4 F ROM T H E EDI TOR Ortho Tribune U.S. Edition | May 4, 2019 Orthodontist burnout By Dennis J. Tartakow, DMD, MEd, EdD, PhD, Editor in Chief, Ortho Tribune, U.S. Edition According to Boyers (2012), edu- cation 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 suc- cess. However, it is no secret that ortho- dontists’ job dissatisfaction is soaring to unprecedented levels as a result of removable aligner therapy from gen- eral dentists guided by laboratories; now even the patient directs and con- trols his/her own orthodontic treatment from over-the-counter marketing com- panies without any professional super- vision. Peck (2018) 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 indus- try now doing a lot of our thinking? Did we do it to ourselves or have we been subtly manipulated into a changed per- ception?” (p. 672) The practice environment is becoming more difficult to provide compassion- ate, high-quality care for patients (Van Dyke, 2019). 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 be- comes more threatened by the insurer and/or employer-provider relationship. Contempt is difficult to elude and cir- cumvent as employers change insurers, insurers change physician groups and patients are required to change physi- cians as a result of insurer-employer renegotiations. This often results in doc- tors 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 (2018) noted: “… autonomy, mastery, and purpose to be drivers of intrinsic motivation. But we also expe- rience the human factors, friction, and uncertainty in a highly complex deliv- ery and reimbursement structure. This reality demands grit and resilience to sustain the high standards of excellence and compassion necessary for deliver- ing personalized care.” (p. 3). 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 (Tartakow, 2010). The proliferation of imperfect treatment performance is also quite ob- vious, 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 ethi- cal 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 instanc- es, 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 chap- ter. As Peck stated: “…all this may help as- sure the best destiny for the specialty of orthodontics. And for those of us who care deeply about it, that will mean a lot.” (p. 674). geferences • Boyers, J. (2012, December 30). Is Higher Education even worth it? Retrieved 8/18/16 from: www.huffingtonpost.com/jayson- boyers/is-college-worth-it_b_2016933.html. Norton, J. (2018). The Science of Motivation Applied to Clinical Burnout: Lessons for Healthcare. Frontiers of Health Service Management, Vol 35, No 2. Peck, S. (2018). Wither Orthodontics? Angle Orthodontist, Vol 88, No 6. Tartakow, D.J. (2010). An analysis of factors that align with faculty vacancies in orth- odontic education. Doctoral Dissertation, ProQuest Information and Learning Com- pany, Ann Arbor, MI. (UMI No. 3438516). Van Dyke, M. (2019). Battling Clinical Burn- out. Healthcare Executive, Vol 43, No 1. • • • • “ SIT, Page 1 Salzmann Lecture, “Miniplate Skeletal Anchorage: An Update and New Perspec- tives,” at 8 a.m. today in Room LACC 408. A frequent lecturer at orthodontic meetings worldwide, De Clerck is an ad- junct professor at the University of North Carolina at Chapel Hill and maintains a private practice in Brussels, Belgium. His research interests include skeletal an- chorage, biomechanics and orthopedics. Edward H. Angle Lecture Dr. Peter Buschang will present the 2019 Angle Lecture, “30 Years of Achieve- ments — Our Proudest Moments” at 1 p.m. today in Room LACC 150/151. An anthropologist with a PhD degree, Buschang is regents professor and direc- tor of orthodontic research at Texas A&M University Baylor College of Dentistry. He has published more than 260 peer- reviewed articles, numerous book chap- ters and several books. John Valentine Mershon Lecture The 2019 Mershon lecture will be given by Dr. Greg Huang, a professor and chair of the orthodontic department at the University of Washington School of Den- tistry. Huang will present “Results from the National Dental PBRN Adult Anterior Openbite Study,” at 2:10 p.m. today in Room LACC 150/151. Huang led the AAO Practice Based Re- search Network Committee, formed in 2013 to encourage orthodontic research in network settings. The adult anterior openbite study was the first project to be approved, and the AAO began recruiting member participants in 2015. Huang’s lecture will include results of the study. In memorium Following the recent passing of Dr. Wil- liam Proffit, the 2019 Annual Session Planning Committee designated the lecture period during which Proffit was to speak as the William R. Proffit Memo- rial Lecture (10:20 a.m. Sunday in Room LACC 403). Dr. Kevin O’Brien of Man- chester, United Kingdom, has accepted an invitation to give the lecture and will present, “Standing on the Shoulders of a Giant: A Retrospective on Bill Proffit.” ORTHO TRIBUNE PUBLISHER & CHAIRMAN Torsten Oemus t.oemus@dental-tribune.com PRESIDENT/CHIEF EXECUTIVE OFFICER Eric Seid e.seid@dental-tribune.com EDITOR IN CHIEF ORTHO TRIBUNE Prof. Dennis Tartakow d.tartakow@dental-tribune.com INTERNATIONAL EDITOR ORTHO TRIBUNE Dr. Reiner Oemus r.oemus@dental-tribune.com GROUP EDITOR Kristine Colker k.colker@dental-tribune.com MANAGING EDITOR ORTHO TRIBUNE Sierra Rendon s.rendon@dental-tribune.com MANAGING EDITOR Fred Michmershuizen f.michmershuizen@dental-tribune.com MANAGING EDITOR Robert Selleck r.selleck@dental-tribune.com PRODUCT/ACCOUNT MANAGER Humberto Estrada h.estrada@dental-tribune.com PRODUCT/ACCOUNT MANAGER Maria Kaiser m.kaiser@dental-tribune.com PRODUCT/ACCOUNT MANAGER Jordan McCumbee j.mccumbee@dental-tribune.com CLIENT RELATIONS COORDINATOR Leerol Colquhoun l.colquhoun@dental-tribune.com Tribune America, LLC 116 West 23rd Street, Suite 500 New York, NY 10011 Phone (212) 244-7181 Fax (212) 244-7185 Published by Tribune America © 2019 Tribune America, LLC All rights reserved. Tribune America strives to maintain the utmost ac- curacy in its news and clinical reports. If you find a factual error or content that requires clarifica- tion, please contact Group Editor Kristine Colker at k.colker@dental-tribune.com. Tribune America cannot assume responsibility for the validity of product claims or for typographical errors. The publisher also does not assume respon- sibility for product names or statements made by advertisers. Opinions expressed by authors are their own and may not reflect those of Tribune America. EDITORIAL BOARD Jay Bowman, DMD, MSD (Journalism & Education) Robert Boyd, DDS, MEd (Periodontics & Education) Earl Broker, DDS (TMD & Orofacial Pain) Tarek El-Bialy, BDS, MS, MS, PhD (Research, Bioengineering and Education) Donald Giddon, DMD, PhD (Psychology and Education) Donald Machen, DMD, MSD, MD, JD, MBA (Medicine, Law and Business) James Mah, DDS, MSc, MRCD, DMSc (Craniofacial Imaging and Education) Richard Masella, DMD (Education) Malcolm Meister, DDS, MSM, JD (Law and Education) Harold Middleberg, DDS (Practice Management) Elliott Moskowitz, DDS, MSd (Journalism and Education) James Mulick, DDS, MSD (Craniofacial Research and Education) Ravindra Nanda, BDS, MDS, PhD (Biomechanics & Education) Edward O’Neil, MD (Internal Medicine) Donald Picard, DDS, MS (Accounting) Glenn Sameshima, DDS, PhD (Research and Education) Daniel Sarya, DDS, MPH (Public Health) Keith Sherwood, DDS (Oral Surgery) James Souers, DDS (Orthodontics) Gregg Tartakow, DMD (Orthodontics) and Ortho Tribune Associate Editor