Dusting off the Skeletons in my Closet

Written by: Maggie Augustyn, DDS, FAAIP, FICOI

There are moments in my life that I’d rather forget; I’d prefer to pretend that the mistakes I made never saw the light of day. But I realize that when we push the past into nonexistence, we also fail to see our own growth. The lack of reflection keeps us static. And as humans, we are not designed to be static. We are eternally progressing, changing, and evolving.

Who we are today will not be who we are going to be tomorrow, next week, or next year. So, let’s dig up some of that past. Let’s open the doors and windows and let the shadows of our past actions see the light of day.?Let’s release them privately, if needed, or publicly, if appropriate, so that we can be free of the darkness. And if for no other reason, let it be to celebrate the distance we’ve traveled.

SUPPORT IN OUR MISTAKES

When I think back, I begin to see how unsupported I was as a young dentist in our industry. I was terribly inexperienced, “wet behind the ears,” as they say. By “unsupported,” I mean having no one to share experiences with and pretending I was living the easy, unwrinkled life of a dentist. I also mean having no one who could relate to and understand the total weight of my experiences as a provider, having no one to help put those experiences into perspective, and having no one to ask for advice. Yes, I had family and friends, but they didn’t get it. So, when I felt unsupported back then, I simply viewed it as a rite of passage. I convinced myself that not many are lucky enough to have their hands held—are there even any at all? There is no manual for growing up as a young dentist, nor is there a manual for life. While I thought I was unique in feeling unsupported, two decades in, I understand the fallacy of that belief. The new associates who are graduating, and those who have graduated, are equally, if not more, unsupported.

This realization was brought to the surface for me after a recent conversation with a young dentist. She made a significant mistake—one that jeopardized her job, strained her relationship with the owner, and even exposed the practice to potential litigation. I listened and helped her navigate this difficulty. I attempted to name and place the emotions with her and guide her toward a place of responsibility and self-acceptance. As I did this, I became acutely aware of the same past, the same mistakes, that had been part of me all along. Her present was very much my past. I, too, made difficult-to-admit, gut-wrenching mistakes—things I would never want to admit to anyone. Yet, for the benefit of her growth, I chose to share those mistakes with her. I then repeated them and processed them again with my confidants. Letting the truth out, no matter how messy, dark, debilitating, or embarrassing, created a realization within me. If we could all just become brave enough to say that “we didn’t know” and “we messed up,” then maybe, just maybe, we would feel less alone in this life; maybe, just maybe, we could ease someone else’s hardship; maybe, just maybe, we could lend a hand to those who feel unsupported.

EGO WAS MY ENEMY

I come from a place of a failed private practice associateship that lasted less than a year. I come from a place of a second failed associateship with a corporation that also lasted less than a year. I come from a place of practice ownership that has lasted over 18 years with a partner—ownership that only became profitable in the last five years. However, as I reflect on my journey, I realize that many of those failures arose because I worried solely about myself and fed my ego.

They stemmed from being unprepared, untaught, and unmentored. The only reason I have improved as a dentist, clinician, owner, and human is because of those failures. I have been able to transition from failure to less failure and then onto success because of the painful lessons I learned. Support at that time would have meant someone pointing out how much I was feeding my ego. It could have shaved a decade off my journey here, but only if I had been humble enough to listen.

DO UNTO OTHERS…

What do you do when a new patient comes in with an active infection?

The patient’s regular dentist, who also practices in town, is on vacation. Upon arrival, the patient stated that he’d had a recent extraction and hadn’t been feeling well. There is pain radiating from that area. A radiograph shows a root fragment left behind, and it appears to be infected. This could likely be the cause of the pain. What do you do?

Option 1: You can inform the patient that a root tip has been left behind and subsequently remove it during that same appointment. However, this could inadvertently lead the patient to believe that his original dentist committed some wrongdoing. If you do this, you might gain that patient and become the “savior of the day,” potentially leading to referrals as well.

Option 2: You can address the immediate infection by putting the patient on antibiotics and informing him that there is a root tip present, stressing that these things can happen to the best of us. You can then send him back to his original dentist, emphasizing the importance of that future encounter and allowing the original dentist to pick up where they left off. Now, turn the tables and think: what would you want done if this were your patient? Does the answer differ? Should it? Why?

One thing I learned in my 20+ years of experience is that you should never, ever, throw another provider under the bus. There are many reasons for this. The top reason is that it is unethical to do so. Another is that, as backup providers, we are unaware of the entire situation and what the initial doctor was dealing with clinically. We don’t know the full story, and quite honestly, we don’t always know if the patient is being honest. There are many more reasons, but the last one I will mention is the golden rule: “Do not do unto others as you wouldn’t want done unto you.” I do not suggest that we hide clinical findings from our patients to protect one another. I am simply encouraging grace and understanding for one another as clinicians because, collectively, we know how unforgivingly difficult our jobs are.

A PLACE OF SHAME AND GUILT

In my first private practice associateship, I failed to play by the rules. My situation mirrored the one that the young dentist I was counseling was dealing with. I will retell my story because hers isn’t mine to tell. It was an evening appointment at my employer’s practice about two decades ago. Dr. Jason (not his real name), the owner, had earned well-deserved time with his family and was not in the office. The hygienist and I saw a long-time patient of the practice for a re-care appointment. The patient had 4- and 5-mm pockets on his posterior teeth, and maybe even a 6 in a place or two. The hygienist simply scaled the patient. She likely did an excellent job; she might have even used Oraquix, which was all the rage back then. When I entered the operatory and reviewed the 5-mm pockets from that appointment and the ones prior, I informed the patient that he had gum disease. I told him that he needed additional treatment and more frequent recalls. I was in disagreement with what the patient had been told over the years at this practice. When he inquired further about his condition, I might have said that the hygienist was incorrect and that I had studied dentistry longer in school, held a license as a dentist, and had a more valid opinion.

Stop. Sigh. Look down. Break. Please understand that writing these words, admitting to them, and freeing them is incredibly difficult. As these words see the light of this page, the shame and guilt are very real within me. But it’s also a way for me to clear my soul and acknowledge the mistakes I’ve made. It allows whoever is reading this to learn from my error without having to make the same mistake. It’s a way for those who have made the same mistake to feel less shame and guilt, be less alone, and do better tomorrow. I am not diminishing the fact that what I did was heinous and horrendous. I now live with the gravity of that. In one or two statements, I undermined the trust that the patient had in their long-term dentist and hygienist. In one or two statements, I undermined the authority of the hygienist, who had far more experience than I did. With those statements, I threw both the owner dentist and his hygienist under the bus. These two people made it possible for me to earn a living and welcomed me into their practice. I did them this disservice. And so, the question begs: why?

EGO WAS THE ENEMY

Twenty years later, I am wholeheartedly clear on why I did what I did. It had everything to do with my ego. You see, as a young woman in dentistry who looked even more junior than I was, I felt constantly undermined, underappreciated, under-respected, and unheard. I felt that my patients were taking me for granted. All the effort and time it took to earn my degree—all the evenings, days, weekends, and nights I spent studying—felt like it was all for nothing because I didn’t feel heard. I’d recommend treatment to patients that went ignored. So, when I had the opportunity to put my skills and knowledge on display and be heard for my opinion, I seized it. I jumped at the chance to be right. I jumped at the opportunity to feel validated. Yet, by doing that, I destroyed others. I destroyed goodwill, trust, and relationships—both theirs and my own. That unappreciated part of me was begging for attention, and the ego won. It finally got me the recognition I’d been waiting for, or so I thought.

A SOLUTION?

Knowing the long and difficult road I traveled—especially the one that led to my favoring my ego—the advice I gave to the young associate was to look inward. Determine the reason, the true reason, the deep reason, for which she found herself in hot water. If she made a mistake similar to mine, was it due to her ego? And if so, what does that mean for her moving forward as a clinician? What does it mean for the practice that employs her? What does she need from me and her current employer to rise above it and feel supported? I envy her for having that support. I’m not saying my advice is the ultimate gift; rather, by admitting my worst, I was able to help her feel less alone, less ashamed, and more worthy of forgiveness. My choice two decades ago, in a situation similar to what that young associate was currently facing, was to play into my ego and ultimately get fired. Hers was to write a letter of apology and wait for a time when emotions had calmed to talk it out with her employer.

HELP IS ON THE WAY

It isn’t uncommon for young dentists to feel unheard or to feel that the reward for the hard work it took to become a dentist is ignored. This dynamic can lead to an internal struggle of proving oneself and wanting to be right, feeding the ego. But it comes at a cost—a cost of failed associateships and failed practices. It leads to lost relationships, with patients and team members walking away. Two decades in, people—whether they are patients, team members, colleagues, or contemporaries—are worth so much more than feeding my ego. The hardest part in all of this, however, is that no matter how unsupported I felt back then—mentor-less—not much has changed. It takes a minimum of eight years of study to become a clinician. We take difficult tests along the way, pass them, and gain confidence. Yet, when we try to put that knowledge to use, we often fail. We fail because we haven’t been taught how to communicate with patients, people, and colleagues. The cycle continues: the more treatment we present without adequate communication skills, the more proposed treatments go unscheduled, and the more irrelevant and ignored we feel. When that happens, the ego pushes back, throwing tantrums and wanting to be heard. At whatever cost, it attacks, and we lose even more.

The ego doesn’t have to win. It doesn’t have to be this way. The solution is to tame the ego by supporting one another, being honest about our challenges, and, above all, mentoring others. We are fortunate to live in an age where that kind of help is available. Productive Dentist Academy has announced The Clinical Calibration Institute, designed specifically for young associates wanting to keep their heads above water. Within this program, they can find experts and mentors who acknowledge the missteps that have shaped them and how we have created a life woven with threads of vulnerability and resilience. This program shows how to navigate the complexities of our professional lives and gain clinical prowess by sharing decade-old stories—not to relive the pain of our past, but to illuminate the pathways for those who come after. We need more of that: nurturing environments where humanity replaces ego, where learning flourishes over shame, and where connection becomes the bridge that unites it all.

ABOUT THE AUTHOR

Dr. Maggie Augustyn is a practicing general dentist, the owner of Happy Tooth, a faculty member at Productive Dentist Academy, an author, and an inspirational speaker. She obtained her Doctorate of Dental Surgery from the?University of Illinois at Chicago (UIC).?Augustyn is passionate about reading, researching, writing, and speaking on topics that encompass the human experience, including our struggles, pain, and moments of vitality.

Her personal mission is to inspire individuals to embark on a journey toward a more authentic self-actualization. She has a notable presence in the media and is a frequent contributor to Dental Entrepreneur Woman.?Dr. Augustyn takes great pride in her role as a contributing author to Dentistry Today, where she publishes a column titled?“Mindful Moments.”

She has also been featured on various podcasts and is a sought-after national speaker, emphasizing the significance of authenticity and self-discovery.

FEATURED IMAGE CREDIT: Prazis Images/Shutterstock.com.