Subjective complaints of pain are an extremely difficult area for medical diagnoses and treatment.  As a dentist you are likely to encounter times when physical or psychological pain interferes with your daily practice of clinical dentistry.  The question arises quite often as to whether this pain is disabling?   Is the pain legitimate or is it imagined?   The knee jerk reaction is often to ignore the real pain and move on.   Is this the right thing to do?

Physical injury or severe illness is easy to visualize. Medical practitioners can identify the underlying etiology of symptoms quickly and start rehabilitation/treatment efforts in an organized manner.   For those of us who have primarily subjective complaints, the diagnostic process is much more challenging.  It doesn’t matter whether it is  orthopedic/joint/back pain, chronic headaches, or psychologic anxiety/stress.  Subjective complaints need to be legitimized in the eye of the patient, the medical providers involved in care, and often third parties such as insurance companies.

This places the patient at a significant disadvantage. Not only are you dealing with the underlying symptoms of disease; you have to essentially prove that your symptoms are legitimate and need care. Skepticism from family, peers, and ill-equipped medical practitioners doesn’t help. There is a solution to the problem and it begins with you as the patient.  If you question your pain, it will be difficult to get proper care and support. It all starts with you and don’t let anyone question your motivation. It doesn’t matter whether you are seeking pain control, pain relief, or pain tolerance. Pain is pain and no one should practice with unmanaged pain or pain that severely limits their safe practice.

Begin with seeking experts in the medical field that specialize in diagnosis of illnesses that you may have. Getting second opinions is fine, but starting with experts is critical to your survival.  It will take effort and research.  Not every medical practitioner is skilled in diagnosis and treatment of subjective illnesses.  You may need a skilled neurologist for fibromyalgia or headache care.   An orthopedic surgeon who is motivated to care for chronic back/neck pain may be needed.  A caring psychiatrist who is top in his field on the care of depressed doctors and dentists may be just what you will need.  Your average general practitioner or internist will likely be way out of his field in the care of illnesses that present primarily as subjective in nature.  Understanding this will lead you to the conclusion that you need experts or specialists in the field.  You may have to travel to another state, but it will be worth it. Don’t take no for an answer, be diligent in your pursuit of the best care and treatment.

Subjective pain for dentists is often compounded by the realistic demands of modern dental practice. The significant financial and competitive aspects of dental practice can easily interfere with attempts to seek treatment and help.  The answer to our question at the beginning of this article is YES.  A dentist can be disabled from SUBJECTIVE PAIN ONLY. Basically anything that prevents a dentist from practicing at full capability can be considered disabling. The degree of the disability can be determined. This will require input from the dentist and unbiased diagnostic efforts by treating physicians.  Severe impairment may be diagnosed and you may be eligible for disability benefits from your disability insurance company. The length of the disability is also a diagnostic dilemma, and your efforts to seek care and help from your physicians is rehabilitation and recovery is needed. We understand that some conditions may be permanent and for those unfortunate individuals, transition is the right choice.  By transition we mean moving on to new careers is volunteering, consulting, or teaching as examples.  Understand it is not the end and just the beginning of a new phase of you life. A welcome idea and well-earned.

For those dentists who are in pain and feeling hopeless, we offer real support and encouragement. You have alternatives to practicing in chronic pain. No matter the etiology, you owe action to your family, patients, and staff.  Understand  that you need to function daily at a high level of proficiency and failure to keep up with the true standard of care due to any reason may have serious personal and financial consequences.  Don’t make the mistake of thinking you are alone. You have a great support system already in place. Call your dental friends and you will be surprised how empathetic and helpful they will be. It is very likely they too have faced similar situations and will have strategies for success and survival.  Look to our posting on the tens steps to survive disability as a start.TEN STEPS TO SURVIVE DISABILITY  We will be there as a resource, don’t hesitate to contact us for assistance.



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