The American Academy of Periodontology (AAP) Spring Conference held earlier this year was entitled The Team Approach to Managing Implant Complications. Its purpose was to explore the variety and complexity of implant complications, understand how to evaluate such clinical dilemmas, and to expand practitioners’ critical thinking through a collaborative perspective involving their colleagues.
As the first in my family to receive a doctorate, I am well aware that it is often necessary to make personal sacrifices to secure a better future. Dentists are now facing increasing professional challenges, including increased government regulation, competing workforce models’ attempting to expand their own scopes of practice, a more intrusive impact of insurance on their practices, and financial hardships imposed on patients by an economy struggling to gain momentum. Despite these challenges, practitioners need to remember that they made a commitment to make a difference in this profession the day they entered dental school. It is that commitment to excellence and professional growth that drives practitioners, such as those at the AAP Spring Conference, to gather with colleagues and share their expertise to improve their ability to offer the finest clinical care to their patients.
Careers are made of many defining moments, moments that shape our thinking and change our perspectives. For me, the 24 gates that enclose Harvard Yard, the center of the Harvard University Campus in Cambridge, Massachusetts, serve as a metaphor for such moments. Those large, ornate structures were built in the 1800s with great endowment and intention, and contain inscriptions and memorials intended to inspire those who passed through, each one with their own story. Over the years, the gates go largely unnoticed by the busy students and faculty, except during two particular moments in time: upon the students’ arrival to the campus for the first time, full of ambition and hope; and then again upon their departure, leaving the campus for the last time, looking back on the meaning of their time spent at Harvard.
In many ways, those gates symbolize how dentists spend time in their profession—both how we enter it, and how we transition from it—after what is hopefully a long and satisfying career. The forces that shape the journey between those passages, in many ways, serve to define the best practitioners, such as the Spring Conference attendees, and to reaffirm their engagement in an extraordinary profession.
The management of a dental practice, to provide the highest level of care, requires a delicate balance between delivery of services and adapting to a changing environment that includes new technology and an overwhelming amount of new information from various sources. It is a daunting task to manage all these demands to best serve the interests of our patients, all of whom deserve the best possible treatment. Yet the more we are united in our commitment to sharing information and confronting patient care challenges when they occur, the stronger our understanding of the team approach will become.
Complications, the topic of this conference, can be an example of what are known in business as “organization-level failures.” As a team, it is important for everyone involved to understand that managing complications is rarely a one-person job. So when complications do occur, all team members need to work together, from the beginning to the end. The great comedian George Burns once said, “No snowflake in an avalanche ever feels responsible.” As a team it is important to understand that holding one person responsible for a complication is as pointless as blaming that single snowflake for the avalanche. The real heroes are not those who assign blame, but instead commit to working together, sharing information, and finding a resolution in the best interest of the patient. It involves engaging in a process of discovery, remedy, and action.
Patients demand that their health care providers be prepared to respond to adverse events as an interdisciplinary team, with coordinated treatment. It is important to remember that the process of repairing lost trust can be difficult and multi-dimensional, and is ultimately defined by three characteristics: ability, benevolence, and integrity. Demonstrating ability by responding with a thoughtful, workable treatment action plan. Showing benevolence by addressing the problem and working day-by-day to achieve the best outcome for the patient. And finally, demonstrating integrity by supporting the patient and fellow team members, sharing information, and coordinating care. In the end, it’s all about accountability and trust.
As noted management expert Peter Drucker said, “Unless a commitment is made, there are only promises and hopes, but no plans.” Participating in events such as the AAP Spring Conference is a demonstration—not of promises or hopes, but of a clear plan of action—to expand our clinical acumen and commitment to being an integral part of a team.
Robert A. Faiella, DMD, MMSc
President, American Dental Association
Private Practice
Osterville, Massachusetts
