I don’t know if this happens to you, but while catching up on my Christmas reading – on a completely different topic – I came across something that was not only relevant to daily life but so compelling that I need to pass it on.
In case you think I’m up to date, by the way, this was a book that someone bought me for Christmas 2012 and I needed the bookshelf space to accommodate this year’s acquisitions....
Anyway, the book is Thinking, Fast and Slow by Nobel prize-winningauthor Daniel Kahnemann, who hasthat wonderful quality of impartingknowledge surreptitiously while you arejust enjoying a good story. It is worth aread.
Although subsequently famed as an economist, Kahnemann studied for a while as a psychotherapist, which is really what dentists do a lot of the time I reckon. When we’ve sorted out the ones with actual acute issues (oral healthwise I mean), much of the rest of the day is spent discussing patients’ worries and concerns which may, or may not, involve their dentition.
During his training, he received a lecture from an esteemed professor who said something along the lines of: “Occasionally you will see a new patient who comes to you because their successive previous practitioners have been unable to solve their problems. They are very articulate in describing just how things went wrong in their previous treatment, but they have realised that you understand their plight and are just the person who can sort them out.”
Uncannily, you feel the same way about them, you ‘click’ with them and sympathise with their past troubles. You might even be quite sure that you know instinctively how to resolve them. It is clinical ‘love at first sight’.
The lecturer then goes on, in a considerably louder tone: “Do not, whatever you do, accept them as a patient. Throw them out!” (I can see the General Dental Council not being too happy with that bit, but in the US, psychotherapists get up to all sorts, I’m sure). He says: “They will almost certainly turn out to be psychopaths!”
Now I must confess to seeing one or two psychopaths in my time, and perhaps the scenario is somewhat extreme for translation in to a dental surgery setting, but if you ask anyone (well, almost anyone) who advises on dental litigation, they will recognise the problem at once.
I well recall the middle-aged lady who had been unable to get on with any of her removable partial prosthodontics. She oozed confidence in my youthful abilities, and I could immediately see the problem and where my hapless predecessors had gone wrong. All it needed was some straightforward endodontics and two crowns.....
Nine months and two solicitors’ letters later, my defence organisation and I agreed that in my innocence I had indeed inherited a ‘dentopath’. I think I learned my lesson, but it would have been easier if I’d learned from someone else’s.
All of which leads me to believe that love at first sight is not what it’s cracked up to be. In fact, that might be an interesting study to conduct – someone probably has already: “A retrospective study of instant attractiveness and the durability of subsequent relationships”.
Dental examinations should be cautious, measured and without too much undue positivity at the outset. An eminent lecturer recently said that one should never arrive at a diagnosis (of anything other than a simple case), much less a treatment plan, at the first visit, and that getting to know the patient is more than the simple snapshot image that an initial visit provides.
We’ve all come across the patient who would like the ‘front teeth fixed’ first, or the bleaching before the periodontal treatment, and I firmly believe that unless the patient’s health is seriously at risk, one should embark on something extremely straightforward before plunging into the depths of complexity.
Professional relationships are, like puppies and kittens, not just for Christmas; they should be enduring if they are to be successful. And the two letter word? Well, it’s sometimes the hardest to say, isn’t it? It’s no.