Board Certified Periodontist

49 – Taking Offense

As I was changing lanes the other morning on my way into work, I was moving from one line of traffic to another slower line in order to move onto the freeway – which meant I have to put on my break, signal and find a place to merge left. As I was doing this a white car coming somewhere behind me raced off with one long sustained horn blast.  

No doubt he was an excellent driver because he was able to handle both the steering wheel and horn with the same hand. His other hand was raised up out his open window as one would if waving goodbye. In this case, however, I got an entirely different message.  

Unfortunately for him, beyond the anger, his message was pretty much lost to me, because I have yet to figure out what it was I did. In fact, it is possible his temper tantrum was toward some other car.  

Hi there. Believe it or not, you are listening to the Perio Hygienist Podcast and I am Dr. Ben Young, a periodontist in private practice in San Antonio, Texas.  

This podcast is certainly open to anyone who cares to listen but is actually produced for dentists and dental hygienists who share my interest in how best to manage periodontal patients. My opinion is that most treated periodontal patients can return for continued care by other dental offices, but there is a caveat.  

Because we are talking about a team approach, it means we have to work as a team, which means we have to have a general common philosophy of care and it also helps if the patients become convinced that we are working and communicating together on their behalf all the time. This is what makes a podcast a powerful communication tool, because people can listen when most convenient to them. My responsibility is to make the content useful. So I try to make it as real-world and practical as I can. I call the podcast the Perio Hygienist Podcast also because of the critical role played by dental hygienists in the care and management of periodontal patients, especially treated ones who are returning for Supportive Periodontal Therapy in their offices. So I try to offer help in how to manage these patients and when it might be a good idea to send them back to the periodontist.  

Another reason for this podcast is a personal one to me and that is talking honestly about how to survive patient care in dentistry. It is one thing to work selflessly for the benefit of patients, to make sure we give them the best we can and that is available, which then means we have to be committed to continuing education. But it also means we have to manage all the hassles of practicing in offices with other people – things we were not thinking about when we were in dental or dental hygiene school. Back then, all any of us really wanted was to graduate and move on. Now we have graduated and have moved into practices and practice patterns that either enable us to enjoy what we do or frankly hate it. If we burn out, most of us will leave dentistry and move into areas we hope are more suited to our personalities. To a few, I think that is a reasonable plan, but for most of us, my hope is to try the best we can to develop ways no just to cope, but to thrive, in the professions we have already dedicated so much time to learning. 

So today I would like to talk to you about Taking Offense.  

It’s easy to offend (you can do it without knowing – like I evidently did in the story I shared with you a moment ago) and it is easy to be offended.  

And when you treat patients in a dental environment, you are right up close and in people’s personal space all day long.  

Another way we sometimes describe the idea of taking offense (because that doesn’t paint us in the best light) is to talk about having our feelings hurt.  

Please don’t misunderstand me, however. I’m not trying to discount this. In fact I am acknowledging that it happens and that emotional pain is a real thing. Here’s an example, if someone shares with me, for my own good of course, something they don’t like about me, and they recommend I work to improve – and then I have to immediately encounter someone else in order to provide them care, my mind can be completely distracted. Without preparation and training over time, these sorts of things can affect my performance.   

Let’s also face the fact that we are living in a very sensitive time – everyone is a little more on edge. Emotional sensitivity is linked to times of increased uncertainty.  Looking at it from the opposite situation, people are emotionally more resilient when life is more routine and stable and surprises are fewer and farther between.  

However, even in good times, it is important to acknowledge that conditions can and will change on a dime in each of our lives personally, as well as, once in a while, collectively. But, even beyond acknowledging this may occur, I believe it is important to prepare ourselves. How do we do this? By building space into our lives. The more hectic life is, the more step away and recreating become. 

Recreation, to me, is not entertainment. It is something that involves, rest and recovery often through activities that are enjoyable along with exercising the habits of gratitude and reflection. It doesn’t all have to be done in solitude, although this is very useful and important. Part of it should be accomplished in community, when phones and other electronic devices are put away and people just talk with one another. Recently I bought a small propane fire-ring that I am enjoying in the evenings at my Airstream. What I find is that a fire draws in a few neighbors who come over and sit and visit for a spell. And my little ring is easy to take with me when I travel.   

Entertainment and recreation are not the same thing although there are certainly times when they do blend. To me, entertainment can be just a way of escape, a process of getting lost in something that distracts my mind for a little while.  Here’s a food analogy I just made up. Recreation is like a good healthy meal involving a variety of foods. Entertainment is the dessert.    

But what about the dental office? Environment is important, no doubt, but for those who work there, it is a place to work – and sometimes work is hard, and we all know that people can be annoying – including you and me.  

So here is how I look at work. If you work in a dental office or environment — regardless your position, employee or employer, it doesn’t matter, you go there to work – which, to me, means to serve.  

I am serving people when I go to work. It is not where I go to be served, even as an employer.  

I go to serve myself and to serve along side those I employ – on behalf of patients.  

So patient have to be the focus from beginning to end when in the work environment.  

Does this mean they get to be bossy and annoying?  

To some extent the answer is yes.  

If certain lines are crossed when someone is demeaning someone else, I’m sure you understand what I am saying here, whether a worker or patient, then it may be time for me to step in. I might talk about that another time.  

Back to my main point here.  

The work environment is for work and workers need to come as emotionally prepared as possible to serve patients.  

This does not mean we can’t provide one another on the team emotional support, but it can never be enough or all we need as human beings.  

I’m not the first, I’m sure to make this analogy, but it really works for me. The dental office or environment – if you are a department in a larger facility – is like putting on a play every time a patient is in the office or on the phone. This is performance mode. When patients are not around, we can be in rehearsal mode. This means we can review events and work out ways to improve the care we provide.  

One of the problems with every team involves the fact that no one’s personality is like anyone else’s. This is also true for everyone’s background and experiences.  

It is not necessary that we as team members like one another, that’s certainly nice, and sometimes we can get there, but what is critical is that we can work together. This involves agreements for how we will manage ourselves in the office. So again, I’m back to the problem of Taken Offense. In today’s environment, it is often the case, apparently, that people are taught to actually take offense and react to what are called microagressions. If people do this in healthcare, I can pretty much predict patient care will suffer if the enterprise doesn’t completely collapse. So I take the opposite position that we as individuals are responsible for our own behavior and this includes feeling management. What I have found that works best for me is to practice not taking offense. That means striving to maintain an atmosphere of grace – not taking things personally as much as I possible can.  

Which takes me back to the Serenity Prayer. 

God grant me the serenity to accept the things I cannot change. 

The courage to change the things I can. 

And the wisdom to know the difference.  

Breaking this prayer down into three steps. First I have to accept the things I have not control over. What are some of these? How about the behavior of others? We have all tried to. What this looks like in work places are power games, intimidation, back biting – it’s a mess – all in the attempt to control others. If instead we begin by acknowledging that we are all adults who have self will and the right to make our own decisions, then working with one another then results in respectful negotiations.  

Should I as the employer expect to be obeyed? Well, actually, no. Not if I am wrong. Instead, I want to work with people who again agree with me that we will work best together if we focus on what is best for patients. So I want employees who will speak calmly and truthfully about whatever they believe will improve patient care. Neither they nor I should attempt to have others meet our particular needs – unless our need is to improve patient care.  

The second part is asking for the courage to change the things I can. So what do I have control over? Just me. I can control my actions. I can control my temper. I can control my time. To name a few. The point here is that it takes courage to step into the areas in my life that are messy and need more attention. It requires, for one thing, admitting when I am wrong, and that I need help at times, but that I do not have to be winy about it.  

Finally, I need wisdom to know when I need to work at something and when I need to let something go because I fundamentally have no control over it.  

I know it sounds easy. It’s not easy. It is walking a narrow path and self control. 

Finally, let’s talk about interactions with patients. They come to us to help them with particular problems, but they may have more problems than they tell us about or we can handle. This often spills over into their behavior. When you can’t figure out why a patient is upset or even angry, understand, first and foremost, that it isn’t about you personally. It seems personal I know. It even sounds personal at times. It is never personal about you. It is always personal within them. Hard to remember in the moment when a patient loses it, but still this is what we need to prepare for and expect to happen at times. The good news, is that these moments can pass on by and the same patients can actually sing our praises if we treat them well and do not lose our cool – if we stay in performance mode in the moment and go recreate later.  

Well that’s it for this episode. Let me know what you think, especially if you disagree with something. That’s how we grow. Remember, it takes courage to change the things we actually control – and I have a lot of control over the content of this podcast. If you see ways where I can make it better for you, let me know. This has been the Perio Hygienist Podcast and I am still Dr. Ben Young. Thanks for listening. Have a great day. Bye for now.