When I entered dental school in 2000 at the University of Illinois at Chicago, I was part of the first class that had an equal ratio of men to women. I remember an endodontics faculty member, Dr. Nijole A. Remeikis, who was the first woman Diplomat of the American Board of Endodontics, saying that she could finally think about retirement now that the ratio had hit 50/50.
Having studied science at Benedictine University, and then being a dental student, I had always been considered an equal and on par with my male counterparts. It had never occurred to me that the world outside the walls of academia would be any different. So, what I’ve discovered in my professional life has come as a real surprise.
As a woman in private practice with a male dentist, I have found that patients consider my treatment plans with an air of suspicion, much to my chagrin. I do want to mention, however, that all of this is based on my own experience. I have not kept in touch with many of my classmates, and I have not had an opportunity to share or compare my experience with other women in the field. I would be very curious to see if their experience has matched mine.
Inequalities Persist
When we look at the architecture of the big stage, in speaking events, women are not equally represented. This is changing, but it’s changing too slowly. Women are not represented equally in practice ownership either. They are more likely to either practice part-time or be associates in a group practice. Thus, patients are still more likely to be seen by male dentists than by female dentists.
There is no arguing that a woman’s primary role in our culture—and, more importantly, our passion—has been to raise children. There is nothing wrong with that. As a mother myself, I put my family ahead of my career or any growth opportunity. That’s not to say that I deny myself chances to improve as a practice owner or dentist. It’s simply that they come secondary to my role as a mother.
Motherhood almost brings about a devoltion, which I certainly didn’t expect to develop, toward raising children. Putting our families and children first does remain a choice for women, but it’s undeniably a compelling one. Much of this is what reduces the filtration of women into the lecture circuit and practice ownership.
I have always been a bit of a maverick, walking a path to the beat of my own drum. Eighteen months after dental school graduation, I bought and began to grow my own dental practice. I had partnered with a male colleague and have stayed in co-ownership with him for the last 14 years. The learning curve of practice purchase and subsequently practice ownership, so early following graduation, was too steep to even put into words. Also, I was the first person in my family to ever own or operate a business, which meant that I was basically on my own.
Because of my partner’s lack of complete involvement, predicated on his family situation, I initially was doing all the research, due diligence, and practice purchase negotiation by myself. The fact that I had learned a lot on my own in those first few years made it much easier for me to trust my own gut when making decisions, including ones I make today. And all along the way toward my practice purchase, I never felt like I was treated any differently when I was working with accountants, attorneys, and real estate agents. I felt equal with my male counterparts.
Within the confines of the negotiation and lease agreement, I had a small snafu with the practice seller and building owner, who was well into his seventies, which I just attributed to a difference in personality. At one point, the now-building-owner-past-practice-seller picked up the phone, called my male business partner, and said he no longer wanted to have conversations with “that bitch,” referring to me. That might have been the first time I started to wonder if he would have referred to my partner in such a degrading fashion had he been negotiating instead of me.
Differences on the Job
Following this steep learning curve into practice ownership and having accepted the new relationship I had (or didn’t have) with the now-building-owner-past-practice-seller, I finally had an opportunity to focus on patient care. My partner was able to join the practice full time, and I began, for the first time, to see the difference between us and how patients treated us as providers. Patients reacted to him very differently. Especially women.
To this day, certain women between the ages of 40 and 50 absolutely refuse to see me as their provider, even in emergencies or when he’s running significantly behind for recall appointments. They wait for him, and when he enters the room, they bat their eyelashes, smile a big smile, and compliment him on how great a doctor he is. His treatment plans are wildly accepted, as opposed to mine, needing little supportive information.
Before my patients sign on the dotted line, I have to do a song and dance—draw a picture, present copies of brochures, take intraoral photos, and walk them through the financial part of the treatment plan. I’m not saying that treatment plan presentations don’t need drawings, photos, X-rays, and brochures. But my presentations differ from his, quite significantly, and I have always thought it had to do with the difference in our genders.
As a provider and even off the clock, I speak intelligently. I’ve always taken pride in that. I’ve completed a lot of education and consider myself a well-rounded individual in areas other than dentistry. However, it would seem that this background has put me at a disadvantage with certain populations.
We are taught that as female providers, when we’re addressing the needs of a male patient, our doctor stool ought to be slightly above the patient chair. But put me in a room with a man who holds some status, and his demeanor changes very quickly if my chair is just slightly above his. These men become borderline defensive, with an air of arrogance. That’s why I have come to adjust my stool so it is slightly below theirs, resolving the matter.
As far as practice management is concerned, I have noticed over the years that my patients are much more likely to disrespect me openly, write negative reviews about me, and complain to others about me compared to my male counterpart. Past team members were more likely to walk all over me, or at least attempt to, and be impolite to me and question me.
Combine all of these issues, and you might see why I felt like I was at a disadvantage—until recently, when I realized that my only disadvantage was comparing myself to my male counterpart. It came very easily. After all, he was practicing just a few feet from me.
Looking Ahead
For years, the idea of not being treated equally has been very difficult for me to embrace. And it has taken me several years to figure out my value as a female dentist. Once I accepted that patients view me differently, I began to think about what advantages I had as a female dentist over a male dentist. What did I bring to the table as a unique individual and as a woman?
Once I was able to put my head around that idea, my own self-acceptance and practice in dentistry really took off. It was a matter of mindset. Not to say that inequality didn’t exist, but, simply stated, I decided I wasn’t going to let it affect me or the relationship I wanted to form with my patients. I had wasted too much time already comparing myself to my partner.
No two individuals are ever treated the same, whether it’s a man and a woman, a woman and a woman, or a man and a man. Each brings forth different talents and characteristics, so the organic relationship built between the patient and the provider inadvertently has to be different.
If my counterpart’s patients flirt with him and don’t want to see me, it may not have anything to do with me. It might not be about me being a woman. They simply could have connected with my partner and wanted to continue that relationship with him. The visit at the dentist with him might have been the highlight of their week, so they didn’t want to see me.
I have come to accept that some days I need to lower my chair more when I’m speaking to a self-assured business executive. I shouldn’t have to do it, but I do, and it works in my favor. It’s what gets them to listen to me.
I have come to embrace taking the photos and drawing the teeth in my treatment plans because it makes them easier to understand. And, ultimately, it creates value for my patients.
I have to come to recognize that patients are more likely to open up to me and lower their emotional boundaries, creating a stronger interaction with me, because I am a female dentist. Many patients feel comfortable enough to cry with me, which is rather unlikely to happen in my counterpart’s operatory. Perhaps it isn’t a frequent interaction, but the connection developed at that kind of appointment tends to last longer.
I consider the parts of me that are uniquely female, as I’ve developed them or daily come to realize their existence, a strength and almost a superpower. My new attitude combined with the intensity of the new connections I now form are a success I never expected.
The good news is that more and more practicing dentists are women. Today, young women with a dental degree are more likely than ever to establish their own practice and find a way to work while fully submerged in motherhood. I’ve seen many women hire their husbands to help them run a practice, which might have not happened much just 15 or 20 years ago.
The tide is turning, but it hasn’t turned yet. In this waiting period, embracing what is uniquely female will make our work worthwhile and enjoyable. Whereas before I was stuck comparing myself to my male partner, today I welcome each opportunity to meet new patients and exercise my unique ability to connect with them on a deeper level. I welcome the opportunity to speak intelligently and with a warm smile, gently bringing them toward me.
Dr. Augustyn is a practicing general dentist. She earned a DDS from the University of Illinois at Chicago. She also has completed the course sequence with the Dawson Academy’s continuum in oral equilibration and cosmetic dentistry. She completes a minimum of 30 hours of continuing education each year as well, including orthodontics, implantology, periodontics, prosthodontics, and cosmetics. Additionally, she is an active participant in the Chicago Windy City Seminars branch of the Seattle Study Club. She can be reached at maggie.augustyn@gmail.com.
