I am sure everyone has these days on occasion, but mine seem to be getting more and more often.

I was going to post a long rant on how I didn't want to be working right now, how tired I was and how I was getting burned out. And it would be true, at least partly.

Yesterday we got back from a long weekend (well, actually we got back on Tuesday but I had that day off as well), and it seemed like I was just swamped with little things to do, difficult things like fillings in hard-to-access teeth, fillings on kids, and procedures that can go fast but can really take up a lot of time (and yesterday they all took up a lot of time). And emergencies.

I don't really want to be an "emergency clinic" but when someone, a fairly regular patient, has a problem, what are you going to do? We have a lot of patients. They don't necessarily all keep to a routine recall schedule where we can be diagnosing problems before they become emergencies. The consultants tell us that this is what we need to strive to do - have a patient base that values regular, high quality care, and not patients who just move from one emergency to another. Patients who are proactive about their oral health, not reactive.

But the fact is, most of us (humans, that is) are NOT proactive about their teeth. People ignore them until one of them develops a problem, be it a fractured cusp, a cavity that grows big enough to break through the enamel and become a hole or become an abscess, or a broken restoration like a denture or a bridge. Then they call up and it's a big emergency and we have to see them THIS MINUTE! (if not sooner!)

So finding those patients who are proactive about their oral health is not easy, and in the meantime, how do you earn a living? It's not easy.

And when you have enough patients so that you can keep your hygienist busy, and yourself busy with dental work diagnosed during hygiene appointments, you also have a lot of those "few and far between" patients. (Some of them are the ones filling in the hygiene schedule - they don't come every 6 months, but every few years they decide they really oughtta get their teeth cleaned up and checked out.) In a practice like mine, I get a lot of emergency calls. I have four today. I had about 5 yesterday. It wears me out!

And the more patients I see, the more times I have to "switch gears", mentally speaking. I have to alter my mindset about the type of dentistry I'm doing and how I'm doing it on almost every patient. That wears on you, too.

Emergencies require a lot of thinking on the fly, coming up with a diagnosis and coming up with all the options quickly, and then explaining it all to the patient. This is usually done during the time allotted to someone else's treatment, maybe when they're getting numb or maybe when we're taking preliminary impressions. And most of my day is taken up with actual procedures, not just diagnosis and talk. I think about my MD, who reviews data collected by a nurse or auxiliary of some sort, then comes in and asks me a few questions, then talks about his diagnosis (if necessary) and maybe refers me for a test or prescribes me some meds. I, on the other hand, cut body tissues pretty much all day. When an MD does it, it's called "surgery". When I do it, it's called a "filling" or a "crown prep". Maybe we should call them "surgeries" also. We are, after all, Doctors of Dental Surgery.

Surgeries are tiring. Try doing six or seven of them in one day!

Anyway, it turned into a whiny rant after all. Sorry about that...