50 Days, and 3 Lessons Learned

*50*

That's (roughly) how many more days I will be here in Alaska.

It's been a wild journey. I still have, at minimum, just over a year left on my military commitment. If I choose to separate in 2019, my wife and I will likely settle somewhere in Colorado. Fortunately, my next base is also in Colorado, so that would be an excellent way to transition.

I also wanted to quickly touch on three things about the military to give prospective dentists a heads up about this world:

1. Flexibility vs stability

One of the tough things about military dentistry is that it doesn't afford you the flexibility that private practice can afford you. However, this is certainly a double edged sword. What it lacks in flexibility, it gives back in supreme stability. A steady and predictable paycheck, a pre-set number of days off per year, working 5 days per week with federal holidays off, 7-4 every day with a 1 hour lunch. You can pretty much plan out your whole life, but you can't magically have more time off or more money (and that's just fine for many). Many people see control of these two things, time and money, as the pinnacle of self-actualization, and you're just not going to have that in the military. Some people even enjoy the unpredictability of where they'll live next, something that is nearly impossible to emulate as a dentist in the private sector. Don't get me wrong, the time off is better than most jobs and the pay is certainly good, but it's an incremental and perpetual carrot at the end of a pre-cut stick. On the flip side, others are willing and able to forfeit the stability of the military for a chance at more flexibility and freedom with their time, life, and finances.

2. Inefficiency

The military is quite inefficient, and we don't do nearly as much dentistry as our civilian counterparts. I would argue that, by in large, it is of equal or greater quality, but there's virtually no incentive to learn new techniques and procedures or even do more dentistry per hour or per appointment. This can lull many people (in all military jobs) into a pattern of trying to work less and less for the same financial benefits. In the military, more productive work does not equal more freedom or more money; it's the dark side of having that job stability and it can be very demotivating to a person over a long period of time. There are other factors as well that make military dentistry inefficient: limited physical building space, limited support staff, lack of standardization, administrative burdens placed on the dentist rather than support staff, etc. I strive for efficiency, but that's under the pretense that I may not stay in the military long term and getting a higher volume of experiences is necessary, and fulfilling, for me. For those civilian dentists out there, it would surprise you to see how little dentistry we actually accomplish with vast number of days we are in the clinic. It's not unusual for a young military dentist to "produce" 1/4-1/2 of what a civilian would on about 200 working days/year. It's possible to push yourself to do much more than that, but be prepared to be met with resistance from those around you that don't see the value in the push to be faster, better, and more efficient.

3. Long term thinking

Ironically, there is very little long term thinking in the military, at least on a local level. While I would certainly argue that this is also a problem on the civilian side, it's surprising that a military force would lack this focus and direction. This one thing alone could help so much to alleviate the problems associated with point #2 above, since people tend to be more efficient and productive when presented with clear and meaningful goals. Because of this constant pull to see the military as a job, rather than a higher calling and working towards a tangible and meaningful goal, people tend to get in a rut very easily and quickly and decide not to improve or change the systems that operate within the military. The other reason that people get into a rut is that individuals are constantly moving in and out of different places and it's hard to even establish those long-term local goals. This means that people get burned out quickly if they try, since the team is always changing around them. So people usually move in and out of places with the idea they they will just do their job, collect their paycheck, and go home. People certainly do their jobs, but people rarely do more than that because there's 1. no long term goal/thinking and 2. no real incentive to step outside of their day-to-day tasks. This can be a drain on the team and its members. People promote to higher ranks in a relatively step-wise manner, so staying the course will still set you on a nice career trajectory.

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These are not necessarily universal negative things, but three important things to think about and they all come with their counter-points. I think they are all natural outcomes of a "salary without bonus" payment structure and a "move every 3-4 year" system. Honestly, I don't have any good solutions for the downsides, so you'll have to decide for yourself if you want to live inside these structures for a long term career. There are certainly exceptions to the rule, but the fact that we can call people that deviate from point #2 and #3 above "exceptions" help prove that, by in large, the rules exist.

I hope these musing give you some insight into military dentistry and whether its right for you. I had a vague idea that these were tradeoffs of the military system, but I now believe they are so powerful that few can truly muster the strength to rise above them regularly without ultimately deciding their vision for the life is better articulated outside this structure. If you try to beat down the walls of these structures long enough you'll ultimately give up (and work your way up the ranks for your career) or get out. More power to those that can endure, or ignore, it for a whole career. And even more power to those that see this calling as the purpose for the life and truly do make a difference.

Like I've said before, I would absolutely do this again, but I'm leaning a little more toward the "flexibility" end of the spectrum now and starting to see the unbreakable ceiling above my head in terms of what I want my life to look like in the long run.

As always, email me with any questions you may have!