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MyView: Dentistry as an endurance sport

September 19, 2016

By Kerry K. Carney, D.D.S.

Kerry K. Carney, D.D.S.
What if we thought of our professional lives as an endurance sport instead of a business career? What if the goal was to stay mentally and physically strong and healthy? What if our primary driver was to remain happy and to continue to enjoy helping our patients achieve and maintain oral health over the decades that span the course of a career in dentistry?

Many practice management courses spend a lot of time trying various strategies to maximize production: the shortest possible time to return on investment, the most efficient scheduling to meet production goals, the minimizing of nonproductive downtime. If the office is open, it should be producing at maximal potential. Time is money and overhead is high, so increasing speed and proficiency is an obvious goal in order to achieve success. If monetary success is the measure then we run, run, run (or, as my husband likes to say, “Work, work only!”).

When I was in dental school, one of our clinical instructors advised us to never run our practices continuously at 80 miles an hour. He said we would need to be able to accelerate our speed when necessary but we needed to maintain a sustainable pace, one that would not wear us out. I was reminded of that advice when I was doing some physical therapy recently.

For a career in dentistry to be experienced as an endurance sport, we need to look at all the pieces that go into that sport and how we can train to excel in that sport. A day in the office requires physical fitness. Dentistry has habitual positions that can lead to stress on some parts of our bodies and weaken others.

In the first half of the century, the dentist’s habitual position was standing, now the seated position is usually preferred. An occupational hazard then was varicose veins, now it is hemorrhoids. We all have taken ergonomic classes that reinforce the need for good posture and healthy body mechanics. However, it only takes the restoration of the distal aspect of an upper third molar in a patient with restricted opening to know that the dentist will assume whatever contorted position necessary to complete the procedure.

We buy the aids: head-mounted lights, stools with armrests and loupes for improved vision, but if dentistry is an endurance sport, we need to be thinking about how to help the body strengthen the muscles that are not engaged in that habitual position. We need to learn how to stretch and lengthen those muscles that are always flexed in the dentist’s habitual work position.

In dental school, we spend a lot of time on head and neck anatomy, but recently I have had to spend a lot of time understanding the workings of the muscles of the back, legs and body core. I have learned that the health of the psoas muscle is critical in those who, like dentists, sit for a living. If dentistry is an endurance sport, we should dedicate time to understanding our muscular-skeletal interactions and train to keep our bodies fit and ready for the fatiguing, straining rigors of everyday practice.

The nutritional aspect of training for an endurance sport has to be considered as well. In dental school, we learned basics about nutrition and its effects on the dentition. But what about the nutritional guidelines for dentist athletes? Maybe we should have spent some time studying what we should be eating. What individualized diet would provide us the appropriate quantity and quality of calories for our level of activity? When should we be eating and what should we be eating to stay alert and relaxed? Caffeinated afternoon pick-me-ups are probably not the best answer for endurance training.

Every sport has a psychological aspect. Psychology for the dentist athlete is complicated. The dentist needs the ability to focus on the fine motor skills for performing surgical and therapeutic interventions but everyday dentistry requires a lot more than that. The dentist needs the kind of team training to be able to work smoothly and efficiently with office staff and colleagues.

As dentist athletes, we have the added complication of patient interaction to consider in our mental training. In order to be able to endure and be happy, we have to learn how to compartmentalize some aspects of our interactions with patients and staff. Our patients trust us to care for them. We must be able to empathize with our patients. Even when our patients are transported to us on vehicles of pain and fear, we cannot get wound up in psychodramas of their own making.
Some people are natural athletes and some are natural psychosocial athletes. For some of us, the psychological aspects of dentistry are what trip us up, burn us out and cause us to have a short and/or unhappy career in dentistry. This psychosocial component of training is frequently undervalued, overlooked and underdeveloped. We need to train for a mental fitness that can sustain us along the emotional and psychological obstacle course that must be negotiated day after day.

Every training program has to incorporate rest and relaxation and dentistry as an endurance sport is no different. It is too easy to think we are indispensable and irreplaceable. The dentist athlete needs to build into the training schedule time to sleep, rest, relax and recreate.
A career in dentistry is not a sprint. Dentistry is surely an endurance sport and one that is practiced not in loneliness, like the long-distance runner, but with companions and friends. It is a veritable steeplechase day after day. With some luck and effective training, it is an endurance sport we should be able to look forward to enjoying every day for the long haul.

This editorial, reprinted with permission, first appeared in the July 2016 issue of the Journal of the California Dental Association, of which Dr. Carney is the editor-in-chief.