Just say no….

It’s easy isn’t it?

To say “No”.

Really?

I would love to say that having been close to and through burnout on a few occasion as both an employed dentist, a practice owner and (even) as a coach – yeah, yeah I know, I should know better – saying “no” is still one of the hardest things to do.

You want, and think you need, the business, the popularity, the money.

You don’t want to turn someone away, to use a negative word, to let them down.

What if this is the last person who asks you?

What if this leads to a hugely successful opening or opportunity?

What will they think of you when you turn them down?

We all know that we are all trying to achieve too much, demands on the only thing that everyone has (time) are growing, last week I visited Practice Owner and mother of three sorry, Mother of three and Practice Owner, Lauren Harrhy and marvelled at her composure and balance as she seeks to carry on her good work and become a BDA rep. 

Tony Barton from Red Kite World who was one of my teachers during my Coach Training sent me a link this morning. It features Greg McKeown and his book “Essentialism – The disciplined pursuit of less”.

I own this book but haven’t read it – yet.

Why? Because I haven’t found the time.

Why? Because I keep saying yes to other things.

Take a look at Greg speaking

Burnout – Physicians

From The Lancet 13 July 2019.

Hui Wang, a 32-year-old Chinese ophthalmologist, experienced sudden cardiac death on June 30, after working with fever for 6 days in Beijing. Hui was the father of a 1-year-old girl, and married to a doctor, who donated Hui’s corneas to two patients after his death…

According to a viewpoint published in the Chinese Medical Journal, reports on sudden deaths among Chinese physicians sharply escalated from 2008 to 2015, and most of the deaths, resulting from heavy work load, were male surgeons and anaesthesiologists in tertiary hospitals in large cities…

Physician burnout, defined as a work-related syndrome involving emotional exhaustion, depersonalisation, and a sense of reduced personal accomplishment, is not only a serious concern in China but also has reached global epidemic levels. Evidence shows that burnout affects more than half of practising physicians in the USA and is rising…

Physician burnout, defined as a work-related syndrome involving emotional exhaustion, depersonalisation, and a sense of reduced personal accomplishment, is not only a serious concern in China but also has reached global epidemic levels…

Evidence shows that burnout affects more than half of practising physicians in the USA and is rising. The 2018 Survey of America’s Physicians Practice Patterns and Perspectives reported that 78% of physicians had burnout, an increase of 4% since 2016. Furthermore, 80% of doctors in a British Medical Association 2019 survey were at high or very high risk of burnout, with junior doctors most at risk, followed by general practitioner partners. Increasingly, physician burnout has been recognised as a public health crisis in many high-income countries because it not only affects physicians’ personal lives and work satisfaction but also creates severe pressure on the whole health-care system—particularly threatening patients’ care and safety.

The 11th Revision of ICD (ICD-11) in May, 2019, provided a more detailed definition of burnout, characterising it as a syndrome of three dimensions—feelings of energy depletion or exhaustion, increased mental distance from one’s job or feelings of cynicism or negativism about one’s job, and reduced professional efficacy…

Addressing physician burnout on an individual level will not be enough, and meaningful steps to address the crisis and its fundamental causes must be taken at systemic and institutional levels with concerted efforts from all relevant stakeholders. Tackling physician burnout requires placing the problem within different contexts of workplace culture, specialties, and gender. Physician wellbeing has long been under-recognised in LMICs, and physicians’ sudden death and suicide due to overwork—the consequences of extreme burnout—have not been uncommon in many Asian countries. With rapid development of medical sciences, it is time to use medical advances to benefit the health and wellbeing of all people, including physicians themselves…

The Weekend Read – Stand out of our light by James Williams

Full Title: “Stand out of our light : Freedom and resistance in the attention economy.”

This relatively short, but very important, book takes a good, hard look at “The Attention Economy” and the insidious effect it is having on our lives. The author, winner of the intriguingly named Nine Dots Prize, worked at Google as a strategist for a decade where he received the Founders’ Award – the company’s highest honour – for his work on advertising products and tools. More  recently he has studied at Balliol College, and the Oxford Internet Institute. His research topics are the philosophy and ethics of attention and persuasion as they relate to technology design.

He argues that, “attention is the fuel of our lives but we are living through a crisis as our attention is reduced by technology that we have allowed to dominate our lives. His writing pleads for society and the tech industry to ensure the technology we all carry with us every day does not distract us from pursuing our true goals in life.”

As information becomes ever more plentiful, the resource that is becoming more scarce is our attention. We have moved from a time where we marvelled at and enjoyed the novelty of instant communication to where we are now. The advertising and marketing industries sees us all as fair game and will do whatever they can to sell us anything and everything, behaving as if it their right, not ours, to choose what we see and when we see it. As Williams says, “…digital technology does not act as an honest GPS, but instead entices you along paths that make your journey longer. All in the name of capturing your attention, such that you are deflected from your intentions.”

The author’s philosophical yet practical approach to the subject is worth a read and will encourage you to examine the way that you spend your seconds, minutes, hours and days.

Thanks to reestheskin for the birthday present.

Available HERE.

 

 

Is it me or am I in a supermarket checkout time loop?

Headline from yesterday’s Guardian:

“Removing sweets from checkouts could help tackle obesity – study”

Every dental professional who ever lived will probably shake their head and roll their eyes, (not a good look), when they read this, and mutter, “Isn’t that what we have been trying to achieve for years, or is it decades?”

Back to Google:

The Sybil Fawlty award this time goes to the research published in PLOS (Public Library of Science) journal. I apologise to the good and diligent researchers who have shown again that putting sweets and snacks in close proximity to people means that those people will buy them – or pester a parent to buy them; and that removing them is good for our health by leading us not in to temptation but delivering us snack free at the exit.

BUT

Removing them reduces the risk of the supermarket making sales and therefore risks their profit margins.

We know all this. We all know this.

We know what causes/contributes to tooth decay, obesity, diabetes etc

We know that avoiding snacking is good for us….and have done for decades.

We know that checkout snacks are tempting and not a good thing.

So what will happen? Cognitive dissonance is a wonderful / dreadful thing.

 

Merry Christmas from ASDA (has this stuff got relatively cheaper over the years?):

 

 

 

 

 

HPV vaccination (yet) again

July 2018: The Words:

UK Government advisers have recommended extending funding for human papillomavirus (HPV) vaccines to boys.

The HPV vaccine was previously offered to girls aged 12 to 13, with the new recommendation meaning 400,000 boys will also benefit every year.

All UK Governments took on board the Joint Committee on Vaccination and Immunsation’s (JCVI’s) advice.

‘The JCVI’s advice that boys should be vaccinated is very welcome news for boys and their parents,’ HPV Action campaign director, Peter Baker, said.

‘It will also benefit those girls who, for whatever reason, have not been vaccinated against HPV.”

December 2018: The Reality:

Steve Brine MP has said there will be no catch-up HPV vaccine programme for boys.

In a letter to the shadow public health minister Sharon Hodgson, he argues boys will benefit from ‘herd protection’.

However, the BDA believes up to 2 million boys will remain unprotected from HPV without a catch-up vaccine programme.

‘The latest data on vaccinations among girls illustrates precisely why we’ve needed a gender-neutral approach, Mick Armstrong, chair of the British Dental Association (BDA), said.

‘It also shows why penny pinching on a catch-up programme will leave many school-aged boys unprotected.

‘There can be no guarantees of “herd protection” when nearly one in five girls are missing out on the vaccine.

‘A catch-up programme remains the best way to protect all our children from this cancer-causing virus.’

….and many still believe that this bunch will come up with a fairer NHS Dental Contract.

Yerkes-Dodson is still relevant – if you want to enjoy your clinical career

Why should a “law” described first in 1908 be relevant to everyday Dentistry (and more)?

Robert Yerkes and John Dillingham Dodson described their tests with rats that could be encouraged to complete a maze when stimulated with slight electrical shocks. When the strength of the shocks was increased however the rats just ran about looking for an escape. They concluded that arousal levels helped to focus attention and motivation on the task at hand but only up to an optimum point and after that point fatigue appeared and performance declined.

Research has found that different tasks require different levels of arousal for optimal performance. For example, difficult or intellectually demanding tasks may require a lower level of arousal (to facilitate concentration), whereas tasks demanding stamina or persistence may be performed better with higher levels of arousal (to increase motivation).

The first image shows the classic inverted ‘U’ shape of a difficult task (placing implants, molar endo, treating some children are examples that come to mind). It also shows a continuation without decline of more simple tasks which can be maintained for longer without reaching a point influenced by fatigue (examinations, routine restorations on well adjusted patients).

 

 

The second image shows the typical “stress curve” where performance takes a while to peak if we are under too little stress, then goes through a short period of optimum stress before reaching too much and heading down through exhaustion to burn out.

The reason that I have written about this is that we need to look at the time periods that these curves represent from the short (an hour say) to long (months or even years). There are different challenges that dentists face with differing solutions.

Firstly of course there is the fatigue that comes from trying to do too much challenging work in a short period of time. This results in high stress levels and possibly poor performance on a daily basis. Often there are time management issues where we are obliged to match our performance to the patients availability. This can see a clinician “coasting” by dealing with the relatively straightforward whilst at their peak in terms of readiness and responsiveness but then having to find reserves of energy when the patient “demands” treatment at later times in the day. I have never understood why dentists are reluctant to tell the patient exactly when and why they would like to see them. My own experience in a practice with large numbers of children was to insist on seeing under 11s for any treatment (examinations excepted) first thing in the morning. For the most part when people have reasons explained to them and can understand that it is for their benefit then they will comply with your wishes.

Also to consider are the long term problems of fatigue that arise from the day after day, just doing it without time off. Even in the best time managed (at a relatively micro level) practice if there is often not enough time spent away to unwind, recharge the batteries and recover, then burn out will creep up on you. The prodromal signs are a lack of efficiency and, more importantly, effectiveness.

Dentistry is still a macho occupation for many who seem to get a perverse enjoyment from overwork. It’s sad but true that for many there is an opportunity to build the life they want but put obstacles in their own way as if frightened of taking control.

Time management on both micro and macro levels is hugely important, ignore it at your peril. Get help if you need it.

Our society is being highjacked

Thanks to Cal Newport for pointing me towards this site in his latest Study Hacks blogpost, “Beyond Digital Ethics”.

He talks about the work of Tristan Harris and The Centre for Humane Technology from whose website I have taken a page.

What began as a race to monetize our attention is now eroding the pillars of our society: mental healthdemocracysocial relationships, and our children.

What we feel as addiction is part of something much bigger.

There’s an invisible problem that’s affecting all of society.

Facebook, Twitter, Instagram, and Google have produced amazing products that have benefited the world enormously. But these companies are also caught in a zero-sum race for our finite attention, which they need to make money. Constantly forced to outperform their competitors, they must use increasingly persuasive techniques to keep us glued. They point AI-driven news feeds, content, and notifications at our minds, continually learning how to hook us more deeply—from our own behavior.

Unfortunately, what’s best for capturing our attention isn’t best for our well-being:

  • Snapchat turns conversations into streaks, redefining how our children measure friendship.
  • Instagram glorifies the picture-perfect life, eroding our self worth.
  • Facebook segregates us into echo chambers, fragmenting our communities.
  • YouTube autoplays the next video within seconds, even if it eats into our sleep.

These are not neutral products.
They are part of a system designed to addict us.

Take a look here.

 

 

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