THE OVERVIEW: The following model represents the stages that dentists take in moving toward true interdiscipinary dentistry. This model is based on extensive research with general dentists and specialists nationally. Interviews were also conducted with doctors nationally who have reached the highest levels of interdisciplinary dentistry and are successfully treating complex cases. This research continues as I survey SSC clubs who are clients.
I presented the following model as part of the Director's Session at the 2009 Seattle Study Club Symposium in Cancun. The topic was continued in greater depth at the 2009 SSC Directors Summit in Bellevue, WA.
THE MODEL:
Desired movement is from lower left to upper right, from number 1 to number 10.
STAGES 1-4 "My patients won't ... It won't work here"
The white triangle on the left represents the obstacles and objections that may keep the doctor from moving upward toward interdisciplinary dentistry. They represent the most common "weights" that hold the doctor down.
1. Economy and Insurance: These are significant, real-world issues that can keep the doctor from moving forward. The doctor must work to see beyond the existing challenges and to find creative and positive ways to manage these issues. Role models who have "been there" and dealt with these issues can be of significant influence.
2. Prejudging patients: Doctors often make judgments of what he or she thinks the patient can afford or would accept instead of allowing the patient the opportunity to hear all options and make his/her own decision.
3. Practice: Doctors may believe that they don't have the type of practice that would support interdisciplinary dentistry. Alternatively they may believe the typical patient of the practice would not accept interdisciplinary dentistry. At this point the doctor has constructed limitations that may not be actual or realistic
NOTE: Issues 1,2,3 represent factors that the doctor may feel he/she has no control over. Consequently, many doctors remain 'stuck' in this area because they don't accept they have options or because the concerns are too great in relation to accepting responsibility and moving forward. The weight is great in these three areas and that weight holds the doctor down making it difficult to move forward.
4. Self: When the doctor is able to move through 1-2-3, he/she is then faced with looking internally at the fears and responsibilities of moving forward. Though the weight of 1-2-3 is behind, the "self" looms ahead and this is a challenging step. Some doctors are unable to get through this stage. The process of looking at "self" can be painful but rewards can be great. The roadblocks here may be: "I don't want other doctors to see my work." "I don't want others to know that I'm unsure of myself or my clinical skills." "I'm afraid of getting in over my head and then failing." Ironically, sometimes doctors forge through this stage because of pain! That is, the pain of not knowing how to proceed in a very difficult case, may propel the doctor to seek interdisciplinary assistance. Positive outcomes of these cases can lead the doctor to embracing the interdisciplinary process.
STAGE 5-6. "I understand the benefits of interdisciplinary dentistry, I see the possibilities, maybe I can do this."
This stage can be a slippery slope where the doctor may waver between sliding backward and moving forward. A lot of support and reinforcement is necessary to encourage the doctor to continue to progress. When the doctor makes the commitment to move forward, it is with the understanding that there will be significant growth.
STAGES 7-10: "I'm working toward increased understanding and excellence, knowing that ultimately I can and I will practice true interdisciplinary dentistry. I see the benefits for my patients and my practice and for me both personally and professionally."
The white triangle on the right represents the opportunities and the collaboration that continually support the doctor and help the doctor move upward. This range of growth represents skills that are refined to enable the practice of true interdisciplinary dentistry.
7. Verbal skills: Building on the self awareness of stages 4-5-6, the doctor understands how important excellent verbal skills are. Development of excellent communication skills are key to collaborating with colleagues and confidently presenting treatment plans to patients. A vital part of this stage is building confidence in giving and receiving honest, direct communication with other members of the interdisciplinary team.
8. Team & Process: The doctor works toward ensuring that the staff of his/her practice fully understand interdisciplinary treatment, what it means to the practice and how communication must occur among offices of the interdisciplinary team. At the same time, the doctor works on development of a process of communication among interdisciplinary colleagues. Development of this process is key to treatment progressing as planned and ensuring that the patient doesn't fall through the cracks.
9. Relationships: The doctor continues to build and develop relationships with current and with new colleagues. This process truly extends from 7 all the way to 10. However effective development of these collaborative relationships comes more naturally once verbal skills are in place (stage 7), team and process are functioning smoothly (stage 8). A great deal of fulfillment occurs at this stage when strong relationships lead to greater clinical and nonclinical skills.
10. True Interdisciplinary Collaboration: It is at this point when collaborative doctors are able to manage clinical challenges and achieve predictable outcomes based on treatment plans. Interestingly, in discussions with those who have successfully reached this level, it is clear that they still continue to consider themselves students and that is where the "10+" comes into play. Doctors at the highest levels continue to challenge themselves clinically and intellectually, resulting in individuals who continue to grow!
SSC DIRECTORS: