We need to talk

Dr Tchia, what were your initial thoughts on the profession as you began your career?

Honestly, I was still just coming to grips with being called 'doctor' and working without a supervisor! It was a mixture of nerves and excitement in those early days. Two of the big challenges I faced in my first year were communicating complex treatment plans and managing patient expectations when things didn’t go to plan. Once the nerves and excitement faded away, I realised my training provided the foundation of knowledge to safely practice as a clinician, but there was still so much for me to learn.

How well did your studies and placements prepare you for starting work as a dentist?

JCU prepared me so well for working in rural and remote health through the amazing placement locations we are afforded throughout the clinical years of the program. In my final year, I was fortunate to not only go back home to Darwin and work in Townsville, but I was also able to go to Cambodia for three weeks, seeing how remote health is delivered in underserved populations.

This gave me a profound insight into the working conditions of these settings but more importantly equipped me with the experience to be able to adapt and thrive in these environments.

When did you first start experiencing professional burnout, and what were some of the factors that caused it?

It was June 2020, when the pandemic was starting to affect our industry and there was a great deal of uncertainty around how we could practice. This burnout is what I call the lowest point of my life and career. I was suffering from chronic stress, anxiety, and panic attacks. I dreaded going to work. The whole experience made me question if dentistry was the right career for me.

Looking back now, some of the factors that likely led to this burnout episode include, striving for perfection (a common characteristic among dentists!), a lack of self-care, poor self-management strategies of my emotions and feeling like I was the only person going through it.

From your perspective, how has COVID-19 impacted the dentistry profession and increased the risk of burnout?

Our industry has been one of the most directly impacted given the majority of the procedures we carry out to patients are aerosol generating. More stringent protocols in personal protective equipment (PPE) as well as temporary shut down of private dental practices during lockdown periods have created a great deal of uncertainty, which can bring out stress and anxiety.

These increased pressures on clinicians have increased signs and symptoms of burnout and poorer mental health in general. They’ve been exacerbated by reduced social interaction and access to support systems due to lockdowns and border closures.

How did burnout affect your personal and professional life?

Burnout was causing me stress and anxiety to the point I was dreading going to work and wanted to quit dentistry. I had low self-esteem clinically and tended to feel very tired or low in energy. I was beginning to withdraw socially, and the stress was also taking a toll on my relationships with my friends and family. Professionally, I started to shy away from dental procedures that stressed me out, making me feel like I was stagnating early in my career and impacting my earning potential.

As research indicates, over one in four dentists are reportedly at high risk of burnout. Why do you think it is such a big issue in the dentistry profession?

In today’s age, where patients and clinicians have access to essentially the same amount of information, and in a more highly litigious society, the nuances of practising dentistry in the 21^st century has gotten more complex. Coupled with social media showing us amazing dentistry and highlight reels every day, you begin comparing the best of what you see with the worst of what you may be experiencing. The most common trait I believe most dentists have which can predispose us to burnout is perfectionism. We strive to do things perfectly, and that can foster a mindset of finding flaws in everything you do.

What are some of the signs and symptoms of burnout you think dentists should be aware of?

Burnout often presents as a sense of helplessness or hopelessness which can lead to detachment of ideals, motivation, and hope. Burnout can also be presented as feelings of dread about going to work or feeling like life isn’t worth living. Feeling dread about going to work or feeling like you want to quit dentistry because it’s all getting too overwhelming can be signs you are burning out.

Burnout was included in the 11^th Revision of the World Health Organization’s International Classification of Diseases (ICD-11) in 2019 and is summarily classified as "a syndrome conceptualized as resulting from chronic workplace stress that has not been successfully managed."

What were the avenues you took to address the issue?

Given I had hit rock bottom, I no longer wanted to experience this low feeling and wanted a way out of my mess. This opened the door to a deep dive into a transformative personal development journey, where for six months, with the help of some coaches and mentors, I used mindset tools to find balance and harmony in my career and my life.

The biggest step was having the courage to share what was going on in my mind with my practice manager and other dentists in my practice. When I shared what they were already noticing, I truly got the support I needed.

What steps would you recommend for young dentists and students to prevent or address burnout?

I have three main tips to prevent or overcome burnout, which revolves around shifting your mindset and applying new habits:

• Choosing progress over perfection: instead of striving to do things perfectly, aim to be just a little bit better today than you were yesterday. This takes the pressure off trying to be perfect and shifts the focus to incremental improvement.
• Trading expectation for appreciation: instead of saying “I have to do this” or “I’m expecting this outcome”, say “I get to do this” and “I’m grateful to have the opportunity to help this patient”. Practising gratitude is one of the simplest but most effective ways of overcoming stress, anxiety, and burnout.
• Being graceful with your growth: Recognising that if we are going to dismantle our perfectionism, then when we take on a new growth journey to expect to make mistakes. When we give ourselves the grace to not expect a linear improvement we are less likely to spiral down when things don’t go to plan.

It’s important to prioritise your mental health and wellbeing during these challenging times. You can reach out to a colleague who understands your situation or through services such as Dental Practitioner Support. This is a 24/7, free, confidential phone hotline for all Australian dental professionals. Find out more at on their website or call 1800 377 700.

You can find out more about how Dr Tchia is supporting his fellow dentists to prevent or overcome burnout through @TheLimitlessDentist on social media.

JCU students can access support to help cope with stress, address mental health concerns and access professional help. The Australian Dental Association offers support for practitioners by connecting them with a range of mental health services.