Why Dentistry Will Never Get It



Many years ago dentistry was a simple profession.  Patients came in to get their teeth fixed, filled or cleaned.  Occasionally they would get their whole mouths fixed up.  And sometimes just get a tooth pulled.  And things were pretty much cash and carry.

Most people stayed with their dentist for years.  The family dentist was like the family doctor or lawyer or accountant.  Ahh, life was so simple back then.

images-2A lot has changed.  And a lot hasn’t changed.

As the world and industries change, the requirements of jobs change.

The cost of dentistry has skyrocketed.  That is not a complaint, everything goes up especially wages.  Those who watch the economy notice that prices have far exceeded wages.

With those economic changes have come cultural changes like the growth of dental insurance, and the loosening restrictions on advertising professionals.

Then there was the cosmetic dentistry revolution of the nineties when everyone wanted their teeth whitened but not necessarily fixed.

And dentists began to feel the heat.  They didn’t do as well as when times were much simpler.

But some still thrived…a minority who understand that when times get tough it’s time for a new strategy.  But most of dentistry doesn’t understand what that strategy should center on.


But here’s the rub…most of us think we’re really good at relationships.  So most of the continuing education dollars are spent on how to place implants and veneers rather than how to build trust.

We learn how to build complex 4 on 4 cases that we rarely get to do because we haven’t learned how to build the trust to make it happen…consistently.

Most dentists don’t have coaches.  Not mentors or teachers, but coaches.  A coach is someone who observes the way they practice and provides feedback through critique and correction.

Most dentists get cases accepted and never really understand what they did right…or wrong.  If they get to do many large cases they chalk it up to the halo effect.

Wikipedia defines the halo effect or error as a cognitive bias in which one’s judgments of a person’s character can be influenced by one’s overall impression of him or her.  In other words one gets credit for being a great communicator when really they are just a good dentist.

So, why won’t dentists get this, and why will organized dentistry continue to change so that only the very astute will be able to thrive and do the cases they love?

Because it takes a lot of humility to admit we need help in these interpersonal skills.  We must lose the arrogance that tells us we are master communicators.

We must ask ourselves what skills are essential for doing, actually doing great dentistry consistently?

We must be willing to be coached.

We must take ownership of understanding our own present skill levels.

We must truly understand what makes a great dental professional.

I think it’s humility!



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  1. Barry, you hit the nail on the head, as usual. Gone are the days when the title “doctor” conferred a God-like ability to influence anyone and everyone. Dr Pankey taught us that when we finally realize that we don’t know what we don’t know is when we choose to become enlightened.

    Learning is a life long endeavor. If any good is to come of the age of consumerism in dentistry – and health care in general- it will be for the benefit of the patients of those of us who understand the critical importance of self- improvement in both the clinical and the soft skills of our field.

    Like you, I’ve been practicing for a while. And like you, I wake up each morning with a sense of urgency to be better today than I was yesterday and to recognize that I’ll be better tomorrow.

    It is all about trust. It is all about knowing your patient, knowing yourself, knowing your work, and applying your knowledge. This simple truth is extremely complex and , for many, is clouded by the lack of communication that typifies many of us in and era where texting is booming, eye-to-eye contact is becoming rare, and third party payers who could not care less about the service for which they are paying.

    Good post, Barry. Keep up the good work


  2. Alan–you can write, Dude. Your comment was clear and to the point.
    Yesterday Orb won the Kentucky Derby. Every year on Derby day I remember when I went to Churchill Downs…40 years ago, 1973, when I graduated from dental school at Penn. The great Secretariat won that day. I started in private practice in September that year.
    Things have really changed…
    Just saw the movie 42. Jackie Robison story took me back to those simple times when people weren’t movingh so fast and watching screens all day.
    I am not saying that we shouild go back in time…but we need to carry some of those values into the present.
    A lack of leadership. A lack of heroes. A lack of any significant voice in the dental community…including the ADA (paper tiger), and state dental societies has allowed the dental industry to fall prey to market forces. Unlike medicine, there are no rules at all. Rising costs on every front for patients, as well as students has created a situation where taking the time and effort to “master” the profession is afforded to very few.
    It’s a shame…really.
    Dentists who care need to have a voice…I wouldn’t be surprised if so many raised their hands to join a group that wanted to fight back against some of the issues we are facing from insurance companies and corporate dentistry.
    Wanna start a movement? The tools are available.

  3. Let’s talk, Barry. I’m moving in 2 weeks and am frantically packing and making calls to lawyers, agents, etc. My office might be a more tranquil place to reach me this week. Looking fwd!

  4. Michael Martin says:


    Thanks for all your great contributions! Building relationships is hard work, especially with so many unspoken assumptions from both parties.. but when we find the win-win, isn’t it great!

    • Thank You Michael,
      I see you used the word…assumption, in your comment. So many of us assume things that get in our way. One of the keys for me is to follow my exam process and slow everything down…take the time to learn and discover. Something that helps me with that (yes, I need help with that), is meditation and Yoga, and a bit of emotional intelligence.

  5. Deborah Bush says:

    Barry, as I work in new health care realms (other than dentistry), clearly humility and the desire to be more effective for the patient’s benefit are internal attributes that allow the health care provider and patient to connect. In the arena of maternal health care, studies have shown that when care providers spend real time “discussing” educational materials and going over important information while looking at educational materials together with the patient, there is not just information transfer but development of understanding. Those patients who are informed AND UNDERSTAND (can reflect back understanding) are much more likely to comply with their care provider’s instructions and much more likely to respond appropriately when they experience signs and symptoms. Studies also show that those health care providers who Slow Down and spend the time doing this also become more aware of the signs and symptoms and have heightened recognition of the dramatic consequences of NOT observing the signs and symptoms as early as possible. These clinicians become more and more conversant about what can go wrong when clinical evaluation and care is delayed. As a result, their patients recognize the importance to their health and take action sooner with better results. Literacy is a recognized problem but what many health care providers do not understand is that even college educated patients do not take the time to read brochures and information sheets handed to them. Taking time for conversation Saves lives (or in the case of dentistry, more often oral function and teeth), not to mention Builds clinician-patient trust, patient empowerment, and clinician reputation.

  6. Thanks for commenting Deb.
    As you know, there are dentists who have been fighting this battle forever. And there are those who take trust and interpersonal relationships for granted. Interpersonal skills can be learned…mostly it takes time and commitment. We both know many dentists who truly understand this concept…and as I mentioned in the blog post, it takes humility…knowing what you don’t know. And as Bren’e Brown says, it takes a certain amount of vulnerabilty. I will be posting a piece on the charismatic dentist this week…the dental community may not like it…especially the male dentist community.


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