My time working in the dental division of a public health center is over. A couple of things I learned (details of the clinic omitted):
1) Stay Busy: When I didn’t have a job, I often dreamed of the kind of work where prestige, income and benefits would come easy with little to no effort. Life with the parents flowed nicely and with no real desire to accomplish anything except comfort, easy was at the top of my priorities. After spending a good half of the 12 weeks having nothing assigned to me by my supervisor, I realize idling at work is a guaranteed way to go insane, lose any sense of self-worth, and eventually lower your standards for everything else you do in life. Plus, after reading articles discussing the amount of people who have 8-5 jobs that require them to do absolutely nothing, not even to look busy (Thanks Obama), I can’t help but feel terrified at the prospect. Funny how often times we worry about being overburdened with too much work when the exact opposite can be just as awful for your health. But there’s a definite bright side. Before the internship, I had never felt such a strong sense of initiative. I’m proud to say none of my time at the internship was wasted, though it very easily could have been. Observing the system at work around me and drafting my own projects to further investigate my observations kept me occupied and I learned more than I could have by just following instructions. Sure, much of my learning wasn’t academic but I got quite a bit out of it. Having nothing to do at work is as close to pure misery as I’ve ever been, and I guess that’s all it took to develop some self-motivation.
2) Communicating to Patients: How do you get people to keep up with their oral hygiene? From my experience, people aren’t great at looking into the future, and with that kind of shortsighted approach to teeth, it will always be too late. These days, everything to do with a dentist appointment can be equated to massive sums of money. So all too often, a patient comes in for the first time, dentist tells them how to take care of their teeth, the patient tries but lacks the foresight to follow through, comes back, needs immediate treatment, and ends up complaining about the price plus the dentist’s lack of care. It’s not the patient’s fault. Sure both parties can hear what the other is saying but the most essential part, the call to action, isn’t being communicated effectively. In most offices I’ve seen, the dentists focused on increasing public oral hygiene often ask the question “what is the best way to deliver a sense of urgency to people who aren’t on top of their oral hygiene?” But I think that may be the wrong approach. Scaring people won’t work. Sure, you can post picture of rotting, decaying, blackening teeth all over the walls. You can raise your voice whenever it comes time to explain the outcomes of forgoing treatment and maintenance. But the patients might start off strong for about a week, then have a long day at work and end up not brushing that night. They’ll wake up without any pain in their mouth, then forget again one more time, and it still won’t hurt. Pretty soon the routine has been dropped and we’re back to square one. It’s like setting your alarm clock on a table far away. It might get you to come out of bed the first time, but after that if you’re tired enough, your mind will adjust and even Spongebob’s massively amplified alarm won’t be able to wake you up. Instead of playing off people’s fear, which can only last if they’re consistently reminded of the unpleasantness (which is difficult when you don’t share a roof with a dentist who cares for you), why don’t we just stress how easy it is to do? Emphasize the ease in which brushing and flossing can be completed no matter where you go. Emphasize the ease in which brushing and flossing slips into the daily checklist of eating, showering, and sleeping. Emphasize the ease in which brushing and flossing can be done well in such a short amount of time. I have yet to see clearly how much weight that kind of mental approach would hold, but I’ll keep it in mind.
3) Chain-of-command: Good management requires that the boss keeps accountable for all of the actions of his/her direct subordinates. The boss delegates duties, not responsibility. Unfortunately, under stressful situations up top, good management is hard to practice, and shit begins to roll downhill. And when shit begins rolling down a hill, it picks up a bunch of other stuff that might have seemed alright at first, but is now covered in shit as well. With a big ball of shit that gets its very biggest at the very bottom of the chain, being an intern isn’t exactly an ideal position to hold in such a situation. An additional difficulty is figuring out how to introduce a change in an established workplace. The chain-of-command is a great structure for stability and organized efforts, where everyone’s held accountable for a fixed set of events, but can act as a terrible hindrance to effective change for an organization, no matter what position you hold. Resistance to change is inevitable, and fighting for it requires skillful navigation, continuous negotiation, and stubborn determination. It forces you to really question yourself as to the true motivations for the change, and how badly you want to see it happen. Why do you want this to change? Are you putting the interests of the company first and actually trying to increase its efficiency? Are you trying to introduce a change that will put you in a position to move up the chain? Or do you just enjoy being the smartest kid in the room? Understanding the chain-of-command can seem like a common and mundane theme, but I can already tell that life can really suck without learning to resolve that conflict. Just ask the characters from The Wire.
4) Communicating to Patients pt. 2: You haven’t witnessed true fear until you’ve seen a dental patient in pain who has no idea what the hell their dentist is telling them at the moment. If a patient’s last three consecutive words have been “What?” during an explanation of his/her treatment plan, then maybe it’s time to skip the jargon and start making sense. I’ve noticed that when it comes down to just fixing the pain/problem, patients really don’t pay much attention to your vocabulary. They’re concerned with your ability to tell them what’s wrong, give them a clear set of options, and help them make a decision, all in layman’s terms. So there’s really no need to voluntarily share that academic information with patients without a request.
5) Commuting is Dangerous: Respect for my parents and every other working man and woman in the suburbs has grown tenfold, who have to drive for at least 90 minutes twice a day moving at an average speed of 30 mph. Plus, these three months of having to share 6 lanes on the highway with morons who are undeservedly certified to drive has cost me my life (no hyperbole in use here) more times than in all my 19 years of life combined. I’ve seen a fender-bender from every angle possible, and sometimes the automobile’s version of sodomy is just as terrible to witness as the real thing. The paranoia that ensues after seeing it happen to so many people is even worse, and some days I look towards the rear-view mirror more than the windshield. Hopefully I’ll have the resources in the future to avoid long commutes to work, and reduce time wasted throwing my life into the hands of strangers who I only communicate with through a vehicle horn.
6) Few Number of Males in Community Health: Being the only guy in a group of 10 women has its perks, even if they are all married and most have at least two kids. Many have vocally expressed their appreciation of my fresh perspective (from a gender standpoint) in the workplace. I’ve never felt manlier in my life.
So I’ve learned a lot but don’t know if I’m any closer to becoming a dentist.