What Burnout Really Looks Like in Dentistry and How to Reset

If they are starting to think about leaving the profession, if they are feeling hopeless and struggling to see a path forward, these are the types of things where there needs to be something more than just, you know, the micro resets that we talked about. We need to either look into getting therapy and medication or looking at, you know, just the clinical workload and see is there something that can be changed. Welcome to Austin, Texas, and welcome to the Dr. Phil Klein Dental Podcast. I think anybody who's in an operatory that practices dentistry knows that dentistry as a profession is very demanding. It requires precision, focus, responsibility, and so much more. And on most days, you're expected to deliver all of that back to back, patient after patient, often without much time to pause and reset. But what happens when you start to feel a little different? Maybe the work that used to energize you now feels draining. Maybe your patience is a little shorter. Your focus isn't quite as sharp, or you find yourself carrying the stress of the day home more than you used to. Are those just normal tough days in dentistry, or could they be early warning signs of burnout? On today's episode, we're going to talk about something that doesn't get discussed nearly enough in this profession, how dentists can recognize the subtle emotional and physical signals that show up long before full burnout sets in. Things like emotional fatigue, irritability, feeling disconnected from patients, or simply not feeling like yourself anymore. My guest today is Tiffany Castellanos. She is a licensed clinical social worker with a master's degree in social work and a practicing psychotherapist. But what makes her perspective especially unique for this audience is that her husband is a dentist, actually a prosthodontist. So she understands the pressures, the pace, the perfectionism. and the unspoken expectations that so many dentists quietly carry. In our conversation, we're going to explore some very practical things dentists can do to protect their mental energy, like quick micro-resets you can do between patients without slowing down your schedule. We'll also talk about the double-edged sword of perfectionism and the difference between perfectionism and clinical excellence. We'll also get into one of the trickiest areas for dentists, boundaries with patients. Where do dentists tend to get into trouble? Is it over explaining procedures, feeling uncomfortable about fees, or answering texts and messages after hours because they don't want to seem unhelpful? And how do you set healthy boundaries while still being compassionate and patient-centered? And of course, leadership plays a huge role in all of this. If you're managing a dental team, balancing being supportive with being clear and assertive can add another layer of stress to the day. And finally, we'll talk about when it might be time to bring in outside support, whether that's coaching, therapy, mentorship, or even taking a closer look at your work environment. Because every dentist has rough weeks. That's part of the profession. But how do you recognize the difference between a tough stretch and something deeper that deserves attention? It's an important conversation and one that I think a lot of dentists will relate to. Before we get started, I'd like to thank all of you for tuning in. If you're enjoying the show, please follow us on Apple Podcasts and Spotify, and even better, leave a review. By doing so, you're not only showing support for what we do here, but your reviews are instrumental in getting more dental professionals to listen and benefit from our content. We really do appreciate it. Tiffany, welcome to the show. Thank you so much for having me, Dr. Klein. I'm really excited to be here. We're very happy to have you on the show, not only as someone who really understands dentistry through your family connections, because I know your husband's a dentist, prosthodontist, but also from the perspective of a therapist who is very busy helping people with their issues. So I think it's very timely that we have you on the show considering how pervasive burnout is in the dental profession. And that is the topic of today's episode. To begin, let me ask you this. emotionally depleted or not quite like themselves. I think we've all been there. What are the early warning signs of burnout that they should not ignore? And also talk to us about the subtle signals, both emotionally and physically, that typically show up before full exhaustion hits. Yeah, so I always like to kind of define what we mean by burnout. And basically, burnout is caused by prolonged chronic work-related stress. And it happens when the person gets to the point where the demands of the job exceed their emotional, physical, mental capacity. So some early warning signs that that might be happening include this constant feeling of exhaustion. So not the type of exhaustion where once you get a good night's sleep, you wake up the next day and you feel recharged. This is the type of exhaustion where you can't recharge, where you wake up and before the day even starts, you already feel mentally drained. Okay, so that's one sign, just constant exhaustion. Another is irritability. So this might show up with maybe less empathy towards patients. or patients who are especially anxious patients. This could show up with being maybe a little more snappy or short with staff. So irritability is another one. And then a third one that I see a lot is a decrease in professional satisfaction. So where a dentist might go from the feeling, I really enjoy what I do to just getting through the day. So from the information we have, how prevalent do you think burnout is? amongst our colleagues. Well, I'll say the statistics show that over half of dentists will experience some form of burnout. So it is very prevalent. And yes, in my own family, I saw that happen. And that's actually what motivated me to... been a psychotherapist. My clinical training is a clinical social work, but I have a private psychotherapy practice. And I've been a psychotherapist for many years. But as I saw, had a front row seat. My husband's a dentist, a prosthodontist. And I saw just the professional demands he was under and some of our friends who are also dentists. I realized that dentists. aren't really are trained highly trained to care for others but there's nobody who's really caring for them and they have a lot of stress and it wasn't just what i was seeing anecdotally among my husband and friends when i did my own research i saw that there's a lot of statistics about dentists um so uh 40 of dentists identify as having some sort of mental health challenge whether that's anxiety depression um They're about 40% of dentists think about leaving the profession. That's a lot. Very high. Dentists have two to three times a higher suicide rate than other professions. Yeah. I mean, when I went into dentistry way back, people would say, why would you want to become a dentist? Because, you know, it was that proverbial, it has the highest suicide rate. I don't think it does anymore, but it's still up there. It's still very high up there. Yeah. So before we go on. And I want to ask you a whole lot of stuff about the nervous system and resetting yourself to try to get out of this funk. But the bottom line is it's so prevalent. Do you think it's the clinical aspect of dentistry? Do you think it's the business aspect? Is it the patients working with patients that are demanding? Is it one thing or is it just piled up on top of each other where, you know, there's nowhere to escape? Everywhere you turn, there's some bucket of stress that faces you. And after a while, that becomes overwhelming. And then you kind of blame it on yourself and feel like maybe I'm just not cut out for this. I know we talked offline. It may not be the actual person themselves not having the capability of getting through it. There's something deeper there. But do you know if it's the clinical that's the major part of this? It's not one thing. I think what it is is... dentists have to juggle so many balls and wear so many hats so from you know their clinical workload managing staff uh financial pressures of trying to run a profitable business the physical strain you know wear and tear on their body all of that contributes to you know, the things that we just talked about. So it's not one thing. It's the kind of a combination. I will say, though, in my own practice, when I've treated dentists, one of the stressors they say that is the most challenging for them is managing staff. We'll be getting right back to our guest in a second. But first, for the optimal bond between zirconia and your resin cement, check out Bisco's Z Prime Plus. Rated best in class by thousands of top clinicians, Z-Prime Plus, featuring MDP, creates a strong, reliable bond to zirconia, metal, and alumina substrates. And nothing could be simpler. It comes in a single bottle, and it's 100% compatible with both light-cured and dual-cured resin-luting cements. It's time you get the most out of your zirconia restorations. To learn more about Z-Prime Plus and the entire Bisco adhesive product line, visit bisco.com. So what are some simple, what we can call micro resets a dentist can realistically do between patients that don't require leaving the operatory or heaven forbid, adding any more time to the schedule. We don't want to do that. And the objective, I assume by doing these things during the day, what we call these micro resets is kind of like releasing the valve a little bit and letting the pressure out. So by the end of the day, You don't have this buildup where you just feel like, you know, by the end of the day, you just want to blow up. Exactly. So one of the things that I hear from dentists is that they're just the whole day they're always on and that that can be overwhelming just going from patient to patient. Plus, you know, maybe your front desk needs to come talk to you there and ask you a question. or your hygienist needs you to do hygiene checks. So it's just, it becomes overwhelming and your nervous system can become, you know, dysregulated. So what I like to talk to Dennis about is how to practice this idea of micro resets, which is basically a brief intentional pause in between patients. And it's designed, I tell them the three, think of three R's, release, reset, reenter. So the release part of the reset is releasing physical tension. So maybe doing some standing up, doing some neck rolls, shoulder rolls, shaking out your fingers, your hands, squeezing, releasing, getting some of the tension out of your hands, and then taking some deep breaths. That's very helpful for calming down the nervous system. And in fact, they've done some research on deep breathing. And it's really important when you do the deep. breaths, that your exhale is longer than your inhale because that relaxes the parasympathetic nervous system. So I will say try to think of four, six, breathe in for four and breathe out for six. And if you can do three slow breaths in between your patients, that helps with the release part. And then, you know, reset part would be to kind of mentally say to yourself, okay, I'm this appointment with this patient is done. I'm closing that. That's over. And then let me think about who my next patient is. Take a pause, prepare kind of for the next patient so that you can kind of enter into the room with calm presence. The breathing part certainly affects your nervous system. Is there anything else they can do to combat the psychological challenges they're facing when it comes to, like you said, they could have a full night's sleep. They slept eight hours. They should feel rejuvenated, but they get up. and they're not and that's that's not physical necessarily even though it's obviously tied in together you can be tired from psychological problems so what's psychological exercises can they do that actually allow them to relax that way even though like you said the breathing is certainly part of it yeah so breathing but also i think trying to You know, if we're talking about micro resets, like in between patients, trying to mentally unload the last patient, like literally like even saying to themselves, OK, that appointment is done with Mr. Jones. That appointment is done. And setting it to the side, almost like compartmentalizing in your mind, like you're putting a file up on a shelf. That's done. I have to set that to the side and let me think about my next patient. And you can even ask yourself the question, what does this next patient need from me? Is it reassurance? Is it answers about a treatment plan? Is it, you know, think about what does this patient need for me? And kind of set that intention. And then I think if these are things that can help, especially to prevent burnout from getting really bad. But if it's already gotten to a really bad stage, then they might need more than this. And this might be the time where they consult with, you know, a professional. I've talked to dentists who have gone through. therapy and they're actually taking medication as well and they said without the medication and therapy they they wouldn't not only be practicing they wouldn't even be here today right um right you know that that compartmentalization that you're talking about is very very important but i think it's easier said than done because if you're seeing patient number two at 9 30 in the morning and at three o'clock you're still thinking of patient number two that's going to be really tough Right. Right. So because patient number two could have just been a real disaster. It was one of those patients where you knew you had to get it right. It didn't go well. You know the family. And then you start thinking about this. And these are the kind of things that you could train your brain not to do. Right. I mean, there's there must be some exercises, some meditation or something to train yourself to escape that. Yeah, I think that part of what you're talking about is how to teach your brain not to ruminate. We use that term in psychology. Rumination is when you kind of are thinking over and over and over about something and trying to flip it around different ways and see if you could have done something better. And what they show is that in psychology and studies is that rumination actually only increases anxiety. So I think our brain thinks if we think about something over and over again. Maybe we'll see something we didn't see or we'll feel better, but it actually has the opposite effect. So what I tell dentists is if you find yourself doing that, you need to actually acknowledge what's happening. So say to yourself, okay, I'm ruminating about this patient. Just like say it to yourself, like that's what's happening. That's not helpful. I need to set that to the side for now. And maybe there's something I can come back to at the end of the day or the next day I talk to my team about. But that's kind of where also, I know we're going to talk about this, where perfectionism versus excellence comes in. Yeah, and I want to get to that in a second. Before we jump into perfectionism, which runs deep in dentistry, if my wife was a dentist, which she's not, I could guarantee you that if she started to ruminate, she would go into her office. take out her phone and watch cat videos. She would watch. Okay. Yeah, that actually could be a good technique. Right, right. The structure brain. Right, so I don't know how many dentists out there would like to watch cat videos. but it is the most popular thing on the internet but uh do you recommend doing something completely outside of dentistry during the dental day where you go in and and you don't want to be bothered now you can't do it every between every patient because that would add up to too much time but are there certain periods where it's like off-limits period to the boss and i'm going in here and i'm going in my little chamber briefly tell us what you think about that i think that that's really important to do is just have at least 15 minutes, if you can find them in your day to like unplug, recharge, distract yourself, maybe look at cat videos. If you're not in a cat, you know, look at something else, read something, kind of get your brain off of dentistry and the patients. And that gives you a chance to really recharge and sort of unplug, even if it's for just 15 minutes. And I say even go outside, like take a walk around the... your office, like get some fresh air, go to the bathroom, splash some cool water on your face, just sort of anything to, you know, if you're ruminating, interrupt that and sort of bring you back to your senses, you know, like looking outside, looking at the birds, looking at the trees, you know, the cold water on your face, like just feeling in your body and take yourself out of your mind and bring yourself back into your body. Yeah. So those micro resets keep the day going where you can. function. But again, if it's constantly needed where you have to do these resets or else you can't function because it's just too stressful, something else has to change. And we'll get into that and maybe it is therapy and maybe it is something else, but we'll talk about that in a few minutes. So there's a big difference between perfectionism and excellence, especially in the field of dentistry. I mean, if a dentist can't discern between the two of those words and they lean towards perfectionism over excellence, they are headed down a dangerous path. So can you tell us the difference between these two words and how it has such an impact on a dentist's career? The way that I see them as different is excellence is you have high standards, you see challenges, opportunities to learn and for growth. And when there is a mistake or failure that happens, because let's be honest, in any field, but even in dentistry, there's going to be failures. A person who strikes for excellence sees that as an opportunity to grow, has a growth mindset. That's what I call it, a growth mindset where they learn from that. And then they keep it moving and they keep their standards high and they keep things moving. Someone who's struggling with perfectionism, it looks like high standards, but it's actually fear. in disguise. It's very fear-based. It's worried that they are going to make a mistake, worried they are going to disappoint someone. They're holding themselves this unrealistic, flawless standard, and they have zero tolerance for errors. They're in the wrong profession. Yeah, zero tolerance is dentistry ain't the right profession for you. But anyway, I didn't mean to interrupt. Right, because even if, let's say, and I've talked to Dennis about this, even if you do your job flawlessly. There's so many other variables. You can't guarantee the patient is going to follow your instructions. You can't guarantee the lab is going to do their part flawlessly. So there's so many variables outside of your control, right? So that is not an attainable standard. And it's really fear. Yeah. So is it an insecurity that the dentist thinks that unless they reach this level of perfection. They're not a really great dentist and they want to be a great dentist. Is that part of it? I think so. And I think I think part of it is, you know, even in your training, you know, you you don't you want patients to be happy. You want to you want them to be satisfied. You want things to to work out perfectly. And you're working in such. you're working in millimeters, right? So it has to be so precise. So I think it's kind of built in there. But again, perfection is not realistic. And a lot of it is based in fear, based in like, what happens if the patient sues me? What happens if the patient's unhappy? What happens if this or that? And again, I think that's where dentists can find themselves getting into rumination. So how do you get a dentist to move out of the mindset of perfectionism? into the world of excellence so that they're protected from the destructive collateral damage that that perfectionism brings. I think a couple of ways, and I've helped many dentists to do that. And that's so rewarding to see a dentist go from feeling all this fear and having these unrealistic standards to really letting that go. And it's really awesome to see. And they enjoy their work so much more when they can. But I think two things. One is a level of acceptance that failures are going to happen. That's number one. And then number two is this growth mindset idea that mistakes are opportunities to learn and to grow. We'll be right back to our guest in a second. But first, when it comes to chairside milling and same-day crowns and bridges, speed usually means compromise, but not anymore. Katana One Speed by Curare is a major breakthrough in Zirconia CAD CAM blocks. It allows sintering in as little as 9 minutes without sacrificing strength, fit, or aesthetics. That means faster turnaround, true same-day possibilities, and less downtime in your lab or practice. With the unparalleled flexural strength and aesthetics Katana is known for, you get predictable clinical outcomes and the ultimate in patient satisfaction. The bottom line is, efficiency matters. and stunning beauty is non-negotiable. And Katana One Speed delivers both. Join the growing number of dental offices and labs embracing faster workflows without compromise. Learn more about Katana One Speed at curaredental.com. You do a lot of your work with dentists virtually. Do you not? Yes. Yep. All of my appointments are virtual. Yeah. Okay. We're going to leave information about how to get a hold of you, Tiffany. It's on the notes of this podcast, but I'll also mention at the end. Where do you see dentists getting into trouble the most? Is it over explaining every detail of a procedure to a patient? Is it feeling guilty about their fees? They want to help somebody, but they know the patient has limited resources. Some dentists are kind of obsessed answering texts and messages after hours. They don't want to seem unhelpful. And maybe the bigger question is how do dentists set healthy boundaries without feeling like they're being uncaring or dismissive toward their patients? Where's that balance between being compassionate and still protecting your time, your energy, and your practice? Right. That's a really good question. That's something that a lot of dentists I know struggle with. What I've realized is a lot of struggles with patients and dentists come down to leadership and communication. And I think in dental school, I don't think dentists get a lot of education on leading a team, how to communicate effectively. The times I've seen dentists do that the best, they've taken courses after they've graduated, like continuing education courses where they've learned those skills after dental school. So those are very important skills. And so I think a lot of issues, both with patients and staff, come from not having clear communication. So with patients, it's really important that the dentist and the team are very proactive about having very clear policies. that explain how they're going to handle redos, how they're going to handle finances, and they need to be able to clearly, all of them, the dentist and all the staff, communicate that to patients. in an empathetic way, but firmly. And avoiding over-explaining things. Because I think what can happen when you over-explain, what happens as a dentist, the more they talk, the more drained they feel. The more you have to talk. And then the more potential questions a patient might have. So I think it's very important to have direct, clear communication, but concise. Don't go into over-explaining. Just state. in a few sentences, what you want to communicate and then just stop talking and let them ask questions if they need clarification. It always depends on the patient because sometimes you have these very high maintenance patients. They themselves in the mind of the dentist is stressful, right? Just knowing that that patient's coming in that day. Right. But for the most part, I think patients respect. the dentist time, and they understand that the dentist can only spend so much time with them in the operatory. I just did a recent podcast on patients that have substance use disorder, which is really, you know, the politically correct way of saying someone is addicted to drugs, you know, and it's controlling their lives. And this particular key opinion leader who I interviewed, who's a periodontist, literally said, there's no money in this. You're not going to bill for your time. intervening with a patient who's addicted to drugs, but it's our responsibility to spend time with them and talk to them. And I said to him, I said, you know, the dentists, all they have to sell is their time. So if they're not getting any compensation, I understand that you want them to talk to the patient about their problem because they're seen most commonly as a healthcare provider by dentists. I get that, but we have to also be cognizant of the stress that the dentist is under. And their role. And their role. Right. Right. Yeah. So he's looking at it from the standpoint, it's our responsibility. And it is, I agree. But, you know, it's also the dentist has a responsibility, the practice, the business, his or her other employees, his or her other patients. So it was just an interesting thing where he kind of... To me, that would be an example of where a dentist could have, you know, one or two people that they could refer patients that had substance use disorders to and, you know, acknowledge that, you know, address that. I think this is something that, you know, you need to look into and I highly recommend and then refer them to the appropriate professional because, you know, your role as a dentist is their dental health and you can't, you know, get into the role of. substance use counselor or mental health therapist. Right. And it's nice to hear that from someone like you who's a licensed social worker. Yeah. Yes. And you also have a lot of training in psychology. So let's talk about leadership. There's no question that a dental, especially a dentist who's a practice owner, who's running the practice from the standpoint of managing other employees. That can be a huge contributor to burnout. So for dentists who are managing a dental team and navigating practice dynamics, how do you balance being a nice team member, quote unquote, nice team member, with being clear and assertive? We'll be right back with our guest in a second. But first, if you're looking for a digital dental camera, I highly recommend the iSpecial digital camera by Shofu. Hands down, it's the easiest camera to use, takes beautiful high-res photos, and it pays for itself quickly with the boost in case acceptance. Don't wait. Visit Shofu.com and use the code VIVA for a special offer. This is a great question because this is actually what... out of 10 of the dentists I speak with tell me is their biggest stressor is managing staff. And they struggle with how can I be, you know, what you said, like a good boss, you know, I'm well liked, but also still maintain professional boundaries, have authority. And I like, I always say this, I think it's important to be warm and caring to your staff. I think warmth builds trust, but also being clear with them. that builds authority so warmth builds trust clarity builds authority so again a lot of leadership issues from what i've seen come from unclear standards and expectations when they're not clear on what the what the dentist who's the leader is expecting or it's not consistent across staff that's when there tends to be issues so it's really important to be clear about what you expect be consistent And then if there is an issue, if you see a staff member that's making a mistake or there's something happening that's not consistent with what you expect, addressing it early. Because what happens is a lot of times dentists are not sure how to address it or they feel uncomfortable with those kinds of conversations and they may avoid it. But that actually leads to. Number one, the staff repeating those mistakes, the dentist feeling more and more frustrated, and eventually maybe lashing out in not a very professional way, rather than addressing it early on. It gets confrontational, and that adds to stress. But let me ask you this. If I was starting my own practice right now, and I was hiring people, I spoke to one key opinion leader, and when he was doing that, he wanted to be popular amongst the dental team. He wanted to be liked. That was his priority, being liked. Now, from my standpoint, I wouldn't go in that way. I would go in there saying, listen, you know, I have my friends outside of this office. I have a social life. I've got my wife. I've got my kids. I want to get along with everybody in the dental team, but I'm not here to be their friends. Now, tell me if I'm going wrong here. No, I agree. Okay, good. Because the benefit of that, in my opinion, would be that I could be more assertive and I could be almost somewhat feared. I don't want to say, I don't want to. rule through fear. Right. But I want the team to understand that this is a business. They're working for me. I'm paying their salaries and I'm not here to be popular amongst the team. Is that a good approach? Yes. And it is. And it is. Yeah, you can't be their friend and their boss, but you can be warm. You can show interest in their lives. You can show appreciation. to them. I also, there's a lot of studies that show when the dentist can bring some light humor into the workday that everyone enjoys the work environment more. So bringing some humor, you know, but you want to, you do want to avoid oversharing about your personal life, right? So you want to have some professional boundaries. you know you're not their friend right um you want to make sure that you're consistent with everyone in terms of whatever the expectations are right but you still suggest if they have office parties or you go out to a bar and have cocktails that's all cool that's okay to do Yeah. Yeah. I think that's fine. Occasionally, I think that builds the team and camaraderie. Yes. And maybe you don't stay as long as everybody else. And maybe you don't talk as long to some people as you do others. Right. Selective where you sit. And you're not oversharing. And maybe you're not. getting drunk maybe they can but maybe you don't right you know you have to have some you sound like a great therapist i gotta tell you i could have used you a long time ago in my career i'm doing okay now because i'm just doing podcasts i don't have a whole right a lot of stress here but yeah um no i love what i do yeah i love helping dentists yeah it's it certainly sounds like it so at what point should a dentist i'm talking about this therapy And having a professional to talk to like yourself. At what point, Tiffany, should a dentist really start thinking about getting outside support, whether that's coaching, therapy, mentorship, or even taking a hard look at... environment and saying, you know, is this where I want to be? Because we all have tough weeks in dentistry. That's part of the profession. But how do you know when it's more than just a rough stretch? What are the red flags that tell you, okay, this isn't just a bad week. Something bigger is going on here. Right. Okay, so I think there's a few things. One is if the dentist is having persistent anxiety, so constant worry, constant ruminating on cases, difficulty disconnecting after work, difficulty sleeping. If this is causing them to use unhealthy coping skills such as alcohol, drugs, overeating. If they are starting to think about leaving the profession. If they're feeling hopeless and struggling to see a path forward, these are the types of things where there needs to be something more than just the micro resets that we talked about. We need to either look into getting therapy and medication or getting some leadership coaching training or looking at just the clinical workload and see is there something that can be changed. Now, do you recommend, and I know this would be good for your business, of course, but I... know you as a very honest stand-up person, would you recommend earlier coaching and therapy before things kind of get a little out of hand, even when someone's starting a practice? I mean, there's no one going into dentistry that's starting their own practice that is not going to face rough days and rough weeks. There's absolutely no way that can happen. Dentistry is too filled with unknowns and there's too many components to running a practice. Maybe it wouldn't be a bad idea for these individuals that are starting their own practice to talk to somebody and especially a mentor, somebody who's already gone through it. That certainly would help. But even someone like yourself where they can say, okay, I'm feeling pretty good. I have some bad days, good days. Everything seems to be going well, but I have a lot of things ahead of me. I have a family. Is there some sort of like monthly? you know, thing I can get on with somebody like you, would that have significant impact on the plus side for someone to do that? Absolutely. I think so. I'll say two things. Number one, I think any new dentist, I think I said this a little bit earlier, should take advantage of getting some CEs on leadership. and team management. I think that those are things that a dentist new to the profession really needs. And if they get that at the beginning, things will go so much smoother. They'll save themselves so much headache if they can get those communication skills and leadership skills early on. And then second, I also think therapy early on, before it gets to the point where you're thinking about leaving, before it gets to the point where you're not sleeping or you're abusing alcohol or drugs. Having, you know, most people I meet with weekly, but there are some dentists who, you know, have felt like, I don't know if I can commit to every week, but so we meet every other week and it's helped them tremendously, tremendously. I'm thinking about one particular dentist I worked with who was a new dentist and she was, she's, she's very smart, very bright, very talented, a high overachiever, all always got straight A's. But when she started practicing, she had immense anxiety to the point where she would go into the bathroom and just be like sweating and like almost to the point where she's having panic attacks. You know, like, do I know what I'm doing? A lot of like, you know, feeling imposter syndrome and like, what if I mess this up? And it was paralyzing her. How deep is someone into it when they start to have those panic attacks? Because that's what those are. Those are panic attacks. Yeah, yeah, yeah. anxiety eliciting itself in a very extreme way yes well this was early on so fortunately she you know uh was open to coming to therapy because she knew like oh i can't i can't go on like this and a lot of her anxiety was coming from perfectionism so we were really able to work on that when she was able to let go of that and let go of her fear of making a mistake and now she's doing awesome The two biggest factors is one is leadership and HR that you said is a major stressor in a dentist's life. And the second one is perfectionism. And putting those two together, those are big ones. It seems to me that the dental school education should certainly include something on business way more than they do. I don't know if they have anything on it. leadership. These are really big things. Now, when I went to dental school a long time ago, I understand that wasn't part of it, but things have changed now and there's corporate dentistry and then there's doctors that start practices, right. Where there's no, they're out of the PPO network. It's just a whole different world right now. And you, and there's also a tremendous shortage of hygienists and assistants. So there's a, um, an HR crisis right now, which is another issue for dentists, stressors, like they're afraid of losing staff. Right. So, I mean, I did a podcast on the office manager interview. Like, what is the best way to really do a good office manager interview from A to Z? And that will be airing coming up on the Dr. Phil Klein Dental Podcast Show. But yeah, these are all important things that should be included in dental school education. They're not. The curriculum is so packed. They barely have anything on laser. dentistry. And that's a shame because laser dentistry is huge in so many ways, including periodontal therapy, endodontics, and dentists are coming out of dental school and they don't have too much knowledge on that. But it is what it is. That's why CE is so important. So Tiffany, what's the best way to get a hold of you? Because I know you do virtual consultations, which I think is amazingly convenient for a busy dentist. Definitely. And I do really early morning appointments. So I have some dentists who we have our sessions at 6 a.m. So I can do 6 a.m., 7 a.m. And I do that to give them that opportunity to meet before they go into work. But the best way to get in touch with me is through my website, which is just my name, www.tiffanycastellanos.com. So it's Tiffany. And then last name is spelled C-A-S-T-E-L-L-A-N-O-S. And on the website, they can find my phone number and email address, and they can reach out to me either way. I'm happy to set up an initial consult with them just to figure out if we're a good match. And I'd love to work with them. And I'm also excited just to say that I am working with the University of Florida Dental School right now to offer a continuing education class on dentistry and well-being and a lot of these similar topics about burnout. It's interesting, but also kind of... unfortunate that the most highly requested topic on this show, from the feedback we get from our listeners, and we have over 490,000 subscribers to Viva Learning Worldwide, 85% North America, and we're getting over 30,000 listens per month on this show. We get a lot of feedback. And the most popular request is career satisfaction. and how to handle stress, anxiety, and burnout in the dental setting. So hopefully dentists will start to catch this a little bit earlier rather than wait because it's typical for any human being to say, yeah, I could handle this. I'm going through a rough stretch. Things are tough. Life isn't easy. This happens in every profession, but there's nothing wrong with saying I need to get a little bit of therapy or coaching. And it is possible to go from feeling like I might want to leave this profession to enjoying it again. I've seen it happen. And it's so much better to be able to enjoy what you do than to feel miserable. Yeah, there's no question about it. Yeah. All right. Well, listen, Tiffany, thank you very much for your time. Really appreciate it. And we're looking forward to having you on the show very soon again. Great. Thank you so much for the time. I really enjoyed it.