Humans want to know. Whatever the topic, we want more
and more knowledge of it. This has been from the beginning of our time. The
satisfaction of answering a question leads to an insatiable desire for more
questions and answers. It feels good to learn. If you have young children in
your house, the never ending “why, why, why..?” will usually result in the
highly irritated response of “because it is” by the beleaguered parent. This is
our nature.
In medicine
and dentistry alike (you thought I may
have forgotten the topic of this diatribe) the quest of knowing is no
different and, in fact, its ostensibly moral and benevolent nature in seeking
this information for the good of mankind does provide ample motivation for its
continuance. In the hunt for cures and treatments to limit the suffering and
death of our fellow men, we must make sure we leave no stone unturned and
realize the potential of our intellect and abilities to solve the mysteries of
biology, disease and health.
To start this
journey sometime, during high school, someone with aspirations of becoming a
doctor (from here out I will focus on
dentistry since that is the path I know well, but it is a similar one for a physician
and other healthcare providers as well)
must start considering colleges. In order to get into a good dental
school it helps to go to a good college, usually with a strong science
curriculum. All colleges are expensive
and the better ones even more so. $$$ (every time you see dollar signs I am trying to indicate without
being overly repetitive the impact on the eventual cost on health care delivery
our current system).
Ok, you are
in your undergraduate school of choice and with the help of mom and dad, uncle Sam,
banks, and loans $$$ you spend four years hard at work studying and graduate
with excellent grades. Then you start looking into applying to dental schools.
There are applications, entrance tests, visiting schools, buying a suit and
going on interviews. $.
With some luck you get into a great dental school.
$$$. Spend four years studying and learning, yada, yada, yada. You get the idea- education is expensive! But
the knowledge our profession (as well as other fields of study i.e. physics,
computer science, engineering) has grown to the point where even a four year
graduate education is merely scratching the surface of what the collective
information there exists. The student has the responsibility of learning and
retaining this information to bring into the real world and use it to improve
the life of our patients.
What a
dentist needed to know in 1955 is probably 10 % of what a dentist graduating
from dentals school in 2013 must know. For medicine it’s probably even more
dramatic. Just think of what is available now just in the small subset of
healthcare that is dentistry. Since 1955 we now have implants, cone beam (3D
scans), rotary files for root canals, myriad of bonding adhesives, microscopes,
cements and composite materials, Cad Cam (milling crowns and inlays by
computer), bleaching, veneers, Invisalign, numerous types modern ceramics,
computer records, digital x-rays, bone grafting, gum grafting, non surgical
periodontal treatments (Arestin), Lasers for surgery, lasers for tooth
preparation and periodontal treatment, digital imaging. I could probably fill a
full page, so what does this mean? – Specialization $$$, Continuing Education
beyond dental school $$$, staff and doctor training to use specialized equipment
$$$.
Specialization
was inevitable when the breadth our knowledge grew. But to be a specialist
means additional years of schooling. $$$. When specialists do finally get out,
they want to treat patients with all the latest and greatest things that they
have learned. $$$. Even general dentists upon graduating are no longer really
prepared to practice modern dentistry. What is taught in dental school provides
the foundation for practicing dentistry. It is then the responsibility of young
graduates to seek out post graduate training to really learn how to do
procedures that patients want since they were unable to master in dental
school. Implants are the perfect example; in most dental schools undergrads get
very little practical experience with implants. Enrolling in an implant course
$$, is just the beginning. To fully be proficient you must continually educate
yourself and join groups or academies $$ that provide further information and
support. The days of a dentist graduating from dental school and “hanging the
shingle” are over. In fact now to get your license, graduating from an
accredited dental school is not enough you must pass licensing tests and do a one year post dental school program $$
before you can practice.
All of the progress our profession has made in the
advent of new technologies and understanding of pathology and the best ways to
treat our patients requires a significant investment in time and money to fully
grasp and integrate into our practices.
The end result is extraordinary advances in the profession that have the
potential to change people’s lives. If you have ever seen a child with cleft
lip, you know there is no way we cannot use every advancement we have to try
and correct these malformations. There
are so many ways that all those technologies listed previously have made a
difference in our quality of care, and there is no going back. But once again
the progress trap comes into play, are we creating doctors that spend so much
of their lives educating and training, and mounting huge financial debts, that
when they come out to practice, the fees they need to charge for these advanced
treatments are out of reach for the average person. I’ll leave you with a dialogue I had not too
long ago:
Patient- “you would think by now, you dentists
would have come up with a way of giving someone back their
tooth by now”
Dentist –“we
have – they’re called implants”
No comments:
Post a Comment