Stress isn’t just about having a bad week or a difficult month. It’s often the culmination of factors that, over a period of time, conspire to pile on such excessive pressure that we suffer physical, emotional and behavioural symptoms.
The mental health foundation defines stress as the way you feel when you’re under abnormal pressure.1 They say stress may be caused either by major upheavals and life events, such as divorce and moving house, or even by a series of daily minor irritations. A moderate level of stress can make us perform better, but stress is only healthy if it is short lived. Excessive or prolonged stress could lead to serious illness.
According to the HSE work related stress caused workers in Great Britain to lose over 10 million working days in 2011/12.2 And a paper published in the BDJ in 2004 looked at stress and health in the general dental practitioner (GDP) noted that there was a need to develop interventions to reduce GDPs’ work-related stress.3 But has anything changed in the last ten years?
The pressures of dentistry
Dentistry is widely considered to be a stressful profession and psychiatric disorders remain a significant reason for sickness and early retirement. Last year 15% of the claims we paid to men and 16% to women were for psychiatric disorders. Last year alone, we paid a total of £270,000 for depression and more than £100,000 for anxiety disorders demonstrating the severity of the situation.
As a dentist, you work mostly alone in a close environment with colleagues, constantly trying to meet the health needs of anxious patients with high expectations. Then there is the clinical governance and business planning to balance alongside regulatory demands and operational tasks required to meet the ever-increasing layers of compliance, all in an environment of change and uncertainty.
Financial uncertainties in these changing times can also add to these demands, practices experience continual increases in the running costs and as a result have seen a downward trend in profitability. As a business that provides prevention-orientated healthcare it can mean that profits are uncertain, especially when patients’ pockets are light and attendance is unpredictable.
The National Association of Specialist Dental Accountants and Lawyers (NASDAL) estimated that, in 2014, it cost a single-handed practitioner £11,200 a year to meet the requirements of the Care Quality Commission and HTM 01-05 alone. Combined with the ARF and other mandatory registration fees plus your indemnity, the figure went up to £15,011.4 In an unpredictable economic world, this – and more – can test the most resilient of people.
Bryan Gross, our head of claims and underwriting supports this saying: ‘In our experience, psychological disorders – such as anxiety, stress and depression – can hit dentists at any age, and are often brought about by their working situation. This can obviously have a significant impact on them and their ability to work, as well as on their personal lives.’
Stress manifests itself in many ways and its causes are multifaceted. Difficult interactions – both with patients and within the team – are an accepted part of everyday life but can often be the root cause of stress.
Last year, research by the British Dental Association (BDA) into the work pressures on dentists working in primary salaried care suggested they were twice as likely as other workers to experience high levels of job-related stress. The most common sources identified were: Time constraints or pressures (27%); challenging patients (26%); management (21%); administrative duties and other non-clinical responsibilities (14%); workload (13%) and staffing issues – particularly staff shortages (12%). This was exacerbated by high numbers of patient referrals, performance targets and insufficient resources to meet patient demand.5
Stress is a general concern within the profession, so much so, that the BDA itself runs an eLearning course entitled, A practical guide to reducing stress at work, acknowledging that work-related stress is ‘currently the second most common cause of ill health associated with work’.6
Some people seem to be more affected by stress than others, so it is important not to ignore physical warnings, such as tense muscles, over-tiredness, headaches or migraines. Identifying what triggers stress in you, could help you to sidestep the causes, as well as helping to find the best coping mechanisms.
“Dentistry can be a solitary and lonely profession, often without the regular opportunity for peer review of clinical activity, business planning and regulatory procedures. Sometimes a dentist’s introversion and solitariness can create an inability to recognise problems and stress triggers in others and indeed in themselves.” said Susie Sanderson, associate dento-legal advisor at Dental Protection Ltd (DPL). Dental Protection also offer an advice booklet on how to deal with difficult times that can be found on their website as well as offering a personal and professional counselling service.7
Within dentistry, stress continues to have a significant impact on the health and motivation of dentists. Work pressures are an inevitable a part of your professional life – and may even sometimes motivate you – but it is important to stay in control and take preventive measures to stop them affecting your health, wealth and general wellbeing.
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