One of the biggest contributors to burnout in dentists, in my opinion, comes from decision fatigue. Constantly we are faced with our patients’ problems that we did not create and are expected to find a solution to this problem.
We must evaluate the problem, excavate possible causes for this issue, determine solutions to manage it, and present it in a way that aligns with the values of someone we’ve just met a few moments before.
We often joke that the teeth are the easy part of our job, while the patients that the teeth are attached to add the layers of complexity to our job.
Communication with Patients Who Have Avoided Dental Visits
It is not uncommon in my practice to encounter a patient who has avoided dental visits for many years who presents with a broken, carious, and non-restorable tooth on a Friday afternoon.
Often this patient greets you by saying how much they hate being here and dislike the profession you’ve chosen to dedicate the majority of your life to. They also want a solution to get them out of pain and replace this tooth as quickly and cheaply as possible.
Sound familiar?
My greatest struggles in these moments is communicating to dental patients all of the options, as well as, their risks and benefits to a patient in a way they will understand. As dentists, we have to distill the knowledge we have gathered from dental school and throughout our career into a few short sentences. I work very hard to impart to patients that even the best tooth replacement option in my toolbox, is never going to be as good as what they lost.
No matter what option they select, there will be drawbacks and it will require routine maintenance, just like their teeth. Dentures will require adjustments, implants must be kept clean, bridges have drawbacks and a lot of patients do not realize these facts.
When a tooth is lost, every solution or treatment plan we can present to a patient requires the patient to compromise in some way. Implants are as close as we can get to replacing a natural tooth, however, patient will not have the proprioception that they did with natural teeth. Many patients are not candidates for implants or cannot afford them. Edentulous patients may not have to worry about brushing their teeth daily or having tooth aches, but dentures only give patients 10% of their chewing function back and are difficult for patients to learn to wear. Bridges compromise adjacent tooth structure and can be more challenging to clean and maintain.
As the dentist, it is our job to think through all of the factors surrounding all of our tooth replacement options and gather as much information from the patient as possible to determine which option may suit them best. Managing and providing realistic expecations for the patient is a true challenge and you won’t be able to please everyone.
Dentists have a tendency to want to people please and problem solve. For a lot of us, this is what attracted us to dentistry. However, you must put the responsibility on the patient. You did not put the caries in that patients’ tooth. You do not have to be the hero that saves the day. It is important to remember that sometimes a referral is what is best for a patient and that doing nothing is always an option.
Do Not Make Your Patients Problems Your Own Outside of Work
Trying not to take on the patients’ problems as your own and to leave work at work is one of the best ways to combat burnout as a dental professional, but it is easier said than done.
As a general dentist, the other option in our back pocket, is to refer patients to trusted specialists who may be able to better manage the patients expectations or provide a more predictable outcome for a patient.
Yes, there are patients who might refuse to see specialists, but to me, that’s the patient making a decision about where they are willing to compromise on their care. As the dentist, you cannot allow a patient to back you into a corner and you have the right to tell the patient no that you will not perform that treatment.
Remember the doctor-patient relationship works both ways, and sometimes the best treatment option for everyone is no treatment at all.
Keep Reading: The Principles of “mise-en-place” for the Dental Office
Photo by Cedric Fauntleroy
