Why I Received Fired My First Yr as a Dentist


It was the summer season of 1982, and I wasn’t a dentist but. I used to be a 20-something biochemistry and artwork historical past main on the College of British Columbia. I noticed a e book on my mother’s bookshelf—Life Extension by Pearson and Shaw. I didn’t understand it on the time, however that e book would set me on the trail to useful dentistry—lengthy earlier than the time period “useful medication” had been coined. It will be a long time earlier than I might understand I’d be charting a brand new path in dentistry.

The best way this e book talked in regards to the physique was not like something I’d seen. This e book wasn’t simply well being recommendation. It reframed the physique as an interconnected system—the place small disruptions might ripple outward into illness, and early alerts mattered greater than late-stage signs. It gave me a framework to suppose upstream, to seek for what set sickness in movement lengthy earlier than the signs confirmed up. The authors didn’t use the time period “useful medication,” however their philosophy anticipated it: intervene early, deal with the foundation trigger, view the physique as a system, and use rising biochemical science to remain forward of illness. It was radical for the time—particularly in 1982—and it captured one thing I didn’t know I’d been trying to find. I learn it cowl to cowl—all 858 pages. Then many times.

A number of years later, I might attend dental college in San Francisco. In dental college, the curriculum is tight. You’re taught to acknowledge signs, outline illnesses, and deal with them effectively. That’s the method: establish, diagnose, code, and invoice. It’s not about stepping again or connecting dots. Dental college is designed to get you licensed, to cross your boards and to grow to be a “secure newbie” and begin treating. When you’re in observe, insurance coverage firms reinforce the identical sample. The system doesn’t reward curiosity. It rewards compliance. I feel that’s maybe why so few dentists ever make the shift away from typical dentistry.

As a brand new dentist recent out of dental college, you’re inundated with emergencies that pile up—ache, an infection, necrosis. You’re underwater, and also you need to do extra to assist your sufferers heal, however the insurance coverage mannequin expects you to remain there. In most practices, reimbursements from insurance coverage are mounted. Meaning it doesn’t matter how complicated the case is or how a lot time you spend—your pay is similar. The one technique to hold the lights on is to see extra sufferers, quicker. The enterprise mannequin solely works when therapy is predictable and billable.

And it’s the supplier—caught within the center—who’s compelled to decide on. A supplier who needs to do the best factor however continues to be on the whim of a 3rd get together—the insurance coverage firm—that determines reimbursement.

When dentists graduate, we’re buried in debt. The amount of illness wears down curiosity, and the stress to pay again a whole bunch of hundreds of {dollars} pushes you towards prioritizing velocity and billable procedures.

My first job out of dental college was in a high-volume observe the place the main target was velocity and manufacturing. I acquired fired for spending an excessive amount of time with sufferers. My boss pulled me apart and mentioned, “Simply get again to work, you’re losing time.”

I used to be additionally referring sufferers out—sending them to the best specialists for procedures our clinic wasn’t geared up to deal with. The primary time I did it, the periodontist referred to as me again, confused. “Do you’re employed at South Bay Well being Middle?” he requested. “Is South Bay now sending sufferers out? That’s not like them.”

I instructed him no—it wasn’t them. It was simply me, an worker. He couldn’t imagine it. They needed to know who I used to be. 

Then he requested, “And Mr. Ward is okay with this?”

I mentioned, “Mr. Ward is just not a dentist. He’s half-owner of South Bay Well being Middle, however he’s not a dentist. He doesn’t get to make these selections about what’s finest for the affected person.”

No shock, I used to be fired shortly after that. The entire thing lasted about eight months.

Inside months, and with the help from my spouse, I opened my very own observe within the coronary heart of Silicon Valley, successfully within the yard of Apple and Intel HQ.

So, naturally, a whole lot of my sufferers had been programmers. And programmers, particularly in these early days, had been additionally beta testers. When one thing didn’t work, they didn’t simply take a look at the signs—they went again to the supply code—in different phrases, the underlying logic that determines how the entire system runs. Debugging it meant digging into the origin of the issue and rewriting the directions.

That was the proper mirror for the way I had began enthusiastic about dentistry. I wasn’t simply treating the cavity—I used to be debugging the physique. I used to be asking what had gone mistaken in its working logic. I used to be searching for the supply code of dental illness—the earliest dysfunctions, the prodromal part of illness—the place issues begin to go off beam lengthy earlier than a prognosis is feasible or signs are apparent.

I wasn’t simply inserting fillings anymore. I used to be tracing root causes. The tradition of Silicon Valley inspired that—and I leaned into it.

I used to be nonetheless doing what I used to be skilled to do, in fact—and my sufferers had been comfortable. I crammed cavities, did root canals, restored enamel.

However one thing was lacking. It felt shallow, like we had been simply treating the floor. It didn’t matter that the scientific work was technically sound—clear margins, correct occlusion, predictable outcomes—as a result of my sufferers would hold coming in with the identical points.

And I knew it was unacceptable to tread water alongside my sufferers for the remainder of my profession. That’s not what a practitioner ought to do. We shouldn’t be complicit in dysfunction—we must always interrupt it. That is the upper calling of the healthcare practitioner—whether or not you’re a nurse, physician, myofunctional therapist… however it requires stepping exterior the curriculum, exterior the billing codes, and deciding to suppose for your self.

As sufferers and colleagues began to note the unconventional approach I used to be working towards, they referred to as it “holistic dentistry.” However that label by no means felt fairly proper. Again then, holistic typically meant vitality strains and meridians—concepts I couldn’t co-sign as a result of they weren’t grounded in biology or knowledge. And even after I agreed with elements of holistic dentistry, the label didn’t match the larger image I used to be making an attempt to work from.

What I used to be constructing wasn’t only a philosophy. It was a framework. A techniques strategy to oral well being. And that wanted its personal title.

For years, I didn’t know what sort of dentist I used to be. I didn’t match into the organic dentistry camp—too centered on supplies, not sufficient on techniques. Integrative dentistry was useful in its emphasis on collaborating with different healthcare suppliers, however nonetheless reactive, and dealing downstream of signs.

I all the time felt misplaced—too scientific for the holistic dentists, and too crunchy for the traditional ones.

I didn’t got down to be totally different. It occurred organically—a gradual collision between the way in which I used to be skilled and what I knew my sufferers truly wanted. I couldn’t ignore the hole between scientific protocol and long-term well being outcomes.

I imagine that that e book—Life Extension—had planted a seed in the way it challenged the belief that illness is inevitable. I didn’t need to simply repair issues. I needed to enhance life span and high quality of life for my sufferers. And, fortunately, as a result of lots of them had been techniques thinkers, they had been receptive and open.

And now, a long time later, my eldest daughter (who was born 5 days early on the day I opened that personal observe) has helped me convey my message to YouTube, this text you’re studying, Instagram, podcasts, and extra. And now, increasingly more dentists are realizing: that is the place the way forward for our occupation is headed.

We’re dropping almost one million lives yearly to illnesses we might have prevented. The continual illness disaster isn’t slowing down. It’s dashing up. And dentistry—the mouth, the airway, the place to begin for digestion and immunity—continues to be sitting in a silo.

That may’t proceed.

We have to redefine what it means to be a dentist. We have to be techniques thinkers. Engineers of human well being. We have to go upstream, to the prodromal part of illness. And fiercely advocate for our sufferers.

We have to cease solely treating signs and begin intercepting illness.

That’s the promise of useful dentistry.

If one thing on this clicked, you’re not alone. My CE course, Foundations of Practical Dentistry, is constructed from 4 a long time of observe. When you’re carried out firefighting and able to get upstream—hit reply. I’ll ship the main points.

This CE course is for the dentist who’s uninterested in firefighting. Who finds extra which means in stopping a cavity than in filling one. Who is aware of it’s more durable to quantify illness prevention—however it’s the place the actual energy is. Prevention means altering the trajectory of somebody’s well being earlier than signs ever present up. That’s not administration. That’s true care.

As a result of the true which means of “physician” is trainer—and healer. And the way efficient would you like your healer to be? Always underwater, reacting to signs? Or on the opposite aspect—considering upstream, taking cost, serving to sufferers rewrite their well being future?

Be part of a neighborhood of dentists and rewrite the story of what dentistry could be. 

We’re not simply treating enamel. We’re treating techniques.

Hit reply and let me know in case you’re , and my staff will add you to the waitlist.

When you’re searching for a dentist who “will get it”—begin right here. You deserve a accomplice who understands airway, vitamin, and the oral-systemic connection.
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