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SUCCESS 
 
 IN 
 
 DENTAL PRACTICE 
 
Digitized by tine Internet Arciiive 
 
 in 2010 witii funding from 
 Columbia University Libraries 
 
 http://www.archive.org/details/successindentalpOOjohn 
 
SUCCESS 
 
 IN 
 
 Dental Practice 
 
 A Few Suggestions Relative to the Most 
 
 Approved Methods of Conducting 
 
 a Practice 
 
 BY 
 
 C. N. JOHNSON, M.A., L.D.S., D.D.S. 
 
 Professor of Operative Dentistry in the Chicago College of 
 Dental Surgery ; Editor of the Dental Review, and 
 Author of "Principles and Practice of 
 Filling Teeth," "Text-Book of 
 Operative Dentis- 
 try," ETC. 
 
 SECOND EDITION 
 
 PHILADELPHIA (2f LONDON 
 J. B. LIPPINCOTT COMPANY 
 
Copyright, 1903 
 
 BY 
 
 J. B. LipPiNCOTT Company 
 
 Copyright, 191 3 
 
 BY 
 
 J. B. LiPPiNCOTT Company 
 
 Electrotyped and Printed by 
 J, B. Lippincott Company, Philadelphia, U. S. A, 
 
Preface to the First Edition. 
 
 ¥ 
 
 The charge has frequently been made that 
 dentists as a class are seriously at fault with 
 regard to the methods employed in the business 
 management of their affairs. Probably it would 
 be more exact to say that the real charge is that 
 they have no method. But whether this be en- 
 tirely true or not, the fact still remains that there 
 are few dentists whose affairs are so conducted 
 that they may not be greatly improved by the 
 application of good business methods. 
 
 When business methods are mentioned in this 
 connection it is not to be inferred that a dental 
 practice should ever in any wise be so conducted 
 that the commercial element is allowed to pre- 
 dominate over the professional. Commercialism 
 is a serious menace to any profession ; but there 
 is a vast distinction between an offensive com- 
 mercialism and that methodical conduct of 
 affairs which results in a successful practice and 
 
4 PREFACE TO THE FIRST EDITION 
 
 a financial balance on the right side of the ledger 
 at the end of each year. No man is doing his 
 full duty to himself, to his profession, or to those 
 dependent upon him who completely ignores this 
 phase of his professional life, as some practi- 
 tioners seem to do, and it should no longer be 
 considered any discredit to a dentist to devote 
 part of his talents to the accumulation of a com- 
 petence. ^ 
 
 The suggestions in this book are naturally in- 
 tended for the most part to apply to the younger 
 members of the profession, though it is con- 
 fidently believed that even those long in practice 
 may derive benefit from a study of the plans laid 
 down. It is not expected that practitioners 
 firmly settled in their ways will revolutionize 
 their methods in accordance with the suggestions 
 herein contained ; and yet a consideration of the 
 question cannot fail to be of advantage to any 
 man, even of the most extended experience. 
 
 The book is not offered as a panacea for all 
 the ills which harass a dentist in the conduct of 
 his practice, but merely with the hope that it 
 may prove of some small service in attempting 
 to establish an equitable and intelligent relation- 
 
PREFACE TO THE FIRST EDITION c 
 
 ship between the practitioner and the public. If 
 this is accompHshed it will make the work of the 
 dentist more pleasant and assuredly more profit- 
 able. 
 
 C. N. J. 
 
Preface to the Second Edition, 
 
 ¥ 
 
 When this book was first issued it was hardly 
 expected that it would run into another edition. 
 It was intended for the most part for the 
 younger men in the profession and the basis of 
 it was a series of lectures on the subject deliv- 
 ered to senior students in college. If it served 
 a temporary purpose for a limited number the 
 author was content. But the interest in the 
 work has extended more widely than was antici- 
 pated, and the consequence is the call for a 
 second edition. In bringing this out some revis- 
 ion has been made, and it is hoped that the book 
 has been improved. 
 
 Since the first appearance of the book a wave 
 of interest in business methods has swept over 
 the profession. Much space in dental periodi- 
 cals has been devoted to the '' business side of 
 dentistry " and many articles have appeared 
 from time to time. Some of the advice given 
 has been good and helpful, while some has 
 
 7 
 
8 PREFACE TO THE SECOND EDITION' 
 
 been very ill-advised and even harmful. To 
 constantly magnify the business of dentistry at 
 the expense of the professional spirit which 
 should be the chief mainspring of every man's 
 motive who conducts a practice is to degrade 
 dentistry and make it a by-word in the land. 
 We need better methods of business, but we do 
 not necessarily thereby have to sacrifice the 
 higher ethics of professional life. The well- 
 rounded man is the one who combines sane 
 business methods with the purest essence of pro- 
 fessionalism, and it is in the attempt to make 
 suggestions toward this end among those who 
 are coming into the profession that the present 
 volume is dedicated. C. N. J. 
 
 May, 1913. 
 
Contents 
 
 PAGB 
 
 I. The Arrangement of an Office ii 
 
 II. Winning Patronage i8 
 
 III. Location 48 
 
 IV. Extending Acquaintance 54 
 
 V. Managing Patients 63 
 
 VI. Records and Book-keeping 77 
 
 VII. Appointments and Sittings 100 
 
 VIII. Giving Credit, Collecting Accounts, Paying 
 
 Bills 106 
 
 IX. Fees 127 
 
 X. Employinp an Assistant 143 
 
 XI. Economy in Purchase and in Avoiding 
 
 Waste 145 
 
 XIL Bank Account and Investments 151 
 
 XIII. Professional Relationship and Citizenship 157 
 
Success in Practice 
 I 
 
 THE ARRANGEMENT OF AN OFFICE 
 
 The Reception-Room. — The economy of 
 space, particularly in localities where rents are 
 high, is an important factor in the arrangement 
 of an office. If the practice is conducted in a 
 methodical and systematic manner, and the work 
 is done by appointment, as it should be, there is 
 little need for a large reception-room. Under 
 these circumstances it is unusual for many people 
 to be in this room at one time, or for any one to 
 remain there long. And yet those who are there 
 should be pleasantly entertained by a diversity 
 of reading-matter on the centre-table. The selec- 
 tion of this matter requires some judgment, in 
 view of the difference in tastes among patients. 
 It should run the gamut in periodicals from 
 
 short, crisp story-books to the heavier and pro- 
 
 II 
 
12 SUCCESS IN PRACTICE 
 
 founder magazines. It is almost unnecessary 
 to say that flashy hterature of any kind has no 
 place in a dental office. Old, back-numbered, 
 and dog-eared magazines should be rigidly dis- 
 carded, unless perchance some such magazine 
 may contain a very able article which has 
 strongly appealed to the dentist, or has a sug- 
 gestive bearing on contemporaneous thought. 
 Such an article should be heavily underlined on 
 the title-page and the article itself red-pencilled 
 to call attention to it. The ordinary dental jour- 
 nals are out of place in the reception-room, on 
 the ground that everything which smacks of the 
 shop should be excluded from this part of the 
 office. 
 
 A reception-room should be cheerful and in- 
 viting, with an air of comfort and culture about 
 it. If the dentist himself is lacking in the requi- 
 site taste to fit it up in this way, he would better 
 consult some one who has the taste, — ^preferably 
 a lady, — best of all his wife. 
 
 The Operating-Room. — In view of the fact 
 that the dentist spends most of his working 
 hours in this room, it is important that he gives 
 the closest attention to its arrangement. It 
 
THE ARRANGEMENT OF AN OFFICE 13 
 
 should be well ventilated at all times, and if 
 possible should admit the sunlight. A good 
 arrangement is to have two windows, one facing 
 the south, to allow the sun free admission during 
 the winter months, and the other, preferably an 
 east light, for operating. A corner room facing 
 the southeast seems in many respects the most 
 desirable arrangement. In summer the sun is 
 so high that its rays do not enter the south win- 
 dow in mid-day to any uncomfortable extent, 
 but flood the east window early in the morning 
 and move around out of range by the time oper- 
 ating begins. In winter the south window ad- 
 mits the sunlight to the room at the operator's 
 back through most of the operating hours, which 
 at this time of the year particularly is a matter 
 of great importance so far as the dentist's health 
 is concerned. 
 
 The problem of light is a very important one, 
 both as it relates to effective work and to the 
 preservation of the operator's eyes. This mat- 
 ter is too often overlooked by dentists, either 
 through thoughtlessness or a failure to under- 
 stand the real requisites of an operating light. 
 The impression seems to prevail that the more 
 
H 
 
 SUCCESS IN PRACTICE 
 
 light in the room the better, while the fact is that 
 too much light is altogether disastrous. The 
 only light needed for operating is that which 
 shines directly into the patient's mouth, and 
 therefore the area of the operating window need 
 not be large. A window three or four feet wide 
 is ample, and it should be situated well up to- 
 wards the ceiling. The idea is to concentrate 
 the light as much as possible at one point, — viz., 
 in the vicinity of the head-rest of the chair. Of 
 course, allowances must be made for raising and 
 lowering the chair, but any extra rays of light 
 other than those in actual use in lighting the 
 patient's mouth are a positive detriment. A 
 bright flooding of the room in the region to- 
 wards which the operator faces is a serious tax 
 on his eyes and will sooner or later ruin them. 
 An element of particular danger lies in reflected 
 light being thrown up in his face while oper- 
 ating, and in this respect few operators are suf- 
 ficiently alive to their best interests. The color 
 of the wall-paper or tinting is seldom considered 
 except with the idea of having a pleasing shade, 
 and these shades are usually selected in bright 
 colors. Nothing could be worse for an oper- 
 
THE ARRANGEMENT OF AN OFFICE 
 
 15 
 
 ating-room. All bright colors reflect the light, 
 and the operator who daily faces such a wall is 
 unconsciously subjecting himself to eye-strain 
 which must eventually impair his vision. This 
 matter has been sufficiently tested in a practical 
 way to leave no doubt of its importance, and the 
 suggestion is hereby strongly urged for oper- 
 ators to tint the walls of their operating-rooms 
 in some of the neutral shades which absorb the 
 light instead of reflecting it back in the oper- 
 ator's eyes. A color which has proved for years 
 a most satisfactory one and which is not in any 
 way sombre in effect is a soft chocolate. There 
 is a sense of restfulness to the eyes in an oper- 
 ating-room tinted in this shade which in the 
 course of years becomes a really important fac- 
 tor in the comfort of daily work. 
 
 The sunlight which streams In at the oper- 
 ator's back from the south window in winter is 
 no tax on the eyesight, because the operator does 
 not face it, and with a wall tinted as just indi- 
 cated there is no glare, even when the light does 
 strike it. 
 
 Consultation- and Dressing-Room. — Where 
 economy of space is important, these two rooms 
 
1 6 SUCCESS IN PRACTICE 
 
 may be combined in one. It is necessary in a 
 busy practice to have some small room conven- 
 ient to the operating-room where brief exami- 
 nations may be made or emergency cases treated 
 without disturbing the patient in the chair. As 
 a rule it should be the aim of the operator to 
 avoid leaving a patient during an operation, but 
 emergencies occasionally arise which insist on 
 immediate attention and where a few moments 
 will suffice to adjust any passing trouble and 
 leave the dentist free to complete his operation 
 unmolested. The fact of some one waiting in 
 the reception-room to see him is always more or 
 less of a distraction to an operator, and a con- 
 venient consultation-room will often relieve him 
 of this annoyance. This same room may be used 
 as a dressing-room, the operator having no use 
 for it while changing patients. 
 
 The Laboratory. — This room is too often a 
 disgrace to a professional man in being made 
 the dumping-ground for all the rubbish of the 
 office and in the amount of dirt and dust that 
 is allowed to accumulate in it. The opinion 
 which seems to prevail among practitioners that 
 the laboratory must of necessity be more or less 
 
THE ARRANGEMENT OF AN OFFICE ly 
 
 untidy on account of the work which is per- 
 formed therein is erroneous. It may be kept 
 presentable at all time?, and may even be made 
 attractive, if the practitioner takes sufficient 
 pride to keep it so. It is merely a question of 
 devising a ready means of getting rid of the 
 refuse as fast as it accumulates and not allowing 
 old plaster or other evil-smelling products to lie 
 around in sight. A little systematic tidiness in 
 the laboratory will well repay any dentist who 
 takes the least pride in the general appearance 
 of his office, and if managed in the proper man- 
 ner it will not consume an appreciable amount 
 of time. 
 
II 
 
 WINNING PATRONAGE 
 
 Advertising. — After an office is fitted up, the 
 next consideration is to secure patients. This 
 is a problem which has taxed the minds of very- 
 many in the profession, and yet it is really a 
 simple matter if approached in the right way. 
 The most fatal mistake a young man can make 
 is to attempt to gain a practice by newspaper 
 advertising. This statement is made in the pres- 
 ent connection entirely aside from any considera- 
 tion of the ethical phase of the question. Even 
 if it were perfectly ethical to resort to circulars, 
 or hand-bills, or posters, or display advertise- 
 ments in the public prints, it would still remain 
 a bad business policy in a profession like den- 
 tistry. While there are always exceptions to 
 every rule, the generality of patients who come 
 to a dentist as the result of this kind of adver- 
 tising are not of the class which make good pa- 
 tronage for any self-respecting young man. 
 i8 
 
WINNING PATRONAGE 
 
 19 
 
 Even if newspaper advertising per se were in no 
 w^ise objectionable, the depths to which it has 
 been dragged by irresponsible impostors would 
 tend to brand it as a doubtful expedient for 
 honest men to traffic with. The stigma of the 
 " dental parlor" is a shadow which no young 
 man can afford to have trailing after him 
 through life. Unless there be present in the in- 
 dividual himself those qualities which draw and 
 hold people to him by the force of his own per- 
 sonality, newspaper advertising will prove at 
 best only a temporary advantage to be imme- 
 diately lost the moment the advertising ceases; 
 while if the young man possesses those quali- 
 ties, he assuredly has no need of the newspaper 
 to aid him. Few young men start out with the 
 idea of continuing throughout their entire pro- 
 fessional life the habit of paying part of their 
 income to the newspapers for the purpose of 
 bringing in patronage. Their plan usually is to 
 utilize this means for a time till they are well 
 established, and then they fondly hope to be in- 
 dependent of such methods and able to pilot their 
 own bark. The fallacy of this has been demon- 
 strated repeatedly. It is the rarest possible ex- 
 
20 SUCCESS IN PRACTICE 
 
 ception to find any young man who has resorted 
 to this kind of advertising ever to attain to any 
 prominence in the profession, or to succeed per- 
 manently in a financial way. Even laying aside 
 the question of respect on the part of profes- 
 sional associates, the history of professional men 
 generally will amply prove that there is no tan- 
 gible or lasting success to be had by this plan. 
 But granted that there were, this question of re- 
 spect cannot be laid aside. Men may talk loftily 
 and loudly about not caring what the profession 
 thinks of them so long as they make the money, 
 but sooner or later, money or no money, there 
 comes to the heart of every man an overwhelm- 
 ing desire to be thought well of by his fellows. 
 He may hide it for a time behind the mask of 
 an artificial complacency, but it will not down. 
 It is human nature. If there is a man who is 
 devoid of this desire, he is far more to be pitied 
 than envied or emulated, and in that man there 
 is not the element of true happiness. 
 
 To build up a practice by newspaper advertis- 
 ing is to establish it on the most insecure foun- 
 dation. There are two ways of attracting people 
 to a dental office, one by advertising, which 
 
WINNING PATRONAGE 21 
 
 appeals for the most part to individuals who are 
 looking for cheap work and who usually make 
 undesirable patients, and the other through the 
 recommendation of those who have already re- 
 ceived service from the dentist and are suffi- 
 ciently impressed with his ability to refer other 
 people to him. In the first instance the relation- 
 ship is based on the desire to economize in 
 money. Such people are constantly drifting 
 hither and thither and there is no stability in 
 this kind of practice. In order to maintain 
 a practice by advertising it is necessary to keep 
 up the advertising. This is a recognized prin- 
 ciple in all advertising business — the moment the 
 advertising stops the business stops. If a man, 
 has the qualities of mind and heart and the abil- 
 ity to render good service he may possibly hold 
 some of those who come to him through public 
 advertising, but if he has these qualities he does 
 not need the advertising. It is true that in 
 some way he must secure patients before they 
 can send him others, and this matter is con- 
 sidered in the chapter on " Extending acquaint- 
 ance." It is safe to say that whenever an in- 
 dividual goes to a dentist as the result of an 
 
22 SUCCESS IN PRACTICE 
 
 advertisement there is always a mental reserva- 
 tion in the act. 
 
 The inner history of every man who has fol- 
 lowed quack methods for building up a practice 
 will disclose the fact that there is something 
 fundamentally wrong with the method. A man 
 who always remains a quack eventually fails in 
 the respect of his fellow-men as well as his fel- 
 low-practitioners, and he who starts out as a 
 quack with the ultimate intention of reforming 
 and becoming ethical as soon as his practice is 
 established will find that the stigma of his early 
 methods will cling to him long after he has dis- 
 carded them, and will crop out and embarrass 
 him throughout his entire professional career. 
 
 Essentials to Success. — If it be true, then, that 
 quackery is a failure as well as a wrong, by what 
 means shall a young man draw a patronage to 
 himself in such a way that he may be both suc- 
 cessful and respected ? I have stated that this is 
 a simple matter, and so it is; but the require- 
 ments for carrying it out are somewhat exacting 
 and cannot — must not — be ignored. 
 
 No single element in a man's make-up will 
 be found all-sufficient to ensure success in dental 
 
WINNING PATRONAGE 
 
 23 
 
 practice. In fact, to be a successful dentist re- 
 quires a rare combination of qualities more 
 exacting than for that of any other calling. This 
 statement would seem formidable and discour- 
 aging were it not for the fact that these quali- 
 ties are such that they can be cultivated and ac- 
 quired by almost any young man of ordinary 
 ability. There are some stations in life which 
 to fill properly demand of a man an inherent 
 genius in one certain direction, a genius born in 
 him, and which, lacking this birthright, cannot 
 be cultivated to a successful issue. A great mas- 
 ter, whether of music, or art, or literature, can- 
 not be made of common clay; neither can the 
 breadth of brain necessary to make a successful 
 President of the United States be imparted to 
 a man by education. The solving of great prob- 
 lems which affect the destiny of nations or 
 masses of people requires a mental capacity not 
 inherited by the average man and which the 
 average man cannot acquire by study. For such 
 things a peculiar mental calibre is requisite 
 which marks a man as something apart from his 
 fellow-men and gives him a distinctive position 
 in the world. 
 
24 
 
 SUCCESS IN PRACTICE 
 
 Of such is not the practice of dentistry, and 
 yet I must hasten to add that in this statement 
 I do not in any wise admit a place of minor im- 
 portance for our calHng so far as relates to its 
 honor, its dignity, or its usefulness in the world. 
 It is merely that the chief requisites for the suc- 
 cessful practice of dentistry are such as can 
 largely be cultivated, not of course by every 
 chance ignoramus or sluggard, but by the hun- 
 dreds of bright, energetic young men who are 
 yearly entering its ranks. 
 
 Efficiency. — In attempting to enumerate some 
 of these requisites the first place must unequivo- 
 cally be assigned to efficiency. Unless a man be 
 a good dentist and eminently qualified to serve 
 his patients skilfully, he is handicapped at the 
 very foundation ; and the thing for a young man 
 to do, if he finds himself lacking in skill in any 
 department of his work, is to so apply himself 
 that the deficiency is overcome and he finds him- 
 self on a level with the best. Mediocrity will 
 not win in this age of active progress, — to-day 
 there is little room in the profession for the 
 '' average man." People are becoming too dis- 
 criminating to allow a man of meagre attain- 
 
WINNING PATRONAGE 
 
 25 
 
 ments to impose on them for any length of time, 
 and the condition no longer exists where mere 
 ghbness of tongue can compensate for lack of 
 ability. 
 
 It may seem a vague sort of advice to tell a 
 young man to become proficient in his work, but 
 what is meant is this : With almost every recent 
 graduate there are some things which seem more 
 easy of accomplishment than others, and prob- 
 ably at least a few things which seem exceed- 
 ingly difficult. For instance, he may find that 
 to build a gold filling properly in a disto-occlusal 
 cavity in a lower molar or bicuspid is a prob- 
 lem which taxes him to the uttermost, and of the 
 result of which he is never certain. The thing 
 for him to do the moment he recognizes this 
 particular limitation is to devote his every energy 
 to the mastery of this class of cavities. Let hinj 
 seek all the light possible on the subject from the 
 literature of the profession, and let him request 
 the privilege of watching some skilful operator 
 fill such a cavity. Let him study the problem 
 from every available point of view and never 
 rest content till his brain has conceived the best 
 way of accomplishing the result and his fingers 
 
26 SUCCESS IN PRACTICE 
 
 have learned how to execute it. Success in life 
 is attained only by the constant overcoming of 
 obstacles, and unless a dentist brings this per- 
 sistent determination into his daily work he need 
 never hope to rise above mediocrity. I would 
 much rather see in a young man the disposition 
 to plot and dig and delve, and the patience to 
 persevere, than to see the highest degree of bril- 
 liancy unaccompanied by seriousness of purpose 
 or continued application. 
 
 No young man in the practice of dentistry to- 
 day can afford to stop short of the greatest pos- 
 sible proficiency in his work. A bungling 
 method of operating, or a seeming lack of deci- 
 sion as to the precise thing to do in a given case, 
 is instantly recognized by the patient, and a men- 
 tal note made of it; while a ready, sharp, and 
 decisive line of procedure, with no hesitation or 
 doubt, appeals at once to the patron and creates 
 confidence. The man who approaches an opera- 
 tion with the conscious conviction that he is 
 entire master of the situation, unerringly com- 
 mands the co-operation of the patient and ac- 
 complishes his work under the most favorable 
 conditions. It is this which draws people to him 
 
WINNING PATRONAGE 27 
 
 and which holds them in the firm grasp of an 
 estabHshed confidence. 
 
 Personal Habits. — Another requisite in build- 
 ing a practice relates to the personal habits of 
 the dentist. The chief article in the dental faith 
 may be written in one word, — cleanliness; and 
 there is no other single word so big with possi- 
 bilities as this. The operator on approaching a 
 patient should be the very pink and essence of 
 purity. His linen should be clean, his person 
 irreproachable by frequent bathing, his face 
 fresh shaven every morning, if he shaves at all, 
 and his hands most scrupulously cared for. The 
 finger-nails — oh, ye immaculate gods of pris- 
 tine purity, how often have ye been offended by 
 the finger-nails of dentists! There never was, 
 there never can be, any excuse for a dentist 
 starting to work on a patient's mouth with soiled 
 finger-nails. No matter how many patients the 
 operator may have in a day, he should wash his 
 hands thoroughly and dry them carefully every 
 time a patient takes the chair. And this should 
 invariably be done in the presence of the patient 
 as the very last act preceding the commencement 
 of the operation. When a discriminating patient 
 
28 SUCCESS IN PRACTICE 
 
 sees the dentist hang up the towel from drying 
 his hands, and go at once to his work, there is a 
 settled sense of satisfaction on the patient's part 
 which though often unexpressed is none the less 
 a potent factor when it comes to recommending 
 other people to a dentist. 
 
 There is never any precaution too great to 
 be taken in avoiding offensiveness of whatever 
 character connected with the personality of the 
 dentist. His breath should be the object of es- 
 pecial care, and he should eschew all food mate- 
 rials calculated in any way to leave a taint upon 
 it. To smoke during office hours is the great 
 unpardonable sin, and no dentist who has any 
 respect either for himself or for his patient will 
 commit such a breach. 
 
 It would seem to go without saying that the 
 teeth of the dentist, above all things else, should 
 be given the most scrupulous care, and he who 
 fails in this respect cannot well hope to impress 
 his patients when he advocates such attention on 
 their part. 
 
 The question of cleanliness must also be car- 
 ried beyond the person of the dentist, and be 
 made to include his office-fittings and instru- 
 
WINNING PATRONAGE 
 
 29 
 
 ments. Everything about the chair should be 
 kept beyond reproach, the Hnen well laundried 
 and frequently changed, and the cuspidor and 
 other metal accessories polished clean, bright, 
 and sparkling. The slightest trace of neglect 
 connected with the cuspidor becomes exceed- 
 ingly offensive to individuals of fastidious 
 tastes, and, even aside from sanitary conditions, 
 such neglect is short-sighted and prejudicial. The 
 instruments should be cleaned after each patient 
 by scrubbing them thoroughly with a brush and 
 soap and water previous to immersing them in 
 an antiseptic. None of these precautions is ever 
 lost sight of by discerning patients, and no 
 dentist who aims to gain and maintain a good 
 practice can afford in the least to ignore them. 
 
 Deportment towards Patients. — Another im- 
 portant consideration in the building of a prac- 
 tice relates to the deportment of the dentist to- 
 wards his patients. He should at all times be 
 absolute master of himself so far as his de- 
 meanor is concerned, and no matter how many 
 little worries or untoward occurrences arise 
 during the day he should never give way to 
 impatience or ill-humor. In the very worst 
 
30 SUCCESS IN PRACTICE 
 
 dilemmas he should sustain himself by the reflec- 
 tion that the exigencies which arise in a dental 
 practice are usually not of a profoundly serious 
 matter and not ordinarily permanent in their 
 character, so that the thing which appears like a 
 mountain to the young man to-day may dwindle 
 in importance to a mole-hill a week or two hence. 
 To be a perfectly poised gentleman under every 
 species of petty annoyance is a wonderfully 
 strong recommendation for any man, and par- 
 ticularly so for a dentist. It has a compelling 
 influence with his patients to make matters run 
 smoothly, and develops in the office an air of 
 quiet and restfulness which has a far-reaching 
 effect among cultivated people. In all his pro- 
 fessional relations he should be the essence of 
 kindness, and if possible of tolerance. It is of 
 course necessary at times to be very firm in his 
 convictions, but his firmness should invariably 
 be so tempered with a calm courtesy that his con- 
 tention for the right may never seem arbitrary 
 or offensive. Impulse, while in one way an ener- 
 gizing force in a young man's character, is at 
 the same time his greatest danger. Impulse 
 sometimes leads a young man blindly to his own 
 
WINNING PATRONAGE 
 
 31 
 
 destruction; and even when it is not so serious 
 as this, it frequently results in his embarrass- 
 ment and chagrin. A good motto for the impul- 
 sive young dentist when a seeming affront has 
 been offered him either by a patient or by his 
 professional associates is to " think over night 
 before retaliating." If many a man had waited 
 till the following morning to write a letter in 
 answer to some aggravating communication he 
 would have immeasureably strengthened his case 
 and saved himself subsequent humiliation. 
 
 Strive to be calm under all circumstances. 
 The power to remain calm in the face of great 
 provocation is one of the surest safeguards 
 against mistake, and at once places the indi- 
 vidual at an immense advantage over the man 
 who blusters and fumes. For any man to habit- 
 ually lose his temper is an evidence of weakness, 
 and for a professional man like a dentist to do 
 so is vulgar. It may sometimes be necessary and 
 proper to stamp out a grievous wrong by an ex- 
 pression of righteous indignation, but any pet- 
 tish display of temper is disgusting in the ex- 
 treme and marks the individual who indulges in 
 it as a man unfit to assume professional relation- 
 
32 
 
 SUCCESS IN PRACTICE 
 
 ship with cultivated people. To gain the reputa- 
 tion of being a perfect gentleman at all times is 
 one of the best recommendations a dentist can 
 have to win him a permanent patronage. 
 
 Morals. — In line with this and leading up to 
 it is the question of morals. This book is not 
 written in the spirit of pharisaism, and yet a 
 consideration of success in practice cannot be 
 altogether divorced from the fundamental sub- 
 ject of morality. Leaving out of the question 
 its religious or ethical feature, it still remains a 
 matter of the greatest importance from a purely 
 business point of view that the dentist live an 
 upright, moral life. Laxity in morals has a 
 wider-reaching effect than the average young 
 man is likely to imagine. He cannot help real- 
 izing of course that respectable people do not 
 care to patronize a dentist who is known to be 
 morally bad, and yet he who makes moral lapses 
 often fondly hopes that his escapades are known 
 only to the few associates who take part in them. 
 There never was a greater fallacy than this, for 
 no matter how close the bond of secrecy between 
 such associates may be, the facts invariably leak 
 out somehow, sometime, somewhere. Many a 
 
WINNING PATRONAGE 
 
 33 
 
 young man has irretrievably lost his reputation 
 and his practice as the result of moral delin- 
 quencies without seemingly being able to account 
 for his failure. It is difficult to overestimate 
 the effect of morals on daily life and practice. 
 Even if it were possible to keep the knowledge 
 of immorality from the public, there is irrevoca- 
 bly a concomitant disintegration of character 
 which goes with an immoral life, and which 
 sooner or later undermines a man's success. The 
 young man in his orgies may foolishly hope to 
 extend his acquaintance and gain patronage 
 among those with whom he associates, but even 
 if such people were calculated to make good pa- 
 tients, it is not always certain that they care to 
 patronize a dentist who is lax in his morals. 
 The relation of dentist to patient is of so inti- 
 mate a nature that no ordinary requirements — 
 such as those which pertain to trade — will suf- 
 fice to establish confidence, and very often the 
 people who are glad to be hail-fellow with a den- 
 tist will dispense with his professional services 
 simply because of his hail-fellowship with them. 
 Professional relationship is more intimate 
 and exacting than an ordinary business relation- 
 
 3 
 
34 
 
 SUCCESS IN PRACTICE 
 
 ship. A man may sell goods over a counter and 
 his morals will not be scrutinized so closely as 
 will those of a man who is practising a profes- 
 sion and who comes in closer personal contact 
 with those who patronize him. In any walk of 
 life moral obliquity is a handicap to the pros- 
 pects of the individual, but in professional life 
 it is peculiarly disastrous. People are becoming 
 more discriminating in their selection of profes- 
 sional men. Years ago it mattered not so much 
 if a physician or dentist was known to imbibe 
 too freely at times, in fact it was in many in- 
 stances looked upon as something of a joke. 
 When professional men were scarce and people 
 had little choice it was customary for them to 
 tolerate lapses of this sort, but now conditions 
 are different. There are more physicians and 
 dentists to the population, and people are not 
 obliged to tolerate such things. They are be- 
 coming more intelligent in their estimate of pro- 
 fessional service, and they will not employ men 
 whose brains are befuddled with overindulgence 
 of any sort. A man must have a steady hand to 
 practise dentistry successfully, and this he can- 
 not have if he abuses his health by excesses. 
 
WINNING PATRONx^GE 35 
 
 Nor is the moral code as lax as it formerly 
 was. Men may exclaim about the prevalence 
 of immorality to-day, but the fact is that the 
 exactions in moral rectitude are more closely 
 drawn at the present time than ever before, and 
 this is particularly true of men in professional 
 life. The day has gone forever when mere 
 brilliance of intellect will compensate for moral 
 turpitude. No matter how brilliant a man may 
 be his moral offences are no longer condoned 
 as they once were. And after all, exactions of 
 this kind are only in line with the normal evolu- 
 tion of mankind. Immorality is a retrogression 
 -which saps the foundations of society, and what 
 is true of immorality in general is doubly true 
 of immorality among professional men. 
 
 The simple truth is that a moral life is a more 
 important factor in real success than most people 
 imagine. It is the only certain foundation on 
 which a professional practice can be built, and 
 the sooner a young man comes to a full realiza- 
 tion of this fact the better it will be, not only 
 for his peace of mind, but for his material ad- 
 vancement. Bad habits disintegrate always; 
 good habits invariably build up. And habit is 
 
36 SUCCESS IX PRACTICE 
 
 SO insinuating, so dominating. It is often said, 
 and truly, that bad habits are hard to break; 
 but how many people recognize the significant 
 fact that good habits are equally tenacious ? As 
 the years go on towards maturity and the indi- 
 vidual becomes more and more dominated by 
 habit, it will be found as difficult to give up a 
 good habit as a bad one. This is at the same 
 time a most encouraging fact and a solemn 
 warning. It emphasizes the far-reaching im- 
 portance of establishing good habits in youth 
 when the individual is in the formative period 
 and when the delicate balance between the right 
 road and the wrong one is so easily turned. Let 
 every young man carefully take account of his 
 present status in this matter, and resolve to so 
 place himself in relation to morality and the 
 trend of his habits that his future may be secure 
 in the fulfilment of all that is best and most 
 worth attaining in life. 
 
 Honesty of Purpose. — Another concomitant 
 adjunct to success in practice is the demonstra- 
 tion to the patient of an absolute honesty of pur- 
 pose in everything that is done. A firm convic- 
 tion of what is just and equitable to both patient 
 
WINNING PATRONAGE 37 
 
 and operator should form the basis of every-day 
 practice, and the dentist should early seek to 
 establish confidence among his patients by a rigid 
 adherence to a policy which has for its ground- 
 work the principle of eternal right. If a man has 
 in his very soul the essence of a basic honesty, 
 he does not need to tell his patrons that he is 
 honest. They will know it without the telling. 
 The fact will shine through his every action, 
 and will so illuminate his professional pathway 
 that people will be intuitively drawn to him. 
 When a man once establishes the reputation for 
 rigid honesty he is more than half armed against 
 dissension and misunderstanding. If a differ- 
 ence of opinion arises between a practitioner 
 and his patient, the question as to whether or 
 not the practitioner is really honest is one of the 
 first which enters the mind of the patient. And 
 if the dentist is known to be honest, his con- 
 tention is invariably respected, even though the 
 patient may not agree with him in opinion. 
 
 This matter of honesty relates as much to the 
 details of the work performed, the pains taken 
 with each operation, the character of the opera- 
 tion, the best judgment as to what shall or shall 
 
38 SUCCESS IN PRACTICE 
 
 not be done in a given case, and the advice upon 
 matters with which the patient is not famihar, 
 as it does to questions of finance or the purely 
 business phase of practice. In other words, the 
 dentist should be professionally honest as well 
 as commercially so. 
 
 The mere fact of honesty is an element of im- 
 mense strength to a man in any walk of life. 
 The man who is fundamentally and profoundly 
 honest need not be afraid of any other man or 
 combination of men, and usually he is not. Hon- 
 esty begets confidence, and confidence is the key- 
 note to attainment. Unless a dentist has con- 
 fidence he cannot expect to succeed. It is only 
 through confidence in himself that he can inspire 
 confidence on the part of others, and he should 
 most assiduously cultivate this element in his 
 character. It is hardly necessary to state in this 
 connection that there is a vast distinction be- 
 tween an honest confidence and a vulgar self- 
 conceit, though many a young man would seem 
 to confuse the two. Self-conceit undermines 
 and belittles, confidence builds up and magnifies. 
 Confidence is cumulative, strong, and psychic in 
 its influence, and there is scarcely any other one 
 
WINNING PATRONAGE 
 
 39 
 
 element so potent as this In the successful build- 
 ing of a dental practice. 
 
 Punctuality and System. — The virtue of punc- 
 tuality and system must also be emphasized in 
 considering the requisites necessary for success 
 in professional life. The man who conducts his 
 practice in a hap-hazard way will have hap- 
 hazard results, and such a man w^ill usually be 
 the first to wonder why he does not succeed. 
 There is a reason for everything in this world; 
 and if a man fails in life, there is some reason 
 for it. It is only for the one who fails, to search 
 out the cause of his failure, and then resolutely 
 set himself to work to correct the fault, no 
 matter at what cost of determination and perse- 
 verance. This last statement would seem to im- 
 ply that the causes of a man's failure must neces- 
 sarily be found connected with the man himself, 
 and this is not merely an assumption, but a fun- 
 damental and most profound fact. 
 
 Many a promising dentist has thrown away a 
 rare chance of success by lack of punctuality and 
 system. In this age of intense activity in mate- 
 rial pursuits the value of time becomes an im- 
 portant element in the conduct of one's affairs. 
 
40 SUCCESS IN PRACTICE 
 
 and no patient of any consequence will continue 
 to patronize a dentist who does not economize 
 time by being systematic. If a piece of work 
 is promised at a certain time, the dentist should 
 make it a rule to have it done at that time. The 
 necessity for constantly apologizing on account 
 of lapses in this regard invariably weakens the 
 hold a dentist has on his patients and destroys 
 the confidence they have in his general integrity. 
 There is nothing so demoralizing as to find a 
 man careless of his word or his promise. When 
 an appointment is made with a patient for a cer- 
 tain hour, it should be the aim of the dentist to 
 be ready for the patient at the appointed time if 
 at all possible. Of course in a professional pur- 
 suit where the relief of pain is the paramount 
 duty emergencies will arise which sometimes de- 
 lay the practitioner beyond the time set, but these 
 are only occasional and are easily explained and 
 readily understood by the patient. This ques- 
 tion of appointments will be considered in 
 greater detail in a subsequent chapter. 
 
 Knowledge of Human Nature. — Above all 
 things else, to be a successful dentist a man must 
 be a close student of human nature. I have 
 
WINNING PATRONAGE 4I 
 
 already said that the chief requisite for success in 
 the practice of dentistry is efficiency, — in other 
 words, that to be successful a dentist must be 
 skilful, — and this statement still holds good. But 
 I have also tried to show that there are other 
 requisites aside from mere skill which enter ma- 
 terially into success, and of all of these I know 
 of none more essential than this matter of study- 
 ing the characteristics and temperaments of pa- 
 tients. To be perfectly and completely a master 
 of his environment the dentist should be able to 
 read like an open book every man or woman 
 who comes into his office. And this can be ac- 
 complished by study, — a kind of study which 
 really becomes the most fascinating and most 
 profitable of all pursuits. To do this a dentist 
 must come in contact with people as widely as 
 possible, and he must cultivate to the highest 
 degree the power of observation. No act or 
 movement or impulse of any individual should 
 escape him; and without in the least degree 
 being impertinent or obtrusive he should try to 
 fathom the motive which prompts people to act. 
 This one great fundamental fact of motive is the 
 key which unlocks many a hidden mystery of 
 
42 
 
 SUCCESS IN PRACTICE 
 
 human action and makes clear what would 
 otherwise appear paradoxical in an individual. 
 No two people can be successfully managed by 
 the same methods, and in scarcely any pursuit — 
 with the possible exception of medicine — is the 
 ability to read human nature more important 
 than in dental practice. A quick intuition of the 
 temperament, the whims, the prejudices, the 
 fancies, and the peculiarities of individuals is a 
 wonderful talisman in the management of a 
 practice, and the man who has successfully cul- 
 tivated this has gone much farther than half way 
 towards making his affairs run smoothly and 
 satisfactorily. 
 
 The intimation is not here intended that a 
 dentist should be at all cringing or subservient 
 to the petty caprices or unreasoning domination 
 of those who seek his services, but merely that 
 he should have the tact, based on his knowledge 
 of temperament, to so manage his patients that 
 he can win their confidence and subsequently 
 their full control. You cannot control patients 
 till you have their confidence, and you cannot 
 gain their confidence till you understand them. 
 This study of human nature is most broadening 
 
WINNING PATRONAGE 
 
 43 
 
 in its influence, and it is prolific of great good 
 aside from the mere advantage it presents in a 
 practical way. 
 
 It may not be clear to all as to just what 
 is meant by the suggestion to handle patients 
 differently on the basis of a knowledge of their 
 varying moods and temperaments, but a single 
 illustration will suffice to indicate the meaning. 
 A business-man whose time is valuable, w^ho has 
 vast interests at stake, and who is not much 
 given to speech may apply for an appointment. 
 What that man wants is to have his dental work 
 done in the most expeditious manner and with 
 the fewest possible words. He does not come to 
 the office to visit or gossip. Every unnecessary 
 remark made by the dentist is just so much waste 
 time to him, and he naturally resents personali- 
 ties or trivial talk of any kind. A gentlemanly 
 " Good-morning. Please be seated," and a 
 prompt and business-like approach to the work 
 in hand appeals to him at once. An operation 
 may often be performed for such a man with 
 scarcely a word from beginning to end, — the en- 
 tire attention and energy of the operator being 
 concentrated on the work rather than on any- 
 
44 
 
 SUCCESS IN PRACTICE 
 
 thing of a conversational nature. To a man 
 like this any casual remark — even that connected 
 with the nature of the work being done — is a 
 needless distraction which diverts from the main 
 purpose of the sitting and steals so much of his 
 time. The fewer words the better with such a 
 man, and anything aside from the ordinary cour- 
 tesies of salutation and dismissal is uncalled for. 
 It is all business with him, there is little of the 
 social element in his make-up, and what small 
 percentage there may be does not find the proper 
 environment for its display in a dental office. 
 You can gain that man's respect and favor more 
 by what you leave unsaid than by anything you 
 can say. It is the doing he wants, — the doing 
 promptly and without any fussiness. 
 
 On the other hand, there are some individuals 
 who are so socially inclined that they must talk 
 and be talked to. The dental office is of course 
 not the place for visiting or shop-talk or gossip 
 of any kind. It should not be made the clearing- 
 house of all the petty scandal of the community ; 
 and yet it must not be turned into a monastery 
 or a bear's den. People must be courteously re- 
 ceived, and some of them must be more or less 
 
WINNING PATRONAGE 45 
 
 entertained while there. Certain individuals are 
 so cheery and friendly in temperament that the 
 dentist must himself take on an air of cheeriness 
 and friendliness in dealing with them. To carry 
 an individual of this character through an opera- 
 tion in the same brusque fashion demanded by 
 the reserved business-man just referred to w^ould 
 be simple barbarity. It is necessar}^ with some 
 patients during an operation to make more or 
 less of a running commentary on the work as it 
 is being done. The mere fact of conversation 
 is to them a wonderful relief of tension; and 
 while they may be so situated with appliances in 
 the mouth that they cannot well talk themselves, 
 the carefully modulated and sympathetic voice of 
 the operator encouraging them in trying periods 
 of the work has a sustaining influence which 
 must not be overlooked. 
 
 It should of course ordinarily be the aim of 
 the operator to proceed with his work with as 
 little waste of words as possible, and he should 
 invariably discourage by example too much 
 talking during an operation. The concentra- 
 tion of energy necessary to accomplish the best 
 results — particularly where intricate work is 
 
46 SUCCESS IN PRACTICE 
 
 being done — is always disturbed and the har- 
 mony of results marred by frequent diversions 
 of speech; and yet with patients of the tem- 
 perament just indicated a certain amount of 
 talking is necessary, not only for the pleasure it 
 gives the patient but for its quieting influence 
 during an operation. 
 
 This is only one of many ways in which a 
 quick intuition of temperament may be made to 
 do service in the management of patients. A 
 constant display of tact and delicacy, the ad- 
 vantage to be taken of certain moods and fan- 
 cies, the ability to say the right word at the right 
 time, and particularly to avoid saying the wrong 
 word, all of these embodied in an intricate and 
 intimate knowledge of human nature will at 
 once place the dentist in possession of the power 
 to solve many of the difficult problems to be en- 
 countered in conducting a dental practice. 
 
 Essentials to Success can be Cultivated. — In 
 thus briefly enumerating the various essentials 
 to success it will be noted that the original 
 proposition to the effect that these requisites 
 were for the most part of a character that could 
 be cultivated by persons of average ability still 
 
WINNING PATRONAGE 
 
 47 
 
 holds good. A man cannot necessarily become 
 a successful dentist by merely wishing to be, but 
 he can attain to any of the essentials of success 
 by application. It is the steady, sturdy plodder 
 who wins in the end ; and any young man with 
 a taste for dentistry can assuredly win success 
 if he only applies himself. The best message 
 that can be sent out under this head is sumimed 
 up in the one term — application. Without this 
 no man can succeed in any calling, least of all in 
 dentistry. 
 
Ill 
 
 LOCATION 
 
 The question of selecting a location is an im- 
 portant consideration for a young dentist. The 
 choice between a country town and a large city 
 always comes up for decision, as also does fre- 
 quently the matter of locating in one's native 
 place. Unless the young graduate has had some 
 grounding in the management of the public and 
 has some financial backing, he would probably 
 better locate at first in a smaller place, because 
 of the lesser responsibility and expense and the 
 opportunity it gives him to study his capabilities 
 and learn his limitations in practice. Few young 
 men have an adequate idea of how much they 
 still have to learn after graduating, and this 
 training in the conduct of a country practice will 
 prove of inestimable value, even though they 
 eventually intend to seek a large city. There 
 are very many things to be said in favor of the 
 
 country town as a place of permanent practice, 
 48 
 
LOCATION 4g 
 
 and most of them apply with double force to 
 the young man just starting out. He can more 
 rapidly widen his acquaintance and can come 
 personally into contact with a larger number of 
 prospective patrons than he can hope to do in a 
 city. If his practice falls off at times, he will 
 not be immediately swamped by high rent and 
 other corresponding expenses. 
 
 There are two chief drawbacks to a small 
 place, one of which is really of no consequence, 
 though it usually seems like a mountain to the 
 over-sensitive young man, while the other may 
 be considered a real objection. The first is the 
 element of petty gossip so prevalent in small 
 towns where people meet daily and almost 
 hourly in conversational intercourse, and where 
 the insignificant things of life are threshed over 
 and over in the absence of matters of greater 
 moment. The ancient if not venerable Mrs. 
 Grundy — that past-mistress in the gentle art of 
 annoying people — almost invariably takes up her 
 blessed abode in the environs of a village or 
 smaller town, and usually manages to make it 
 interesting for the young men and maidens of 
 the place. Her especial prey is the new-comer, 
 
 4 
 
50 SUCCESS IN PRACTICE 
 
 and woe betide the sensitive youth who allows 
 himself to be annoyed by her prattle. The ex- 
 tent of injury she is able to work upon him is 
 gauged solely by the nature of his attitude to- 
 wards her. If he is irritated or chagrined or 
 disturbed by her gossip, then he is to that degree 
 injured; but that she can ever do him serious 
 harm aside from this has never yet been demon- 
 strated. One of the first things a young dentist 
 should do in going to a strange town is to re- 
 solve to live an upright, manly life entirely above 
 reproach, and then to pay no attention to the 
 brigade of petty gossip-mongers. If he does this 
 they will soon let him alone. 
 
 The other objection to a small town is the 
 professional isolation. The constant association 
 of men of his own calling is really of the greatest 
 importance to a young man in the development 
 of a well-rounded professional life, and lacking 
 this he is too often inclined to drift away from 
 high professional ideals and to lose the inspira- 
 tion which comes only from contact with the 
 thinking men of his profession. In the city he 
 has the advantage of frequent society meetings, 
 and this is a great source of help to him at a 
 
LOCATION 
 
 51 
 
 critical period of his career. But the country 
 dentist need not by any means be entirely de- 
 prived of professional association. There is 
 always his State society, with possibly others at 
 convenient distance, and then the dental jour- 
 nals, if conscientiously read, will keep him in 
 close touch with the progress of the profession, 
 so that he will not entirely lose the spirit of true 
 professionalism. 
 
 There is one argument in favor of starting in 
 a small town and subsequently moving to a 
 larger place which relates particularly to the 
 probability of numerous mistakes being made 
 by the young practitioner in the early days of 
 his practice. It is difficult for the beginner to 
 avoid making mistakes, many of them of a na- 
 ture that the older practitioner readily escapes; 
 and it is frequently the bitter dregs from this 
 crucible of early experiences which load a young 
 man down and cling to him to his detriment 
 long after he has attained sufficient perfection to 
 avoid making mistakes of a similar nature. This 
 incubus sometimes casts a shadow over his ca- 
 reer in the town where the mistakes were made, 
 and it is frequently a fortunate circumstance 
 
52 SUCCESS IN PRACTICE 
 
 which takes the young man away from such an 
 environment and places him where he can begin 
 life anew, armed with the superior knowledge 
 which his experience has given him. While on 
 general principles it is bad policy to move fre- 
 quently, it may yet be the very best policy to 
 move once and leave mistakes behind. Not that 
 a man will ever get over making mistakes, but 
 that many of those incident to early experience 
 need not be made later on. 
 
 As to a young man locating in a town where 
 he has grown up, the arguments are largely in 
 its disfavor. The just distinction between a 
 harum-scarum boy going to school and a digni- 
 fied professional man conducting a practice is 
 too great to be realized by the average commu- 
 nity as existing in the same individual, and if a 
 young man starts practice in his native place 
 the people are too likely to look upon the newly- 
 fledged dentist as only a very slight remove from 
 the tow-headed boy, and are accordingly slow 
 to admit him to a dignified standing in the com- 
 munity. They find it difficult to leave off calling 
 him '' Jack" or '' Billy" or " Pete," and when it 
 comes to calling him " Doctor" they blush for 
 
LOCATION 53 
 
 his impertinence in assuming such a title. But 
 let this same apparent young upstart go to a 
 strange town, and he gets his title as the natural 
 order of things, and without any hesitation on 
 the part of the people. 
 
 It is true that the mere fact of calling a man 
 " Doctor" does not insure his success in prac- 
 tice; but in order to command proper respect 
 as a professional man the dentist should carry 
 with him a certain degree of dignity which can- 
 not well be attained in the face of too much 
 familiarity. Then again, to begin practice among 
 the people with w^hom one has grown up in- 
 volves a difficulty in maintaining good business 
 relations. There is always the expectancy on 
 the part of those who apply for services that 
 there shall naturally be some favoritism on the 
 ground of old acquaintanceship. It is better to 
 establish a practice among strangers and turn 
 the patients into friends than to begin with 
 friends and attempt to turn them into satisfac- 
 tory patients. 
 
IV 
 
 EXTENDING ACQUAINTANCE 
 
 When a young man locates in a place it be- 
 comes necessary to extend his acquaintance as 
 widely as possible along legitimate lines in order 
 to rapidly gain patronage. If he goes a stranger 
 into a town, or even into a city, it is always de- 
 sirable to take letters of introduction to the influ- 
 ential people of the place. The first move he 
 makes is very important, particularly with regard 
 to the character of the people he meets. He 
 should aim to cultivate good society at the out- 
 set, not necessarily — and often not preferably — 
 the swell set, but people of good moral and busi- 
 ness standing. 
 
 Letters of Introduction. — In presenting a let- 
 ter of introduction the young man should exer- 
 cise great care not to prejudice his case by 
 consuming too much of the recipient's time. 
 Usually men or women worth meeting have 
 many demands on their time, and if a young 
 man approaches such an individual without due 
 54 
 
EXTENDING ACQUAINTANCE 55 
 
 regard for this fact, he is quite Hkely to prove 
 a bore. Let him present his letter in a busi- 
 ness-Hke way, stating that he is desirous of 
 making their acquaintance, but that he does 
 not wish to waste their time. He can readily 
 gather from the nature of the answer he receives 
 just how much leeway he has in this particular, 
 and can govern himself accordingly. Usually 
 people of the right sort are glad to welcome new- 
 comers to a town; and if the young man makes 
 a favorable impression at the outset, it is not a 
 difficult matter to extend his acquaintance. 
 After he has met a dozen people in the place, 
 his success from that time forward depends on 
 himself. He should beware of boasting too much 
 about what he proposes to accomplish in the 
 way of practice, particularly if he goes to a 
 place where there is already a dentist, but he 
 must at all times preserve an air of quiet con- 
 fidence that he will succeed. The unobtrusive 
 self-assurance that he has within him the certain 
 elements of success, the constant conviction that 
 he must win, no matter what obstacles are placed 
 in his path, this of itself is a potent factor in 
 carrying a young man to success. No man ever 
 
56 SUCCESS IN PRACTICE 
 
 yet accomplished great things through the me- 
 dium of despondency. Let the young man place 
 the most promising construction on his prospects, 
 but let him do it in such a way as not to give 
 offence. A vulgar display of conceit always en- 
 genders distrust and reacts against the indi- 
 vidual, but an attitude of calm assurance backed 
 up by steady application creates confidence and 
 more than half wins the battle. 
 
 The First Patient. — The first patient a young 
 man puts in his chair for professional services 
 should mark an event in his life. No matter 
 how humble in position or circumstances this 
 patient may be, the dentist should seek to make 
 a favorable impression. In fact, in the manage- 
 ment of each individual who applies to him the 
 aim should invariably be to so treat the patient 
 that it will result in the sending of other patients. 
 The recommendation of an individual who has 
 been in the hands of a dentist counts for more 
 than any other kind of advertising, and it has the 
 advantage that this is legitimate advertising. 
 Show each patient that you have a vital interest 
 in his or her welfare and that your relationship 
 with the public is different from that of a trades- 
 
EXTENDING ACQUAINTANCE 57 
 
 man. Advise the patient always for what you 
 beheve to be the best, irrespective of your own 
 financial relation to the matter, and when the 
 fact that you do this becomes known, as it surely 
 must, it will prove a strong tie to bind people to 
 you. 
 
 The dentist should early seek to establish a 
 community of interest between the patient and 
 himself, so that their relationship becomes some- 
 thing more than a mere barter of money for 
 professional services. He who develops an 
 abiding friendship between himself and those 
 who come to his office will never lack for 
 patients, and some of the most cherished associa- 
 tions of a lifetime may be made in this way. 
 
 Social Functions. — Extending acquaintance 
 through the medium of social functions is a per- 
 fectly proper thing to do, though the young man 
 should have a care not to deport himself in such 
 a way as to raise the suspicion that he is trying 
 to advertise his profession. In fact, there is 
 nothing more lacking in good form than the 
 habit of talking shop at a social gathering. Aim 
 to be cordial and pleasant with everybody, so 
 that people are attracted to you by virtue of your 
 
58 SUCCESS IN PRACTICE 
 
 personality. There is no other quahty so win- 
 ning in society as that of invariably being a per- 
 fect gentleman, and this is something a young 
 man can acquire by a close study of what is con- 
 sidered good form. The prime requisite for 
 success in society is a never- failing and genuine 
 courtesy. This will win where mere flashiness, 
 either of apparel or wit, will fall short of per- 
 manent success. 
 
 If a young man draws people to him by virtue 
 of his inherent qualities of sturdy manhood and 
 uniform good will in society, they will naturally 
 inquire into his calling, and the next step to that 
 of their patronage is easy. But there is one 
 feature of this that requires careful considera- 
 tion. It is better always that people should not 
 become personally too friendly or familiar with 
 the dentist, for the reason that in the proper 
 conduct of a practice there are always certain 
 requirements which the dentist must demand of 
 the patient and to which the patient if approached 
 on a strictly professional basis will graciously 
 accede, but which if the dentist is a close per- 
 sonal friend will not be so likely to be considered 
 obligatory. In other words, it is more difficult 
 
EXTENDING ACQUAINTANCE 59 
 
 to establish legitimate professional discipline 
 with a friend than with a stranger. The one 
 matter of appointments will serve as an illustra- 
 tion of what is meant. It is necessary for the 
 dentist, in order to profitably occupy his time, to 
 arrange for his work on appointment, and it is 
 to him a question of considerable moment that 
 appointments be kept punctually. With a 
 stranger this is quickly recognized and abided 
 by, but an intimate friend is quite likely to 
 ignore his obligation on the ground of famili- 
 arity and to presume on his friendship w^ith the 
 dentist for all kinds of laxity. As has already 
 been said, it is better to obtain patients among 
 strangers, and then when they have become 
 familiar with the business methods of the dentist 
 they will not depart from those methods and can 
 safely be made into close personal friends. 
 
 The Church. — The church is often used as 
 a means through which to extend acquaintance, 
 and under certain circumstances it is a perfectly 
 legitimate medium. The close personal relation- 
 ship of the members of a church and the fre- 
 quency with which they meet each other all tend 
 to favor the rapid spread of personal acquaint- 
 
6o SUCCESS IN PRACTICE 
 
 anceship, and there is quite naturally a bond of 
 common sympathy arising from mutual aims and 
 interests which links the members together more 
 closely than under ordinary associations of life. 
 To fall in with this in a natural way on the part 
 of a man who is at heart a sincere professor of 
 religion and whose proper place is found in the 
 church is well and good. There can be no criti- 
 cism of this; and if a young man creates ac- 
 quaintance under these conditions he may honor- 
 ably find it of benefit to him in a business way. 
 But there is nothing in all the category of 
 professional meanness which can compare in the 
 slightest degree with an effort to use the church 
 as a medium of securing practice on the part of 
 a man who otherwise has no interest in it. To 
 pose as a church-going man or as one who has 
 religious motives by an individual whose only 
 aim is to further his business ventures is the 
 basest of all perfidy and should entitle him to 
 the hearty contempt of every one. Hypocrisy is 
 bad enough in any relation in life, but hypocrisy 
 which uses the church as a cloak behind which 
 to build up worldly interests is absolutely be- 
 yond the pale of decency or tolerance. Unless 
 
EXTENDING ACQUAINTANCE 6 1 
 
 the young man has religious instincts, or can go 
 to church with pure motives for the purpose of 
 receiving mutual or moral benefit, he would bet- 
 ter stay away; or if he desires to go as a means 
 of social enjoyment, let him at least avoid as- 
 suming a sanctimonius air or taking any promi- 
 nent part in the functions of the church. In 
 other words, let him avoid hypocrisy or deceit. 
 No matter how successful a man may seem to be 
 at this kind of game for a time, his sins will 
 surely find him out, and his ultimate portion 
 will be contempt and distrust on the part of the 
 people. Even if he could succeed in deceiving 
 the people, and thereby secure their patronage, 
 there is always behind every hypocritical act a 
 corresponding disintegration of character in the 
 individual himself which ultimately will under- 
 mine the strongest personality and defeat the 
 shrewdest aims. 
 
 Let the young man be honor-bright in every 
 relation of life, but particularly let him avoid 
 trafficking with things so sacred as the religious 
 convictions of the community in which he lives. 
 I would rather cope with an open-handed devil 
 any time than trust for one moment the fawning 
 
62 SUCCESS IN PRACTICE 
 
 pretence of a sanctimonious hypocrite. Perma- 
 nent success never yet came from following un- 
 worthy methods, and of all of these methods 
 none is more detestable than the one of working 
 the church for professional purposes. 
 
MANAGING PATIENTS 
 
 The Management of Children, — To be suc- 
 cessful in the management of children means a 
 great deal in the maintenance of a satisfactory 
 and permanent practice. The children of to-day 
 make the patients of a few years hence, and if a 
 practitioner has the tact and patience to control 
 children from the time they first come to him 
 till they grow to years of accountability he can 
 then have a class of practice built upon the lines 
 of his own choosing and of a character to har- 
 monize best with his individual preference. 
 There is nothing more interesting in life than to 
 watch the development of a child and study the 
 various manifestations of character-building as 
 exemplified in their attitude towards one with 
 whom they are brought into such close relation- 
 ship as the dentist. Child-study is always in- 
 structive, and it is doubly so when conducted 
 from the point of view of a professional associa- 
 
 63 
 
64 SUCCESS IN PRACTICE 
 
 tion. The dentist should early aim to under- 
 stand his little patients, to gain their confidence 
 and enlist their sympathy with whatever he at- 
 tempts to accomplish for them. If he really 
 loves children and always treats them in a frank 
 and cordial manner, he will in turn receive at 
 their hands a reciprocal attachment which event- 
 ually will prove one of the greatest inspirations 
 to high professional endeavor. The implicit con- 
 fidence of a child is no small thing to attain, and 
 he who has this is not altogether bereft of satis- 
 faction in the conduct of his affairs. 
 
 The first thing a dentist must learn in the 
 management of children is not to deceive 
 them. He should aim to avoid giving pain to 
 a child whenever possible; but if it is found 
 necessary to inflict pain in an operation, the 
 child should never be promised that there will 
 be no pain. The magnitude of the hurt must of 
 course not be exaggerated in advance. In fact, 
 it is best ordinarily to make light of it and place 
 the best possible construction on it. It is usually 
 well to say to the child that the dentist cannot 
 always tell precisely whether an operation will 
 hurt or not, but that if it does hurt a little, the 
 
MANAGING PATIENTS 6$ 
 
 child may be sure that the dentist will be very 
 careful about it and not hurt in the slightest 
 degree more than is necessary. But to promise 
 that it shall not hurt, and thereby gain the little 
 patient's consent to an operation which in the 
 nature of it must give pain, is an abominable 
 subterfuge which reacts on the dentist and raises 
 a suspicion in the child's mind which subsequent 
 years are powerless to efface. Different children 
 require different methods to manage them, and 
 with some especially obstinate and unreasonable 
 children it may at times be necessary to employ 
 force in accomplishing the end, but ordinarily a 
 little tact will win the day. With most children 
 an adroit appeal to their manhood or woman- 
 hood will work marvels. The child-mind is 
 wonderfully susceptible to praise and encour- 
 agement, and a word which touches their pride 
 will go far towards nerving them up to an oper- 
 ation. 
 
 No attitude should ever be taken towards a 
 child except one of extreme kindness. Even if 
 it becomes necessary to coerce a child into an 
 operation, it should be done in the kindliest man- 
 ner, and never with a display of temper; and if 
 
 5 
 
ee SUCCESS IN PRACTICE 
 
 an issue has arisen whereby the child has been 
 compelled to submit against his will, the dentist 
 should take great pains to so soothe his feelings 
 subsequently by a kindly encouraging interest in 
 his welfare that the child will leave the office 
 without harboring any resentment. It is some- 
 times astonishing how a stubborn child will yield 
 to a gentle reasoning and a cordial show of kind- 
 ness immediately following a contention in which 
 the dentist has come out master of the situation. 
 Kindness is very soothing under these circum- 
 stances, and it also proves to the child that, after 
 all, the dentist is a good friend, and if he does 
 hurt, it is only because of necessity and solely 
 for the patient's good. 
 
 But it is best if possible to avoid giving much 
 pain to children. Usually palliative measures 
 are preferable wherever they can be made effec- 
 tive, particularly till the little patient has grown 
 accustomed to coming to the dentist and has 
 been led up by a skilful system of management 
 to the point where a reasonable amount of pain 
 will be tolerated without protest. The first visit 
 of a child to a dental office is usually a mo- 
 mentous occasion, and except under the most 
 
MANAGING PATIENTS 6/ 
 
 urgent necessity no pain should ever be given 
 at this time. The child, if timid, should be 
 entertained by the dentist in such a way that 
 so far as the dentist personally is concerned 
 there is no fear. It is frequently well to make 
 the first examination of the teeth without put- 
 ting the little tot in the dental chair, and if the 
 child is very young, it is usually best to have 
 the mother or nurse hold it in her lap. Then 
 when the first mere glance is had the dentist 
 should say something complimentary either of 
 the teeth or of the patient, and if the child is 
 not too timid he should pat the little round cheek 
 in a friendly way, and the ice is broken once 
 for all so far as that child is concerned. The 
 gentle touch of the human hand has a wonderful 
 effect on a child, and a demonstrated tenderness 
 on the part of the dentist at this first visit influ- 
 ences largely his subsequent success with the 
 little patient. 
 
 It is sometimes marvellous what children will 
 bear in the way of pain without protest if perfect 
 confidence has been established and an appeal is 
 made to their pride. And the first requisite 
 is the establishment of confidence. 
 
es SUCCESS IN PRACTICE 
 
 The teeth of children are often sensitive and 
 unfortunately there are in many instances two 
 serious handicaps under which the dentist must 
 proceed. One is the proverbial dread of the 
 dental chair which has usually been instilled into 
 the mind of the child by foolish tea-table chat 
 at home in which their elders have vied with 
 each other in an attempt to tell the biggest story 
 about the awful things which have happened to 
 them in the dental office. It seems to be a 
 peculiar trait of human nature to wish to pose 
 as a hero, and lacking any other opportunity of 
 displaying heroism most individuals readily fall 
 back on dentistry as a stock topic. From the 
 individual who had a tooth extracted with 
 " four prongs all standing straight out," or 
 " hooked around the jawbone," or having " been 
 pulled all over the office," to the equally luckless 
 mortal who " had a live nerve taken right out 
 without an anaesthetic," they run the gamut of 
 dental adventures to the delectation of their lis- 
 teners and themselves. And the children hear 
 all this, and store it away in their little im- 
 pressionable consciousness till they go to the 
 dentist, and then up looms the vision of all these 
 
MANAGING PATIENTS 
 
 69 
 
 terrible things they have heard, and they intui- 
 tively shrink from the dentist as if he were a 
 goblin made for the especial purpose of devour- 
 ing them. This sort of handicap is sometimes 
 difficult to overcome, but tact, ingenuity and 
 patience will usually accomplish it. 
 
 The other handicap referred to relates to the 
 kind of discipline — or lack of discipline — to 
 which the child is accustomed at home. Un- 
 fortunately many children are allowed to grow 
 up without the slightest conception of responsi- 
 bility or without the development of any stam- 
 ina or moral fiber in their make-up. They 
 have always been allowed to drift along the 
 lines of least resistance, and to escape every issue 
 of a serious or disagreeable lature. They are 
 petted and pampered till they become convinced 
 that the world was made to revolve around them, 
 and that it is their inherent right to have life 
 made easy for them — that in short if anything 
 unpleasant or painful is to happen it must be 
 made to happen to some one else and not to 
 them. It has been the custom of their parents 
 to shield them in every possible way, to remove 
 
JO SUCCESS IN PRACTICE 
 
 the pebbles from their paths and to round off 
 all sharp or irritating corners from the walls 
 along the walks of life. It is a revelation to a 
 child brought up in this way to find that when 
 a sensitive cavity appears in a tooth and the 
 tooth pains as a consequence that the only pos- 
 sible way to have the condition remedied is to 
 allow the dentist to excavate the decay from the 
 cavity and do other disagreeable things, and to 
 do them on the child's own tooth. Here is a 
 case — and it may be the first one the child has 
 ever encountered — where some one else may not 
 accept the hard knocks of fate, and the awaken- 
 ing is sometimes an exceedingly bitter one to the 
 child. Under such circumstances the dentist is 
 likely to be looked upon not only as an ogre but 
 as a malicious enemy, and the handicap of such 
 an impression is not always an easy one to over- 
 come. But there is usually a way — not often 
 twice the same way — by which these unfor- 
 tunate children can be managed, and it is the 
 duty of the practitioner to devote his best ener- 
 gies to the task. 
 
 There is a wondrous mentality wrapped up 
 in a sensitive child, and it should be a sacred 
 
MANAGING PATIENTS 7 1 
 
 trust for those to whom the care of such chil- 
 dren is committed to study carefully the myriad 
 mainsprings of motive behind every act and 
 thereby learn to bring out the best there is in 
 this tiny " bundle of possibilities." 
 
 To the dentist it is given to accomplish great 
 good with such children on account of the close 
 relationship existing between patient and prac- 
 titioner; and no man can make a careful and 
 continued observation of child-life in this con- 
 nection without thereby being made vastly better 
 himself. The results will repay a thousand 
 times for the effort. 
 
 The Management of Nervous Patients. — Next 
 to children, those patients who are nervous or 
 in ill-health require more diplomacy to manage 
 than any other r^-^-^, and no rule or set of rules 
 can be made to apply to all of them. They vary 
 so in their freaks and fancies that it is a matter of 
 constant study to control them, and yet, in view 
 of the fact that they are often in need of dental 
 service, no dentist can ever be in the highest 
 degree successful unless he develops sufficient 
 tact to deal with them. The keynote in their 
 management, the same as with children, is 
 
72 SUCCESS IN PRACTICE 
 
 kindness. Above all things the dentist should 
 cultivate a gentleness of manner and a sym- 
 pathetic, well-modulated tone of voice, which 
 more than anything else will be effective in 
 gaining their confidence. Patience of the most 
 sublime type is also required, and a constant 
 scrutiny of their varying moods so as to be able 
 to adapt one's self to them. On approaching the 
 mouth to do anything for such patients it is 
 essential to practise the utmost delicacy of touch 
 and to avoid if possible giving any pain, par- 
 ticularly in the early stages of the operation. 
 There is one influence of immense advantage to 
 be used in the management of these patients, — 
 viz., encouragement and commendation; To say 
 an encouraging word and to compliment the pa- 
 tient on the manner in which the operation is 
 being endured is frequently a wonderful stimu- 
 lus. But occasionally a case presents in which 
 the patient is more foolish than nervous and 
 where a certain amount of firmness and decision 
 is needed. If an operator continues to allow a 
 patient of this type to impose on him, he not 
 only wastes his time, but even loses the respect 
 of the patient. Every practitioner should make 
 
MANAGING PATIENTS 
 
 73 
 
 a careful study of this type of patient so that he 
 may quickly distinguish between an individual 
 who is really nervous, and who accordingly re- 
 quires and deserves the utmost consideration, 
 and one who is simply irresponsible and whimsi- 
 cal. This latter class can usually be detected by 
 a little artifice on the part of the operator. If 
 there is a suspicion in his mind that the patient 
 is feigning distress in an operation where there 
 is no occasion for it, by flinching and otherwise 
 acting badly, he can test the matter very readily 
 by merely placing an excavator or other instru- 
 ment with some pressure against a sound part of 
 the tooth where he knows there is no possible 
 chance of causing any pain. It will frequently. 
 be found with this type of patient that there wii 
 be the same flinching and the same protestations 
 of pain as if a sensitive part of the cavity had 
 actually been touched. It has merely become a 
 fixed habit with the patient to protest, and such 
 persons seem never to feel quite satisfied unless 
 they are discommoding the operator in every 
 conceivable way. This sort of trifling with an 
 operator's time and patience should not be toler- 
 ated in the slightest degree, and when the im- 
 
74 
 
 SUCCESS IN PRACTICE 
 
 position is once discovered the patient should be 
 given to understand most emphatically that the 
 operator has some rights in the case and that 
 he proposes to enforce them. It may at times 
 even be necessary to be somewhat severe with 
 such patients; but the dentist should never be 
 ungentlemanly in any instance, and wherever 
 severity is used it should invariably be tempered 
 by a subsequent kindliness of manner which 
 proves to the patient before the sitting is over 
 that the dentist is not pettish or vindictive and 
 that he does not give way to severity through 
 any display of temper. Above all things the 
 patient should be dismissed from the office carry- 
 ^^ing away an impression that the dentist is master 
 ^^Df the situation, but that he dispenses his mastery 
 with the utmost kindness. A dentist owes it to 
 himself, to his patients, and particularly to his 
 profession that he maintains the reputation of 
 being at all times a high-minded gentleman, and 
 in no instance of his professional relationship is 
 this of greater moment than in his dealing with 
 the class of patients under consideration. 
 
 It is often possible by the exhibition of a little 
 tact and judgment to so control some of these 
 
MANAGING PATIENTS 75 
 
 irresponsible individuals that a permanent im- 
 pression is made upon them to the betterment of 
 their disposition, and a dentist's influence for 
 good may thereby be widened far beyond the 
 mere service he performs upon the teeth. A 
 man in any walk of life should have the broadest 
 possible conception of his duty to his fellow-man, 
 and in the practice of a profession this duty is 
 particularly obligatory; so that a dentist should 
 never be content with the mere performance of 
 his technical operations without a wider interest 
 in his patient's general welfare. This does not 
 imply that a dentist should ever go out of his 
 way to pry into matters that are none of his 
 affair. A gossipy, inquisitive dentist is an abomi- 
 nation in the sight of intelligent people, and, 
 aside from its impertinence, such a course is espe- 
 cially prejudicial to his success. But he can take 
 an active interest in his patient and can often 
 find opportunities for a genuine service in char- 
 acter-building — particularly with children and 
 nervous, irresponsible individuals — without in 
 the slightest degree intruding beyond the limits 
 of propriety or in any way compromising him- 
 self. 
 
76 SUCCESS IN PRACTICE 
 
 The Management of Patients in General. — As 
 has already been intimated, no dentist can expect 
 to be successful unless he first learns how to 
 manage the different types of people who come 
 to him, A dentist should be able to read char- 
 acter in the face of every individual and to know 
 how to approach each different class the moment 
 they appear. Not that he should constantly sink 
 his own individuality into that of others, but that 
 he may so control the individualities of those who 
 come under his ministrations that he can make 
 his practice run along smoothly and without the 
 friction which often mars the career of the most 
 promising practitioner. Enough has already 
 been said along this line, but its importance can- 
 not be too strongly urged nor too often repeated. 
 
VI 
 
 RECORDS AND BOOK-KEEPING 
 
 In approaching this part of the subject the 
 author reaHzes that he is assuming a herculean 
 task in attempting to convince the dental profes- 
 sion of the necessity for keeping acurate records 
 and for establishing and maintaining a business- 
 like method of book-keeping. It has long be- 
 come proverbial that the average dentist is 
 notoriously careless when it comes to matters of 
 record, and so far as his accounts are concerned 
 it would tax more than the genius of an expert 
 book-keeper to unravel them and make them in- 
 telligible to an ordinary business-man. 
 
 The necessity for keeping records relates not 
 only to the business aspect of the case but to the 
 professional as well. No man can gain the 
 greatest possible benefit from his experience in 
 practice without having records of his work for 
 ready reference as a basis to guide him in future. 
 It is only by this means that he can form an 
 
 77 
 
78 SUCCESS IN PRACTICE 
 
 adequate idea as to the relative value in his hands 
 of the different methods of practice. He may 
 read in the journals and text-books of the char- 
 acteristics of the various materials used for filling 
 teeth, but not till he has demonstrated in his 
 own practice the relative permanence of each 
 material is he in a position to properly judge as 
 to v^hich material is the one for him to use in a 
 given case. He may see in our literature various 
 methods of practice advocated, and he may form 
 an opinion as to which method he should follow, 
 but until he has made a practical test and ob- 
 served the results he is not qualified to properly 
 discriminate in favor of one method as against 
 another. 
 
 And the only way to judge of the value of 
 materials or methods is through the medium of 
 records carefully preserved. If an operator has 
 a record of each operation, with the date, the 
 kind of material used, and other particulars, he 
 can at once refer to the history of a given piece 
 of work when he sees it and be able to form 
 an opinion as to the virtue of that method of 
 practice. 
 
 The clinical value of a well-kept record be- 
 
RECORDS AND BOOK-KEEPING 
 
 79 
 
 comes inestimable as the years go on, and it may 
 eventually be turned to the advantage of the 
 profession at large as well as to the individual 
 himself by a publication of the data furnished 
 by it upon any given subject. It is therefore a 
 duty which each man owes the profession to so 
 record his work that the sum total of the knowl- 
 edge gained thereby shall be added to the infor- 
 mation already extant upon the subject, to the 
 end that the greatest progress possible be made 
 by the profession as a body. 
 
 But even if the professional phase of the ques- 
 tion does not appeal to a man, there is still an 
 argument which should move every practitioner 
 not to think lightly upon so important a precau- 
 tion from a business point of view. This relates 
 to his protection from imposition on the part of 
 patients concerning the permanence or otherwise 
 of the work which he has done for them. It is 
 manifestly out of the question for a dentist to 
 remember the facts about each filling he inserts, 
 the kind of material, the date upon which it was 
 inserted, or other particulars of the operation; 
 and if he makes a practice of merely charging 
 for an operation without keeping a special record 
 
8o SUCCESS IN PRACTICE 
 
 of it he is at the mercy of the patient so far as 
 concerns its length of service. Patients are 
 much inchned to misrepresent an operator in this 
 particular, sometimes innocently and sometimes 
 wilfully. 
 
 If a filling, for instance, is lost from a cavity 
 anywhere in the mouth it is quite the habit for 
 persons to jump to the conclusion that it was in- 
 serted by the operator who last worked for 
 them, and he frequently gets the reputation of 
 having done a faulty piece of work unless he can 
 prove otherwise. It is often the case that a 
 patient suddenly finds a cavity in a region of 
 the mouth where within a year there has been a 
 filling inserted, and the natural inference is that 
 the filling has fallen out. Cases of this kind 
 often occur where the enamel suddenly breaks 
 in over a carious place and makes manifest a 
 large cavity which previously had been hidden 
 from the patient, and in the assertion that a fill- 
 ing has been lost a patient may be perfectly 
 innocent. Then again it is an unfortunate fact 
 that there are some individuals who do not hesi- 
 tate to charge a dentist with the loss of a filling 
 when they know he is blameless, as a subterfuge 
 
RECORDS AND BOOK-KEEPING 8 1 
 
 to gain favoritism in its reinsertion. There are 
 numberless abuses of this character which assail 
 a busy practitioner, and his only safeguard is a 
 system of well-kept records. When it becomes 
 prominently known that he records every opera- 
 tion, patients will be more careful about at- 
 tributing failures to him until they are certain 
 of their ground; and in the event of an honest 
 difference of opinion in regard to the character 
 of an operation or the length of service it has 
 given, the matter can readily be cleared up to 
 the satisfaction of all concerned by a reference to 
 the records. Not only this, but the fact that a 
 dentist keeps records of his operations at once 
 establishes confidence on the part of patients. 
 They are impressed with the fact that he is will- 
 ing to stand by his work and abide the conse- 
 quences, and they come to him with all the 
 greater assurance that he is a responsible party. 
 In fact, the most desirable class of patients are 
 so fast becoming educated to the idea of having 
 records kept that they are naturally suspicious 
 of the operator who fails in this important par- 
 ticular; and if a dentist were unable to show 
 
 such a patient a diagram of the work done he 
 
 6 
 
82 SUCCESS IN PRACTICE 
 
 would at once lose caste so far as that patient 
 was concerned. 
 
 It is an immense satisfaction after many years 
 of practice in one locality for the operator to be 
 able to refer to the records of operations per- 
 formed for his long-standing patients, and note 
 the tenure of service performed by some of his 
 painstaking operations. It is almost invariably 
 the case that patients err somewhat in their esti- 
 mate as to the length of time a given operation 
 has stood. No matter how vividly they may 
 remember the circumstances of an operation, they 
 are inclined as the years go by to place the 
 time of its performance at a period more recent 
 than is actually the case, and this occurs with 
 the most conscientious patients. It is only in 
 line with the universal fact of the rapid flight of 
 time and is no reflection on their veracity. But 
 it is sometimes a great satisfaction for the den- 
 tist to be able to turn to his records and establish 
 the precise date for the patient. They are thereby 
 frequently impressed with the value of dental 
 service in a way that nothing else could accom- 
 plish, and are at once placed in a more apprecia- 
 tive mood towards future efforts on the part of 
 
RECORDS AND BOOK-KEEPING 83 
 
 the practitioner. They are also more willing to 
 adequately remunerate the dentist for his work. 
 
 A case in point may be related as typical of 
 many similar ones which arise in the experience 
 of every practitioner of long standing. A patient 
 one day pointed to a gold crown on a lower 
 molar and remarked that it was the best tooth 
 he had. The dentist asked him how long it had 
 been in use. He thought a moment, and said: 
 '' It must have been put on nine or ten years 
 ago." 
 
 The operator consulted his records, and found 
 that the crown had been placed there fifteen years 
 before; and when the patient heard this he ex- 
 pressed surprise, and asked : " How much did 
 you charge me for that crown ?'* 
 
 " Twenty dollars." 
 
 " Well, it has paid for itself many times over. 
 What a pity my teeth were not properly attended 
 to when I was younger." 
 
 A father with sentiments like these is not likely 
 to allow his children's teeth to go neglected, and 
 the aggregate of impressions made upon the 
 people in this way will go farther than anything 
 else towards developing a proper regard for the 
 
84 SUCCESS IN PRACTICE 
 
 value of dental service and a desire to have it 
 attended to early in life. Without a record and 
 a diagram properly marked it would have been 
 difficult to convince this gentleman that his 
 crown had done service so many years, but with 
 the record there was no longer any doubt. 
 
 One of the most important considerations 
 connected with record-keeping by the dentist re- 
 lates to the identification of the dead. It some- 
 times happens in criminal cases, and in the event 
 of a great disaster, such, for instance, as the 
 burning of the bazaar in Paris and the Iroquois 
 fire in Chicago, that bodies are disfigured beyond 
 recognition by any ordinary means. The effect 
 of fire, or a long period of decomposition such 
 as is found in some murder cases, may obliter- 
 ate completely the usual marks of identification. 
 It is well known that the teeth are the last 
 structures of the body to undergo disintegration 
 after death, and thus the records of dental oper- 
 ations are more permanent and reliable than any 
 other. It was by this means that identification 
 was established in doubtful cases following the 
 Paris disaster, and it has been instrumental in 
 clearing up many an otherwise unsolved prob- 
 
RECORDS AND BOOK-KEEPING 85 
 
 lem in criminal history. A body was found in 
 one of our Western States decomposed beyond 
 recognition. The authorities tried every means 
 of identification but without avail, till they hit 
 on the idea of examining the mouth. A chart 
 was prepared of the dental work done on the 
 teeth, and this was published in leading dental 
 journals, through which medium identification 
 was established by the dentist who had done 
 the work. Criminologists and detectives are 
 becoming more and more impressed with the 
 reliability of dental records and are frequently 
 appealing to dentists for aid in clearing up 
 doubtful cases. In the light of present-day 
 knowledge on the subject it would be a serious 
 reflection on a dentist if his services were sought 
 in one of these cases and it was found that he 
 did not keep records. 
 
 Another important advantage of having 
 records relates to the rendering of accounts, a 
 matter which will receive more detailed con- 
 sideration further on. In fact, no dentist can 
 hope to keep his affairs in systematic or satis- 
 factory order w^ho fails to make and preserve 
 accurate records of all his work. 
 
86 SUCCESS IN PRACTICE 
 
 Methods of keeping Records and Accounts. — 
 There are two principal methods of keeping ac- 
 counts and two of making records. Accounts 
 may be kept by means of the index-card system 
 or by books in the usual way. Some operators 
 prefer the card system as being best adapted to 
 their use, while others favor books, and each 
 operator should examine both systems and select 
 that which most appeals to him. There is this 
 to be said in favor of books, that in many years 
 of practice the bulk of cards which accumulate 
 where records are preserved as they should be 
 is as much greater than books as the cards are 
 thicker than paper, and an operator can therefore 
 keep preserved between the covers of the book 
 a larger number of records and accounts in given 
 bulk than he could of cards stored away in boxes. 
 The card system may in some cases appeal to 
 beginners on account of a few favorable features, 
 but with men in practice who have already a 
 large number of records in book form it can 
 hardly be expected that they will change their 
 system for something so radically different. 
 
 As to the manner of making records of opera- 
 tions there are, as has been said, two plans, — 
 
RECORDS AND BOOK-KEEPING Sy 
 
 one by means of a code and the other by a dia- 
 gram. The code system is descriptive, while the 
 diagram is illustrative. To use the code method 
 the operator must employ to a large degree the 
 first letter of a word in lieu of the word itself. 
 For instance, if he has inserted a filling in the 
 disto-occlusal surface of a bicuspid, instead of 
 writing " disto-occlusal," he merely writes 
 " d-o," and this kind of abreviation is carried on 
 throughout the system. By this method no dia- 
 gram is used; and while with some who have 
 studied the matter closely and have used it for 
 some time in practice there may be a fair degree 
 of accuracy about it, yet to the mind of the 
 author it cannot compare in several important 
 particulars with the diagram method. In the 
 first place, to trace a certain filling from the 
 mouth to the date on the ledger or record book 
 one might at times be obliged to go through the 
 entire record before coming across this particular 
 filling, while with a diagram a mere glance at the 
 tooth in the record book with its accompanying 
 number will tell the whole story at once. Then 
 again a code system is never quite so impressive 
 to patients, and, short of a great deal of unneces- 
 
88 SUCCESS IN PRACTICE 
 
 sary explanation, cannot be made sufficiently in- 
 telligible to appeal to them ; but a diagram, wjth 
 the teeth clearly outlined and a filling in a 
 given position on any tooth plainly marked, in- 
 stantly conveys its own description and can be 
 readily understood. For these reasons, and for 
 others which will become apparent later on, the 
 diagram method should be adopted for general 
 use. 
 
 Examination of the Teeth. — When a patient 
 applies for dental service and requests an exami- 
 nation of the teeth, the examination-blanks put 
 up in pads by the dealers with a diagram of the 
 teeth upon them should be used for recording 
 cavities in the presence of the patient. It is 
 seldom that patients have any idea of the number 
 of cavities they have in their teeth, and it is 
 always best to impress them with the precise con- 
 dition of affairs at the outset, so that there can 
 be no subsequent misunderstanding about the 
 amount of work to be done. The surest way to 
 do this is to place the examination-pad upon the 
 operating-table in front of the patient, and, as 
 the examination goes on, record each cavity with 
 a pencil on the exact region of the tooth where 
 
RECORDS AND BOOK-KEEPING 89 
 
 the cavity occurs, and draw a line out from the 
 cavity towards the margin of the examination- 
 sHp. These Hnes radiating out from the cavities 
 serve a useful purpose in several ways. They 
 can be numbered to indicate the cavity instead 
 of attempting to place the number near the 
 cavity and thus blur the diagram of the tooth, 
 and besides they prove an eloquent reminder to 
 the patient as to the number of cavities present 
 in the mouth. If, when the examination is com- 
 pleted and the cavities recorded, the patient does 
 not seem to be sufficiently impressed with the 
 extent of the work to be done, and it is thought 
 advisable to call attention to it, a very neat way 
 of doing so is to merely count the cavities on the 
 examination-slip and to check them off in the 
 presence of the patient. This will instantly im- 
 press the matter upon the patient's notice, so that 
 there can be no possible chance of misconception. 
 When the examination is completed and an 
 appointment made, the slip should be placed on 
 a hook provided for this purpose convenient to 
 the operating-case, and every morning before 
 office hours the appointment-book should be ex- 
 amined and the slips for the patients who have 
 
90 
 
 SUCCESS IN PRACTICE 
 
 appointments for that day should be placed in 
 regular rotation on top of all other slips, so as 
 to be convenient. When a patient takes the 
 chair, a mere glance at the slip shows what is 
 to be done, and this does away with the neces- 
 sity of examining the teeth each time the patient 
 comes. When a tooth is filled, an indication of 
 this fact with the kind of material used is made 
 on the examination-slip, as will be illustrated 
 later, and the slip laid aside till the day's work 
 is done. At the end of the day the operator can 
 take the slips for that day and transfer with ink 
 the records to the diagrams in the ledger, and 
 make the charges. As he does this he can cancel 
 the fillings thus recorded on the examination- 
 slips, so that a glance will show which cavities 
 have been filled and which not. The slips are 
 then hung on the hook again ready for the next 
 appearance of the patient. If an operator em- 
 ploys an assistant, as all operators should, this 
 clerical work can be relegated to the assistant, 
 and all the record-making that the operator need 
 to do is to mark the cavities in pencil on the 
 examination-slip as he looks over the mouth for 
 the first time. 
 
RECORDS AND BOOK-KEEPING 
 
 91 
 
 To illustrate the working of the system the 
 following examination-slip may be taken as typi- 
 cal: 
 igo Pa 
 
 fones 
 
 A^ 8 J Blank Street 
 Tf^ First National Bank 
 
92 
 
 SUCCESS IN PRACTICE 
 
 This slip in its present condition shows that 
 the left lower second molar has been filled Vx^ith 
 amalgam and that the roots have also been filled 
 as indicated by the small mark to the lingual. 
 The cross over the filling cancels the record and 
 shows that it has been transferred to the ledger. 
 The upper right second bicuspid has been filled 
 with gold and the record transferred to the 
 ledger. The distal surface of the upper left cus- 
 pid and the occlusal surface of the lower left first 
 permanent molar have been filled with gold but 
 have not yet been recorded in the ledger. All 
 the other cavities are still unfilled. The cancel- 
 mark being made with ink over the pencil cavity- 
 mark, shows very plainly, and the merest glance 
 at the slip indicates instantly the progress of the 
 work in that mouth. 
 
 The Ledger. — This patient's page in the 
 ledger at this stage would appear as shown in 
 the accompanying diagram. ( Fernandez ledger. ) 
 
 This would mean that on October 3 the teeth 
 had been cleaned and a treatment made, con- 
 suming three-quarters of an hour, and for which 
 a charge of seven dollars was made. It is always 
 well, whether the dentist charges by the opera- 
 
RECORDS AND BOOK-KEEPING 
 
 93 
 
 tion or by the hour, to indicate the length of time 
 spent in such work as cleaning or treating, in 
 case of any question arising regarding fees. 
 People in general have not yet been sufficiently 
 educated to a just appreciation of the effort in- 
 volved in cleaning and treating teeth, and they 
 are inclined to look upon it as a trifling service. 
 A filling is something tangible to them, and they 
 are willing to pay for it, but an adequate charge 
 for cleaning or treating is sometimes resented 
 unless the dentist can show them the actual time 
 spent in such work. On October 6 a gold filling 
 was inserted and a treatment made, — fee twelve 
 dollars. The number in the third column of the 
 ledger corresponding with the number on the 
 diagram shows the precise filling which was in- 
 serted on that date. On this same day the patient 
 paid ten dollars on account, which is duly entered 
 in the credit column. On October 13 the roots 
 of the lower molar were filled and amalgam in- 
 serted in the cavity, — fee seven dollars. 
 
 Thus the record and account may be carried 
 on down till the work is finished, and w^hen more 
 work is done for the patient at a subsequent date 
 it is entered on this same page and the record 
 
94 
 
 SUCCESS IN PRACTICE 
 
 of the mouth kept complete in one place, to be 
 referred to at a moment's notice. There is 
 always room at the margin of the diagram or at 
 the foot of the account column to record any- 
 thing special about a given tooth, so that the 
 entire history of the mouth may be kept in the 
 most compact and convenient manner. By the 
 use of abbreviations to indicate operations and 
 fillings as here illustrated it is possible to con- 
 dense a vast number of records and a very exten- 
 sive series of accounts in one book, thus giving 
 a ready reference under one cover for a great 
 many patients. 
 
 Mailing-Sheets. — To facilitate the monthly 
 rendering of accounts it is necessary to have some 
 plan whereby the operator or his book-keeper is 
 not obliged to go through the entire ledger or 
 series of ledgers each month in search of unpaid 
 accounts. This is readily managed by having 
 ruled mailing-sheets printed, as shown on 
 page 95. 
 
 These sheets should be about eight by eleven 
 inches in size ; and when a patient's work is com- 
 pleted and the last entry made in the ledger, 
 the book-keeper should place the name on this 
 
RECORDS AND BOOK-KEEPING 
 
 95 
 
 
 5! 
 
 > 
 
 
 > 
 
 
 
 w 
 
 en 
 
 U5 
 
 
 > 
 
 s 
 s .^ 
 
 > 
 
 H 
 W 
 
 > 
 
 D 
 
 W 
 
 n 
 
 t 
 
 > 
 
 
 
 c 
 
 H 
 
96 SUCCESS IN PRACTICE 
 
 sheet, with the address, page of the ledger ac- 
 count, date of the work, etc., as indicated, and 
 from this the accounts may be made out each 
 month and mailed. By this means not only is 
 the mailing of accounts rendered very easy, but 
 the operator has at all times a list of outstanding 
 bills gathered together in the most compact form. 
 These sheets may be conveniently slipped into 
 the front or back of the ledger for the most ready 
 reference, and it is usually well every six months 
 to go through the ledger to see that all outstand- 
 ing accounts are recorded on the sheets. When 
 an account is paid, a line should be drawn 
 through it to cancel it, in addition to crediting it 
 in the ledger. 
 
 The Day-Book. — In order to keep informed 
 on the amount of charges and cash for each day 
 it is necessary to have a book ruled somewhat in 
 the manner shown on page 97. 
 
 This would indicate that on November 3, 
 1902, Mr. G. H. Brownmier had ten dollars 
 worth of work done ; that Mrs. E. X. Zane had 
 eight dollars charged, and paid five dollars on 
 account ; and that Mr. O. V. Blank made a pay- 
 ment of twelve dollars on a previous account. 
 
RECORDS AND BOOK-KEEPING 
 
 November, igo2 
 
 97 
 
 CEAEGES CASH 
 
 G. H, Brownmier 
 Mrs. E. X. Zane 
 O. V. Blank 
 
 $io 
 
 8 
 
 $5 
 
 12 
 
 The columns of charges and cash may be footed 
 up and carried forward from page to page till 
 the end of the month, when the sum total of each 
 may be reckoned, and the dentist knows at once 
 how much work he has done and the amount of 
 cash taken in during the month. 
 
 At the end of this day-book a page may be 
 ruled off in such a way as to record the monthly 
 charges and receipts, from which by the mere 
 
98 
 
 SUCCESS IN PRACTICE 
 
 adding up of a column may be estimated the 
 yearly statement : 
 
 1902 
 
 CHARGES 
 
 CASH 
 
 1903 
 
 CHARGES 
 
 CASH 
 
 Jan 
 
 Feb 
 
 March . . . 
 
 April 
 
 May 
 
 June 
 
 July 
 
 August . . 
 
 Sept 
 
 Oct 
 
 Nov 
 
 Dec 
 
 $1,184 
 
 1,033 
 
 1,345 
 
 1,405 
 
 983 
 
 1,534 
 1,213 
 750 
 1,079 
 1,428 
 1,346 
 1,106 
 
 $1,296 
 
 948 
 
 1,298 
 
 1,501 
 
 1,047 
 
 1,318 
 
 1,108 
 
 914 
 
 836 
 
 1,309 
 1,401 
 
 983 
 
 
 
 
 Total.. 
 
 $14,406 
 
 ^13,959 
 
 
 
 
 By this method a glance will show the amount 
 of work done and cash collected in a given month 
 or a given year, and the plan is very simple and 
 not at all cumbersome in its practical application. 
 
 The system of records and book-keeping herein 
 outlined is not submitted as being ideal or suited 
 to the needs of every practitioner, but that it is 
 a very effective system has been amply proved 
 
RECORDS AND BOOK-KEEPING 99 
 
 by many years' test, and the more the records 
 accumulate and the accounts extend the more 
 effective does it seem to become. Through this 
 agency the operator may almost instantly refer 
 to the diagram record of any mouth, he may 
 know at once how a certain account stands, he 
 can have his bills mailed each month from a 
 convenient list, and he can determine at a mo- 
 ment's notice the exact amount of w^ork and the 
 cash receipts of any given day, month, or year. 
 
 Whether this particular method is used or 
 some other plan more suited to the individual 
 operator, the plea is once again very strongly 
 urged to establish a system of record-making and 
 book-keeping whereby the business interests and 
 professional status of the profession shall be 
 maintained in the highest possible degree of 
 excellence and precision. 
 
VII 
 
 APPOINTMENTS AND SITTINGS 
 
 In such work as dentistry it is usually neces- 
 sary that it be done for the most part on appoint- 
 ment. Of course exigencies arise in every prac- 
 tice which demand immediate attention, but for 
 extended operations the only satisfactory way is 
 to arrange for them in advance. In view of the 
 fact that the dentist's time is his capital, he 
 should early seek to establish among his patients 
 a just appreciation of the necessity for punc- 
 tuality, and in order to do this he must always 
 aim to be punctual himself. There must of 
 course be a little latitude for emergencies on the 
 part of both operator and patient, and this should 
 be taken good-humoredly, but the general rule 
 should obtain that when an appointment is made 
 it shall be kept promptly on both sides. 
 
 Broken Appointments. — There should be an 
 understanding with the patients that when an 
 appointment is not kept there shall be a just 
 
 ICX) 
 
APPOINTMENTS AND SITTINGS loi 
 
 remuneration for loss of time unless the dentist 
 receives sufficient notice to fill the time with 
 another patient. To justify himself in making* 
 such a charge he should have a notice on his 
 appointment-cards to the effect that the time 
 appointed is reserved for the patient and that a 
 failure to keep the appointment will necessitate 
 a charge for loss of time unless a reasonable 
 notice is given. Every patient who makes an 
 appointment should receive a card with the day 
 and hour plainly marked on it, to avoid mistakes 
 through misunderstanding or forgetfulness. If 
 an appointment is made by telephone, it is usually 
 best to mail an appointment-card or request the 
 patient to make a note of it at the time the 
 appointment is made. 
 
 Examination Notices. — Connected with the 
 appointment system there is a certain feature in 
 vogue in the better offices which should be more 
 generally introduced than it is. This relates to 
 a system of notification whereby patients are 
 reminded at stated intervals by the dentist that 
 their teeth should be examined and an appoint- 
 ment arranged for that purpose. With patients 
 who are extensively occupied with other affairs 
 
102 SUCCESS IN PRACTICE 
 
 — as most patients are — the time is too often 
 allowed to slip by till the teeth are suffering 
 through neglect, sometimes to the extent of irrep- 
 arable damage. If there is a mutual under- 
 standing between patient and dentist, the matter 
 may be so arranged that a memorandum is made 
 in the appointment-book, and the patient notified 
 at the proper time to appear for examination. 
 Most patients if intelligent are very appreciative 
 of this service, and the arrangement is exceed- 
 ingly satisfactory to all parties concerned. It 
 relieves the patient of the responsibility of re- 
 membering that his teeth may need attention and 
 assures him that they will not be neglected, while 
 it enables the dentist to keep better control of the 
 teeth and to avoid annoying complications 
 through deferring operations too long. 
 
 A propitious time to broach this plan to the 
 patient is at the conclusion of a series of sittings 
 which have been made more taxing and pro- 
 longed on account of previous neglect, when the 
 patient is usually in a mood to gladly welcome 
 such an arrangement. Of course in no instance 
 should such a notice be sent to a patient without 
 a previous understanding in the matter, lest there 
 
APPOINTMENTS AND SITTINGS 103 
 
 arise a suspicion in the mind of the patient that 
 the dentist is soliciting patronage. To prove to 
 patients that it is the regular custom of the prac- 
 titioner to send these notices, it is well to have 
 notification-cards printed ready for mailing at 
 the appointed time. These cards may read some- 
 thing like this : 
 
 " In accordance with your request of (naming 
 the date of last sitting) I beg leave to remind 
 you that your teeth should be examined at this 
 time." 
 
 Or, if the patient prefers, the notification may 
 be made by telephone. 
 
 This plan carried out extensively in one's prac- 
 tice insures good attention to the teeth and 
 enables the operator to systematize his work and 
 utilize his time to the best advantage. 
 
 Length of Sittings. — There is a great variation 
 among practitioners in regard to the number 
 of appointments they make in a day, and every 
 man must arrange his sittings according to the 
 plan which appeals most to him ; but in a general 
 way operators should avoid giving long sittings 
 whenever possible. There are several reasons 
 why short sittings are most desirable. To keep 
 
104 
 
 SUCCESS IN PRACTICE 
 
 a patient too long in the chair is to run the risk 
 of nervous strain, and in fact the fortitude of 
 many a patient has in this way been broken so 
 as to engender a vivid dread of dental operations 
 ever after. In the highly nervous organisms 
 with which we are called upon to deal in these 
 days of stress it is taking serious chances to 
 detain a patient under a dental operation for 
 three or four hours at a time, as is sometimes 
 done. It is also a severe tax on the dentist to 
 operate for one individual so long. A change 
 from one patient to another breaks the monot- 
 ony of operations and proves a rest. Then 
 again where long appointments are arranged 
 with patients it is a more serious matter to have 
 an appointment broken, and entails a greater loss 
 either on patient or operator, than where short 
 sittings are made. Another minor considera- 
 tion relates to the impression on the patient as 
 regards the size of the bill. To many individuals 
 a sitting is a sitting and they make little dis- 
 crimination between one of two hours and one 
 of three hours, while the difference to the dentist 
 is quite appreciable. Usually a patient will more 
 cheerfully pay a reasonable fee for eight sittings 
 
APPOINTMENTS AND SITTINGS 105 
 
 of one hour each than for two sittings of four 
 hours each. 
 
 Under ordinary circumstances it is never well 
 to give a longer sitting than two hours, and with 
 most of our operations one hour is ample. Of 
 course the operator should never crowed his ap- 
 pointments to the extent of interfering with 
 perfect service, but the tendency of the day 
 should be towards short sittings rather than long 
 ones. 
 
VIII 
 
 GIVING CREDIT, COLLECTING ACCOUNTS. PAYING 
 
 BILLS 
 
 The evil of long credits is one of the greatest 
 abominations attaching either to the professions 
 or to trade, and yet with the established customs 
 of the day it seems necessary for the dentist to 
 occasionally extend credit to his patients. The 
 nature of the work is such that to give a bill at 
 each sitting is burdensome, and in many in- 
 stances with certain patients of the very highest 
 class it would be embarrassing, so that short 
 credits at least seem inevitable. This of itself 
 would not constitute a serious evil if these same 
 short credits did not too often become long ones. 
 Lengthy credits are wrong in principle and ex- 
 asperating in practice, and the dentist should 
 so conduct his affairs that it soon becomes mani- 
 fest to his patients that he is opposed to giving 
 unlimited credit. 
 
 There are two phases of the question for the 
 io6 
 
COLLECTING ACCOUNTS, ETC. 107 
 
 young practitioner to consider, — the persons to 
 whom credit shall or shall not be given, and the 
 length of time that shall be extended to those to 
 whom it is deemed advisable to give credit. 
 When new patients apply to the dentist for his 
 services it is usually customary for them to men- 
 tion the name of the person who has referred 
 them. If a stranger asks to have work done 
 without some reference of this kind, it is best for 
 the dentist to adroitly bring up the subject in 
 some inoffensive way. He must sail his bark 
 between the Charybdis of offending a possible 
 prospective and desirable patient and the Scylla 
 of doing work for a possible dead beat. If no 
 other opportunity presents, it is well to remark 
 in a casual way, as if it were merely incidental 
 and without special significance : " Did one of 
 my patients refer you to me?" This will force 
 an answer without giving offence, and the char- 
 acter of this answer will readily determine the 
 dentist in his subsequent management of the 
 case. If the answer is too non-committal and 
 unsatisfactory, the dentist should not hesitate to 
 say in a kindly, gentlemanly manner that it is 
 customary in his practice to have some kind of 
 
Io8 SUCCESS IN PRACTICE 
 
 reference before doing work for strangers, — ex- 
 cept so far as it relates to the relief of pain. It 
 is of course understood, or at least it should be, 
 that if an individual is suffering it is the duty 
 of the dentist at any or all times to relieve the 
 pain with absolute disregard to the credit of the 
 patient; but with anything further than this he 
 is perfectly justified in making an issue. No 
 individual of any intelligence will resent a state- 
 ment of this sort if properly put, and any patient 
 who does take offence is better under the patron- 
 age of some other dentist who cares more for 
 the number of patients he gets than he does for 
 conducting a profitable and equitable practice. 
 
 If a stranger applies under the recommenda- 
 tion of a patient whose own credit is not of the 
 best, it is well to look personally into the stand- 
 ing of the new patient. Usually " birds of a 
 feather flock together," but the rule is not invari- 
 able, and it so chances on occasion that a very 
 undesirable patient will send one who is in all 
 ways satisfactory. The whole question resolves 
 itself back to the recommendation already made, 
 for the dentist to become a close student of 
 human nature. In some instances the most acute 
 
COLLECTING ACCOUNTS, ETC. 109 
 
 observer will be deceived and will be led to be- 
 stow his confidence where it is not deserved, 
 but in general the man who studies humanity 
 closely w411 soon learn to detect the imposters 
 when they apply to him. 
 
 In cases where a patient comes on the Implied 
 recommendation of another patient who is relia- 
 ble, and yet there exists a doubt in the mind of 
 the practitioner as to the stranger's integrity, it 
 is always best to inform himself by an appeal to 
 the individual who gives the recommendation. 
 This is sometimes a delicate matter and requires 
 considerable tact, but there is always a way of 
 doing it without embarrassment if the practi- 
 tioner only studies the situation. It may simply 
 be necessary to drop a note of thanks, expressing 
 the appreciation of the practitioner for having 
 recommended Mr. So-and-so. This is always 
 proper in any event, and particularly so if the 
 individual who sends the new patient is a pro- 
 fessional man. This note of thanks opens the 
 way at once for an exposure of the fraud in case 
 the new-comer has used the other's name without 
 warrant, as sometimes occurs. But the circum- 
 stances may be such in certain instances that the 
 
no SUCCESS IN PRACTICE 
 
 practitioner feels he must have definite infor- 
 mation regarding the standing of the patient 
 making appHcation for work, and under these 
 conditions a letter something like the following 
 may be sent in those instances where it is not 
 convenient to see personally the party who 
 recommends the patient: 
 
 " My Dear Sir : Mr. So-and-so has just ap- 
 plied to me for dental service, giving your name 
 as reference. It sometimes happens that the 
 names of very worthy people are used in this 
 connection by individuals who are not altogether 
 responsible and who have no warrant for such 
 use, and I accordingly venture to ask what you 
 know as to the standing of the gentleman in 
 question. I need not assure you that any in- 
 formation you may give me will be held in the 
 strictest confidence, and I also beg to thank you 
 in advance for the favor. I enclose a stamp for 
 answer. 
 
 " Yours very truly. 
 
 But sometimes conditions arise in which the 
 practitioner must use his own judgment and 
 
COLLECTING ACCOUNTS, ETC. m 
 
 abide by the consequences. As has been stated, 
 the best of observers will be deceived at times, 
 and the only thing to do under such circum- 
 stances is to accept the situation philosophically 
 and not waste time or energy in crying over the 
 proverbial " spilt milk.'' 
 
 It will not always do to depend solely on 
 appearances in judging character, as was once 
 very forcibly illustrated by a prominent practi- 
 tioner in a manner the details of w^hich are so 
 very good that they must be related. 
 
 The practitioner in question had arrived at a 
 point in his practice where he was eminently 
 satisfied, with one small exception. Said he to 
 a friend one day : "I have all the patients I 
 want now, in fact more than I can attend to; 
 but there is one family in this State that I par- 
 ticularly desire to have as patients, and to whom 
 I believe I am entitled. I have many of their 
 friends, and for a long time I have been anxious 
 to secure them, but for some reason I have never 
 been able to. That is the governor's family. 
 If I had them I should be perfectly happy so far 
 as my practice is concerned." 
 
 Some time later, as the practitioner w^as in 
 
112 SUCCESS IN PRACTICE 
 
 the midst of an operation one day, he was called 
 to the reception-room and met there a small, 
 very plainly-dressed, and altogether unobtrusive 
 individual, who said he wished some dental work 
 done. The practitioner scrutinized him a mo- 
 ment and concluded that he would not make a 
 very desirable patient, so he excused himself on 
 the basis of being busy, and finally referred him 
 in a bland manner to a fellow-practitioner across 
 the hall for whom he had no very particular 
 liking. 
 
 In a few days he met the friend again, and 
 his first salutation was to congratulate the den- 
 tist on securing the governor as a patient. The 
 practitioner looked at him blankly a moment, 
 and then said : " I don't know what you mean. 
 The governor has never been to me." 
 
 " But I know he has," protested the friend. 
 " I sent him to you myself, and in fact he went 
 direct from my office to yours." 
 
 The practitioner thought a moment, and then 
 said : " Describe him. I never remember having 
 seen the governor." 
 
 When his friend had finished describing the 
 governor, the practitioner was pacing the floor, 
 
COLLECTING ACCOUxNTS, ETC. 113 
 
 smiting the air, and But his remarks will 
 
 not permit of reproduction in print. Appear- 
 ances are sometimes deceptive, and this should be 
 borne in mind in judging the probable responsi- 
 bilities of a new patient who applies for service. 
 It is never safe to wholly condemn a man till 
 you know him, any more than it is to implicitly 
 trust a stranger without some kind of reference. 
 Collecting Accounts. — For a practitioner to 
 be a poor collector of accounts is to work an in- 
 justice not only on himself and his family but 
 on the people whom he credits. It is demoral- 
 izing in every way and to all concerned to estab- 
 lish a habit of laxity and irresponsibility in 
 regard to the just payment of obligations, and 
 each individual in a community with the standing 
 that a professional man usually has owes it as 
 a duty to those about him to maintain integrity 
 in this respect to the extent of his ability. If a 
 patient accepts professional services and then 
 is allowed to dally along indefinitely without 
 paying for them, he is quite likely to lose any 
 appreciation he may ever have had for the value 
 of them, and eventually ends in losing respect 
 
 for the practitioner. The longer an account runs 
 
 8 
 
114 
 
 SUCCESS IN PRACTICE 
 
 the more difficult it becomes to collect it, and 
 the lapse of time invariably lessens the debtor's 
 sense of his obligation. Another particular feat- 
 ure of the case relates to the loss of patronage 
 a practitioner often sustains by letting accounts 
 run. If a patient owes a dentist a bill and subse- 
 quently finds that more work is needed, it is the 
 rarest thing for the patient to apply to the same 
 dentist for the service. On account of that long- 
 standing bill another dentist is sought out, and 
 if he chances to be a good collector, his bill is 
 often paid readily while the first dentist is left 
 to sigh for his money. 
 
 As to the frequency with which bills should be 
 rendered the dentist must be governed somewhat 
 by the usages of the locality in which he prac- 
 tices, but ordinarily an account should be ren- 
 dered on the first of the month following the 
 completion of the work, and if not paid, should 
 be rendered monthly after that. When a bill has 
 been sent the second or third time in this way 
 without response, the patient's attention should 
 be called to the matter either by a carefully- 
 worded and polite letter or by a tactful collector^ 
 Usually, if the dentist has an assistant, it is best 
 
COLLECTING ACCOUNTS, ETC. 115 
 
 to have the assistant call in preference to a pro- 
 fessional collector, as this is less likely to be 
 resented. Unless there is some satisfactory ex- 
 planation of the delay, there should be little let 
 up on the patient till a settlement is forced in 
 some way. There is a trite saying that '' it 
 takes all kinds of people to make a world," and 
 in the collection of accounts it is equally true 
 that it takes all kinds of expedients to work suc- 
 cess. The dentist should study the temperament 
 of his patient and should aim to appeal to him at 
 his vulnerable point. Sometimes, though not 
 very often, it may be advisable to enter proceed- 
 ings in court to force the payment of an account, 
 but in a general way this method is productive 
 of more bother and worry to the dentist than 
 the results will warrant. 
 
 In any event, where there has ever been diffi- 
 culty in collecting an account from a patient, un- 
 less there seems some good reason for it which 
 is satisfactory to the dentist, no future appoint- 
 ment should ever be given without a definite 
 understanding in regard to payment. Let the 
 patient see that you do not think lightly of de- 
 ferred obligations, and the impression will soon 
 
Il6 SUCCESS IN PRACTICE 
 
 get out that you are not to be trifled with by 
 irresponsible people. 
 
 Of course the dentist should not so demean 
 himself as to give rise to the idea that he is a 
 hard-hearted money-grabber and absolutely cal- 
 lous to the sensibilities of his patients. He must 
 be a gentleman above all things, and in every 
 instance where he finds it necessary to be strin- 
 gent in his demands he must temper his severity 
 with the strictest adherence to principle and the 
 most beneficent administration of justice. In 
 no case should he ever be caught doing so base 
 a thing as to persecute for money's sake any 
 poor or unfortunate individual who through 
 force of circumstances has found himself in- 
 debted to him. While he administers his affairs 
 with business-like promptness, he should never 
 ignore the behests of a common humanity nor 
 fail to extend charity where charity is indicated. 
 
 Form of Bill-Heads and Manner of Making 
 Out Accounts. — It is a matter of some conse- 
 quence in the smooth running of a practice to 
 know how best to render accounts. It should 
 no longer be considered necessary nor in good 
 taste for a professional man to put down every 
 
COLLECTING ACCOUNTS, ETC. 117 
 
 item of service on a bill when it is being ren- 
 dered, the same as the grocer or dry-goods man. 
 Professional service is something distinct from 
 trade or barter, and everything smacking of 
 trade in the conduct of a practice should be dis- 
 countenanced. Professional men should so de- 
 port themselves that the word professionalism 
 shall stand synonymous with honor, and to-day 
 it would have been so considered had they always 
 lived up to their highest possibilities. But un- 
 fortunately there have been rogues in the pro- 
 fessions as well as in other callings, so that it is 
 difficult to conduct a professional practice along 
 lines strictly in keeping with the best traditions 
 of the craft. And yet every practitioner owes 
 it to his profession to so manage his affairs that 
 the public is made to realize the difference be- 
 tween the ethics of professionalism and the ethics 
 of trade, and this can often be done by the man- 
 ner of rendering professional bills. 
 
 The style of the bill-head should be plain, neat, 
 and typographically perfect. No flourishing 
 head- or tail-pieces or borders should ever be 
 used. In size they should be simply large enough 
 so that when folded once they will conveniently 
 
Ii8 SUCCESS IN PRACTICE 
 
 go into an ordinary envelope. They should be 
 made of good, substantial paper, the difference 
 in cost between good paper and poor paper being 
 so trifling as not to enter seriously into the case 
 when the maintenance of a high professional 
 standing is considered. Economy in these par- 
 ticulars on the part of a professional man is 
 always prejudicial with the most desirable class 
 of patronage. 
 
 The bill should be made out simply " For pro- 
 fessional services," and with patients who have a 
 due regard for the dentist's honor and confidence 
 in his integrity this is all that is necessary. But 
 to avoid any possible misunderstanding, it is 
 always best to have a printed foot-note on 
 the bill-head as indicated in the illustration on 
 page 119. 
 
 One reason why it is unsatisfactory to itemize 
 an account is because it frequently becomes 
 necessary to charge twice as much for one filling 
 as for another of the same material, and the lay 
 mind cannot always see the signficance of this 
 without a verbal explanation. In fact there are 
 many apparent discrepancies in the items of an 
 ordinary dental bill which might cause needless 
 
COLLECTING ACCOUNTS, ETC. 
 
 119 
 
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120 SUCCESS IN PRACTICE 
 
 dissatisfaction, and so it is best to render the 
 account " For professional services." But there 
 are very many worthy individuals whose educa- 
 tion and experience in professional matters have 
 not progressed far enough to enable them to 
 accept such a bill without considering it arbi- 
 trary and high-handed. They want to know 
 something more about the service they are pay- 
 ing for, and it is for the benefit of these people 
 that the foot-note is printed. It at once dis- 
 arms suspicion, and if for no other reason than 
 this, the keeping of diagram records is a very 
 profitable procedure. 
 
 In cases where work is done for the various 
 members of a family, and the bills are sent to 
 the head of the family, it is well, in view of the 
 fact that he is not supposed to know the amount 
 of service rendered to each member, to indicate 
 this on the bill. Every precaution should be 
 taken in rendering an account to disarm pos- 
 sible criticism in advance, and this is particu- 
 larly true in dealing with new patients. After 
 patients have been coming for some time and 
 have become accustomed to the dentist's methods, 
 and have gained confidence in him, he can take 
 
COLLECTING ACCOUNTS, ETC. 121 
 
 greater latitude without misunderstandings, but 
 he should make sure of his ground at every step. 
 A bill such as just indicated may be made out in 
 the manner shown on page 122. 
 
 A discriminating practitioner will soon learn 
 by his experience with the individuals who come 
 imder his care just how to approach them with 
 bills to the best advantage, and if he makes this 
 matter a study he will eventually be able to 
 conduct this department of his practice with very 
 little friction. But in order to accomplish this 
 he must first establish a reputation for absolute 
 honesty in all his professional dealings. With 
 this as a basis he need have no fear of conten- 
 tion; and if contention does occasionally arise, 
 he can face the result with perfect confidence that 
 whichever way the issue goes he will have no 
 compunction of conscience in the matter and 
 nothing of serious import to grieve over. But 
 unless he is fundamentally honest he will never 
 have any assurance against suspicion, and no real 
 resource to fall back upon in case of contention. 
 If men were far-sighted enough to see the results 
 of doubtful dealing, surely all men would be 
 honest for policy's sake if for nothing else. 
 
122 
 
 SUCCESS IN PRACTICE 
 
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COLLECTING ACCOUNTS, ETC. 123 
 
 Paying Bills. — In intimate conjunction with 
 the close collection of acuunts must go the prompt 
 payment of bills. No dentist of any self-respect 
 will ignore his business obligations to the extent 
 of gaining the reputation for being poor pay. 
 Carelessness in this respect is almost criminal, 
 and in a profession like dentistry, where the 
 invested capital is small and the obligations not 
 necessarily large or numerous, it is inexcusable 
 to form the habit of not paying legitimate bills. 
 It is usually not of necessity that dentists are poor 
 pay, but merely because their business methods 
 are lax generally and because they allow them- 
 selves to drift into shiftless and irresponsible 
 habits. 
 
 A legitimate business obligation should be 
 held as binding and as sacred as any other 
 obligation in life; and if a man plans his affairs 
 properly, it is as easy to pay a bill at one time 
 as another. It is largely a matter of habit and 
 self-discipline. Many a man who is not at heart 
 dishonest carelessly allows himself to get behind, 
 and, through sheer lack of decision and self- 
 restraint lets matters drift along month after 
 month and year after year till it all ends in a 
 
124 SUCCESS IN PRACTICE 
 
 total loss of credit, and then such a man wonders 
 why the world is hard on him. 
 
 The desire to have things without the ability 
 to pay for them is a disease which when chronic 
 becomes as fatal to the ultimate self-respect and 
 happiness of the individual as does tuberculosis 
 to his physical system. Many of the things we 
 buy in our modern civilization are luxuries in- 
 stead of necessities, and while it is true that in 
 the constant change of customs and tastes the 
 luxuries of yesterday seem to become the neces- 
 sities of to-day, it is yet a fact that many of 
 the items of expenditure in the life of the aver- 
 age individual are wholly unnecessary. It is 
 well and proper for a man to have some of the 
 luxuries and to indulge his taste for the sublime 
 and the refined in the modern amenities of life, 
 but it is not well, neither is it proper, to do this 
 until he can afford it. To indulge in luxuries 
 at the expense of one's business credit and repu- 
 tation and to buy luxuries that one is not cer- 
 tain of paying for is equivalent to downright 
 dishonesty. 
 
 Let the young man starting out in life be 
 cautious about contracting bills, and particularly 
 
COLLECTING ACCOUNTS, ETC. 125 
 
 in those cases where there is the sHghtest doubt 
 about his abihty to pay. Let him look ahead 
 very carefully, and if there is not in his mind 
 a positive assurance that he can meet his bills 
 when due, let him resolutely deprive himself 
 of the things he otherwise would buy and wait 
 till his circumstances so change that he will be 
 justified in the purchase. There is nothing so 
 discouraging or disheartening to a young man 
 as to have a load of debts hanging over him. It 
 may be necessary under certain circumstances, 
 in fact it frequently does become necessary with 
 a young dentist starting out in practice, to go 
 in debt for his equipment, but it should be his 
 constant aim backed by the closest economy to 
 discharge the obligation as early as possible and 
 get even with the world. To be out of debt and 
 able to look every man in the face is a wonderful 
 satisfaction to any right thinking individual, but 
 for a young dentist to attempt to conduct a prac- 
 tice with the collector calling at his office every 
 few days is to travel an uphill road filled with 
 rolling stones and paved with briars. It is not 
 within his power to do the best service for his 
 patients while he is harrassed by debts. 
 
126 SUCCESS IN PRACTICE 
 
 To gain a reputation in the community for the 
 prompt payment of accounts estabhshes a man's 
 credit and adds immeasurably to his self-respect. 
 A man under these circumstances can confidently 
 ask for credit in time of need, and people are 
 only too glad to accommodate him. There is 
 so much innate goodness in humanity even in 
 business relations that there is never lacking the 
 desire to help those who attempt to help them- 
 selves, and the surest way to gain friends is to 
 prove one's self worthy of them. 
 
IX 
 
 FEES 
 
 There are two principal plans for arranging 
 fees in a dental practice, — by the hour or by the 
 operation, — and there are arguments for and 
 against each. To charge wholly by the hour is 
 in some respects an equitable arrangement, but 
 there are objections to it as an invariable prac- 
 tice. It is true that a dentist's time is his chief 
 stock in trade, but it is also true that his ex- 
 penditure of energy is an important element in 
 the case, and there are some operations which 
 tax a practitioner far more than others. To 
 have a set fee then for each hour's work is not 
 just to the operator, and to have a sliding scale 
 according to the character of the operation is 
 practically charging by the operation. Then 
 again, while as a professional proposition the 
 cost of material should never enter into con- 
 sideration in arranging fees for professional ser- 
 vice, yet it is undeniable that in some cases it 
 
 127 
 
128 SUCCESS IN PRACTICE 
 
 becomes a factor. For instance, the difference 
 between an hour spent in removing deposits and 
 poHshing teeth and one spent in condensing gold 
 in a cavity would amount to something in the 
 way of actual cost, to say nothing of the dif- 
 ference in nervous tension. To work by the 
 hour is to be constantly watching the clock, par- 
 ticularly if the operator is conscientious and has 
 his patient's interest at heart, and there is always 
 a feeling that he is working on time which 
 belongs to somebody else instead of himself. 
 Any diversion from the real work in hand or 
 any interruption in an operation seems so much 
 of a direct robbery of the patient, and this fact 
 always being prominent in an operator's mind, 
 makes him more or less a slave to his surround- 
 ings. Another inequitable feature about the case 
 is the fact that no operator is able to give uni- 
 formly good service at all times. There are 
 days when he is not up to the mark and when 
 matters move slowly despite his best effort, and 
 there are other days when he is in the highest 
 perfection of physical, mental, and nervous 
 balance, so that he is able to accomplish twice 
 the work in a given time that he can on other 
 
FEES 129 
 
 occasions. To charge the same fee per hour for 
 service rendered on two days so different in 
 accomplishment is not equitable, and an opera- 
 tor cannot well say to a patient : "I am not in 
 condition to-day to do the class of service I 
 ordinarily do, and so I must not charge you my 
 regular fee,*' neither can he say : ''' I am feel- 
 ing so well to-day that I must charge you 
 more than ordinarily." 
 
 A fee should be based on the amount of ac- 
 complishment more than on anything else, and 
 this fact also illustrates a frequent injustice 
 where, on the other hand, charges are made solely 
 by the operation. To charge a set fee, for in- 
 stance, for an amalgam filling is wholly wrong, 
 because it may require three or four times as 
 long to insert one amalgam filling as it does 
 another, and the limit of accomplishment in the 
 one case is vastly different from the other. The 
 element of time in an operation cannot therefore 
 by any means be ignored, and the most equitable 
 arrangement is to have a combination of the two 
 systems of charging. There should be a mini- 
 mum fee for each kind of operation, and the 
 charges should run upward from this minimum 
 
 9 
 
130 SUCCESS IN PRACTICE 
 
 according to the time and energy required in 
 its performance. 
 
 As to the size of an operator's fees the mat- 
 ter must of course be regulated to some extent 
 by the customs in vogue in the locahty where 
 he practises. It is suicidal in every particular to 
 make one's fees lower than the regulation fees 
 of the neighborhood, as it is also usually inju- 
 dicious to make them very much higher. This 
 applies more particularly to practices in smaller 
 towns, where an operator's fees are a matter of 
 common gossip and where the precise fee for a 
 given operation becomes well known. If an 
 operator varies in any way from the regulation 
 fees, it is always safer to raise the fees than to 
 lower them. This may seem a strange state- 
 ment, and yet it is amply borne out by obser- 
 vation. If a man's fees are lower than his neigh- 
 bor's, there is always a suspicion that he is not 
 so capable a practitioner, and invariably the 
 cheap man draws around him a class of practice 
 which at best is very undesirable. He gets the 
 shoppers and the misers and the financially irre- 
 sponsible. His is the patronage of the ''great 
 unwashed." 
 
FEES 
 
 131 
 
 To establish in a neighborhood the reputation 
 of being the highest-priced dentist in the place 
 is often a sheet-anchor of strength. It may drive 
 some people away, but if the fees are at all within 
 reason it will not drive very many worthy peo- 
 ple away, and for one such who leaves a dozen 
 others will come. In fact it is the very rarest 
 thing imaginable for a dentist who is capable of 
 giving good service to ever lose his patronage 
 on account of high fees. Of course he must be 
 sufficiently skilled to justify himself in charging 
 well, and he must have some sense of honor in 
 making his charges ; but where there is one den- 
 tist who has failed on account of high fees there 
 are ninety-and-nine who have failed from other 
 causes. In many instances high fees are made 
 the scape-goat of a man's failure when the real 
 cause was something else. The mere fact of de- 
 manding and maintaining good fees tends to 
 establish confidence in a man and draws to him 
 the most desirable people. 
 
 When a young man starts out in practice, par- 
 ticularly if it is in a large city where fees vary 
 greatly among practitioners, he cannot expect to 
 get as high fees as the older and better estab- 
 
132 
 
 SUCCESS IN PRACTICE 
 
 lished practitioners; but as he gains patronage 
 and experience he should gradually raise his fees 
 till he gets them up as far as his capabilities will 
 justify. To do this requires some tact and judg- 
 ment. It will not do to make too prominent a 
 display of the fact that his fees are being raised. 
 He should quietly go about it, stiffening up here 
 a little and there a little, and from time to time 
 as the opportunity seems propitious he should 
 advance his minimum fees till the volume of his 
 income is perceptibly increased. In this way his 
 practice will gradually undergo a process of evo- 
 lution without any serious protest on the part of 
 his patients, but with an ultimate weeding out 
 of undesirable patronage and the establishment 
 of an adequately remunerative fee system. 
 
 Estimating Work. — In some instances pa- 
 tients make a request to have the cost of their 
 work estimated in advance, and while this seems 
 to them a perfectly legitimate and natural thing 
 to ask, it is in many cases a very difficult matter 
 to comply with it, and under certain circum- 
 stances the request is wholly unreasonable. It 
 is often quite impossible to predict by a mere 
 examination of the teeth the extent of service 
 
FEES 133 
 
 it will require to put them in a healthy condi- 
 tion, and the patient might with equal propriety 
 ask a physician what he would charge to carry 
 him through a case of illness where the exact 
 nature of the disease was unknown. This 
 feature of the case should be fully explained to 
 patients, and most individuals will instantly rec- 
 ognize the situation and see the justice of the 
 dentist's contention. And yet it is necessary for 
 patients in many of the exigencies of life to 
 know something of the obligations they are 
 about to assume, and the dentist should give 
 them as accurate an idea as he can. In esti- 
 mating work in this way the operator should in- 
 variably explain the contingencies of the case to 
 the patient and should emphasize the fact that 
 it is only an opinion he is giving as to the prob- 
 able cost and not an agreement to perform the 
 service for a stated amount. Anything in the 
 way of bargaining over a dental fee should be 
 frowned upon by a self-respecting practitioner, 
 and yet this has no reference to a cordial con- 
 sideration of the question of cost with a worthy 
 but impecunious patient. With those who are 
 so situated in life that they are obliged to plan 
 
134 
 
 SUCCESS IN PRACTICE 
 
 their expenditures in advance it is well to esti- 
 mate work by placing the probable cost between 
 two sums, — a minimum and a maximum 
 amount, — with considerabile leeway betvv^een the 
 two to allow for discrepancies of judgment. 
 
 But while it is ordinarily best — as has been in- 
 timated — to avoid giving estimates on work in 
 advance, it is occasionally the case that the den- 
 tist may wish to force a consideration of fees on 
 the patient before the work is undertaken. 
 Sometimes irresponsible people, or those who 
 may not be familiar with the dentist's fees, make 
 appointments for work without sufficiently con- 
 sidering the obligations they are assuming, and 
 with such individuals it is always well to have 
 some sort of understanding. The time to bring 
 this about is, as has already been stated, when 
 the examination of the teeth is made at the first 
 sitting. A little precaution in this respect will 
 frequently avoid subsequent complications and 
 unpleasantness. 
 
 Other instances where it is sometimes well to 
 broach the subject of fees before the work is be- 
 gun is where a child or ward is sent to the den- 
 tist by a father or guardian and the mouth is 
 
FEES 
 
 135 
 
 found in a much worse condition than has been 
 suspected, and also in those cases where the pre- 
 vious dentist has been one whose fees are very 
 low. Under either of these circumstances the 
 amount of the bill may be much greater than had 
 been anticipated, and there is likely to be dis- 
 appointment and sometimes even serious dis- 
 satisfaction when it is rendered. In such cases 
 it is well to drop a polite note to the father or 
 guardian informing him of the condition of the 
 teeth and stating that the practitioner deems it a 
 duty to him to apprise him of the facts before 
 doing the work. 
 
 One of the greatest abominations connected 
 with obtaining legitimate fees is to have patients 
 come from a man whose fees are notoriously 
 low, and whose patients are therefore not edu- 
 cated to a just appreciation of the value of den- 
 tal service. When a responsible practitioner 
 gets a patient under these conditions he must 
 exercise rare judgment and tact and see that the 
 patient is by some means made to understand 
 what his fees are in advance. Precautions of 
 this sort often protect the dentist against charges 
 of extortion and dishonesty. 
 
136 SUCCESS IN PRACTICE 
 
 Disputes Over Fees. — But it occasionally 
 arises in the conduct of a full practice that diffi- 
 culties occur in adjusting fees, and patients 
 sometimes dispute a bill or complain of its size. 
 The only safe way for a dentist to avoid trouble 
 of this sort is to be perfectly equitable and just 
 in his charges at all times, and then if a con- 
 tention arises he is in a position to say to the 
 patient that his bill is in strict accordance with 
 his regular fees. If the patient still persists 
 in complaining, it is in order for the dentist 
 to take the ground in a gentlemanly and cour- 
 teous manner that it is his province and not that 
 of the patient to set an estimate upon his ser- 
 vices, and that while people are not obliged to 
 patronize him, when they do come they must let 
 him say what his services are worth. Above all 
 things he should talk reasonably and good- 
 humoredly to the patient and never allow him- 
 self to give way to ill temper. The moment a 
 man gets angry or the least bit abusive he jeop- 
 ardizes his case and loses his advantage, besides 
 branding himself as a man unworthy to be 
 classed as a professional gentleman. If patients 
 are so ignorant or overbearing that they will not 
 
FEES 137 
 
 listen to reason or explanation, it is better for 
 the dentist to excuse himself from their presence 
 and refuse to have anything further to do with 
 them. It is better even to lose a bill entirely 
 than to stoop to an unseemly quarrel. Make it 
 a rule with patients and let them so understand 
 it that you will have no contention over accounts, 
 and when this is well established as a tenet of 
 your professional faith you will have little cause 
 for contention. Not only this, but it will be 
 found that in the course of a year there will 
 actually be fewer accounts lost by pursuing this 
 plan than by continually combating people. 
 
 The Ideal Status of the Fee Question. — But in 
 the broadest consideration of fees and the best 
 means of regulating them the whole matter sifts 
 itself down to the fact that the ideal condition 
 in the conduct of a practice Is where fees are 
 never discussed at all. To be continually talk- 
 ing fees to patients is degrading and smacks too 
 much of commercialism. It emphasizes the sor- 
 did side of life and does not comport with the 
 dignity of true professionalism. There should 
 be eventually established between patient and 
 operator such a stable confidence and such a com- 
 
138 SUCCESS IN PRACTICE 
 
 munity of interest that it is never necessary with 
 long-standing patients to mention the subject 
 of fees from one year's end to another, and this 
 very condition can be largely brought about if 
 the operator sets himself to work along that line 
 as he is building up his practice. But it cannot 
 be wholly accomplished at the outset nor till the 
 practitioner has demonstrated his integrity to 
 the satisfaction of patients and established a firm 
 conviction in their minds that he can be depended 
 upon for equity In all his dealings. When this 
 has once been attained, patients simply come and 
 have their work done, say nothing about fees, 
 and expect a bill on the first of the following 
 month. A check is then mailed to the dentist, 
 who receipts the bill, or has his book-keeper do 
 it, and returns it to the patient, when the finan- 
 cial part of that transaction is forever closed. 
 To maintain a practice on this basis is the acme 
 of professional success so far as relates to the 
 material aspects of the comity between patient 
 and practitioner, and such a condition leaves the 
 dentist's mind free from the baser influence of 
 financial bickering and gives ample opportunity 
 for the closest possible attention to the higher 
 
FEES 
 
 139 
 
 development of his professional skill. It is not 
 only better in a financial way, but better men- 
 tally and morally in fostering the loftier impulses 
 of honor and confidence and placing human in- 
 tercourse on a more exalted plane of mutual 
 equity and harmony. 
 
 Charity Work, — In the exigencies of profes- 
 sional life it becomes the duty of every prac- 
 titioner of dentistry to do more or less charity 
 work, and this should be most cheerfully done 
 whenever the merits of the case warrant it. 
 When it comes to the relief of pain the question 
 should never arise as to the patient's ability to 
 pay. There are many unfortunate circumstances 
 occurring in the lives of individuals which fre- 
 quently throw them on the mercy of others, and 
 when reverses happen among his patients the 
 dentist should never be remiss in his duty so far 
 as exercising charity is concerned. He should 
 adopt the golden rule in this matter as in other 
 affairs of life. 
 
 But there is another side to the question which 
 must be faced with resolution and carried out 
 with judgment. The dentist should have a care 
 that he does not do more harm than good with 
 
I40 
 
 SUCCESS IN PRACTICE 
 
 his charity. In anything he does beyond the 
 mere relief of pain for a patient he should first 
 make certain that the object of his charity is 
 worthy, and even then he should not carry his 
 benevolence too far. This is not so much be- 
 cause of imposition on himself as for the possible 
 injury to the object of his charity. There is 
 nothing in all human experience more demoral- 
 izing to an individual than to voluntarily accept 
 unlimited charity, and the moment a man holds 
 out his hand and receives aid from another with- 
 out return that moment he sinks in his own self- 
 esteem and loses an appreciable segment of his 
 character. With all the laudable intentions be- 
 hind our various systems of charity to-day, it 
 is fast becoming evident to thoughtful people 
 that more injury than good is being done by 
 them. Many of them are merely helping to cre- 
 ate a pauper class and are making people irre- 
 sponsible and dependent who otherwise would 
 develop some self-reliance. After giving a man 
 a certain amount of aid in time of need he should 
 be thrown on his own resources in order to bring 
 out the best there is in him. Those who aim to 
 be the best of friends to man are often led 
 
FEES 
 
 141 
 
 through mistaken charity to be his worst ene- 
 mies. Reach down your hand wilhngly to hft 
 up a fallen brother, but when he is once firmly 
 set upon his feet let him stand alone. 
 
 Guaranteeing Work. — The request is some- 
 times made by patients to have their work guar- 
 anteed. This, as every practitioner knows, is 
 an unreasonable request, and the only guarantee 
 a dentist should ever give is to guarantee that 
 he will do the very best he knows how for the 
 patient's welfare. He may say to the patient, 
 and in fact he should say, that if his operations 
 fail through any fault of his he will cheerfully 
 make the failure good. But he should never 
 under any circumstances guarantee, for instance, 
 that fillings will remain in for a certain number 
 of years nor that a set of artificial teeth will wear 
 a given time. Unless a patient has sufficient con- 
 fidence in a dentist to know that he will remedy 
 any defect in his work without a guarantee, the 
 attitude of the patient to the practitioner is not 
 such as to make their professional relationship 
 harmonious and satisfactory, and they are better 
 apart. A physician might with almost equal 
 propriety be asked to guarantee that when he has 
 
142 SUCCESS IN PRACTICE 
 
 once cured a patient of an illness the patient will 
 never get ill again, as to ask a dentist to guaran- 
 tee his work ; and no practitioner who is honest 
 will ever be led to do so unreasonable a thing. 
 
X 
 
 EMPLOYING AN ASSISTANT 
 
 In the conduct of a practice which is at all 
 extensive the dentist will consult his best inter- 
 ests by employing a young lady assistant. No 
 office is ever kept in quite the pink of perfection 
 without the ministrations of a feminine mind 
 to supervise its care and smooth over the rough 
 excrescences left upon it by the average male 
 habitant. There are so many useful services 
 for the assistant in a dental office that an oper- 
 ator who has once employed one will never be 
 found without her. She stands between him and 
 many of the petty annoyances which would 
 otherwise fall to his lot. She saves nearly one- 
 half of his time by dexterously assisting him in 
 his operations and by attending to the clerical 
 work, such as making appointments, notifying 
 patients to come for examinations, keeping books 
 and records, sending bills, and the hundred and 
 one little routine details of an office practice. She 
 
 143 
 
144 SUCCESS IN PRACTICE 
 
 protects him from the ubiquitous book-agent and 
 the perennial Hfe-insurance man. She accepts 
 the blame many times when he is himself at 
 fault, and to have some one to do this is most 
 delightful. She remembers things that he for- 
 gets and attends to all his memoranda. She 
 looks after the linen of the office and keeps the 
 instruments cleaned and sterilized. 
 
 In fact to have a competent assistant is to re- 
 lieve one's self of many of the small cares of 
 conducting an office, and no man in full prac- 
 tice can afford to do without one. It is economy 
 in every way, financial, physical, and mental. 
 
XI 
 
 ECONOMY IN PURCHASE AND IN AVOIDING 
 WASTE 
 
 Purchasing Instruments and Supplies. — If all 
 the folly of dentists in purchasing material they 
 do not need were represented by an aggregation 
 of the stuff so bought it would create a pile that 
 would reach to the moon, and if another pile 
 were made of the material they should buy but 
 do not it would reach equally high. This might 
 be construed into an intimation that they do not 
 always use good judgment in their purchases, 
 and an examination of the average dental office 
 will amply corroborate the inference. It is sel- 
 dom that one sees an office which is too well 
 equipped, but it is quite common to see offices 
 sadly lacking in the essentials and strewn about 
 and lumbered up with a mass of material of no 
 practical utility. A certain amount of such accu- 
 mulation seems inevitable in years of experience, 
 
 as it is impossible for a dentist to judge accu- 
 
 lo 145 
 
146 SUCCESS IN PRACTICE 
 
 rately with regard to the probable utiHty of 
 every instrument or appHance he examines, but 
 that a man may come much nearer it than most 
 dentists do is certain. The young dentist in par- 
 ticular should form the habit of studying care- 
 fully the instruments he buys, and should ordi- 
 narily see a practical test of every instrument or 
 appliance before he purchases it. This plan of 
 procedure will not only save him many dollars 
 in the course of a year but it is really of great 
 advantage to the dealer who sells him his sup- 
 plies. To purchase an instrument that proves 
 ineffective in the buyer's hands is to create dis- 
 affection, and it frequently brings about the re- 
 quest to have the instrument exchanged for 
 something else. This is always unsatisfactory 
 to the dealer, because of the accumulation of 
 second-hand material for which there is very 
 little market. The irresponsibility of dentists 
 in not knowing just what they want and in pur- 
 chasing what they do not need is proverbial in 
 our supply-houses, and the evil is so great to all 
 concerned that it should be remedied if possible. 
 The dealer is not in a position to remedy it, be- 
 cause he cannot predict whether a certain appli; 
 
ECONOMY IN PURCHASE 147 
 
 ance will appeal to a given operator or not. 
 There is a great variation among men as to their 
 adaptability to instruments, and one operator 
 may find an instrument invaluable to him in his 
 work while another will pronounce it useless. 
 No one can judge of this matter but the indi- 
 vidual himself, and it is high time that dentists 
 made a more discriminating study in regard to 
 the purchase of their supplies. 
 
 This does not infer that they shall be nig- 
 gardly or penurious about their equipment. No 
 man can serve his patrons in the highest degree 
 of excellence without having the necessary ap- 
 purtenances to do it with, and it is economy both 
 of time and patience to have the most perfect 
 equipment. A well-appointed dental office ap- 
 peals to patients and inspires a certain amount 
 of respect, while it gives the operator a greater 
 d^ree of confidence and satisfaction. 
 
 A consideration of this question cannot be 
 complete without a word as to the paying of bills 
 for supplies. There is altogether too much 
 laxity among dentists in regard to obligations 
 of this sort, and it is a serious reflection on the 
 profession as a whole that many practitioners 
 
148 SUCCESS IN PRACTICE 
 
 shirk responsibility in this particular as long as 
 possible. They seem to imagine that because 
 the dealers make their living on the patronage 
 of dentists, the latter are thereby privileged to 
 take all sorts of liberties and ask for all sorts of 
 favors. Some of them accept it as almost an 
 affront to have a regular monthly bill presented 
 to them, and if a draft is made for a long over- 
 due account it is construed as the very acme of 
 imperiousness and high-handed usurpation. 
 They forget that business is business and that 
 dealers are simply business-men with business 
 methods. 
 
 It must of course be taken for granted that 
 this imputation does not by any means apply to 
 all dentists. There are many in the profession 
 who pay their bills promptly and are in no wise 
 open to the charge of irresponsibility; and even 
 with those who are derelict it is many times the 
 case that it is due more to carelessness and pro- 
 crastination than to any real desire to escape 
 their just obligations. But the legitimate way 
 is to pay bills when due, or rather the best way 
 of all is to have no bills to pay. The cash buyer 
 is always at an advantage over the one who asks 
 
ECONOMY IN PURCHASE 
 
 149 
 
 credit, and in dealing with dental-supply houses 
 an appreciable saving may be made. Most 
 houses have a rule that by depositing ninety 
 dollars with them the depositor is given credit 
 for one hundred dollars' worth of supplies to be 
 obtained from time to time as the dentist re- 
 quires them, and there is no rate of percentage 
 that pays better than this. It is a profitable ar- 
 rangement in every way, and with responsible 
 houses it is a perfectly safe one. As soon as a 
 dentist begins to take advantage of this offer his 
 relations with that particular house may be said 
 to be on a very satisfactory basis, and if any 
 favors are to be shown in the courtesies of com- 
 mercial relationship he is most certain to be the 
 one to receive them. 
 
 Avoiding Waste. — In a world where the 
 genius of a man is constantly being taxed to util- 
 ize the by-products of civilization there should 
 be a universal sentiment against undue waste, 
 and in the commercial world this is true. The 
 waste of yesterday becomes the staple article of 
 commerce to-day, and fortunes have been made 
 and saved by preserving the rejected. In the 
 practice of dentistry, where the precious metals 
 
150 
 
 SUCCESS IN PRACTICE 
 
 are largely used, an operator may gain much in 
 the course of a year by carefully saving the dust 
 and scraps. Little particles of gold falling to 
 the floor during the operation of filling should 
 be picked up and kept in a bottle. Disks or 
 strips used in finishing gold fillings should be 
 preserved and sent to the refiner. The platinum 
 pins in broken teeth, the dust from the lathe in 
 grinding gold crowns, bridges, or plates, all of 
 them should be carefully gathered and saved. 
 It requires little time to do this, and the aggre- 
 gate of accumulation from this source in a life- 
 time of practice would make the average man 
 independent. It is never well to be penurious 
 about anything, but it is always well to be 
 saving, and if all the wanton waste of the world 
 were carefully utilized there would never be the 
 need for deprivation. 
 
XII 
 
 BANK ACCOUNT AND INVESTMENTS 
 
 A YOUNG man should establish a bank account 
 as early in his career as possible. The moment 
 he gets a few dollars ahead he should put it in 
 a good bank, and so far as convenient he should 
 pay his bills by check. It creates a favorable 
 impression in the community and gives him a 
 more stable standing. Besides this, a check 
 paid for a bill and duly endorsed is a receipt, 
 and the cancelled checks accumulating month 
 after month are a vivid object-lesson and a con- 
 stant reminder of his expenditures. He has 
 more confidence in himself when he has a balance 
 in the bank, and it gives him a greater incentive 
 to save. If he has much currency in his pocket 
 there is always the temptation to spend it for 
 anything which may catch his eye, but if his 
 money is in the bank he is likely to think 
 twice before drawing on it. A bank account 
 brings him in contact with business people and 
 
 151 
 
152 SUCCESS IN PRACTICE 
 
 establishes a relationship which is frequently ad- 
 vantageous to him in the way of profitable 
 investments by the time he has a sufficient 
 accumulation to seek investment. 
 
 This matter of investing one's earnings profit- 
 ably is a very important consideration for the 
 professional man and should be studied with the 
 same care that is given to other material factors 
 of life. A man's professional usefulness does 
 not continue unabated to old age, and unless he 
 saves something in his palmy days he is likely to 
 face want in his declining years. There is no 
 more pathetic spectacle than an old, broken- 
 down, penniless dentist, worn out by years of 
 service at the chair or the bench, his patients 
 slipping away one by one, till finally the last 
 loyal patron seems to have abandoned him for 
 a younger man, and he left with nothing but re- 
 grets, to face a meagre existence eked out by 
 charity. That this has been the lot of many a 
 practitioner who in his day was capable and 
 active is only too apparent, and it should prove 
 an object-lesson for the young men of the hour 
 to so shape their affairs that when the hand be- 
 gins to lose its cunning and the brain to be less 
 
BANK ACCOUNT AND INVESTMENTS 153 
 
 alert they will have something laid away to en- 
 sure their independence. How doubly sweet it is 
 for an old man to be able to dispense charity in 
 his latter years instead of being obliged to ac- 
 cept it. 
 
 As to the kind of investments suitable for 
 a professional man he must be governed largely 
 by the nature of his surroundings, and no ex- 
 plicit advice can be given ; but there is one fea- 
 ture of the case that every young man should 
 be warned against. The frantic craze to become 
 suddenly rich has wrecked more men than any 
 other one factor of commercial life, and the ten- 
 dency for speculation is largely backed by this 
 desire. It is the most alluring of all phantasies, 
 and there is little wonder that young men fall by 
 the thousands in its pursuit. The young profes- 
 sional man, of all others, should avoid this siren. 
 Even if speculating were a profitable and legiti- 
 mate procedure he is not so situated that he can 
 expect to excel at it. When men who are con- 
 stantly studying the stock exchange and the 
 grain market frequently find themselves on the 
 losing side, how can a young man who never 
 gets more than the merest occasional glimpse of 
 
154 SUCCESS IN PRACTICE 
 
 the inside expect to speculate successfully? The 
 moment a young professional man begins play- 
 ing the stock exchange or the wheat pit on mar- 
 gins, that moment he begins to lose a grip on 
 his practice. A speculative procedure diverts 
 attention from professional matters and unfits 
 a man for the closest possible attention to his 
 work. 
 
 There are of course exceptions to every rule, 
 but it is the rarest thing imaginable for an out- 
 sider to ever make a competence in speculation, 
 and if the vast sums of money put into specula- 
 tion by professional men were placed beside the 
 amounts they have made thereby, the former 
 would bury the latter so deep that it could never 
 be detected. 
 
 One thing in particular needs special em- 
 phasis. In these days of " get-rich-quick " 
 schemes many an alluring bait is dangled in 
 front of the young professional man who has 
 accumulated a few dollars. Promoters of all 
 sorts lie in wait for him, and the ingenuity of 
 their attack is beyond comprehension. They 
 frequently come with the ostensible recommen- 
 dation of reputable people, and they never hesi- 
 
BANK ACCOUNT AND INVESTMENTS 
 
 155 
 
 tate to use names without warrant. Their plans 
 are as wily and varied as the wit of man, and to 
 resist them sometimes requires rare determina- 
 tion and self-control. But it is a safe prediction 
 that if a young man invests in any of these 
 schemes, — whether it be a gold mine, an oil well, 
 a plantation, a new manufacturing venture, or 
 any other project over which he cannot have 
 direct supervision — ^he will lose nine hundred 
 and ninety-nine times out of a thousand. And 
 the pathetic thing is that the average profes- 
 sional man is so gullible that he is marked at 
 once by questionable promoters who make him 
 their particular prey. The wreck of many a 
 professional man's life may be traced to the 
 alluring wiles of these men who sell stock in 
 worthless concerns, and in other instances to 
 foolish investments in concerns launched by men 
 of good intent but lacking in business acumen. 
 
 A safe plan is for the professional man to 
 select an adviser in the form of a banker or 
 business man in his investments and abide by his 
 judgment. It is as logical for him to consult an 
 expert in investments when he wishes to place 
 his savings as it is for the banker or business 
 
156 SUCCESS IN PRACTICE 
 
 man to consult a dentist when he wishes to have 
 his teeth cared for. The only requisite in either 
 instance is that the adviser shall be competent 
 and honest. In this way the dentist may make 
 investments in safe and legitimate securities and 
 guard against the cruel waste of his earnings. 
 
 The young man should studiously avoid all 
 the myriad glittering schemes for making money 
 rapidly, and should content himself with slower 
 but safer investments. First mortgages or good 
 bonds are preferable to flyers on the Board of 
 Trade, and a safe dividend-paying stock bought 
 outright and placed in the vault will beat a mar- 
 gin speculation nine times out of ten. Of course 
 interest on mortgages or bonds is not high, but 
 it is one of the most marvellous things in all 
 business experience to watch how interest will 
 accumulate as the months and years go on. A 
 few hundred dollars put out at interest each 
 year during the time of a man's greatest earn- 
 ing capacity will secure him a competence when 
 he is old. The dentists to-day who are inde- 
 pendent are for the most part men who have 
 saved little by little and invested it safely, rather 
 than those who have speculated. 
 
XIII 
 
 PROFESSIONAL RELATIONSHIP AND CITIZENSHIP 
 
 No consideration of a dentist's success in life 
 would be complete without reference to his pro- 
 fessional relationship and his status as a citizen. 
 To be successful in the truest sense of the word 
 a dentist must have intimate association and the 
 most cordial relations with his fellow-practition- 
 ers. Whatever else he may get out of life in the 
 way of money or friends there is always a void 
 unless he numbers among his most intimate asso- 
 ciates the members of his craft. There is some- 
 thing wonderfully sustaining in the true friend- 
 ship of those working along similar lines, and 
 it is perfectly natural that a mutual interest 
 should develop between the members of a com- 
 mon profession. He who holds himself aloof 
 from this kind of association misses much in life 
 in the way of enjoyment and professional prog- 
 ress. No man can advance as rapidly alone as 
 he can by the aid of those interested in the same 
 
 157 
 
158 SUCCESS IN PRACTICE 
 
 pursuits, and when a man refuses to fraternize 
 with others of his profession he injures himself 
 more than any one else. Everything pertaining 
 to professional welfare should have his hearty 
 support and loyal endorsement. To hang back 
 and be an odd sheep brands him at once as being 
 possessed of qualities that are undesirable, and 
 this judgment is passed on him not only by the 
 profession but by the public at large. There is 
 nothing more unprofitable than a self-imposed 
 ostracism. 
 
 The dentist should join the various dental 
 societies of his locality and take an active interest 
 in their welfare. He should write papers for 
 them and should contribute to the periodical 
 literature of his profession. He may not be able 
 to write a brilliant paper, but every man has it 
 in him to say something that shall be of benefit 
 to his fellow-practitioners, and he has no right 
 to withhold it. And even if he cannot write, 
 he can be useful in other ways and thus leave his 
 impress on the profession in such a manner that 
 he will be a distinct personality instead of a 
 nonentity. In short, he should consider himself 
 part and parcel of the profession and not a mere 
 
PROFESSIONAL RELATIONSHIP 159 
 
 excrescence waiting to be wiped off by the 
 breath of progress. 
 
 Not only this, but he should take a vital inter- 
 est in affairs aside from the profession. A man 
 who wraps himself up in any one pursuit and 
 thinks of nothing else is prone to become nar- 
 row-minded and self-opinioned, and in all hu- 
 man relations there is no one more illiberal than 
 a narrow-minded dentist. If a dentist is at all 
 active in mind he needs some outside interest 
 or some fad as a diversion from the grind of 
 professional life, and if he is not active, he needs 
 it all the more to create activity. He should aim 
 to be broad in his sympathies and his interests, 
 and should remember that he is a man first and 
 a dentist afterwards. 
 
 This involves the obligation of good citizen- 
 ship, and to be a good citizen is to take cogni- 
 zance of public affairs. It means that the indi- 
 vidual should vote at all municipal. State, or 
 national elections, and in order to vote intelli- 
 gently he should make himself familiar with the 
 leading questions of the day. This does not im- 
 ply that he shall be offensively obtrusive with 
 his political beliefs nor that he shall consort with 
 
l6o SUCCESS IN PRACTICE 
 
 ward-heelers or unworthy politicians, but that 
 he shall look upon it as a duty to take an interest 
 in the proper administration of government and 
 to lend his aid towards the election of worthy 
 officials for this purpose. 
 
 To sum up the factors which enter into the 
 making of a successful dentist, a man should 
 not only develop his professional attainments to 
 the highest state of perfection, but he must aim 
 to provide for those dependent upon him by 
 strict adherence to a sound financial policy in the 
 conduct of his affairs, and in addition he must 
 hold true to his obligations to the profession of 
 his choice and to the commonwealth in which he 
 lives. A dentist who fulfils these requirements 
 to the best of his ability may be considered to 
 have attained all in a material way which his 
 particular lot in life permits of him, and of such 
 a man it can never be truly said that he has 
 lived altogether in vain. 
 
 THE END 
 
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