcome to pick my brain anytime...There's not a lot in there, especially after all the abuse it took in dental school (along with the liver), but buried deep there are probably a few gems you could tease out.

    Since the prognosis of endo depends upon the amount of chronic infection associated with a tooth, broken instruments only alter the prognosis if they are broken early enough during treatment that a decent amount of instrumentation and disinfection was not achieved, and/or the tooth was chronically infected. Retained broken instruments in vital teeth will not significantly alter the prognosis of the endo (assuming the overall endo was good) but can increase the chances of persistent post-op sensitivity (I think because of retained pulp within the apical canal area).

    Good endo outcome studies follow teeth over at least 5 years because endo failures can take that long (or more according to Strindberg) to be observable. I'm sure you've seen asymptomatic patients with persistent or enlarging apical lesions.

    I also don't pretend to be the best dentist out there, but we can only strive to better ourselves with our approaches to treatment and patient management. Unfortunately, as I said before and as you indicated, too many of us strive to better our production at a detriment to the best interest of the patient. Unfortunate, but it's human nature. I guess we have to try to be more than human to not fall into that trap.

    By Blogger Unknown, At Sunday, August 06, 2006  

  • Hi Dr. Mommy,

    Most dentists remain pure of self interest when recommending treatment. I assume the same for you as such, any treatment decisions are between you and the patient. The Principal dentist should mentor the Associate and when a the proposed treatment is contended; the dialogue should be educational - conciliatory, not confrontational.

    While I do not have all the facts in this matter, your comments indicate a draconian work environment. It's not that uncommon either.

    All best, always,

    Bill

    By Anonymous Anonymous, At Monday, August 07, 2006  

  • thanks guys for all of your comments. i really appreciate all your feedback - and you all have pretty different opinions and perspectives.

    i've had some time to process it all, and i think it's a bit of both. yes, she is a tad controlling, and it does bug me that i have very little autonomy. but at the same time, it's not like she's standing there with a whip over my head, criticizing my work and being a slave driver, either. there actually have been several times where she has bailed me out, on a difficult extraction, once with a PITA kid, and she actually asks for my clinical opinion and judgement (which makes me feel good, it reminds me that i'm an colleague, not a minion). i have learned a lot from her these past few weeks, and when i'm not sure of something, it's very comforting to know that there is someone readily available with a lot more experience who can help me.

    but at the same time, i'm just not getting the right beat on her and i have to figure out if my feelings are a function of my insecurities as a new dentist in a new practice (of which there are many!) or if she is truly being difficult and picky. i guess only time will tell, so i have to just stick it out and wait for the answer to come to me. until then, i'll check my ego at the door and just do what i was meant to do - fix them teeth!

    thanks again for the insight!

    By Blogger Dr. Mommy, D.D.S., At Monday, August 07, 2006  

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