By ANNE NUGENT GUIGNON
Imagine spending an entire appointment assessing a patient's oral health status and documenting your findings, which include generalized bleeding on probing and 4-6 mm pockets around all posterior teeth. You then provide an elegant, thorough explanation of why a simple prophy is not the right procedure for their needs. Without a doubt, every clinician reading this article has spent time with patients who arrive in our offices with this kind of situation.
I don't know about you, but it makes me nuts when people only want treatment that is covered by their dental insurance, complain about the high cost of dental care, or who steadfastly refuse recommended treatment because a portion of your practice fee involves an out-of-pocket payment.
It makes me even crazier when they slip their expensive car keys into a designer handbag and start telling me about their latest trip to Paris or Hawaii while still insisting that their dental health is fine and they don't need any "fancy" treatment. Why do the messages about prevention, early intervention, or appropriate treatment fall on deaf ears? If I had the magic answer to how to turn needs into wants, I'd feel like I had just won life's emotional lottery jackpot.
Our own land of denial
Quite honestly, when clinicians complain about musculoskeletal aches and pains but refuse to do anything to modify how they are working or claim they can't afford to take appropriate action to reduce the stress to their bodies, I feel the same way. Working in the land of denial baffles me. Each of us knows one or more clinicians who suffer every day from sore backs, necks, shoulders, and hands.
We are preventive specialists in our treatment rooms. Yet like some patients, many of us don't want to hear the prevention or treatment messages when it comes to our own bodies. Some hygienists expect doctors to provide every piece of equipment and are unwilling to consider purchasing anything such as a headlight, a pair of loupes, a saddle, some new sharpen-free instruments, or their own power-driven scaler.
When I was in school, no one warned me that the potential for injury was so high in our profession. But that was 45 years ago. By the time I had been in practice full time for a decade, my body started rebelling. The muscles in my neck and shoulders were constantly tight and aching. I would wake up in the night with cramps in my right elbow and a tingling sensation that ran from my elbow to my fingertips. While I loved the challenge of patient care, I felt lousy.
My employer at the time really did not care, and I was too scared to move on. Then I got replaced by a younger, cheaper hygienist. So I was then on the streets, working as a temporary dental hygienist and looking for a new job. What I saw scared me. Many offices had even worse equipment and less appointment time per patient.
My risk for musculoskeletal disorders was on the rise, so I took a stand. I understood that having good equipment that could protect my body was not a want but a real need. My first investment taking care of my body was purchasing new hand instruments. I've never looked back.
Over the next few years, I kept on purchasing more necessities, and eventually I owned multiple sets of great instruments, my first pair of magnification loupes, a headlight, my own chair, and finally my own ultrasonic scaler and inserts. Having equipment that would keep me safe and reduce the risk for developing an injury became a priority. I drove an old car, bought my purses at Target and did not take fancy vacations, but I had the best equipment money could buy, and my aches and pains gradually started dissipating.
Even though I started on the journey to take care of myself close to 30 years ago, the damage to my body from the early years finally reared its ugly head. Eleven years ago, I had carpal tunnel ligament release surgery. The surgery was not successful. To this day, I still have parathesia in my right thumb and my index and middle fingers. Obviously, the injury is higher up, most likely in my right elbow.
To make matters worse, I could not work for six weeks and had a large deductible and copay. I shudder to think what I could have done with all the money spent on unsuccessful surgery, compounded by the lost wages. While I could focus on what happened to my hand and neck, I prefer to put the spotlight on how many more years I was able to practice because I made an active choice to put my physical needs first and not stand in ceremony waiting for a dentist to rescue me.
A fund for your body
So how do you find the money to make changes like this? First of all, if you're living paycheck-to-paycheck, tighten your expenses and set aside a specific amount of money every pay period for your new "take care of my body" fund. Or forgo that fancy coffee every day or expensive lunches, and make your own brew or brown bag it once or twice a week. Take a deep breath, and put every "new want" to the "do I really need it?" test. If you hesitate even slightly, you'll probably survive without that new shiny object in your life, at least for the next few months or a year.
Consider purchasing equipment using an interest-free credit card, but just make sure you understand the penalties if you fail to pay the bill on time. Or find a company that sells supplies to hygienists with interest-free payment plans. I've actually employed each one of these strategies very successfully to help me achieve my equipment goals.
Society has trained us to confuse wants with needs. Having to have the latest cell phone or tablet, the most current style of jeans, or the newest car model are perfect examples of the pressure to have the latest and greatest. But the thrill can be fleeting and especially hollow if our bodies are aching after work each day. The intangible reward of taking charge of one's career and keeping your body and spirit healthy is a huge payback for creating and following your own plan. RDH
ANNE NUGENT GUIGNON, RDH, MPH, CSP, provides popular programs, including topics on biofilms, power driven scaling, ergonomics, hypersensitivity, and remineralization. Recipient of the 2004 Mentor of the Year Award and the 2009 ADHA Irene Newman Award, Anne has practiced clinical dental hygiene in Houston since 1971, and can be contacted at [email protected].