Howard Speaks Howard Farran, DDS MBA, MAGD, Publisher, Dentaltown Magazine

Extinguish Burnout
– by Howard Farran, DDS, MAGD, MBA, Publisher, Dentaltown Magazine

Burnout is the biggest problem in dentistry today. I hear it all the time from the thousands of personal contacts I’ve made lecturing 50 times each year since 1990, and from the hundreds of thousands of connections I’ve made with dentists and dental professionals around the world via Burnout lives in the closet of so many practitioners and everyone is afraid to talk about it.
Burnout will ruin your life. It can lead to harmful vices like alcohol and drug addictions, extramarital affairs, and a litany of self-destructive behavior. Burnout has also killed. It’s sad. It’s depressing. And it must be stopped. One huge contributing factor in burnout is your environment.

There are only 168 hours in a week. You spend (roughly) 56 of those hours asleep. You spend 40 of them in your dental office, which equates to 23.8 percent of time each week. About a quarter of your life will be spent at work in your practice. Knowing this, what do some of you do? You settle on renting out some ugly, dingy, ridiculous 1,500- square-foot office, in which you cannot stand to practice. There are no amenities whatsoever. You don’t have a break room or even a private office where you can turn on CNN and chill out for a few minutes. There isn’t any space in your practice where you can put your feet up. The second you walk in, you want to go back home to where your favorite projects are like your garden or your golf clubs or your grill. When you wake up in the morning, you dread the day ahead. Your office sets the scene, and guys, this scene is grim.

This is hugely dysfunctional.

For those of you who practice like this every single day, get this: real estate is selling at a 20-year low! In the 10 largest real estate markets in the United States, the pricing is down about 35 percent on average. Wake up, guys! Now is the time to get out of that soul-sucking hellhole you’ve been renting for the last dozen years and lock in a mortgage at a low interest rate and get a nice, breathable commercial location at two-thirds the price! But you have to be smart about the space you buy.

At the risk of sounding like a broken record, don’t be the guy on the third floor of a medical building where you have no visibility, no walk-ins, and where you have to spend half of your budget on marketing just to get people in the neighborhood to realize your practice even exists.

I love coming to work every day. Know why? I own my own land. I own my own building. I share a parking lot with a Safeway grocery store, a Walgreens and a bank. It’s “mom central” over here (remember who makes the most appointments)! I get one or two walk-ins every day. My practice is visible on all sides from about a quarter mile away on a busy street. Inside my office I have a break room, my own office space, a fridge, TV and radio. If I need a break, I’ve got somewhere I can take it. I try to make the office as comfy for myself as I do my patients. Why don’t you?

Some dentists will buy themselves a boat or a cabin or a Harley Davidson because, hey, why not? They’re fun! But what fun stuff do you have at the office that makes it worth commuting to every day?

I’m often approached by dentists who ask me if I think they should buy a laser or CAD/CAM or a digital X-ray. I always think back to my four boys when they were little and playing in the sandbox. If you put them in the sandbox with no toys, they’d get up and leave! But if you threw a bunch of bulldozers and trucks and pails and shovels in there, they’d stay there until they died from starvation!

So, you want to know if I think you should get a laser? Absolutely!

When dentists approach me to find out what I think about lasers, I usually throw the question back at them. I ask, “What do you think about lasers?” First thing I see is a sparkle in their eyes. Then they say, “I just think a laser would be really cool.” They’re right!

I don’t care what you use a laser for, and I can tell you that you could probably run a really good practice without a laser. But if you think a laser is really cool and it gets you excited about doing dentistry – like you’ve got 19 speeding tickets in the last week because you can’t wait to get to work – you can’t afford not to have one in your sandbox!

Same thing goes for CAD/CAM. I can’t tell you how many dentists have asked me if I think they should get a CEREC or E4D. Again, do you want to buy a one because you think it will lower your lab bill and you will actually make more money? That’s certainly true, but should you buy it for that reason? Yes! Duh! It will significantly lower your lab bill! The thing pays for itself! It is a solid return on investment.

What’s even more important is the dentists who have invested in CAD/CAM think it’s really cool and it gets them excited every day to come into the office and work with it. That excitement spills over to your staff and your patients. Pretty soon, everybody who walks in and out of your practice is rockin’ and rollin’, and cranked up to 11! That enthusiasm increases word-of-mouth referrals and decreases your desire to retire early.

What Gets You Excited?
I am 47 years old. I graduated from dental school in 1987. I have been at this for 23 years. I am telling you I don’t get excited anymore doing a DO filling on #4. There is no challenge there. There is no adrenaline rush. It is just simple work. No excitement whatsoever.

But what does excite me is pushing myself over the years. I got my International Congress of Oral Implantologists (ICOI) Diplomate. I am telling you placing an implant is a rush. There is no way you can get bored placing an implant when you are trying to avoid dropping into a sinus or hitting a nerve with it. When you are placing an implant you are totally alert, totally focused and the time flies.

Same thing with pulling wisdom teeth. Why are you referring out all your wisdom teeth? You have to push yourself! Go to the Las Vegas Institute for Advanced Dental Studies (LVI). Go listen to David Hornbrook lecture. Learn cosmetic dentistry. Take on a challenging case. How can you get burned out doing upper 10 veneers on some attractive patient with a high lip line who has really high expectations and wants them to look perfect? You don’t burn out on something like that.

This is why I hate golf. You won’t push yourself in dentistry but you will shell out $30,000 every year to be a member of a country club. You’ll pay $100 an hour for golf lessons. You’ll buy the most expensive set of golf clubs you can find. Meanwhile, you’re wasting all of your competitive instincts on golf.

If you play golf but you won’t do Invisalign or implants, you are not a smart dentist. You need to spend those competitive instincts and energies pushing yourself to new levels of dentistry. I spent five entire weeks at the Pankey Institute learning full-mouth rehabs. Push yourself. Go to The Scottsdale Center for Dentistry and take some courses! You love golf? Fine, come play golf while you take classes at the Scottsdale Center. How can you listen to Frank Spear and not want to run back to your dental office and put some of these practices into place?

You need to make the change before it’s too late! What happens when you burn out? First thing, you want to retire. This means you’re putting your retirement fund under tremendous pressure because you’re going to try to live on it earlier instead of working longer and building it stronger.

When people retire from work, their longevity is broken up into quartiles. The lowest quartile income of retired men only lives three-and-a-half years and the highest quartile lives six-and-a-half years. Why do you want to retire and start that countdown? Take a look at the godfather of dentistry, Dr. Gordon Christensen. How old is he? In the last 12 months he gave 84 lectures and he has more energy than any other dentist I have met who is half his age because he loves what he is doing.

If you say to me that you want to retire early, I think it’s something you should get counseling about. Then again, maybe it’s nothing biological… but environmental, because you work in a crappy office, you don’t have a laser, you don’t have CAD/CAM and you just perform what I call burnout dentistry (cleanings, exams, X-rays, fillings and crowns, and that’s it). You can blame burnout on just about anything, but nine times out of 10, you’re burned out because you caused it.

Howard Live
Howard Farran, DDS, MBA, MAGD, is an international speaker who has written dozens of published articles. To schedule Howard to speak to your next national, state or local dental meeting, email

Dr. Farran’s next speaking engagement is September 17, 2010, at the Greater Springfield Dental Society in Springfield, Missouri. For more information, please call Colleen at 480-445-9712.

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