Thursday, July 3, 2014
Here is another guest post from Dr. Donald Lurie.
It seems to me that goals and aspirations upon entering dentistry have changed drastically over the years. A few weeks ago, I was attending a conference and the subject arose as to "Why did you become a dentist?" I thought this was a really easy question until I tried to write down the reasons that I entered this wonderful profession 50 years ago. As I reflected upon the question, I realized that the dynamic had changed so dramatically over the years that it was now, for me, a most difficult question to answer and to update.
I listed the reasons that started me on this journey: to heal and to cure the sick, to maintain independence and be my "own boss", to have the ability to make a substantial income, to provide for my family, to obtain respect in the community were but a few of the immediate reasons for charting this path. But now the dynamic has changed so much that I am not sure that I could compare those thoughts to a new student with aspirations. You would have to interpret the ability to be "your own boss". I am not sure that, in these times, that is as possible as in the "old" days. The time of solo practice, of studying, training, postgraduate degrees and residency and then entering practice on your own appear to be over.
I remember going to the bank and asking for a loan to open my own office. The banker (a classmate from college) advised me as to what he thought it would take, shook my hand and said there would be some paperwork to fill out. He suggested that I go and find my location, lease the property and prepare to renovate the space for my needs. He also suggested that I bring the information back to him so he could advise me. Thus, with the help of my accountant who was already on my team----before I even had an office---the Team of Retirement (which I have talked about in earlier articles) was started. This is actually a philosophical term of practice management that has served me well. It has served me well. Can you imagine being able to do that in today's financial world? And would you have the fortitude (guts) to do it. In those early days, this was the norm. There were very few group practices, especially in general dentistry. Some of the specialty practices had small groups but there were fewer specialists in total. I suspect that this was a means to keep the "market closed". As time went on, more specialists opened on their own and over the years, many of them merged; and many of them dissolved.
The desire to heal the sick and to make people well and return them to function has never dissipated. This is still a goal that has been with me my entire life and even in retirement I continue to give and to donate effort to this ideal. However, I wonder if the freedom to exercise this is as easy as it was in my beginning. There is so much litigation, so much inspection, so many bureaus to satisfy, that I wonder if I would have the courage to try some of the new techniques and projections that I did in those days. If a doctor had an idea, he would suggest it to a patient and many times, it was accepted and tried. Now I am not talking about moribund procedures, but rather a new technique or variation on a theme mixed with good common sense and based on good surgical knowledge and experience. And if the "experiment" went wrong, the social media that is now present would crucify me and the good that I had done over the course of my years in practice might disintegrate quickly. These are just thoughts but it gives me pause as I look back on reasons why I became and Dentist and Oral Surgeon.
I think that the opportunity to make a good income and to provide for one's family is still viable but I am not sure that it is as attractive as it once was possible. The tax laws are so different and the age of insurance and government interference have also changed the dynamic. The large groups are doing quite well and are able to diversify but the small solo practitioner may be another story. I have to yield to the accountants for introspection on this, but it is something that I have heard many times recently.
I mentioned above about the respect of the community and I think that is still true. The doctors of today are TALL and WELL REGARDED. I think that this has always been so and it is a tribute to the schools and to the profession that has nurtured us on our journey. We feel discomfort when one of our group is challenged or if a bad report hits the news since we feel it reflects on all of us. It is part of our heritage that we want to "do no harm." I also feel that (especially in these times) our brothers and sisters do a fantastic job of carrying on the respect of the professions.
And so I think that you can understand how difficult it was to list and compare the reasons that started me in this profession of dentistry and surgery. The years of training were many (including dental and medical school and then residency), but they are even longer now. I would challenge you to sit and reflect on your career and for the reasons that you are where you are at this time. Reflect, meditate and make it better while you can. And may this wonderful career bring peace and joy to you and to those you serve.
We are all here to help one another. Please do not hesitate to send me you thoughts, questions or comments. It would be an honor to help.
Dr. Donald B. Lurie
Posted by The Dental CPAs Team at 1:55 PM