In many of The Wealthy Dentist surveys dentists have complained of career burnout.

Burnout is considered either emotional or physical exhaustion, usually caused by stress at work. It was initially described in the 1950s by Hans Selye as ‘the nonspecific response of the body to any demand made upon it and discouragement in the work setting’.

According to the U.C. Irvine report, burnout is viewed also as a complex of psychological responses (strain) to the particular stress of constant interaction with people who are in need. Differing from other interactional symptoms related to job stress is the effect on others seen as a depersonalization of clients.

Symptoms of Burnout -

1. Negative Feelings.
Feelings of disillusionment and being ‘stretched too thin’. Feeling that you aren’t making a ‘difference’ in your approach to lifelong goals. Other feelings of burnout are the feeling of being ‘run down’, easily frustrated and feeling that you are unable to concentrate.

2. Interpersonal Problems.
Your tolerance level drops as the burnout grows and you find yourself increasingly unable to handle social interactions. You begin to dehumanize your relationships by thinking of your dental patients not as people but as objects.

3. Physical Manifestations.
Burnout shows up physically as exhaustion, muscle pain, headaches, insomnia, respiratory illnesses, gastrointestinal disorders, depression, and hypertension.

4. Substance Abuse.
Often people suffering from burn-out will self-medicate their anxiety, depression and insomnia with drugs or alcohol.

5. Inefficiency at Work.
Burnout causes productivity to wane as you become less effective overall, either by hiding in your office or staying away from work more often.

Remedies for Burnout -

1. Take a Two Week Vacation.
Quite often by distancing yourself from your work you will be able to make some decisions on things you can do differently to alleviate stress when you return to your dental practice.

2. Cut Back Your Work Hours.
Sometimes burnout appears from an unwillingness to delegate job duties. Consider cutting back on your work load by delegating tasks you don’t enjoy and consider cutting back your dental practice hours if you can.

3. Schedule Time For You During the Day.
Make sure you always take a lunch break. Make it at least an hour and a half three days a week and schedule some light exercise for the last half hour like a brisk walk around the block or a yoga class.

4. Put Your Health First.
Go to bed at the same time every night and work on getting enough sleep. Look at your diet and see where you can cut out high sugar foods, and make time to relax with good friends on weekends.

5. Write Your Thoughts Down.
Some people find that keeping a journal at home and expressing your feelings of frustration on paper can go a long ways towards helping you deal with burnout. Commenting anonymously on this blog might even help too.

The most critical thing about burnout is to recognize it’s a shout out from your exhausted self. Try changing things up a bit in your life to break out of your routine. Come into the office thirty minutes later, drive a different route to work, learn a new hobby, or work on something you love. Take a break and list all the reasons you chose dentistry as your profession in the first place.

Have you ever suffered from burnout?  What advice would you give dentists for dealing with burnout?

Considering the state of the economy, we wondered if this is still an accurate financial assessment of dental incomes.

The Wealthy Dentist conducted a survey asking dentists if they think that they are wealthy. Two out of three dentists said no, they are not in fact wealthy.

“The idea that all dentists are wealthy is absurd,” wrote a Minnesota dentist. “The public has no idea what it costs to run a dental clinic. Lab bills are $12,000 a month. Salaries are $20,000 a month. Add in equipment, rent, liability insurance, and of course, endless supplies, and now you have some very serious overhead. In reality, dentists must produce so very much revenue before they pay themselves that very few dentists are truly wealthy.”

Click on Play to watch the video and hear what dentists are saying about being wealthy -

Do you feel that most dentists are wealthy? Leave us your thoughts in the comments.

Many dentists are hesitant to increase their fees over fears that they will see a reduction in patients.

The fact that the U.S. is currently reentering a second major economic slowdown in three years turns a fee increase into a serious dental practice management issue.

As one Illinois dentist put it, “I am concerned about raising fees and losing patients who already have money woes.”

The Wealthy Dentist decided to survey dentists and ask them when was the last time they raised their
fees. Here is how dentists responded:

• 27% raised their fees in the last 6 months.
• 29% raised their fees in the last year.
• 26% raised their fees in the last 2 years.
• 11% raised their fees in the last 3 years.
• 7% raised their fees in the last 5 years.

Suburban dentists were 3 times as likely to have raised their fees than their urban or rural counterparts.

What dentists had to say:

Economic woes …

“I am hesitant to raise fees due to present “slow” period.” (Kansas dentist)

“I raised them in the last 6 months, but I had not raised them for 3 years because of the economy.” (Texas dentist)

“We wait and see how the economy does.” (Tennessee dentist)

“It’s tough-as-hell to do in this economy.” (Illinois dentist)

“With this economy and my competition, I felt I should lower some of my fees.” (Missouri oral surgeon)

Keeping pace with inflation …

“We at least raise them annually to cover for inflation (approximately 3%). We raised our gold crown fees significantly more due to the increased price of gold and the lab fees.” (Ohio dentist)

“We raise them every year usually by about 2 – 3%.” (Minnesota dentist)

“Gold is up, so fees must follow. Our distributors adding gas surcharges, so they need to be addressed.” (New York dentist)

“Fees should be raised every year to keep up with inflation, increased supply fees and the loss of value of the dollar.” (Kansas dentist)

“We raise them every year on Jan. 1.” (Florida dentist)

“We raise our fees on a rolling schedule. We raise fees in certain areas (hygiene one quarter, crowns the next quarter etc.) every quarter. We base our fee increases on the prevailing fees in our zip code which we obtain through an annual fee survey which we purchase. While it may not be 100% accurate, it gives us a guide as to the fees in the area.” (Illinois dentist)

Insurance is a problem …

“How can we raise fees when insurance dictates everything anyway? One time a patient has Met-life that pays the fee for a service and the next time that we see them they still have Met-life, but the fee-schedule plan is at greatly reduced fee. Our fees don’t seem to make much of a difference. The insurance companies set fees at 1995 levels.” (Texas dentist)

“Are other dentists experiencing denied, or reduced fees that are submitted to the insurance companies lately (e.g., Delta)?” (California dentist)

“I haven’t raised fees for 3-4 years. I used to raise them every year. But raising fees is almost a moot point because the majority of my patients are on PPO insurances that are not raising fees at all, and in some cases, lowering reimbursements.” (Nevada dentist)

Have you raised your treatment fees? Tell us your thoughts in the comments!

The Wealthy Dentist decided to ask dentists if they projected their dental practice revenue for 2011 to be more than it was in 2010.

A Illinois dentist replied, “It depends on when the debt limit is set.”  Another Illinois dentist agreed by saying, “If Washington can just get it together, we’ll be fine.”

Dentists were evenly split with their responses: 38% of the dentists surveyed said their revenue in 2011 will be greater then 2010; 30% said their revenue will not be better than 2010; 29% felt their revenue would be the same, while 3% weren’t sure.

Here’s what dentists had to say about 2011 dental practice revenues -

Revenues are down for some -

“We are probably down about 5-7% from 2010.” (Illinois dentist)

“So far we are 3% less.” (Louisiana dentist)

“My gross revenues are about 1/2 of what they were before 2008.” (California dentist)

Too many dentists worry others -

“We have too many dentists in same small area.” (Oklahoma dentist)

“There seems to be too many dentists here.” (Florida dentist)

“Can we turn off the flow of new dentists? Or at least reduce it? I don’t know one general dentist with revenues up in 2011 and more numbers of dentists than ever going to managed care practices driving fee prices down. It’s terrible.” (Colorado dentist)

Some dentists are thriving -

“Up 40% over 2010 which was a good year.” (California dentist)

“An office with good leadership will thrive in any environment!” (Kansas dentist)

“We are projecting to do 2.2 mil this year with one doc and three hygienists.” (Pennsylvania dentist)

Reinvention is key -

“I’m taking courses and adding more treatment options to increase profitability.” (Virginia dentist)

“In spite of the weak economy we have had increased revenue the past three years. We have advertised using discount based ads based on the economy. They have worked well.” (Colorado dentist)

“Every 3 months we examine how many unscheduled treatments are out there and make a personal call to the patients to see what the issue is and work with them to get them into treatment.” (Oregon dentist)

“I am currently ahead in production about 20%, but collections are behind and we are readdressing our financial policy.” (California dentist)

“A 5 percent increase over last year. We work 4 days a week about 9 hours a day. We noticed for us in downtown Philadelphia, that patients do not tend to show up on Fridays and Saturdays in the summer. We have a summer schedule where we work Mon. Tues. Wed. and have a long weekend. That has been the best change of schedule and thus our time at the office is more productive.” (Pennsylvania dentist)

How is your dental practice revenue in 2011?

As part of The Wealthy Dentist dialogue on dental practice management and marketing, we offer weekly surveys and invite your participation.

In order to understand different perspectives on the dental industry, we have developed surveys to canvas a diverse group of dental practices on their view of the dental industry, what constitutes current good practice in dental marketing and quality care.

The information collected will be used to prepare articles for The Wealthy Dentist readership.

The survey should take no more than 90 seconds to complete -

“We are finding that the recession has actually gotten worse,” said one dentist.

In fact, only 18% feel things are improving. For 78% of dentists and practices, the recession is still going strong.

Here are some dentist comments:

• “Still doing big cases, but fewer. Feeding the staff too. Going to survive, but it was a rough 2009, and 2010 has not been a lot better. It took a while to adapt.” (General dentist)
• “Down 40% over last 2 months. Across almost all dental offices we’ve talked to and almost all business.” (Pennsylvania dentist)
• “Forty years and worse business than ever. Almost no new patients and lost a dental hygiene day for first time in 38 years.” (California dentist)
• "We are working harder, but we are up 10% for the year." (General dentist)
• “Definitively slowing down since beginning of September.” (Orthodontist)
• "We are finding that the recession has actually gotten worse." (Pennsylvania dentist)
• "Yes, I feel that the recession is finally over, but I'm not holding my breath that there won't be a double dip recession on the horizon. We are staying prepared just in case!" (Ohio prosthodontist)
• “How can the recession be over when the unemployment rate is at record highs?” (California dentist)
• “While I see some improvement, my schedule is so much lighter than two or three years ago. The majority of my patients choose to do only essential dental work and defer most cosmetic dentistry treatment.” (General dentist)
• “If we listened to everything the Government said we would all be taken for fools!” (Florida dentist)

Read more: Dentists Say the Recession Is Not Over

“It’s a good idea to keep your name out there. An economic downturn does not mean people will not need dental implants and dental care!” advised one dentist.

While 38% of dentists in this survey say they're increasing marketing and internet dental marketing, only 33% report cutting spending.

Read more: Dentists Increase Dental Marketing in a Recession Economy

Half (48%) said they're reducing office expenses, 30% are instituting layoffs or staff reductions, and 13% are reducing employee compensation.

In terms of  dental marketing, 30% have increased their spending, while 9% have reduced marketing costs.

Here are some of their comments:

• “In rural areas, the downturn is not affecting us as much. We don't see the big ‘ups,’ but also don't see the big ‘downs.’” (General dentist)
• “People are reluctant to spend.” (New Jersey dentist)
• “We are relying upon the internet for more of our new patients, especially Yelp.com."
• “Fewer chairside hours.” (California dentist)
• “We did not lay off team members, but we chose to work with a smaller team and did not replace some team when attrition occurred. Team has 6, including 1 dentist.” (Canada dentist)
• "We added staff.” (Georgia dentist)
• “We have added new procedures.” (Texas orthodontist)
• “We negotiated and joined a couple of dental insurance plans. We negotiated a very good fee schedule and are getting more new patients, too!” (Ohio prosthodontist)

Read more: Recession Economy Affects Dentists, Dental Practices

Well, it just may be an example of the "lipstick effect," wherein people only splurge on small luxuries during hard times.

It's said that Americans bought twice as much lipstick after 9/11.

The survey also revealed that more women would be willing to part with their hair dryer or straightener than their electric toothbrush.

Read more

According to an ADA survey, half of dentist respondents reported that, during the final quarter of 2008, they saw fewer patients and made less income.

Dental patients have not stopped seeking dental care, but they're more likely to drag their feet nowadays. Dentists report that some patients are choosing less expensive treatment options and postponing regular hygiene visits.

Read more about it