As dentistry rapidly moves forward with relentless technological advancements and dentists who own individual solo practices become less relevant, as DSOs expand their reach, and as millennials become a greater percentage of the practitioner population, ageism is clearly a growing issue in dentistry.
Ageism is the stereotyping and discriminating against individuals or groups on the basis of their age. The term, patterned on sexism and racism, was coined in 1969 by Robert Neil Butler to describe discrimination against seniors.
Technology’s impact
One distinct factor influencing the prominence of ageism in dentistry is the shift in authority derived from ever-faster technological change. Younger dentists have significantly more tech capabilities, whereas senior dentists are often technologically impaired. In the 1920s, an engineer’s “half-life of knowledge” — the time it took for half of his expertise to become obsolete — was 35 years. In the 1960s, it was a decade. Now it’s five years at most, and, for a software engineer, less than three.
Traditionally, you needed decades of experience in coding or engineering to launch a successful startup: William Shockley was 45 when he established Fairchild Semiconductor, in 1955. But change begets faster change: Larry Page and Sergey Brin were 25 when they started Google, in 1998. Mark Zuckerberg was 19 when he created Facebook, in 2004.
The pull of Silicon Valley
Young dentists, plugged in to technology and change, see Silicon Valley as the mecca and model to follow. It’s their Mount Olympus — where the gods live. And Silicon Valley believes that bold ideas are the province of the young. Zuckerberg once observed, “Young people are just smarter,” and the venture capitalist Vinod Khosla has said that “people over 45 basically die in terms of new ideas.” Paul Graham, co-founder of the Valley’s leading startup accelerator, Y-Combinator, declared that the sweet spot is your mid-twenties: “The guys with kids and mortgages are at a real disadvantage.” The median age at tech titans such as Facebook and Google is under 30; the standard job requirements in the Valley — which discourage a “stale degree” and demand a “digital native” who’s a “culture fit” — all select for youth.
Implications for dentistry
This attitude is beginning to show itself in dentistry. It is one of the areas of friction observable between senior doctors and associates. Simply put, young dentists think they know more and better than their senior doctors. But this is now true in every business sector — including my own. Ageism is considering dentists over 50 less relevant, less smart, less endowed, less gifted, and less talented than younger dentists.
This attitude shows up in how younger dentists talk about the older generation, which is called “elderspeak.” In the baldest forms of ageism, older people are addressed in high, loud tones and a simplified vocabulary — and tarred with nouns like “coot” and “geezer” or adjectives like “decrepit.” In dentistry, “elderspeak” is subtler, but very much present. Listen to how young associates talk about the senior dentists.
What the younger generation doesn’t understand is that knowledge is not wisdom. Information doesn’t turn into wisdom until it is linked to experience. Information needs to “stew” in experience to turn into wisdom. Experience requires time, and often encompasses failure, pain, heartbreak, grief, and despair. Experience leads to self-examination. Experience is “slow cook,” not microwave. Experience happens over time, not instantaneously. Experience is not an app. Information makes you smarter; wisdom makes you more able to deal with people and situations.
The importance of wisdom
Ageism and age discrimination is increasing in dentistry, and one of the first casualties is wisdom. The decline of wisdom will be a terrible loss to the future of dentistry, and most importantly to patients. Successful relationships are a function of wisdom. The wiser I am about myself and others, the better relationships I can generate. Ultimately, the dentist-patient relationship is the most fundamental and critical relationship in dentistry. More wisdom leads to more successful relationships. Information has zero impact on the ability to generate relationships that embody trust, affinity, and confidence.
Treatment acceptance, recall frequency, risk management, and case acceptance have far more to do with the dentist-patient relationship than they do with a screen shot on a large monitor picturing a patient’s tooth. It’s very straightforward: the more wisdom that exists within a dental culture, the better the relationships with patients, staff, and fellow dentists. This is not to say information is not important — but one must realize the limitations of information and the power of wisdom.
— Marc
