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Wednesday, July 23, 2025

Why I Obtained Fired My First Yr as a Dentist


It was the summer season of 1982, and I wasn’t a dentist but. I used to be a 20-something biochemistry and artwork historical past main on the College of British Columbia. I noticed a guide on my mother’s bookshelf—Life Extension by Pearson and Shaw. I didn’t comprehend it on the time, however that guide would set me on the trail to useful dentistry—lengthy earlier than the time period “useful medication” had been coined. It will be a long time earlier than I might notice I’d be charting a brand new path in dentistry.

The way in which this guide talked concerning the physique was in contrast to something I’d seen. This guide wasn’t simply well being recommendation. It reframed the physique as an interconnected system—the place small disruptions might ripple outward into illness, and early alerts mattered greater than late-stage signs. It gave me a framework to assume upstream, to seek for what set sickness in movement lengthy earlier than the signs confirmed up. The authors didn’t use the time period “useful medication,” however their philosophy anticipated it: intervene early, deal with the basis trigger, view the physique as a system, and use rising biochemical science to remain forward of illness. It was radical for the time—particularly in 1982—and it captured one thing I didn’t know I’d been trying to find. I learn it cowl to cowl—all 858 pages. Then many times.

Just a few years later, I might attend dental college in San Francisco. In dental college, the curriculum is tight. You’re taught to acknowledge signs, outline ailments, and deal with them effectively. That’s the components: establish, diagnose, code, and invoice. It’s not about stepping again or connecting dots. Dental college is designed to get you licensed, to move your boards and to turn out to be a “secure newbie” and begin treating. When you’re in observe, insurance coverage firms reinforce the identical sample. The system doesn’t reward curiosity. It rewards compliance. I believe that’s maybe why so few dentists ever make the shift away from standard dentistry.

As a brand new dentist contemporary out of dental college, you’re inundated with emergencies that pile up—ache, an infection, necrosis. You’re underwater, and also you need to do extra to assist your sufferers heal, however the insurance coverage mannequin expects you to remain there. In most practices, reimbursements from insurance coverage are fastened. Which means it doesn’t matter how advanced the case is or how a lot time you spend—your pay is identical. The one solution to maintain the lights on is to see extra sufferers, quicker. The enterprise mannequin solely works when remedy is predictable and billable.

And it’s the supplier—caught within the center—who’s compelled to decide on. A supplier who desires to do the best factor however remains to be on the whim of a 3rd get together—the insurance coverage firm—that determines reimbursement.

When dentists graduate, we’re buried in debt. The amount of illness wears down curiosity, and the stress to pay again lots of of 1000’s of {dollars} pushes you towards prioritizing velocity and billable procedures.

My first job out of dental college was in a high-volume observe the place the main focus was velocity and manufacturing. I received fired for spending an excessive amount of time with sufferers. My boss pulled me apart and mentioned, “Simply get again to work, you’re losing time.”

I used to be additionally referring sufferers out—sending them to the best specialists for procedures our clinic wasn’t geared up to deal with. The primary time I did it, the periodontist referred to as me again, confused. “Do you’re employed at South Bay Well being Heart?” he requested. “Is South Bay now sending sufferers out? That’s not like them.”

I informed him no—it wasn’t them. It was simply me, an worker. He couldn’t consider it. They needed to know who I used to be. 

Then he requested, “And Mr. Ward is okay with this?”

I mentioned, “Mr. Ward shouldn’t be a dentist. He’s half-owner of South Bay Well being Heart, however he’s not a dentist. He doesn’t get to make these choices about what’s greatest for the affected person.”

No shock, I used to be fired shortly after that. The entire thing lasted about eight months.

Inside months, and with the assist from my spouse, I opened my very own observe within the coronary heart of Silicon Valley, successfully within the yard of Apple and Intel HQ.

So, naturally, numerous my sufferers have been programmers. And programmers, particularly in these early days, have been additionally beta testers. When one thing didn’t work, they didn’t simply take a look at the signs—they went again to the supply code—in different phrases, the underlying logic that determines how the entire system runs. Debugging it meant digging into the origin of the issue and rewriting the directions.

That was the proper mirror for the way I had began fascinated by dentistry. I wasn’t simply treating the cavity—I used to be debugging the physique. I used to be asking what had gone fallacious in its working logic. I used to be on the lookout for the supply code of dental illness—the earliest dysfunctions, the prodromal section of illness—the place issues begin to go off track lengthy earlier than a prognosis is feasible or signs are apparent.

I wasn’t simply putting fillings anymore. I used to be tracing root causes. The tradition of Silicon Valley inspired that—and I leaned into it.

I used to be nonetheless doing what I used to be educated to do, after all—and my sufferers have been blissful. I crammed cavities, did root canals, restored enamel.

However one thing was lacking. It felt shallow, like we have been simply treating the floor. It didn’t matter that the medical work was technically sound—clear margins, correct occlusion, predictable outcomes—as a result of my sufferers would maintain coming in with the identical points.

And I knew it was unacceptable to tread water alongside my sufferers for the remainder of my profession. That’s not what a practitioner ought to do. We shouldn’t be complicit in dysfunction—we should always interrupt it. That is the upper calling of the healthcare practitioner—whether or not you’re a nurse, physician, myofunctional therapist… however it requires stepping outdoors the curriculum, outdoors the billing codes, and deciding to assume for your self.

As sufferers and colleagues began to note the unconventional method I used to be training, they referred to as it “holistic dentistry.” However that label by no means felt fairly proper. Again then, holistic typically meant power traces and meridians—concepts I couldn’t co-sign as a result of they weren’t grounded in biology or information. And even once I agreed with elements of holistic dentistry, the label didn’t match the larger image I used to be attempting to work from.

What I used to be constructing wasn’t only a philosophy. It was a framework. A programs strategy to oral well being. And that wanted its personal identify.

For years, I didn’t know what sort of dentist I used to be. I didn’t match into the organic dentistry camp—too centered on supplies, not sufficient on programs. Integrative dentistry was useful in its emphasis on collaborating with different healthcare suppliers, however nonetheless reactive, and dealing downstream of signs.

I all the time felt misplaced—too medical for the holistic dentists, and too crunchy for the traditional ones.

I didn’t got down to be completely different. It occurred organically—a sluggish collision between the way in which I used to be educated and what I knew my sufferers really wanted. I couldn’t ignore the hole between medical protocol and long-term well being outcomes.

I consider that that guide—Life Extension—had planted a seed in the way it challenged the belief that illness is inevitable. I didn’t need to simply repair issues. I needed to enhance life span and high quality of life for my sufferers. And, fortunately, as a result of lots of them have been programs thinkers, they have been receptive and open.

And now, a long time later, my eldest daughter (who was born 5 days early on the day I opened that personal observe) has helped me deliver my message to YouTube, this article you’re studying, Instagram, podcasts, and extra. And now, an increasing number of dentists are realizing: that is the place the way forward for our occupation is headed.

We’re shedding almost one million lives yearly to ailments we might have prevented. The continual illness disaster isn’t slowing down. It’s dashing up. And dentistry—the mouth, the airway, the place to begin for digestion and immunity—remains to be sitting in a silo.

That may’t proceed.

We have to redefine what it means to be a dentist. We have to be programs thinkers. Engineers of human well being. We have to go upstream, to the prodromal section of illness. And fiercely advocate for our sufferers.

We have to cease solely treating signs and begin intercepting illness.

That’s the promise of useful dentistry.

If one thing on this clicked, you’re not alone. My CE course, Foundations of Purposeful Dentistry, is constructed from 4 a long time of observe. In case you’re completed firefighting and able to get upstream—hit reply. I’ll ship the small print.

This CE course is for the dentist who’s bored with firefighting. Who finds extra which means in stopping a cavity than in filling one. Who is aware of it’s tougher to quantify illness prevention—however it’s the place the actual energy is. Prevention means altering the trajectory of somebody’s well being earlier than signs ever present up. That’s not administration. That’s true care.

As a result of the true which means of “physician” is instructor—and healer. And the way efficient would you like your healer to be? Continually underwater, reacting to signs? Or on the opposite aspect—considering upstream, taking cost, serving to sufferers rewrite their well being future?

Be part of a group of dentists and rewrite the story of what dentistry might be. 

We’re not simply treating enamel. We’re treating programs.

Hit reply and let me know if you happen to’re , and my crew will add you to the waitlist.

In case you’re on the lookout for a dentist who “will get it”—begin right here. You deserve a accomplice who understands airway, vitamin, and the oral-systemic connection.
→ Search the Purposeful Dentist Listing

Advocate somebody for the Listing
In case your dentist belongs on this record—otherwise you do—hit reply. I’d love to listen to from you. My crew vets each submission.

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