The Silent Epidemic: Diagnosing the Root Cause of Dental Burnout

Announcer:
Hello, everyone. Welcome to The Millionaire Dentist Podcast, brought to you by Four Quadrants Advisory. On this podcast, we break down the world of dentistry finances and business practices to help you become the millionaire dentist you deserve to be. Please be advised we do speak with an honest tongue, and may not be safe for work.

Casey Hiers:
Hello and welcome. This is Casey Hiers, back at the Millionaire Dentist Podcast in studio with co-host Jarrod Bridgeman.

Jarrod Bridgeman:
Casey, I'm so excited for you to be here today. I feel like I never see you. You're always traveling, you're always out and about, and just you're a hard little worker.

Casey Hiers:
Oh, I accept any and all compliments. That's right.

Jarrod Bridgeman:
Have you gotten to any point this year where you're just feeling a little burnt out from just all the work you do?

Casey Hiers:
Wow. You just build me up. Some workhorse. I mean, yes and no, right? Ultimately, our mission is to help practice owners. And so keeping that mindset of we're trying to help people, which we do, mentally, I can wire my brain not to feel burnt out.

Jarrod Bridgeman:
Right.

Casey Hiers:
It's like this is important things that we need to educate people on, potentially help people. That being said, when things are frustrating across the board, everything's amplified. So yeah, do I feel burnt out? I feel pretty good right now. I went to my chiropractor last week, got a massage. There's something about self-care. Had a cigar this weekend.

Jarrod Bridgeman:
And not too long ago, you took a little vacation with your family, which is always a nice palate cleanser.

Casey Hiers:
Yeah. I've said this many times, burnout's real. Life's real. It's mindset. But Stephen R. Covey's Seven Habits of Highly Effective People, what's the seventh habit?

Jarrod Bridgeman:
Nail biting.

Casey Hiers:
Keep your ax sharp.

Jarrod Bridgeman:
That's right. That's right.

Casey Hiers:
And so if you're a lumberjack hacking down a tree and you don't take time, you don't take breaks, you don't get your mind right ...

Jarrod Bridgeman:
You're just whacking at it with a blunt instrument.

Casey Hiers:
... and you're going to be ineffective, right?

Jarrod Bridgeman:
Yeah.

Casey Hiers:
So yeah, no, those things all help.

Jarrod Bridgeman:
I feel like a lot of times, burnout in any field really comes from an unhappiness with something in that place. I've had previous jobs where I felt burnt out, but that's just because I did not like the company I worked for, versus a place like this, where I actually enjoy coming to work. I like being here, so if anytime I feel burnt out, it might just be I'm tired of looking at this spreadsheet or whatever, that kind of thing. But with dentists and people that own their own practice, they don't really have another opportunity to go somewhere else and be less burnt out, so you need to find, we got to find, what's the core idea. What's the core thing that's really driving this burnout? People try to blame things like, "Oh, it's my staff, I'm just so tired of my front desk lady," but is it really her, or is there something else behind that that's causing that?

Casey Hiers:
Well, that's a good point, and I'm really proud of you. There was no burnout joke, like the people you hung out with in high school were burnt out.

Jarrod Bridgeman:
Yeah, that's right.

Casey Hiers:
The fact that you didn't, then I had to say that, but yeah.

Jarrod Bridgeman:
Appreciate it.

Casey Hiers:
That's a different kind of burnout, right?

Jarrod Bridgeman:
That's right.

Casey Hiers:
That's a good point. There's different types of burnout, right? There's physical, especially in dentistry. It's a physical occupation. And so there's physical burnout, burning out. There's mental, just feeling stressed, frustrated, tired, lost a little bit.

Jarrod Bridgeman:
And how often does that burnout from work carry over to your home life? It's kinda hard to shake that off.

Casey Hiers:
Oh, it's all connected.

Jarrod Bridgeman:
Yeah.

Casey Hiers:
And how about decision fatigue, right, decision-making? People can burn out as a business owner, as a practice owner, on all the decisions and all of that, and then ...

Jarrod Bridgeman:
And if you made a couple bad decisions in a row, you might get that fear of making that decision.

Casey Hiers:
Yeah. No, there's practice owners I talk to. They've spent sometimes like a decade just making decisions, moving forward. And they've made some good ones, they've made some bad ones, but unwinding from the bad ones is exhausting.

Jarrod Bridgeman:
How much of that, especially those first 10 years, would you say ... I think we mentioned that a couple of episodes ago ... but are there decisions based reactionary instead of being like a forethinking, progressive, working towards a goal?

Casey Hiers:
I think a lot of times, dentists and specialists are smart, they're sharp, and I think they get away with some of the decision-making on the front end. I think the hard part comes when the middle of a career and maybe they're making 350 to 550,000, but they're still feeling that stress, that burnout. They've been on this ascent, and then they almost hit a plateau, almost. That can be frustrating.

Jarrod Bridgeman:
And then they kinda sit there for a year.

Casey Hiers:
Well, they're always used to moving forward in their life. You can think about school, college, associate, dentist, practice ownership. There's always that next thing, and then that can become financial burnout. When your money's right, you're happier. When your money's not right, there's more stress, and then, like you said, it's all connected, the domino effect.

Jarrod Bridgeman:
Well, in that mid-career kinda slump, I jokingly said to you earlier today, it's almost like a man in his midlife crisis, where he gets the hot new younger-model wife. Well, with practices, maybe their mid-career crisis is, oh, they bought a new building, or they opened a second practice. Something else to give them that juice that they needed that reminds them of their earlier days of being like, "This is fresh, this is new."

Casey Hiers:
Well, and to be fair, maybe a female also goes and updates.

Jarrod Bridgeman:
Yeah, and gets a nice hot trophy husband, yeah. I can't wait to be one of those.

Casey Hiers:
Yeah. No, that's a good point. They're used to that next thing. And so then, potentially because all these areas ... the money's not exactly right, always wanting to move forward ... they just, "Okay, I'm going to make this big decision, this potential million-dollar cash flow debt, is it going to pay off." That's a lot. That's heavy. That weighs heavy on your shoulders and your health.

Jarrod Bridgeman:
This isn't like petty cash you're playing around with, either.

Casey Hiers:
No, no. And when I talk to practice owners, and they throw out ideas, and I'm like, "Oh, tell me about how you reached that decision," there's not a lot of depth to it. There's not a lot of analytics.

Jarrod Bridgeman:
How often in situations like that, where they grasp the newest thing they can think of, does that actually become a successful venture?

Casey Hiers:
Well, I think it's a coin flip. And I think when you're talking seven digits, coin flip decisions, that's incredibly risky. You're not deciding if you want to do a startup or buy a practice when you're 32, what side of town it's on. Typically, now there's more to risk when you're making those decisions. And again, that analogy of feeling like you're on an island when making decisions, like all of that burnout ... the physical in the chair, the decision-making, the finance, and then all of a sudden your staff, time ... there's no time. "I can't go on vacation. I can't go because my money's not right." It's a ball of stress that so many practice owners are under, and again, not talked about.

Jarrod Bridgeman:
Yep. And some of them, as I mentioned, maybe they open a second location, buy a new building. All they're doing is adding to that burnout if the system itself is not correct to begin with.

Casey Hiers:
Yeah. And you mentioned it earlier, what's the origin of the frustration? And if anybody's in relationships, you'll know that your significant other, if they're frustrated, mad, short, body language, a lot of times the things they're complaining about is not the actual origin or the first domino of the frustration. You're getting the secondary.

Jarrod Bridgeman:
Like when I get yelled at for chewing too loud.

Casey Hiers:
Yeah. It might not be the chewing. It was probably a day or a week of other frustrations that then spill out. And so then again, home life isn't as good, culture in the office. We've said this many times. If the boss is stressed, intense, and frustrated and short, well, that's probably going to trickle down to the staff, but then the staff is a frustration point. Well, is it? If your overhead wasn't 78% and you weren't writing off 40% in insurance, and you were making another $150,000, and you had some certainty in your life, well, some of these other things might not bother you as much.

And we're not going to get into the whole, like Hulk Hogan says, take your vitamins and say your prayers, but is sleep important? Absolutely. I mean, all these other factors, but again, what's the root cause? What's the origin? Bottom line, there's a lot of burnout in dentistry, and it's undiagnosed burnout, number one. It's not talked about. People aren't getting ready in our study clubs, sharing all of their burnout.

Jarrod Bridgeman:
No, they don't share it with their peers.

Casey Hiers:
It's staff. That's the common place.

Jarrod Bridgeman:
Yes. They don't share it with their peers, and they're too afraid to share it with people not in the industry, because we've talked about this before, but to the layman, "You're a dentist. You're a doctor, you own your own business. I'm sure you make great money. You make more than I do."

Casey Hiers:
And that's the temptation, right? "Well, I am burnt out, and I'm frustrated. However, I'm doing better than most." So then you start making deals with yourself and rationalizing. And there's another word that escapes me, but you mentally just try to make, "Well, this is just how it is," and maybe, but perhaps not. Again, if the origin is cash flow and money, and then time, time and money are the biggest resources, so how can you correct that? What things can you do to improve that cash flow? And there's not one, two, or three answers. There's dozens of things that need to be mastered.

Jarrod Bridgeman:
But if you find that solution or at least find a way to help alleviate that, how much ... again, more cash flow, more time, maybe not working on the books after hours and stuff like that ... do you have to then maybe focus on some of the smaller things that frustrate you? Maybe you need to retrain that one person, or maybe you have more time to go out to dinner with your family, whatever the case may be. Those little things can all help. Every little bit helps.

Casey Hiers:
Instead of pining over QuickBooks or other documents.

Jarrod Bridgeman:
Or trying to get a hold of your tax accounting and then trying to talk to your finance guy.

Casey Hiers:
Yeah. Instead of spending five hours a week on QuickBooks. Well, my gosh, if you could be out in nature working out, would that help? Yeah. That's a small one.

Jarrod Bridgeman:
But again, things add up.

Casey Hiers:
Yeah.

Jarrod Bridgeman:
What's the one thing, is that if you're in the office eight hours, nine hours, whatever that day, and then you go home and work on the books, yeah, I think you're going to get burnt out. I get burnt out on just hanging out with my kids. Boy, sports every week. All kinds of stuff, dude.

Casey Hiers:
Yeah. In dentistry, they're diagnosing issues with patients all day. Use that muscle memory and that skill to diagnose what is causing. And again, a lot of practice owners don't feel a ton of stress. A lot of different lanes here, but even the ones that don't feel stressed, they feel uncertainty. They're like, "Well, I think. I think, and I hope when I talk about retirement and end goals," and sort of, "I think this, and I hope this," and those two words are big tells that you're busting your hump to produce dentistry, and just keep moving forward with your head down and everything's going to work out. Again, there's that feeling in the pit of the stomach sometimes, that is it?

And that's a heavy weight that practice owners carry, and then it's, "Well, I'm going to try one new thing," and they hope that that one thing fixes everything, right? "Well, I'm going to renegotiate my insurance fees." That's a good start, right? There's nothing wrong with that, but that's not going to solve everything.

Jarrod Bridgeman:
No.

Casey Hiers:
You have to properly diagnose.

Jarrod Bridgeman:
Even if you need to speak to a specialist or an expert. I mean, just last week my tooth hurt, and so I went and saw my dentist, and she actually diagnosed what the actual problem was. All I said was, "Well, I feel like my jaw hurts and my tooth hurts." So maybe your cash flow hurts, maybe this hurts. You may not know the specific reasons or the things of why it's not going as well as it goes, but reaching out to your CPA, to your planners, or bringing in someone else to help you run a diagnostics. Talk to the people that know what they're doing and can help with you, help you at least find out the problem, get your prescription.

Casey Hiers:
Yeah. And there's an old saying, right? Diagnosis without examination is malpractice. If you walked in to your dentist, who happens to be a client of ours, and just like, "My tooth hurts," and they were like, "Oh, it must be this," and they start treating something that doesn't need treated or don't treat it in the right way, well, it's not going to solve anything. Same thing with sources of burnout and frustration. You got to get to the bottom of it. But the other problem is these external people that help the business side of dentistry. There are a lot of cheerleaders, and there's a lot of folks that tell their people what they want to hear, not what they need to hear when it comes to money. And we're talking accountants, investment advisors, personal financial planners, practice advisory. There's so many cheerleaders, because again, well, you're the dentist, you're on the mantel here.

Jarrod Bridgeman:
And cheerleaders make you feel good.

Casey Hiers:
They make you feel good, no doubt about it. And it's like, are they going to make you better? Again, are they going to help you retire years earlier, stop getting tax surprises, finally correct the insurance adjustments in your practice, finally improve cash flow in your practice, get that income where it needs to be? Unfortunately, a lot of practice owners work five days a week, and they almost flirt with working a half a day on Saturday. No, no, no. If you're working five, what's the plan to work four? If you're working four, what's the plan to work three and a half, while you're also improving all these things? It's all connected, but time and money.

Jarrod Bridgeman:
And let's say you fix all of this. You got your cash flow right, you've got your retirement savings starting to be where you want it to be, and all these other things, and you still feel kinda burnt out. It might just be something else beyond cash at that point.

Casey Hiers:
Oh, yeah. There's a lot of other factors, right? But again, typically when these top-line items are good, if you've got more time and money and less stress, those three things typically help the other. That being said, there's a lot of people we talk to like they have some serious personal things going on in their life, and that's not going away. But I mean, we encourage people that come to our events, like, "Talk to your external team. Get these things right at minimum, because they don't just take care of themselves. Things don't just get better by happenstance. Typically, you've got to have some focus on it."

Jarrod Bridgeman:
And ignoring it doesn't help either.

Casey Hiers:
So many practice owners in dentistry, they have the perfect technique, and they have the perfect mindset, and they execute wonderful dentistry, and then they don't use those same principles in other areas of their life, and it can be hard. And I mean, even here, when people, they do have their money right, and they do have more time and less stress, there's still burnout that we're looking for, right? How are people doing? Let's talk about the real things. And it sounds so simple, but having those conversations with your entire team. Typically, it's emotional, but people walk away going, "Oh, my gosh, I should have talked about this sooner. I wish I'd done this plan years ago instead of now," but it's all about looking forward. People can feel vulnerable with a topic like this. Trying to identify sources of stress or burnout is a vulnerable feeling, but ultimately, solving it puts you in a much, much better place.

Jarrod Bridgeman:
This isn't grade school. We're not going to make fun of you if we're feeling bad about something. Casey, thank you so much for stopping by and talking about this. One of the things that people can do to maybe even start thinking in the right process is attending one of our CE events. As usual ... we talk about it every week ... we've got events coming up. We're going to be in Columbus, Ohio. We're going to be in Cincinnati. We're going to be in Rochester. We're going to be in New York and Amherst. We're going to be all over the place, Orlando, even our home area of Carmel, Indiana. That's a new one that's coming up here pretty soon. So if you're interested in attending one of our events, please go to fourquadrantsadvisory.com and click the little button that says Events, and you'll find your way there. Casey, thanks again so much for stopping by, and you're traveling again this week, so have a good time.

Casey Hiers:
Thank you.

Announcer:
That's all the time we have today. Thank you to our guests for their insight and for sharing some really great information. And thank you to you, the listener, for tuning in. The Millionaire Dentist Podcast is brought to you by Four Quadrants Advisory. To see if they might be a good fit for you and your practice, go on over to fourquadrantsadvisory.com and see why, year after year, they retain over 95% of their clients. Thank you again for joining us, and we'll see you next time.