The Hidden (Financial) Cost of Burnout

I recently DSO is people burnout and are spoke was more amongst not with stressed surprised her the team. HR than to Director hear ever It at a large national that her major concern is well-documented that following the onset of the COVID-19 pandemic. Things have gotten so bad that on May 23rd, 2022, the Office of Surgeon General issued an advisory “highlighting the urgent need to address the health worker burnout crisis across the country”. Even before the pandemic hit, the World Health Organization (WHO) included “Burn-out” in its 11th Revision of the International Classification of Diseases (ICD-11) as an occupational phenomenon and updated its definition to read as follows:

“Burn-out is a syndrome conceptualized as resulting from chronic workplace stress that has not been successfully managed. It is characterized by three dimensions:

• Feelings of energy depletion or exhaustion;
• Increased mental distance from one’s job, or feelings of negativity or cynicism related to one’s job; and
• Reduced professional efficacy”.

In addition to the health-related issues resulting from burnout,

which are considerable, there are important financial considerations Dentists need to be aware of, both personally and as an employer.

Productivity

As the WHO points out, productivity tends to suffer when someone is experiencing burn-out. There is ample evidence explaining how burn-out impairs focus, attention, motivation, problem-solving skills, and leads to severe emotional and physical exhaustion, all of which drain productivity. In addition, burn-out leads to health-related issues, and businesses see an increase in absenteeism and employee turnover. Consequently, a practice fraught with burn-out will likely experience a negative self-perpetuating cycle similar to the following:

• revenue drops as team members are out sick more frequently, leading to fewer patient visits
• team members are less engaged and motivated at work, leading to lower case acceptance rates and new patients
• team members must take on others’ work while they are out, leading to increased cynicism and resentment amongst the team
• patients pick up on the tension between team members and have a poor experience
• the practice reputation suffers as the quality of care declines, limiting the number of new patient consultations

As entrepreneurs and leaders, dental practice owners need to be mindful of their own wellbeing, as well as their team’s, to ensure they are running a productive practice. Just like when the airlines encourage you to put your own oxygen mask on first, you need to take care of yourself properly so you can be the leader your team needs and provide the clinical care your patients deserve. Below are a few suggestions that can help you become reenergized and productive in the office:

1. Remember your why -- a byproduct of burn-out is detachment and experiencing a loss of meaning in work. Most dentists did not go to dental school to learn how to run a business; rather, they went to school to learn the skills to care for patients. It can be easy to lose sight of your why when having to keep up with the day-to-day demands of being a business owner and a health care provider. By intentionally contemplating your why, you can reignite your passion for practicing dentistry and/or being a leader, which will lead to a more productive and enjoyable day.
2. Delegation -- by constantly revisiting your why, you will become more aware of the areas in your life and daily responsibilities that detract from your happiness and productivity. Remember, as a business owner, you have the power to structure your business however you want. If items drain your energy, find someone who enjoys doing that type of work and empower them to do it well.
3. Take control of your day by owning your calendar -- If you don’t take control of your own schedule, someone else will. One major cause of burn-out is feeling a loss of control, so be mindful of how you structure your day and do not compromise. Furthermore, consider timing certain events to occur at specific times of the day to optimize the results. For example, a growing body of research supports making key decisions early in the day while you have the brain power to make good decisions; decision fatigue is a real thing! In addition, timing your exercise and meals can give you the energy needed to power through your day. Finally, you must prioritize getting proper sleep to stay healthy and function at a high level.

Don’t forget about your team; they also need to prioritize self-care and are looking to you as the leader to empower them to do so. Remember that what works for you may not work for others, so

a be empathetic to the needs of your team members and be patient

very bad thing. Similar to acute cortisol exposure, it reduces as you work together as a team to strike the right balance as a

the quality of our judgment and our ability to assess objective group.

probabilities”.

As a CERTIFIED FINANCIAL PLANNER™ working with den-

From my experience working with investors during the 2008 tists, I understand the positive impact running a profitable prac-

Financial Crisis, the 2020 and 2022 bear markets, I have witnessed tice can have on the well-being of dentists, their families, and team

impulsive fear-driven reactions first-hand. Despite all the research members. As your practice becomes more profitable and cash flow

that promotes staying the course and discouraging “panic-selling,” improves, you will have opportunities to reinvest in your team’s

investors give in to their emotions when things are uncertain in well-being, reverse the self-perpetuating cycle of burn-out, and

the financial markets and economy. increase the overall value of your business. As burn-out declines, morale amongst the team improves, patient care improves, and

An effective method to prevent “panic-selling” is to implement the virtuous cycle fuels itself forward.

a rules-based, disciplined approach to managing a portfolio. For example, automate your savings so you continue investing during both good and bad times. Counterintuitively, investing during a DISCRETIONARY INCOME AND SPENDING

bear market is a good thing for long-term investors because assets are acquired at discounted prices. Furthermore, consider rebalAnother hidden cost of burn-out relates to personal disposable

ancing your portfolio using pre-defined thresholds or at periodic income and expenses. Specifically, individuals coping with burnintervals. The key is to stick with whatever game plan you develop out will likely see their income drop over time. As health declines,

and to remain disciplined. people will be out sick more frequently and need to see the doctor more often, resulting in higher medical bills. For both dentists

Lastly, consider hiring an objective third-party fiduciary to oversee and team members, less time in the chair means less money. Furyour investment strategy on your behalf. thermore, those participating in an incentive compensation plan may receive lower bonuses because they have grown disconnected

Fortunately, people can recover from burn-out and regain their from their work, resulting in a lackluster performance.

motivation, focus, productivity, and health. Much of the research relating to burn-out focuses on health and well-being, as it should; In addition to making less money and spending more on medical

however, the financial ramifications can be devastating as well. If bills, burn-out can also impair judgment leading to poor spending

you or anyone on your team experience symptoms of burn-out, decisions. When someone is overworked, feels underappreciated,

seek help from a professional or contact the ADA or state dental and is exhausted, they can justify spending more money on themsociety to inquire about available programs in your area. selves. Whether it is out of convenience, like paying more for food delivery services, or large splurges to treat oneself for their hard work, burn-out impacts the part of the brain that modulates impulse control and willpower. When exhausted after a long day, people don’t have the energy to monitor their finances diligently and are prone to impulsive purchases.

enjoys partnering with clients to design a life that is in alignment with their beliefs, When people are stressed, activity in the pre-frontal cortex slows,

values, and aspirations. His ultimate role as a which is where more complex cognitive behavior occurs in the

Wealth Advisor is to empower clients to focus brain. In response to a stressor, the nervous system triggers a “fight

on what matters most and to live a fulfilled or flight” reaction in the body, which prompts people to eliminate

life. Thomas is a Partner and Wealth Advisor the threat and seek safety at all costs. The “fight or flight” response

at CI Brightworth. He graduated from The University of the South is hard-wired in our brains as a survival mechanism and hapin Sewanee, TN, in 2006, obtained the CERTIFIED FINANCIAL pens automatically. In the event of life or death, there is no time

PLANNER™ certification in 2011, and the Certified 401(k) Profesto think through all aspects of the situation or to contemplate

sional designation in 2014. He is originally from Atlanta, GA, and has various possible outcomes.

lived in Charlotte since 2006. He and his wife, Erin, are proud parents to two amazing childrena daughter and a son. Though what we perceive as a “threat” has evolved, our brains still behave the same way today when we feel threatened. When someone is experiencing burn-out, the “persistent overhang of stress results in chronic exposure to elevated levels of cortisoland permanently higher levels of cortisol in our bloodstream is