AME: Am I a Horrible Clinician?

[00:00:01] This is a production of The Very Dental Podcast Network

[00:00:10] Alan Mead is a dentist with too much time on his hands and too much recording equipment in his basement

[00:00:16] Armed with an obsession to bring entertaining and informative content to the dental world in a way that's never been done before

[00:00:23] I give you the Alan Mead experience

[00:00:27] Well, hello and welcome to another episode of the Alan Mead experience. I'm your host dr. Alan Mead

[00:00:32] I'm a dentist, podcaster, and a murder bot

[00:00:37] I'm actually not a murder bot, but I am

[00:00:41] Running through what I think is the best science fiction series of all time, which is

[00:00:49] Entitled The Murder Bot Diaries. It's an author by the name of Martha Wells

[00:00:54] I have probably listened to these books

[00:00:57] I'll bet this is my fifth time through them something like that

[00:01:00] I've already mowed through the first two in this weekend and they're short. They're real short

[00:01:04] They're super good tons of action and you can't help but love the character

[00:01:08] So I highly recommend I don't even know why that came to mind except I've it's all I've been listening to this weekend

[00:01:14] So it's fantastic. So I have a really interesting topic to talk to you about a couple weeks ago

[00:01:19] I put up a post in the Very Dental Podcast Facebook group

[00:01:24] And so if you're not a member, you should become a member go on Facebook

[00:01:28] Just look up Very Dental and then when you click on it and request an invite

[00:01:32] You got to give me one of five passwords names. You got Papa Randy, McQuethy, Lipscomb

[00:01:40] Hornbrook or Timmerman any of those five will get you in I'm amazed that you're not a member

[00:01:45] Hornbrook or Timmerman any of those five will get you in I'm amazed that I can remember all of those but I do

[00:01:51] Not in the same order necessarily. I like to keep it interesting. But there you go

[00:01:55] Give me one of those names and we'll get you in it's a great group a lot of good discussion

[00:01:59] It's not as busy as some dental groups. It's also

[00:02:03] Uh, it's not a garbage fire like most dental groups. It's very uh, I'm the only I'm the only um

[00:02:10] administrator

[00:02:11] so

[00:02:12] If there's something there that I don't like I just delete it. There's no it's it is a it is a

[00:02:18] It's mostly libertarian, but it's a little bit of a dictatorship too because if any anything is in there that i'm that is unintentionally there

[00:02:24] I delete it, but I don't have to do that very much because it's all good people and basically I only put the passwords out

[00:02:30] On the podcast so the only people in there are other people listening to the podcast. So there you go

[00:02:36] Uh Very Dental Facebook group go join that so I put this up a couple weeks ago

[00:02:40] There's a backstory and i'll get to the backstory

[00:02:43] But I put this up. Um

[00:02:45] It says i'm gonna just read it

[00:02:47] I'm going to suggest that every dentist goes through periods where they feel like a bad clinician

[00:02:53] For me, it's typically a few unfortunate poor outcomes unable to find a canal struggling with a root tip or the classic

[00:03:00] It didn't hurt until you worked on it. That's like that one just crushes my soul every time

[00:03:06] I'm pretty good at shirking off one or maybe two of these but several in a short time can really get me down about myself

[00:03:12] One does this happen to you? If it doesn't I want to know your secret two. What helps you pull out of it

[00:03:18] Um, I have some thoughts but i'm curious to know what helps you

[00:03:22] Fyi, i'm going to record a podcast about this and now I am recording that podcast

[00:03:26] So if you have any thoughts or even just want to be on beyond to talk about it

[00:03:30] Let me know so no one reached out to want to talk about it, but I did get a lot of good comments

[00:03:34] So the reaction first reaction from dr

[00:03:37] Russell schaefer who's been on the show before and has his own podcast called totally oral which you should go and download right now

[00:03:43] I would suggest that if it doesn't happen to you and you instead think you are amazing that you might be a narcissist

[00:03:49] And unwilling to recognize your own mistakes

[00:03:53] Uh, that's a strong statement. It's probably true. I I worry less about those people because I think most

[00:03:59] Most regular dentists feel this on a regular basis if you really don't feel you probably you probably have

[00:04:05] well on some level I I maybe am jealous of your

[00:04:09] Of your self-confidence because I just I I don't know. I'm not sure I buy that that people do that

[00:04:15] Dr. Brett Kessler who's going to be on the show in the next couple weeks, uh, the incoming ada president and longtime friend of mine

[00:04:21] We are imperfect beings working in a technically demanding profession with precision expectations

[00:04:26] Not only from ourselves

[00:04:28] But our patients and reimbursement models

[00:04:30] And we do this in a small dark hole with all sorts of obstacles tongue-cheeked saliva upside down and backwards that raise the level of difficulty

[00:04:37] Of the task at hand which also is very hard on our bodies in our support team's bodies

[00:04:42] This causes many of us to perform while in pain with the same highest expectations

[00:04:46] Plus the stress of our patients staff overhead equipment facility family social stresses financial, etc. Other than that. What's the problem?

[00:04:55] Please give yourself some grace to be human. We are perfectly imperfect

[00:04:58] It's surprising that less than perfect outcomes aren't more than norm. That is a very good point

[00:05:03] I was talking to my lab technician last week

[00:05:05] and and uh

[00:05:07] He had a

[00:05:09] He he has a mill. It's a new mill. He got it just like two or three months ago

[00:05:12] So he's actually able to mill his own stuff, which has been a long time in coming

[00:05:16] And the mill went down like it wasn't working and the poor guy

[00:05:20] I mean like two months in and his mill goes down and you know, the technical support was essentially no help whatsoever

[00:05:26] he ended up needing it was the computer he got another computer and it is milling now, but

[00:05:31] like

[00:05:33] When you have a workflow set up in one way

[00:05:36] And then it breaks down and you have to switch up. That is a wildly stressful thing

[00:05:40] And we were laughing a little bit about you know

[00:05:44] He doesn't have the his lab he does so much milled

[00:05:48] He doesn't have a casting arm and so if he has to do any casting he has to send that out too

[00:05:53] Which I think is probably pretty typical

[00:05:56] And then I flashed back to dental school and I graduated from the university of minnesota a very proud gold casting school

[00:06:04] Uh from the mid 90s. I graduated in 1997

[00:06:07] We had to cast our own gold that was actually going to go in people's mouths

[00:06:12] And I remember the first thing we learned in fix pross

[00:06:16] That uh

[00:06:17] the third

[00:06:19] quarter of

[00:06:21] First year all through second year fixed pross was basically the process of preparing your crown impressioning your crown pouring the model, you know

[00:06:29] Uh all the stuff the fixed stuff that goes from stone to wax to investment to you know

[00:06:35] Burnout to casting to finishing so like every one of those steps

[00:06:40] Was a step that could go wrong and and cause distortion and problems

[00:06:45] So like what I learned as a second year student is how in the world does any of this stuff ever work?

[00:06:51] How does it ever work and that's kind of what brett said he's like

[00:06:54] It's it's surprising that less than perfect outcomes aren't more than norm and i'm like, yeah

[00:06:59] How does it ever work and it's amazing actually because it really mostly works quite predictably

[00:07:05] Most of the time now so it is kind of amazing when you think about that. So

[00:07:08] uh

[00:07:09] Zach minors, uh of the very clinical podcast write something very important and I want you I want you all to listen to this

[00:07:16] Or you see a variety of failure a variety of failures on recalls and begin to wonder whether dentistry works at all

[00:07:23] And it begins to affect the way you treatment plan because in the back of your head

[00:07:27] That little voice is saying that's not going to work

[00:07:29] and then your schedule goes to shit because you're recommending less because you don't want to see another failure and then you begin to feel

[00:07:35] Like a failure in business and dentistry vicious cycle. Just me

[00:07:38] No, zach

[00:07:39] It's not just you because I do the same thing

[00:07:41] It takes a lot of smooth weeks and seeing successes in recall to get me out of this funk sometimes and actually

[00:07:46] Successes in recall is that's a that's a great point. It's a really good point

[00:07:49] Just remember when you're feeling really bad. You have a really bad day

[00:07:53] It is important to look at some recalls because you know what most of the stuff you've done is pretty great

[00:07:59] Yeah, you don't give yourself that credit when you see the the failure stuff and and I mean I I get it so

[00:08:05] and actually

[00:08:07] Zach and brad madison have a big back and forth about this and it's worth reading

[00:08:12] I'm not going to read the whole thing because it's long but it's so good

[00:08:14] So you should go to the very dental facebook page and read their back and forth because it's really good

[00:08:19] Kelsey esposito says i've just learned

[00:08:23] That the worst thing you can do is to avoid or ignore the situation always best to talk it through and problem solve in person

[00:08:29] For the best outcome never on the phone or email

[00:08:31] I always feel better after talking about it and think the patient does too. Usually we come to some plan or compromise that's

[00:08:39] That's good advice

[00:08:40] Uh, I think sometimes the problem is you're not sure

[00:08:44] Some particularly for the bad out

[00:08:46] Okay, if you know that it's a bad outcome when it happened like at the time that it happened

[00:08:51] Yes, 100 you need to be in person in their phase explaining and i'm trying to think like bad outcome. Um

[00:08:58] A crown that has that where you missed a margin or an open margin that you're gonna have to send back to the lab

[00:09:04] That's one

[00:09:06] Most patients understand if you're doing it for the for because you want to have the best outcome. They're cool with it

[00:09:12] Uh, geez, you missed a root tip in an extraction and you can't get it out

[00:09:17] Uh perfed an endo can't find a canal something like these are all things you can talk about at the time

[00:09:22] Sometimes the bad outcome is pain or sensitivity that that you didn't know how it was going to work or not

[00:09:28] Sometimes it's something removable where they have a sore spot

[00:09:31] Bottom line talking to the patients in person is the best thing next best thing is a phone call when they're not expecting a phone

[00:09:36] Call honestly, I sometimes wonder if a phone call when they're not expecting a phone call

[00:09:41] Is even better because you have the surprise like oh my gosh

[00:09:44] The dentist really cares about me because it's true

[00:09:47] You do care and it's bugging you in nine times out of ten. That is usually a really good, uh, really good interaction

[00:09:53] So, uh, that's I I will i'm with you on that though. Kelsey. I think that's a good a good thought brad keener

[00:10:00] This is so good. This is so good

[00:10:03] There are days when the handpiece thinks i'm frank speer and then there are days when it thinks my name is something like I don't

[00:10:08] Know kenny

[00:10:10] Uh brad keener. I'm with you. I'm with you

[00:10:13] Clara dutton griffey says, uh, thank you for bringing this up. It definitely does happen

[00:10:18] I remember listening to the dental acts podcast in dental school

[00:10:21] And you once said something about having one of those days or maybe periods of time where everything I touch turns to shit

[00:10:27] Uh, I think I probably have said that in multiple times on the podcast to be perfectly honest

[00:10:32] And that staying or saying

[00:10:34] That saying stuck with me and has come to mind here and there over the past few years

[00:10:39] I've had a few of those days recently and it really made me hate going to work no advice

[00:10:43] But I would love to hear others experience with this. That is very true

[00:10:46] it is and I I got a great story that i'm going to tell you once i'm done reading these things because

[00:10:51] it also

[00:10:52] Literally, those problems can be solved

[00:10:56] Instantaneously because it's typically you beating up on yourself

[00:11:00] uh

[00:11:01] Patients can be mad and patients cannot be mad

[00:11:04] That almost you almost have no control over that it's almost separate from the outcome being bad right like

[00:11:10] because

[00:11:12] I have patients that like me enough that they're gonna

[00:11:15] They will cut me the slack even if I don't deserve it and I have patients that will cut me no slack

[00:11:19] Even if everything goes great, you know, i've got both ends of that thing

[00:11:23] so that's

[00:11:24] You almost don't have control over that except for the fact that you have control over how good of a relationship you have on someone before

[00:11:31] Treating them and if you are skeptical, this is I mean i've said this a million times, but if you're concerned

[00:11:36] About the patient not being in your corner

[00:11:39] Don't treat them. The worst time to find that out is after they're in a temporary

[00:11:44] Or you've prepped a tooth or you've numbed them up or whatever. Yeah, it's just I mean i'm it happens but

[00:11:49] uh rob apple says I find the poor outcomes always happen on patients with a mouthful of questionable dentistry and of course

[00:11:56] They are also the loudest complainers seems like a common denominator

[00:11:59] Whenever I have a poor outcome on a great patient

[00:12:01] It seems easier to manage because they appreciate the effort to make it right which makes me feel less shitty

[00:12:05] That is 100 100 anticipating potential complications and preparing patients ahead of time makes it feel like less of an excuse after the fact

[00:12:13] Not always possible though. This is where informed consent and i've talked about this a million times is really important and frankly

[00:12:20] Informed consent is probably always worth it

[00:12:23] And a lot of times it's on the procedures where I think it's going to be a cakewalk where I wish I had talked

[00:12:28] About complications a little more ahead of time. It's very very good stuff. Very good stuff

[00:12:33] Aaron elliot

[00:12:34] That erin elliot, dr

[00:12:36] Erin, I focus on the 99% thing to go well learn from what I can do better have people like dr

[00:12:41] Kelly harness speak words of encouragement and remember that at least it's not brain surgery

[00:12:45] I also know my abilities while I challenge myself. So I keep growing

[00:12:48] I also absolutely know what I don't enjoy or i'm not good at and refer to the other docs in my office that enjoy it

[00:12:54] and then so

[00:12:56] Her partner kelly actually joined the very dental facebook group so she could reply which is so cool. I freaking love that

[00:13:03] This is a reason I could never practice alone. I need dr

[00:13:06] Aaron elliot, uh to talk me off the ledge every now and again if she can handle being married to her husband husband tom

[00:13:13] I should be able to handle dentistry

[00:13:15] The story is that there are times when I think

[00:13:20] There are times when I love working alone and not having other dentists

[00:13:23] But there's a lot of times where I think it'd be pretty fun to work with someone that you liked and trusted and that

[00:13:27] You could lean on because I do lean on other dentists when I have bad stuff whether it's in in, you know

[00:13:32] facebook groups or it's in

[00:13:34] Uh group chats or if it's calling a friend or something like that

[00:13:37] If you had someone in the office all the time, that'd be so good. I mean I I

[00:13:42] So, uh kelly and aaron I i'm a little jealous that you have each other

[00:13:46] Uh on it like on a daily basis like that and I will say that my dad practiced. Uh, it was really cool

[00:13:52] My dad's office

[00:13:53] Was in a building with another dentist's office and they shared a lab like the lab actually connected the two offices, right?

[00:14:00] so

[00:14:01] They would when they had time when I have time between patients or waiting for something to get numb

[00:14:06] I'll go and jump on social media and melt my brain when they had time between patients

[00:14:10] They would go to the lab and half the time

[00:14:13] The other guy was there and they could talk or they could joke or they could complain about patients or whatever

[00:14:18] And i'm very jealous. They didn't they their practice wasn't it wasn't the same practice

[00:14:22] But it was the same building and they shared the labs. It was a really cool setup

[00:14:26] I I gotta say that that's having someone to lean on is a big deal

[00:14:30] Uh, dr

[00:14:31] Gary holtz class says yes happens around once a year where I feel like nothing will go right for a couple days to a week

[00:14:36] Or so during that time i'm unable to see what goes right. That is so true. So true

[00:14:42] I'll also say it as often you're seeing that one to two patients a ton of number

[00:14:46] I'll also say it often is that you're seeing that one or two patients a ton

[00:14:51] So the number seems higher because here she or he is again

[00:14:56] Which makes sense because a lot of times when you're dealing with complications, you're seeing them a lot

[00:15:00] Uh the partial that that is never going to be right or the crown that's sensitive or whatever

[00:15:06] I'm going to tell you this right now

[00:15:08] lately

[00:15:09] The the sensitive crown I have solved this with ivo cliers bonding agent. Okay, hang on. It's the viva pen adhese universal. Okay, so

[00:15:18] Basically if I have a sensitive tooth that has the slightest bit of exposed

[00:15:23] Denton i'm gonna just literally I don't even have to numb up. I don't have to do anything

[00:15:26] Just dry it paint this stuff on because it's a self-fetcher. You can total etch but it's a self-fetcher

[00:15:31] I'm gonna put two layers on dry that and hit it with the light and i'm gonna tell you that 80 of the time

[00:15:37] The patient literally you can blow air on it water on it right there and then and and it's not sensitive anymore

[00:15:42] When it's dental hypersensitivity, I swear to god. This stuff is amazing

[00:15:45] um, I like I like ivaclar stuff, but I I particularly like this adhese universal pen because

[00:15:53] I mean I have two different bonding agents. I use one of them's alcohol based and this one is is uh,

[00:15:57] Acetone based and I I like it. I like having one of each

[00:16:01] But I will tell you that this stuff works for desensitization better than anything i've ever used before

[00:16:05] That is a little clinical tip that I wasn't expecting to give but yet here we are here

[00:16:09] That's what we do in this podcast. We're a value podcast

[00:16:12] Sarah meyer says i've been trying to help my perfectionist eight-year-old by telling him a mistake

[00:16:17] I make every day while the family goes around the table. I never have to think very hard about it

[00:16:22] My mistakes loom large in my brain on the plus side. I do think it's helping him a little bit

[00:16:26] So sharing the load, uh is definitely helpful on those sorts of things. There's no doubt about it. Um

[00:16:33] Natalie ballast says wait, you only go through periods I get it. That's funny. Sometimes that's how it feels there it is

[00:16:40] uh paul

[00:16:41] fair, uh

[00:16:45] paul

[00:16:46] fairly

[00:16:48] Man, paul your name is still hard for me to say even though i've talked to you in person lots of times

[00:16:52] I still your last name is hard to say

[00:16:54] It used to happen a lot more when I was starting out mostly when I took more ownership of the initial situation

[00:17:00] Or the problem than the patient did that would lead me to feeling like crap and things would spiral in these situations

[00:17:05] Somehow just always got bunched together. I would be on a streak of feeling fine

[00:17:10] Then all of a sudden i'd feel like everything I did was crap

[00:17:13] I talked to dr

[00:17:13] Michael melkers who's also going to be on the show soon

[00:17:16] About it when I was in a really bad place and just felt like I was the worst dentist and everything I was doing

[00:17:20] Was terrible. He just looked at me and said you think you're the only one that made me feel much better

[00:17:25] Knowing I wasn't the only one who felt that way at times and if he felt that way, too

[00:17:30] I knew it was eventually going to be okay. The negative wave would pass all very true

[00:17:34] Uh taking ownership of the problem i've been doing this for since 1997. Let's do the math. That's 27 years

[00:17:40] Uh 27 years worth of this and I still struggle with taking ownership of the patient's problem

[00:17:45] I

[00:17:47] Would like to have the emotional range of spock from star trek when it comes to this stuff

[00:17:53] I would love to be able to look directly at the patient's problem

[00:17:57] tell them exactly what it is and then

[00:17:59] Just walk away from it and say I don't care if you do anything about it

[00:18:02] I told you about it

[00:18:03] If you want to do something about it, we can I wish I could do that

[00:18:06] But a lot of times I don't and worse than that some of these patients i've literally known for 27 years since i've been practicing

[00:18:12] And I feel like they're more like family than patients and I just feel horrible because a lot of them are getting older and are

[00:18:17] Breaking down. It's terrible

[00:18:19] So all this stuff was a great conversation

[00:18:22] There's a lot more in this thread that I haven't I haven't talked about

[00:18:25] So you need to go to the very dental facebook group and read all of it because it's going to make you feel better

[00:18:29] Um, I have a story that goes along with this

[00:18:31] This is the reason that I started this thing

[00:18:33] But again, if you if you haven't joined the very dental facebook group, you got to go to very dental facebook group

[00:18:38] Request an invite give me one of five passwords. Let's see if I can remember the name timmerman hornbrook mcquathy lipscomb papa randy

[00:18:46] Those five one of those five all those five some of those five whatever you want to do

[00:18:50] We'll get you in you can read this fantastic thread that's worth reading. I gave you the highlights, but there's a lot more there

[00:18:55] It's like a textbook in dealing with this kind of mental space

[00:18:59] Let me tell you a little bit about what inspired me to start this post in the first place

[00:19:05] Relatively new patient

[00:19:07] Painfully nice guy painfully nice guy. Honestly, he was kind of a mess

[00:19:11] Um, interestingly, he was willing to do stuff though. He was willing to do work

[00:19:17] Uh, he had one of those teeth that had been restored with fillings a bunch of times and he had recurrent decay

[00:19:23] It was on the root surface. I should have known it was going to be a problem child

[00:19:27] Did the restoration crossed our fingers and he called having pain he called having quite a bit of pain

[00:19:33] um

[00:19:35] and

[00:19:37] so I I took a look at him and and

[00:19:40] Decided that we could we could do the end. We could do a root canal

[00:19:42] The tooth was tooth was if it wasn't abscessed it was getting there and I wanted he was dying

[00:19:47] And so I got him in an emergency basis and I got him numbed up

[00:19:51] But I mean he had I had actually written him. He actually called

[00:19:55] Oh, man, I think he called on the weekend. He had his daughter call on the weekends and he was dying

[00:20:00] And he knew that I couldn't call I could only call in Tylenol 3 for pain

[00:20:04] He knew that that should have been a red flag. We'll come back to that

[00:20:07] uh

[00:20:08] This is a guy who continued to have pain no matter what I did. I did bring him in

[00:20:13] I said I would try and open the tooth the tooth

[00:20:16] Was pretty I could see a canal in the distal as a lower lower second molar

[00:20:20] I could see a canal on the on the distal. I thought I could see the mesial canals, but they were pretty small

[00:20:25] I

[00:20:26] Had him in the chair for like an hour and 20 minutes and I got into the distal canal pretty well

[00:20:31] And I got into one canal on the mesial but interestingly

[00:20:34] I couldn't get anything bigger than a 10

[00:20:37] File down that can I was a spindly little canal. I'm like man. That is a really it's really weird considering

[00:20:43] I mean the distal was pretty decent sized and I felt like I was getting close to to perforating

[00:20:48] I I couldn't find the two mesial canals

[00:20:52] I found one and what I suspect when I when I put some calcium hydroxide in it

[00:20:56] It looked to me like I may have found the middle mesial which is a real accomplishment except I couldn't find any other canals

[00:21:03] so it's

[00:21:04] So I I got some calcium hydroxide in there and I I said, you know

[00:21:07] I gotta send you to an end honest. I I am worried this tooth's gonna give us a hard time

[00:21:10] We I looked at the x-ray

[00:21:12] In that middle mesial canal, I blew out some calcium hydroxide and it came out mid-route

[00:21:16] I'm like, oh man, did I perf this thing? I in so in my mind i'm thinking

[00:21:21] I haven't done a good job here. I should have I should have punted this before I messed it

[00:21:25] I was real really worried that I had perforated the tooth

[00:21:28] Except I I sent it to several friends like no, that's a canal as two canal shaped. I I don't know what so

[00:21:34] I sent him to the endodontist and but in the meantime

[00:21:37] So I had calcium hydroxide that had actually kind of uh, it was in the the pdl space. So you knew he's gonna be hurting

[00:21:43] um

[00:21:44] So he hit me for I I sent him home with

[00:21:47] With uh, like norco like a generic norco hydrocodone, but I never I never write many I wrote like eight or something like that

[00:21:55] Well, he calls in later

[00:21:58] This is all in retrospect. I wasn't you know, i'm elbow deep in other stuff dealing with it

[00:22:01] So I wasn't super worried about it, but I have never written for

[00:22:06] Uh percocet i've never written for oxycodone in my entire career

[00:22:10] I am i'm a recovering drug addict and I know that's the good stuff. I never wrote for that stuff

[00:22:15] Uh for the longest time my dea I didn't I I didn't even allow myself to write class two

[00:22:20] I only could do just because I just wanted limited

[00:22:22] So this guy talks me into a percocet script because I and I felt terrible because he was hurting so bad

[00:22:28] and I knew that this the

[00:22:31] This endo had gone poorly. I hadn't you know, I and of course he couldn't get into the specialist

[00:22:36] For a month or a month and a half and I was like, oh god, so i'm feeling bad. I'm medicating him and all this stuff

[00:22:41] So finally last week, oh this is so good. This is so rich

[00:22:46] Last week I get into the office and there had been a message left from the endodontist's office

[00:22:52] That that they had gotten this patient in

[00:22:55] Early for me in the in the answering machine was

[00:22:59] Can you give us a call when you when you get this and you're just like?

[00:23:02] Oh, no, I was right. I perfed it. I I screwed the tooth up. Oh i'm gonna hear all about this

[00:23:06] I was so the whole time I'd felt like i'd done such a horrible job and and

[00:23:13] And then and then on top of that, oh it gets so much better

[00:23:16] The patient had had called and left a message

[00:23:21] Canceling their further appointments with my office

[00:23:24] So I mean, I don't know if you hear this and you're like, oh man

[00:23:28] I I felt like I mean, I just had fear in my heart. I'm like, oh i've screwed this up so badly

[00:23:34] I just just the worst, you know here i'm trying to do this guy a favor and I mess everything up and

[00:23:39] And so i'm thinking that the endodontist is going to scold me for doing such a terrible job and in the patient was mad

[00:23:44] and he was i'm i'm, you know lawsuit incoming all this stuff on and i'm and then

[00:23:49] So my office manager calls the endodontist's office

[00:23:53] says

[00:23:54] Yeah, uh, so your patient came in here

[00:23:57] And before he even sat down in the waiting room, he came in and he had a couple prescriptions

[00:24:03] He said i'm gonna need to have this filled

[00:24:06] Before before he ever sat down before he did anything, you know

[00:24:10] And and she said well we we really need to see the tooth before we can even evaluate any of that and and uh,

[00:24:17] He got so mad that that they didn't tell him that

[00:24:22] That they would refill his prescriptions that he walked out

[00:24:25] He walked out. He was never seen by the endodontist after all that

[00:24:28] So so I spent a solid two hours that morning thinking I was the worst dentist on the face of the earth and I had

[00:24:34] Done a terrible job on this patient and the endodontist was going to scold me when in reality is my patient

[00:24:40] uh

[00:24:41] You know, I know drug seekers well because I have that I have that in my past literally as a recovering addict

[00:24:47] And this guy snowed me. I never I I didn't put two and two together because I thought I had done

[00:24:52] Done him so wrong with this tooth

[00:24:55] Um, so yeah, he canceled all his appointments on me after he went into the endodontist's office and

[00:25:02] uh

[00:25:03] Tried to shake them down for prescriptions before they ever saw him

[00:25:05] So he never actually saw the endodontist and he's kind of canceled himself from my office

[00:25:09] So I figure listen I if he needs to be seen again, I will happily see him again

[00:25:13] I have a lot more data now that I used to

[00:25:15] Yeah, I don't uh

[00:25:17] i'm pretty sure that specialist won't see him again and I could find him another specialist if he wants to be treated but my guess

[00:25:22] Is I won't ever hear from him again, which sucks because he's got calcium hydroxide, which is fine for the short haul

[00:25:28] But if that tooth if he's going to finish that endo it needs to be finished or it's going to blow up on him

[00:25:33] I just feel bad for him and but i'm not going to write him any more scripts. Let's just say that much

[00:25:37] So yeah, I got suckered people. I got suckered

[00:25:40] Uh, yes, the outcome wasn't good, but it was a case selection problem more than anything else

[00:25:45] This was a tougher tooth than I should have been trying to do and I was trying to do him a favor

[00:25:49] Because he kept telling me about how horrible the pain was on this tooth after I had done a restoration on it

[00:25:54] That was pretty straightforward

[00:25:56] what is the truth, I don't even know but I have let myself off the hook because I

[00:26:03] Instead of being yelled at by the endodontist what a terrible job I did

[00:26:06] And that was literally when I when I first opened this tooth up and tried to get to it

[00:26:10] That's when I posted this two weeks ago

[00:26:12] It was only a week and a half later that I realized that he got into the endodontist office and never even saw the endodontist

[00:26:18] so understand

[00:26:21] That stuff can happen. Yes, you can have poor outcomes you can

[00:26:26] You can try to make them better. You can try to talk to the patient

[00:26:29] You can try to get their expectations down. You can do really good informed consent all this stuff, but it can still happen to us

[00:26:35] So your best bet is to understand is give yourself a break

[00:26:39] that you know as long as you did your best as long as you were trying to hurt someone and

[00:26:43] It

[00:26:45] happens to all of us it happens to all of us and

[00:26:48] And it sucks for all of us

[00:26:50] And what you really need is you need to have someone you can trust that you can talk to

[00:26:53] To kind of talk you off the ledge. Like I said, Aaron and Kelly

[00:26:56] I'm very jealous of you because you have each other to talk you off the ledge in these situations

[00:27:01] so maybe we need to have a

[00:27:03] A private group in the very dental facebook group the talk off the ledge group. It could be anonymous for crying out

[00:27:08] I love that

[00:27:10] But understand that it comes with the territory

[00:27:13] if you are a

[00:27:15] Regular clinician doing their best you are going to have some bad beats that make you feel like you're terrible

[00:27:20] You're not terrible. It happens to all of us. You're doing your best and and

[00:27:25] There's lots of people out there that understand what you're going through

[00:27:28] So I hope I hope this has been helpful

[00:27:31] Uh, the original thread was very helpful for me

[00:27:33] And if you are not a member of the very dental facebook group

[00:27:35] You need to go in there and read this thread because it is freaking amazing. It's really and it's still going

[00:27:39] There's still people adding stuff. It's really good

[00:27:41] But also i'm really glad that I could tell the entire story and feel a little bit better about it

[00:27:47] Because it was bad and then it got really bad

[00:27:50] In like in a moment after hearing about what what actually had happened

[00:27:54] I started feeling much better about it that I wasn't the horrible clinician that I thought I was

[00:27:59] Or at least if I was I wasn't doing anything bad or evil or wrong. I did the best that I could

[00:28:06] So, I hope you guys appreciate that and I hope you guys give yourselves a break because everyone goes through this

[00:28:11] I really appreciate you guys listening go check out the very dental facebook group. It's a great group

[00:28:16] And uh, tell a friend about the podcast and I hope you find it helpful

[00:28:20] And we will catch you next week