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According to Boyers(1), education is the single greatest catalyst for lasting change on our society, and the author suggests committing ourselves, as well as helping others gain access, to quality education. It is one of the best ways for sustained personal and professional success.
However, it is no secret that orthodontists’ job dissatisfaction is soaring to unprecedented levels as a result of removable aligner therapy from general dentists guided by laboratories; now even the patient directs and controls his/her own orthodontic treatment from over-the-counter marketing companies without any professional supervision. Peck(2) so adroitly stated: “It makes a retired orthodontist with a long memory wonder, when did we go astray as a learned, university- and hospital-affiliated, clinical scientific group, and why? Also, what have we missed along the way? Why is the orthodontic industry now doing a lot of our thinking? Did we do it to ourselves or have we been subtly manipulated into a changed perception?”(2)
The practice environment is becoming more difficult to provide compassionate, high-quality care for patients(3). There appears be at least six symptoms of orthodontists’ burnout: (a) feelings of contempt, (b) loss of zeal, zest and enthusiasm for work, (c) increasing competition, (d) passive pressure from social media comments, (e) excessive documentation and (f) general feelings of malaise.
The doctor-patient relationship becomes more threatened by the insurer and/or employer-provider relationship. Contempt is difficult to elude and circumvent as employers change insurers, insurers change physician groups and patients are required to change physicians as a result of insurer-employer renegotiations. This often results in doctors having to accept reduced fees for services. All this leads to motivation, which can also contribute to what is driving clinical burnout in orthodontics.
Norton(4) noted: “… autonomy, mastery, and purpose to be drivers of intrinsic motivation. But we also experience the human factors, friction, and uncertainty in a highly complex delivery and reimbursement structure This reality demands grit and resilience to sustain the high standards of excellence and compassion necessary for delivering personalized care.”(4)
Retaining such valued resources as improved patient care and appreciated, high-valued staff is also waning.
The realization that these workload pressures have a direct contribution to clinical burnout is apparent(5). The proliferation of imperfect treatment performance is also quite obvious, which is not peripheral to patient care but rather the bullseye of the target. Less clear is how to successfully address this raging epidemic. Promoting an ethical practice environment is omnipotent. A holistic approach to care that ensures the orthodontist, as well as the patient and family have a voice in the treatment plan, is underlying in resolving ethical conflict. Maybe it is time and necessary for a “third-party” to help sort out what appears to have become not only a basis for clinical burnout but, in some instances, an underlying ethical dilemma.
Emergent policies, regulations and possibly legal intervention are necessary to solve what has become an ethical and moral crisis in our profession. We cannot change what history has already written; we can only change ourselves and begin with unsure hands to write a new chapter.
As Peck stated: “…all this may help assure the best destiny for the specialty of orthodontics. And for those of us who care deeply about it, that will mean a lot.”(2)
- Boyers, J. (2012, December 30). Is Higher Education even worth it? Retrieved 8/18/16 from: http://www.huffingtonpost.com/jayson-boyers/is-college-worth-it_b_2016933.html.
- Peck, S. (2018). Wither Orthodontics? Angle Orthodontist, Vol 88, No 6.
- Van Dyke, M. (2019). Battling Clinical Burnout. Healthcare Executive, Vol 43, No 1.
- Norton, J. (2018). The Science of Motivation Applied to Clinical Burnout: Lessons for Healthcare. Frontiers of Health Service Management, Vol 35, No 2.
- Tartakow, D.J. (2010). An analysis of factors that align with faculty vacancies in orthodontic education. Doctoral Dissertation, ProQuest Information and Learning Company, Ann Arbor, MI. (UMI No. 3438516).
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