Letter From an Editor: Adapting as Specialists in Changing Times

Dear ACOMS members,

It’s hard to believe we’re now 25% of the way through the new century. The potential Y2K doomsday seems like a short memory ago, and since then the rapid evolution of technology has made us constantly available and progressively stimulated. Despite this, our sense of security was repeatedly tested with sentinel events like 9/11, the financial crisis of 2008, the pandemic, and political polarization. This past year has felt especially unsettling, with economic concerns at the forefront of political discourse and infiltrating our daily interactions with patients.

Earlier this year, social media influencers pontificated on self-proclaimed “recession indicators,” such as seemingly banal findings of increased sales of inexpensive lipsticks and decreased sales of men’s underwear. Though these observations weren’t necessarily factual gauges, I think we all felt it in our offices this year. I personally felt it was the slowest summer of my eight years in private practice and that patients were increasingly deferring treatment, most commonly due to financial pressures. Unfortunately, the demand doesn’t necessarily change, as people continue to require such treatment, but the state in which they presented seemed to be worse than usual due to self-imposed delays in seeking care.

We’re all well-versed in patients seeking advice from “Dr. Google” for home remedies, which as we know are largely unsuccessful, but this now seems to have escalated with artificial intelligence. Recently, a patient presented for a consultation on extraction of a fractured tooth and replacement with an implant. I politely had to ask him to stop reading ChatGPT to me about this procedure, as he was in my office for me to impart the knowledge. After a suboptimal post-operative course, he explained he continued to seek advice from ChatGPT rather than my provided post-operative instructions and admitted perhaps that was why he had an issue.

On top of all this, it seems like, despite having more experience each day, our overall cases are becoming more challenging. Increasingly, all the wisdom teeth seem to be deep horizontal impactions and the implant patients have suboptimal bone volumes. Some days it seems everyone has a complex medical history. More and more nonspecialists are taking weekend courses to perform specialist-level procedures, often under sedation, in an attempt to keep revenue in their practices.

As well-trained and competent specialists, how do we navigate these dynamics and maintain our enthusiasm for our chosen profession when it seems everyone is skeptical of our expertise or thinks they have it without having done the training? In our less-than-busy periods, I think it’s important to try to maintain perspective. Take this time to condense to a more efficient schedule and spend the extra free time with family or pursuing hobbies. Patients are apprehensive and want to “do their own research,” but perhaps the increased time in the schedule can ensure you are providing each patient with extra time and attention, and thus a five-star experience. Some downtime means you can potentially get around to the team training that has been perpetually postponed. With more flexibility in your days, you may be able to reconnect with your referrals over lunches, which otherwise never seemed to be feasible. With regard to patient financial considerations, perhaps you can research and offer other third-party financing options with no or low interest rates.

Ultimately, the economic fears will abate, the demand for surgery will rebound, and we will be back to wondering why there aren’t enough hours in the day. And, as the holidays approach, enjoy the more relaxed pace while it lasts!

Sincerely,

Lauren E. Basile, DMD