Feelings of insecurity

Nov. 1, 2006
We’ve all met them: the dentists who belittle, the assistants who won’t talk to us, and even the colleagues who like to find our mistakes and make them known to the world.

We’ve all met them: the dentists who belittle, the assistants who won’t talk to us, and even the colleagues who like to find our mistakes and make them known to the world. We’ve also run across the seemingly intelligent hygienist who keeps to his or her self rather than socializing with the group, the friend who walks face to the ground and arms crossed, or the patient who whispers. There are bullies and wimps, loudmouths and the very quiet. The irony is that many of these folks suffer from the same condition manifested in different ways - insecurity.

It isn’t always easy to differentiate between someone experiencing a bout of insecurity and someone who is just difficult or ornery. I am willing to bet we all have a story of dealing with the moody patient who, it turned out, was caring for an ailing spouse, or the employer who appeared to be a nitpicker but was actually facing trouble with a child. We all have our stories of those people.It is less likely that we will admit that on one or more occasion that person was us.

I have moments of self-doubt, and will readily admit it. Sometimes I call it writer’s block or blame the many distractions in my life. The truth is that, now and then, I just don’t do a task because I doubt it will be good enough. Until recently, it never occurred to me that it could be labeled insecurity. I, of all loud and opinionated people in the world, could not think of myself as insecure.

We’ve all heard the horror stories or even worked with the dentist who enjoys pointing out any tiny error. This employer will point out the roughness on the lingual of No. 31 in front of the patient and may even pretend to fix the horrifying roughness by scaling it and then giving that huge sigh of “glad I got that beast before it caused total health destruction.” We, on the other hand, only feel slightly vindicated when the roughness is actually decalcification and instead of removal the dentist creates a hole in the tooth which now requires a restoration. The patient suffers from another person’s need to be right.

Every one of us has left calculus, plaque, or some other debris on a tooth surface. Perfection may be our obsession, but it is not the reality. Yet, it is not appropriate for anyone to degrade our work in front of patients or co-workers. The suggested comeback to such affronts is to reply with your own observations. Instead of stuttering and saying you are sorry, then rushing to fix the shoddy work, try this approach. Dr. Xyz is performing an examination and loudly states, “You left calculus on the distal of No. 25 and the buccal of No. 14 is rough.”

You reply, “While you are in the area, doctor, you might want to check the overhang on the mesial of No. 15 and the open margin on the distal of No. 13.” Hopefully, the dentist will take the hint that a private conversation is in order. While it might be fun and self gratifying to continue pointing out flaws, the insecure person may not respond in a positive manner. Pointing out the decay on the distal root of a crowned tooth is helpful; stating that the tooth was crowned two weeks ago might be a bit over the edge.

Insecurity is not a condition limited to dentists or employers. We have all run into our share of assistants and office managers with the same issue. I have heard more than one tale of woe about the assistant who would not help with room turnover or instrument sterilization because the hygienist is paid on production. The idea is that teamwork doesn’t need to exist when only one person is benefiting. From the outside, we can see that increased production and the ability to work well with others is a huge asset in any employee, but internally the assistant may feel used or less appreciated. What’s in it for me? is still the prevailing attitude in today’s society.

A friend and fellow RDH told me of the following situation that drips with insecurity. The office manager thought the hygienist should do all her own appointment confirming. My friend pointed out that there was no time in her schedule to do this task and the office manager suggested the RDH take the schedule home to confirm. The rationale: the hourly wage of the hygienist more than justified doing work at home after office hours. Needless to

say, this did not sit well with my friend. The dentist employer solved the problem by revising job descriptions and assigning the task of appointment confirmation to the office manager or receptionist.

Not satisfied that she had made her point that the hygienist was overpaid, the office manager set another plan in action. The assistant’s new job description did not state the responsibility of sterilizing hygiene instruments or helping with setting up or breaking down the hygiene operatory - tasks previously shared between the assistant and hygienist. The office manager basically forbid the assistant from performing any tasks not listed in her job description, instead keeping her busy with other, less important jobs.

My friend had a great insight and just let the situation play out without complaint or whining. The assistant got tired of the games, and both she and the receptionist quit because of all the tension. In the end, it became uncomfortable for the office manager to keep up her petty fight and she also left. The transition to new employees was not flawless, but the office is now a pleasant place to visit. There are often no real winners in the battle of insecurities.

On the flip side of the above situation is the RDH who is above doing assistant tasks. To me this attitude is ludicrous. I am not a good assistant, and willing to say probably one of the worst chairside assistants on the planet. Unless an RDH also has training and experience as an assistant, the thought that we can simply switch duties makes no sense. I’ve heard hygienists say they will not sterilize instruments, stock rooms, or do other office tasks because they are not assistants. While this insecure attitude is not healthy for an atmosphere of teamwork, the assistant should not feel threatened. The hygienist is merely stating that he or she lacks the proper training to do the tasks of an assistant.

The need to dominate

Feelings of insecurity are not only found in the dental office. We encounter these people at every corner in our life path. The person who must dominate every conversation, the individual continually bragging of monetary success, and those who cannot acknowledge the success of others are everywhere. My favorite is the person who will never let you forget a favor done on your behalf. Just because someone introduced you to a potential employer or job offer does not make that person responsible for all future success in the career arena. Yet, we let our own insecurities lead us to believe we could have never done it on our own.

Those who are threatened by the success or opinions of others will often attack with words. Opinions (and even facts) not held by the insecure are labeled as false, preposterous, and even unsafe or unethical. These folks will argue until the conversation no longer includes whatever point they were trying to make. You may start out discussing the importance of probing and end of arguing over bananas. Winning the war of words becomes more important than sharing and discussing pertinent facts.

Remember the bullies from your school years? The bully didn’t need to be right to have power; he or she merely needed an audience who thought they were important. My elementary school actually had a bully who was a teacher’s pet. Try standing up to someone holding that much clout. As adults, we need to act according to our own beliefs and truths and stop letting the insecure beings of the world control the environment. At the same time, we need to be compassionate to what is causing the person to feel threatened by us in the first place. It’s all about balance, and perhaps maturity.

When having a conversation with a group of your peers, watch for the one who needs to interrupt and take over the conversation. Keep an eye out for that individual who continually tries to change the topic to one he or she can dominate. This is the person you may want to talk to alone later and find out if there is anything you can do to help them feel more secure. Find out why this person is threatened by the success of others and help them see the danger in continuing on this path. A person can only be controlling for so long before others simply choose to avoid him or her. You can be the one who helps this person feel better about their role in life and dental hygiene. Just because someone is insecure does not mean he or she does not have vital and important information to share. It is just a matter of learning how and when to do that sharing.

Is organized dentistry insecure?

On a larger scale, it may just be insecurity or the feeling of being threatened that keeps the ADA from wanting any forward progression of dental hygienists. It is much easier on the ego to have a chairside-trained assistant perform polishing, fluoride, and, in some cases, supragingival scaling than it is to turn those duties over to someone who may be more qualified than yourself.

If organized dentistry can pay someone less to do it their way, why pay more for someone with the education and skill to do it the best way for patient health? We’ve all heard the argument, “If we let them scale without the patient first seeing a dentist, those power hungry hygienists will want private practice next.” They would like the public to think only a dentist can recognize calculus or disease and then instruct us on how to treat it. If we let organized dentistry know we don’t want to be dentists, just health-care providers able to provide care consistent with our education, maybe the insecurity will go away. Or, maybe not.

My own reality of insecurity came with the sale of an office. In one swoop, I went from being the head of the hygiene department to an employee. I thought I was not only ready, but excited about not having all the responsibility. Nothing could have been further from the truth. It is hard to watch your role as the “go-to person” for current information or needed research change to the ”RDH who works on Thursday.” No longer is my relationship with company and product reps respected as an asset to the practice. I do not set up or moderate hygiene meetings; in fact, such meetings no longer exist. Yet, aside from the occasional whining to friends, I thought I handled the transition well.

Last week I walked into work and clocked in for my day. The surgical assistant looked at me and said, “Why are you so grumpy all the time?” Grumpy? Me? My first inclination was to tell her to mind her own business, but she is my friend and would have had some sarcastic comeback. So, we talked about it over lunch instead. While it was hard to admit, I was threatened by the sudden changes, mostly the perceived change in my status at work. When I should have been relaxing and enjoying less responsibility, I was sulking and trying to win back my position: a position that doesn’t even exist anymore. The office is very team oriented now and I am having a hard time not being quarterback.

While we cannot always change the attitudes and actions of those around us, we can be aware of those moments of insecurity in ourselves. Nobody gets through this life without feeling threatened by a person or situation now and then. Recognize it and get rid of it. It’s that simple. Refuse to let your own feelings of inadequacy affect the lives of those around you. It’s not the number of awards or kudos that matter in the end; it’s the number of friends you can count at the finish line.

Lory Laughter, RDH, BS, practices in Napa and Sonoma, California, in both general and periodontal offices. She is a partner of Dental IQ, a team committed to arranging quality continuing education opportunities for Northern California. Through her involvement with Dental Hygienists Against Heart Disease and other organizations, she hopes to bring a total health concept to the dental practice. You may contact Lory at [email protected].