Challenges exacerbated by the COVID-19 pandemic have led to increased levels of burnout in the dental industry.
Nine dentists recently spoke with Becker's about what is causing burnout, how it is affecting the industry and what is needed to reduce burnout.
Editor's note: These responses were lightly edited for clarity and length.
Jordan Cooper, DDS. Cooper Family Dentistry (Jacksonville, Ark.): Burnout is rampant in the dental industry. As the number of procedures performed becomes more numerous and complex, administrative headaches grow due to more complicated insurance problems, patient demands, inflation and staff turnover, the dentist (especially owner doctors) and admin staff have had increasingly more on their plates the last few years. Then enter COVID-19. Mandatory shutdowns and difficulties with staffing, periodic COVID-19 scares and subsequent wage increases have all made us weary of our responsibilities. This applies to not only dentistry but all of healthcare. The result is that while a lot of the world was learning to work from home and focus on their own personal health, we trudged on. Now, we are burnt out. My saving grace was that I joined a DPO (MB2 Dental) in 2018. Belonging to a partnership organization has taken so much weight off my shoulders and given me comradery during the most difficult times, and now the pendulum is swinging back in full force as we are growing together as an organization.
Michael Davis, DDS. Smiles of Santa Fe (N.M.): Clinical dentistry by its very nature is very stressful. The actual procedures demand highly precise abilities, with minimal tolerance for error. Further, no matter how advanced a dental clinician's ability to mitigate patient pain and discomfort, some degree is routinely inflicted upon our fellow human beings.
The most important component of stress reduction personally has been a fully funded retirement account. One has the ability to completely walk away from providing dental services and financially be able to meet obligations.
Elements that obstruct this goal toward stress reduction (stress elimination impossible) may include substantial student loan debt, working for an "owner" and forfeiting capital earnings and appreciation of EBITDA, and overextending on personal debt such as home mortgage, vehicles, children's education, care of elderly parents, divorce, etc.
Examination of Cabot's Cross as espoused by the late Dr. L.D. Pankey can also be valuable. Without going into details, these components of a balanced life include work, play, love and worship.
Allen Dorsey, DDS. Dorsey Dental Services (Houston): After almost 30 years of practicing dentistry, burnout occurs only when collection is low for me. I love what I do, but if burnout occurs, I usually change my environment to work at another location or take a vacation. This almost always works for me. Everyone burns out with any type of career, but if one takes it slow and easy, then it is always fun to return the next day.
Raul Escalante, DDS (San Marcos, Calif.): Burnout is a common factor in the business of dentistry. I have heard people say, "If you love what you do, it won't feel like work." I obviously can't speak for all dentists, but I'll tell you, I love what I do and, in spite of that, I have gone through a burnout phase in my career. I think everyone who works full-time eventually gets to a point where you end up asking yourself "What am I doing here?"
Especially in dentistry, I feel burnout is very common. This field can be very challenging in many ways and if you let it get to you, it will. I have dealt with burnout by taking time off, selecting procedures I enjoy doing and working with people I enjoy working with. I have had the difficult task of letting people go. An employee that doesn't fit in with the office will make your life absolutely miserable. It affects productivity, morale and, in time, you will experience burnout. Of course, a sense of humor helps. I also find that regular exercise helps me. I think the dental industry as a whole could possibly alleviate the issue by providing counseling at the local level. I believe the ADA offers some help in that. I haven't taken part in that, but I think this is a good service the ADA offers. Mainly, you have to take care of yourself and do what works for you so you can come back and be productive.
Huzefa Kapadia, DDS. Kapadia Dental Care (Waterford, Mich.) and Detroit Sterling Dental: Yes, burnout was a major issue during COVID. First, when the state of Michigan went into a shutdown, we couldn't work at all. I was very depressed, started to play video games at home, watched too much TV and ate a lot of junk food. I felt like a useless bum. Then, I realized I could still treat emergency patients. So I was really looking forward and excited to go to work doing root canals and extractions, or treating other issues that required immediate oral care. We didn't have a full schedule. Some days I would work only two or three hours max, but it still felt good to do something productive and get out of the house.
However, at the same time, I knew of two colleagues who died from COVID-19. One was an oral surgeon, and the other was a dentist. So this scared me and I went through a lot of anxiety and stress trying to treat patients. I was always thinking, will I also die from being exposed to this patient's mouth while I try to remove his infected tooth? Everyone was on edge, including staff and patients. People seemed to have little patience and would snap easily at times. It seemed a lot more people were very demanding. I was one of the only dental offices open in both of my locations and some days we were overwhelmed with emergency patients. All of these issues, and of course losing dental hygienists during this time, lead to burnout. There have always been burnout and suicide issues facing dentists, but it got worse during and after COVID. Many of my friends sold to DSOs in order to escape the stress of managing staff and overhead. Many dentists and hygienists/office managers retired, leaving a large vacancy in the field.
I try to make jokes throughout the day and TikTok Videos, to not only lift my mood but also the patients and staff. Humor definitely helped me in terms of stress and also dealing with life in general. I think it definitely helps to talk to other dentists. We tend to live isolated lives and rarely want to talk about our problems. That's a brief look into what I faced. Thank God, I'm alive and still healthy. It could have been a lot worse. Being grateful for everything we have also helps me keep a positive perspective.
Krista Kappus, DDS. Fitch Mountain Dental (Healdsburg, Calif.): Performing dentistry represents a relatively minor aspect of my professional responsibilities. On a frequent basis, I receive text notifications from team members who are unable to work for the day due to illness or familial health issues. A substantial portion of my time is dedicated to the management of insurance claims and the facilitation of patient collections. We handle our own bookkeeping, human resources and equipment maintenance. Furthermore, upon entering an operatory, it is not uncommon for me to encounter patients expressing sentiments such as, "I hate dentists and I hate being here," as I hope they will maybe at least pay their copay.
Eric Rossow, DDS. Aspen Dental – Private Practice of Cherry Creek (Denver): Dentistry requires a great degree of perfection. If the work is off by a millimeter, it is often no good. And dentists cannot perform this work without a support team. So it takes a supporting workforce that also has attention to detail and believes in perfection to pull it off. With the workforce dwindling in numbers and the remaining workforce having less attention to detail than ever before, I think it will become increasingly more difficult to perform good dental care. That lack of quality support staff is affecting dental practices and has got to be the leading cause of burnout in the industry. It will take a total revamping of the dental workforce model to turn this around. The 10-year time frame the ADA reports it will take to correct the workforce shortage is far too long of a time frame, and have they even calculated for the millennial and Generation Z version of attention to detail?
Todd Sarubin, DDS. Sarubin Family Dental (Pikesville, Md.): I have never experienced burnout as a dentist. I have been a dentist for over 37 years and I have no plans to retire. My dad, his brother, his brother's son and now my older son are all dentists. We love creating beautiful smiles and we love each other. It makes it very rewarding.
I believe if a dentist is experiencing burnout but they still love and are passionate about dentistry, they need to look at their own situation, their team, their patients, their location and what procedures they're performing. Find those things about dentistry that once made you passionate and grab hold of those. Take courses, learn new procedures and move if you have to. Most importantly, get therapy. It helps in all aspects of life. You must love yourself before you can love your career, staff and patients. Not to mention, your family and friends.
Rick Singel, DDS. (Cincinnati): I am convinced that burnout is a function of greed in the dental profession. Period. All of these DSOs are driven by production and the hustling of patients. These dentists work quick and dirty, getting patients in and out. Speed is of the essence. Combine speed and hustle, and the greed is satiated. And burnout sets in.
In private practice, if you don’t rush and don’t hustle people, there is no burnout. I see one patient at a time, I leave plenty of time for procedures and I am relaxed. I am not wealthy, but that was not my goal. I am comfortable and happy.
The bottom line is if you burn out, you do it to yourself in the pursuit of money, or you work in a DSO.