Coming into my decision to pursue dentistry with the Air Force, I had heard all the typical lines about why I should (or shouldn't) do the HPSP to pay for dental school. I made the decision to join the Air Force prior to even starting dental school, so basically I had to hope that the benefits outweighed the risks like I imagined.
This post explores three themes from the book Uncomplicate Business, by Howard Farran. He mentions people, time, and money as three pivotal factors in controlling your destiny as a dentist. Don't miss how much you can learn about these 3 things while serving in the military! They are often forgotten points of learning by new and seasoned Air Force dentists alike.
These three benefits of being a military dentist are:
1. Not Enough People
If you have any desire to leave the Air Force after your commitment is over, this one point is huge. I've heard Air Force dentists complain extensively about the difficulty in managing and dealing with co-workers, many of whom either did not want to be in dentistry at all or did not want to be stationed where they are stationed. They blow this off as one of the downsides of being in the military. WRONG! This is, in my mind, one of the overwhelming benefits!
When in your career would you be able to work to motivate and collaborate with a group of people from all areas of life, from all over the country, who may or may not even want to be doing what they're doing? Working through this problem, rather than blowing it off, allows you to hone your leadership and people management skills in ways that your civilian dentist counterparts will likely never experience.
The other factor is that you cannot simply re-hire to fill vacancies. Staffing decisions are made at a higher level than your local clinic level, so clinics are frequently understaffed for all the needed positions. The biggest area I see this is in how many dental assistants there are. In a typical private practice, you usually have more dental assistants than dentists. In the Air Force, it's typically a 1 to 1 ratio, meaning there are several 10-15 min breaks during the day where the assistant is breaking down a room or setting up a room and you're in your office working on notes or other things. Realizing you have the capacity to work 2 or 3 times as much as you are can be discouraging, but just use that opportunity to get treatment done quickly so you can have free time to do other things.
2. Not Enough Time
I ended the previous section talking about how much free time you have in a given day, so you're right to be skeptical for a moment. The problem (or as I'll argue, the benefit) is that on a larger scale, your time is not under your control.
You should always be striving to do more, and time is our most valuable currency. In the military, or any government job, the concept of working overtime isn't really feasible from a dentist's perspective. Being in a non-commander role, it's not really up to me to rally the herd and stay open an extra hour each week, or shut down on a Friday and fly everyone to Anchorage for a teamwork seminar.
Time is always against you, but in the military, this is especially pronounced. Like I said in the previous paragraph, your time flexibility on a scale from 0 to 10 is somewhere closer to that 0. Having to squeeze 10 unexpected patients into an afternoon that was set aside for military training so that the base can send those people to Guam by next week, are the kinds of time constraint issues you run into. You exist to keep the Air Force running smoothly. Your time is the military's time. And if you can figure out ways to creatively control your schedule to continue improving your skills in this environment, you'll see huge benefits when you step out and finally get to control your own time.
Fortunately on a day to day basis, you do have control over the lengths of procedures, just not on the actual work week or overall schedule itself.
3. Not Enough Money
Imagine you're out and about on a Saturday when suddenly the craving for hamburger hits. You and your spouse drive to a nice place to have lunch and then come home. Does this seem like a money-intensive process? Probably not. Why not? It costs money to put fuel in your car, it costs money for the wear and tear on the car, you need to have purchased car insurance and have a license to drive the car, not to mention the cost of the meal when you arrive. Did you consider all that?
Ok, now imagine you're 16 years old again and you want to have lunch with some friends. You don't own a car and you don't have gas money because you rely on your parents for an allowance and you spent it all on a video game last week. So your friend (who is 17 and has a job) decides to help you out. They come pick you up and buy your meal for you. It's a little annoying but they don't mind.
Being in the military is like being 16 years old again. You have almost no control over the amount of your "allowance" that comes in each month and you foot the bill for your own dental license and often for your own CE courses. You hope the "allowance" comes into the clinic on time so you can buy what you need and if it doesn't, you're going to have to choose between gas and food.
This sounds a little extreme, but it does happen. The government has situations where they can't promise money to a medical clinic or dental clinic, and so your clinic may be forced to operate on a drastically reduced budget. So what's the benefit in that?
Learning how to operate a clinic for 5 months on a budget roughly 35% of its normal size when you're in charge of ordering supplies for the clinic, forces you into all kinds of new and uncharted territories. Finding out which items are crucial to not only keep the clinic open, but to maximize the potential to meet the specific mission of your base, is no easy task. Saying "no" when people ask if you can buy this or that, or completely reorganizing every treatment room to streamline your supplies so that absolutely nothing goes to waste, are two delicate but vital strategies. Some day you'll leave the Air Force and be a grown up dentist, not reliant on the Air Force's "allowance" anymore. But those important financial pivot points will already be part of your natural decision making process. Lucky you!
Not having money obviously means not having what you want. But often times the standardization of the clinic will trump your preferences. The benefit here is flexibility. You'll need to learn to work with other doctors (and even your assistants) to come up with supplies you can all agree on. It may not be your favorite bonding agent, for example, but it's cheaper and more efficient and the expiration dates are 2 years out, so it fits well within your clinic's goals.
These are the type of weird supply decisions that have to be made when there are people moving in and out of your clinic every few months. We are fortunate enough to have such a tight-nit group of doctors at Eielson that agreeing on standardized supplies is rarely a problem. Again, knowing the clinic's main mission helps clarify and point us in the right direction.
Here are questions we have had to ask ourselves at Eielson when considering changes in supplies:
Should we focus on getting every doctor exactly what they want, or take into consideration that assistants will get confused if every treatment room is set up differently?
Do we buy burs for $0.98/each and put the sterilization burden on someone to package all of these burs for us, or do we order burs that come sterilized from the factory for $1.01/each?
If diamond burs are not consistently cleaned properly, or sometimes get dull without the next doctor knowing, is it worth it to re-process these or should we move to single-use diamonds?
The list goes on and on. The supply game is a hard one to play, especially in light of the money game! But learning how to make compromises and think of the clinic mission every time you make a supply decision will lead to huge benefits in how you eventually think about your own practice some day.
I hope this post was helpful. My goal here was to pick out 3 topics (people, time, and money) that are most often cited as downsides to military dentistry and show you how, when looked at from a different angle, are actually 3 of the biggest benefits. As always, email me (see right side of blog) if you ever have any questions!