Perception

Hello again
There is a perception that the UK is a first world country. We have running water, indoor plumbing, street lighting and a welfare system. We have a system of laws and a deep cultural history that is the envy of most other countries. The country is an infinitely complex network of businesses, services and infrastructure.
It works, but underneath the polished facade we see that the system appears to be straining. This is because it has become too complex. As our population and technology grows, we find more and more ways to remove the simplicity from our lives. This does not make our lives any easier, despite the perception that it does.
Take the I-phone. It couldn’t be easier to use, and yet I challenge any of you to tell me how it actually works. I know how a normal bog standard telephone works, and if one broke I might even be able to fix it. But an I-phone, hell I haven’t got a clue.
Take my car. A few months ago a little orange light lit up on the dashboard. I phoned up the garage to ask what it meant...........

“Oh, that means that a little orange light has come on. Bring it in and we’ll let the computer diagnose it.”

They needed a computer to tell us what was wrong with my car...... what happens when something goes wrong with the computer? How do they diagnose that, another computer? Now I remember my dad fixing his own car years ago............ no chance of doing that these days, not unless you like driving around in classic cars.
I bought a pair of shoes the other day. Remember those tags that were placed on clothing so that it couldn’t be nicked from the shop without the alarm going off.......... well in this case the tag was (and still is) inside the shoes. RFID technology. Marvellous............ and also unsettling.

Now there is a danger to all this. As technology advances it makes old technology obsolete. The old technology is replaced and becomes a curiosity residing in museums and the garages of eccentrics and collectors. It becomes more and more difficult to go back to that old technology. And have you noticed that as technology progresses it becomes more and more fragile. It also tends to make us more reliant on said technology. (If a major Coronal Mass Ejection from the sun hits us in the future, the books in the library will still be there. Probably won’t be able to say the same for much of the digital recording media we like to use.)

“The things you own end up owning you” – Tyler Durden

As an example, take the I-phone again. My first mobile phone allowed me to ring people and send these amazing things called text messages. My I-phone allows me to take pictures, view my bank accounts, read my emails, watch TV, plan my whole life and there is probably even an App that allows me to control satellites. And if you lose it you better hope you have it all backed up.

There is also the view that this technological advance actually holds back our advancement as a species. In 1969 some chaps went to the moon using the computing power of today’s pocket calculators. Unfortunately we no longer go to the moon because it is too expensive and too complicated. We now have a situation where we are surrounded by electromagnetic radiation, where unhappiness is rampant and where cancer strikes one in two. Cancer used to be a rare curiosity. I would argue that technology is not benefiting us as much as we think it is.

And speaking of NASA, there is a story that explains my point quite nicely. NASA spent about a billion dollars inventing a pen that could write in zero gravity. It could write upside down, under water and in a vacuum. It was a very impressive achievement.............. but you know what, the Russians didn’t have that problem.

They used pencils.

We are now creating technology for the sake of creating technology. And all this technology requires more technology to make it work. And in a time when the earths resources are beginning to disappear like draught beer at a student party.......... that’s not wise.

In fact, it’s complete insanity.

And look at dentistry as another example. Care to tell me how many different types of composite there are on the market. How many different bonding systems are there? Oh is that one stage, two stage or three stage? Do we remove or keep the smear layer? And let’s just go through all the different porcelains shall we.

It’s enough to make you head spin. And yet you the technology that was available when I qualified in the 90’s is more than adequate to restore the majority of the population’s dentition. And it’s not just technology that is becoming more complicated, it’s also a mindset. Let me explain the mindset as I see it. I’m not saying this is the truth, it’s the truth “as I see it”. Many of you will disagree with me, and I would be upset if you didn’t. I bring you ideas but I don’t expect you to accept them blindly. After all, I’m not some Guru in an Ashram.

Speaking of Gurus, there are a collection of so called “Dental Gurus” who preach a message of excellence. Excellence in clinical dentistry, in customer service and in service delivery. Much of what they preach is valid, valuable and useful, and unfortunately they have started preaching a message that is also damaging, at least in my mind. There is now a growing perception that unless you have super high tech, professionally designed dental practices with flashing lights and interactive websites, that you are somehow not a “successful” dentist. Don’t get me wrong, there is nothing wrong with this kind of practice. I just don’t think it is the model for most of us. Let me explain.

All this costs money. The marble floors and 50 inch plasma screens in every room requires a significant investment. This means the person sitting in your chair needs to pay more... a lot more. My question is really, is it necessary? Is this what the patients want.......... or is it what our EGO’s want? And it also means that you, as the dentist, are snared by that practice, you become locked in. Your investment actually limits your options and brings considerable, and I would say unnecessary risk. I think there is an easier way. The key is not what the premises look like, not the fancy gadgets you buy to complicate your life even more. I have to question the concept of getting oneself into massive debt to deliver what are effectively the same services.

Dentists seem to have an amazing ability to spend money. In Texas, they have a saying for it

“Big hat, but no cattle”.

They also seem to have an amazing ability to work more hours than they should....... “because they have to”. Unless you are one of the rare breed that absolutely live for your job (you know, the type of person that eats lives and breathes dentistry) I think it is important to remember that there is a life to be had outside the dental surgery. I know of a private dentist working a 6 day week because he’s so busy with new patients. To me, that’s no different than the old NHS treadmill that killed so many of us. He and the many like him are too busy making a living to actually take the time out to design a life.
I’ll put it this way. If on your death bed you complain that you didn’t do enough crown preps in your career, then please work as long and as hard as you like. If you are an entrepreneur who wants to be the next James Hull, then please burn that midnight oil, create your legacy. You are to be commended. For the rest of us, just concentrate on the basics. Keep it simple, keep it safe and keep them smiling.

You can do good dentistry from basic premises. They just need to be:

• Clean
• Comfortable
• Welcoming

You put good staff and ethical, caring and skilled dentists in there, and you will have a successful business. “You should go and see my dentist, he’s really nice”. THAT is the key in my view. And there is nothing to stop you making the place look nice aesthetically, but do you really need to take out a loan the equivalent to the national debt to do it? When I bought my practice I put in wooden floors. It cost about £3k, and I paid for it from the profits of the business. A very basic thing to replace the manky tiled carpets that were there previously, but even to this day the patients comment.

In my opinion, ONE of the reasons to be in primary care is to make a living sufficient enough so that you can earn your financial independence. This way you can reach a point where you are working because you want to, not because you have to. And that point should come well before retirement age. That way, when life comes along and drops a bombshell at your feet (and it will) you can deal with it without the added pressure of worrying about your finances.

You shouldn’t be working in your 50’s because you have to. You should be working because you WANT to.

The old model of treadmilling didn’t allow this. And the way I see the economy heading over the next 5-10 years, putting a huge financial monkey on my back is perhaps not the way i want to go.
Regards

Stephen Hudson BDS, MFGDP, DRDP

Please help support the Sick Dentist Scheme and the BDA Benevolent fund by buying my book Choose Your Reality. A proportion of the profits from its sale are split equally between these two charities


Disclaimer: S.Hudson or SNH Publications will not be held liable for any actions taken based on the information provided in this newsletters. This information is for entertainment only.