My Medically Necessitated Transition out of Dentistry

It was a stretch of the imagination to anticipate what could possibly have caused me to stop practicing dentistry. I entered my career with the sense that my body and mind were able to manage the strains and pressures of clinical practice. Essentially most dental students are near their physical “prime”. I felt that my athletic activity, yoga , and schedule control could balance out the occupational forces and strains that might eventually compromise my spine. Things did not work out quite that way.

No one really knows how their body will compensate to the physical challenges of work. My family history clued me in to a predisposition for arthritis . Now I can look back from the vantage point of having two neck surgeries in the past six years, and I wonder if any of my disability could have been avoided. I am “medically disabled” at 52 years old and unable to practice dentistry. However, I seek to make sense of the process that resulted in my limitations and also to offer insights to my younger colleagues in order to guide them in making good decisions about their insurance , lifestyle and mindset.

For me, the essential question is about how I can find comfort in a shift that has taken me away from my long-standing passion for dentistry. What can I do to productively channel my existing grief and pain? Can I identify new roles and identities to replace my lost professional identity? The answers are very personal and varied.

I am still at the beginning of my search for answers after 7 months of retirement . Fortunately, I did not channel all of my life energies into my practice. I had always made room in my live for other roles and interests. When I have spoken to dentists my own age, I have found that many have few life alternatives, passions or hobbies aside from their career. My reflections will focus on my medically necessitated transition, although these thoughts may be helpful to others who exit dentistry for different reasons.

My transition has inspired me to compile a framework I call the “The Three P’s of Disability.” They are preparation, prevention and processing. Each shall be reviewed.

How does one mentally and financially prepare to cease their professional career? We are often advised to begin a process with the end in mind. How many of us visualize stopping our careers while in our 20’s, 30’s, or 40’s? I did not. Even two months before my most recent surgeries I was not able to consider full retirement . I believed that I could sell the practice and be an associate for a while. My three surgical consults and my successor’s business plan set me straight.

Fortunately, my wife has a career, liberating me from the stress or being the sole bread winner. I would advise you not to get bogged down in traditional domestic roles, as task flexibility reduces tension for most family systems. I believe community participation helps broaden the definition of who we are. I have been involved with social, spiritual, and athletic activities since my 30’s, as family time allowed. When I turned 50 years old (watch out for 50!), a passion within, or a desire for a grander legacy, inspired me to create a greater social and wellness imprint on society. A new, second career has emerged since then and it fuels my spirit. It is important to grasp that we each have a long road to travel, each day contains adventure, and I believe we have some part of a grand purpose.

Financial preparation is a function of ongoing responsibilities, beliefs, and lifestyles. The cost of education, establishing a business and daily family life can create a money pit. What are our priorities, deserved rewards and future desires? A certified planner can assist in planning a budget for these items. Insurance often comes up as an investment vehicle, with different benefits associated with each type of plan. A dental career is physically taxing. The adage that you are seven times more likely to be disabled than die, while in your career, seems accurate. Disability policies can be expensive. Seek multiple quotes and examine the policy’s definition of disability. Your employment status and budget will influence your options. I found that of the five policies I accrued in my career, each had a slight variation in the definition of disability, in adjunct benefits, and in duration. The oldest policy from the 1980’s had the most liberal definition of disability. The newest policy had the shortest benefit term. Consider an insurance policy with an option to increase benefits on a renewal cycle. Base the waiting period before benefits begin on your projected cash reserves. Try to go out at least 90 days, as this could greatly affect the premium.

It is reasonable to assess your lifestyle, family health history, and career span when looking at disability and long term care (LTC) insurance. Increased longevity has increased the demand for this insurance product. All things equal, premiums are lower when the plan begins at an earlier age. My wife and I purchased a moderate cost and benefit plan in our late 40’s. The lower premiums for younger applicants allowed us to justify purchase of this insurance product. After four years of assessment, I believe that creating a strong retirement nest egg might lead to having enough personal assets which would equal the benefits in a formal insurance plan. Scrutinize the details of different long term care plans as the benefit packages contain subtle and significant differences.

Another issue is the establishment of a group of dentists who can share office coverage of their practices in the eventuality that one dentist is out on a prolonged recovery. You will also need a succession plan for your practice in case of a practitioner’s premature death . This group of collegial relationships may prove valuable to your family and estate.

I have purchased several types of life insurance over the years. They are term, whole and variable life policies. In hindsight, the term may have been sufficient, and I could have invested the other premium dollars elsewhere. Now that my wife and I have nearly completed funding our children’s college educations, my life insurance needs have diminished significantly.

The prevention of disability is not often in the forefront of the minds of dentists. It is important to comprehend that health problems can seriously impact on earning capacity and professional lives… and bodies require regular tune-ups. Who even thinks about health problems until you are facing a disorder personally? I know that I never thought about cervical stenosis until it was diagnosed and limiting me. I suggest identifying and addressing your own medical weaknesses. In hindsight, I could have learned more about a diet that might alleviate arthritis . While there are dietary supplements that I have taken for years, it is not clear to me that I benefited from them; however they don’t appear to have hurt me either. One must also be aware that there are qualitative differences between supplements. I just learned of a shopping club for pharmacy grade supplements and plan to explore more about this possibility.

I strongly recommend utilization of various specialists for the maintenance of body and mind. Evaluate how you prepare (warm up) and wind (cool or stretch) down from your physical activities. For me, finding good wellness specialists has been valuable. I am a long term client of massage and physical therapists. I am currently receiving acupuncture for my arthritis. I use light weights for strength on each side to focus on individual muscles, and yoga for flexibility and relaxation . As you may notice, self maintenance is one of my hobbies.

Professionally, dentists often create our own physical problems. I was guilty of poor posture, even after my first surgery. Old habits do die hard, if at all. Your focus on posture requires vigilance always. Use clinic chairs that support your back, employ sufficient staff to draw stress away from the doctor, block schedule for efficiency, and exert discretion over the procedures you offer in order to minimize taxing your mind, body, schedule and wallet. Conservative planning of the dental office design considering type and age of dental equipment will reduce physical practice burdens.

For me, processing my new status as “retired” and “disabled” has been a revolutionary experience. More questions have arisen for me than have answers. The below list are some of the questions that I have encountered, although each of you may face your own and different concerns:
• Who am I now, what is my life purpose and how am I relevant and to be respected?
• Am I disabled, or just playing with a handicap?
• Have I abandoned my former patients, and what do they think of me?
• What are my core values and priorities?
• How do I know if I am grieving, depressed or in denial?
• Does physical pain have an emotional basis?
• Is psychological therapy or counseling necessary, and for how long?

The challenge for me at this time is how to continue being a healer, a sometimes scary but also invigorating process. My home has become my office for now. I am appreciating that I am now more available for my family and have been surprised at how helpful this has been to them. The option to be present during a family member’s time of stress and need has been of significance.

I am thankful for all that has transpired in my career and personal transition, especially for the support I received and the encouragement I got from others to help me move forward with optimism. I am still working out my life’s road map and it is considerably more uncertain than was the original well-trod path into dentistry as a career. My quest is to find new measures of success in my emerging life roles which will permit me to grow as a person and reflect my pride in the accomplishments of my career in private practice dentistry. As all dental professionals experience their own career transitions, I am hopeful that my reflections will be useful to you in your life and career.