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Howard Speaks: Suicide and Trust Howard Farran, DDS, MAGD, MBA, DICOI; Publisher, Dentaltown Magazine

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Suicide and Trust
by Howard Farran, DDS, MAGD, MBA, DICOI; Publisher, Dentaltown Magazine

I recently came across a feature on Business Insider.com called "The 13 Careers Where You're Most Likely to Commit Suicide" by Mamta Badkar and Gus Lubin).¹ The list includes welders, mathematicians, musicians, carpenters, artists, authors and dancers. At the top of the list: dentists. According to the feature, dentists are 5.45 times more likely to commit suicide than average. The source material used for this report came from the book Suicide and the Creative Arts and the 2002 Social Science Quarterly article "Occupation and Suicide" – which were both based on data from more than 20 years ago – and far from what I consider a credible source, but the list got me thinking about the correlations between dentists and suicide.

Myth or not, in my more than 25-year career as a dentist, I've lost too many friends and colleagues to suicide. We have all heard stories of the "rampant suicide rate in dentistry," and we all know someone who has been affected by suicide in one way or another.

Oftentimes, suicide is preceded by drug or alcohol abuse. So it's almost no surprise that dentists and musicians top the list; dentists and musicians are around drugs a lot! Listen, I love likening you guys "rock stars" but for other reasons! I also don't want to turn this into a column on addiction – I'm leaving that up to the expert, Dr. William Kane, who runs the Missouri Dental Association Well Being Program. I really want you to read his article on page 76.

Yes, addiction is a major contributor to suicide, but what's another factor? Stress!

Guys, there's a lot on our shoulders. We all know it! We are expected to be on our game all of the time and there's very little room for error. Even though Dentaltown has eased some of the feeling of isolation, we still operate in our secluded little worlds constructing tiny things in tight spaces. We inflict pain on people. Our patients aren't usually happy to see us. Our entire practice, livelihood and staff 's paychecks rely on how good of a practitioner we are. Oh, and don't forget to tack on the stress of your personal life – mortgage, car payments, house projects and getting to little Johnny's soccer game on time. Nobody outside of dentistry truly understands how stressful the life of a dentist can be!

On top of all of that pressure, many of us make things harder than they have to be. My entire professional life, I've lived by the five Ds: 1. Design Your Plan; 2. Drop Everything You Don't Need to Do; 3. Delay Everything You Can't Drop; 4. Delegate; and 5. Do. Did you read number four?

Delegate.

There are way too many dentists who don't delegate; who have to control every single aspect of the practice. You're already stressed out but even more so because you don't delegate. You don't delegate because you don't fully trust your employees. Why is that?

As a dentist, you want your patients to trust you, right? That's why you went to school for eight years and have credentials hanging on your wall. That's why you dress professionally. That's why you're a member of the American Dental Association and why you take hours and hours of continuing education. I've given hundreds of lectures in dozens of countries, and for 21 years, I've asked dentists in the room if they brought their staff with them. The few docs who bring their employees with them usually bring in around $2 million annually; the docs who don't are burned out, give out negative vibes and might be struggling to keep their practices open. You don't want them to hear what's wrong with your practice? Fine, but I bet they know what the problem is already; you don't trust them! The docs who bring their teams to lectures laugh out loud when I talk about dysfunction in offices. I've seen dental assistants in the crowd wad up a piece of paper and toss it at the doc's head in jest when I mention something that docs do wrong. They all trust each other. Nobody's perfect. Everyone makes mistakes. These teams understand that.

In the unhealthy office, the doc says to his staff, "I want to buy a CAD/CAM machine," and the assistant doesn't say a word (because arguing is either pointless or could get her reprimanded or fired) and calls Henry Schein or Patterson. She might think it's the worst idea in the world, but she knows he doesn't value her opinion, so she won't give him her feedback.

In a healthy office with a staff the dentist trusts, the dentist might think, "I'm going to buy a CAD/CAM crown milling unit. It's going to cost me $125,000." He's going to talk to his staff about it. If this is a really trusting setting, the staff is going to argue – passionately. There's no disrespect to anyone, but the staff might say, "No, doc, we really should take that $125,000 and spend $50,000 on marketing and get some help from an outside company. Then we should take the remaining $100,000 and remodel this old office." The decision becomes a team decision. They all trust each other and all want what's best for the practice. Whether the practice buys a CAD/CAM is up to the team.

One of the biggest signs of trust is that your assistant argues with you. My assistant, Jan, has been arguing with me for the past 20-plus years! Let's say I take an impression and give it to Jan to give to the lab. I'd either never see it again or she'd come back and tell me that it needed to be redone. She never timidly crawled back to ask if I thought the impression was OK. She would know if I made a lousy impression because she knows what the lab will and will not accept. Because I trust Jan and I trust my lab, I would retake the impression. I never argued. If it wasn't good enough for Jan, it wouldn't be good enough for my lab.

Dental assistants often approach me before a seminar asking me things like, "Dr. Farran, can you talk about how to take a quality impression? My dentist can't take an impression and he won't listen to me." This is so wrong! Your staff should be able to talk to you openly and honestly, and vice versa. If there isn't open communication, it means there is no trust. If you have someone on your team who you know can't do the job, fire them and get someone who can. If you have someone who can do the job, you have to trust that person and delegate.

I lead from behind. For years, I have said, hire the best damn people in the world, get completely out of their way, stand behind them and just try to keep up with them. I don't micromanage. If I ever feel like I have to micromanage someone I would rather just fire that person and find someone who I don't have to micromanage. Between Dentaltown and my dental practice, if I have 40 blossoming people then the whole company blossoms. But I'll bet you it is not like that in 80 percent of the dental offices in America.

My favorite CEO in the world is still Jack Welch of GE. At GE, there were almost 20 divisions that reported to Jack Welch and they ranged from light bulbs to jet engines to nuclear power plants to NBC. He knew nothing about how to make a light bulb or how to hire actors for a hit TV series. Rather than trying to know everything about everything, he found people who knew what to do and he trusted them. He concentrated on his team. Jack Welch had 500,000 employees in about 20 divisions. He concentrated on the four legs on managerial economics: What is the score? What are we going to measure and focus on? What is the reward incentive? And what is the job description? Jack Welch didn't know how a jet engine works, he just had to know a job description and he found all the engineers and the right people, designers, marketers and advertisers to run it. That's trust! Remember what Ralph Waldo Emerson wrote, "Trust men and they will be true to you; treat them greatly, and they will show themselves great." Jack Welch lived by that, and you should, too!

Guys, you can fix this! You can turn this behavior around! Stop trying to do everything yourself. Start realizing that you can't be perfect at everything and don't get offended when your staff offers you constructive criticism. Start trusting your staff enough to delegate the day-to-day goings on at your practice. And please, stay healthy, not just for the life of your practice, but for your own life.

References
1. Visit: http://www.businessinsider.com/jobs-commit-suicide-2010-10#1- dentists-are-545-times-more-likely-to-commit-suicide-than-average-13 if you want to see the report. Word of warning: it's a slideshow.
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, e-mail colleen@farranmedia.com.

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