{"id":2441,"date":"2016-04-12T06:00:26","date_gmt":"2016-04-12T11:00:26","guid":{"rendered":"http:\/\/allisonwatts.com\/?p=2441"},"modified":"2020-08-28T12:05:23","modified_gmt":"2020-08-28T17:05:23","slug":"ep-48-avoiding-burnout-practice-dr-clark-gaither","status":"publish","type":"post","link":"https:\/\/allisonwatts.com\/ep-48-avoiding-burnout-practice-dr-clark-gaither\/","title":{"rendered":"Ep #48: Avoiding Burnout in Your Practice with Dr. Clark Gaither"},"content":{"rendered":"<p><img width=\"300\" height=\"300\" loading=\"lazy\" decoding=\"async\" class=\"alignright size-medium wp-post-2441 wp-image-2443\" src=\"data:image\/svg+xml;base64,PHN2ZyB4bWxucz0iaHR0cDovL3d3dy53My5vcmcvMjAwMC9zdmciIHdpZHRoPSIzMDAiIGhlaWdodD0iMzAwIj48cmVjdCB3aWR0aD0iMTAwJSIgaGVpZ2h0PSIxMDAlIj48YW5pbWF0ZSBhdHRyaWJ1dGVOYW1lPSJmaWxsIiB2YWx1ZXM9InJnYmEoMTUzLDE1MywxNTMsMC41KTtyZ2JhKDE1MywxNTMsMTUzLDAuMSk7cmdiYSgxNTMsMTUzLDE1MywwLjUpIiBkdXI9IjJzIiByZXBlYXRDb3VudD0iaW5kZWZpbml0ZSIgLz48L3JlY3Q+PC9zdmc+\" alt=\"-G6YFG4l\" data-public-id=\"G6YFG4l\/G6YFG4l.jpg\" data-format=\"jpg\" data-transformations=\"f_auto,q_auto\" data-version=\"1587010416\" data-seo=\"1\" data-size=\"300 300\" data-srcset=\"https:\/\/res.cloudinary.com\/transformational-practices-llc\/images\/w_300,h_300,c_scale\/f_auto,q_auto\/v1587010416\/G6YFG4l\/G6YFG4l.jpg?_i=AA 300w, https:\/\/res.cloudinary.com\/transformational-practices-llc\/images\/w_150,h_150,c_fill,g_auto\/f_auto,q_auto\/v1587010416\/G6YFG4l\/G6YFG4l.jpg?_i=AA 150w, https:\/\/res.cloudinary.com\/transformational-practices-llc\/images\/w_200,h_200,c_fill,g_auto\/f_auto,q_auto\/v1587010416\/G6YFG4l\/G6YFG4l.jpg?_i=AA 200w, https:\/\/res.cloudinary.com\/transformational-practices-llc\/images\/w_144,h_144,c_fill,g_auto\/f_auto,q_auto\/v1587010416\/G6YFG4l\/G6YFG4l.jpg?_i=AA 144w, https:\/\/res.cloudinary.com\/transformational-practices-llc\/images\/f_auto,q_auto\/v1587010416\/G6YFG4l\/G6YFG4l.jpg?_i=AA 512w\" data-sizes=\"(max-width: 300px) 100vw, 300px\" data-delivery=\"upload\" onload=\";window.CLDBind?CLDBind(this):null;\" data-cloudinary=\"lazy\" \/>This time on <em>Practicing with the Masters, <\/em>my special guest is Dr. Clark Gaither. Dr. Gaither, also known as Dr. Burnout, is a board-certified family physician in private practice and has been practicing medicine full-time for the past twenty-five years. He is the best-selling author of <em>Powerful Words: Inspired Communication through Emotional Connection.<\/em><\/p>\n<p>Dr. Gaither knows first hand the pain and the value of struggle in growing your practice. During his lifetime and over twenty-five years of practice as a family physician, he has faced and overcome many difficult challenges both personally and professionally.<\/p>\n<p>Dr. Gaither\u2019s story is inspiring in his perseverance and hard work. He has faced a fear of public speaking, alcoholism, professional burnout and devastating personal tragedies. Not only has he learned to overcome but he has learned to embrace the gloriousness of change.<\/p>\n<p>Dr. Gaither\u2019s primary focus is to help transform the lives of individuals who feel they are burned out by retooling their mindset for success and unleashing their creative potential. He is an expert in the identification, treatment, and prevention of job-related burnout. Dr. Gaither joins me today to help you set the framework to stop burnout in its tracks.<\/p>\n<h3>What You&#8217;ll Learn From This Episode:<\/h3>\n<ul>\n<li>The six major causes of burnout.<\/li>\n<li>Why professional burnout is more prevalent in the corporate world.<\/li>\n<li>The three key factors of a fair workplace.<\/li>\n<li>The easy steps you can take to empower your staff.<\/li>\n<li>The three symptoms of burnout.<\/li>\n<li>The difference between stress and burnout.<\/li>\n<li>Why you want to implement a wellness program for your office.<\/li>\n<\/ul>\n<h3>Listen To The Full Interview:<\/h3>\n\n<h3>Featured On The Show:<\/h3>\n<ul>\n<li>Connect with Dr. Gaither: <a href=\"http:\/\/www.clarkgaither.com\/\" target=\"_blank\" rel=\"noopener noreferrer\">Dr Burnout<\/a> | <a href=\"http:\/\/www.clarkgaither.com\/blog\/\" target=\"_blank\" rel=\"noopener noreferrer\">Blog<\/a> | <a href=\"https:\/\/twitter.com\/clarkgaither\" target=\"_blank\" rel=\"noopener noreferrer\">Twitter<\/a> | <a href=\"https:\/\/www.facebook.com\/drburnout\" target=\"_blank\" rel=\"noopener noreferrer\">Facebook<\/a> | LinkedIn | <a href=\"https:\/\/www.youtube.com\/channel\/UCj50yHWp9w4Iv7u97bam_4Q\" target=\"_blank\" rel=\"noopener noreferrer\">YouTube<\/a><\/li>\n<li><em><a href=\"http:\/\/www.amazon.com\/Powerful-Words-Maximizing-Emotional-Connections-ebook\/dp\/B00XDA77ZU\" target=\"_blank\" rel=\"noopener noreferrer\">Powerful Words: Discover Your Secret Language for Personal Success and Maximizing Impact Through Emotional Connections<\/a> <\/em>by Clark Gaither<\/li>\n<li><em><a href=\"http:\/\/www.amazon.com\/gp\/product\/B00267SROQ\/ref=dp-kindle-redirect?ie=UTF8&amp;btkr=1\" target=\"_blank\" rel=\"noopener noreferrer\">The Truth About Burnout: How Organizations Cause Personal Stress and What To Do About It<\/a> <\/em>by Christina Maslach and Michael Leiter<\/li>\n<li><a href=\"http:\/\/psychology.berkeley.edu\/people\/christina-maslach\/\" target=\"_blank\" rel=\"noopener noreferrer\">Christina Maslach<\/a><\/li>\n<li><a href=\"http:\/\/www.daveramsey.com\/home\/\" target=\"_blank\" rel=\"noopener noreferrer\">Dave Ramsey<\/a><\/li>\n<li><a href=\"http:\/\/www.pankey.org\/\" target=\"_blank\" rel=\"noopener noreferrer\">Pankey Institute<\/a><\/li>\n<\/ul>\n<h3>Full Episode Transcript:<\/h3>\n<p><a href=\"http:\/\/allisonwatts.com\/wp-content\/uploads\/2016\/04\/EP048-PWTMTranscript.pdf\" target=\"_blank\" rel=\"noopener noreferrer\"><img width=\"311\" height=\"77\" loading=\"lazy\" decoding=\"async\" class=\"aligncenter size-full wp-post-2441 wp-image-2277\" src=\"data:image\/svg+xml;base64,PHN2ZyB4bWxucz0iaHR0cDovL3d3dy53My5vcmcvMjAwMC9zdmciIHdpZHRoPSIzMTEiIGhlaWdodD0iNzciPjxyZWN0IHdpZHRoPSIxMDAlIiBoZWlnaHQ9IjEwMCUiPjxhbmltYXRlIGF0dHJpYnV0ZU5hbWU9ImZpbGwiIHZhbHVlcz0icmdiYSgxNTMsMTUzLDE1MywwLjUpO3JnYmEoMTUzLDE1MywxNTMsMC4xKTtyZ2JhKDE1MywxNTMsMTUzLDAuNSkiIGR1cj0iMnMiIHJlcGVhdENvdW50PSJpbmRlZmluaXRlIiAvPjwvcmVjdD48L3N2Zz4=\" alt=\"Allison&#039;s-Button\" data-public-id=\"Allisons-Button\/Allisons-Button.jpg\" data-format=\"jpg\" data-transformations=\"f_auto,q_auto\" data-version=\"1587010383\" data-seo=\"1\" data-size=\"311 77\" data-srcset=\"https:\/\/res.cloudinary.com\/transformational-practices-llc\/images\/f_auto,q_auto\/v1587010383\/Allisons-Button\/Allisons-Button.jpg?_i=AA 311w, https:\/\/res.cloudinary.com\/transformational-practices-llc\/images\/w_300,h_74,c_scale\/f_auto,q_auto\/v1587010383\/Allisons-Button\/Allisons-Button.jpg?_i=AA 300w\" data-sizes=\"(max-width: 311px) 100vw, 311px\" data-delivery=\"upload\" onload=\";window.CLDBind?CLDBind(this):null;\" data-cloudinary=\"lazy\" \/><\/a><\/p>\n<h3>Avoiding Burnout in Your Practice with Dr. Clark Gaither<\/h3>\n<div id=\"transcript-link-2441\" class=\"sh-link transcript-link sh-hide\"><a href=\"#\" onclick=\"showhide_toggle('transcript', 2441, 'CLICK HERE TO READ THE TRANSCRIPT (8,709 WORDS )', 'Hide The Transcript (8,709 Hide Transcript)'); return false;\" aria-expanded=\"false\"><span id=\"transcript-toggle-2441\">CLICK HERE TO READ THE TRANSCRIPT (8,709 WORDS )<\/span><\/a><\/div><div id=\"transcript-content-2441\" class=\"sh-content transcript-content sh-hide\" style=\"display: none;\">\n<p>Welcome to <em>Practicing with the Masters<\/em> for dentists with your host, Dr. Allison Watts. Allison believes that there are four pillars for a successful, fulfilling dental practice: clear leadership, sound business principles, well-developed communication skills, and clinical excellence. Allison enjoys helping dentists and teams excel in all of these areas. Each episode she brings you an inspiring conversation with another leading expert. If you desire to learn and grow and in the process take your practice to the next level, then this is the show for you. Now, here\u2019s your host, Dr. Allison Watts.<\/p>\n<p>Allison:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Welcome to <em>Practicing with the Masters<\/em> podcast. I\u2019m your host, Allison Watts, and I\u2019m dedicated to bringing you masters in the field of dentistry, leadership, and practice management to help you have a more fulfilling and successful practice and life.<\/p>\n<p>Thank you guys all for being here. I\u2019m Allison Watts and I\u2019ve got Dr. Clark Gaither here today, also known as Dr. Burnout. He\u2019s a board certified family physician in private practice in Goldsboro, NC. He has been in the full time practice of medicine for the past 24 years. Has it been longer than that now, has it been 26?<\/p>\n<p>Clark:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 It\u2019s 25, well it will be 25 in September.<\/p>\n<p>Allison:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Okay. Dr. Gaither knows firsthand both the pain and the value of struggle. During his lifetime and 26 year career as a family physician he has faced and overcome many difficult challenges: fear of public speaking, alcoholism, professional burnout, and devastating personal tragedies. Not only has he learned to overcome, he has learned to embrace the glorious magnificence of change.<\/p>\n<p>Dr. Gaither is an expert in the identification, treatment, and prevention of job-related burnout after personally experiencing burnout himself. His primary focus is to\u00a0help transform the lives of individuals who\u00a0feel they are burned out\u00a0by retooling their mindset for success and unleashing their creative potential. He personally overcame a moribund fear of speaking, even in private, to become the North Carolina State Serious Speech Champion.<\/p>\n<p>He battled alcoholism while in residency training in 1989 but went on to become the North Carolina Family Physician of the Year in 2002. He has also authored a bestselling book in 2015, called\u00a0<em>Powerful Words<\/em>, inspired communication through emotional connections. You can learn more about Dr. Gaither by visiting his website, ClarkGaither.com. You also have Dr. Burnout, right?<\/p>\n<p>Clark:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Yes. Either one will get you to the same location, that\u2019s right.<\/p>\n<p>Allison:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Okay, well thank you so much for being here tonight.<\/p>\n<p>Clark:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Listen, I appreciate the invitation.<\/p>\n<p>Allison:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Yeah, we have a lot of people interested in this topic. I know you&#8217;re a physician but the reason I reached out to you is because I feel like it\u2019s a problem in dentistry as well. I\u2019m wondering too what you think about, I think the corporate thing that\u2019s happening in dentistry right now is going to make it even more so. I don&#8217;t know, do you have a good idea where you\u2019d like to start?<\/p>\n<p>Clark:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 I\u2019ll pick up where you just left off. I think you\u2019re absolutely right. As corporate entities absorb more practices or large groups are formed, it turns out it\u2019s the work environment that burns out individuals most of the time, it\u2019s like 90 percent of the time. You can take an on fire, passionate, purpose-driven dentist and put them in the wrong work environment and you will burn them out. I don\u2019t care how passionate they are about the profession.<\/p>\n<p>It turns out there\u2019s certain mismatches that occur in the work environment that set people up for job-related burnout. It\u2019s only about ten percent of the time that the individual actually burns themselves out either from problems that they carry into the workplace or other realms of their life that are being affected that are spilling over into their profession. But 90 percent of the time, it\u2019s the work environment that burns out the individual.<\/p>\n<p>Allison:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 So when you say work environment, what I think of in my practice, I have my own practice. I created, in a way, I mean obviously I\u2019ve got team and patient, but I\u2019m also creating my own environment.<\/p>\n<p>Clark:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Yeah, it\u2019s less of an issue for individual or private practice because you can control things better. In the corporate world, you lose control. In fact, that\u2019s one of the six major mismatches. A lot of this work was done by Christina Maslach back in the 80s. In fact, she came up with the Maslach Burnout Inventory which is still used as the gold standard today for measuring that metric of job-related burnout.<\/p>\n<p>In her book, <em>The Truth about Burnout<\/em>, she explains that there are about six major mismatches. There\u2019s more than six, but there\u2019s six major ones that create job-related burnout. One of them is lack of control. So are you a solopreneur? Are you a solo dentist in your own office then?<\/p>\n<p>Allison:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Yes.<\/p>\n<p>Clark:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Well, you have, you know, everything stops with you or begins with you. So you can control your book, you can control how fast you see patients, you can control how many patients you see in a day, how many days you work. You&#8217;re in charge of your staff. But if you were a dentist\u2026<\/p>\n<p>Allison:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Sometimes I think it\u2019s the other way around but we\u2019ll go with that.<\/p>\n<p>[Laughter]<\/p>\n<p>Clark:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 I had that thought in the back of my head when it came out of my mouth. Some days I wonder if run my office or if my staff runs my office. But I still sign their paycheck I guess. But think of a big corporate enterprise that perhaps has ten or twelve dental offices and the dentists work for the corporation and there\u2019s a manager or administrator.<\/p>\n<p>So the dentist answers to them. So their book of business may not be under their control or the staff may not be under their control. So that\u2019s one of the first obstacles that some people hit in organized medicine or corporate medicine, when you have big hospitals, or big groups, or big dental groups. Lack of control is one of those mismatches. Do you want me to just go through those six mismatches and see if any of them sound familiar?<\/p>\n<p>Allison:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Yeah, I think that\u2019d be great. Now when you say mismatches, you&#8217;re saying a mismatch between the person suffering the burnout and their environment?<\/p>\n<p>Clark:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 It\u2019s the individual and their work environment or workplace.<\/p>\n<p>Allison:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Okay, yes. I&#8217;d love for you to go through those.<\/p>\n<p>Clark:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Okay. The first one that was identified was work overload. I don\u2019t have to tell you, well in medicine I can tell you that we are stretched about as thin as we can be stretched now with work and things to do. It\u2019s probably getting that way in dentistry. A lot of that work may not be actual hands-on dentistry, it may be bureaucratic work. It may be shuffling paper and filling out forms and of course you\u2019ve got the battles that we wage all the time with the insurance companies. So work overload is one.<\/p>\n<p>Then on top of that, lack of control, which is the second one. The third one is insufficient reward. With big groups, market forces have forced businesses to get more efficient and efficient translates to reducing costs. So they\u2019ll start cutting the rewards that people seek.<\/p>\n<p>People seek tangible rewards from meaningful work. It\u2019s not always money. It could be security or recognition or benefits or the intrinsic satisfaction of the job. When people are working harder and harder and harder and they&#8217;re getting less and less reward they begin to wonder, \u201cWhy am I working so hard?\u201d It\u2019s like a very simple equation. More work plus less reward equals dissatisfaction. So that\u2019s the third one, insufficient reward.<\/p>\n<p>The fourth one is one that people don\u2019t think about a lot but it\u2019s extremely important and that\u2019s breakdown of community. As some organizations get bigger and they grow too fast, too quickly, there\u2019s a breakdown in the character of the organization. Everybody can probably tell a story about some business that they really liked, it was kind of a mom and pop operation and they provided an excellent product or service and you knew everybody there.<\/p>\n<p>Then they started growing and as they got bigger and bigger they lost something. They lost some quality that made them special. What that quality was was probably that sense of community. That sense of belonging. Not only among the employees, but the employees with the customer because maybe you saw new faces every time you went in and it just didn\u2019t seem like the same business anymore.<\/p>\n<p>So the community becomes extremely important. If you&#8217;re working in an office where you may not even know the person well that works in the hall across from you or in the office across town. You don\u2019t know anything about their life. You don\u2019t know anything about the problems they&#8217;re having in their office or how they solve problems in the office. So that sense of community becomes a key aspect of whether or not people feel like they belong to the job or they have some ownership in it.<\/p>\n<p>The fifth one is absence of fairness. Dr. Maslach explained a workplace was deemed to be fair by the employees if they felt there was trust, openness, and respect. When all three of those were present, the employees feel valued. When they&#8217;re absent, they felt like there was no fairness in the workplace.<\/p>\n<p>It wasn\u2019t always about the CEO making a big fat salary and nobody getting a raise, it also had to do with does the worker feel like they are valued? Do they feel trusted? Do they trust the managers? And is there openness and respect? When those are present, people feel like they&#8217;re being fairly treated and when they&#8217;re not, they feel they&#8217;re being unfairly treated and that can lead to burnout.<\/p>\n<p>Then the sixth one is a big one I know in medicine right now and it\u2019s conflicting values. That\u2019s when basically you&#8217;re being asked to do something that goes against your internal compass, your core being or your core values. You feel like they&#8217;re being assaulted or you feel like you&#8217;re violating your code of ethic every time you go to work because you&#8217;re being asked to do things you would not do if you did not work there.<\/p>\n<p>That will burnout people very quickly if they are conflicting values. If your company and organization says, \u201cWe provide excellent service and the customer always comes first\u201d and you know behind the scenes that\u2019s not the case, then that\u2019s a big conflicting value.<\/p>\n<p>So those six things: the work overload, lack of control, insufficient reward, breakdown of community, absence of fairness, conflicting values, those are the actual causes of job-related burnout as Dr. Maslach described them.<\/p>\n<p>Allison:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 It almost seems like you could\u2014I know you have some preventative and some solutions for it. It almost seems right now as we\u2019re speaking that you could actually somehow infuse a little bit of each of these things to sort of counteract or prevent burnout. I didn\u2019t think about that when we were getting ready for the call but I just thought of it now. I mean, although some places you just can&#8217;t, right? You just can&#8217;t. Like corporate, I mean I\u2019m not in the scenario.<\/p>\n<p>Clark:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Well on the surface it seems like yeah, sometimes you&#8217;re the David and corporate entity is the Goliath and since they&#8217;re in charge you really have no control. My message has always been, okay, what are we in business to do?<\/p>\n<p>You&#8217;re in business to serve the public or provide a service or a product. It\u2019s got to be a good service or a product or people won&#8217;t buy it. Or if you produce an inferior product, people are going to complain about it. You&#8217;re going to have to refund people\u2019s money or do something over that you\u2019ve already done because they weren\u2019t pleased with the results.<\/p>\n<p>So my point has always been, if you do some things up front that cost very little money\u2014imagine fewer customer complaints, imagine fewer employee complaints. Imagine more profits to the bottom line because people are wanting to come and take advantage of your product or your service.<\/p>\n<p>All those things can be done because your employees feel good about who they work for. They feel valued. They don\u2019t feel like they&#8217;re overloaded. They have some autonomy. They can innovate on the fly and make decisions themselves. They don\u2019t have to refer to some manual to know what the right thing to do is.<\/p>\n<p>So the remedies for a lot of these things are just the exact opposite of what\u2019s occurring. So if you give the employees back a little more autonomy, a little more power over the decision-making process, it can make a huge difference. Even if they are three or four of these mismatches going on, you don\u2019t have to eliminate all of them even. If you just make some of them better, people feel like there\u2019s been a big change or a big difference.<\/p>\n<p>Allison:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 All right. So these are the mismatches and if we\u2019re experiencing these\u2014I don\u2019t know if you want to go into a little bit of the solutions? I know there\u2019s also symptoms of burnout which I actually thought until your article, I read your article by the way, congratulations on that.<\/p>\n<p>Clark:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Oh, thank you.<\/p>\n<p>Allison:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 To me, when you and I were talking, I felt like I do see how burnout and stress seem, like the symptoms of stress seem like they would be very similar. I do think that I bet you there\u2019s a lot of people in dentistry too that have some symptoms of burnout and they think they&#8217;re just stressed and they\u2019re trying to do stress-reduction protocol and that sort of thing. And that\u2019s not, in fact, it\u2019s almost the exact opposite.<\/p>\n<p>Clark:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Yeah, that doesn\u2019t work.<\/p>\n<p>Allison:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Yeah. I found that really interesting.<\/p>\n<p>Clark:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 We can talk about the symptoms, we\u2019ve talked mainly about the causes. But the symptoms people present with, there are three principal ones that are measured on the Maslach Burnout Inventory. The first one is emotional exhaustion. The key word being exhaustion.<\/p>\n<p>People feel like they&#8217;re depleting, completely depleted to a point where they can no longer give on an emotional or psychological level to the patient or the client or the customer. They will tell you, \u201cI feel all used up.\u201d Or, \u201cI have nothing left to give.\u201d Those are a couple of common statements to someone who feels like they&#8217;re emotional exhausted.<\/p>\n<p>The second one is depersonalization. The key word for that one is cynicism. It\u2019s the development of negative or cynical feelings which leads to a callous and almost dehumanized perception of the patient or the client or the customer. That almost to leads to the view that they&#8217;re somehow deserving of their problems. So people get very cynical.<\/p>\n<p>The third one is a lack of a sense of personal accomplishment. People are feeling so little reward from what they do there\u2019s a tendency to evaluate themselves in negative terms. This can lead to immense dissatisfaction and unhappiness. So the key word depersonalization\u2014or a lack of personal accomplishment is inefficacy. So men and women go through those a little differently. Woman usually go through all three of them in order. They get emotional exhausted, then they depersonalize, and the last thing is a lack of a sense of personal accomplishment.<\/p>\n<p>Men on the other hand, depersonalize first. They become cynical first. Then they get emotional exhaustion, they go back up and hit number one. And for some reason, call it the male ego, most men do not feel\u2014they don\u2019t fully get number three if at all, which is a lack of a sense of personal accomplishment. Men always feel that whatever they&#8217;re doing has some value and so they don\u2019t usually get that one.<\/p>\n<p>Allison:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 That\u2019s interesting.<\/p>\n<p>Clark:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Yeah. What that means in real terms is by the time you get a man who hits one of the three, if he hits either depersonalization or emotional exhaustion, he\u2019s 50 percent burned out already. So men burn out quicker than women. Although the suicidality is actually higher in woman than it is in woman when it becomes to job-related burnout. So those are the symptoms.<\/p>\n<p>A lot of times, organizations when they are having high rates of turnover they will bring in some stress management people because everybody what? Everybody looks stressed. Everybody says they&#8217;re stressed. And while it\u2019s true, if you are burned out, I can guarantee you, you are stressed. It\u2019s a given. But you can be stressed and not burned out. I went through some of those differences in that article. But the reaction of most hospitals or big groups where there\u2019s an administrator, the first reaction is to bring in stress management people.<\/p>\n<p>In a subtle way, you&#8217;re telling the provider that, \u201cYou just don\u2019t know how to handle your stress. You&#8217;re either inept or too stupid or dumb to handle your stress, so we\u2019re going to teach you.\u201d And that\u2019s the subtle message which is not good. It\u2019s humiliating. I can tell you, if you teach somebody stress management techniques, you may make them feel better temporarily but unless you correct those underlying mismatches, you\u2019ve not really solved the problem. So they will just burnout all over again. And it doesn\u2019t take long for those positive benefits of stress management to go away if actually what you&#8217;re dealing with is burnout.<\/p>\n<p>Allison:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 So it\u2019s diagnosed based on the three things that you said, the three symptoms?<\/p>\n<p>Clark:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 What was the question?<\/p>\n<p>Allison:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 I\u2019m saying, how would you distinctly diagnose burnout versus stress? Because I mean I would describe myself when I\u2019m stressed sometimes as emotional exhaustion but you&#8217;re talking about sort of a chronic condition of\u2026<\/p>\n<p>Clark:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Right.<\/p>\n<p>Allison:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 It\u2019s not just like this week, it\u2019s not just a short-term thing.<\/p>\n<p>Clark:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Right.<\/p>\n<p>Allison:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 All three of these, it seems more chronic, right?<\/p>\n<p>Clark:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 It can start off rather insidiously and it sneaks up on people, but yeah, it\u2019s really a chronic condition. One of the symptoms, overt symptoms, that people will tell you about or comes to mind is, \u201cOh my god, I can\u2019t wait until it\u2019s Friday.\u201d Or, \u201cOh my god, it\u2019s Sunday already and I can&#8217;t stand the thought of going to work tomorrow.\u201d That\u2019s not stress. That is job-related burnout.<\/p>\n<p>If you go back to that list where I talked about the difference between stress and job-related burnout, stress is characterized by over engagement. Burnout is characterized by disengagement. People actually pull back. Sometimes when people are stressed they work, what? Harder. The solution is to, \u201cWell, you know I\u2019ve got all this work. I&#8217;ve got certain goals I want to accomplish. I feel like I\u2019m under the gun, so I\u2019ll just work harder.\u201d<\/p>\n<p>Somebody who\u2019s burned out will start to disengage. In stress, emotions are overactive. In burnout, emotions are blunted. People can actually get depressed. You can be stressed and not depressed. But when people are burned out, their emotions get blunted. They become, that emotional exhaustion, that key word being exhaustion, they feel like they&#8217;re depleted on an emotional level or a psychological level.<\/p>\n<p>Stress produces urgency and hyperactivity. Job-related burnout produces a sense of helplessness and hopelessness. People feel trapped. They feel like they have no choices, they can&#8217;t extract themselves from their current work situation. Stress leads to a loss of energy. Job-related burnout leads to a loss of ideals, motivation, and hope. Stress leads to anxiety disorders. Burnout leads to the detachment and depression.<\/p>\n<p>With stress, the damage is primarily physical. There are physiologic changes that occur with stress. With burnout, the damage is primarily emotional. Prolonged and excessive stress can kill you prematurely. Burnout will just make your life seem not worth living. But it can increase the risk of suicide. In fact, it\u2019s interesting right now if you&#8217;re a coroner and somebody tells you there is a dead professional on the slab for autopsy, if you guess physician, you will be right more times than you are wrong. That\u2019s how bad it\u2019s gotten.<\/p>\n<p>Allison:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Really?<\/p>\n<p>Clark:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 That\u2019s how bad it\u2019s gotten in the house of medicine right now.<\/p>\n<p>Allison:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 It used to be for years, I know for a very long time that dentistry had the highest suicide and divorce rates. Do you know where dentists fall on that at this point?<\/p>\n<p>Clark:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 No, and I will tell you this. I went online a couple of months ago to see what I could dig up about dentistry because even though medicine is my wheelhouse, I understand medicine, I understand all of the internal workings of medicine and what has made medicine bad these days, the hallmarks and the causes of burnout are the same for all professionals.<\/p>\n<p>So I was digging for burnout rates on attorneys, dentists, teachers, social workers, people who have professional roles. And there is a dearth of data for dentists. I found a couple of studies in Canada. I found one that was done in the UK. But there are very few studies, and there\u2019s opportunity there for somebody, even if it\u2019s just a survey at some big national meeting. There are very few studies on burnout rates in dentistry and there needs to be some because I know dentists are suffering.<\/p>\n<p>Allison:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Oh, yeah. We have a question. I\u2019m going to go ahead and unmute you, Bethany. You&#8217;re unmuted.<\/p>\n<p>Bethany:\u00a0\u00a0\u00a0\u00a0 Hi, can you hear me?<\/p>\n<p>Clark:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Yes.<\/p>\n<p>Allison:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Yes.<\/p>\n<p>Bethany:\u00a0\u00a0\u00a0\u00a0 Okay, hi. Hey, this is a really near and dear subject to my heart because I left dentistry because I was stressed and exhausted. Your definition of being burned out, I\u2019m not sure I was ever burned out because I never stopped. I never stopped caring. So are there any studies or what is it that causes that tipping point from stressed out to burned out and are there people who have more tolerance to stress for a longer period of time? Because it sure seems like I was extremely stressed for about 15 years.<\/p>\n<p>I never got depressed but now my career is to help dentists remove stress from their lives or deal with it better before it\u2019s too late. So I guess that means stop them from slipping into burnout and exhaustion. So what\u2019s exactly, I mean, are there any, where is that point?<\/p>\n<p>Clark:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Well as you might surmise, it will be different for different people.<\/p>\n<p>Bethany:\u00a0\u00a0\u00a0\u00a0 Sure.<\/p>\n<p>Clark:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Let me ask you a couple questions. Are you practicing dentistry now or are you just working with dentists?<\/p>\n<p>Bethany:\u00a0\u00a0\u00a0\u00a0 No, I\u2019m coaching dentists to relieve stress.<\/p>\n<p>Clark:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Okay.<\/p>\n<p>Bethany:\u00a0\u00a0\u00a0\u00a0 I left two years ago.<\/p>\n<p>Clark:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Did you stop dentistry earlier than you had planned?<\/p>\n<p>Bethany:\u00a0\u00a0\u00a0\u00a0 Well, yeah. When I first came into dentistry, I thought I&#8217;d practice my whole career. I practiced for 20 years and 8 of it was spent trying to get out because it\u2019s not easy, there\u2019s a lot of factors, you know.<\/p>\n<p>Clark:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 I would submit then you were probably burned out but still standing. I mean you were burned out but you were still working but probably because you had commitments and obligations and that was you what you did. You were a dentist. Other than switch careers, you had very probably limited choices as to what you were doing, although the how and the why can change. We can get into that deeper as we go.<\/p>\n<p>Let me just say, as you coach dentists, keep in the back of your mind, and I do this all the time when I coach physicians. About ten percent of the dentists that are practicing dentistry, about ten percent of physicians that are practicing medicine, don\u2019t need to be in medicine. And those dentists don\u2019t need to be doing dentistry, they need to be doing something else because they ended up in dentistry because either their dad was a dentist and wanted them to be one or it seemed like a good thing to do because they could make money and be off on Fridays.<\/p>\n<p>Bethany:\u00a0\u00a0\u00a0\u00a0 Yeah, it always looks good on the outside.<\/p>\n<p>Clark:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Yeah, so about ten percent of professionals are really doing work that they were not intended to do, that really doesn\u2019t match their core values or it really doesn\u2019t match their talents and abilities, their unique set of talents and abilities. So always keep that in the back of your mind.<\/p>\n<p>The other 90 percent, you can do some good work with but the tipping point will be different for different people. Some people just put their head down and say, \u201cOkay, this is the way it is. I\u2019m just going to slug this out.\u201d But that to me is no way to live if you&#8217;re miserable at what you&#8217;re doing or if you dread going to work on Monday and all you look forward to is the weekend. That\u2019s just not\u2014you&#8217;re not going to practice your best dentistry and produce your best work feeling that way.<\/p>\n<p>Bethany:\u00a0\u00a0\u00a0\u00a0 And that\u2019s not fair to your team and patients either. So do you, let me clarify one thing. You said being mentally exhausted and burned out is usually you&#8217;re depressed. So you can be exhausted, mentally burned out and not depressed?<\/p>\n<p>Clark:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Yes. Yeah. Not everybody gets depressed. I said it can lead to detachment and depression. I didn\u2019t mean to give the impression that everybody gets depressed.<\/p>\n<p>Bethany:\u00a0\u00a0\u00a0\u00a0 So it\u2019s more common than not though?<\/p>\n<p>Clark:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Yeah, it\u2019s very common. It\u2019s more common than somebody who\u2019s not burned out.<\/p>\n<p>Bethany:\u00a0\u00a0\u00a0\u00a0 Yeah.<\/p>\n<p>Clark:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Just like drugs and alcohol, a lot of people who burnout will act now. Not everybody, but some will. Some will act out with drugs and alcohol, it usually starts innocently enough. People will start relief drinking at night to relax or to help them get to sleep. Then slowly over time it escalates until they&#8217;re in trouble. So other than suicide, burnout can lead to all sorts of crazy additions.<\/p>\n<p>Bethany:\u00a0\u00a0\u00a0\u00a0 Yeah, just one more comment then I\u2019ll let you have your teleconference back, Allison.<\/p>\n<p>[Laughter]<\/p>\n<p>Allison:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 No, it\u2019s great.<\/p>\n<p>Bethany:\u00a0\u00a0\u00a0\u00a0 I\u2019m really interested in this. So the trick is, how do you reach depressed professionals who have their head down? Because they&#8217;re the ones who need help and they&#8217;re the ones with their head down. You know, how do we reach those people before it\u2019s too late?<\/p>\n<p>Clark:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Well, there is a framework I use called reignite but basically it\u2019s an acronym. The R is for review, you get people to review their current circumstances and events which led to them, I mean all the way back to when did you decide to become a dentist and why? Tell me about that. So you get them to tell the story. You also get them to tell the events in their life where they thought were tragedies, where something really bad and terrible happened.<\/p>\n<p>For most people, the events in our life we think, \u201cThat was a real bad terrible thing that happened back there.\u201d When it is all said and done, you probably ended up better off after the event. It\u2019s just when you were going through it, it was very painful. It was a hard time in your life. But you learned something from it or you ended up better off afterwards. That\u2019s true for most people.<\/p>\n<p>So if you can get people to realize that even though you&#8217;re going through this bad thing now, you can get passed it. There is something better on the other side of this waiting for you. So I take them through this exercise where they review their past and frame that and how it can lead to a brighter future. That\u2019s what the E in reignite is for, it\u2019s envision. Envision your brightest preferred future.<\/p>\n<p>I want them to write down on a piece of paper exactly how they picture their future. Where are you living? What kind of a house do you live in? What kind of a car do you drive? How many weeks a year do you take on vacation? Who is with you? Who do you live with? Then knowing where they are at point A and they want to be over here at point B, you can begin to map out some sort of strategy to get them from where they are to where they want to be.<\/p>\n<p>Bethany:\u00a0\u00a0\u00a0\u00a0 Thank you.<\/p>\n<p>Clark:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Then the I is introspection. That\u2019s where we take an inventory of their core values. Most people feel like they have values, most people can&#8217;t name their top ten core values because they\u2019ve never done a core value inventory. The reason I do that is because I want to know if what they&#8217;re doing, the role they&#8217;re filling in dentistry or the position they have or the place they&#8217;re practicing, I want to know how closely it matches their core values because if it doesn\u2019t, they don\u2019t need to be there. They need to go somewhere else. They need to go somewhere where it\u2019s a better fit for them because they will be much happier in that location or in that position.<\/p>\n<p>G is generate a plan of action to transform their life from where they are to where they want to me. N is neutralize all those self-placed obstacles and barriers. Most people don\u2019t, I mean, if you think about all the things that you want to do but you don\u2019t do and you start naming reasons, nobody gives us those reasons. We generate them all up in our own head.<\/p>\n<p>So we\u2019re almost our own worst enemies when it comes to accomplishing goals. The voice that shouts \u201cno\u201d the loudest is the one up in our own head. So getting people to neutralize those self-placed barriers and obstacles is key. Then the I is implement where you actually set specific goals and targets, \u201cBy this date you will have done this.\u201d People begin to transform in that way, which is the T.<\/p>\n<p>Then the last letter is E for engagement. The opposite of burnout is engagement. The three hallmarks of engagement are the exact opposites of the hallmarks of burnout. The hallmarks of engagement are vigor, dedication, absorption. Vigor. Dedication. Absorption. What everybody wants, that\u2019s what every employer wants their employees to have because those are your on fire employees that you have to tap on the shoulder and say, \u201cHey, it\u2019s time to go home.\u201d<\/p>\n<p>Bethany:\u00a0\u00a0\u00a0\u00a0 Thank you.<\/p>\n<p>Allison:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Clark, what did you say the T was?<\/p>\n<p>Clark:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 In reignite?<\/p>\n<p>Allison:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Yes.<\/p>\n<p>Clark:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 It\u2019s transform, transformation. That\u2019s when we do a look back and people begin to see that their life is changing. I\u2019ll tell you one of the offshoots of this is a lot of times people, although the job may have created the conditions for burnout, the mismatches may have caused the burnout, people don\u2019t change because they&#8217;re lives are usually out of balance and they feel that they can&#8217;t.<\/p>\n<p>By that I mean, you have to look at all four life realms: the mental, the emotional, the physical, and the spiritual. Because if you&#8217;re just attending to one of those and the rest is out of balance, it\u2019s very difficult for people to make a good decision on where they should be and what they should be doing.<\/p>\n<p>A prime example is, and doctors do this all the time and I imagine dentists do it too. You work, you go to undergraduate for four years, you go to graduate school for four years, in my case, it was med school and then a residency for three. I don&#8217;t know how long it is for dentists, certainly if you specialize, there\u2019s probably some after dental school years you\u2019ve got to put in like for orthodontics or periodontal surgery or something.<\/p>\n<p>You put in all this time and then the day comes, you start working, and you get a big fat paycheck and people go hog wild with spending. First it\u2019s the big house and then the big car. Then, well sure, we\u2019ve got to have a place at the beach. Then the kids have got to go to private school and the whole time they\u2019re building up debt on debt on debt on debt.<\/p>\n<p>The next thing you know, they can&#8217;t look up from what they&#8217;re doing because they\u2019ve boxed themselves in with this debt situation. They feel like they can&#8217;t take time off. Sometimes even doctors end up working extra hours and on weekends, just to pay off the debts for all the stuff they bought.<\/p>\n<p>Allison:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Mm-hmm.<\/p>\n<p>Clark:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 So Dave Ramsey\u2019s Financial Peace University, I\u2019m a big believer in that. Of getting some of these doctors to reduce their debt and to show them that they don\u2019t have to own everything they\u2019d like to do. That you can rent things and you don\u2019t need as big of house as you think you need. The car you can afford is the one you can walk in and pay cash for, not borrow money to own. So it\u2019s a big, huge problem among physicians is they saddle themselves with too much debt. You know, I don\u2019t have to tell you how expensive it is to start a dental practice.<\/p>\n<p>Allison:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Oh, yeah.<\/p>\n<p>Clark:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 There\u2019s a big debt right there. Then you graduate with a mortgage and no house because of student loans.<\/p>\n<p>Allison:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Right, yeah.<\/p>\n<p>Clark:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 So what that does is limit your choices. If you do end up in a horrible work situation or environment, you feel you can&#8217;t get out because you&#8217;re under too much debt. It will cost you too much money to make a change. So you just put your head down and begrudgingly you keep working.<\/p>\n<p>Allison:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Bethany, I\u2019m sorry, I stepped in. Do you feel complete or did you have more?<\/p>\n<p>Bethany:\u00a0\u00a0\u00a0\u00a0 Oh, thank you. I\u2019m complete. Thank you.<\/p>\n<p>[Laughter]<\/p>\n<p>Allison:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Okay, thanks. I\u2019m going to mute you again. All right. Yeah, that\u2019s fantastic. I totally agree with that. Actually, Barry Polansky who\u2019s on this call sat with me at a Pankey meeting one time, there was kind of a roundtable discussion, a bunch of us were having this conversation about\u2026 and he\u2019s raising his hand right now so I\u2019m going to unmute you, Barry.<\/p>\n<p>Barry:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Okay.<\/p>\n<p>Allison:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 You\u2019re unmuted. Yeah.<\/p>\n<p>Barry:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Okay. Clark, what you&#8217;re saying is very interesting. I\u2019m fairly familiar with the Maslach inventory. My question is this, dentistry and medicine has changed over the last 30, 40, or even 50 years. Even though burnout has been around forever, it seems to be more of a problem today, almost to the point of becoming a public health issue that the lay public is not even aware of.<\/p>\n<p>Clark:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Right. I would say, I can speak for the house of medicine because I have more data on it. The house of medicine is in a medical emergency in slow motion right now.<\/p>\n<p>Barry:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Yeah.<\/p>\n<p>Clark:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 That\u2019s quickly accelerating. In December, the <em>Mayo Clinic<\/em> <em>Proceedings<\/em> came out with an article, the burnout rates among 3,000 doctors that answered the survey went from 45 percent to 55 percent in just three years. So 6 out of 10 doctors would quit today if financially able. 90 percent of physicians would not recommend medicine as a career path to a family member. Those are horrible statistics. I can imagine the same thing is going on in dentistry.<\/p>\n<p>Barry:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Yeah. One of the things, the Maslach inventory talks about the lack of control. I mean the first person who ever, we\u2019re all dentists on this call, but the first person who ever taught me how much control meant to a professional was Dr. Peter Dawson. Once you get control of your work, things get a lot better.<\/p>\n<p>In today\u2019s world, because there are so many obstacles to obtaining and maintaining that kind of control, we\u2019re stuck in this vortex. I really feel bad for the younger dentists because they start out in survival and just can&#8217;t get out and can\u2019t get any degree of control.<\/p>\n<p>But my question is this, if this becomes a public health issue, I mean I understand the solution that you provided which sounded a little psychotherapeutic and on an individual level it might work, but if it becomes a public health issue, where is the help going to come from? I\u2019m a student of the positive psychology movement and the positive institution movement that\u2019s going on right here at University of Pennsylvania. I see a lot of work being done there but I don\u2019t see a lot of work coming out of the medical or dental community.<\/p>\n<p>Clark:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 There are a few pockets throughout the country that have got\u2014Mayo is one of them, there are some hospitals in Colorado, some pockets in California and down in Florida and Georgia is starting to wake up. North Carolina, the North Carolina, I sit on a roundtable that was created by the North Carolina Medical Board because they&#8217;re very interested now in physician wellness and resilience and hardiness which are the antithesis of burnout. So people are starting to wake up.<\/p>\n<p>The way I approach organizations, or the way I would approach a big hospital for instance, is they will say, \u201cWell we can&#8217;t do all of that, what you&#8217;re proposing, because it costs too much.\u201d Then I ask them a question. I say, \u201cWhat\u2019s your physician turnover rate?\u201d They\u2019ll say, \u201cOh last year, 20 hospitalists came and went.\u201d It costs anywhere from $150,000 to one million dollars to replace one doctor. One doctor. If it\u2019s an internist, $150,000. If it\u2019s a neurosurgeon, one million.<\/p>\n<p>People say, where does that million go or where does it come from? It comes from sign-on bonuses, moving expenses, training, the first three months they work they can&#8217;t bill Medicare or Medicaid for anything. I mean, you can cost it out. And people have costed it out and it\u2019s $150,000 to one million dollars to replace one doctor.<\/p>\n<p>So I tell them that, \u201cLook, if you took $100,000 and put it into some physician wellness programs. If I reduce your turnover by just one physician, you have saved money.\u201d That gets their attention. That they understand. They don\u2019t understand all the feel good stuff about preventing job burnout. They understand bottom line economics.<\/p>\n<p>Then you tell them, \u201cYou&#8217;re going to get less patient complaints. You\u2019re going to get sued less often. The employees are going to stop turning in your doctors for harassment and hostile work environments\u201d and on and on and on the benefits of a wellness program. In California, a lot of physicians work days don\u2019t start until 10:00 am because they want to take their kids to school. There is no hard and fast reason why somebody has to start work at 8:00 or 8:30 in the morning. They can work a little later in the afternoon if that\u2019s needed.<\/p>\n<p>So flexible overlapping hours for physicians or for dentists. Part time work, a lot of women go through medical school. Undergrad medical school, residency, and then when they get out they say well, \u201cGee, I put having a family off for so long, I need to start.\u201d So they have some kids and then they find it\u2019s very difficult to be a mom that they want to be to their children and work at the same time.<\/p>\n<p>So some of these places have discovered, \u201cWell, hey, would you work two days a week part time?\u201d Because this other female physician, she would like to work two days a week. So you work Monday and Wednesday and she\u2019ll work Tuesday and Thursday. So there are ways to give people, to incentivize them to be on your team. When they discover that this is not only cost effective, it\u2019s income generating, then the system will change.<\/p>\n<p>Barry:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 The system will change, yeah. But that\u2019s going to seem like a long evolutionary process. In the meantime, we\u2019re having a lot of physician and dentist morbidity going on here.<\/p>\n<p>Clark:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Well, I understand. We didn\u2019t get to where we are overnight and the solutions, there are short-term solutions, there are medium-term solutions, and then there are longer-term solutions. So yeah, it\u2019s a process.<\/p>\n<p>Barry:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 What about the role of medical schools and dental schools?<\/p>\n<p>Clark:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Well, I\u2019ve been traveling around my state talking to graduating fourth-year medical students about physician-related burnout and what to expect. It\u2019s an eye opener for a lot of them, especially when I talk about debt because they&#8217;re all saddled with it. So just having them\u2014and reading contracts. A lot of these poor souls sign contracts they\u2019ve not really read.<\/p>\n<p>So they go to work for somebody, they get a big fat sign-on bonus, they get promised a $160,000 a year starting out as a hospitalist. Then when their contract comes up for renewal, it drops down to $130,000 and they say, \u201cWhat? What?\u201d They say, \u201cWell you didn\u2019t hit your performance quotas.\u201d Well you know now they\u2019ve got their kids in private school, they\u2019ve got the big house, they\u2019ve got the one at the beach, the two cars, and now they can&#8217;t move. This is how a lot of them get into trouble.<\/p>\n<p>Barry:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Yeah, I just hear it all the time when I speak to dentists. I mean, there are some dentists who are thriving. I mean the language they&#8217;re using is almost the opposite language that the positive psychologists use when they talk about thriving versus burnout. Flourishing. I&#8217;ve been around dentistry for over 40 years now so in my early years I was having my issues.<\/p>\n<p>But I&#8217;ve spent the last 25 years trying to thrive in dentistry and I think I&#8217;ve done okay with the help of the Pankey Institute and a lot of continuing education. But I look around and see some of these young dentists today and I just feel so bad for them because of the circumstances and the situation. Our circumstances years ago were a lot easier than they are today.<\/p>\n<p>Clark:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Mm-hmm. Yeah but you know the thing that got you through it was your mindset.<\/p>\n<p>Barry:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 No doubt about it.<\/p>\n<p>Clark:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Not a lot of that is taught. You know, resilience and hardiness isn\u2019t something you\u2019re born with. It is a skill that can be learned. If you don\u2019t have it, you can pick it up. But it\u2019s just not taught. People are not made to be mindful of the other parts of their life that spill over into what they do at work. They have to have a good life at home. They have to exercise regularly. Eat right. Get plenty of rest. You know, all those things we recommend our patients to do, physicians by and large don\u2019t do.<\/p>\n<p>Barry:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 But it goes against science because if you remove the decision-making ability from a professional, it takes away his entire motivation. I mean, the human brain, when somebody is able to make decisions and stay in control and exercise their freedom of choice, there\u2019s a secretion of dopamine that goes on that makes them feel better and motivates them to do more. When that\u2019s missing\u2026<\/p>\n<p>Clark:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Well, if you go to Florida, 17 percent of the physicians in Florida accept no payer contracts. They have none. They\u2019ve torn them all up. Patients pay at the door. They pay, and I\u2019m not talking about concierge medicine where you pay a big retainer. I\u2019m talking about fee-for-service. They pay $40 for an office visit, cash at the door. No insurance is filed. They\u2019ll print out a form for them. The doctor can spend a longer amount of time with them. The patients love it because they have time with the physician.<\/p>\n<p>The physicians love it because they&#8217;re in absolute complete control. They don\u2019t answer to anybody. Nobody looks at their charts. They don\u2019t have to have electronic medical records. Most of them are bare. They don\u2019t even have malpractice insurance. In Florida, you have to post a bond which is I think it\u2019s $150,000. So there are ways to deal with what\u2019s going on. It takes a good amount of courage and some planning but it doesn\u2019t have to be the way that it is right now. There are always choices.<\/p>\n<p>Barry:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 I agree with you. I did it for my own life. I know plenty of dentists who have done it. It\u2019s just that it\u2019s not easy. Simple but not easy.<\/p>\n<p>Allison:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Yeah. We\u2019ve got work to do. [Laughs] We\u2019ve got work to do.<\/p>\n<p>Barry:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Yeah.<\/p>\n<p>Allison:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Do you have more, Barry?<\/p>\n<p>Clark:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 I would like to see mentor programs. I would like to see certainly in medicine, but dentists, it would apply very well to dentists where students are hooked up with dentists that they can either shadow or ask questions to or be mentored so they\u2019ll know a little bit more about what to expect when they come out and avoid some of the mistakes that perhaps the mentors have made.<\/p>\n<p>We\u2019re looking at a model like that in North Carolina. And of course you want to pick dentists that by and large are hopeful, positive, motivated, success-oriented because if you give them a dentist who is burned out then it\u2019s going to have the opportunity effect I\u2019m afraid. But there\u2019s tremendous opportunity out there for change.<\/p>\n<p>Barry:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 I agree. As a matter of fact, Allison, I want to mention this. Sometime in July, I think I\u2019m going to be going down to Dallas for a meeting of the positive psychology group that is going be speaking to not dentists or doctors but lawyers and teachers, professionals, to build positive institutions. So there\u2019s a convention that is based just on this. I mean, there\u2019s definitely a need out there.<\/p>\n<p>Clark:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Absolutely.<\/p>\n<p>Barry:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 One more question. I just looked up your book, <em>Powerful Words<\/em>?<\/p>\n<p>Clark:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Yes.<\/p>\n<p>Barry: \u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Is that a book on burnout?<\/p>\n<p>Clark:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 No. My book on burnout is going to be out later this year, it\u2019s called <em>Reignite: From Burned out to on Fire<\/em>. That\u2019s the title. This book that you&#8217;re referring to, <em>Powerful Words<\/em>, was the first book I&#8217;ve written. It\u2019s really a book about stories and people\u2019s lives and how they connect with others on an emotional level. That\u2019s where we have our greatest influence.<\/p>\n<p>So it\u2019s more of a motivational, kind of inspirational book. I wrote it before I started work on <em>Reignite<\/em>. I do have a workbook for <em>Reignite<\/em> for my workshops that served as the basis for the book which will be out later this year.<\/p>\n<p>Barry:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 I see, okay. Thank you, thank you. Very helpful.<\/p>\n<p>Allison:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Thanks, Barry. Thank you. Clark, I have a quick, we only have like four minutes left. Thank you, Barry, actually both of your questions, you and Bethany asked really good\u2014I appreciate it. Those were great.<\/p>\n<p>I have a quick question, Clark, I think you already answered it but I noticed when I read your bio that I really like the\u2014it says your primary focus is to help transform the lives of individuals who feel they&#8217;re burned out by retooling their mindset for success and unleashing their creative potential.<\/p>\n<p>Clark:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Yes.<\/p>\n<p>Allison:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Is that through the steps that you shared with us? Or is there more to that?<\/p>\n<p>Clark:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 No, that\u2019s through the reignite. Most people don\u2019t know, just like I didn\u2019t for most of my life, I tell people all of the time, I spent the first two-thirds of my life learning how to live the last one-third. We have so much capability that it\u2019s just seething to be released.<\/p>\n<p>Once it was released in me, I have become more productive in the last three, four years than I think I was for the last 30. Because once you hone in on your why, not your how and your what, but why you do what you do and you get in touch with the things that are really meaningful to you and you begin to share them with others and you see the effect that it has on them, you can really 10x your potential almost overnight.<\/p>\n<p>I mean, I see it in the people I hang out with all the time and I hang out with a different crowd now than I used to. They serve as motivation and examples of what can be. That\u2019s my message to physicians that are suffering is that there is so much on the other side of where you are right now that once you&#8217;re there you\u2019ll look back and you will be thankful you&#8217;re going through this because it\u2019s going to propel you into your preferred future.<\/p>\n<p>Allison:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Nice. Yeah. And we can always look back and see that. Like you said earlier, or not always, but many times the struggles that we go through we can look back and say, \u201cMan, that was the impetus where everything changed.\u201d But doing it in the moment, that\u2019s the trick. Bringing people present to the gift while it\u2019s happening or helping them see hope and possibility while they&#8217;re in it is a gift.<\/p>\n<p>I think we\u2019re pretty much out of time. If anybody has a quick question, we have a couple minutes. Just press *2. You guys know how to get ahold of Clark. He\u2019s at ClarkGaither.com or DrBurnout.com.<\/p>\n<p>Clark:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Yep. There\u2019s a contact page. Most of the pages have my cell phone number down at the bottom so if you need something, just call me or shoot me an email.<\/p>\n<p>Allison:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Do you have any little, I\u2019m interested in your book now, but do you have any little white papers or any kind of e-book or something with the reignite steps that will give a little more detail?<\/p>\n<p>Clark:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 The skeleton of reignite will be on my website within I&#8217;d say a couple of weeks. If you go to my website, there\u2019s a place to put in your name and email address and that unlocks\u2014there\u2019s eight or nine downloads, an assessment guide for physicians for burnout. An assessment guide for administrators. Wherever it says physician, you can just think dentist because like I said, the hallmarks and the causes are all the same and so are the remedies.<\/p>\n<p>But there\u2019s also, \u201cAn apple a day gets the doctor to stay, 50 low cost or no cost ways to keep your doctors happy.\u201d It will also work for dentists. If there\u2019s a large provider group that are looking for cheap ways to get at two of those mismatches, actually three, breakdown of community, insufficient reward, and absence of fairness. You can get at them with that list of 50 low cost or no cost ways to keep your dentists happy. It says doctors, but dentists are doctors too.<\/p>\n<p>Allison:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Yeah.<\/p>\n<p>Clark:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 But there\u2019s a lot of free at least educational tools there. The reason I was looking online, I was going to adapt one of my e-books, one of those downloadable PDF files, I was going to change it to dentists. But I needed statistics and I couldn\u2019t find any. I mean, there\u2019s very little data out there for burnout rates among dentists in the US. I think that\u2019s one area the dental schools need to put some effort.<\/p>\n<p>It could be done easily at a national meeting if somebody could find some funding, they could do some mass burnout inventories on all the attendees. Of course, there\u2019s a little selection bias there, but still, it would be some data and there\u2019s almost none. So if any of y\u2019all have contact with powers to be that are into that sort of thing, there probably needs to be some study of burnout rates among dentists.<\/p>\n<p>Also, at what age are dentists leaving the profession of dentistry? I can tell you in 1995, if you asked a doctor when he was going to retire, it was, \u201cWell, as long as I\u2019m healthy, I\u2019ll probably never retire.\u201d I mean they were literally carrying doctors out of their offices on a stretcher. Then if you asked them in 2005, it was retirement age. And in 2015, it was mid-50s.<\/p>\n<p>Allison:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Wow.<\/p>\n<p>Clark:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 So physicians are getting out much earlier than they would have because they&#8217;re burned out and I imagine the same thing is going on in dentistry.<\/p>\n<p>Allison:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Yeah, I think that\u2019s true.<\/p>\n<p>Clark:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Yeah, the book <em>Powerful Words<\/em>. I\u2019ve got another book coming out soon called <em>The Graduate\u2019s Handbook<\/em>. That will be out on my website in a few weeks. It\u2019s your no nonsense guide for what comes next and it\u2019s for high school, college, or graduate school graduates. It\u2019s got some very good basic information and advice in there. We talked about some of it this evening. The <em>Reignite<\/em> book will be out later in the year, but I put all that stuff up on my website when it comes out.<\/p>\n<p>Allison:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Okay, well thank you so much, Clark. I really enjoyed this. I think everybody did.<\/p>\n<p>Thanks for listening to <em>Practicing with the Masters<\/em> for dentists, with your host, Dr. Allison Watts. For more about how Allison Watts and Transformational Practices can help you create a successful and fulfilling practice and life, visit <a href=\"http:\/\/allisonwatts.com\/category\/podcast\/\">transformationalpractices.com<\/a>.<\/p>\n<p><\/div><br \/>\n<a href=\"https:\/\/itunes.apple.com\/us\/podcast\/practicing-with-the-masters\/id947061776\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft wp-post-2441 wp-image-2945 size-full\" src=\"\" alt=\"subscribe-with-itunes-button\" width=\"400\" height=\"136\" \/><\/a> \u00a0 \u00a0 \u00a0 \u00a0<br \/>\n<a href=\"http:\/\/www.stitcher.com\/\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft wp-post-2441 wp-image-2946 size-full\" src=\"\" alt=\"\" width=\"400\" height=\"159\" \/><\/a><br \/>\n&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>This time on Practicing with the Masters, my special guest is Dr. Clark Gaither. Dr. Gaither, also known as Dr. Burnout, is a board-certified family physician in private practice and has been practicing medicine full-time for the past twenty-five years. He is the best-selling author of Powerful Words: Inspired Communication through Emotional Connection. Dr. Gaither [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_et_pb_use_builder":"","_et_pb_old_content":"","_et_gb_content_width":"","_cloudinary_featured_overwrite":false,"footnotes":""},"categories":[303],"tags":[309,305,304,307],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v22.5 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Ep #48: Avoiding Burnout in Your Practice with Dr. Clark Gaither - Helping You Live Your Brightest Life From The Inside Out<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/allisonwatts.com\/ep-48-avoiding-burnout-practice-dr-clark-gaither\/\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"Allison Watts\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"48 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\/\/allisonwatts.com\/ep-48-avoiding-burnout-practice-dr-clark-gaither\/\",\"url\":\"https:\/\/allisonwatts.com\/ep-48-avoiding-burnout-practice-dr-clark-gaither\/\",\"name\":\"Ep #48: Avoiding Burnout in Your Practice with Dr. Clark Gaither - 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