What does it mean to be a dentist?

A little over a month ago I left working full time at a Federally Qualified Health Center.

Photo of Dr. Simpson

Dr. Simpson

I have spent the last six years of my career working in public health, and the first three years were a couple of short stents working in mobile dentistry visiting nursing homes, a couple of different private practices, “Medicaid offices” and suburban offices with all the latest technologies.  Out of all of those, public health was my favorite.

However, I knew from dental school that at some point I would want to end up in academia. I used to daydream about someday becoming a “dental school counselor”:  having students come to my office to vent about the stressors of school. I would think about all my favorite professors and how their concern for me buoyed me through school, and I wanted to do that for future students.

I knew academia was my goal, but I also love patient care.  There is a moment, right before you hand a patient a mirror to see your handiwork in creating their new smile, when you know they are going to be so happy. I loved hearing patients say, “No one has ever explained it to me like that” or, the ultimate, “I didn’t even feel the shot!”  I loved all that.

But as I walked to my car on my last day at my previous job, I felt a finality that I wasn’t expecting to feel. It was a feeling I hadn’t experienced before: relief.

I cried the whole way home talking to my significant other about how I was going to miss my coworkers, the best team I had ever worked with, how I was going to miss the feel of the drill in my hand, and how I wasn’t sure that entering into academia, even though it was what I thought I always wanted to do, was going to be what I was imagining.

Was it going to be a situation of thinking that the grass would be greener on the other side only to be be disappointed?

In patient care, the buck stops with us. The decisions rest on our shoulders. The Yelp reviews reflect us, no matter who in the office it might have been about. Our assistants make sure things are set up the way we want them. We are in control. We love to help our patients. We get a lot of glory and respect (sometimes undue) out of it.  I was scared of losing that glory. I was going to miss having my assistants have things ready for me and set up the way I like. I was going to miss feeling like the queen bee. Yes, I said it.

As much as we talk about how a career in dentistry affords us so many options, most of us pretty much end up doing the same things: full-time patient care. There seems to be a formula coming out of school: work as an associate for a large practice for a couple of years, and then go into private practice without really thinking if that really is what is best for us, our personalities and lifestyles.

In a previous job I was an adjunct faculty for a dental school. It wasn’t uncommon to hear graduating seniors talk about going into private practice by being someone’s associate first and eventually buying the practice. I feel like I can safely say, this is all we think there is or maybe specializing (and opening our own practice). Even when meeting people outside of work, upon finding out that I am a dentist they will inevitably ask, “Do you have your own practice?”

Of course we go in to dentistry to do dental work BUT, what actually makes you a dentist?

I was talking with a friend one day recently and asked, “Am I still a dentist or am I a professor now?” I pictured filling out paperwork in some random situation, and in the section where it asks “occupation” I thought “I don’t think I can put dentist anymore.”

We really celebrate the dentists who have lucrative practices. We celebrate the dentists who have huge staffs, multiple locations, and the latest technology. We don’t celebrate (as often), the dentists who go into public health. We don’t celebrate the dentists who work in prisons. We don’t celebrate the dentists who go into radiology or oral pathology. We don’t celebrate the dentists who go into academia. We don’t celebrate the dentists who are associates for the span of their career.

One of my mentors, whom I worked for one summer after my freshman year of college, had her own practice for years. She ended up selling it to become an associate for another dentist part time. She also worked in a prison part time, stating that she was tired of the business side of dentistry.

I met a dentist who practiced for a few years after graduation and realized she didn’t like patient care. She now works for Crest and loves it. How can a new grad/young dentist explore the options of their career if we keep holding the successful private practices up as the pinnacle of success for our profession?

Full-time in-patient care is not for everyone. I fear for dental students who come out of school, get a job as an associate in an office that just isn’t a good fit. Maybe the next office isn’t either, and begin to feel like something is wrong with them. They then scroll through social media and see how well their classmates appear to be doing and feel worse.

I look at myself as an example in my newly burgeoning career in academia and think “am I still a real dentist?”

I recently was looking through a dental magazine with the eponymous “40 under 40.” There were a few dentists who were lauded for their success in the public health setting but the vast majority were private practice owners.

To be honest, I had a fleeting moment where I thought, “I’ll never be that.” And yet, in my heart I love what I do; I am proud of the choices I have made in my career, but the list made me feel less than for a few minutes.

New dentists: the degree and the diploma are what make you the dentist, and unless you have some heinous/grave issue that comes up, you will always be a dentist. You get to decide the trajectory of your career. If you have been out and don’t like patient care, do something else. Please don’t look at your colleagues and feel like you are beholden to the full-time private practice, eventual practice owner path to be the definition of success.

Let us truly celebrate the options in our career. Spend some time alone. Maybe this means not talking to dental friends and colleagues, or maybe getting off social media for a little bit. Take a hard look at your life and career to figure out who you are, what your needs are, and what you really want out of life and your career. How much money do you really need to be happy and to live the life you want?

I had no idea how much patient care was affecting me until I was at the dental school on the clinic floor, working with students, and I realized I didn’t have a million thoughts swirling around in my head. I didn’t how it was affecting me until I realized that I felt physically lighter and unburdened. Like I said, I LOVED being in patient care.

For me, that old adage of “do what you love and you’ll never work a day in your life” came true when I started in academia. I don’t feel like I’m at work. I would even go so far as to describe the feeling as, when I’m on the clinic floor, at peace.

People tell you to open your own practice to be able to do things “your way” and to not have to answer to anyone. That is fine. We are not all built to carry the weight of stress that comes with being a practice owner, and that’s OK.

Life is short, but you don’t know until something comes along to show you how short it is. A classmate of mine passed from cancer last year in his early 40s. Can you imagine if he had spent his years practicing unhappily because of feeling like his career should have looked a certain way? You are the captain of your ship. Make it a ship that fits your individual journey.

Let us truly celebrate our career and all the options and versions of success it provides us.

Dr Elizabeth Simpson is a general dentist from Indianapolis, Indiana. She attended Tufts University School of Dentistry for her dental education. After graduation, she did a one-year General Practice Residency at Meharry Medical College School of Dentistry. She is now a clinical assistant Professor at Indiana University School of Dentistry. She is a member of the American Dental Association Council on Advocacy for Access and Prevention, on a diversity task force with the Indiana Dental Association, and a guest blogger with the ADA New Dentist Now Blog. 

11 comments

  • Steven P Geiermann DDS

    Well said, Elizabeth! Students are lucky to have someone who can be open, candid, enthusiastic and professional…all at one time! You are a gift! Happy Holidays!

  • Dr., what a fabulous column! Thank you for sharing your thoughts.

  • LOVE, LOVE, LOVE this, Dr. Simpson! I couldn’t agree with you more! After 25 years in private practice 20 for owning my own practice, I left clinical during the COVID pandemic when the furlough allowed me to feel the relief of not practicing dentistry and pursue other connections and interests. I’ve volunteered as a Covid vaccinator for 10 months and just picked up a paid gig as a vaccinator part-time and absolutely love it! And that gives me the time to pursue my new interest in oral health, healthcare integration, and prevention, we’re all be developing my own program to get medical and dental folks in communities collaborating to provide infant anticipatory guidance on oral health and create Connection and collaboration. I also went through that pause when people ask what I do, and I wondered if I can answer I’m a dentist if I don’t practice clinical dentistry. Of course I can! That is where my degree in education is, and there’s many more ways to apply my knowledge than simply include the clinical care. Thank you for sharing the some of the multiple paths that a dental degree can lead you down!

  • Dr. Simpson, Great to hear a fresh perspective. I was in the private practice trenches for 36 years and now transitioned to part time 10 hours per week of patient care. It was a great relief no longer carrying the burden of running a successful full time private practice. As you indicated, it is different for everyone. For me, private practice gave the freedom to design my own environment from the ground up including facilities, patient care, Team support, relationships, comprehensive treatment planning, nearly no insurance contracts (only one), and practice in dental fields of interest. It has been a great experience. And now, as many others in their careers do, they pivot or shift to other areas of interest including teaching which allows us to pass on alot of great experiences and knowledge to those just starting their careers. I commend you on your choice to teach and bring a fresh perspective of public health dentistry to students. I have talked with many public health dentists over the years and listened to their successes and frustrations. For those of us that have volunteered in the public health dental realm working with organizations like Dental Lifeline Network, Local Dental Foundations or Assistance Leagues providing dental care for underserved populations, it is an incredible challenge working with certain population groups with challenging life situations, lack of transportation or means of communication, and for many lack of support beyond the overburdened social workers that work in our communities. In your position, you have the ability to find some solutions to advocate for dental schools to get funding to improve the Access issues for patients and improve the clinical teaching challenges for the patient population shortages in our dental schools. Congratulations on your “new” career as a dentist and educator.

    God Bless and Happy Holidays,
    Dr John Sudick
    USC Ostrow School of Dentistry 1985

  • Dr. Simpson, thank you for sharing your thoughts. Everyone goes into a career not fully knowing what to expect. I am a human being that happens to do dentistry. I don’t define myself by my ability to practice following the status quo.

    Early on in my career, I wanted to make an impact on both my patients and my community. How it looks for me is unique to me and the goals I use to define success. I have been an associate, I have been an owner, I am again an associate. I have taught at dental schools as well as academic hospitals. I have been involved in leadership in all areas of organized dentistry. I have served on several non-profit boards both inside and outside of dentistry. I love the opportunities that have been afforded to me BECAUSE I am a dentist.

    I agree with your theme – follow your heart. Define your life the way you want to live. Break all the molds in pursuit of this. Be courageous! I have worked with too many of our colleagues that worked themselves into burnout, addiction, other physical and mental illnesses and even suicide as they pursued someone else’s definition of success. The pandemic has been a humbling reminder that although tomorrow is probable, it is not guaranteed. That is why I try to get the most satisfaction living within my purpose every single day.

    Brett Kessler
    Trustee, 14th District

  • Dr Tanvi Pangam

    Dr. Simpson , it was indeed an inspiring article. I could relate myself to your journey quite much. I surely feel relieved after reading up and realising how much we tend to idealise everything and expose ourselves to unnecessary stresses. “Just do what you love” is gonna be my mantra henceforth.
    Thank you once again.

    Regards,
    Dr Tanvi Pangam,
    AIMS hospital,
    Thane, India

  •  DR. Simpson, It was a truly inspiring article. We should learn from your experience and provide the best possible outcome.

  • Very Well Explained! Dr. Simpson you’re doing a remarkable work by sharing such informative column with us. This post will definitely help to learn about the dentist’s responsibility in reality.

  • Thank you for taking the time to publish this blog post. There are so many valid points to gather. Very inspiring work. I especially appreciate your comment about making a ship to fit your journey that you will captain. Have a wonderful rest of the day.

  • Probably my favorite article I’ve read on this blog. It’s amazing just how common and relatable your thoughts are and I really wish this was a perspective that every dentist was aware of. It would save a lot of emotional distress in our profession. Great article! Thank you so much for writing it.

  • Thank you Dr. Simpson for your insight. As a pre-dent student, it was very eye-opening reading this blog. I hope to reach my goal to get into dental school within the next couple of years.

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