Thick Skin & Thin Schedules: The Surprising Burnout Solution

Burnout isn’t just a buzzword—it’s a real problem in dentistry. But why? Join us as we dive into the growing issue of burnout and how you can find joy in your career again. You'll get strategies for combatting burnout, learn how to manage the stress of practice ownership, and understand the key mindset shifts that make all the difference in your workweek. These insights will help you step back from the chaos and make changes that reduce stress and prevent burnout!

Topics discussed in this episode:

• Why is burnout on the rise?
• Mindset shifts to overcome burnout
• Balancing roles as owner and clinician
• Strategies to manage stress and avoid burnout

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Chapters

• 0:00 Dental Burnout Epidemic
• 3:31 The Perfectionist Problem
• 9:26 Learning From Failures
• 15:15 Chaos vs. Systems
• 18:48 Finding Joy & Taking Control
• 19:50 Coaching & Solutions

Transcript

Paul Etchison: 0:02

You are likely hearing more and more dentists talk about burnout. You've got an immense pressure to not make mistakes, you've got upset patients, team frustrations and you're likely juggling so many responsibilities that it's hard not to sometimes and sometimes more than sometimes feel overwhelmed and exhausted. Now, is it just part of the job, or do we have more control over it than we think? Today I'm joined with my DPH legendary coaches to unpack what really causes burnout and how shifting your mindset, your approach to your practice and schedule can help you get back to enjoying your career and life at the practice. Stay tuned you are listening to Dental Practice Heroes, where we help you create and scale your dental practice so that you are no longer tied to the chair. I'm Dr Paul Etcheson, author of two books on dental practice management, dental coach and owner of a $6 million group practice in the suburbs of Chicago. I want to teach you how to grow and systematize your dental practice so you can spend less time practicing and more time enjoying a life that you love. Let's get started. Hey, welcome back to the Dental Practice Heroes podcast. I am joined by my two DPH coaches, dr Henry Ernst and Dr Steve Markowitz, both gifted dentists with grown a big business and practice very little right now and we're talking about something that's very important.

Paul Etchison: 1:23

In the dental industry, we've seen a shift of people talking about mental health more. We got this word that came out maybe it seems like it came out about five, 10 years ago burnout. It's just people being sick of what they're doing, depressed, not liking their job, and if you go on the dental forums you see this a whole lot. Nowadays is people getting on there and saying I just graduated, I feel like I made a huge mistake and I don't know what to do about it. So I'll pass to you first. Like Steve, does it feel to you that there's more dentists burning out, or this is becoming more common, or is it more of a thing that we're just talking about it now?

Stephen Markowitz: 1:58

I think it's more of a thing that well, yes, we're seeing it more in dentistry, but we're seeing it in everything, and I don't want to blame COVID, but it seems like that was kind of the shift of things becoming harder. What I always think of burnout is lack of progress, and I think for us as dentists and dental owners, because it's been harder, there is less progress that we're making within our practices. Sometimes I see practices every day that they're seeing more patients, they're working harder than they ever have, yet they're less profitable than they've ever been, and that in itself can lead to feeling like I'm not growing at all. This sucks.

Stephen Markowitz: 2:38

And then you just get stuck in that negativity and what I see is that most dentists now they have a fixed mindset, they live in the negativity and they're living in the gap which they see online of. They either see two ends of the spectrum one end where everything sucks and they're going to get out of dentistry, and that resonates with someone who is negatively minded. And then the other end is someone who only prints pictures of their full mouth cases Everything's perfect and they have never had more money and they think, holy crap, I got to do that to be successful and that also makes them feel shittier about themselves, which leads to more burnout. So, yeah, it's more prevalent than it's ever been and I think it's also feeds on itself as a topic, and I'm excited for us to kind of unpack how we can overcome some of those challenges and see progress in our offices.

Henry Ernst: 3:30

Yeah, what do you think, henry? So I'll take it from another angle. This is going to make me sound old and, yes, I turned 50 a week from today, so I am getting older. I feel like this new generation is just, they're soft. I mean, call me, I don't know, they're soft. I talked to a dentist that I've mentored. She's been in her family. She's been my patient for years. She's a third year dental student. I helped her get into dental school and, for example, they took their board exams as third year students. She already passed her board exams.

Henry Ernst: 4:00

So like the clinical board it's done after the third year, yeah, it's all done, wow. So when I was in school as a fourth year, like you graduated, then you pray that you pass the board exam or else you could be parking cars for a few months Like that was stress and that was like John Taffer's show Bar Rescue. There's a stress test. I feel like this younger generation doesn't have like stress like on them, like we did, and dentists always try to be perfectionist. So now you get into practice and people say negative things about you or somebody's actually hurt after a root canal. It's like the worst thing in the world, right? I mean, maybe it's a hard thing to say, but you just need to have thick skin in this business, right? People are going to say negative things. You're going to do lots of stuff and you have a lot of power. You're fixing people's teeth and you're correcting pain and there's going to be people that call you at nighttime. There's going to be things that happen. You just have to. This is part of it. It's the business we chose. So that's one aspect is just you just have to learn what you got into. Really, I know it stinks once you've borrowed $500,000 to be a darn dentist. The other thing is I feel like there's a lot of burnout from the owner point of view because you think, oh, this dentistry thing, it really stinks. But now I'm going to be an owner, now everything's going to be fixed and solved and my stress is going to be gone. Yeah, I see you guys laughing a little bit. That makes it worse sometimes, because now you've got, now you go home and you got work to do from the business.

Henry Ernst: 5:16

So from the owner point of view, I think lack of a plan. Am I going to be a big group? Am I going to be a one doctor of family practice? What am I going to do? Have a plan. Learn how to delegate. We always talk about this here. Delegate, and delegate the right way, because dentists are perfectionists. They want to do everything themselves. You can't do that on top of all the other stressful things I talked about in the beginning. So, thick skin. Have a plan. Learn how to delegate. This is a tough business, guys.

Paul Etchison: 5:46

I got a buddy that's like a plastic surgeon and I was talking to him once. I'm like man when I do these big cosmetic cases. I'm doing one on Wednesday that I'm delivering and I'm dreading because I just know the patient, I just know that it's going to be an issue. So do you get a lot of people complaining? He said almost everyone, almost every single person, will come back and there is something that they wanted that it didn't result in that. He's like there's some happy, but most of them it's. There's something expectation is wrong. And I said well, dude, how do you deal with that? He's like it's just normal. He's like I don't let it bother me. He's like that's just how people are. But I think, like you, like you mentioned, henry is we're such perfectionists, we're so hard on ourselves. I think our expectations are all wrong. We expect people to everything to work out and I think dentistry is unpredictable. It very much is.

Stephen Markowitz: 6:33

And we learn so much more from our failures and if we're not putting ourselves in the position to have challenges, then we're never going to grow as much as we possibly could.

Stephen Markowitz: 6:44

And I think, to add to what Henry was saying, especially within the first five years of being a dentist or being a practice owner, learn all those things. I remember in dental school. The two greatest things that I learned was one I had a root canal on number five and I went right through the side of the tooth. And two I got an impression coping on my girlfriend at the time wife now and I torqued it in the wrong place. Those two things were stressful, but I'm so thankful that I had those challenges because it made me better at doing root canals. It made me learn implant dentistry so much more and if it wasn't for those situations that felt crappy, I wouldn't have felt as comfortable as I was in the first couple of years doing implant dentistry or doing root canals. So I think, from a mindset standpoint and what helps with burnout is this I'm going to learn a lot from this, even though it feels really crappy right now.

Paul Etchison: 7:38

I used to say one of the biggest problems at my practice is growing too fast, and I think that was part of what led me to burnout. I mean, did you have a time in your career, Henry, where you felt like you were experiencing that?

Henry Ernst: 7:50

No doubt, and when our practice has always had extended hours. So it was probably when I was about two, three associates at that time and there was one time I had to fire an associate. And you know now all of a sudden that schedule that is totally full. We don't just get rid of it Like I was that person. I'm like I jumped in there. So now I'm working six days a week until I find another associate and I can't even do anything in the business. So yeah, those were times where I was really stressed and just I was hating it and I was just so dreading it and I had to come up with a plan like look at what's happening and not going to continue this path, we're going to change paths. So in that case that required me to say hey, from now on, when I get another associate, I'm not working three or four days in a week, I'm going down to two. So if I have to jump in I'm going to go to four and that's normal, right. But one thing to jump on some stuff you said, steve, is I think it's really important.

Henry Ernst: 8:42

It came to my mind when I was talking with this young, soon-to-be dentist and a phrase that was told to me while I was in dental school by an endodontist. And it's so true your first five years out of school you are truly practicing dentistry. You're going to screw up stuff and you're going to be really slow. It takes five years to get quick. You know, on my first second year and I've treatment plan a root canal on 14 in the back of my head.

Henry Ernst: 9:06

I'm like please, let me get through this root canal, let no problems happen. And you don't know if it's going to happen, like there's party that doesn't know if this is going to come out right or it's going to work. Well, all of a sudden, like five years, sometime in that period of time, you just hit you in the head. You know what? I don't even think like that anymore. I just treatment plan the root canal, the buildup and the crown Heck. I'm adding stuff on top of that. So if any younger dentists are out there and maybe an opportunity just hit me as we were talking, steve, is don't just share the good stuff, share the good stuff, share the bad stuff with your people out there, because I could do 20 root canals and my first 20 root canals all came out perfect and that 21st one I did a steve and I popped through the side of the tooth and I've done that too steve. I've gone through the furcation of a 30, so doing a steve yeah, there's a lot of doing steve steve's two teeth

Henry Ernst: 9:54

a ste or a Henry. I did number 30 right through the damn furcation so I did it too. But the point is that one screw up. I learned a whole much more than I did from those 20 like lucky things. Like I said earlier, thick skin, you can't put your head in the ground like an ostrich. You got to say, okay, what did I do wrong? I'm going to learn from it and not do it again. And this stuff happens.

Paul Etchison: 10:17

Yeah, I totally agree. A lot of this is mindset, a lot of this is expectations and like is this the way it's supposed to be? And it's not getting our expectations met. I think back when I was growing my practice, when I was a solo doc, I was getting burnt out because I was coming in early and I was staying late because we had so many patients and it just got to the point where I couldn't do any of the business functions because I was just doing so much clinical. And then when I brought on an associate, I had an extra day. I cut back to three days and it was awesome.

Paul Etchison: 10:47

Now, as we grew and had a second associate and a bigger team and a third associate and a bigger team, at a certain point I was still going like two, three days a week but I didn't have enough days to run the business and that caused me to burn out a ton because there were so many things that I couldn't get to as an owner.

Paul Etchison: 11:06

I think that's one of the things about dentistry is that the business will still function without management. It just won't function really well. The things that don't function well are the things that are keeping us up at night or the things that are just like, at least for me, that were keeping me up at night just thinking about like man I really. Why is my culture bad? What's going on? Is the practice going falling apart? Oh, was it better when it was small and just second guessing myself? And when I actually cut back my clinical and had time to work with my team and scale and build people up, build other leaders, everything changed for me, where I actually started loving the profession again and loving being at my office.

Stephen Markowitz: 11:45

You talked about. You felt burnout when your practice was growing too fast. I guarantee that if you sat at the beginning of that year and said, guys, we're going to do, we were doing 1 million, we're going to do 2.5 million this year, you would have been jumping for joy in the beginning of the year. Yeah, but so it's not the actual growth that was causing the burnout. There was something more in that growth. You wanted to grow, you wanted to build a practice, you wanted to build a business you were proud of. There was something that was happening that wasn't providing you joy, and it wasn't the growth. The growth was. Maybe there were things within that growth that were causing you frustration, which led to burnout.

Paul Etchison: 12:22

It was so many more moving parts and just bigger team and more volume. It was a lack of systems.

Stephen Markowitz: 12:28

Yeah, maybe the problem was it felt chaotic, oh yeah, and chaos to you is a place where you lose joy and feel burnout. I think for the listener it could be so different depending on who they are as a leader and who they are as a dentist and what kind of things they really enjoy or hate. So I think the first thing when you're feeling that is to truly identify the problem of okay. The result of this is we're growing too fast, and I've said the same thing. I'm like damn, I wish we were growing slower, but I don't really wish that. I wish that I had a stronger sense of our systems, of how to scale to multiple practices or had different leaders in place with experience. That may have made it feel less stressful to me.

Stephen Markowitz: 13:18

It wasn't that we were growing. So, I think, identifying the problem and then finding that place of true joy and this is going to sound so fricking corny, but like there are people that work I'm putting that in quotes hundreds, hundred plus hours a week and they love it and they couldn't and wouldn't do anything else and they never get burnt out. So it's not about the number of hours that people are doing. Something like that's just true passion. When we start to lose joy is when we start to see burnout, so we need to be very aware of the things that bring us joy in our day.

Paul Etchison: 15:05

Yeah, I think it's so true. It's the joy thing and I think, when I look at my journey, like chaos is not joyful for me and there might be certain people that can handle that chaos better than me, but personally, when there's chaos at my practice, that's what hits me on all angles. If you feel like chaos is what's burning you out, the solution is to step back and address the chaos. It's to stop seeing clinical patients so much so that you can address that chaos.

Henry Ernst: 15:31

Some of the stuff that's hitting me in the head here is as an owner, you have two jobs. You're a clinical dentist, but you also have a business that you're in charge of running. And it just seems like, like I was saying before, I feel like you have to understand who you are. Am I a lifestyle practice? And if that's the case, great, I'm one doctor. We're not going to grow, we're not going to open up any more offices, we're going to stay right here, we're going to take care, and that's great.

Henry Ernst: 15:56

But my suggestion for you is don't work five, six days a week, right? You need to have those days, like you mentioned, paul, a day or two, for be the CEO of the business. That's your second job. Don't just be the clinical dentist and the business just somehow runs itself. And the other thing is like, if you listen to us, we're all very similar and a lot of coaching clients, like I've seen the same thing. When they do that magical thing of stepping back from the clinical role, role number one, and they focus on the CEO role and actually focus on the business, they are just naturally happier. And it seems very nerve wracking. But I've seen it hundreds of times, literally hundreds of times. The business produces more every single time because you're a better owner, you're a better visionary and you're a better leader. Like you said, paul, you can work on that. People, person, people in your office, people aspect.

Paul Etchison: 16:47

I've seen it a million times too the practice grows, the practice becomes more profitable, life becomes better. So I think the important takeaway here is to really, if an owner is feeling like they're not liking where they're at, is to zoom out. Like you mentioned, steve, find out what's really bothering them, find out what brings them joy and try to design their practice and their life around that, so that they can have more of that joy and less of that chaos. Steve, what do you think of that?

Stephen Markowitz: 17:15

I mean, it's easy to say that. I think it's hard when you're in it. No matter what size my dental practice organization has been, there's always been issues. If all I'm doing is focusing on those issues, I'm never going to see true progress. So I think what you said was perfect is you need to take a step back. You need to look at your organization and yourself as a whole as like all right, what do I want this practice, this business, to be for me? And then work on those things that bring you joy, make the practice fit your true goals and continue to create plans. Like Henry said, that will allow progress and if you're enjoying what you're doing, growing towards your goals and continue to see progress, there will be seasons that you feel more stress or less enjoyment, but when you take a step back, you'll continue to love what you do and have less feelings of burnout.

Henry Ernst: 18:14

I'll expand on what you said, Stephen. Maybe think of it like living in the reactive world here. Like most dentists live in the reactive world. I'm practicing, I'm practicing, I'm practicing. Problem, problem, fix it, fix it, Problem, problem. It's totally reactive. That's stressful as hell.

Henry Ernst: 18:29

Right, you need to live in a proactive world where we're like you said, Paul, we're analyzing what the chaos is, we're going to fix it. And I would say this here I would have never hit that magical point in my practice career where I was hitting the wall and I was hamster wheeling it and I was just working harder and it just didn't seem like more. I needed somebody that was there, that was a mentor that told me emphatically you need to step back and work two days a week, not four or five. You're not gonna do this anymore. And it took somebody to trust somebody that was a mentor and to listen to them. They've been in my shoes and the damn thing worked. So living in the proactive world involves making decisions and analyzing the chaos and having somebody you trust, whether it's a mentor, whether it's a coach that has been in your shoes, that can fix it, that knows what you need to do, and then you just need to do the damn things.

Paul Etchison: 19:16

Yeah, absolutely, and I think that's where the coaching comes into is somebody that can look at your practice and say I think you need to do this, and I think that's what's so great about us.

Paul Etchison: 19:25

Three is that all three of us have been through these situations and I've had coaching clients on a numerous occasion say to me man, it's so weird to hear that you're having problems at your office.

Paul Etchison: 19:35

I just think by this time in your career you'd have everything perfect by now, and that just goes to show you the expectation is that a well-run office is not supposed to have problems, and that is an unrealistic expectation and your office is always going to have things going on. But I would say in my career, the burnout, the solution, has always been more so addressing what's bothering me rather than readjusting my expectations. Obviously it's going to be a combination of both, but for me it's been addressing what is causing the issues and for me that has always been putting more time and energy into the issues and less time into seeing patients. So if you're listening and you think you might be experiencing this and you want to work with a coach and try to cut down your days and run a better practice, please go to our website dentalpracticeheroescom and check out our coaching options. Thank you so much for listening and we'll talk to you next time. Take care.