Stress is biting down hard on SA's dentists
Declining incomes, long hours and unrealistic patients are leaving many in the profession depressed and exhausted
Dentists are feeling depressed and burnt out – and it is not because their patients’ breath stinks.
Instead, it is caused by unrealistic expectations, according to a new survey by the Medical Protection Society.
Almost 40% of the 173 SA dentists surveyed said they felt burnt out, and many cited demanding patients as a reason.
The survey found 83% of dentists agreed that patient expectations had increased in the past five years, with more than 70% saying they found it very challenging to manage unrealistic patient expectations.
Many said they found patients negative and nervous.
One told a researcher: “The work environment is stressful and patients are mostly negative and nervous, which eventually reflects in yourself.”
Another said they felt burnt out because of the “challenging working environments, having to travel far to go to work every day, fatigue, stress due to difficult patients and high expectations, [and feeling] you’re never good enough”.
The recent suicide of UCT medical dean cardiologist Bongani Mayosi has highlighted the stress and depression faced by many medical professionals in SA.
Dr Alasdair McKelvie, head of dental services, Africa at the Dental Protection at Medical Protection Society, said: “It is now well recognised that rates of burnout within the dental profession are significant. Studies from around the world quote rates of 15-84% depending on the dimension of burnout studied.
“Dentists want the best for their patients and the stress of working with anxious or demanding patients day after day can be very difficult.
“The experience can be isolating and can have a negative impact on professional confidence," said McKelvie.
Medical Protection Society is an international not-for-profit idemnity organisation for doctors, dentists and healthcare professionals.
The South African Dental Association’s head of education, Nosipho Mzobe, who was not involved in the research, said dentists were burnt out and struggling. “We need a break,” she said.
The biggest problem facing dentists in the private sector was that medical aids paid very little towards dentist visits, she said.
In the 1990s, 15% of all medical aid expenditure went to dental treatments and today it was just 2.3%.
Many medical aids pay for dentistry out of patients’ day-to-day benefits.
“Dentists are working longer and longer hours to pay overheads,” she said. “This leads to burnout.”
Mzobe said dentists worked 52 hours week to cover costs. This was a long time because of the intensity of the work, intricate and microscopic surgery, and the hours spent standing.
She said dentists also had to do more and more administration to follow regulations. Every part of the work was regulated, including what equipment was used.
A surveyed dentist told the Medical Protection Society that “my workload is making it difficult to find a balance between family and my duties as a dentist”. Another said they didn’t think the job was worth it.
“I think the stress and anxiety is not worth the remuneration. I feel far less joy out of the profession than I used to.”
One of the reasons for financial pressure is the weakening rand.
Nearly everything dentists use is imported, Mzobe explained. For example, tiny titanium files used to clean root canals cost R1,000 for a set, and could be used only once.
Dentists’ lecturers were also struggling, since the national Health Department had pushed for more dentists to be trained with the same staff. There were more and more students to supervise, she said.
“Something has got to give.”