Sunday, July 5, 2015

Tooth Life

Q: Why are dentists so unhappy?
A: Because they are always looking down in the mouth.
                                                                                           --old riddle

This is, first, the story of two root canals.

The first root canal was a failure in every way possible.  I was in the dentist chair for 2 1/2 hours.  During that time, before the dentist even came in, the assistant told me that the dentist was left-handed and that she was having trouble coordinating tools and procedures with him.  During that time, the battery on his forehead light lost power and he had to drive to his other office, a 45-minute round trip, to get a replacement.  During that time, he finally realized that he did not have the tools and the expertise to complete the surgery.  So he sent me to a specialist.

The specialist's office was the most beautiful medical facility I have ever been in.  Located in an office building overlooking a shopping mall, it had an open feeling due to its partial walls on the interior and the floor to ceiling windows on the exterior.  He told me that all he did was root canals, nothing else, and so the tough cases came to him.  With an efficient assistant and state-of -the-art equipment and anesthetic, I was in and out of the chair in 25 minutes.  Not kidding.

The cost of this expert root canal was $949.

Now, think about that for a second.  If fully booked, he could do two of these surgeries every hour, and for a full day and a full week, could make close to $16,000 a day, or $80,000 each week.  If he took three weeks of vacation every year, he could gross close to $4,000,000 a year.  Now, I know there are equipment costs and rent and insurance and other employees to pay, but still, he could make quite a chunk of money every year and probably does.

Depending on where you look, the high suicide rate for dentists (over 5x higher than the general population) is either an alarming fact or a punchline.  Doctors also have suicide rates that come close to or occasionally surpass dentists.  Military veterans, while their statistics are alarming, are not as high.

According to, the suspected causes of suicides among these professionals are things like "stress, demanding nature of the job, patient complaints, perfectionism, and even loans to pay off from dental school."

I have another theory: what if your job involved doing the exact same thing over and over, hour after hour, day after day, week after week?  What if you were a highly and expensively trained professional and yet all of your expertise reduced to a very narrow use of skills?  Because that is where the money is, right?  You want to make big money as a doctor or dentist?  Then you have to specialize, narrow your practice to an area that few others can do and probably not as well as you can.

And that may mean walking into pre-op room after pre-op room and putting random strangers to sleep before surgery.  Or doing root canals with such efficiency that your patient is little more than a tooth surrounded by blue latex that you work on with an x-Ray and a microscope and a drill.  All you have to say to him or her is "Do you need to be suctioned?" or "You're doing great" or a narrative of the procedure that you deliver in a monotonic, done-this-a-thousand-times voice.

If you check the hours of dentists, most of them are not seeking to maximize profits like my mathematical example above.  Instead, they work 4, maybe even only 3, days a week.  Now that could mean that they are so wealthy they don't need to work more, but that doesn't seem to be the case, in general.  Maybe they just can't take the grind, and need a golf course to decompress and to regroup.

An assembly line is an assembly line whether you are building cars or fixing teeth, and even if one is far more lucrative, that does not mean that it is any more fulfilling.  Most of us dread going to the dentist's office and can't wait to leave, even if it is a routine visit.  What if you lived there and that was your routine?


Sylvester Mckenzie said...

Well, that's why root canals are tough; it is a sensitive operation that deals with a very delicate part of the teeth. You should really ensure that you are getting top line dental service in that regard. The job is so tough that it cannot just be handed out to anyone.

Sylvester Mckenzie @ Cody Dental

Billy said...

I've often found dentists and lawyers to be similarly motivated. Both generally (although certainly not universally) were motivated by the likelihood of financial gain and general cultural respect. The only difference is most successful lawyers must change their entire way of life -- their notion of work hours, of "on" and "off," of what it means to have leisure time or family time -- and most dentists just have to figure out how to best schedule out their weeks and build and manage their client base. Which is no easy feat, but there are worse problems. I don't know many successful dentists who clock in 60-70 hours a week for 40+ weeks every year, and I don't know many successful lawyers who clock less than that more than a handful of weeks out of the year.