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A similar example to the one described above is the balance between enthusiasm and caution, and how important this is to our behaviour. In this, the first of two leaders looking at that balance, I shall consider the term cautious enthusiasm which looks at how we need to be very careful not to be overly influenced by the enthusiasm of others.

I would return to the practice filled with confidence that I was now equipped and able to change the world. The speaker sounded so capable, the slides looked superb and the whole day was packaged with such style that I was completely taken in by it.

In my earlier days I was often guilty of allowing the pure enthusiasm of others to influence both my thinking and my behaviour. I would attend a postgraduate course held by an enthusiastic speaker (often from abroad) and return to the practice filled with confidence that I was now equipped and able to change the world. The speaker sounded so capable, the slides looked superb and the whole day was packaged with such style that I was completely taken in by it. My colleagues in our practice were more circumspect, warning me against changing my entire clinical technique based on the anecdotal ideas of a single person and on a single day, but I was so carried away by the enthusiasm I considered everyone else to be too cautious. After all, they had not seen what I had seen and heard what I had heard.

In time I learnt to temper my gullibility. My sessions as a part-time lecturer at 'The London' taught me that enthusiasm (and good slides) is no match for properly conducted research studies that provide real evidence. This becomes even more relevant when you have the responsibility of teaching dental students as well as treating your own patients. Further experience as an editor has taught me that what we read in some dental journals is not always as evidence-based as we would like to think, and that published papers in respected and refereed journals are not always as rigorous as they should be.

The strange thing is that, despite the good sense of being sure that what we do to patients is in their best interests, we can still get carried away by the enthusiast. There is a seductive attraction for the rebel, for the person who ignores the system or, better still, beats it. Our entertainment media are full of heroes who have to (or choose to) fight the system and our history tends to focus on the rebels rather than the ordinary. For this reason the rebel 'expert' who challenges the traditional also has an attraction, especially when that individual has a charismatic style on the lecture circuit. Perhaps that is why I was so attracted to those postgraduate courses I mentioned earlier, for the combination of the misunderstood rebel who exudes constant enthusiasm is quite compelling.

The answer to all this is to be more aware of the seductive effect of the enthusiast, and to exercise caution before moving away from a traditional way of treating patients or giving advice. We need to be wary of the charismatic lecturer who uses entertaining techniques to gloss over the lack of supportive evidence for his or her material, or the well-written article that lacks any form of reference or support for the suggestions within the article. Enthusiasm is a powerful tool, and when used appropriately can be a superb catalyst towards change. All I am saying is that we should remember to exercise caution appropriately as well.

This leader has focused on the danger of being influenced by the enthusiasm of others. In the next I will look at the other aspect of enthusiasm — how we can often fool ourselves because of our own enthusiasm.