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Five strategies to prevent burnout as a dentist

Have you ever found yourself lacking the energy to do activities you once enjoyed, snapping at loved ones, or feeling a flood of dread when your alarm goes off on a work day? You may be experiencing signs of chronic stress, which when unmanaged, can lead to burnout.

Research shows that burnout is on the rise for healthcare professionals. The World Health Organization defines burnout in the International Classification of Diseases (ICD-11) as “a syndrome conceptualized as resulting from chronic workplace stress that has not been successfully managed.” Dr. Christina Maslach, one of the world’s foremost experts on occupational burnout, outlines the three key dimensions of burnout in her research as “overwhelming exhaustion, feelings of cynicism and detachment from the job, and a sense of ineffectiveness and lack of accomplishment.”

Dr. Barto

It’s important to note that burnout differs from stress. Stress involves increased demands that lead to hyperactivity and over-engagement, but there is an attitude of hope that when the work is complete there will be relief. On the other hand, burnout is an accumulation of unmanaged stress that leads to feeling disengaged and devoid of motivation, and an attitude of hopelessness.

It’s critical to be aware of how unmanaged stress accumulates in your life so that we can focus on preventing burnout. As a new dentist practicing full time, I’ve experienced chronic stress. As a yoga teacher and wellness coach, I’m equipped with the tools to successfully manage this stress. I’ve gathered five strategies that have worked for me to manage stress and prevent burnout.

1. Optimize basic health behaviors: master the way you sleep, eat, & move

We must master the foundations of our well-being so that we have the energy to show up as the best versions of ourselves. The way we sleep, eat, and move ultimately gives us the energy we need to thrive. When we try to operate at full capacity without taking care of our own health, we end up on the path to burnout.

I won’t expand on how we can optimize the way we eat and move in this article, but I will expand on sleep as I believe it is the most under-used yet powerful tool available to us. As one of my sleep teachers, Jennifer Piercy, so eloquently puts it, sleep is anti-inflammatory medicine that nourishes literally all physiological and psychological functions — hormones, circulation, cardiovascular and brain function, metabolism, memory, consolidation of learning experiences, emotional processing, creativity, and ability to focus.

The greatest strategy for improving quality sleep is practicing a digital sunset. At least one hour before bed, shutdown technology and avoid computer work, phone scrolling, and watching TV. Instead, create a sleep ritual that allows you to slow down before falling asleep. Consider relaxing activities like reading, practicing restorative yoga, taking a bath, snuggling with a pet, meditation or yoga nidra. A digital sunset calibrates our circadian rhythm because blue light exposure at night suppresses the release of melatonin. We can support melatonin production by getting ~10 minutes of sunlight in the morning and evening

If you have trouble falling asleep, consider Yoga Nidra, an ancient sleep-based guided meditation ranging from 10-45 minutes, in which you are led into deep states of rest and repair. My favorite sleep hack is to practice Yoga Nidra on Insight Timer using this special eye mask either before bed, upon waking, or in substitution of an afternoon nap.

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While I listed only three basic health behaviors, there are several other basic health behaviors that when optimized, have a high impact on our performance. Most notably, the way we breathe, our ability to focus (i.e. reduce mind wandering and increase focus on the present moment), and learning to regulate our nervous system are important tools for optimal health that require their own future discussions.

2. Conduct an identity check-up 

We spend nearly a decade training to be dentists. We embark on this journey with the promise that if we just work hard now, then we will be successful later. Often, when we graduate dental school, we realize the goal post has just moved further away from us. Somewhere along the journey, we may wake up to the fact that the life we are living isn’t the life we expected or realize that we’ve been working towards someone else’s goals. When our life feels misaligned like this, reconnecting with our authentic selves is a powerful step in creating a fulfilling life and preventing burnout. It is natural that our identities have evolved in the years we’ve spent training to be a dentist

Conduct an identity check-up: Set aside one hour to conduct an identity check-up and consider how your identity is evolving by answering the following questions:

  • What are my values?
  • What are my signature strengths?
  • What do I truly enjoy doing? When do I feel in flow?
  • How do I define a successful life?
  • How do I want to feel everyday?
  • What is my vision for my life?
  • Are my current goals aligned with this vision?

3. Do less: break up with busy-ness

To prevent or recover from burnout requires a radical shift in our relationship with busy-ness. Most of us have spent our lives busy and over-scheduled. Busy-ness has become our programmed baseline, and when we are below baseline, there is a homeostatic tendency to return to busy. If we want to prevent burnout, we have to stop wearing busy-ness as a badge of honor.

Doing less isn’t about putting in less effort, but rather only doing the things that are in alignment with your life vision. When you let go of the distractions and the non-essential, you can accomplish more. Rather than rushing through life with frantic energy, you can savor everyday moments and feel more fulfilled

As we adjust to being less busy, we can feel agitated or like we should be doing more. It requires doing the inner work to truly understand our drive toward achievement and external definitions of success

Here is what helped me break up with busy:

  • Only take aligned action: It’s important to do that identity check-up and evaluate if your current goals and actions are aligned with your desired identity. As James Clear puts it, “Every action you take is a vote for the type of person you wish to become.” Get realistic about how you are currently spending your time. What are you busy doing that is and isn’t aligned with your vision? What things can be optimized, automated, or outsourced?
  • Say no and set boundaries: Boundaries are the path to self-respect and self-compassion, and the tendency towards people-pleasing can be a major contributor to stress and burnout. Consider boundaries related to scheduling, specific procedures, cutting back on working days, changing jobs, or hiring more support. Start to filter new opportunities by asking; is this aligned with my vision, does this need to be done now, can this be done by someone else?
  • Time blocking instead of to-do lists: Your happiness is NOT at the end of a completed to-do list. To-do lists do not account for the time it takes to complete tasks. Instead, set aside a specific amount of time for a particular task. In your calendar, create time blocks for work as well as your other values like family, self-care, rest, creative projects, social media, etc. This allows us to show up with focused, undistracted energy and we can overcome the nagging feeling that we should be doing something else.

Doing less of what drains you creates space for more effectively doing what energizes you, and this is a powerful tool in reducing stress and preventing burnout

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4. Celebrate the highs and learn from the lows

Another tool in preventing burnout is to create a system to celebrate your successes and learn from your failures. This is important because it helps us decompress after stressful procedures, separate our identity from our clinical failures, learn and grow from experiences, and it allows us to build our ‘cookie jar.’

Consider the following to create a system for self-evaluation in the face of success and failure:

  • Keep a notebook or a note in your phone, and after significant cases reflect on what went well, what didn’t go well, and how you can improve. I call this a ‘Keep-Stop-Start’ review
  • When you receive positive feedback or are happy with an outcome, add it to your ‘cookie jar.’ Keep a record of these wins at the back of your notebook or in a digital note for a positive reminder when the going gets tough
  • Connect with a buddy on a regular basis to share highs and lows

5. Ask for help

We are always more successful with the support of others. Asking for and receiving help is an opportunity to build vulnerability and connection, and it’s a sign of strength. Consider reaching out to another dentist who has been open about their journey through burnout. Participate in communities of like-minded dentists through study clubs or mastermind groups.

Expand into new communities outside of the dental world that may be aligned with other passions of yours. Often, we are so entrenched in the world of teeth, we forget that there is an entire world outside of dentistry. Exploring different interest groups or hobbies is a fantastic way to rebuild your identity outside of dentistry and connect with supportive communities.

If you’ve made it to the end of this article, have implemented the steps above, and still feel burned out, it may be a sign that there is something greater going on. Consider speaking with a licensed counselor, therapist, or coach. I have worked with professionals on BetterHelp, a virtual therapy service, as well as with two dental-specific coaches. I worked with Dr. Laura Brenner on identity and career contentment and Dr. Jessica Metcalfe on dismantling impostor phenomenon, perfectionism and burnout. Working with coaches who have been in my shoes is incredibly empowering.

Summary

To prevent burnout, we must learn to successfully manage stress, detect early warning signs, and stay vigilant about protecting our well-being. If you are seeking additional support in preventing burnout, I’ve created a guided mini-course available for free here. You’re not alone, you’ve got this!

Dr. Shivani Kamodia Barto is a general dentist, yoga teacher, and wellness coach. She completed her 200hr yoga teacher training in 2012 and graduated from the University of Michigan School of Dentistry in 2018. Shivani is an active leader in organized dentistry, environmentally sustainable dentistry, and wellness for dentists. In addition, Shivani is passionate about empowering other health care professionals to apply the science of well-being so that they too can thrive in dentistry without sacrificing their mind or body. She currently provides support through immersive retreats, private coaching, and online programs. More information can be found at drshivasana.com

3 comments

  • Dr Barto, great article and advice. So good to see younger dentists recognizing these symptoms as a work / life scenario is out of balance. I have practiced dentistry for over 38 years and 35 years as a practice owner and dentist wearing many hats. My balance was to include closing the office for 6 weeks out of the year to take vacation. I started this 6 weeks off per year my very first full year of practice back in 1986. My longest time off was 3 weeks to backpack through Europe with my wife for our 5 year anniversary. I grew my practice as a single dentist office ten fold in my years as a owner. What made it challenging was when family challenges including sick aging parents, teenage children’s needs, etc came along that required more time, energy, and emotional needs than normally alotted in my schedule and balance. Something has to give, and yes it is usually your health. Gradually my back has suffered over the years. This is true for many dentists due to our work. I only wished I had taken more time for exercise, stretching, and core muscle building to protect my back. I did find that sometimes it is just taking time off work here and there to meet the needs of family is a wise choice. It is not easy but if the Dental Team’s expectations are discussed, it is workable. It’s Ok to close the office when needed. It gives Team members time for their families as well. You also become more efficient with your office schedule as well. Offices that have two doctors or more can still function without the other doctors presence however more Team members require more attention and management including the office doctors or partners. It comes down to communication with your Team and your spouse and family. Let them know how you are doing and take the time you need to keep yourself healthy.

    This information also applies in semi retirement. I found this information helpful for Dental Team members as well and have passed along the article to them.

    Thank you for Sharing your thoughts on this important topic

    God Bless,

    Dr. John Sudick

  • I completely agree that is important to only do what is important to maintain a healthy work/life balance.

  • Pursuing activities that require creativity and encourage some self-discovery along the way, helps to enhance and balance out Life. I have been practicing Judo for 40+ years and it is a sport where one must devise and invent a way to throw an opponent at that moment. So, on the mat, one is constantly in an ‘Inventive Mind Set.’

    These ‘invent on the fly’ skills have spilled over into my Dental Life, positioning me to develop 7 new toothbrushing methods over the years (on YouTube), and the Love Toothbrush, just to name a few. I also regularly write adventure stories in which a Dentist must overcome situations, both worldly and otherworldly!

    Find, stay, and grow with your acquired passions, and every morning you’ll wake up thankful while relishing your new chances at Progress!

    Oh yes…and spend time ‘biofeedbacking’ in a quiet and shady garden as often as you can!

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