“If you don’t change you will never progress”
Oh, how dentistry has change since I entered dental school in the late seventies. I must admit that I “swanned” my way through dentistry, doing what I had to do but not overdoing it. Mark Twain said, “Never let your schooling get in the way of your education” and I took his advice to heart. Well, I did make it, mainly because I turned up to lectures and I did a bit of work on the side. Could have been more but a pass is a pass.
Then out into the big wide world. Technically, I could have even opened a new dental practice the day after graduation and started treating patients with no experience, not even a mentor in the other surgery. No dental foundation year, but we certainly had more experience by the time we left dental school. We learnt by our mistakes!
Any change, even a change for the better, is always accompanied by drawbacks and discomforts.-Arnold Bennett
For some reason I decided not to go into practice but went into the hospital service. It was not that I knew what I wanted to do but received a ‘phone call from a consultant asking if I would like a job for six months. No application form, no CV even required, no national recruitment and not even an interview to worry about. But thrown in at the deep end, on call from day one, expected to deal with anything that arrived into Accident and Emergency and remember this was in the mist of the “troubles” in Northern Ireland. That was a learning curve. Up to sixty-eight hours a week on call and that was not counting the nine to five job. The European directive cut this to thirty-seven and half hours but after I had left the hospital service. I wonder if Brexit will produce a change in the future.
Change is inevitable. Change is constant.-Benjamin Disraeli
As I “sailed” through the hospital grades, I did have to interview each year, but there always seemed to be more jobs available than applicants, so it really was a big decision. No major problems in the previous year so they kept giving me another year. Of course, I had to prove my worth and therefore had to sit first and second part Fellowship. I decided I liked Glasgow so much that I went back twice to do my first part. Had really got fed up with the travelling back and forward to Glasgow that I decided that I would only sit second part once. No poster presentation in my day but I don’t think A3 size printing to printers had been invented, no need to present any clinical audit or even do some research and write a paper that was left to the academics. How the system has changed and the more you can add to the end of the CV the better. It almost seems the more presentations and papers produced means you must be a skilful surgeon. Perhaps we are overlooking the surgeon who is skilful with their hands but not academically inclined.
The world as we have created it is a process of our thinking. It cannot be changed without changing our thinking.-Albert Einstein
Even as I progressed up the hospital grades in Oral Surgery changes came in, or as we called it “goal post moved”. To progress, I would have had to gone back and study medicine with the hope that if I qualified, I would then be looking for a training post, with no guarantees. Due to personal reasons that were not feasible therefore I decided to leave the hospital service and set up a dental practice limited to Oral Surgery. Remember this was 1987 where there was no General Dental Council specialist list. I was relying on my primary care colleagues to send patient my way rather than to the hospital. That took a lot of convincing but slowly but surely the patients came.
Change before you have to.-Jack Welch
The General Dental Council changed and introduced specialist lists. Oral Surgery, rather than be talked about as a speciality, became and speciality and a dental speciality. The clarification in our situation became helpful; we could now call ourselves Specialist in Oral Surgery rather then someone who carried out Oral Surgery treatment. I first became a grandfather or at least was grandfathered at age 36.
The first step toward change is awareness. The second step is acceptance.-Nathaniel Branden
The year 2000 brought in one of the most dramatic changes I have experienced. The General Dental Council decreed that general anaesthetic should not be carried out in primary care and all general anaesthetics should be given in acute hospital facilities. Even though my practice carried out numerous general anaesthetic, on children mainly, I welcomed this decision even though it produced a substantial loss of business. I had no alternative but to change my practice to cope with the loss. There was nothing I could do, no point crying over it, change was thrust upon my practice. Sold my building and bought another and set up to cope with Oral Surgery patients requiring treatment under local anaesthetic or local anaesthetic and sedation.
Be the change that you wish to see in the world.-Mahatma Gandhi
Have you noticed there are many more patients who are talking a variety of medication and generally there are a large number of elderly patients? We hardly see a patient requiring a full dental clearance, we do see patients that will evidently become edentulous or could do with a dental clearance. It is more surgical removal of a single tooth usually complicated by a complex medical history. Where will it change to next? And when we extract these teeth the patients will demand a replacement with an implant. When I qualified, many years ago, implants were so specialised that they were only carried out by the specialised trained surgeon but now they are so many expert practitioners offering implants, they are routine treatment.
If you don’t like something, change it. If you can’t change it, change your attitude.-Maya Angelou
So, my advice, from someone who has seen change over the past thirty years in dentistry and oral surgery is to embrace the changes that occur in your life. Find the positive in every change and use it to your advantage and do not get frustrated by change otherwise you will not progress in your career, in fact you will be left behind. If you do, you can reach your goal in life and may be in the position to introduce change for the better or your colleagues and patients.
And just for fun… “Change is inevitable–except from a vending machine.”-Robert C. Gallagher
Martin W. Curran BDS FDS(RCPS) MFGDP