Reena Wadia reflects on her experiences so far as a young dentist and the challenges she faced.
I am sure that this is a question that is too familiar to most newly qualified dentists. I often smile back and take it as a compliment. However, a part of me cannot help but feel insecure about a possible perception of a young dentist being an inexperienced and even incompetent dentist. Entering the 'real world' of dentistry following graduation can be a very exciting yet testing time. The challenges faced by young dentists are often similar in nature and you soon come to realise that you may not be the only one facing a particularly daunting situation.
Young and vulnerable
After 5 years of the cosy sheltered hospital environment, seeing patients in practice for the first time can feel like the safety bubble around you has finally popped. I completed a survey during my first year, which questioned whether being a 'young-looking' dentist affected the patient's perception of the dentist. Specifically, I researched into whether this made the patient feel the dentist may lack in knowledge and skill in comparison to a more 'mature-looking' dentist. 68% answered with a yes; this is a significant and worryingly high percentage. However, there may be an element of truth in this perception.
After discussion with my peers and other colleagues, undergraduate clinical experience in comparison to graduates from the earlier decade, does actually seem to be limited. Quotas or minimum numbers of clinical procedures have been reduced significantly and students often graduate having completed very little in terms of quantity. There is then a lack of confidence in a number of procedures and therefore these may be avoided during the first year in practice. A risk of a vicious cycle of poor clinical experience is thus created. Hence, the young dentist seems to already be at a disadvantage even before the patient journey begins. Thankfully, most first practices and trainers are very supportive and encourage the newly qualified dentist to gain as much experience as possible. I certainly completed more clinical work in the first few months of training than the full five years at dental school!
Vulnerability is also associated with the surrounding environment, not only the individual. We are living in an increasingly litigious society and every year there is an upsurge in the number of complaints received by the Dental Council about dentists and dental practices. Individuals are far more confident and better practiced at complaining than ever before. Whether the complaint concerns the supply of faulty goods, poor customer care at a shop or slow service in a restaurant, we all seem to be more willing to express our dissatisfaction and demand an appropriate solution. Dental patients are of no exception.
As a young dentist, I found that some aspects of the general practice environment were initially very alien. For example, the business and management skills of primary care are rarely taught or otherwise discussed at dental school. Thus, these skills need to be rapidly developed on starting in practice; otherwise vulnerability then exists in this aspect of patient care. I certainly feel there is a gap in the current undergraduate curriculum for formalised teaching of these skills. After all, business and management does directly affect the quality of care that is provided to the patient.
Communication difficulties
Being part of the younger generation, which is often referred to as 'Generation Y' (1980-2000), and treating the 'Baby Boomers' (1943-1963) or 'Generation X' (1964-1979) can often bring its own challenges. Generational theory assumes that the prevailing social, economic, political and cultural milieu in which different groups spend their formative years, gives them their own unique generational 'character'. Essentially, this means that the older generations may differ from the earlier generations when considering their values and priorities; they also seem to have a preferred set of vocabulary and may interpret a phrase differently to another generation.
From personal experience, I find my communication style does vary according to the age of the patient I am treating. For example, when treating 'Generation Y', communication seems straightforward and no special adjustments in communication method or style are required. The 'Baby Boomers' and 'Generation X' often feel they know better, they may question your judgment and it is not uncommon for a few to also try to coerce you into performing certain treatments. These communication difficulties can create stressful situations that may be difficult to manage.
It often helps to remind myself that the older generations may have a slightly different focus. For instance, the intricacies on a new technology may interest me as a young dentist; to the older patient, they may just be interested purely in the benefits it provides rather than the minor details themselves. Thus, the communication needs to be tailored accordingly. A mismatch in expectations and any other discrepancies needs to be identified and addressed early on through clear communication.
Overcoming personal difficulties within practice
After completing my first year in practice, I have realised the importance of self-confidence and a strong belief in your abilities, even if you feel apprehensive initially. During the first few weeks, several patients mistook me to be the nurse rather than the dentist. This didn't provide the best confidence boost! Discussion with my peers highlighted that I was not the only one facing this problem. Thereafter, I started to change the way I introduced myself, including the fact that I was the dentist. I also then wore a name badge highlighting the title. When explaining diagnoses and treatment plans, I provided as much relevant supportive evidence as possible. Furthermore, I created a patient handbook, which was professionally printed and distributed to all patients. I would regularly offer the patient a second opinion from my trainer or other dentists in the practice. All of this helped to create a professional image; patients trusted me and had full confidence in my skills and abilities.
It is just as important to be aware of your limits. As mentioned, many young dentists may not be confident in several procedures due to lack of experience. Here, I found it helpful to be open and honest to the patient. Often there would be a second dentist present, usually my trainer, to guide me for certain procedures that I was unfamiliar with. This also made the patient feel more comfortable.
Handling complaints
Until you receive your first letter of complaint it's hard to describe the feeling you will get, especially if it's unjustified. I received my first letter mid-way through my first year in practice. My heart sank on reading the lines. At first, it was demoralising and the stress of handling the complaint affected my work and personal life. However, although it was an unpleasant and disheartening experience, especially so early in a career, I swiftly decided to use the complaint positively and handle it according to the current requirements. Support of your peers and colleagues is invaluable during these times. Moreover, the yearly indemnity fees surely felt worthwhile! Through this experience, I realised that even the most careful dentists receive complaints. As a young dentist, there is a higher risk of complaints and handling them effectively is crucial. Complaints are a valuable method of feedback that can help to improve the service you provide. Furthermore, research has shown that when a complaint is handled effectively, the loyalty of that patient is usually strengthened.
It can't all be doom and gloom!
As a young dentist, I believe this is a particularly exciting time to start a dental career. Technology, materials and techniques are rapidly improving and we are heading towards the optimal patient experience. I believe that we should embrace all challenges and grab every opportunity that comes our way, allowing us to thrive in what I believe to be a very rewarding career!
Reena Wadia
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