Striking a Balance
The Knowledge Revolution has put a premium on learning, which by now doesn't surprise us too much. Still, I was recently stunned to read an unusually meticulous article in Fortune stating that within the next six years, the growth rate of our scientific knowledge would double. A notion such as this is enough to vapor-lock your central nervous system.
The first question that bedeviled me was how in the world would I be able to double my professional knowledge in the next six years? How could I possibly learn, remember, and reasonably apply that much new knowledge in such a short time?
If the past is any guide, then, mercifully, the coming changes will be more evolutionary than revolutionary. Consider the discovery, advent, and application of titanium wires. A great deal of new scientific knowledge brought this product to orthodontics and other disciplines, but those of us who began to use it didn't have to acquire metallurgical degrees before we could benefit from it. There was a normal learning curve in which we had to learn what titanium wires could and couldn't do, but we quickly modified our clinical behavior to reflect the realities of these marvelous new wires.
I remember only too well the general dentists who refused to let me bond brackets to their own children's teeth because it required etching the teeth with phosphoric acid. Twenty years ago, bonding may have seemed radical to someone unfamiliar with Buonocore's seminal work, but those who endorsed bonding early on brought such a new measure of comfort, esthetics, and clinical excellence to their patients that within a short period of time it became standard practice in general dentistry as well as orthodontics.
It's been pretty much the same with other technological improvements over the past 25 years. The development of magnetic resonance imaging and arthroscopy, to mention only two, required almost quantum leaps of applied knowledge. By and large, though, their implementation was accomplished gradually, without a whole sale upheaval of the healing arts.
There will be many more new things to learn in the next few years, but they probably won't overwhelm us. If we approach this new knowledge with open, receptive, and analytical minds, we may find the kind of stimuli that will enliven and enrich our personal and professional lives beyond any reasonable expectation.
On the other hand, if leveraging knowledge to create value is to be the new rage, then we need to develop another skill that is at least equal in importance--that of forgetting.
There is abundant evidence that unlearning old lessons is even more difficult than learning new lessons. Whenever we learn to do anything, the natural tendency is to keep trying to do it better. But usually any improvement involves step-by-step, ritualistic, more-of-the-same-but-better modifications. Such a linear progression reinforces our commitment to ideas and techniques previously learned, and lessens our adaptability and our disposition to react creatively to unforeseen circumstances.
We've all heard that practice makes perfect, but that isn't the whole story, as any golfer can tell you. Practice makes permanence, not perfection. If you have a bad golf swing and continue to practice it, you will only groove that habit more deeply and make it more difficult to change. Orthodontic habits are just as difficult to change once they're deeply grooved. Forgetting old lessons may, indeed, be more difficult than learning new ones and may prove more of a threat to our professional progress than the flood of new information that solicits our attention.
It seems to me that orthodontists need to achieve some kind of balance in their search for professional excellence. As we all know, many a "new" idea is often little more than some failed and recycled old idea. To wit, the notion that we can somehow expand mandibular cuspid widths with impunity. There has probably never been any orthodontic dogma more thoroughly studied, more thoroughly disproved, and more widely reported. Yet people keep exhuming this dead mule and expecting it to run.
To be sure, there will remain many topics about which people can and should hold opposing opinions and debate them in a healthy, constructive way until at least an approximation of the truth is discovered. Being approximately correct is much preferable to being precisely wrong. Unfortunately, there are a large number of orthodontic beliefs (the orthodontic equivalents of alchemy) that are, without any doubt, precisely wrong. The sooner we get rid of them, the better off we and our patients will be. As Lysle Johnston has said, "It isn't unprofessional to question a person's science. It isn't uncollegial to demand proof. It isn't impolite to recognize glaring conflicts of interest."
I think most professionals recognize their necessity to constantly and continually learn. Our entire educational system is built around learning theory. But little has been said about planned forgetfulness. Maybe by lighting a candle in this darkness, we can begin to devise some strategies of systematically forgetting outdated beliefs before they strangle us.