Wellness

Betsy Shapiro: Welcome to the American Dental Association 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 American Dental Association. In this episode, we're talking about life balance in dentistry with newish dentist Dr. Erinne Kennedy. Here are five fun facts about Dr. Kennedy. She's a 2015 graduate Nova Southeastern University College of Dental Medicine, with both a DMD degree and a Master's in Public Health. She then spent a year doing a DPR at a VA hospital in Baltimore. Most recently she was awarded a certificate in Dental Public Health from Harvard. And then she started to pioneer a new degree from Harvard as she seeks her Master's in Dental Education, a brand new program for them.

In between all of this, she works at a federally qualified health center in Boston and never stops giving back as a mentor, a volunteer in organized dentistry and serving on a few editorial boards. I told you I'd give you five facts and I just did. Here's a bonus. She actually has a real life. In no particular order: she likes to exercise, she loves her family and her church and she mentioned something about a place called The Flower Bakery, which we might have to ask her about when we get to the travel part of this episode. Erinne, welcome to the show.

Erinne Kennedy: Hi Betsy. Thanks so much for having me today.

Betsy Shapiro: We are delighted to have you. I'm very pleased you could find time to fit us in. But that's what we're going to talk about, how you find time to fit everything in. And how you master staying healthy and being productive and doing all this good that you're doing.

Erinne Kennedy: All right. Let's get started.

Betsy Shapiro: I know that you have parents who are both in the dental industry and the profession. Can you talk a little bit about that and then how you got into dental school? What made you decide to choose that direction?

Erinne Kennedy: Absolutely. So my dad is a dentist and my mom is a dental hygienist and his office manager. And actually my uncle is also a dentist and all three of them graduated from the Ohio State Dental School back in the 80s. I grew up in a really small town called Middleport in Southern Ohio. I'm right on the Ohio River. And so from my early childhood I obviously spent a lot of time in a dental office. But it really wasn't until I was in college, high school, college that I decided that I wanted to become a dentist.

My parents really drove into me that education is something that nobody could take away from you. And so from a really early time in my childhood slash life, I knew that I wanted to continue and be a part of the education process, whether that was in medicine or whether it was in dentistry. And when I was in high school, I started going on mission trips to the Dominican Republic. And actually it was through that service that I realized that I wanted to become a dentist, not only to serve people abroad to countries, communities abroad, but also to serve people in my backyard and the people that I call diverse. And so that's when I decided to become a dentist.

Betsy Shapiro: I have a very critical question, because I too had a parent who was a dentist and I too worked in their dental office when I was in high school. Did you have to clean the bathrooms in the office?

Erinne Kennedy: I did. Oh my gosh, thank you for bringing that up! Because I had like the scutwork job actually. And for, it was probably four summers, between high school and college that I worked in their office. And they had all of these dental assistants and staff members that were all young women and they all happened to get pregnant and go on maternity leave. Like during the summer, like, I don't know if this is all planned, but I was always working. So I worked full time every summer in their office and I always had to clean the bathroom and take out the trash.

Betsy Shapiro: Me too. It was a gratifying feeling for me when I got to go back and actually be the dentist and say to someone else, "Could you please go clean that bathroom." I also still ended up doing it from time to time, as a dentist, when it needed to be cleaned.

Erinne Kennedy: Well actually looking back on it, it was a huge leadership moment for me. Because when I started leading my own office, I had already done all of the really tough jobs. And so it's really easy for me to jump in and say, “hey, let me help you with that.” Or “Hey, let me show you how we can do this better," or whatever the case may be. So from a leadership perspective, doing all of the jobs along the way, it just helped me grow as a leader. And there's a book actually about that that I love and it's a great tip for any like young dentists, newish dentists out there. And it is, “You Don't Need A Title To Be A Leader.” It's a fabulous book. And I think it drives the point home about cleaning the bathrooms no matter where you are in an organization, no matter where you are in your office, you can make an impact as a leader. And that's something that I kind of took home from that experience.

Betsy Shapiro: Oh, that's excellent. I love that there's actually a book that relates to our shared experiences of filing records endlessly and cleaning bathrooms. So...

Erinne Kennedy: Oh yes, the filing records and I don't know if anyone's going to recognize this, but does anybody remember the pride way of organizing your chart?

Betsy Shapiro: Oh, I am absolutely certain there are a fair number of people who remember the pride way of organizing your charts.

Erinne Kennedy: So I am a master pride organizer. I can assemble charts super quickly and I've been doing it since I was about five.

Betsy Shapiro: You're about ready to retire then. That's how you'll achieve ultimate work life balance. So let's talk a little bit about dental school. I know you did a lot of volunteering there, but you managed to come out with both your dental degree and your Master's in Public Health. So what speaks to you about involvement in service and still making it through it all?

Erinne Kennedy: You know, I tell students this all the time. I said, "You're going to pay a lot for your dental education. It's going to be fabulous, but you're going to learn the most outside the four walls of your dental school." And that was really true for me. I had to be really great at managing my time when I was in dental school because I was involved in ASDA. I was involved in creating a bunch of organizations at my dental school. My fourth year of dental school, I was our class president and I really helped us work through the board exam and make a bunch of changes that year. And I spent a lot of weekends away from dental school because I was traveling for either ASDA or some other form of organized dentistry. And what I learned so much during that time was it's so important to be involved.

And I remember one of my leaders saying, "Well, you can't make a change if you don't have a seat at the table." And I think that really rings true, especially for women in leadership. We need to have more women in leadership. We need to have more women sitting at the table because that's how we can make change and create change and have our voice heard. So for me it was something that I made a priority to be involved. And it started out with ASDA and when I was a second year, they needed a lunch and learn coordinator and it was kind of the low level job. One because it required a lot of work. Two, it required you to coordinate and bring all this food in all the time and then you'd have to dispose of all the food. And it was just, it was a lot of logistics and I had no idea. I was naive and I was like, "Oh, sign me up for anything," I just said yes. That's how I ended up getting involved. And of course like anything, I went crazy with the role and we ended up having like 50 or 60 lunch and learns that year. And what was hilarious is that the end of it, I ended up sitting, I think in the Dean's office with like all of these other people because I had overtaken the lunch calendar. You know, I'd had taken up too many spots. And I was really proud of what we did that year in ASDA and I just wanted people to know about things outside of school.

You know, if there was a product we didn't use their company, we weren't involved in. My philosophy was get as much knowledge as you can and learn how to make good decisions early on in your career. And I knew that required exposure to things outside of maybe what we were taught in dental school. And so I fell in love with organized dentistry through lunch and learns.

Betsy Shapiro: That's a perfect story. And I think it prepared you well probably for getting involved in your local dental society where your first job usually is either scheduling the restaurants or picking the topics for CE. So you're way ahead of everybody else. You have a dossier, a Rolodex ready to go.

Erinne Kennedy: You know, it was crazy. I just went back to my Alma mater, NSU this past week for their white coat ceremony. And I ended up sitting next to a couple of members of organized dentistry and we looked at each other and we just hit it off. And I feel like when I walk into a room anywhere in Florida, I have so many contacts. And to be honest with you, it's wonderful because I then meet students who need to find a dentist in this area or need a company to provide this in that area. And I can give a warm handoff.

And so I really loved my time. And I think it taught me how to network, which for some students it's really hard when you first start out to talk about networking and to be able to introduce yourself and to get involved. And so, I don't know, if you're a new dentist or if you're a dental student and you struggle with networking, being involved as a lunch and learn chair is probably one of the best exercises in growing that I think you could have.

Betsy Shapiro: Thank you for that. You mentioned earlier that you just said yes and that's how you got started. I think sometimes for as accomplished as you are and for as much as you packed into those four years, saying yes can have challenges as well. Did you run into any stumbling blocks or can you describe any challenges that came through for you particularly as you went through those four years?

Erinne Kennedy: Absolutely. Saying yes is probably my greatest strength and my greatest weakness at the same time. If I'm completely honest. I'm a go getter. I like to get things started. I'm kind of an igniter. I can get a lot of energy around the topic. But you can find yourself as a leader when you say yes all the time, especially when I was in dental school, all of a sudden you realize you're let's say the president of three different organizations. And you kind of have to sit back and question yourself like, am I making an impact when I'm so divided or my time is so divided. And so it takes a lot of humility to then say no or even pass that responsibility on to somebody else, because many times it's something you're super passionate about. But what I found is sometimes you can make the most impact when you start pruning things.

And so actually my 2018 word of the year was flourish. And part of my journey through flourish has been to like prune projects. Prune maybe organizations or things that I'm involved with and even research projects and kind of prune it back to like a core of things that I really want to be involved in and be committed to. And I think that's something that every leader learns along the way. And it's still, even once you've learned the lesson, I think it's something that you feel challenged with because you want to say yes to everything. But sometimes you have to pick and choose.

Betsy Shapiro: Well I think the gardeners and the farmers in the audience are going to wholeheartedly applaud you because you did just hit on the nail for getting the best fruit and vegetables was pruning back and then concentrating in in one area. But was it scary the first time you let something go?

Erinne Kennedy: Oh, absolutely. And just to bring in social media for everyone who's really young and in the millennial crowd, I think sometimes you can see people around you always posting their best moments. And sometimes you feel like you need to continue to post more best moments. Right? And so for me, when I started saying no, at first you start to think like, "Oh, well, am I doing enough?" You know, now that I said no. And so you have to fight that urge to continue to say yes and just let where you've planted yourself. Kind of if I want to keep going on with this, this growth thing. But if you want yourself to grow, you just kind of have to be patient right after you start saying no. And what I can say if I'm honest, when I was in dental school, I didn't do that well.

I remember, I pruned a bunch of things and then like two months later I had said yes to a bunch of more things. And it took me some time to realize what that looked like for me and how many yeses I could have maybe in a season of my life. And that comes from knowing yourself and reflecting on yourself. So yes, it was totally scary. It was really frightening. There's a term called FOMO, fear of missing out. And I definitely had that at first. But as I grew in wisdom and experience, I realized that that pruning and saying no was actually the best thing for me and that's when I could be the best leader for others.

Betsy Shapiro: Did anyone or anything in particular help you gain that self-knowledge or was it just taught innately through taking your licks and figuring out you can fit everything in the day?

Erinne Kennedy: A lot of it was my dad actually. He takes life a little bit slower than I do. And for the longest time he would say you've got to pick something to take back. You've got to rein it in Erinne. And it kind of took beating it into my head to figure it out. But a lot of it came from self-reflection too. You know, when you do prune back and you realize, "Oh, things are going better." Oh I feel like I can breathe, I'm much less stressed, or I'm bringing my best self every day to school or work or your family. That's when that positive reinforcement happens. And I feel like it helps perpetuate that good behavior or that thing know when it's needed.

But for me it's, it's been a lot of self-reflection, realizing what worked and what didn't work. And also realizing that you don't have the impact that you want to make if you're not able to put the time in. And for somebody like me, I really want to make an impact. And so it helps me make good decisions when I realized that taking a step back is actually making a better impact.

Betsy Shapiro: Erinne, it sounds like you were able to self-identify challenges, learn how to say no and step back a bit. But I think for some students and some practicing dentists, that's a little difficult to know what to do or to actually see when you have a need. Do you have any bits of advice that you might share along those lines?

Erinne Kennedy: Absolutely. I remember when I was a senior in dental school and I was on a flight back to Fort Lauderdale with my mom. And I remember just crying and saying, "I can't do this. I can't keep up." And that's when I first realized that one, I probably felt a little bit burnt out. And two, I probably needed some help and some resources. And three, that's when I started to learn to say no.

And at that time looked around and I saw all of these leaders and I wanted to be better. I wanted to be more. Honestly, I wanted to be who God designed me to be. And so I knew this was going to require change. And so I actually reached out to my school, they offered free counseling services that helped me identify things that I could say no to perhaps and learn to respond maybe in a better way.

And so since then I have encouraged so many students to reach out and utilize counseling services at their school. So many schools have it mandated where it's free or it's included with your health insurance. And so, if you can reach out, I know there's a huge stigma around having a counselor. But there isn't a huge stigma around having a personal trainer. And one helps you work on having your best physical fitness. And the other one helps you have your best mental fitness and you need both as a leader. And so don't be afraid to reach out and ask for help.

Betsy Shapiro: That is a perfect analogy, thank you. Erinne how do you balance your life now?

Erinne Kennedy: Well, first I want to share with you a little bit about what I think about the word balanced. When I was in residency, I was so frustrated because I felt like I was not balanced. And so I came to terms with the fact that balance is an illusion. And there is a really great leader who also has a podcast, his name is Craig Rochelle. And I listened to this podcast all the time, but in episode 13 there's this great quote that I hope all of the listeners can just kind of like take in. And he basically says balance is an illusion. And if you're striving for balance, you're always going to be frustrated. But really, that balance is all about being faithful to that season of life. And so you have to just learn to respect the season that you're in. And so right now for me, I'm respecting a season of research.

And so what it means is that I'm not able to do as many lectures or maybe go places on the weekends because I have to make sure that I fulfill all these research requirements and these class requirements. Whereas eight months ago I was traveling almost every weekend around the country visiting students and helping out and that was balance in that season. And I'm sure there's going to be seasons in my life when I get married and have kids and do other things in my life where I'm going to not have an opportunity to be so heavily invested in my research or maybe be invested in my travel.

And so for me, balance is looking at that season. And for me it's semesters because I'm in school, and saying, "Okay, what is my focus this season?" And that's when I came to terms with, okay, I'm balanced because my focus is maybe this, this season and maybe something else the next. And so hopefully that helps someone come to terms with what balance means for them. And maybe look at their life more like a season, than feeling perfectly balanced all the time.

Betsy Shapiro: I like that analogy as well. It's a bit like not going snowshoeing in the middle of the summer. It's not the season so you focus on the other priorities.

Erinne Kennedy: Yeah. And then it also helps you feel really confident with yourself. Right? So if you're sitting in a season and it's your season of maybe sowing into your research. You might look at someone else or compare yourself or something like that and feel like, "Well why am I not traveling? Or why am I not doing this?" Well, it really comes down to focusing on your lane and where you are and keeping your eyes and your blinders on to where you plan to go. And for me that's been really helpful.

Betsy Shapiro: And it incorporates the art of saying no to the things that aren't seasonal.

Erinne Kennedy: Yes. And really it's the practice of saying no, I think I've come to terms with, because it's something that I have to practice all the time. Just like dentistry.

Betsy Shapiro: I think in general dentists have to learn that, we're people pleasers we want to say yes. I know you mentioned in the bonus fact we told about you, you said that you like to exercise. Can you talk a little bit about what you do to stay physically healthy as well as mentally healthy?

Erinne Kennedy: Yeah, absolutely. So I have quite a few self-care habits and I didn't add them all at once. It was something that I kind of added over the years as I learned more and kind of learn more about myself and about just good habits and I looked at other leaders and kind of adopted different things. I eat really well. One of the things that I've done over the years is the Whole 30. And a lot of that is just reflecting back on what makes you feel good. And so I'm always learning about new things that have to do with diet and nutrition and trying new things in my own life. So that's been something that's been a really strong habit in my life is eating well.

And exercise. So I used to be a huge runner when I was in college. But a few things have happened over the years and I don't run as much as I used to. But I do do high intensity workouts. So they're called HIIT workouts. I do that probably four days a week. And then I tried to do yoga like probably once or twice. So those are a few things that I do to keep physically healthy.

As for mentally healthy, I think journaling is key. Right now I have a five year journal, so you write like six lines each day about your day. You can write about your mood, a book that you read, a famous quote, anything that goes on in your day. And you can look back over the five years as you go along and see your progress. But more importantly, you see the things that you thought were a big deal, maybe not be such a big deal. And you see things that seemed really insignificant that built up over time and turned into be a huge blessing. And so for me that journaling has been a great tool.

Also I spend time in meditation and prayer. That's something that I hold really dear to my heart. And I feel like is a really important habit for me. And I also communicate with my family daily. And for others, it's friends, it's mentors, it's someone else in their family that they hold in high regard. But for me it's my family and I feel like that helps me stay grounded. And that's one of my really important habits.

And I would say my last habit for health is my planner. If you don't learn to plan your day and assign time to things and to be punctual, it’s really easy to not make time for exercise or not make time for eating right or make time for other things that are really important to you. And so my planner helps me set my priorities in in a good way.

Betsy Shapiro: I think that's all very admirable. But I do have to say that from my point of view, I'm a little more challenged because I try to plan so that I don't have time for exercise. So I can say, "Oh, I would have, but there wasn't time."

Erinne Kennedy: It is really hard and I have to say, you have to find something that you like to do. So many people that I talked to have a workout that they're like, "Well, I don't enjoy this or I don't enjoy that." And so I think it takes a little bit of experimentation. You know, I have someone that I actually met while I was in dental school. Her name's Maria Puntillo and she has an online exercise group of all of these, like young professional women. And we actually work out online together a few mornings a week at a really early hour, I have to say, like 5:00 AM. But I've got to know these women over the years and it's the accountability I need, but it's also really convenient. And so I guess I've just found something that works for me and that's what I challenge everybody to do. Find something that works for you that you'd like to do because if you don't like it, you will never make time for it.

Betsy Shapiro: You will plan around it actively. That's what you will do. I'm telling you.

Erinne Kennedy: Absolutely.

Betsy Shapiro: So we know where you are now. You're at the Federally Qualified Health Center and you're working on the Master's in Dental Education. What's next?

Erinne Kennedy: So I have a year left in my Master's in Dental Education program. That's probably going to be a combination of education classes, teaching experience, which I have a history of. But you know, adding in like new teaching techniques or getting some more evaluation or reflection on how I teach or how I instruct students and then also research. So Harvard is definitely a heavily based research institution and so continuing to work on some of my research in dental education is what I'll be doing for the next year. And then after that I will be looking for a job.

Betsy Shapiro: That sounds familiar to many of us. That day does come when you have to face the real world. Is there anything in your research that you can share with us that we should be watching for in the next year?

Erinne Kennedy: Definitely. So I'll be working on assessing faculty burnout. Burnout is something that's really common among physicians. There are some studies that show that it's as high as 50% of physicians that face feelings of burnout. And it's really like mental and emotional exhaustion. And some related to compassion fatigue, which is common in healthcare and in any health profession really. And so I'll be looking at, among dental school faculty.

As I've kind of stepped into this role and I've been in higher education for going on 12 years now, which is hard to believe. I've had a lot of mentors that are amazing people, but over time I realized that they're exhausted. That even though they plan, plan, plan, plan, and they get all of these things done between students and their colleagues and research requirements and academic requirements and clinic requirements, it is a very taxing profession. In a good way. A lot of good things come from being a dental school faculty, but also making sure that we have resources that are targeted towards them, whether it's faculty development or mental health and wellness resources, not only for students and post-graduates, but dental school faculty is really important. And so that's something that I'll be looking at this year and looking at what resources and even local faculty development might look like.

Betsy Shapiro: That would be phenomenal. I would imagine, like many of the listeners, a face popped into my head from my dental school days. That was a professor who had exceptional experience and a lot to share but just was burned out and students knew it. We loved him, but we knew how to read that situation. And if you can help the faculty just think how they're going to be able to pass that on to the students. You can change the whole face of the profession Erinne.

Erinne Kennedy: Well that was actually where I came from, or the position that I came from. Because as a student and as a resident, I've been a resident for going on four years now basically after dental school. And I look around at my colleagues and I look at myself and we all experienced burnout at some point in time. And that's been shown through some research that residents are especially prone to having moments of burnout.

And when I graduated dental school, I was actually working with the ADA and looking at some of the dental health and wellness resources. And what I realized is that a lot of this culture of burnout, in a lot of different ways, started while we were in dental school. And I kept thinking "What if we recognized signs of burnout early? What if we had resources? What if we were able to teach good habits to students while they were in dental school so that when they started practice, they didn't wake up in five, 10, 15, or 20 years and say, I'm completely burned out. What do I do?"

And so a part of that piece and part of my journey has been looking at resources for students, but then also realizing that creating that culture of wellness I think is going to start with the dental school faculty. But we can't create a new culture until we understand the current culture. So that's something that I'll be working on for the next year or so.

Betsy Shapiro: That is excellent. And we certainly hope you stay in touch with us here at the ADA because we do have some resources on that topic. But it's such a huge field and we hope to keep expanding what we can offer for all of our students and new graduates and our mid careers too. To help them stay healthy, be healthy, and provide good service to the public.

Erinne Kennedy: Absolutely. I think it's really important. It's definitely one of my passions.

Betsy Shapiro: Was there anything else, Erinne that you wanted to share with us as you look ahead and see where life or the profession might take you?

Erinne Kennedy: Well, I would say my number one passion is helping students and raising up young leaders. And so, I'm asked all the time, "Where do you want to go? What do you want to do?" No matter where I am, no matter what I'm doing, I think I'm going to continue to make students my priority. And that's because so many of my mentors made me their priority. And so I think when we look at what the future of dental education looks like, the future of our dental profession, we really need to focus as dentists and continuing to look back and extend a hand and pull up all of those young leaders that we have behind us. Because that's really where the future is.

And so no matter if I'm in a private practice or a health center or a state or federal institution or a school, my focus will be bringing up and raising up more young leaders. Because I just know that I wouldn't be where I am today without some of my amazing mentors. You know, Dean Mason, Dr. Douglas, they both have really impacted my life and helped me be where I am today. And so I just know that my number one goal and passion is going to be helping students.

Betsy Shapiro: Well, kudos to all your mentors. Because it sounds like they've done a very good job. I am not sure if it's because you are an eager student or they were excellent mentors, but it seems to be working out pretty well for you.

Erinne Kennedy: Well, my mom always said when I was growing up, she's like, "You know what? The number one thing you need to have in life is perseverance." She's like, just continue to show up day after day, no matter how hard it gets. And there is a lot of days where all you can do is show up. You know, whether you're a student or a new dentist, there are some tough days ahead of you or you probably already experienced some tough days.

And I just feel like, I don't know if you've read the book Grit by Angela Duckworth, but it's an amazing book. It's an amazing story. And I feel like so many young dentists that I meet and really students as well, I think one of our number one qualities is grit. That ability to just have passion and perseverance day in, day out and just to continue to show up. And so I don't know if you're listening to this and you feel like you have so many steps to go until you reach your goal or your dream, I want to encourage you that it's really about just stepping up day after day. And actually there's a super great quote about that by Abraham Lincoln and he said, "I'm a slow walker but I never walk back." And I think that's something that if just continue to take one step forward each and every day, you will definitely have the career of your dreams. Betsy Shapiro: I think that's a perfect message to end this with Erinne and we'd like to thank you for spending so much time with us and sharing some of your person with us. It's been fantastic. Erinne Kennedy: Well, it's been my absolute pleasure and I look forward to chatting with you again.

Betsy Shapiro: Well, when Erin is not doing dentistry or studying or exercising or eating at the Flower Bakery, she does write and edit articles for a variety of websites including Dental Economics and Dental Entrepreneur Woman. Dental Economics can be found at dentaleconomics.com and Dental Entrepreneur Woman is at DEW.life.

Now we're at the part of the show where we answer a question we've received from a member. In the Practice Institute here at the American Dental Association we answer member questions every single day and wanted to share one we've received with all of you. To help us we've recruited Katie Call. Katie works with the Center for Professional Success at the ADA and is very often the voice or fingers behind the answers you get to your phone calls or emails. So here's the question, Katie. I'm a new dentist just appointed to a local dental society component committee and I have absolutely no clue how to run a meeting or even how to participate correctly. Do you have anything where I can learn more about this process?

Katie Call: Thank you, Betsy. The answer is yes. The ADA has created a series called ADA Leadership Institute, which is made up of a variety of videos and downloadable resources. They cover all aspects of leadership. The content is available free to ADA members and the topics range from understanding your legal obligations as a board member all the way through hitting the ground running as your first 100 days as president. Once you reach that point. The Leadership Institute includes free CE for members as long as it fits under the permitted topics defined by your state board. And even though the series speaks to dental leadership, much of it is applicable for all areas of life and leadership, whether it's your local parent teacher association or running for elected office on a national level. 

Betsy Shapiro: Welcome to the ADA 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 American Dental Association. In this episode we are talking about wellness in dentistry. Joining me today is Dr. Emilia Sam. She's an oral surgeon, an associate professor of oral and maxillofacial surgery at Howard University, an author, a lecturer.

She's also the author of several books on personal development and wellness, and how this all impacts the overall patient experience and the practice of dentistry, and if we really want to dig deep, how it impacts health care too. Emilia, welcome to the show.

Emilia Sam: Thank you so much. I'm so excited to be here.

Betsy Shapiro: Well, we're delighted to have you. I would like to start out by asking you how you came to be where you are today. I mentioned that you're an author, and we'll talk about your website, but anyone who's read your books or followed you on your blog is aware that this has been a very personal journey for you. I'd like if you would share some of your story with all the rest of our listeners.

Emilia Sam: If I remember correctly, it was some career day event in, I think the seventh grade. So I didn't really have a personal familial connection to dentistry, but it was a really practical choice for me at that time. And I can't remember what the presenter said. I can't even remember his face. I just know it was a male, but by the end I had just chosen dentistry as my path.

Then once I got closer to entering university, I did think about the possibility of going to med school, but in all honesty I did not want to have to do a residency after going to school. So that was one of the things that really tempted me about dentistry as well, because I wanted to be a doctor of some type, but I didn't want to do that extra three, four, six years.

Yeah, so for me, once I got to third year of dental school, something just wasn't connecting with me as far as general dentistry. There's nothing wrong with it, but I just wasn't excited, I guess, to go down that path. And the thing that was drawing my attention was oral maxillofacial surgery, but you know that requires at least a four year residency, so I ended up doing the thing that I was trying to avoid in the first place. So that's how I got to surgery.

Betsy Shapiro: Funny how life does that to you, isn't it?

Emilia Sam: Right. You can't escape certain things. You're still going to get them, maybe in a slightly different way, but you're going to go down that road. I learned so much during my surgery residency, and even beyond surgery, there was a whole lot of personal growth. But there are also a lot of things that I experienced that at the time I couldn't articulate, but in retrospect, I think, along with my dental training, impacted me and kind of brought me to where I am today as far as the personal development and wellness aspects of things.

Betsy Shapiro: So when you first started in practicing as an oral surgeon, was the wellness a big part of your being and your practice at that point?

Emilia Sam: No, absolutely not. I had been somewhat of a personal development junkie, and I always felt like my personal interests, I had to keep separate from my professional world. They were just two things that I did not see coming together, and there were probably a few times, a few exchanges that I'd had with colleagues where if I started to delve into what I was learning as far as personal development was concerned, they'd look at me with a side eye or "Oh, hey, what? I don't know what you're talking about." And I kind of learned to stay away from certain subjects.

Betsy Shapiro: Yes. Because that's not science, right?

Emilia Sam: It's not science. It was not accepted as science. So yeah, that was just a boundary that I learned early not to cross, but it actually, it worked in my favor. So I'd always had a love of writing, but I had put that aside while I was doing my schooling because I just figured that was a hobby, and I needed to just buckle down and deal with my formal education. But after I started practicing, I just found that there was something that was missing for me, and I really, I just wasn't really happy.

I just noticed that there was this void that I couldn't quite explain, but that was probably around the time where I started to pick up my writing practices again and journaling a little more frequently. I used to do it years before, but I returned to it, and it was also around the time where blogging became a thing, so all of a sudden anybody could have a platform and write for others, and one day I just had an inspiration to start my own personal development and inspirational website. So that's how I got started with that.

Betsy Shapiro: Can I ask if your patients or your students knew at this point in time that you had this blog? Did you share that with them?

Emilia Sam: Absolutely not.

Betsy Shapiro: Well, I wondered.

Emilia Sam: That was around the time I think Emilia emerged, because my first name is Francis, and everybody had known me as Fran or Dr. Sam, but I like to say after 5:00 and on weekends, Emilia came out. So that also gave me the freedom to just explore what it was like to put my own thoughts out in the world, because it could be really scary baring your deepest thoughts and what keeps you up at night, and things that aren't necessarily related to the professional realm. But I had this ... Care may be too strong a word, but I was just concerned that I may be found out. So that was why I was using my middle name for the longest, and it stayed that way for quite a few years.

Betsy Shapiro: That's interesting. And it's also very flattering to me because you actually asked me to call you Emilia, and so I feel like I got to meet the after-hours weekend person, and maybe that's why I always perceive you as so calm, and competent, and relaxed, and embracing the moment. Maybe that's why. If I called you Francis or Dr. Sam, I would see a different side.

Emilia Sam: Well, thankfully the two have merged along the way. You know, I've never really asked people how they experienced me, say 10 years ago, because I know now Emilia is ... I hate talking about myself in third person, but you get the idea. I'm the same person wherever I'm at. There really is no ... There's not a huge boundary between Dr. Sam and Emilia anymore. I feel like I can be the totality of who I am wherever I am. So it would be interesting to see if people had noticed a shift, if they had known me 10 years ago, how they would have perceived me in practice, from a colleague or a student or a patient's perspective.

Betsy Shapiro: That would be an interesting podcast. Maybe we could get a couple of them in some time and we'll talk about their changing perception. But I actually, I think what you just described, and I'm not a psychiatrist, I am not a mental health expert in any way, but I think you just hit on the nut that all of us are searching for. The method to have all of our personalities, and we all have them, whether or not we admit to it or not. The face you put on in front of your grandmother is probably not the same one you use in front of your boyfriend.

Emilia Sam: Let's hope not.

Betsy Shapiro: Well, I don't know. It depends on either your grandmother or your boyfriend. However, I think that the ability to have all your worlds collide, if you will, and be comfortable in it, is such a wonderful goal for all of us. You've talked in the past about a wellness revolution. Is this kind of what you mean by that?

Emilia Sam: Absolutely. So in talking, I guess, about the convergence of things, how my personal and professional life finally started to merge. I think it really came around after I'd read the book “A Whole New Mind” by Daniel Pink. And he just talked about how times are changing, and how we've been through all of these phases. We've been through the Agrarian Age where farmers were at the head of things. We've been through the Industrial Age where it was factory workers, and we've been through the Technological Age or the Information Age, where we valued what he refers to as knowledge workers.

But the age that we're in now is what he refers to as the Conceptual Age. And he talks about this shifting from the knowledge worker and the left brain, if you want to refer to it that way, as a time where the qualities of the right brain are being heralded. So he talks about these conceptual senses, and one of them being empathy, and throughout the book he had examples of how this sense was developing, specifically in health care. And the minute I read that, all of a sudden my whole life finally made sense, and it felt like the parts of me that I'd been hiding were exactly what we needed to bring to health care in order to see the next iteration.

Betsy Shapiro: I know you've talked about health care needing an overhaul, and I suspect that what you've just expressed is what you mean when you talk about overhaul. We have other versions of overhaul in health care out there in the world, financial and regulatory, and all those kinds of things, but I'm sensing you're speaking mostly to the empathetic nature of health care and how we're delivering it. Is that true?

Emilia Sam: Absolutely. I think we've just come to a point where, and again, this kind of goes back to Daniel's book, where we're all searching for meaning and connection. Even if we're not able to articulate it in that specific way. So when it comes to health care, our patients may be looking for something just beyond our clinical competence, and for practitioners, just delivering treatment is not enough. They want to have meaning and fulfillment as well. And the way that we serve all parties involved is just to create connection. It's just very human, and it's the human aspect that's been missing out of health care. You know, it's interesting, we have "care" in the term, but I think up until now patients have been serviced but not necessarily cared for.

Betsy Shapiro: So what do you think would be the practical application for a dentist in the practice, or his staff person, what would be the baby steps they might take to start down this same path, to be more caring, to be more empathetic? Or how would they display that to a patient?

Emilia Sam: It really starts with self, with self-awareness. And here's where all the emotional intelligence and centering around mindfulness, where all of that comes in. How do we just become more aware of our emotional state? And that evolves around us in a way that serves, again, all parties involved. So it starts with self-care, and this is what I mean by this whole wellness revolution, and not only what we're doing outside of the office to restore and rejuvenate ourselves, but also what we're doing within the office. So for example, it might be in how you're communicating with your patients.

I happened to see at a meeting a couple months ago, an event held by the National Academy of Medicine, and right now they're very interested in clinician wellbeing. And at the top of the meeting they had a discussion around the topic of loneliness, and it was Dr. Vivek Murthy, who was the Surgeon General who was heading part of this discussion. So he was talking about loneliness amongst practitioners, and that really struck me, because over the years, I've heard a lot of reference to how lonely being a fulltime practitioner dentist in your own practice can be.

And it's not necessarily something that's addressed during training, and it's not necessarily something that people know how to navigate once they're out there, and it's not something that people necessarily want to reveal about themselves.

So as far as communication is concerned, in that discussion, when they were talking about loneliness, there was another woman, Dr. Marissa King, and she was saying that she studies social interactions and how to improve them. So she was talking of an experiment that they did where they had placed sensors on physicians to monitor their interactions throughout the day, and what they found out is that the positions who have the highest number of interactions were the most dissatisfied with their job and at the highest risk for burnout and turnover, or the more they found out that it wasn't necessarily the number of interactions, but it was really about the depth and the quality of communication.

When they were able to connect with their patients and their colleagues, it not only gave their patients a higher sense of wellbeing, but it did the same for them as well. And they found that the people who did have the deeper connections were at less risk for burnout. So in choosing how you communicate, that affects how you feel, how your patients feel, your professional success, and really your personal fulfillment.

Betsy Shapiro: That is fascinating. And I wondered, when you were talking about the loneliness, and I agree with you that that is a problem, it leads to stress and burnout, and we do not want to admit to it very often, I wonder if we're going to see that increase because many of our newer graduates come into the practice being much more connected than perhaps, for example, I was. I graduated 30 years ago. We didn't text message, we didn't chat. We didn't do any of that.

So to suddenly be in private practice on your own, and you don't have time to pick up your phone and do these exchanges, I wonder if it will be even more exaggerated or if we'll find that the newer generation is better about being mindful. Do you have any thoughts about that?

Emilia Sam: Really interesting question, because it can really go both ways, can't it?

Betsy Shapiro: I would think. I'm not sure which way the pendulum will swing here.

Emilia Sam: Yeah. And it's interesting, actually, because yesterday I was doing a presentation for a group of undergrad students who are heading towards health professional careers, and interacting with them for three hours was really eye opening. So on one hand, you do have this population who is attached to their technology, as am I sometimes, because I had to take my phone out of the room, and I wasn't sure how engaged they were actually going to be when we were having discussions around this topic.

But they were really eager to share, and I was surprised at how many of them had already ventured into the world of wellness, whether they refer to it as that or not, and really are preparing themselves for what's going to be a challenging path. So it's just going to be interesting to see how the technology plays into it, because technology can take us away from connection and then in other ways it definitely brings people together.

Betsy Shapiro: I know you mentioned “A Whole New Mind” by Daniel Pink as a book that sort of changed the world for you or changed your view of the world a little bit, and you have a book, “Compassionate Competency,” that I'd recommend to anyone of our listeners. I loved the format. It was for people who are busy, it was so easily digestible, but I think very on point, and just very well structured from my perspective. What are some other resources that you've found have been helpful for you?

Emilia Sam: In trying to understand what mindfulness is, I really like the book “Wherever You Go, There You Are” by Jon Kabat-Zinn. And Jon Kabat-Zinn is really the person who popularized mindfulness. What, it's been about 30, 40 years now? Thirty plus years now. So that's another, that format is easily digestible as well. It's not made up of long chapters that are going to take a lot of your time. They're brief readings, whenever you have time. I call it a side table book, a night table book. So I really enjoy that one.

Betsy Shapiro: I think that's one of the things between Jon Kabat-Zinn and Daniel Goleman. They're putting the science out there, which makes it more comfortable. For people who think, "Oh, that's a lot of hokum." We actually see proof now that it really is a functional change and a healthy thing to pursue.

Emilia Sam: It's interesting, because I think up until now, well, in a lot of spaces, but I know certainly in dentistry, with practices, a lot of time the focus is on productivity and efficiency, and unfortunately we put our wellbeing aside for that. But what we're finding now is that when you attend to your wellbeing, productivity and efficiency are natural byproducts of that. So with the studies that they're doing now, they're finding how mindfulness decreases your blood pressure, it improves your efficiency on tasks, it seems to improve working memory, and thus tend to be less reactionary and respond more appropriately to challenging situations.

Betsy Shapiro: I think we see all those things in the industry, either real or perceived pressures to produce, or to be faster, or somehow be superhuman, and we simply can't be. We have a survey, a health and wellness survey that the ADA does, and it's a periodic survey, and we see increasing changes in unfortunate patterns, for thoughts of suicide or depression or loneliness, mental illness indicators, things like that. And so I think what you do and what everyone is starting to learn and embrace can make the shift for not only for the profession, but for our patients and for the whole health care overhaul that you and I talked about earlier.

Emilia Sam: Exactly. It serves everyone involved.

Betsy Shapiro: As we wind down our conversation today, I'm wondering if you have a takeaway you'd like to share with our listeners.

Emilia Sam: So yes, it's that you can build the most successful practice. And if you think of that like a building, a skyscraper that's just magnificent, that everybody stops and stares at. However, if the foundation of that building is compromised, it's going to come down at some point. And I just want you to remember that your wellbeing is the foundation. So it'll serve you well to make sure that you are protecting that and nurturing that in the ways that you see fit, to ensure not only your professional success, but personal success as well.

Betsy Shapiro: And I think that's a perfect note upon which to thank you so much for your time and your expertise. It's been a pleasure speaking with you.

Emilia Sam: And you too. Thank you so much for the opportunity, Betsy.

Betsy Shapiro: Now we're at the part of our show where we answer a question we've received from a member. In the Practice Institute here at the ADA, we answer these questions every day, and we wanted to share one with you. To help us, we've recruited Alison Bramhall, who is the manager of dental health and wellness here at the ADA. Ali, welcome to the show.

Alison Bramhall: Thanks for having me, Betsy.

Betsy Shapiro: Ali, in our conversation with Dr. Sam, we were talking about mental health, wellbeing, how it translates into practice, stress, burnout, all those things that we know exist and that we want to be able to help our members work through. If I am a dentist and I am struggling with an issue, a wellness issue, either severe depression or some type of addictive disorder, anything like that, and I call you, what happens, and how do you handle that call?

Alison Bramhall: Well, Betsy. We generally speak with the dentist, work through the problem and get them connected with a State Dentist Well-Being Program director. We evaluate the problem on the phone, kind of figure out what's the next step, and then get them connected to that State Dentist Well-Being Program. And from that point, it's generally a dentist that they'll work with, a volunteer dentist, and from that point the dentists will work with that particular caller and evaluate the situation, and if needed, if additional care is needed from a professional health professional, that will be the next step.

Betsy Shapiro: Will it go on my permanent record, so to speak?

Alison Bramhall: Absolutely not. Any call that's made here at the ADA or with the State Well-Being Program is strictly confidential. We do not share your information or any of the situations you may be going through with your state boards.

Betsy Shapiro: And when you say that, my next question of course is, will my state board know and will they take my license away?

Alison Bramhall: No, they will not. Depending on the situation, the state's Well-Being directors will definitely go through the proper steps to get treatment for your situation. For example, if it's an addiction issue, there is a treatment protocol in place at the State Well-Being Program director level. As long as you go through those proper steps, you'll be able to maintain your license.

Betsy Shapiro: And I think I have this right, but I just want to make sure with you, we've mentioned the health and wellness survey earlier in the podcast, and you're talking about some resources, a directory of wellbeing programs. I can find all of those on my own on the Center for Professional Success, right?

Alison Bramhall: That's absolutely correct. The state run Dentist Well-Being Program Directory as well as our Well-Being Handbook are all available on the Center for Professional Success.

Betsy Shapiro: So could I call my state directly if I didn't want to call the ADA?

Alison Bramhall: Absolutely. The contact information is all there. You can either contact them by phone or email.

Betsy Shapiro: Ali, is there any charge for any of these resources?

Alison Bramhall: No. These are all member benefits, so it's free of charge.

Betsy Shapiro: Thank you very much, Ali. We really appreciate your information, and we most especially appreciate your support of all of our dentists.

Alison Bramhall: No problem at all. I appreciate being on the call today. 

If you enjoyed listening to this podcast and are interested to see what other topics we have covered, please visit ada.org/beyondthemouth or check the listings where you subscribe to your podcast series. We want to thank our founding sponsor, ADA Member Advantage, for their support, and to Sandberg Media for producing this podcast, and thank you for listening to Beyond the Mouth.

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The ADA teamed up with NAMI Chicago to develop wellness programming and ways to support members and staff during the COVID-19 pandemic. Provided in part through a grant to the ADA from Crest + Oral-B, these resources were designed to help new dentists and their teams support each other’s mental wellness.

The Ultimate Workplace Mental Health Toolkit, created in partnership with Launchways, includes:

• Key mental wellness concepts
• Guidance on an overall approach to workplace mental health
• Quizzes and surveys that can help start the conversation among your team

Download the Ultimate Workplace Mental Health Toolkit (PDF).

Explore other NAMI Chicago resources:

• Protective factors and challenges (PDF)
• Recognizing burnout at work (PDF)
• Monitoring wellness inside and outside of the workplace (PDF)
• Wellness and work (PDF)

Hope For The Day

Hope For The Day (HFTD) is a non-profit movement empowering the conversation on proactive suicide prevention and mental health education. Below are info sheets regarding mental health and the workplace + dental profession.

• Mental Health and the Dental Profession
• Mental Health and the Workplace