As we get older, we usually get better at things through more practice, right? And when we’ve been doing something for nearly 20 years, we usually assume that we should should be really darn good at it. On top of that, if we decide to start branching out into a new aspect of what we‘ve been doing, we probably assume that it shouldn‘t be that much harder to learn it, since it‘s just extending off of what we already know. Especially if we‘ve mastered a number of related skills and are just trying to extend them into new variations. Lastly, if we‘ve typically learned new skills in the past reasonably quickly and easily, we assume that the same will be true this time.
At least, that‘s true of me. However, I‘ve been recently, and somewhat rudely, been reminded that all of the above isn’t necessarily true. As often happens when we learn something new, we discover that there is way more to it than we knew. What was it Donald Rumsfeld said years ago that (unjustly) earned him much ridicule?
The thing is……regardless of how much I despise the man for his role in getting us into the wars in Iraq and Afghanistan following 9/11, he was right on this point. No matter how much we know, even in our particular fields of interest, there‘s always far more that we don‘t even know that we don‘t know yet.
Getting Bored & Needing a New Professional Challenge
The last few months have been quite the self-inflicted professional challenge. It‘s a weird feeling, feeling like I don‘t know what I‘m doing again, and truly being forced to realize again how little I know about some parts of dentistry.
I mean, after 20 years, I was pretty settled in, right? We’d finally overcome the financial mess that I created early in my career, thanks to my wife running the practice and letting me focus on dentistry. We‘re making good money, have overhead under control, our staff has stabilized, we‘ve gotten to take lots of time off to enjoy life as a reward for all the hard work, etc. I already have a lot of the „toys“ in dentistry: microscopes, Periolase and Lightwalker lasers, CEREC Bluecam. I’ve been doing a wide variety of procedures in our Charlotte dental office: easy implants, LANAP, most all endo, the occasional cosmetic case, lots of basic restorative, Invisalign, Six Month Braces, dentures, basic perio/oral surgery. I felt pretty confident in my skills, even though there‘s always room for improvement. Lots of happy patients and great reviews…..
…..but I was also getting bored. Maybe it‘s a normal thing after 20 years of doing mostly the same stuff, maybe it‘s partly my ADHD, who knows? But I wanted a challenge again, and I chose implants and perio surgery. I wanted to learn sinus lifts, GBR, guided implant placement, etc. Thanks to my colleague and mentor, Dr. Michael Melkers, I signed up for the DentalXP Brazil surgery course last December, which blew me away. I did procedures that I thought were years away, and with amazing mentors (and Mike as a fabulous partner), I did it better than I imagined possible. I came back energized and excited to add these new procedures. Spent a lot of time looking at what we needed to have to do it, spent a lot of money buying the instruments, supplies, cone beam, TRIOS, FormLabs 2.
Adding New Procedures Doesn‘t Always Go Perfectly
I‘ve done challenging cases since then. With every case, I learned a lot – mostly, I learned how much I didn‘t know. I made a promise to a truly inspiring dentist and teacher (especially for his youth), Dr. Lincoln Harris, to post every surgical case I do in 2018 in his incredible group, RIPE Restorative Implant Practice Excellence. (For dentists only). In posting the cases, I made myself vulnerable in a way that I hadn‘t since my early days of posting about my practice struggles on DentalTown. I‘ve received some terrific feedback there…..and I‘ve also realized that some of my surgical cases might need to be redone or modified/improved to be prosthetically successful. That hurt. A few nights ago, I struggled to fall asleep, because I was worn out and felt like a failure. That‘s a strange feeling when you‘ve been practicing 20 years, you know?
After a few days of lots of rest and giving myself a mental break, I can look back and know that my patients are still better off than they were, everything will work out fine, and they will all end up with everything they were promised.
Software & Technology Moves So Fast
Learning 5 different programs simultaneously: PreForm (FormLabs 3D printer software), MeshMixer, Blue Sky Plan, Romexis, and the TRIOS software. Remembering all the different parts and pieces, instruments, sequence, surgical and prosthetic procedures all at once. Remembering all the different things to look for when diagnosing a case, surgically and prosthetically, hard and soft tissue, esthetics and function, so that I‘m prepared when beginning the case. When it comes to implant dentistry, it’s all about being prepared. (When you are, even difficult cases will go smoothly. When you aren’t, even easy cases can go wrong or not as well as they could.) Having to teach my staff and educate my patients, how to market to get the patients for the procedures. Having to spend a heck of a lot of money before getting to make it back.
As has been written about by so many people before, the world has changed a lot since I was younger. When I started my practice in December 1999, intraoral digital x-ray sensors were just becoming common, and that was considered really hi-tech. The height of CAD/CAM technology was the DOS-based CEREC 2 (which I made the horrible mistake of buying). Lasers were huge, hugely expensive, difficult to use, and prone to breaking a lot.
Now though? Technology is becoming less expensive, smaller, easier to use, and therefore more common. We just purchased a CBCT (cone beam computed tomography) machine that produces incredibly precise 3D x-rays of the entire jaws, a digital intraoral scanner that uses full-color video to create nearly lifelike, full-color, 3D models of your teeth and gums, and a desktop 3D printer for less than $140,000. Yeah, that‘s still a lot of money, but compared to a few years ago, that‘s way less expensive and gives us way more capabilities than were even imagined back in 1999.
Learning is a Process & Mastery Takes Time
And yet……it‘s still a heck of a lot to learn in a short period of time. I‘ve lost count of the hours of video tutorials that I‘ve watched, and I still have many more hours to watch, and re-watch, and re-watch again until all of it becomes part of my skill set. It‘s been overwhelming and exhausting, both mentally and physically. I know that it will all be good given more time to absorb it all, but in the meantime……whoa!
In the meantime, as friends and colleagues have reminded me, it is important to be patient with myself, and to remember that it‘s ok to slow down. I don‘t have to do ALL of it at once. Some pieces can wait a few weeks or a few months, and some can be temporarily outsourced to take the pressure off. I need to take breaks, to keep excercising regularly, to eat and sleep well, because if I don‘t take care of myself, I won‘t be able to help others, which is the whole point. Ultimately, I‘m not doing this for myself, but for our patients, and there‘s no rush. Better to take my time and do it right, while understanding that a learning curve, and even mistakes, are normal in the beginning. What I hold as most important, however, is that my patients receive the best care.