I am not talented, I am obsessed

I do not know about you, but when I go to work as a GDP, I have goals I work towards. Now, for you, your goals may be slightly different but ultimately, I expect we are all after:

1. Happy and Healthy Patients
2. Successful Clinical Outcomes
3. Adequate Financial Remuneration (adequate will mean different things to different practitioners)
4. Healthy Working Environment

However, who do we need to be in order to achieve these things? Notice the question isn’t ‘what do you need to do?’, it’s definitely ‘who do you need to be?’

Or, to put slightly differently, who are we expected to be? Who are we supposed to be?

· A clinician
· An artist
· A councilor
· A businessman or businesswoman
· Team Leaders
· An actor

I do not know about you, but I was definitely not taught any acting or business skills at dental school.

What I thought I was taught was how to be a good “clinician”—or was I?

I am unsure what other dental schools are like, but when you qualify from the University I did you are made to believe you are the best, that you have had the best training, and when I qualified I believed that; I believed I was ready for the big wide dental world. Little did I know; the big wide dental world was a whirl pool of problems that needed extra skills to be mastered if I was to survive, let alone to thrive.

So, the first day in Vocational training, or Foundation training as it is now known, my nurse brings me a plethora of burs and asks which ones I want to use.

With a confused look on my face, I said; “What do you mean? What am I going to do with all these burs? I have never seen any of these in my life! All I need is a 330 and a 555, that is what we used at dental school for practically everything.”

My nurse’s reply? “I don’t think we have those!”

…Steep learning curve!

Then, I had a case I was slightly unsure about, so I went to my VT trainer, he looks at the tooth and says, “I think an e.max onlay would be the best option here.”

My reply? “A what and a what? What the hell is e.max?

…I was not taught that.

At that point I realised my knowledge and clinical ability were lacking. Yes, I was a good dental student, I had awards and certificates to prove that; but was I a good clinician in the real world where it actually mattered? The answer was; No, I was not! I expect I’m not alone in remembering that moment. The realisation that real life dentistry was much harder than I had been shown and I really was going to struggle unless I made some early and effective upgrades.

This realisation caused anguish and I knew something had to be done. I spoke to several people to seek advice on courses that would improve my knowledge and skills, most of whom just said:

“Ah don’t worry about it, make your UDAs; that’s all that’s important, and in a few years you will get experienced and you will be fine. Spend a few years in practice, learn the ropes and then invest in courses.”

In my heart of hearts, I knew that was bad advice and I knew that I needed to make a change and make a change now!

Because doing the same thing over and over again in exactly the same way is not a recipe for improvement, and the assumption that simply accumulating more experience will lead to a better performance is wrong. Think of any sporting hero or team, they are continually looking for active measured improvements. We should do the same.

I would add that you need to be careful about whom you seek advice from. Some people, albeit not intentionally, do give bad advice; people can only advise you based on their own experiences, their own prejudice and sometimes their own fears. So, seek your advice from someone who inspires you, someone who you deem to already have your version of success.

The question is; what does it take to be a good dentist? Actually, let’s re-phrase that. What does it take to be an amazing dentist?

Several times I have been introduced to other colleagues or to patients and other people as a “very talented” dentist – I have never liked that, because it makes the assumption that I am naturally gifted with some magical ability to perform dentistry.

I do not think I just inherited talent to carry out dentistry. So, why am I able to produce the aesthetic, functional, predictable results I do every day in my working life?

The answer is: Deliberate Purposeful Practice

What does that mean?

Deliberate practice is when experts (which you are all expected to be) strive to improve specific weaknesses that they have identified; they improve by increasing their knowledge and skillset until they master the bugbear in question.

But what does the mastering process involve?

It involves many hours of practice with deep concentration until you reach a level of flow, which means you can perform a challenging procedure almost effortlessly. While your mind is fully focused in its role of executive overseer, your hands move seamlessly, with agility, in harmony with the task. When you have mastered one weakness, you move on to the next.

Do you struggle with endodontic access cavities? If so, when was the last time you sat for a few hours with extracted teeth and practised? Or do you just wait for the next endodontic treatment to come along and pray you will somehow create a better access cavity than you previously did?

So, what are the basic requirements of deliberate practice?

1. A clearly defined goal – You deliberately set the level of challenge to exceed your current level of skill or someone else sets it for you; an example, I want to improve my upper molar access cavities

2. Full concentration and effort – Rather than practicing absent-mindedly, you must practice with deep concentration, effort and full attention.

3. Immediate and informative feedback – You need someone to tell you what you are doing right and to tell you what you are doing wrong; if you do not know what you are doing wrong, you do not know how to put it right. Use the feedback to make adjustments and try again.

Too many of us avoid feedback because we are scared of what the other person will think about our dentistry. Since dental school, when was the last time you had someone check your work? You need to learn to embrace feedback rather than fear it.

Some of us are also afraid to seek help even though we know in our heart of hearts that we are clinically not as good as we can be. It is an important conversation to have with ourselves. As, believe it or not, there are people that are willing to help. It is your responsibility to take that opportunity.

4. Repetition, reflection and refinement – Using feedback, you adjust and refine, until you eventually master the task in hand and get that feeling of flow!

That is what you call experience; it does not come overnight, and you are not born with it. Even the most complex of human abilities can be broken down into its components, and if they are taught well and practised, they can be mastered.

There is NO DENTIST IN THE WORLD who has magic hands! Magic hands don’t exist.

Atul Gawande, a very respected surgeon in America, once said:

“People often assume you need to have great hands to become a surgeon, but it’s not true; what’s most important is practising.”

A lot of us are scared to step outside of our comfort zone. This is understandable as we have all been wired to believe that at some point in our career we will be sued. We are all scared that if we try something different or something a little more challenging it may fail, and if it fails, what then? Will the patient be unhappy? Will I get sued? It’s this fear that prevents us from progressing. A great way to overcome this fear and to step outside of your comfort zone is to have a mentor.

Every professional sports person has a coach. If you have the right training system and a good coach, you can achieve great things. The same is true in dentistry. If you have the right training system with the right mentor, you can also achieve great things. A good mentor is someone who you can relate to, someone who gives you good, constructive feedback and helps you improve. So, my advice is: regardless of your age, find a good mentor. A good mentor, combined with hours of practice, means you can reach your full potential as a dentist.

We are all regarded as professionals but what does this embody? There are four essential
elements which are intrinsically linked:

Professionalism
Knowledge
Skills
Judgement

Professionalism consists of the manner in which we act, both inside and outside of work. It underpins the profession and encompasses putting patients first, as well as following rules, guidelines and the law.

We require Knowledge in order to make decisions. An important facet of our job is decision making—often decisions have to be made on the spot.

What underpins our decision-making is knowledge and experience and it is the combination of these that allows us to decide the best course of action. However, we must ensure that we continually seek knowledge. If there is a certain procedure you are unsure about you must learn how to do it correctly; do not wait and ‘gain repeated experience’ doing it incorrectly for years, as your first port of call.

This leads us onto Skills. Consider the following statement:

“I don’t do endodontics because I’m not very good at it,” or “My talent is not endodontics.” Not liking an aspect of dentistry is a sign of insecurity in relation to that skill. The idea that you ‘just happen’ to dislike endodontics is absolute rubbish. You do not like endodontics because no one has ever taught you endodontics correctly, or effectively in a manner that you would understand, and you have not practised. I have witnessed this a countless number of times on our endodontics course. On day one delegates say they hate endo; a year later they all say: “I now do endo all the time; I absolutely love it.” This goes to show that you do not need to have ‘a talent’ for it. All you need is a determination or grit to learn it. Once you become good at something you start to enjoy it, and once you start to enjoy it you begin to do more of it.

Sometimes the correct course of action is not clear, there are no set rules that tell us what to do, or no guideline guiding us in a particular situation. At this point we must exercise Judgement. It is essentially making a decision after careful thought, acting in the patient’s best interest, whilst taking into consideration ethical principles and values; but we can only make this judgement if we have the relevant knowledge, skills and experience.

A simple example of exercising judgement in everyday practice is when a patient asks for veneers to correct crowding, but you know the best thing for the patient is orthodontics, and you spend the necessary time explaining this. Regardless of the number of £50 notes this patient is sticking in your face, you say no and instead educate the patient.

People may have different definitions of success for different aspects of their life, and being successful may mean different things to different people. For some, success is monetary gain, for others it is personal achievement or inner peace.

When it comes to my own factors for success in clinical dentistry, I have narrowed it down to the following:

1. Clinical skills
2. Emotional Intelligence
3. Correct Materials
4. Time
5. Passion

I have met a lot of dentists who work in this profession because they feel as though they have to, that it’s financially lucrative and it’s just a job; they have no real passion for it, or their passion may have been lost due to a few bad experiences. To have a long, successful career as a dentist you must love what you do, otherwise— sooner or later—you will become bored of it.

If your passion has simply become buried, it can be reinvigorated with the right mentorship and training. If you are taught well, I promise you that you will start enjoying it again!

So, come join us, let us be your mentors, let us set you goals, let us help you with deliberate purposeful practice and let us make you the most amazing dentist you can be!

When you have this, learning takes off, knowledge escalates and performance soars.