How to avoid burnout
In thinking about strategies to combat stress and burnout, most experts link physical activities to better mental health
As the leaves are in full bloom, summer has finally arrived. Thoughts turn to escape and holiday destinations. All too often, we can let our appointment book dictate our time off. And some of us, particularly new graduates, can fall into the trap of pushing holidays out and out and out!
The dental surgery (specialist and general) has a lot of moving parts. Aside from clinical knowledge and application, clinicians also must contend with running a business. In today’s busy environment and the “always on” phenomenon – it is little wonder that recent surveys have shown a sharp up-tick in burnout. Some clinicians will shrug their shoulders and say: “That’s all part of the job”. However, post-Covid and the ‘Great Pause’, it has given clinicians and researchers alike, time to better examine the factors, causes and solutions to burnout.
The Institute of Professional Worklife, based in Minneapolis, Minnesota, has many tools which are geared toward clinicians – to assist them in better understanding the stress they encounter in everyday practice. In a recent paper in the Journal of American Medical Association (Linzer, M., 2018. Clinician burnout and the quality of care. JAMA Internal Medicine, 178(10), pp.1331-1332.), Linzer discusses the factors and causes. This thought provoking paper also links to the Mini Z (Zero Burnout Programme) Toolkit which at its heart is a short survey allowing the participant to adequately assess their level of comfort/burnout. The questions are easy to read – and provide some good cues for the clinician to really understand their levels of burnout.
Some key factors suggested by this study and questionnaire, rest on comfort in the workplace.
How much control (or otherwise) do you have in your surgery? Have you been bothered by lack of interest in your role? These and other insightful questions build an honest picture of where you are on the burnout scale.
The bedrock of burnout scales, however, probably rests with the Maslach Burnout Inventory (MBI) This is a validated instrument with more than 35 years of research supporting its structure and its captured data. It’s a particularly useful tool when it is answered honestly and truthfully.
One of my hats is as Adjunct Faculty at the Graduate School of Healthcare Management at the Royal College of Surgeons in Ireland (RCSI). We use the MBI in our pioneering course (now seven years old) which is the Professional Diploma in Clinical Leadership. Candidates are put through their paces on many aspects of clinical leadership – including team dynamics, organisational structure, clinical leadership and finance. Each year, the Burnout Inventory is used by the candidates at the start and the end of the diploma. And each year, candidates report on its efficacy and guiding data when applied to their own situation.
More often than not, it’s the relationships and activities outside the surgery that provide the most support to clinical staff. That is not to undervalue the team esprit de corps in the clinic – but rather to underline the value of work/life balance. It seems that most dentists still fall in to the trap of paperwork at weekends or after surgery hours. The economics of form filling versus treating patients makes administration more cost-effective to do outside of surgery hours. That said, how often have we sent (or answered) a clinical query be email in late evening? Is this a regular occurrence? This, among other tell tale signs, could indicate that work is getting out of hand.
There is growing evidence within the literature that wellbeing is directly related to higher-quality treatment and better patient outcomes. This might seem self-evident, but recent research has captured the direct corelation. Who amongst us has not groaned at the thought of a denture reline or re-try in for complete dentures on a cold dark November morning? Or celebrated with a smile on the fitting of a well proportioned PFM crown with perfect colour match?
In thinking about strategies to combat stress and burnout, most experts link physical activities/sports to better mental health. While the dental professional has been synonymous with golf over the years, the upsurge in walking (particularly Camino style walks) within Ireland, has seen many dentists take to the pilgrim paths of Ireland recently.
So, whether you are planning that sunny Spanish golfing holiday or braving the showery July walk on St Declan’s Way in South Tipperary, make sure to take that break. Use a tool such as Maslach to assess your own level of burnout – and take the appropriate action.
Finally, my thanks for the many comments on the column. In the last edition, I was pondering the use of AI and other technologies to assist in future clinical practice. I mentioned the use of radiography and wondered about how it might be further used in the future. Of course, we are still in 2024, and, as with all clinical instruments and tools, the current approved guidelines for all aspects of patient care provide the best and optimum advice and guidance for clinicians and their management of patients. It is prudent, sensible and correct to always follow the current thinking and guidelines to provide optimum care for all patients.
Author
Dr Paul O’ Dwyer BDS MSc (Healthcare Mgmt)
