Welcome to the American Dental Association’s practice podcast, Beyond the Mouth, where we won't discuss clinical dentistry, but everything else is fair game. I'm Dr. Betsy Shapiro, a director with the Practice Institute of the ADA.
In this episode we're talking about dealing with burnout. Joining me today are two dentists, Dr. Bill Claytor and Dr. Jim Willey.
Dr. Claytor graduated from the University Of North Carolina School Of Dentistry and also holds a certificate in Chemical Dependency Counseling from Union College. He currently serves on the Dental Well-Being Advisory Committee of the ADA. Dr. Claytor lectures around the country on the opioid epidemic, burnout, perfectionism and addiction.
Dr. Willey retired from the American Dental Association in 2019. Prior to coming to the ADA, he practiced general dentistry in Elburn, Illinois for 26 years. During his tenure at the ADA, Dr. Willey was senior director of the Practice Institute. He initially explored his interest in this topic while earning his MBA, writing his master's thesis on the topic before it was truly identified as a syndrome and has continued exploring on this subject to this day.
Until now, burnout has been called a stress syndrome. However, the World Health Organization recently updated its definition and it now refers to burnout as, “A syndrome conceptualized as resulting from chronic workplace stress that has not been successfully managed.” We're going to explore that a little bit today and see what that really means in the real world practice. I'd like to suggest that you, Bill, have a lot of experience in the everyday world of burnout with some thoughts about how to identify it and how to prevent it or cope with it. And Jim brings a very futuristic look for us, as he's a student, of the trends and the forecasts and thinking broadly about what we need to do as a profession. Welcome to the program, both of you.
Jim Willey: Thank you very much.
Bill Claytor: Thank you Betsy.
Betsy Shapiro: Really appreciate that you're here today. So I'm understanding that burnout is just more than a rough patch. It's a deeper problem and we're seeing it creep up more and more, and it's being talked about more and more. So let's lay a little bit of a foundation here. Bill, how did you get started? What led you into getting your certificate in this area and doing what you do today?
Bill Claytor: Well, thank you Betsy for that question. It's kind of an interesting path, if you will, that I took. After my residency in my late twenties, I went into private practice and got married, started having children; the normal thing that a lot of people do. And as time went on, I started noticing that I was having some real, emotional exhaustion. I would come home and I was not the same person that I used to be. I mean, I knew it; I saw it myself. And at the time I didn't know exactly how to handle it. You know, in the 1980s, when I was going into private practice, I'd never heard of the term burnout. I didn't have any clue what it was. And so I started experiencing a lot of stress and just exhaustion that something wasn't right. As time went on, you go to the doctor’s and they're checking you out and nothing's wrong. You're normal, there are no problems.
And then one day I had a panic attack. At the time, panic was not a word that was in my vocabulary. I had never heard of the word panic attack. I'd never heard of treatment for panic. I did not know what was happening. And of course after that, it followed with prescription medications and then abuse, and then on to a life of recovery where I am now. The thing that I would like to stress, for me, as far as burnout is that when your body tells you there's something wrong, it's time to listen. I like the term, listen to your body. When you wake up in the mornings and you dread going to work, you dread the conflict at the office, the interaction with the staff; those kinds of things are not normal. You need to get help. And so for me, that was my first experience with stress and burnout.
Then a couple of years ago I came to a sort of a crossroads as to what I was going to do with my life. As far as, am I at the point to where I need to rejuvenate my practice, possibly relocate, hire an associate, build a new building, focus another eight or 10 years into this practice? Or was it time to take a different direction? And those in and of itself are two kind of simple directions, if you will, go to the left or go to the right.
The problem was, I was starting to notice things like cynicism. I was very short with people. My wife would say, "Well, maybe it's just you're getting older, you don't have to put up the stuff anymore. That's just part of aging. It's not really burnout." And the other thing, the exhaustion part, I remember having a conversation with my accountant one day.
He at the time was about 68 years old and I had just turned 60. I said, “Oh, Paul, I'm going to practice until I'm like 80 years old. I've just loved industry. And I still do, you know." He said, "Well, I'm going to suggest that things may change." And I said, "What do you mean things may change?" And he said, "You just wait. Just wait." And he didn't say any more than that.
Well, a few years later, it was almost like when you get to a certain point, your body kind of slows down. Things don't work the way that you used to. And you start wondering, whoa, what's going on? You go to the doctor and they say, you're normal, you're healthy. It's just part of the aging process.
And so I was toying with the cynicism and the physical exhaustion that I was feeling, had I lost my compassion for dentistry? And so I had to recognize the signs and then determine what direction I was going to take. And so that's sort of how my path over the last 40 years, the four decades of dentistry, has been looking at my physical well-being and my mental well-being. And so of course I took the path to retiring and to go into teaching.
Betsy Shapiro: I think we're fortunate as a profession that you chose that path. I'm sorry for your patients, but I think it's going to benefit all of us. You pinpointed for yourself, you know the emotional exhaustion, the crankiness or that get-off-my-lawn attitude. Was it just aging or was it really a symptom of something underlying and not being entirely sure whether or not you were experiencing burnout? How do we tell if we have it? Is there a way [to know]?
Jim Willey: Basically researcher Christina Maslach looked at the phenomenon of burnout. The term itself was coined in 1974, but the initial research that she did, she put together, what's today still called, the Maslach Burnout Inventory. It's a series of questions that an individual can take, and not that long a list, and it scores and identifies for three different component dimensions. The three dimensions are depersonalization, which Bill kind of alluded to with his comments about cynicism. The second dimension is personal accomplishment. This is a reverse dimension. If you feel real good about what you're accomplishing and what you're doing, that's low for burnout. But if you don't feel like you're being productive in a profession that's rewarding to you, that would be high for burnout. The last dimension is emotional exhaustion. And what happens when you take the Inventory is it basically kicks out a score which identifies you as high or low for each one of the three dimensions. So when someone takes the Inventory and it shows you’re low, low, low; basically you have a pretty good idea that you're not really having problems with burnout.
But if you come back and you're high, high in two areas and low in another; or you're high, high, high in all three areas, you know that you've got a problem that needs to be addressed in some fashion. At least it increases your awareness of what you're experiencing and what you're feeling in private practice.
Betsy Shapiro: Now you, Jim did an interesting thing. I think when you did your graduate work in this area, you created a version of the Maslach Inventory that was specifically targeted questions as they relate to a dentist, right?
Jim Willey: I took Christina's Burnout Inventory, which was really originally designed to work with federal workers, and I just changed some of the verbiage to make it seem more appropriate to what dentists were feeling and experiencing in the dental office. Very simple changes in the words. We didn't take my inventory and actually go and validate it like Dr. Maslach did, but it still speaks to the same basic questions.
And I will say also back when I was working on that paper, I was looking for answers for me. I felt very good about what I was doing clinically in my dental practice, but I was frustrated. I had started a practice from scratch and was struggling with the business side of dental practice. And I was looking for answers for me; having no idea what a huge problem burnout was going to become in the next 30 to 35 years.
Betsy Shapiro: Well for those of you who are listening, we'll provide a copy for you of Jim's version of the Maslach Inventory. You can come to ADA.org and look for the podcasts. We'll have it downloadable there for any of you. And of course Maslach Inventory is out there in the internet world for people if they want to take a dive into that.
I'd like to follow up. Jim, you said you had no idea how prevalent it would become, how big it would become. How big is it in the dental community?
Jim Willey: Well, the first observation I would... This is actually good news for dentists is that the physicians are way ahead of dentists. There's a biennial survey that's done by the Physicians Foundation and their latest, the 2018 data came back saying that 62% of physicians are pessimistic about the future, 78% of physicians are sometimes, often or always experiencing burnout. This is what they're self-reporting. And I think it's really fascinating that 49% now of physicians would not recommend medicine as a career for their children. This is a huge shift that's occurred in the last 10 to 15 years. You go back to like 2000, 2005, and 90% of physicians and nurses would recommend medicine as a career for them. So we need to look very closely at the experience of the physicians because that environment is becoming what dentistry is dealing with today. And the more we can learn from their experience, I think it's going to help us address the issues that are occurring in dentistry.
Betsy Shapiro: Bill, do you think that it is the nature of the practice of dentistry? Is it the nature of the practice itself or the people who choose it or the isolating factor that if you're in a small practice?
Bill Claytor: I think it's a little bit of all that. You know back about maybe five years ago, The New York Times came out with an article that said to Jim's point about one out of two, or about 50% of the physicians looking at the physicians were burned out and the question was, is it due to their environment or is it due just some susceptible individuals who are just quote unquote weak. And I think the answer is pretty clear: It's the environment in medicine today. The number one issue, the latest surveys that I'm seeing say, that physicians say that one of their biggest headaches, like 90 plus percent are the EHRs, the electronic health records and the inefficiencies there. In dentistry I think we are going to probably go down the exact same path for a different reason. And the reason that I see is you mentioned the isolation factor.
I love to tell the story about a football team versus a professional golfer. I look at medicine sort of like a football team. They have multiple players; 11 players on the offense, and 11 on the defense. The team itself probably has 16 or 18 different individualized coaches for every specific position. They work a lot of times from external pressures and control. In other words, if you're one of the 11 players on the football team playing, you can only control your part of the field. You can't control the overall product. So they have many coaches. They have people who give them advice, they're asking questions, they're not going to play unless they're being accountable to somebody, a coach or a section of the team.
In dentistry, I look at it like a golfer. We're there by ourselves. And that's unfortunate because I don't think we were really meant to be that way. I think we need coaches. I think we need people to help. And I love the story about how dentistry is an isolating cottage industry; that we used to use those terms. But think about it, we put on these loops with the light sources and we focus down into just millimeters of the margin of a crown and we focus there all day. So we're focused there, but yet our lives are becoming that way too because we tend to be a lot of times defensive. We don't take instruction well. We have to be in control, when in reality we're very much out of control.
But it's amazing how well our dentistry really works for the public. It really is. The longevity of our services that we give. I didn't do that by being perfect. I did it by being imperfect. I think the isolation, confinement, and our strive for perfectionism. And also always feeling like—that we're not good enough. I would like to have an environment in dental schools that could teach you that you are good enough. And it's not just because you say it is but because we cannot achieve perfection. We can only achieve excellent work. And I'm all for that. And not accepting perfectionism is not substandard work.
Jim Willey: Bill something you said really resonated with me. I remember after spending a long day at the dental office, working with magnification all day long and coming out of my office and for some reason just looking up at the stars and just going, "Wow, I'm really missing something here." You know, there's a whole great big universe out here that's not within the scope of what I'm dealing with all day long.
And I also agree with you. I think there's a bias. The tendency is for everyone to put the blame for burnout on the individual. Like you're not tough enough. You're not strong enough. There's no crying in dentistry. You've got to straighten up and fly right and do better all by yourself. And it's often much more complicated than that. The environment is definitely involved. One of the things that I tell dentists who are struggling is that the first thing is when you're feeling this, is to do something different. Don't let it paralyze you. Don't get where you're just going down that road with the blinders on and thinking that you can't do anything. Change your schedule, move some things around. Don't do procedures that you don't enjoy doing. Get rid of those procedures. Treat yourself fairly. Reward yourself for what you're doing. Make sure that you feel good about what you're doing in the dental office.
Bill Claytor: Right. And I agree with you 100%. I like the saying that when we do nothing, we're doing something. So doing nothing is doing something. We have to take action.
Jim Willey: Take action, I agree.
Bill Claytor: And I think one of the things along your point is that community is a foreign word a lot of times in dentistry. I mean you've heard the old adage that physicians look at their fellow physicians as colleagues and a lot of times dentists look at their fellow dentist as competitors and that's sad.
I was talking to someone and they said, "I just can't believe I've had two new dentists move into my area, within a mile of where I am. They're going to take all of my patients away." And I told him: "No, this is the wrong attitude. Look at your own practice. See how you can improve. Not what you're doing wrong, but how you can improve. It's about you, not what they're doing to you." I kind of gave him a different perspective on things. Like you say, you have to do something.
One other point about burnout, if I may make, I don't want to give the impression that burnout is an older dentist syndrome. Most of the people that I work with now are in their 30s, young. I mean we have the student debt issue, which is a huge problem. So it's, it's a continuum of different levels.
And to your point about taking the burnout, the Maslach Burnout Inventory. Do it often. Do it frequently throughout your career because this is a dynamic flowing kind of ever-changing process. It's not, I don't have burnout at 31 therefore I won't have burnout at 61. It's not that kind of process. You need to always have people reflecting, what you're giving and you have to have people to look at where you are. That's why I'm big on mentoring. Have a personal mentor that's not in dentistry, just a person you can talk to, go to lunch with colleagues. There are so many resources out there. But like you say, we have to do something. You have to change.
Betsy Shapiro: I think something interesting that you both are talking about is the community aspect. Being connected or having people to talk to. I've always thought physicians did something right in that they allow themselves to discuss their failures with each other in group settings and learn from those teachable moments. Our profession doesn't do that so much. What I wonder is with our newer professionals coming in, or new dentists, who communicate much more often, and much more frequently with each other by text, if they will feel a little bit more connectedness? Or will that add to the stress level? I used to enjoy going to my branch meetings, my component meetings, and I felt like that was a safe space. And I could ask someone how this case wasn't going right. What did they think?
Bill Claytor: Yeah. Well, and to your point, you may be familiar with Dr. Michael and Enid Balint from England. They started the Balint Society for Medical Residents where they could come and talk about human matters, not human doings, if you will.
So we talk about human being matters and you can talk about, I just lost a patient that passed away. How do you deal with these emotions? Because we're all supposed to be able to be a doctor and take all these problems on ourselves. One of the things that I would like to see done. … And I would love to see the concept, which is basically going into the dental schools while dental students are learning dentistry. It doesn't have to be a faculty member. It can be, but it could be an outside person. I have a vision that maybe someone like myself or others could take 10 boxes of pizza in and go to a little room and have the students come by and talk about these issues that deal with their emotions and feelings and how they're handling this.
I think it's so important because the answers are not found with an instructor coming in and saying, okay, the answer to take care of this is to do X, Y, Z. The answer is found in the community, the peers, and it's so interesting to me that when we go to dental school and we look at our first tooth number 19 with an occlusal decay area and we say, "I can put an occlusal composite in that." Or we see a tooth with a mesiolingual cusp broken, you say, "I'm going to put a crown on that." You do that in dental school over and over and over, and then you go into private practice and all of a sudden here comes tooth number 19 with occlusal decay and you say, "I can do that. I’ll cut that out and prep it and I’ll put in a composite.” Or "I can do that. I'm going to make a crown on this tooth." You've had experience, relevance, and you take it out in private practice. We don't do this a lot of times with issues that surround burnout.
How do you deal with patients who are demanding and exacting? And then another student may chip in and say, "Well, I've had this before but I didn't have this," and another one may say, "Well, what I did in that." And then a person like myself or Jim or faculty member, can just facilitate the meeting; sort of like a lunch and learn. You’re just sitting around, you're not bringing X-rays, and you’re not bringing models. You're not bringing root canal files. You're just talking about how you feel and how you deal with those feelings.
Then you get out of dental school and you'd go into private practice and then that person shows up and you're going like, "Oh my gosh, this is one of those exacting patients. I remember what I felt. How do I deal with that? What did I do in dental school?" So it's kind of an opportunity to talk about the emotional, mental side of our being, not just the, can I prep a tooth kind of thing.
Jim Willey: I think one of the things that we have to remember is the physicians basically get a lot of their social environment through their relation to the hospital. Dentists don't really have that available to them. Every dental office is its own emergency room. So I think it's also a strong case about why dentists should belong to their local dental societies and their groups where they can get some feedback. To your second point about social media, I'm hopeful that social media would help the younger dentists and the way that they're learning to relate now. However, it seems to me that the more social media we use, the lonelier America is getting. And I hope we can find some very constructive ways for dentists to share information over social media.
Betsy Shapiro: That would be wonderful. I don't have any statistics. It seems to me like you might be right about that though; not only feeling more isolated, but also more opportunity to feel less than perfect about yourself as other social media influences impact, you didn't get a good review on Google from yesterday's 4 p.m. patient. But hopefully we'll see a change. Bill, you mentioned this dream and I think it would be a wonderful reality about having schools establish this forum where we can get together and talk. I happen to know that you do go into schools to talk about this.
What do you see when you go in there in terms of the perceptions of the students about themselves? Do they think that they are on that path? Do they think it's never going to be them?
Bill Claytor: Yeah, most of it is the latter. It's like, this won't happen to me; unfortunately that is something that can... You know when you go in and talk it's more like, well it may have happened in your situation because your story is horrific or terrific, whatever the term may be, but to me it won't happen. Most of the students that I've talked with are very confident. The two dental schools that I talked to, they're very confident about their future. I do think the attitude of it’s not going to happen to me, but you know Betsy in the middle of all this, after the lectures almost inevitably we have one or two students that come up and they take you over to the side and they say, "I'm having a problem." Or "My mom's drinking too much." And so there are issues there. Fortunately in a lot of the dental schools today, there are avenues that they can pursue for getting help and I stress that usually initially to go to the source there in the school for a source of help.
But I use this analogy back in the 70s when I was in dental school, we used to get the ADA Newsletter and they would have stuff about office design, how to hire an architect, how to contact an accountant, how to do this with an attorney. And I just remember sitting and reading all this stuff and the school was kind of sending out a little paper too about the same stuff and all of it was just like, I've got to do my test bridge. I've got patients coming in at 2 p.m. I'm not listening to anything that they're talking about.
So the problem is trying to make it relevant to the students at that point in their lives because they're thinking about clinical stuff, as they should be. But it's hard to bring in stuff that they can't relate to.
Betsy Shapiro: I think that's human nature. When we're 22 we never think we're going to have a bad knee that needs to be replaced at 55; it's just, we're invincible.
Jim Willey: I think it behooves us though as a profession to really pay attention to what's going on in the dental schools. There's research out of the Mayo Clinic. It stops short of causation, but basically sets up an increased risk of suicide amongst physicians that begins in medical school. And the rates of both suicide ideation and depression are higher for dental students than they are for dentists.
Dental schools really need to have programs in place that identify who may be having suicide ideation, identify students that are at risk of having a problem during their time at the dental school, and programs to help support them. And they really need to have that there and at each dental school because it's there. You can pretend it's not, but it is there. Students are struggling.
Betsy Shapiro: We were very fortunate in the first season of this podcast series to have Dr. Erinne Kennedy speak with us who had some challenges through dental school. She talks very strongly about her personal story and how she sought help. But one of the key takeaways was that for her, she recognized, first of all, that she did need help and likened it to any other physical, or if you are having trouble with your weight, maybe you go to Weight Watchers. If you're having trouble with headaches, you go see a neurologist.
She knew she needed help and she said it took a little to understand that going to use the resources that the school provided doesn't go on your permanent record. It doesn't mean you don't get a dental license. It doesn't mean anyone knows; it's just helping you find the tools and getting help. That's something we tend to forget in all of this, that sometimes there's a little bit of stigma about that and dentists don't want to say, "I think I'm burning out. I'm must be weak."
Bill Claytor: We feel like we should be able to handle these things as if not only emotional issues, but even things like more in the clinical practice, in today's market with the social media that's out there and how you have to play that game, if you will. I'm not an expert in social media. I need someone just like you hire an accountant to do your taxes. You hire a lawyer to help with business transactions. You need a specialist that can do that. I mean, I'm all for getting people who can help me because I'm not the specialist.
Betsy Shapiro: We dentists think we can fix everything with ourselves. I mean, I recall taking an X-ray of a toe of mine that I was pretty sure it was broken and I figured I could just tape it myself and I didn't need to go... We're invincible.
Jim, what else can we learn from the world of medicine and the path they're going down? Are there any other big takeaways that that we should be mindful of?
Jim Willey: I think we should just be observing what they're doing in terms of recognizing and dealing with it so that we're more prepared for it. I think on the larger scale, a lot of the trends that we're seeing in medicine... I have a slide in a presentation where I talk about why are dentists less burned out than physicians. And the answer to that question is it's just a matter of time.
The same pressures that the physicians are dealing with today are eventually going to come into dental practice. Only 18% of physicians believe that quality value measures will reduce costs or improve care. Ninety percent of physicians believe that third party authorizations have an adverse effect on care. We're dealing with all of those same trends and you throw in artificial intelligence and do-it-yourself dentistry and all the pressures that are out there that dentists deal with.
Bill Claytor: My daughter is an internal medicine resident out on the West coast. When she went into her orientation, they were very strong on talking about we have resources when you have burnout, we have resources when you have depression and went through the whole thing and they have to take a class in it. That's great. She said the issue is finding time to go. Now it used to be that they told you that you could go while you were at work and if you needed to take the last hour off, a day off and go see a counselor, you can't do that anymore. She said, people are so busy you have to go on your day off. And so you take the whole day to get an appointment to go see the person. It's just finding time to get help. And in private practice … some of the ones that have dual roles at the hospital and also in private practice, she said, when do they go? You know, if they're not at the hospital, they're in their private practice. And so it's an access issue.
Betsy Shapiro: So give me a quick recap here. When it comes to a person-to-person level, and when I'm looking at myself, what do I want to look for to see if I'm becoming burned out? How do I do my self-investigation? And then the follow-up is, what do I do then and there?
Jim Willey: What I always look for in myself is putting up walls, taking that initial step of depersonalizing, just getting tired with human relationships and shutting down, shutting myself away for a while. That's telling me I need to recharge a little bit. When you're not feeling good about what you're doing on a daily basis that should be a big hint to you. You should look forward to coming to work. You should be pursuing your passion when you come to work. And when you do your dentistry, you should feel good about what you're doing. I mean, the last one you probably should have already addressed, but before you get there—the emotional exhaustion. That's when a dentist is saying, "Cancel my afternoon. Just get rid of all the patients. I'm going to go somewhere and do something else." They've really exhausted themselves. So those are the things I look for.
My big takeaway is just when you feel that way, you've got to reduce the load or reduce the amount of energy that you're putting into something. That way, you can kind of save yourself, and then don't be afraid to ask for help. I think that's a real key point when you're feeling that way, you've got to find somebody to talk to and try to get after what's happening.
Bill Claytor: I think the issue of compassion, we haven't really used this term yet, but “compassion fatigue.” It’s where you see this depersonalization or detachment. You don't like people very much. You don't really want to be around people. I'm exhausted, don't have anything else to give. That's sort of what I look for. Am I getting exhausted with patient care? Am I projecting things that aren't happening? So compassion fatigue for me is something that I have to really be aware of, and I will stress that compassion fatigue, this burnout is more with human relationships. I mean, you're not going to get burned out over a bad computer and you keep trying to fix it. You're just going to throw it away and get another one. But with humans, you can't just throw away relationships there. Your people at work, your people at school, your environment, your home life.
And just one comment about that is for me, I have to look at myself. It's not the other person, it's me. There's something about me that's not right, and so if I'm burned out, if I'm exhausted, if I don't really like what I do or don't feel like I'm making much of a difference, it's a bad place to be for a dentist. I tell my students, look at burnout as a positive opportunity for change in your future.
If you can identify it and you say something's not right and then you reach out to help, whether it be the ADA, or your state dental societies. I know here at the ADA, they have a list of resources to help. Burnout is not a weakness. Burnout is an opportunity to change because you recognize something's not right.
Betsy Shapiro: Thank you. Thank you both. You've provided some excellent information for our listeners. I really appreciate it.
Before you leave, I'll do one more thing. We have a member question at the end of every episode. One of the questions I get fairly often will be from a dentist who wants to get out of dentistry and do something else. And almost always when I listen to them, I realize they don't really want to get out of dentistry. They want to get out of burnout. They've hit some stage where it's just not quite right.
When I'm talking with them, the answers that I would give them would be things about looking at what you're doing every day. What is it you like or don't like? What can you change? What's your vision? Talk to someone, be kind to yourself, which is harder for us to do because we're perfectionists. And very often they will say to me, "Okay, so if I do these things, is it really going to get better?" Here's my question to you. Is it really going to get better?
Jim Willey: There's always hope. I mean, if I could sum up just very briefly what, what we've talked about, make sure you are getting the skills that you need. Like when I self-identified as not having the business skills I felt comfortable with. Go get those business skills. Go learn how to delegate, make sure that you're the best that you can be first and then when you're stuck, do something different. Try something different because you're going to be able to react to that and it's going to bring you to another solution. And then the last thing is, ask for help. Make sure that if you're really at the end of your comfortable coping limits, that you take the time to go ask for help.
Bill Claytor: I think one of the things that we are not taught early in our dental careers is to define who you are. Are you a dentist who is going to be one that thrives in private practice or should you maybe work in public health or military or be a consultant? There are so many different other areas that dentists can work in. I think we have this image that when we get out of dental school, we all are prepared for private practice. Some are, some aren't. The ones that aren't, it's not a bad thing. So what I would do first of all is define who you are and find a practice in your area or someone you know and you like what they're doing. Go visit them, another dentist, see how they practice and say, "I want that. I never want to do this procedure ever again, but I want to do these."
You have a choice. You have a right to choose. Define who you are because you have to live with yourself. Define who you are, control your schedule. Schedule is probably the number one thing that we can do as dentists to control burnout. Asking for help can be very, very difficult. I understand, it's a tough place to be in and I would not look at asking for help as a weakness, but like I said earlier, it's an opportunity to change. You know, there are so many resources out there, there are so many people in the world today that want to help you as a dentist and I highly recommend that wherever you want to start, whether it be the ADA resources or other areas, ask questions, and ask for help. Tell somebody something's not right and you need help.
Betsy Shapiro: I think you both gave long answers that both said yes, there is hope and so you are both examples of how life can be refocused and restructured and changed and still contribute and be a part of the profession that we all love. Thank you again to both of you for spending time with us today. It's been a really meaningful conversation and I appreciate your time.
Bill Claytor: Thank you.
Betsy Shapiro: If you want more information on any other practice management resources or on specific resources for stress management or career changes or how to find help on any of these topics, you can visit our website or contact us at our email address email@example.com. We want to thank our sponsor, ADA Member Advantage, for their support and to Sandburg Media for producing this podcast. And thank you for listening to Beyond the Mouth.