Accountability – Webster’s defines it as “the quality or state of being accountable; an obligation or willingness to accept responsibility or to account for one’s actions.”
Sometimes accountability feels good. An example could be recognition for some service work performed on behalf of someone in need; or being recognized for efforts to improve the livability of our community.
At other times accountability is something we may try to hide ourselves from, such as when we are caught for vandalism, or dishonesty, or mistreatment of another.
As a dentist and as a business owner, I feel the burden and blessing of accountability in many ways. I will take the liberty to speak from my own experience, as it is the only experience that is uniquely mine and for which I may speak authoritatively.
On our website we state our goals for service, integrity, and excellence. We strive to provide a high level of customer service to our patrons. And we are happy to take credit when we receive glowing compliments. Here is one experience of many that a patient has shared with us:
I had an outstanding experience having my teeth straightened with Dr. Warr and his team. I’m in my forties and this was my second time around with braces. I loved the convenience of getting the work done at the same place I get my teeth cleaned and with the familiar staff. I’ve never had billing issues even with my complex insurance. The assistants are without exception friendly, professional, and gentle. Dr. Warr is meticulous and thorough. I’m amazed at how fast it took and how straight my teeth are! I wasn’t sure getting braces again this late in life would be worth the hassle, but I’m so glad I did. I recommend Today’s Dentistry highly, for dentistry AND orthodontics.
Now, sometimes, in spite of our best efforts, our service is sour and we must take credit for that as well. Recently I removed a hopeless tooth for someone. The removal was challenging as the tooth was already severely broken down. Notwithstanding, I was able to successfully remove the tooth efficiently and with minimal trauma to the surrounding tissues. My protocol is to call patients receiving such treatment in the evening to check up on them, after the anesthetic has worn off. Whatever the circumstances were of this particular evening, I failed to telephone this patient. From the patient’s perspective, they were upset because they did not receive a phone call and their post-operative experience was a painful one. (That being said, this patient did not contact the office until five days later to share her concerns.) I take full responsibility for failing to call. In fact, as soon as it came to my attention, I telephoned and expressed my concern and apologies.
When it comes to integrity, I believe in absolute, and not situational, integrity. I am not perfect, and therefore, as much as I hesitate to say it, my work is not always perfect. An example of this could be a crown. On the day that it is delivered, all aspects – fit, function, color, etc. – may look great clinically. However, several months or years later, at a periodic exam when bitewing radiographs are taken, it may be noticed that there is an “open margin” or gap between the crown and tooth that was undetectable to clinical observation when delivering the crown. At this point the clinician has a choice – ignore the finding or inform the patient and ask if s/he can re-do the crown to make it right with no charge to the patient. I choose to take responsibility and inform the patient. Not only is it the right thing to do, I have found that the majority of patient’s appreciate the candor and extend mercy toward my imperfections and my efforts to make it right. And for this I am very grateful.
Excellence in dentistry is challenging to discuss as it can be thought of as subjective. Consider this, while many may not think of McDonald’s as having excellent food, it is hard to argue that they do not have excellent systems that enable them to provide a very high level of consistency throughout their organization. Whether you are in Arizona or Australia or Africa, a Big Mac is a Big Mac is a Big Mac. For McDonald’s, excellence is in their system that creates reproducible results.
For me, excellence is found in the clinical dentistry and in how we treat our patients. As we have already discussed service, I will focus on clinical dentistry. Restorative dentistry is just what it says – restoring teeth to their former state prior to the ravages of decay or bruxism or acid erosion or trauma, and doing this in a way so that the restored tooth/teeth function harmoniously with all other structures in the mouth – tooth, gingivae, mucosa, bone, tongue, and lips. Periodontal treatment focuses on re-establishing healthy gingival tissues and bone around the teeth and teaching/coaching patients in their skills and abilities to maintain their periodontal health.
I am accountable to my patients for the work that I do and to that end I carefully select the materials and laboratories that I partner with to provide excellent clinical dentistry. Are they perfect? No one is. That said, they are extremely skilled and knowledgeable in their fields and when there is a bump in the road, they recognize it and we all work cooperatively for the good of our patients.
My hope is that this has helped us understand the accountability questions in our own lives. Are we giving our best efforts to those things we are accountable for – our personal well being, our relationships, our employers or employees, our community? My best to you all as we consider this important aspect of our lives :^)