Our past certainly is part of who we are and plays a major role in what makes us "us" - but does our past and our current circumstances dictate our future? Being born in 1955 makes me a "Baby-Boomer". Being a teenager in the '70s and trying to fit in was really interesting.

I remember long hair and long sideburns, bell bottoms, leisure suits, platform shoes and discos. Then there was college and "streaking" (no, I didn't!) and souped-up cars.

And then there was dental school. We had to adapt to a rigid schedule, filling out all the proper forms, waiting in line at the supply, sterilization and lab window, and meeting all the requirements of amalgams, crowns, dentures, extractions, root canals, etc. And we were "forced" to sit down and actually talk to a patient and be videotaped!

Halleluia! We finally graduated and started in the wonderful world of private practice - and the pressure of paying off school loans, practice loans and everyday overhead. We also had to fill out insurance forms where we were required to record not only every tooth we treated but also every surface so we could get paid.

Then the insurance company sent a letter back saying that we just weren't "usual, reasonable and customary." Ouch! We were trying so hard.

I remember a dental society meeting I attended in Kansas City in the 80s and the speaker was a representative from a capitation plan. The dentist next to me said that he was going to sign up for every plan he could...and then hope and pray no one would come in for an appointment. What an easy way to make money! I wondered if I should do this too. But it just didn't sound "right".

Then there was the "high-volume, high-production" management course I signed up for. I felt I had to because other dentists in my community were and I sure couldn't be left behind. It just wasn't a good month if I didn't see 40-50 new patients!

And I was terribly stressed and unhappy.

My mentor at the time asked me what I really wanted out of the practice of dentistry. How did I really want to practice? He asked me to think about it not in a selfish way of what is in it for me, but in a way that would give me happiness and fulfillment and peace of mind so I could be my best and serve my patients in the best way possible.

I was shocked because after I thought about it - a lot - it was not at all like I was currently practicing at the time.

The AGD did a survey a few years ago and asked their members what they felt were the issues most important to them at the time. In other words, the issues that seemed to keep them from practicing the way they really wanted to. Here are the results:

A pretty realistic list, isn't it? These are real issues that we are all faced with on a day-to-day basis. If the AGD did another survey today, I am sure the list would look very similar.

The point is, there will always be a list of "stuff" that seems to be getting in the way of how we would really like to practice. That's life. As my 12-year-old daughter has told me, "Cry me a river, build me a bridge and get over it!"

So what is the real issue here? I believe that all the things on the list above or any list similar to it, if they become a major barrier in your practice, have one thing as a common denominator...

...a lack of vision and leadership on the part of the dentist!

Until YOU have answered the question of how you really want to practice, how you can be of best service to your patients, no ifs, cants, buts or excuses, you will be a victim of the circumstances around you, like a leaf blowing in the wind..

As James Allen said in As A Man Thinketh, "Your circumstances may be uncongenial, but they shall not long remain so when you perceive an Ideal and strive to reach it. "

Once you have begun to crystallize your vision, discussed it with your team and set up systems together in your office that are vision-driven and not circumstance-driven, your happiness and fulfillment will soar.

Do it today. Put your vision to paper. If you already have done so, read it again. Is it really what you are all about, your purpose, how you choose to practice? Does it put a smile on your face when you read it? Do you think about it often or do you have to hunt for the piece of paper to remember what it is?

It could very well be the most important thing you do for yourself, both personally and professionally.