March 20, 2025 • 21 mins
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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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Paul Etchison (00:02):
You are likely hearing more and more dentists
talk about burnout.
You've got an immense pressureto not make mistakes, you've got
upset patients, teamfrustrations and you're likely
juggling so manyresponsibilities that it's hard
not to sometimes and sometimesmore than sometimes feel
overwhelmed and exhausted.
Now, is it just part of the job, or do we have more control
(00:23):
over it than we think?
Today I'm joined with my DPHlegendary coaches to unpack what
really causes burnout and howshifting your mindset, your
approach to your practice andschedule can help you get back
to enjoying your career and lifeat the practice.
Stay tuned you are listening toDental Practice Heroes, where
we help you create and scaleyour dental practice so that you
are no longer tied to the chair.
(00:44):
I'm Dr Paul Etcheson, author oftwo books on dental practice
management, dental coach andowner of a $6 million group
practice in the suburbs ofChicago.
I want to teach you how to growand systematize your dental
practice so you can spend lesstime practicing and more time
enjoying a life that you love.
Let's get started.
Hey, welcome back to the DentalPractice Heroes podcast.
(01:11):
I am joined by my two DPHcoaches, dr Henry Ernst and Dr
Steve Markowitz, both gifteddentists with grown a big
business and practice verylittle right now and we're
talking about something that'svery important.
In the dental industry, we'veseen a shift of people talking
about mental health more.
We got this word that came outmaybe it seems like it came out
about five, 10 years ago burnout.
(01:32):
It's just people being sick ofwhat they're doing, depressed,
not liking their job, and if yougo on the dental forums you see
this a whole lot.
Nowadays is people getting onthere and saying I just
graduated, I feel like I made ahuge mistake and I don't know
what to do about it.
So I'll pass to you first.
Like Steve, does it feel to youthat there's more dentists
(01:53):
burning out, or this is becomingmore common, or is it more of a
thing that we're just talkingabout it now?
Stephen Markowitz (01:58):
I think it's more of a thing that well, yes,
we're seeing it more indentistry, but we're seeing it
in everything, and I don't wantto blame COVID, but it seems
like that was kind of the shiftof things becoming harder.
What I always think of burnoutis lack of progress, and I think
for us as dentists and dentalowners, because it's been harder
, there is less progress thatwe're making within our
(02:20):
practices.
Sometimes I see practices everyday that they're seeing more
patients, they're working harderthan they ever have, yet
they're less profitable thanthey've ever been, and that in
itself can lead to feeling likeI'm not growing at all.
This sucks.
And then you just get stuck inthat negativity and what I see
(02:42):
is that most dentists now theyhave a fixed mindset, they live
in the negativity and they'reliving in the gap which they see
online of.
They either see two ends of thespectrum one end where
everything sucks and they'regoing to get out of dentistry,
and that resonates with someonewho is negatively minded.
And then the other end issomeone who only prints pictures
(03:03):
of their full mouth casesEverything's perfect and they
have never had more money andthey think, holy crap, I got to
do that to be successful andthat also makes them feel
shittier about themselves, whichleads to more burnout.
So, yeah, it's more prevalentthan it's ever been and I think
it's also feeds on itself as atopic, and I'm excited for us to
(03:24):
kind of unpack how we canovercome some of those
challenges and see progress inour offices.
Henry Ernst (03:30):
Yeah, what do you think, henry?
So I'll take it from anotherangle.
This is going to make me soundold and, yes, I turned 50 a week
from today, so I am gettingolder.
I feel like this new generationis just, they're soft.
I mean, call me, I don't know,they're soft.
I talked to a dentist that I'vementored.
She's been in her family.
She's been my patient for years.
She's a third year dentalstudent.
I helped her get into dentalschool and, for example, they
(03:53):
took their board exams as thirdyear students.
She already passed her boardexams.
So like the clinical board it'sdone after the third year, yeah,
it's all done, wow.
So when I was in school as afourth year, like you graduated,
then you pray that you pass theboard exam or else you could be
parking cars for a few monthsLike that was stress and that
was like John Taffer's show BarRescue.
(04:15):
There's a stress test.
I feel like this youngergeneration doesn't have like
stress like on them, like we did, and dentists always try to be
perfectionist.
So now you get into practiceand people say negative things
about you or somebody's actuallyhurt after a root canal.
It's like the worst thing inthe world, right?
I mean, maybe it's a hard thingto say, but you just need to
have thick skin in this business, right?
(04:35):
People are going to saynegative things.
You're going to do lots ofstuff and you have a lot of
power.
You're fixing people's teethand you're correcting pain and
there's going to be people thatcall you at nighttime.
There's going to be things thathappen.
You just have to.
This is part of it.
It's the business we chose.
So that's one aspect is justyou just have to learn what you
got into.
Really, I know it stinks onceyou've borrowed $500,000 to be a
(04:58):
darn dentist.
The other thing is I feel likethere's a lot of burnout from
the owner point of view becauseyou think, oh, this dentistry
thing, it really stinks.
But now I'm going to be anowner, now everything's going to
be fixed and solved and mystress is going to be gone.
Yeah, I see you guys laughing alittle bit.
That makes it worse sometimes,because now you've got, now you
go home and you got work to dofrom the business.
So from the owner point of view,I think lack of a plan.
(05:19):
Am I going to be a big group?
Am I going to be a one doctorof family practice?
What am I going to do?
Have a plan.
Learn how to delegate.
We always talk about this here.
Delegate, and delegate theright way, because dentists are
perfectionists.
They want to do everythingthemselves.
You can't do that on top of allthe other stressful things I
talked about in the beginning.
(05:40):
So, thick skin.
Have a plan.
Learn how to delegate.
This is a tough business, guys.
Paul Etchison (05:46):
I got a buddy that's like a plastic surgeon
and I was talking to him once.
I'm like man when I do thesebig cosmetic cases.
I'm doing one on Wednesday thatI'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 peoplecomplaining?
He said almost everyone, almostevery single person, will come
back and there is something thatthey wanted that it didn't
(06:07):
result in that.
He's like there's some happy,but most of them it's.
There's something expectationis wrong.
And I said well, dude, how doyou deal with that?
He's like it's just normal.
He's like I don't let it botherme.
He's like that's just howpeople are.
But I think, like you, like youmentioned, henry is we're such
perfectionists, we're so hard onourselves.
I think our expectations areall wrong.
We expect people to everythingto work out and I think
(06:30):
dentistry is unpredictable.
It very much is.
Stephen Markowitz (06:33):
And we learn so much more from our failures
and if we're not puttingourselves in the position to
have challenges, then we'renever going to grow as much as
we possibly could.
And I think, to add to whatHenry was saying, especially
within the first five years ofbeing a dentist or being a
practice owner, learn all thosethings.
I remember in dental school.
(06:54):
The two greatest things that Ilearned was one I had a root
canal on number five and I wentright through the side of the
tooth.
And two I got an impressioncoping on my girlfriend at the
time wife now and I torqued itin the wrong place.
Those two things were stressful, but I'm so thankful that I had
those challenges because itmade me better at doing root
(07:16):
canals.
It made me learn implantdentistry so much more and if it
wasn't for those situationsthat felt crappy, I wouldn't
have felt as comfortable as Iwas in the first couple of years
doing implant dentistry ordoing root canals.
So I think, from a mindsetstandpoint and what helps with
burnout is this I'm going tolearn a lot from this, even
though it feels really crappyright now.
Paul Etchison (07:38):
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 inyour career, Henry, where you
felt like you were experiencingthat?
Henry Ernst (07:50):
No doubt, and when our practice has always had
extended hours.
So it was probably when I wasabout two, three associates at
that time and there was one timeI had to fire an associate.
And you know now all of asudden that schedule that is
totally full.
We don't just get rid of itLike I was that person.
I'm like I jumped in there.
So now I'm working six days aweek until I find another
(08:12):
associate and I can't even doanything in the business.
So yeah, those were times whereI was really stressed and just
I was hating it and I was justso dreading it and I had to come
up with a plan like look atwhat's happening and not going
to continue this path, we'regoing to change paths.
So in that case that requiredme to say hey, from now on, when
I get another associate, I'mnot working three or four days
(08:33):
in a week, I'm going down to two.
So if I have to jump in I'mgoing to go to four and that's
normal, right.
But one thing to jump on somestuff you said, steve, is I
think it's really important.
It came to my mind when I wastalking with this young,
soon-to-be dentist and a phrasethat was told to me while I was
in dental school by anendodontist.
And it's so true your firstfive years out of school you are
(08:54):
truly practicing dentistry.
You're going to screw up stuffand you're going to be really
slow.
It takes five years to getquick.
You know, on my first secondyear and I've treatment plan a
root canal on 14 in the back ofmy head.
I'm like please, let me getthrough this root canal, let no
problems happen.
And you don't know if it'sgoing to happen, like there's
party that doesn't know if thisis going to come out right or
(09:14):
it's going to work.
Well, all of a sudden, likefive years, sometime in that
period of time, you just hit youin the head.
You know what?
I don't even think like thatanymore.
I just treatment plan the rootcanal, the buildup and the crown
Heck.
I'm adding stuff on top of that.
So if any younger dentists areout there and maybe an
opportunity just hit me as wewere talking, steve, is don't
just share the good stuff, sharethe good stuff, share the bad
stuff with your people out there, because I could do 20 root
(09:38):
canals and my first 20 rootcanals all came out perfect and
that 21st one I did a steve andI popped through the side of the
tooth and I've done that toosteve.
I've gone through the furcationof a 30, so doing a steve yeah,
there's a lot of doing stevesteve's two teeth
a ste or a Henry.
I did number 30 right throughthe damn furcation so I did it
too.
But the point is that one screwup.
(10:01):
I learned a whole much morethan 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 didI do wrong?
I'm going to learn from it andnot do it again.
And this stuff happens.
Paul Etchison (10:17):
Yeah, I totally agree.
A lot of this is mindset, a lotof this is expectations and
like is this the way it'ssupposed to be?
And it's not getting ourexpectations met.
I think back when I was growingmy practice, when I was a solo
doc, I was getting burnt outbecause I was coming in early
and I was staying late becausewe had so many patients and it
just got to the point where Icouldn't do any of the business
(10:38):
functions because I was justdoing so much clinical.
And then when I brought on anassociate, I had an extra day.
I cut back to three days and itwas awesome.
Now, as we grew and had a secondassociate and a bigger team and
a third associate and a biggerteam, at a certain point I was
still going like two, three daysa week but I didn't have enough
days to run the business andthat caused me to burn out a ton
(11:01):
because there were so manythings that I couldn't get to as
an owner.
I think that's one of the thingsabout dentistry is that the
business will still functionwithout management.
It just won't function reallywell.
The things that don't functionwell are the things that are
keeping us up at night or thethings that are just like, at
least for me, that were keepingme up at night just thinking
(11:21):
about like man I really.
Why is my culture bad?
What's going on?
Is the practice going fallingapart?
Oh, was it better when it wassmall and just second guessing
myself?
And when I actually cut back myclinical and had time to work
with my team and scale and buildpeople up, build other leaders,
everything changed for me,where I actually started loving
the profession again and lovingbeing at my office.
Stephen Markowitz (11:45):
You talked about.
You felt burnout when yourpractice was growing too fast.
I guarantee that if you sat atthe 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 thisyear, you would have been
jumping for joy in the beginningof the year.
Yeah, but so it's not theactual growth that was causing
the burnout.
There was something more inthat growth.
(12:07):
You wanted to grow, you wantedto build a practice, you wanted
to build a business you wereproud of.
There was something that washappening that wasn't providing
you joy, and it wasn't thegrowth.
The growth was.
Maybe there were things withinthat growth that were causing
you frustration, which led toburnout.
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 aplace where you lose joy and
feel burnout.
I think for the listener itcould be so different depending
on who they are as a leader andwho they are as a dentist and
what kind of things they reallyenjoy or hate.
So I think the first thing whenyou're feeling that is to truly
(12:50):
identify the problem of okay.
The result of this is we'regrowing too fast, and I've said
the same thing.
I'm like damn, I wish we weregrowing slower, but I don't
really wish that.
I wish that I had a strongersense of our systems, of how to
scale to multiple practices orhad different leaders in place
(13:12):
with experience.
That may have made it feel lessstressful to me.
It wasn't that we were growing.
So, I think, identifying theproblem and then finding that
place of true joy and this isgoing to sound so fricking corny
, but like there are people thatwork I'm putting that in quotes
hundreds, hundred plus hours aweek and they love it and they
(13:35):
couldn't and wouldn't doanything else and they never get
burnt out.
So it's not about the number ofhours that people are doing.
Something like that's just truepassion.
When we start to lose joy iswhen we start to see burnout, so
we need to be very aware of thethings that bring us joy in our
day.
Paul Etchison (13:54):
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 andthere might be certain people
that can handle that chaosbetter than me, but personally,
when there's chaos at mypractice, that's what hits me on
all angles.
If you feel like chaos iswhat's burning you out, the
solution is to step back andaddress the chaos.
(14:16):
It's to stop seeing clinicalpatients so much so that you can
address that chaos.
Henry Ernst (14:20):
Some of the stuff that's hitting me in the head
here is as an owner, you havetwo jobs.
You're a clinical dentist, butyou also have a business that
you're in charge of running.
And it just seems like, like Iwas saying before, I feel like
you have to understand who youare.
Am I a lifestyle practice?
And if that's the case, great,I'm one doctor.
We're not going to grow, we'renot going to open up any more
(14:42):
offices, we're going to stayright here, we're going to take
care, and that's great.
But my suggestion for you isdon'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 thebusiness.
That's your second job.
Don't just be the clinicaldentist and the business just
somehow runs itself.
And the other thing is like, ifyou listen to us, we're all
(15:06):
very similar and a lot ofcoaching clients, like I've seen
the same thing.
When they do that magical thingof stepping back from the
clinical role, role number one,and they focus on the CEO role
and actually focus on thebusiness, they are just
naturally happier.
And it seems very nervewracking.
But I've seen it hundreds oftimes, literally hundreds of
times.
The business produces moreevery single time because you're
(15:27):
a better owner, you're a bettervisionary and you're a better
leader.
Like you said, paul, you canwork on that.
People, person, people in youroffice, people aspect.
Paul Etchison (15:37):
I've seen it a million times too the practice
grows, the practice becomes moreprofitable, life becomes better
.
So I think the importanttakeaway here is to really, if
an owner is feeling like they'renot liking where they're at, is
to zoom out.
Like you mentioned, steve, findout what's really bothering
them, find out what brings themjoy and try to design their
(15:57):
practice and their life aroundthat, so that they can have more
of that joy and less of thatchaos.
Steve, what do you think ofthat?
Stephen Markowitz (16:04):
I mean, it's easy to say that.
I think it's hard when you'rein it.
No matter what size my dentalpractice organization has been,
there's always been issues.
If all I'm doing is focusing onthose issues, I'm never going
to see true progress.
So I think what you said wasperfect is you need to take a
step back.
You need to look at yourorganization and yourself as a
(16:26):
whole as like all right, what doI want this practice, this
business, to be for me?
And then work on those thingsthat bring you joy, make the
practice fit your true goals andcontinue to create plans.
Like Henry said, that willallow progress and if you're
enjoying what you're doing,growing towards your goals and
(16:50):
continue to see progress, therewill be seasons that you feel
more stress or less enjoyment,but when you take a step back,
you'll continue to love what youdo and have less feelings of
burnout.
Henry Ernst (17:03):
I'll expand on what you said, Stephen.
Maybe think of it like livingin the reactive world here.
Like most dentists live in thereactive world.
I'm practicing, I'm practicing,I'm practicing.
Problem, problem, fix it, fixit, Problem, problem.
It's totally reactive.
That's stressful as hell.
Right, you need to live in aproactive world where we're like
you said, Paul, we're analyzingwhat the chaos is, we're going
(17:24):
to fix it.
And I would say this here Iwould have never hit that
magical point in my practicecareer where I was hitting the
wall and I was hamster wheelingit and I was just working harder
and it just didn't seem likemore.
I needed somebody that wasthere, that was a mentor that
told me emphatically you need tostep back and work two days a
week, not four or five.
You're not gonna do thisanymore.
(17:45):
And it took somebody to trustsomebody that was a mentor and
to listen to them.
They've been in my shoes andthe damn thing worked.
So living in the proactiveworld involves making decisions
and analyzing the chaos andhaving somebody you trust,
whether it's a mentor, whetherit'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 thedamn things.
Paul Etchison (18:06):
Yeah, absolutely, and I think that's where the
coaching comes into is somebodythat can look at your practice
and say I think you need to dothis, and I think that's what's
so great about us.
Three is that all three of ushave been through these
situations and I've had coachingclients on a numerous occasion
say to me man, it's so weird tohear that you're having problems
at your office.
I just think by this time inyour career you'd have
(18:27):
everything perfect by now, andthat just goes to show you the
expectation is that a well-runoffice is not supposed to have
problems, and that is anunrealistic expectation and your
office is always going to havethings going on.
But I would say in my career,the burnout, the solution, has
always been more so addressingwhat's bothering me rather than
(18:50):
readjusting my expectations.
Obviously it's going to be acombination of both, but for me
it's been addressing what iscausing the issues and for me
that has always been puttingmore time and energy into the
issues and less time into seeingpatients.
So if you're listening and youthink you might be experiencing
this and you want to work with acoach and try to cut down your
days and run a better practice,please go to our website
(19:12):
dentalpracticeheroescom andcheck out our coaching options.
Thank you so much for listeningand we'll talk to you next time
.
Take care.
You are likely hearing more and more dentists
talk about burnout.
You've got an immense pressureto not make mistakes, you've got
upset patients, teamfrustrations and you're likely
juggling so manyresponsibilities that it's hard
not to sometimes and sometimesmore than sometimes feel
overwhelmed and exhausted.
Now, is it just part of the job, or do we have more control
(00:23):
over it than we think?
Today I'm joined with my DPHlegendary coaches to unpack what
really causes burnout and howshifting your mindset, your
approach to your practice andschedule can help you get back
to enjoying your career and lifeat the practice.
Stay tuned you are listening toDental Practice Heroes, where
we help you create and scaleyour dental practice so that you
are no longer tied to the chair.
(00:44):
I'm Dr Paul Etcheson, author oftwo books on dental practice
management, dental coach andowner of a $6 million group
practice in the suburbs ofChicago.
I want to teach you how to growand systematize your dental
practice so you can spend lesstime practicing and more time
enjoying a life that you love.
Let's get started.
Hey, welcome back to the DentalPractice Heroes podcast.
(01:11):
I am joined by my two DPHcoaches, dr Henry Ernst and Dr
Steve Markowitz, both gifteddentists with grown a big
business and practice verylittle right now and we're
talking about something that'svery important.
In the dental industry, we'veseen a shift of people talking
about mental health more.
We got this word that came outmaybe it seems like it came out
about five, 10 years ago burnout.
(01:32):
It's just people being sick ofwhat they're doing, depressed,
not liking their job, and if yougo on the dental forums you see
this a whole lot.
Nowadays is people getting onthere and saying I just
graduated, I feel like I made ahuge mistake and I don't know
what to do about it.
So I'll pass to you first.
Like Steve, does it feel to youthat there's more dentists
(01:53):
burning out, or this is becomingmore common, or is it more of a
thing that we're just talkingabout it now?
Stephen Markowitz (01:58):
I think it's more of a thing that well, yes,
we're seeing it more indentistry, but we're seeing it
in everything, and I don't wantto blame COVID, but it seems
like that was kind of the shiftof things becoming harder.
What I always think of burnoutis lack of progress, and I think
for us as dentists and dentalowners, because it's been harder
, there is less progress thatwe're making within our
(02:20):
practices.
Sometimes I see practices everyday that they're seeing more
patients, they're working harderthan they ever have, yet
they're less profitable thanthey've ever been, and that in
itself can lead to feeling likeI'm not growing at all.
This sucks.
And then you just get stuck inthat negativity and what I see
(02:42):
is that most dentists now theyhave a fixed mindset, they live
in the negativity and they'reliving in the gap which they see
online of.
They either see two ends of thespectrum one end where
everything sucks and they'regoing to get out of dentistry,
and that resonates with someonewho is negatively minded.
And then the other end issomeone who only prints pictures
(03:03):
of their full mouth casesEverything's perfect and they
have never had more money andthey think, holy crap, I got to
do that to be successful andthat also makes them feel
shittier about themselves, whichleads to more burnout.
So, yeah, it's more prevalentthan it's ever been and I think
it's also feeds on itself as atopic, and I'm excited for us to
(03:24):
kind of unpack how we canovercome some of those
challenges and see progress inour offices.
Henry Ernst (03:30):
Yeah, what do you think, henry?
So I'll take it from anotherangle.
This is going to make me soundold and, yes, I turned 50 a week
from today, so I am gettingolder.
I feel like this new generationis just, they're soft.
I mean, call me, I don't know,they're soft.
I talked to a dentist that I'vementored.
She's been in her family.
She's been my patient for years.
She's a third year dentalstudent.
I helped her get into dentalschool and, for example, they
(03:53):
took their board exams as thirdyear students.
She already passed her boardexams.
So like the clinical board it'sdone after the third year, yeah,
it's all done, wow.
So when I was in school as afourth year, like you graduated,
then you pray that you pass theboard exam or else you could be
parking cars for a few monthsLike that was stress and that
was like John Taffer's show BarRescue.
(04:15):
There's a stress test.
I feel like this youngergeneration doesn't have like
stress like on them, like we did, and dentists always try to be
perfectionist.
So now you get into practiceand people say negative things
about you or somebody's actuallyhurt after a root canal.
It's like the worst thing inthe world, right?
I mean, maybe it's a hard thingto say, but you just need to
have thick skin in this business, right?
(04:35):
People are going to saynegative things.
You're going to do lots ofstuff and you have a lot of
power.
You're fixing people's teethand you're correcting pain and
there's going to be people thatcall you at nighttime.
There's going to be things thathappen.
You just have to.
This is part of it.
It's the business we chose.
So that's one aspect is justyou just have to learn what you
got into.
Really, I know it stinks onceyou've borrowed $500,000 to be a
(04:58):
darn dentist.
The other thing is I feel likethere's a lot of burnout from
the owner point of view becauseyou think, oh, this dentistry
thing, it really stinks.
But now I'm going to be anowner, now everything's going to
be fixed and solved and mystress is going to be gone.
Yeah, I see you guys laughing alittle bit.
That makes it worse sometimes,because now you've got, now you
go home and you got work to dofrom the business.
So from the owner point of view,I think lack of a plan.
(05:19):
Am I going to be a big group?
Am I going to be a one doctorof family practice?
What am I going to do?
Have a plan.
Learn how to delegate.
We always talk about this here.
Delegate, and delegate theright way, because dentists are
perfectionists.
They want to do everythingthemselves.
You can't do that on top of allthe other stressful things I
talked about in the beginning.
(05:40):
So, thick skin.
Have a plan.
Learn how to delegate.
This is a tough business, guys.
Paul Etchison (05:46):
I got a buddy that's like a plastic surgeon
and I was talking to him once.
I'm like man when I do thesebig cosmetic cases.
I'm doing one on Wednesday thatI'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 peoplecomplaining?
He said almost everyone, almostevery single person, will come
back and there is something thatthey wanted that it didn't
(06:07):
result in that.
He's like there's some happy,but most of them it's.
There's something expectationis wrong.
And I said well, dude, how doyou deal with that?
He's like it's just normal.
He's like I don't let it botherme.
He's like that's just howpeople are.
But I think, like you, like youmentioned, henry is we're such
perfectionists, we're so hard onourselves.
I think our expectations areall wrong.
We expect people to everythingto work out and I think
(06:30):
dentistry is unpredictable.
It very much is.
Stephen Markowitz (06:33):
And we learn so much more from our failures
and if we're not puttingourselves in the position to
have challenges, then we'renever going to grow as much as
we possibly could.
And I think, to add to whatHenry was saying, especially
within the first five years ofbeing a dentist or being a
practice owner, learn all thosethings.
I remember in dental school.
(06:54):
The two greatest things that Ilearned was one I had a root
canal on number five and I wentright through the side of the
tooth.
And two I got an impressioncoping on my girlfriend at the
time wife now and I torqued itin the wrong place.
Those two things were stressful, but I'm so thankful that I had
those challenges because itmade me better at doing root
(07:16):
canals.
It made me learn implantdentistry so much more and if it
wasn't for those situationsthat felt crappy, I wouldn't
have felt as comfortable as Iwas in the first couple of years
doing implant dentistry ordoing root canals.
So I think, from a mindsetstandpoint and what helps with
burnout is this I'm going tolearn a lot from this, even
though it feels really crappyright now.
Paul Etchison (07:38):
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 inyour career, Henry, where you
felt like you were experiencingthat?
Henry Ernst (07:50):
No doubt, and when our practice has always had
extended hours.
So it was probably when I wasabout two, three associates at
that time and there was one timeI had to fire an associate.
And you know now all of asudden that schedule that is
totally full.
We don't just get rid of itLike I was that person.
I'm like I jumped in there.
So now I'm working six days aweek until I find another
(08:12):
associate and I can't even doanything in the business.
So yeah, those were times whereI was really stressed and just
I was hating it and I was justso dreading it and I had to come
up with a plan like look atwhat's happening and not going
to continue this path, we'regoing to change paths.
So in that case that requiredme to say hey, from now on, when
I get another associate, I'mnot working three or four days
(08:33):
in a week, I'm going down to two.
So if I have to jump in I'mgoing to go to four and that's
normal, right.
But one thing to jump on somestuff you said, steve, is I
think it's really important.
It came to my mind when I wastalking with this young,
soon-to-be dentist and a phrasethat was told to me while I was
in dental school by anendodontist.
And it's so true your firstfive years out of school you are
(08:54):
truly practicing dentistry.
You're going to screw up stuffand you're going to be really
slow.
It takes five years to getquick.
You know, on my first secondyear and I've treatment plan a
root canal on 14 in the back ofmy head.
I'm like please, let me getthrough this root canal, let no
problems happen.
And you don't know if it'sgoing to happen, like there's
party that doesn't know if thisis going to come out right or
(09:14):
it's going to work.
Well, all of a sudden, likefive years, sometime in that
period of time, you just hit youin the head.
You know what?
I don't even think like thatanymore.
I just treatment plan the rootcanal, the buildup and the crown
Heck.
I'm adding stuff on top of that.
So if any younger dentists areout there and maybe an
opportunity just hit me as wewere talking, steve, is don't
just share the good stuff, sharethe good stuff, share the bad
stuff with your people out there, because I could do 20 root
(09:38):
canals and my first 20 rootcanals all came out perfect and
that 21st one I did a steve andI popped through the side of the
tooth and I've done that toosteve.
I've gone through the furcationof a 30, so doing a steve yeah,
there's a lot of doing stevesteve's two teeth
a ste or a Henry.
I did number 30 right throughthe damn furcation so I did it
too.
But the point is that one screwup.
(10:01):
I learned a whole much morethan 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 didI do wrong?
I'm going to learn from it andnot do it again.
And this stuff happens.
Paul Etchison (10:17):
Yeah, I totally agree.
A lot of this is mindset, a lotof this is expectations and
like is this the way it'ssupposed to be?
And it's not getting ourexpectations met.
I think back when I was growingmy practice, when I was a solo
doc, I was getting burnt outbecause I was coming in early
and I was staying late becausewe had so many patients and it
just got to the point where Icouldn't do any of the business
(10:38):
functions because I was justdoing so much clinical.
And then when I brought on anassociate, I had an extra day.
I cut back to three days and itwas awesome.
Now, as we grew and had a secondassociate and a bigger team and
a third associate and a biggerteam, at a certain point I was
still going like two, three daysa week but I didn't have enough
days to run the business andthat caused me to burn out a ton
(11:01):
because there were so manythings that I couldn't get to as
an owner.
I think that's one of the thingsabout dentistry is that the
business will still functionwithout management.
It just won't function reallywell.
The things that don't functionwell are the things that are
keeping us up at night or thethings that are just like, at
least for me, that were keepingme up at night just thinking
(11:21):
about like man I really.
Why is my culture bad?
What's going on?
Is the practice going fallingapart?
Oh, was it better when it wassmall and just second guessing
myself?
And when I actually cut back myclinical and had time to work
with my team and scale and buildpeople up, build other leaders,
everything changed for me,where I actually started loving
the profession again and lovingbeing at my office.
Stephen Markowitz (11:45):
You talked about.
You felt burnout when yourpractice was growing too fast.
I guarantee that if you sat atthe 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 thisyear, you would have been
jumping for joy in the beginningof the year.
Yeah, but so it's not theactual growth that was causing
the burnout.
There was something more inthat growth.
(12:07):
You wanted to grow, you wantedto build a practice, you wanted
to build a business you wereproud of.
There was something that washappening that wasn't providing
you joy, and it wasn't thegrowth.
The growth was.
Maybe there were things withinthat growth that were causing
you frustration, which led toburnout.
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 aplace where you lose joy and
feel burnout.
I think for the listener itcould be so different depending
on who they are as a leader andwho they are as a dentist and
what kind of things they reallyenjoy or hate.
So I think the first thing whenyou're feeling that is to truly
(12:50):
identify the problem of okay.
The result of this is we'regrowing too fast, and I've said
the same thing.
I'm like damn, I wish we weregrowing slower, but I don't
really wish that.
I wish that I had a strongersense of our systems, of how to
scale to multiple practices orhad different leaders in place
(13:12):
with experience.
That may have made it feel lessstressful to me.
It wasn't that we were growing.
So, I think, identifying theproblem and then finding that
place of true joy and this isgoing to sound so fricking corny
, but like there are people thatwork I'm putting that in quotes
hundreds, hundred plus hours aweek and they love it and they
(13:35):
couldn't and wouldn't doanything else and they never get
burnt out.
So it's not about the number ofhours that people are doing.
Something like that's just truepassion.
When we start to lose joy iswhen we start to see burnout, so
we need to be very aware of thethings that bring us joy in our
day.
Paul Etchison (13:54):
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 andthere might be certain people
that can handle that chaosbetter than me, but personally,
when there's chaos at mypractice, that's what hits me on
all angles.
If you feel like chaos iswhat's burning you out, the
solution is to step back andaddress the chaos.
(14:16):
It's to stop seeing clinicalpatients so much so that you can
address that chaos.
Henry Ernst (14:20):
Some of the stuff that's hitting me in the head
here is as an owner, you havetwo jobs.
You're a clinical dentist, butyou also have a business that
you're in charge of running.
And it just seems like, like Iwas saying before, I feel like
you have to understand who youare.
Am I a lifestyle practice?
And if that's the case, great,I'm one doctor.
We're not going to grow, we'renot going to open up any more
(14:42):
offices, we're going to stayright here, we're going to take
care, and that's great.
But my suggestion for you isdon'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 thebusiness.
That's your second job.
Don't just be the clinicaldentist and the business just
somehow runs itself.
And the other thing is like, ifyou listen to us, we're all
(15:06):
very similar and a lot ofcoaching clients, like I've seen
the same thing.
When they do that magical thingof stepping back from the
clinical role, role number one,and they focus on the CEO role
and actually focus on thebusiness, they are just
naturally happier.
And it seems very nervewracking.
But I've seen it hundreds oftimes, literally hundreds of
times.
The business produces moreevery single time because you're
(15:27):
a better owner, you're a bettervisionary and you're a better
leader.
Like you said, paul, you canwork on that.
People, person, people in youroffice, people aspect.
Paul Etchison (15:37):
I've seen it a million times too the practice
grows, the practice becomes moreprofitable, life becomes better
.
So I think the importanttakeaway here is to really, if
an owner is feeling like they'renot liking where they're at, is
to zoom out.
Like you mentioned, steve, findout what's really bothering
them, find out what brings themjoy and try to design their
(15:57):
practice and their life aroundthat, so that they can have more
of that joy and less of thatchaos.
Steve, what do you think ofthat?
Stephen Markowitz (16:04):
I mean, it's easy to say that.
I think it's hard when you'rein it.
No matter what size my dentalpractice organization has been,
there's always been issues.
If all I'm doing is focusing onthose issues, I'm never going
to see true progress.
So I think what you said wasperfect is you need to take a
step back.
You need to look at yourorganization and yourself as a
(16:26):
whole as like all right, what doI want this practice, this
business, to be for me?
And then work on those thingsthat bring you joy, make the
practice fit your true goals andcontinue to create plans.
Like Henry said, that willallow progress and if you're
enjoying what you're doing,growing towards your goals and
(16:50):
continue to see progress, therewill be seasons that you feel
more stress or less enjoyment,but when you take a step back,
you'll continue to love what youdo and have less feelings of
burnout.
Henry Ernst (17:03):
I'll expand on what you said, Stephen.
Maybe think of it like livingin the reactive world here.
Like most dentists live in thereactive world.
I'm practicing, I'm practicing,I'm practicing.
Problem, problem, fix it, fixit, Problem, problem.
It's totally reactive.
That's stressful as hell.
Right, you need to live in aproactive world where we're like
you said, Paul, we're analyzingwhat the chaos is, we're going
(17:24):
to fix it.
And I would say this here Iwould have never hit that
magical point in my practicecareer where I was hitting the
wall and I was hamster wheelingit and I was just working harder
and it just didn't seem likemore.
I needed somebody that wasthere, that was a mentor that
told me emphatically you need tostep back and work two days a
week, not four or five.
You're not gonna do thisanymore.
(17:45):
And it took somebody to trustsomebody that was a mentor and
to listen to them.
They've been in my shoes andthe damn thing worked.
So living in the proactiveworld involves making decisions
and analyzing the chaos andhaving somebody you trust,
whether it's a mentor, whetherit'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 thedamn things.
Paul Etchison (18:06):
Yeah, absolutely, and I think that's where the
coaching comes into is somebodythat can look at your practice
and say I think you need to dothis, and I think that's what's
so great about us.
Three is that all three of ushave been through these
situations and I've had coachingclients on a numerous occasion
say to me man, it's so weird tohear that you're having problems
at your office.
I just think by this time inyour career you'd have
(18:27):
everything perfect by now, andthat just goes to show you the
expectation is that a well-runoffice is not supposed to have
problems, and that is anunrealistic expectation and your
office is always going to havethings going on.
But I would say in my career,the burnout, the solution, has
always been more so addressingwhat's bothering me rather than
(18:50):
readjusting my expectations.
Obviously it's going to be acombination of both, but for me
it's been addressing what iscausing the issues and for me
that has always been puttingmore time and energy into the
issues and less time into seeingpatients.
So if you're listening and youthink you might be experiencing
this and you want to work with acoach and try to cut down your
days and run a better practice,please go to our website
(19:12):
dentalpracticeheroescom andcheck out our coaching options.
Thank you so much for listeningand we'll talk to you next time
.
Take care.
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