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The Other Side of the Chair

March 1, 2007
You know what you’re thinking about during the day … but what about the dentist? What is that man or woman sitting across from you contemplating?

You know what you’re thinking about during the day ... but what about the dentist? What is that man or woman sitting across from you contemplating?

By Linda V. Zdanowicz, CDA, CDPMA

Have you ever thought about what it’s like on the other side of the chair? You know what it’s like over on your side. You know what you like, what you want, and how you feel about the things that happen during the day - but what’s it like over there? I asked some dentists this question and was duly enlightened.

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Assistants and hygienists, listen up. You know you’re good, right? You do a great job keeping up with your dentist or scaling every last bit of calculus off those teeth, but you still like to hear it, don’t you? It’s nice when your boss acknowledges your contribution. You also know what it feels like to work on a difficult patient. You know what you want to get from what you do, but how about the person on the other side of the chair? The dentists of the world. What do they want? How do they feel? What hurts them, scares them, or worries them? What do they need to get from their day so that they go home feeling good? Does it surprise you to think they even have the same emotions, feelings, and concerns as the rest of us?

How Does It Feel?

How do you think it feels when you care more about a patient’s oral health than they do? Think about making a treatment recommendation that is ignored or disbelieved, only to have the patient call you in the middle of the night to “do something right away because this tooth is killing me!” Patients actually expect that dentist to get out of bed and open the office at 1 a.m., because now they believe that the tooth needs treatment. How would you feel when you tell them the tooth has become hopeless and they look at you and say, “Well, why didn’t you make me do something before it got this bad? You should have been more convincing!” Talk about not accepting responsibility for themselves. Your boss has to deal with that.

What do you think it makes a boss feel like when a staff member makes a mistake or does something wrong and, rather than admit it, the mistake is covered up or ignored? These are the people the dentist trusts to care for his or her patients. Since the dentist can’t be everywhere at once, he or she has to believe that the staff knows right from wrong. If staff members aren’t honest with the dentist, he or she is left to wonder whether they are afraid to tell the truth or if they just don’t have the integrity to face the consequences of their actions. Either way, it’s one more thing to worry about.

Money, Money, Money

Let’s talk about money. Many times staff members see that the practice is doing well. Consequently, they think they deserve a bonus or a raise. Well, people do deserve to be fairly compensated, but do you understand where that dentist came from to get to the place he or she is in now?

Look at it this way. Let’s use $1 million as an easy, round number. Say that when everyone is 20 years old, they are given $1 million with which to start his or her future. One young woman decides to invest her money and realizes a profit of 10 percent a year, every year. Meanwhile, she may also be working and earning a salary. Another person (a young male) decides to take his money and attend college and then dental school. He uses some of his money to pay tuition and living expenses for the next eight years. If he gets married while he’s in school, he and his wife must live within very meager means. When he graduates, he decides to do an internship. So, at the age of 28, he’s ready to start his career. He sinks what money he has left into buying equipment and opening a dental practice. Now he has to attract patients, hire staff, and pay that staff. He’s probably breaking even, if he’s lucky. After about 10 years, he starts to get ahead.

Meanwhile, the woman who invested her money has been building on that for the last 18 years. So the dentist may start doing better, but he has some catching up to do. He’s a lot older when he can start enjoying the fruits of his labor.

While we’re talking about it, don’t forget if his production is increasing, so is his overhead. Staff members don’t think about it, but when the air conditioner breaks or the autoclave breathes its last gasp, the few thousand dollars it takes to handle that problem has to come from the dentist. He doesn’t ask the staff to chip in when there is an extra, unexpected expense. Since he doesn’t bring that up at staff meetings, they go on blissfully unaware of the added overhead expenditure. He’s only keeping about 30 percent of that production that seems so lucrative, and he’s working hard for it. His staff is being paid the salary that they agreed was fair when they accepted their positions. Anything that he decides to give them above that is a gift.

Treatment Time

What does that same dentist feel like when he walks into a room to begin treatment? Well, I’m sure he is often looking forward to the treatment, especially if he knows it will make a difference in a patient’s health or self-esteem. But, he’s a little tense, too. He’s about to give his patient an injection that the patient is probably dreading and, in all likelihood, will cause some degree of discomfort. He knows the patient really doesn’t want to be there, and, just in case he didn’t realize that, the patient will probably tell him. What if he is prepping a tooth and the decay is more extensive than it appeared on the X-ray and he ends up exposing the nerve? Maybe the patient will think he made a mistake or is just trying to create a need for further, more expensive treatment. How about the patients who say things like, “Well I guess I paid for that new car”? Would they like it if their boss commented on their purchases? How do they expect the dentist to buy things if he doesn’t use the money he earns for it? I imagine a dentist might feel like some people don’t think they should prosper from their work and enjoy what they earn.

Worrying About You

Another thing a dentist has to worry about is you and your family. He knows that you depend on your paycheck. Let’s face it, in most families, both parents have to work, assuming there are two parents. If it’s a single parent situation, that paycheck is even more important. He understands that and he probably feels a certain amount of responsibility. What if something happens to him and he can’t work for a while? Does he have enough money to pay that staff while he’s out of work so they don’t have to quit and find other jobs? What if he has to let a staff member go? Even if he tried to make things work and he ignored all the warnings and advice, he’ll still probably feel bad. You may be feeling that he’s lucky to have you, but do you give it all you’ve got? Do you think you’d work or think differently if you were the owner of the practice?

Staff members will often complain that their boss doesn’t appreciate them enough. Well, maybe the dentist just expects you to do a good job and saves the compliments for the really outstanding performance. The dentist has a million problems to think about - don’t make yourself one of them. Get your confidence from believing in the quality of your work and understand that it’s nothing less than should be expected. While we’re at it, when was the last time you complimented or thanked your boss for something he or she did for you? Dentists need that too, sometimes.

The Cost of Continuing Education

Think about the cost of continuing education. Sure, some of those trips the dentist goes on look nice but, for the dentist, they consist mainly of sitting in a big room with a bunch of other dentists all day and learning so that he or she can be even better at what he or she does.

Let’s take a look at one of those glamorous trips. A dentist decides she wants to start placing implants, so she has to learn how to do it. She gets online and finds a course in Mahwah, N.J. It’s a 10-day course broken up into two five-day sessions over two months. she buys a plane ticket, closes the office for two days (losing production and paying the staff anyway), and flies off to beautiful Mahwah. She spends the next five days sitting in a not-so-comfortable chair in a lecture hall. It’s exciting, but it’s probably grueling as well. At night, she eats dinner, then hits the sack. Not exactly living it up, is she? And then she gets to do it all over again the next month.

OK, she’s going to place implants. Now she has to buy all the stuff. So, she shells out $10,000 for it and prays that enough patients will need, and agree to have, implants placed. Hopefully, it all works out and she gets to make a little more money in the process. Shouldn’t she get to keep it and enjoy it, without any guilt? She did take all the risk, after all. She’s the one who gave up her time with her family and probably ended up with no down time before starting her week again.

It’s Not Easy Bbeing the Dentist

You see, it’s not easy being the dentist on the other side of the chair. If you happen to be a female dentist, you may find that you constantly need to identify yourself to people. Female dentists worked hard to get their degrees and they want the respect of earning that title.

Of course, you didn’t think about all the things behind the scenes because no one ever told you about that. So maybe there needs to be more communication with staff about what it takes to build a successful practice.

For the most part, no dentist strolled out of dental school with the keys of a brand new BMW dangling from his or her fingertips. He or she didn’t hop in and drive it to the brand new brick colonial on VIP Drive. The dentist worked for what he or she has, just like you do. The dentist worries about his or her kids, the bills, the business, his or her health, and he or she is involved in the same things you are. The dentist goes to PTO meetings, coaches soccer, tries to go fishing now and then, and jumps up and screams like a lunatic when his or her team scores, just like your husband does. Dentists love what they do and want to excel at it.

We are all more alike than we are different. We were all created from dust and given the world we live in to do with as we will. We are all in this together, and together we can achieve more than we ever can alone.

There’s something else going on though. There’s another side of the chair and there’s an assistant sitting in it. And there’s a room where someone is cleaning a patient’s teeth. Let’s not forget that there’s someone behind a desk, too. There may even be a spouse that is involved in running the practice. They help make it all happen as well. What’s going on with them? What’s their place in all of this? I’ll get to them in the June issue of Dental Office.

A Biographical Sketch

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Linda V. Zdanowicz, CDA, CDPMA has been a dental assistant for 16 years and a practice administrator for the last 2.5 years. Linda has worked in general dentistry, periodontics, endodontics, and orthodontics. Linda earned her CDA in 2000 and her CDPMA in 2004. She lives and works in Hendersonville, N.C., and has worked for Dr. Jeffery Price for nearly eight years as his primary chairside assistant, practice administrator, and patient care coordinator. She has a weblog dedicated to enhancing the practice of dentistry for dentists, auxiliaries, and patients -

Editor’s Note: Be sure to read Linda’s companion article, “Aristotle DDS” in this month’s issue of Dental Economics.