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Burnout in dentistry: the cause and the cure

Sept. 1, 2011
Dentistry has one of the highest burnout rates of all professions. Like many other dentists, I have experienced burnout firsthand.

Dr. Michael Kesner

For more on this topic, go to www.dentaleconomics.com and search using the following key words: burnout,

cause, cure, stress, financial reward, transformation, Dr. Michael Kesner.

Dentistry has one of the highest burnout rates of all professions. Like many other dentists, I have experienced burnout firsthand.

If you are feeling burnout right now, or if you feel like you are on your way there, I have good news for you. There is a cure!

The first thing you need to understand is what causes burnout in dentistry.

Dentistry is a very high-stress and high-risk profession. As you know, it takes many years of higher education to become a dentist. It then takes years of experience and continuing education courses to become good at dentistry.

We work on fearful patients providing restorations that will succeed or fail based upon microns. These restorations often do not get cleaned very well. Dentistry requires a working knowledge of medicine, physics, materials, and artistry — all with great attention to detail. This is stressful.

If you own a practice, then you are also a business owner with the associated risks and responsibilities. You have the stresses that come with employees, capital expenditure decisions, marketing decisions, overhead control, bank notes, lease payments, dental insurance headaches, supply bills, lab bills, etc. We also have the ever-present professional liability risk that requires constant attention.

The bottom line is that clinical dentistry and the business of dentistry are difficult and come with high risks. Therefore, you deserve a financial reward that is equal to or greater than those risks you are assuming.

The problem for many dentists is that the financial reward is much less than the risks encountered daily. In fact, the lack of financial reward actually becomes an added risk and stress on top of everything else.

When, over time, the risks you assume consistently outweigh the rewards you receive, then the result is burnout.

In 1997, after 13 years of solo private practice, I experienced burnout. My risk-to-reward ratio had been out of proportion for years. I decided to sell my practice and work for the new owner as an associate. This way I would lower my risks, responsibilities, and stress by not having to own and run a business. I could just do the dentistry and go home.

In 1999, I sold my practice to an orthodontist who was buying practices as investments. He owned several practices, and I worked in five of them. I was seeing many patients, my income tripled, and my stress level went down. I did not really like being an employee, but it was better than being the owner.

Everything was great for three years until the orthodontist’s wife, a general dentist, caught him at a hotel with another woman. She then waited for her husband to walk into the parking lot and proceeded to run over him with her vehicle. The husband died in the incident.

Many of you might remember seeing this story on the news. The orthodontist’s wife was on “Oprah” twice, there was a made-for-TV-movie about the story, a couple of books were written about the incident, and it made international news for months.

So, I decided to repurchase the practice with a renewed determination to do whatever it took to be successful in dentistry. I learned how to grow the practice from $675,000 in 2003, to the $7 million we are on track to do this year.

I finally figured out how to be successful in dentistry!

People ask me all the time, “How did you do it?” Before I tell you how, let me ask you a couple of questions.

  1. Do you see yourself as a practicing dentist that has to run a business? or
  2. Do you see yourself leveraging your dental skills into the business of dentistry?

There is a big difference between these two questions. I find that most dentists identify more with the first question than the second. Most dentists went to dental school because they enjoy helping people and fixing things, not because they are entrepreneurial.

How can you become successful at the business of dentistry and make the income you deserve if you do not like running a business?

Here’s how:

First, decide what you want, and then make the decision to do whatever it takes to get it. Financial success in dentistry takes hard work and commitment. If it were easy, everybody would be doing it.

Second, believe that you can do it. Whatever you believe is right. If you believe that you cannot build a multimillion dollar practice, you are right. You cannot! But if you believe that you can build a multimillion dollar practice, you are right. You can! Choose to believe that you can. If I learned how to do it, then you can, too.

Third, get some help. You cannot make this transformation by yourself. If you could do it yourself, then you already would have done it. I had help from dental consultants, business consultants, and my team to build a successful practice. As a result, I developed a practice model that works in any economy and in any area of the nation. But there is no way I could have done it by myself.

Here is how my practice success model works.

There are four ways that you can increase practice revenue:

  1. Increase your case acceptance rate
  2. Increase your capacity to do more dentistry
  3. Increase your number of high profit procedures
  4. Increase your number of new patients

I call my business model PracticeSMARTS. It works on all four of these revenue-producing areas of your practice simultaneously. The result has been a rapid breakthrough in growth in dental practices across the nation.

PracticeSMARTS is made up of the following:

• Systems for everything: You would never think of getting on an airplane with pilots that did not use systems and checklists. So, why would you want to “fly” your practice without written systems? Systems make it clear how things should be done. Systems keep your team accountable. Systems keep things from falling through the cracks. Systems keep things running smoothly and efficiently. This adds up to increased profit and decreased stress.

• Marketing nonstop: Continual marketing keeps a steady flow of new patients coming in month after month. The right marketing answers the question in the potential patient’s mind, “What’s in it for me?” If your marketing does not answer this question, it will not be successful. The right marketing is also an investment, not an expense. My marketing brings me a 4:1 return every month. Where else can I get a 4:1 return on my money these days?

• Absolute efficiency: Do you want to see profit at the end of the month? Make everything in your office efficient. Efficiency creates time. The more time I have, the more dentistry I can do. The more efficient my team and I are, then the more patients we are able to see. Efficiency is one of the best ways to reduce overhead because it increases production per hour.

• Reward team with profit bonuses: The right bonus will turn your employees into “business partners.” They will run the practice for you so you can focus on the patients and dentistry. Your time is the most profitable when you are treating patients, not when you are doing the other stuff in your practice. The right bonus motivates your team, empowers it, and lowers your stress.

• Team “selling” for case acceptance: “I’ll think about it, Doctor” or “I’ll do the fillings, but I am going to wait on the crowns.” Are you tired of hearing these comments? Helping patients to say “yes” to the treatment you recommend is a team event. Believe it or not, the doctor plays the smallest role. Your case acceptance will increase when you and your team connect with patients on an emotional level and stop trying to teach them dentistry. Teaching dentistry to patients is the wrong approach. People make decisions about their dental treatment based upon emotion, not education.

• Same-day dentistry: “Mrs. Jones, would you like to get that crown done today while you’re here?” Did you know that your profitability on dentistry done today is much, much higher than waiting until next week? So, why would you want to schedule it for next week, be less profitable, and run the risk of a cancellation? Patients also love same-day dentistry. This way they do not have to make another trip to your office.

Make the income you deserve in dentistry. It will cure burnout and change your life!

Dr. Mike Kesner is a practicing dentist and author of Multi-Million Dollar Dental Practice — How to net $1 million per year … even in this recession. He is founder and CEO of Quantum Leap Success in Dentistry, a consulting company that helps dentists build the practices of their dreams in 24 months or less. Contact him at [email protected].

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