Edvard Munch's "The Scream" (1893)
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Thoughts on the "AngryDDS and the Average Patient" and the dentist-patient relationship
Lynn D Carlisle DDS
There is a video that has become a viral phenomenon in dentistry. A dentist titled as "AngryDDS" made it about "The Average Patient". The video was posted on the Internet on August 2nd and as of the writing of this article one month later has had over 180,000 views. This is approximately one view for every dentist in the U.S. (Granted, many dentists have seen it multiple times.)
It is probably the most viewed dental video in history. AngryDDS posted this comment on his video page on August 28th: "I initially made this video one morning when I was bored, and sent this video to just 6 friends. It's shocking to me how fast these things spread. Power of the internet!" It was featured in a recent In a Spirit of Caring (ISOC) article titled "A hilarious, sad, thought provoking video on the dentist-patient relationship". To view the two and a half minute video, go to: The Average Patient The link may be broken or unavailable because of the volume of clicks to view it.
Why is it so popular? This mesmerising video tellingly captures the archetypal angst of "The Average Dentist about The Average Patient", and the disturbing state of dentistry and dental education today. The video is cathartic for AngryDDS and his viewers. All of us, at one time or another, have wanted to say what he said to average patient at the end of the video. AngryDDS states the purpose of his video: "Just to give the world a taste of what we dentists go through on a daily basis."
 Who is AngryDDS? 
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Who is AngryDDS? I don't know him but I would guess he is probably in L.D. Pankey's 54% of indifferent dentists; he has been in practice less than 10 years; he feels helpless, anxious, angry, stressed and burnt out; he wishes he had chosen another profession; he thinks patients don't understand what he can do for them; he thinks they don't care about their dental health and him; he has not invested in in-depth, advanced technical, behavioral and business C.E. courses; he has not gone far beyond what he learned in dental school. He doesn't know himself; he does not recognize that he is the source of most of his problems; he "doesn't know what he doesn't know"; he doesn't recognize that dentistry is a people business. L.D. Pankey, DDS on dentistry as a people business He is an average dentist. The replies by viewers of his video mirror AngryDDS's perception of dentistry and patients. While AngryDDS is a real person, he and his average patient are also archetypes of many dentists and patients.
Most of us have felt his angst.
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Most of us have felt his angst. We have been there and done that and when we were there, we too were frustrated with dentistry and patients. But, those of us who have gone through the angst have learned to enjoy dentistry. We have found help and/or created a better way to practice dentistry. (And there are still days we want to just scream like the person in the painting.)If AngryDDS doesn't find a better way to practice dentistry (like relationship-based dentistry), he is doomed to a dental lifetime of anger and despair. As Bob McBride stated in his comments after the A hilarious, sad, thought provoking video on the dentist-patient relationship article, AngryDDS is on AM and Average patient is on FM. The video shows how inept most dentists are in their communications with patients. They don't know how to bridge the behavioral gap between themselves and their patients. AngryDDS takes the expert role and he wants the patient to be a compliant petitioner of his dental services. Average patient has something else in mind. Instead of interviewing, questioning, and building a relationship, AngryDDS is telling the patient what she needs. He is arguing with her about her dental health. They don't have a chance at a good dentist-patient relationship. Staying in the Question - the most powerful dental patient communication tool you can use - Part I.
What would I suggest to AngryDDS?
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What would I suggest to AngryDDS - the person and the archetype? That he "pay the price" and learn how patients learn and how to build effective helping relationships; that he learn how to communicate effectively with his patients. Naturally I think ISOC - the advisory board and ISOC resources - could help him. Where should he start? After subscribing and reading the many ISOC articles, he should find a mentor or advanced learning center - people like those on the ISOC advisory board - to help him. He should read my book In a Spirit of Caring Revisited, L.D. Pankey's A Philosophy of the Practice of Dentistry and Bill Lockard's The Exceptional Dental Practice. He should learn how do do a Barkley Co-diagnosis Initial Interview. Other thoughts: It is criminal negligence that dental students graduate from dental school without knowing themselves and with no skills in interviewing and communicating with patients - and in understanding the psychological dimension of the dentist-patient relationship.Dentistry is a challenging profession - "It isn't easy". It is frustrating at times. You need to be a "Hardy Dentist" to meet the challenges that dentistry presents. How to Become a Hardy Dentist Some dentists should be in another profession, AngryDDS may be one of them. But if his video is any indication, he has a gift for storytelling and developing videos. AngryDDS saw dental problems (missing teeth, periodontal disease) that he had solutions to. He gave her answers to needs she didn't know she had. He didn't see the person sitting in front of him. He made judgements without asking clarifying questions and listening with understanding. This is the thing instead of people orientation that is so common in dentistry. We can't help every person who comes to see us. All of us have patients like AngryDDS's representation of an average patient. They are part of being a dentist. If we can't find common ground, we do not need to accept them into our practice. Pankeyisms - L.D. Pankey quotes that pass on the Pankey philosophy legacy His statements about "why did I get tricked into this damn profession"? and "makes me want to go home and blow my brains out" are very scary. He needs counseling on why he feels this extreme hatred of dentistry. Or more importantly, the ADA and dental schools need to meticulously examine what are the conditions in dentistry that led to AngryDDS's statement and the viewers cheering his courage in creating this video. There is enormous denial of the psychological dimensions of dentist-patient relationships in dental education and dentistry. Psychiatrists and Psychologists would have a field day with this video. We need to know ourselves before we can know our patient.
The Pankey philosophy of dental practice. Part III Our perception is the greatest key to our enjoyment of dentistry. Building Smiles that illuminate the world! Dentistry is blessed with masters - past and present - who can help people like AngryDDS climb the ladder out of their angst and enjoy practicing dentistry. They can become triathlon dentists who are adept at the technical, behavioral and business dimensions of a being a private practitioner. Hopefully, AngryDDS can find one of these people or groups to help him climb out of his angst and anger of despair - and he can enjoy practicing dentistry.
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Lynn,
Your "Angry Dentist" review was maybe the most important piece you've written. It really cuts to the core of the conundrum that we seasoned dentists see in the younger practitioners. The video is a symptom of the result of an educational system that has everything to do with technology a very little to deal with Humanity, which is the reason for the profession. I have seen these symptoms in many younger dentists and they are unresolved. What a shame.
In 1969, Dr. Nathan Kohn, Jr., a psychologist, proposed to Dental School Deans that all entering students be subjected to a series of tests that would provide information about their personalities, values, and goals. Interviews with skilled professionals would bring out their inner feelings regarding their expectations of dentistry, their motivations for entering the field, and their preconceived concepts of the profession. The testing and profiling would be repeated in the third and fourth years of training, with post graduate follow up.
The proposal had much more in how courses in personality theory and abnormal psychology could be given prior to student-patient contact.
This elaborate and cogent plan was met by a groundswell of apathy by the dental deans. I can imagine that the anger, lack of communications skills, failure to establish an effective dentist-patient relationship and fundamental techniques of dealing with patient expectations could have been avoided by training and counseling of this young dental student.
Kohn's proposal is as valid today as it was 41 years ago. I wonder how, or if, we will ever be able to institute these educational parameters in the institutions of dental education.
Do you have any ideas?
Bill
Bill,
Thanks for your feedback.
We are co-conspirators when it comes to dental education.
I have sworn off getting involved with dental education because it is an exercise in futility.
However, something will come along like the AngryDDS video and it is like getting poked with a stick.
So I react.
Here are my ideas on dental education from the Education chapter in my book "In a Spirit of Caring Revisited".
To read the chapter, copy and past this in your browser:
www.spiritofcaring.com/members/591.cfm
They are still valid 20 years after I wrote the chapter.
And this article that I wrote 2 years ago: www.spiritofcaring.com/public/619.cfm
Lynn
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