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How real dentists conquer real stress

Dec. 5, 2018
Stress is a very real problem among dentists. But they do not have to handle their stress alone. Here are some helpful ideas for handling the many stressors that come with being a dentist.
When dentists describe their lives, they often use the same three words: stress, overwhelm, and dread. Does this sound familiar?

You are not alone. In the 2015 Dentist Well-Being Survey reportby the American Dental Association, 2,122 dentists described their stress levels and triggers. Over two-thirds of them, 79%, reported moderate to severe stress. More than a quarter of them, 26%, also reported moderate to high levels of depression.

Here’s how one dentist described his spiral into stress. “I didn’t know how to make a budget. I didn’t want to admit to myself that I had no clue how to read a profit and loss statement or a balance sheet. I was stressed out trying to get treatment plans through. I was attending multiple CE courses to offer the very best in treatment, only to find myself regulated to basic procedures. The practice had exploded. I went from 36 hours of office time to 54-plus hours a week. I developed chronic sinus headaches. [But] I was so busy I didn’t dare miss a day of work.”

After years of working with dental professionals and talking to thousands of dentists about their stress, I’ve identified the three critical changes dentists can make to manage that stress.

1. Stop tolerating

The ADA report found that 23% of dentists always or sometimes blame themselves for things that are, in reality, out of their control.

When we tolerate something, we grant it permission. So, the more dentists who hold their tongues with staff, vendors, patients, and colleagues, the more they internalize the blame for situations, and the more permission they give to others to continue behaviors, regardless of how it impacts the dentist, the practice, or patient care.

A dentist in Texas found relief when he finally admitted, “Everything that goes on in my office is not my fault; for example, there are underlying issues between team members. Sometimes it’s difficult when you’re in the middle of a problem to see everything going on. You need a different perspective.”

Dentists also tolerate their slow business growth for far too long, wanting efficiency and success but settling for chaos and flat revenue year after year. Every day, dentists deal with stresses related to finance and business, unaware of the specific and practical changes they could make to alleviate that stress.

A recent graduate of Oregon Health and Science University’s School of Dentistry said, “I hadn’t taken any business courses as an undergraduate, and there was only one business class a year in dental school. As a new dentist with debt, I just needed a way to make the business work.”

In response, we instituted new techniques for this dentist for conducting and improving the patient experience, and we established touch points that encourage his patients to value his advice. He was able to see more patients in the same amount of time and yet feel a greater sense of accomplishment in treating them. As patients began appreciating his practice, his anxiety decreased and his productivity and income soared.

2. Acknowledge the warning signs of chronic stress

Chronic stress is not your staff standing outside your office waiting to ask you ridiculous questions, the pile of bills you stuff in a portfolio for the bookkeeper to handle, or the difficult patients you would rather dismiss than treat. Chronic stress is an internal, biological, physiological, chemical reaction that is part of your autonomic nervous system, and it has clear and identifiable symptoms.

Acute stress consists of low stress levels that spur you forward and enhance your awareness. It may have positive effects on your lifestyle. However, chronic stress consists of high stress levels with a continual release of cortisol over time, and that can be disastrous.

Ignoring the warning signs of chronic stress leads to headaches, forgetfulness, fatigue, mood swings, sleepless nights, indifference, depression, burnout, and more. Consistently, when dental professionals share how they feel, it’s as if they’re reciting from a medical journal about the consequences of stress. But they can’t change what they don’t acknowledge.

Stress affects everyone and it is cumulative. A Florida dentist found that his employees reacted to his, their leader’s, stress levels. “I expected my employees to do everything in a very certain way,” he said. “I learned to let employees work on their own terms and that freed me to work on my business instead of in my business.”

According to the ADA study, 92% of dentists keep working even if they have physical pain, and most do not seek a physician’s help. For example, of the dentists diagnosed with arthritis, 84% failed to seek treatment. The main reason they gave for not seeking treatment for physical and mental stress was their belief that a dentist should be able to solve problems without help.

3. Accept help

The refusal to seek help is an unfortunate cultural attitude in dentistry that is perpetuated and nurtured on message boards, at seminars, during study club meetings, and at conferences. People believe that seeking help is admitting failure.

A study in Medical Education of 477 dental, nursing, and pharmacy students found that 27.5% were experiencing psychiatric levels of distress closely associated with perfectionism. They were also experiencing the imposter phenomenon, which is the fear of being discovered as an intellectual fraud.

The practice of building a dental business to success is a bell curve with a very small number of outliers who are able to rely on skill and a lot of luck to go about it alone. The majority of dentists idealize the outliers, spending tens of thousands of dollars to attend their workshops or buy their programs to become like them, all while listening to and conforming to the cultural attitude that going about it alone is the standard expectation of a successful dentist.

When an Iowa dentist found herself overwhelmed by lack of support at home and in the dental office, she sought help to determine what to change. “We changed vacation time so that I was always fully staffed,” she reported. “We changed patient scheduling. My productivity went up, my overhead dropped about 15%, and my profit is way up.” Those practical changes not only reduced her stress but helped her remain competitive.

What to do

There are many pathways to stress management for dentists who want to stop tolerating the status quo, acknowledge the warning signs of stress, and accept help.

1. In order to stop tolerating, know how toleration is affecting you. This coincides with the first step of stress management, know your stress.
2. To become aware of your warning signs, you must understand just how stressed you are. Assess your stress.
3. Then you are ready to reduce your stress, which you can’t do alone. It takes a network of the right people for you to learn from, share with, problem solve, and lean on. Reducing your stress is a result of intentional work with strategic implementation of defined coping methods.

You will find that you still have your energy and passion for dentistry when you are ready to take these three steps.

Jen Butler, MEd, master certified business coach, has worked in the area of stress management and resilience training (SMaRT) for more than 25 years. The creator of Know~Assess~Reduce Your Stress, she is the author of several books and speaks to dental professionals all around the globe on the impact stress has on their lives and businesses. Listen to Jen on her podcast, email her here, or learn more here.
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