Message Boards
Today's Active Topics Today's Active Cases Browse Forum Categories My Recent Activity My Messages Private Groups My Marked Threads My Subscriptions
Today's Active Images Today's Active Polls Most Active Topics Global Townie Map Advanced Message Board Search Message Board Terms of Use

The Silent Killer of Dentistry by Douglas Carlsen, DDS

View Comments (90) More by this author (62)


Pulitzer Prize-winning American novelist Ellen Glasgow wrote, "The only difference between a rut and a grave are the dimensions."

This makes me wonder, if dentists find themselves in so many daily ruts, why do they keeping digging their own graves? What's the cause behind the compulsive attitude and behaviors commonly repeated by dentists that kill their practices? Answers came to me recently when a theme emerged while working with some of my clients: Stress.

Jen Butler, M.Ed, MCC, BCC, owner of Jen Butler Coaching, will be addressing stress in a series of articles for Dentaltown Magazine in November 2013. This month, I have the honor of interviewing Butler to intoduce her to the Dentaltown audience.

Carlsen: Is stress really significant enough to be called The Silent Killer of Dentistry?
Butler: Stress is the silent killer of dentistry. Even though dentists experience a high level of stress, they rarely talk about it. Just go to any study club and ask a member, "How are you doing?" and you'll get the standard, "Oh fine, and you?" Although in a group of their peers that understand on a deep level what each other goes through on a daily basis, the vulnerability it takes to share feelings of stress often holds dentists back from telling how they really feel.

Also, many dentists do little to deal with their stress in permanent and calculated steps. For example, when attending conferences where both clinical and stress-related topics are offered, the clinical workshops are most often chosen.

Although there are a number of studies that support the claim that stress is the silent killer of dentistry, one particular report stands out. The American Dental Association conducted a comprehensive wellness survey in 2003 and published the results (2005) as the "2003 Dentists Well-Being Survey." Of the 2,565 respondents, 2,052 stated their work was stressful with 1,416 (69 percent) claiming "moderate" stress levels and 247 (12 percent) claiming "extreme" stress levels. Respondents were also asked how they felt due to their stress and 17.8 percent claimed "depressed" while 10.3 percent stated they felt "hopeless."

In spite of signs of depression and being overwhelmed, only six percent sought professional support. When applied to the general population of dentists, these numbers would register into the tens of thousands of dentists experiencing moderate to high levels of stress. Until we break this accepted culture permeating dentistry there will continue to be a lack of resources, support groups and catalysts for change.

What surprises have you found with doctors, either positive or negative, regarding stress?
Butler: In my years of working with dentists I've discovered two profoundly important aspects.

First, dentists experience a level of stress beyond that of the average professional and they have limited resources for seeking assistance. When most dentists are stressed they tend to start with fixing external problems in their practices. They hire or fire staff hoping that will alleviate their stress. They attend clinical workshops thinking that if they enhance their clinical skills their patient retention will increase. They implement new marketing methods to try and attract more patients. These external solutions are not going to reduce their stress. Stress is an internal, biological reaction to a perceived situation. Internal problems take internal solutions. It's like patients saying they are going to cure their periodontal disease by brushing more often, harder or longer. Periodontal disease is under the gums just like stress is under the skin. It takes methodical steps to eliminate the disease and maintenance steps to ensure it stays under control.

Second, dentists are resilient. Through the decades of dentistry, dentists have created a network and culture of resiliency. In spite of their struggles, dentists persevere. They approach patient care with unwavering commitment, implement their clinical skills with delicate precision, all while providing a good life for their families. They hold honor for what they do and it shows in who they are.

How did you become interested in the role stress plays in a dentist's personal life and practice?
Butler: In 1996, while working in the public education system, I developed stress management programs for teachers and parents of children with special needs. The work was extremely rewarding and the topic of stress management became instantly fascinating to me.

Since obtaining my Masters of Education in 1999, I've dedicated my career to serving professionals on the issues of stress. It's taken me to a variety of industries, including dental, given me opportunity to write and implement a dozen stress management programs, and work one-on-one with hundreds of professionals looking to reduce stress, work smarter and live better.

How does stress impact a dental practice?
Butler: Stress impacts the dental practice in three key ways:
  1. direct impact on the dentist;
  2. employee performance; and
  3. patient base
When the dentist experiences any level of stress, he/she has less focus, less patience and less energy to perform the delicate procedures necessary for patients. This not only leads to loss in same-day revenue, the dentist could see a higher than normal failure rate on treatment at a cost to future business. Also, when having physical and emotional stressors, it is normal for one's tolerance of the ebb and flow of a dental practice to decrease resulting in quick tempers, snappy retorts, reactive behaviors and conflict. Often with these results a practice will see higher turnover, emotionally absent staff, decrease in patient retention, and a measurable, negative impact on financials. It's a spiral to which many dentists can relate.

Employee stress is another major factor for the dental practice. There is significant evidence from both mental health and medical professionals indicating that stress is responsible for the loss of production and an increase in injury at the average cost of $10,000 per employee each year.

According to the American Institute of Stress, costs of stress in U.S. industry totals more than $300 billion a year in absenteeism, turnover and diminished productivity, with the median number of missed work days from a stressed employee at 25 days a year compared to the non-stressed worker's six days. Considering every employee in the dental practice plays a key role in the patient experience, the experience becomes compromised in some capacity every time just one team member is not at work.

In the recently released Stress in America Survey (2013) sponsored by the American Psychological Association, more than half of the general population states they are living with a moderate amount of stress and an additional 20 percent declare an extreme level of stress. Dentists should care about the overall stress of the population because that is their patient base. When people are stressed they are less likely to be proactive with their health, feel as if they have less time to visit their health-care providers, and have poor nutrition. This results in lower re-care appointments kept, postponement of treatment, increase in damaged or broken teeth due to grinding and higher numbers of periodontal disease.

I recently sent out an anonymous stress question to 600 dentists - "What's your biggest worry today? What keeps you up at night?" I received a meager 11 percent response rate with only two people listing divorce. Not one mentioned depression, alcohol, drug addiction, bankruptcy or suicidal tendencies. Are dentists afraid to be honest about their inner demons?
Butler: Your survey and responses are a perfect example of just how far dentists have their heads buried in the sand. They would rather point a finger at everything or everyone else than own the fact that they are failing and need help. The real tragedy of this whole culture is that most dentists think, feel and act the same way so they have a definition of normal that is completely destructive and dangerous. It's time for a new normal!

If most of the people you consider your friends and colleagues engage in the same or similar behaviors you do, that behavior, however constructive or destructive, is recognized and taken as normal. Dentists are willing to accept these demons (divorce, alcohol use, depression, etc.) as a normal part of their lives because that is how the dental industry has always been perceived. Even before the 1960s' reports of high suicide rates and making the recent most stressful jobs list on CareerCast.com, dentists are getting reinforced messages that their job is stressful. When people think things are normal it limits their curiosity to seek change. Instead they internalize their results and view themselves as failures or less than their expectations because they cannot handle what others deem as normal. This perpetuates the stress cycle, causes tangible consequences within a dentist's practice and personal life, which reinforces the idea that they cannot handle it.

Most dentists do not realize they are actually fueling the very cycle of disease from which they suffer.

What are some immediate coping mechanisms that doctors can use to ameliorate stress?
Butler: Stress started out as part of our biological systems. Over the years it has turned into a psychological and mental health concern. Addressing stress at the biological roots first gives us the mental space we need to process situations, choose our response and think of out-of-the-box solutions.

Heavily based in scientific research, the most effective and powerful coping mechanism is always accessible, free and is already part of our biological systems - breathing. When people are placed in stressful situations, medical researchers have documented that people often start to shallow breath or hold their breath, reducing their oxygen intake which slows their reaction time, reduces the number of solutions they identify, and increases cortisol and other hormones which trigger the fight or flight response. Intentional deep breathing combats these effects of stress at the biological level and allows for a dentist to manage more situations effectively, with minimal residual impact from their response, which helps them find a solution that creates a win-win-win result.

Another coping mechanism easily threaded throughout the practice so the dentist, all team members,and patients can benefit from its positive effects is humor. Laughter is scientifically proven to have physiological, physical and mental benefits on the body. Intentionally creating a fun, humorous atmosphere within the practice is one way to be proactive in the process of stress management.

Go to www.jenbutlercoaching.com for a step-by-step approach to deep breathing, ideas on how to incorporate humor into your practice, and other coping mechanisms.

Author Bios
Dr. Douglas Carlsen has delivered independent financial education to dentists since retiring from his practice in 2004 at age 53. For Dentists' Financial Newsletter, visit www.golichcarlsen.com and find the "newsletter" button at the bottom of the home page.

Additional Carlsen Dentaltown articles are at: www.dentaltown.com. Search "Carlsen." Videos available at: www.youtube.com/user/DrDougCarlsen. Contact Dr. Carlsen at drcarlsen@gmail.com or 760-535-1621.

Jen Butler, M.Ed, MCC, BCC has decades of experience working as a business and stress management consultant. She has written dozens of stress management programs for small and large organizations that resulted in higher team engagement, job satisfaction and increased revenue. As a nationally certified trainer, Jen has presented to thousands of business persons on the subject of stress management and other relevant topics.

As president and CEO of Jen Butler Coaching and one of 953 Master Certified Coaches worldwide, Butler works with dental professionals to help them reduce their stress, re-engage, and create more of what they want. She has a free, weekly stressLESS call for those looking for additional support and guidance on how to reduce their stress as well as a monthly newsletter. For more information, go to www.jenbutlercoaching.com or contact Jen Butler directly at 623-776-6715.
Dentaltown Magazine
April 2024
Dentaltown Magazine April 2024 Read Current Issue Read Archived Issues
Sponsors
Townie Perks
Townie® Poll
Have you ever switched practice management platforms for your practice?
  
Site Menu
Message Boards Magazine Continuing Education Podcasts Blogs Classifieds News Events Townie® Poll Ebooks Townie Choice Awards
Company Info
Contact Us Advertise With Us Howard Farran DDS, MBA Policies and Agreements
Site Help
Sally Gross, Member Services Specialist
Phone: +1-480-445-9710
Email: sally@farranmedia.com
©2024 Dentaltown, a division of Farran Media • All Rights Reserved
9633 S. 48th Street Suite 200 • Phoenix, AZ 85044 • Phone:+1-480-598-0001 • Fax:+1-480-598-3450