Dr Phillip Palmer, November 2004 - I'm sure everybody at the end of their career consciously or subconsciously adds things up in their mind. Are there things that I'm particularly proud of? What could I have done better? Are there mistakes I made that I'm embarrassed about? What lessons are there to learn?

I believe I was an above average clinician although I recently saw statistics that say that 87% of dentists feel that they are above average as clinicians. For most of my years of clinical dentistry, I kept up to date with the latest trends in dentistry, attending well above average numbers of Continuing Education courses; and I remained up to date with my equipment and technology. Sure I made mistakes, and there are things I could have done better.

Firstly, I’m sure there are some clinical cases that with the benefit of hindsight could have had better results. For many years I only offered my patient’s choices of treatment plans that I felt they would not refuse. This is a mistake I feel that many dentists possibly even most dentists make for fear of rejection. I wish I’d learnt earlier that you shouldn’t try to judge what a patient would accept before suggesting treatment options. I wish I’d learnt earlier that you should diagnose as if dentistry was free.

Generally, when I saw my patients coming in for their maintenance visits, I was fairly proud of what dental work I saw that I had carried out for them. However, every now and again I would see some work in a patient's mouth, and thought, “who did that”? Then I’d look at the clinical notes, and find it was work done by yours truly. I usually redid work like that when I saw it as less than desirable, but honestly, there's still some cases out there that I wish didn't have my name attached to them.

I must have been a sucker early on in my career for reps from dental companies, because when I left my practice I had cupboards full of useless items; like materials no longer in use, composite and GIC in colours that seemed to belong to some other species (and enough GP points to start a new specialist Endodontic practice).

But when I really think about it, the real measure of successes and failures in anyone’s career is in terms of the strength of the relationships formed and maintained along the way. Not just the relationships with employees and patients through the years but also how well you can balance a career with your family relationships. Many would agree that a dentist who is clinically excellent with a thriving practice could hardly be called successful if their career has meant that their family and personal life is a mess.

The successes I am most proud in my career of come from the relationships I was able to form and keep with my fellow dentists, my patients, and my staff. By the same token, the biggest regrets I have in my career relate to my weaker moments in this area.

It took me more than 25 years to learn the leadership, management, communication and other skills I needed as a boss and it was only in the last five to ten years that I really felt confident in this area. For too many of the early years, I had a revolving door of staff coming and going. I didn’t know how to be a boss. I didn’t know how to manage staff. I would put up with poor work or poor attitudes for too long, and then have a confrontation over a minor stupid issue, after which I’d feel like apologising for being so stupid. If only there had been somewhere where I could have learnt how to be a good leader and manager.

While I generally feel that I communicated well with most patients and I didn’t have many patients that I wished would go away, there are patients whom I know I didn't empathise with or relate to as well as I might have.

Looking back, at times my family suffered from my workload and stress more than I should have allowed. I tried to make up for my normal routine of working hard, by taking a week off most school holidays to spend time with my wife and kids. But does that really compensate for 90% of the time being mentally absent?

I remember too many times when I would come home after a hard day’s work and not play with the kids or talk much with my wife. Sometimes I would come home and just stare into the distance for an hour or two. Luckily it didn't cost me my marriage (I know some dentists where it did) and for some reason the kids still talk to me (kids are very forgiving, aren't they?), and seem to lead well-balanced lives despite me.

There really is no need to sacrifice that much as a dentist. It’s hard not to succeed as a dentist. One has to try very hard to be a failure. We’re very lucky - truly lucky - to be in such a wonderful profession as Dentistry. One just has to learn to balance one’s life. To be the best one can be at both clinical dentistry and at the business of dentistry.

[Published Australasian Dental Practice, November/December 2004]