Episode 18: Burnout and Self-care in Dentistry with Dr. Jessica Metcalf

“We always tell our patients to not to wait until they’re symptomatic. How then as dentists do we let ourselves become symptomatic before we take care of ourselves?” ~Dr. Jessica Metcalf

So many doctors forget about the “I” in “investment”. But taking care of yourself is absolutely essential to building an Investment Grade PracticeTM. You can’t be at peak performance, if you’re not taking care of yourself. I know it’s a cliché, but if your glass is empty, you can’t pour more into others or your business. But dentists are notoriously bad at self-care.

Tell me if this sounds familiar: I’m meeting my goals, my team is good, so, yeah, everything is fine. But its it really? I’ve asked so many dentists in surveys to rate their self-care. It’s rare to get a rating above 3 out of 10. Somehow, in our industry, self-care rates as a nice to have, not a must have.

But for those of you dedicated to building an Investment Grade PracticeTM, a routine of self-care is vital to the longevity of your practice. After all, you can’t successfully lead a team, care for patients, and run a business if you’re burned out and running on empty.  

Dr. Jessica Metcalf, winner of the 2021 Dentistry’s Got Talent competition, joins me today to share why self-care is so important to longevity and success in dentistry, including:

  • Soft skills vs. essential skills: Why self-care is ranked so slow in dentistry
  • What stands in the way of dentists taking care of themselves
  • How self-care helps you reach peak performance

Subscribe to Investment Grade PracticesTM on iTunes & Spotify.



Victoria Peterson 1:01
Welcome to another episode of Investment Grade Practice. I’m Victoria Peterson, your host and today I’m super excited to be with Dr. Jessica Metcalf. She is multitalented, amazing human. I got to know you Jessica at dental Festival at the dentistry got talent competition where you took first place. So my first question to you is how heavy is that belt?

Dr. Jessica Metcalf 1:30
Well, it’s heavy enough that it put me overweight, my luggage. Um, but it was so good. I still I remember looking at the videos afterwards. And just in disbelief when my name got called. And then a very proud moment at the same time because I feel like we can’t talk about some of the things that I did talk about. And now that I walked away from winning it, it’s that we are now able to continue to have these conversations.

Victoria Peterson 2:07
I love it. And so for those of you joining us on this podcast, Dr. Jessica is an incredibly brilliant dentist and clinician, she works in the field of oncology, dental oncology, and the discipline of I would call it medically compromised or complex care. And you teach a lot of classes about that on how to treat the medically compromised patients. And I have so much respect for you. And I look forward to bringing that work forward. Today, though, what I’m really super excited about is this duality that you have, not only are you an amazing clinician and a brilliant scientific mind, but your compassionate heart has been open through your own journey. And when I look at Investment Grade Practices, you know, the eye in the investment is really how am I investing in myself as a dentist, as an owner as a human. And there’s so many skills to develop, to successfully build and grow a dental practice. And today, what we’re talking about is your topic that you want. At dentistry. It’s got talent, which is perfectionism and burnout and mental performance. So maybe today we’ll get into some of those soft skills, you know, and why self care is so important to creating peak performance. It’s like a tool in your tool belt. And yet, every dentist I ever interview, we do lots of research, right? And they’ll say, yep, meeting my goal, my team is good. How are you at? How are you at your own self care, like on a scale of one to 10? Jessica, I will say that they typically rate themselves below a three, almost every dentist I’ve ever surveyed rates himself at a below three, like self care is somehow a nice to have, but not a must have. So help us show us what you teach and how you help doctors really understand the value of this.

Dr. Jessica Metcalf 4:13
I want to start with the fact that you had said soft skills. And that’s where we’re already looking at them in a negative way. And then when we look at self care, that’s why it’s ranked so low is because we don’t see it as something that we need to be spending time on. So what if we actually changed soft skills to essential skills? Ah, so now these are skills this is treatment planning. This is imagination, this is creativity, this is now looking into self care. So then you can be at peak performance. But you can’t be at peak performance if you’re not taking care of yourself. And that’s one of the things that I always say is is that why do we tell our patients not to wait until their symptoms Got it, right. We say this all the time, don’t wait until you’re symptomatic to come and see us. Because at that point, it’s too late or it’s gone too far. But why do we allow ourselves to become symptomatic? Before we actually need to make a change? And why do your dentist

Victoria Peterson 5:16
Why do dentists wait so long? Before they put themselves at the, at the first of the line? I mean, I’m talking about, you know, just Could you take 10 minutes to take a breath before you walk in the house or go to the gym a couple of times a week, even basic self care?

Dr. Jessica Metcalf 5:33
Why does it take so long, it’s so and I keep asking this, it’s so funny, I keep having so many of these conversations over and over again. And it’s almost as if you have to reach a breaking point to be able to make that change, because you keep thinking that you can keep going that you can keep living amongst the stress without sleep. And it gets to that point where then the body, and your mind just can’t do it anymore. So if we started to implement changes earlier on, with even things like changing how we choose to communicate to ourselves, oh, this will then all of a sudden set you up for being able to handle that one comment that comes in the day or that one procedure, that one patient who’s on your list, right? Instead of it turning into the tipping point.

Victoria Peterson 6:30
Can you give me an example of that, like how I talk to myself? Hmm.

Dr. Jessica Metcalf 6:35
So one way that we choose to motivate ourselves, especially as high achievers high performers to begin with, is we negatively motivate ourselves? Oh, some works harder than me and someone smarter than me. So which means I need to work that much harder. I need to take more CEE I need to work longer hours in order to be able to make up for this lack there of that I’ve told myself, and I’m the only one who’s told myself this. Oh, do you think that’s

Victoria Peterson 7:04
from selection into? Like, is it part of the educational process that we learned to talk to ourselves this way?

Dr. Jessica Metcalf 7:12
Yeah. So it starts as early back. So there’s two parts of this one, it could have been depending on childhood, and that communication from role models or parents or adults in general. And then as we started to make our way through, we started to perform as that high performer and so you now became the president of a club, or were top athletes or volunteered or had research and all of a sudden, that baseline is now heightened, then you get to dental school, and that baseline is now normalized. And because of that, you are now consistently pushing yourself and pushing yourself. And then when you start to compare, and social media nowadays makes it really easy for us to compare. We then think, Oh, well, why am I not taking on the full rehab cases? Or why am I not doing the complicated extractions? And that’s where we can kind of spiral into, okay, well, I’m not good enough. Or I’m not capable, or I shouldn’t be the one to do these things. And so we push ourselves and we beat ourselves down. But if we even started with how we changed our own inner dialogue, we can then start to create compassion for ourselves. Wow. Well,

Victoria Peterson 8:33
I’m so what’s a better inner dialogue? How do high achievers I know you’ve got a couple of courses like the imposter syndrome and 90 day confidence. What’s a baby step you could take today? So let’s say I am that dentist. I’m short staffed because everybody’s short staffed, I’m working break. My patients are booked out now like six months everybody’s, but it feels like I’m not even productive. I’m just like, busy, crazy exhausted. What’s one thing I could tell myself today that would make a difference?

Dr. Jessica Metcalf 9:05
So one of the first ones is when you start to create awareness in what you’re saying to yourself. So the first is just to pay attention to what that inner voice is saying. Some of us haven’t even paid attention to it because it’s been on repeat for so long. That that’s our normal. So now it’s creating awareness around it. Then what you want to do start to substitute words from the I can’t to I can and I know what you’re saying is okay, if it was that easy, everyone would be doing it. Okay. Well, what you can take it as one step further and separate self doubt, from idea doubt. So what does that mean? self doubt is where you walk into a situation and say, I suck at doing dentistry. Idea. Doubt is where you look at that situation and you remove yourself from it. So idea doubt is now getting really strong. So say, class to restorative procedure didn’t go as well. And you say that margin wasn’t good or wasn’t done as well as I would have hoped it to be. That way you’re then separating yourself from the situation instead of blaming yourself now, you doubt can be energizing, it can help you problem solve, versus self doubt can be debilitating. Then, the last component of it is, is that as you start to substitute your words, as you start to change from self doubt, to idea doubt, you actually have to figure out if you believe it or not, and you tune into your body, and you rank it on a score. So the way that I like to do it is think of the pain scale zero being no pain, 10 being the most excruciating pain ever. So zero is your belief you absolutely are zero is you don’t believe it. 10 is you absolutely believe it. So if all of a sudden that butterfly in your stomach starts to settle down, or the lump in your throat isn’t as prominent, or your chest doesn’t feel as tight, you’re now starting to believe what your inner dialogue is saying. You can get from a two out of 10 to a three out of a 10 to eventually apply to 5.5. It’s just those minor steps of getting there. And love that.

Victoria Peterson 11:20
And that’s so powerful, too, because how we identify is how we show up. So that’s a huge difference taking it in a non dental way of I’m a smoker. Versus I’m someone who smokes. Yes, exactly. Because someone who smokes could quit, someone who smokes could reduce someone who could make a different choice, but I am therefore I will be. So you’re right, those I am I suck I this is I statements about ourselves are so damaging neurologically, because it creates a hard wires us to then be programmed to do that.

Dr. Jessica Metcalf 11:58
Anytime you have that uncomfortable conversation with a patient or a staff member, or a procedure doesn’t go as well, you relate that back every single time and your body remembers that every single time. So it’s that much easier to slip into that anxiousness.

Victoria Peterson 12:17
Oh, that’s amazing. That’s amazing. I’ll share with you a quick example of how a leadership changing their mindset changes everything within the company. So within PDA, going through the pandemic, with all of our consultants, and they’re flying all over the world, they’re pretty independent, infinite thinkers, and then are now everybody’s in their office. And now they’re having to learn to work virtually. And we’re having to learn new things and communicate in a very specific way on legal and financial issues with our doctors. So having 30 opinions on how to apply for or should you apply for PPP, is probably not a good thing for consulting firm, right. And so we got very centralized and a little too micromanaged. And so that that type of leadership kind of got started feeding into like, during pandemic, to the point that people were now holding others accountable. I’m gonna hold you accountable, and our doctors call us and say, we do hold my team accountable, will you fix my team, and that phrase has always bugged me. And it didn’t figure out until the leadership retreat that you and I were talking about, I was like, that’s no longer that word is no longer in my vocabulary. Because what I want to hold my people to be is capable.

Dr. Jessica Metcalf 13:33
so powerful, so powerful.

Victoria Peterson 13:36
So I got quiet enough and saying what is happening, people are vying for power or authority, or there’s all this right and wrong and blame and I don’t know, you know, dentists, maybe you’re listening to this, you’ve got that kind of drama going on in your practice. But when you hear that, then you have to sit back and say, there is a word that’s creating this, what is the word so I kept listening for the word and the word was accountability. And I thought, You know what, what Jessica is doing is really none of my business in terms of holding you accountable. I can only hold me accountable. So then how do I relate to Jessica, as a peer or employee is like, Yeah, I’m wanting to know

Dr. Jessica Metcalf 14:16
that you’re capable.

Victoria Peterson 14:19
And then if you’re not, if this is not getting done, and it’s a capability issue, then I can train it. Or I can bring it up and say, Hey, did you know that this was part of your role? And I’m consistently not seeing it, you go, Oh, God, I just have no capacity for that. Right? Like, I could technically balance a checkbook. I actually have a lot of accounting background, but no one in my company is going to let me near QuickBooks because you can read the financial spreadsheet, so I’ve got the capacity. I’ve got the capability of it, but I don’t have the capacity to sustain it. So I will share with you in the last week. For two weeks, I now have people saying, well, you know what, I feel very capable of getting that done. I know I could get that done by five o’clock. And I had one person say, Well, I think I’m just going to do that, because that’s my comfort zone. It’s another example of it. And I said, Well, I get it. That’s your comfort zone. But what if that was really your power zone? And they’re like, ah, that’s my power zone. I love it. Bringing up about self talk and how we label it really is so powerful. So how do you coach this when you’re working with doctors? Because leadership seeing leadership and team retention? That seems to be the number one and number two topics that I see doctors curious about? And feeling kind of hopeless on? Solution for? Because the topics are so big? So how do you help doctors through this journey?

Dr. Jessica Metcalf 15:56
So a good portion of what I do is really helping individuals break through their self doubt, they’re feeling fear, failure, and overworking. And when it starts to build confidence, you can really understand your abilities, your skill set, and how to create priorities in your life. And so by starting with, asking yourself, What makes you anxious? What keeps you up at night? What are those Sunday scaries, quote, unquote, right? We can then start to really unpack. Okay, well, why is this making you nervous? Is it a specific procedure? Is it the conversation that has to happen? Is it how the staff is being managed at this point in time. And it’s really starting to get into some of those more specific details that we just as humans don’t want to ask ourselves at times. And so when I get there, it can be uncomfortable for the individual to try to process it on their own and kind of work through it on their own. And that’s where then the two of us can work together to create a safe space to then ask the questions as clarifying questions. So think differently, because it’s not that the individual is wrong, or that the anxiousness is wrong, or that the stress is wrong, right. And we’re never going to be free of any of that, right? There’s always going to be stressors, whether it’s in dentistry, or if it’s in life, that happens, there’s always going to be stressors that come up. But if we could figure out how to process them, how to view them differently, and how to interpret them in a way that allows us to take back our safety or vulnerability and the ability to process it, then it becomes that much easier to still work in a stressful environment. But know that this doesn’t define me as who I am. And I don’t have to take this home every single night. Wow. Wow, that’s so powerful. And I know you’re probably

Victoria Peterson 18:12
seeing the same thing, or there’s so many more resources, it feels like we’re coming out of the closet with this dirty little secret. And the secret is entrepreneurship, and clinical dentistry both carry this thread of high achievers, which is just a huge, destructive, self burnout, sort of pace that we impose on ourselves. And you know, in studying entrepreneurship, you see the big success, you know, the guy’s got the the Jaguar and the jet and all of that. But what you don’t see on the cover of the magazine, or the burnt relationships, you know, the divorces, the kids who aren’t talking to you, the addictions, the coping mechanisms. And so I know, for myself, I got in that spiral. I thought I could do it all. Why not? I had a consulting firm, it was successful, it had a marketing firm, I had everything I needed to then go build a management platform. So why not buy five dental practices? I bought three on the same day. Can you believe that? Who does that? It’s like a buy one get one. You know, it’s not the same as buying shoes, right? So within six months, I’ve got 55 employees who live in another state like and I was going through menopause. So depending on where you’re at, in your personal body, and your life cycle and your hormones and your family tree and your genetics and all of that kind of biochemistry kicks in and you end up you know, being treated for PTSD. And my mind couldn’t even wrap myself around it because I didn’t go to Vietnam. I’ve never killed anybody. Like that was my definition of, of Brain Stress was well you don’t get to you don’t get to declare that you’ve got a stressed out brain unless you’ve murdered

Dr. Jessica Metcalf 20:01
And it goes back to exactly our definition of what PTSD looks like, right? And it looks different to every single person.

Victoria Peterson 20:08
So what does it look like in dentistry where there are some archetypes that you might see, because this really is a block to your leadership, it’s a block to your success. And it doesn’t have to be fully PTSD, but on that on that mental scale of stress, so and that’s

Dr. Jessica Metcalf 20:25
why I keep saying the word anxiousness, because you may or may not have been diagnosed and sought out professional help in order to receive that diagnosis. And that’s completely fine. Right? So it’s not putting a label on someone, it’s understanding, okay, where does that anxiousness come from? So then you can work through it. So regardless, if you have an anxiety disorder, or panic disorder of some sort, or PTSD, it’s now understanding, okay, well, how do I understand it a little bit more, so that it doesn’t become debilitating. And so when I talk about anxiousness and we start to work through, it’s really now paying attention to how it starts to come up within you, and when does it come up? And are there certain triggers, just similar to the way that we ask our patients had an emergency appointment right, now we can start to internally ask ourselves that, is it specific type of procedures that you really don’t want to be doing anymore? That kind of sets you off? Right? Did you have that one case, without one patient? And you can likely already picture it as I’m talking about it, right, that comes to mind that you’re like, Okay, now, I’m not going to be able to do this procedure ever again. That doesn’t mean that just because that one didn’t go as planned doesn’t mean that you can’t try again. So what can happen at times, and this is, I’ve worked through with a couple clients is understanding if you’re creating now safety behaviors, and what safety behaviors are deliberate actions, to help you process and reduce that anxiety. And if when you eliminate that safety behavior, all of a sudden that anxiousness will come up. So let’s say you have to look at an x ray three times and you have to look at medical history twice, and you have that process. And when you eliminate one of those things, it’s like you can’t trust yourself. It’s starting to build back that confidence internally, instead of waiting for a patient or a staff member to compliment you. And when you start to build that internal validation, when you start to pay attention to that anxiousness and your stressors, you can really start to curate a dental life that fits you. Because ultimately, that’s all it needs to fit, is you, right, it’s the type of dentistry you want to be doing, and what does that look like on a day to day basis?

Victoria Peterson 22:53
Wow, this is so powerful, and, and I appreciate you, so we’re gonna have you back more and more, because we don’t even have time to get into your clinical chops, which are so meaty. But you know, you brought up a couple of really great points is that leadership begins here. It begins with me. And this last piece, I hope I heard this right is that you know, there’s a lot that you hear business management, you know, at the Speed of Trust and get your team to trust you and your pace to trust you. But if I don’t trust myself, because if I don’t follow this methodically, and I do think that we do, we do search for and the application process helps to elevate people with OCD or Asperger’s or we’re on we’re all on this OCD spectrum somewhere or we wouldn’t be in this highly specific career choice you know, it is meant for all of us. I tell my husband I either clean everything down to the light switches are clean nothing at all. Like there’s no in between for me because it’s it’s really hard. I choose to have someone else clean the house because it’s it’s better for everybody.

Dr. Jessica Metcalf 24:06
I’m at right so you know that and that works.

Victoria Peterson 24:10
Yeah, but when I do get in here and I boy during the pandemic and my Clorox wipes every door handle every light switch was just spic and span everything we touched. It’s really so good to know that there’s hope. It’s really so fabulous to know that there are easy things quick things like in 30 days, 60 days, 90 days that these feelings of anxiousness that prevent me from being my best. This feeling of anxiousness that causes me not to trust myself. Like that could all go away. And then I love the part where you said then you don’t have to wait for others to compliment you. You’re not waiting for external validation. And I think that really it just defines what leadership really is. You know, is this I’m excited With my own inner authority, and I trust myself to lead and guide others. So what a what a beautiful gift to our, to our industry. Thank you.

Dr. Jessica Metcalf 25:11
Thank you. Those are very kind words. Thank you so much. All right.

Victoria Peterson 25:14
If our listeners want to learn more about you, Dr. Jessica, how do they get in touch with you?

Dr. Jessica Metcalf 25:20
They can send me an email at info@drJessicametcalf.com Or they can check me out on social media under the name be Alchemist dentist.

Victoria Peterson 25:29
The outcome is dentist I love it. We’ll get all of that in the show notes. You’re somebody that we definitely need to keep an eye on. You are a rising star and it won’t be long before everybody knows your name.

Dr. Jessica Metcalf 25:42
Thank you.

Narrator 25:46
Thank you for tuning in to this episode of Investment Grade Practices Podcast. If you find value in this episode, help us spread the word by passing it along to a dental friend. Subscribe and give us a Like on iTunes or Spotify. Learn more about building your Investment Grade Practice at productivedentist.com Today

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This site may not be used as a supplement or alternative for health care, and is not intended and does not warrant or guarantee the quality or quantity of any services of any of the advertisers identified; further, the information provided is merely for educational purposes, and its accuracy is not guaranteed. Do not use this site as a substitute for health care. Please consult with your doctor or other health care provider regarding any health questions you may have. This site may not be used for health diagnosis or treatment. Do not use this site to disregard any health advice, nor to delay seeking health advice, because of something you read or see in this site.

You understand and agree that neither Productive Dentist Academy nor its suppliers or vendors or linked domain names are responsible or liable for any claim, loss, or damage of any kind, directly or indirectly resulting from your use of this site or the information or the resources contained on or accessible through it.

Productive Dentist Academy expressly disclaims any implied warranty or representation about the information or accuracy, relevance, completeness, timeliness or appropriateness for any particular purpose of any kind. Your use of this site is also subject to all additional disclaimers that may appear throughout the site.

Other Internet Sites Links
This site also includes links to other internet sites created and maintained by Productive Dentist Academy’s suppliers, vendors, affiliates, or subscribers. Be aware that Productive Dentist Academy does not control, makes no guarantees about, and disclaims any express or implied representations or warranties about the accuracy, relevance, completeness, timeliness or appropriateness for a particular purpose of the information or the resources contained on these or any other internet sites.

Further, the inclusion of these links is merely for your convenience and is not intended and does not reflect Productive Dentist Academy’s opinion on the accuracy or the importance of these other sites; further, Productive Dentist Academy does not endorse in any manner any of the views expressed in, or products or services offered by these other sites. All information in any site by Productive Dentist Academy, or associated or linked site, is extracted, read, used, or relied upon by you at your own risk.

Disclaimer of Warranty
Productive Dentist Academy and its suppliers and vendors disclaim all express or implied representations or warranties regarding the information, services, products, materials, and any other resources contained on or accessible through this site, including without limitation any implied warranties of merchantability or fitness for a particular purpose. All information provided by Productive Dentist Academy is made available “as is” and “as available” without warranty of any kind, or any express or implied promise, including, by way of example, its continuing availability.

Limitation of Liability
With respect to products, goods, or services purchased from any entity identified, listed, named or contacted through Productive Dentist Academy’s website, or any links to Productive Dentist Academy’s website, to the maximum extent permitted by applicable law, in no event shall Productive Dentist Academy or its suppliers or vendors be liable for any direct, indirect, special, punitive, incidental, exemplary, contractual, or consequential damages, or any damages whatsoever of any kind, resulting from any loss, which by way of example, includes loss of use, loss of data, loss of profits, business interruption, litigation, or any other pecuniary loss, whether based on breach of contract, tort (including negligence), product liability, or otherwise, arising out of or in any way connected with the use or performance of this site, with the delay or inability to use this site, or with the provision of or failure to make available any information, services, products, materials, or other resources contained on or accessible through this site, even if advised of the possibility of such damages.

You acknowledge and agree that the limitations set forth above are elements of this agreement, and that this site would not be provided to you absent such limitations.

You agree to indemnify, defend, and hold harmless Productive Dentist Academy and its suppliers and vendors from any liability, loss, claim, and expense (including reasonable attorneys’ fees) related to your violation of this agreement or use of this site in any manner. Your use of this site shall constitute your acceptance of the terms of this Agreement, as revised and modified, if any, each time you access this site. Productive Dentist Academy may modify this agreement at any time, and such modifications shall be effective immediately upon posting of the modified agreement.

Productive Dentist Academy’s failure to insist upon strict enforcement of any provision(s) of this agreement shall not be construed as a waiver of any provision or right.

This agreement and the resolution of any dispute related to this agreement or this site shall be governed by and construed in accordance with the laws of the State of Washington, without giving effect to any principles or conflicts of law. Any legal action or proceeding between Productive Dentist Academy or its links, suppliers or vendors and you related to this agreement or this site shall be brought exclusively in a state or federal court of competent jurisdiction sitting in Skagit County, Washington.

All materials on this website, including the site’s design, layout, and organization, are owned and copyrighted by Productive Dentist Academy or its suppliers or vendors, and are protected by U.S. and international copyrights.

This site contains links to other sites. Productive Dentist Academy is not responsible for the privacy practices of other sites that are linked to us.

Should you have any questions or concerns regarding Productive Dentist Academy’s Privacy Policy and Terms of Use, please contact us.

Read More About Our Terms of Service and Why It Matters

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