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00:00:01
Episode 6:
50 Plays2 years ago
Stephy Steph and Bobby chat about the challenges that doctors face. This one specifically deals with how mental health is stigmatized. Bobby chats about what has changed in Texas at the dental board to try to be proactive on this important topic. Bobby is representing his own opinions in this episode. They also talk about the important work of the Dr. Lorna Breen Heros Foundation. https://drlornabreen.org/
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Transcript
Introduction and Setting the Scene
00:00:03
Speaker
Hey there, y'all. Hey there, guys. I'm Stuffy Stuff, and this is Bobby, and we're reporting from Dallas, Texas today. That's right. We are between two teams. It's 105 degrees, but it's a nice 62 inside. That's right. That's right. It is. It looks like you just came off the hockey rink, of course. Yes, I did. Do you know what we're talking about? I know what we're talking about, but I'd like to take a minute and
00:00:30
Speaker
And I just, before we get into what we're talking about here. Because we're talking about a serious thing. We're talking about a serious thing, ergo the strategic pause. And so I just want to set the scene, set the mood here.
Mental Health and Regulatory Barriers
00:00:42
Speaker
We're talking about the regulatory environment.
00:00:46
Speaker
You're supposed to say give me an R and I was gonna like come through. Yeah but you know the moment just passed. No so they've turned it off now but it's gonna be we're gonna have a really important interesting discussion. You got your hockey drip going on there. I'm also signing with a division one team called the Thunder Buddies. Yeah that's right you think they'd sign me on? I bet they would. You know they did.
00:01:07
Speaker
All they did. Listen, let's get right into it. We're talking about mental health issues. We're talking about protecting health and saving lives, basically caring for our caregivers. You're a new doc. I'm not a new doc. I'm in the regulatory arena. And part of the push has been people like me, regulators,
00:01:30
Speaker
The data shows we get in the way of people getting help they need for mental health and including substance abuse issues.
00:01:38
Speaker
I asked this question last night when we were around a lot of dentists, actually. And the question was, when you were going to dental school, was it reasonable to kind of ask, how are you doing really? We like that question because everyone says, how are you doing? I'm great. Well, no, that's the question. When you went to dental school, was that a thing?
00:02:01
Speaker
Uh, no, not at all. I, when I went to dental school, even though it wasn't like really outspoken, it was starting to become like a, Hey, you know, are you okay? Are you doing all right? And it was becoming less stigmatized to talk about wellbeing and mental health awareness.
00:02:18
Speaker
So times have changed. I think COVID, what COVID did was take a tricky situation and just blow things up. And so there's a big push for, especially first responders who really had to deal with things during the, certainly the initial phases of the COVID pandemic.
Dr. Lorna Breen's Story and Its Impact
00:02:35
Speaker
and de-stigmatizing people, asking questions like you're talking about, but also just seeking care. There's this great organization called the Dr. Lorna Breen Heroes Foundation and she was an ER physician that
00:02:52
Speaker
was at the forefront of things during the pandemic in New York. She was an ER physician. She had no prior history of issues with mental health issues. She contracted COVID. She was overburdened, overworked, just basically became paralyzed. And she was afraid to get help because of
00:03:13
Speaker
regulators, she was afraid of losing her medical license, she was afraid of credentialing committees kind of poking into history. Of course she was. She had no known history of challenges and she ended up, she died by suicide. And her relatives looked at this situation and said, we've got to do something.
Changes in Licensing Questions on Mental Health
00:03:35
Speaker
We don't want her to her death to have no positive outcome.
00:03:41
Speaker
So they started this foundation and it's actually been very helpful. Once again, I'm the chair of licensing on the Texas State Board of Dental Examiners. We just went through a fairly lengthy process and it was to change how we ask questions. We used to have questions. We used to have have you ever questions. Have you ever had a significant issue with mental health issues? Have you
00:04:04
Speaker
Ever had an issue with alcohol? Have you ever had a question or an issue with drugs? And all the data supports when you ask that question. You call these, would you call these questions?
00:04:18
Speaker
I call them chump questions and I've got, I have other questions based on what you're saying. I know you're in the middle of a spiel, but. That's what I do. It's an interaction and a dialogue. By asking those questions, people don't answer them and it prevents people from getting the help they need.
00:04:35
Speaker
I would agree, and this is a very, this is a debatable topic. There's a ton of, so I'm a wellness ambassador for the American Dental Association. And one thing we talk about is access points. The state board with licensing is absolutely an access point, but there are other access points as well. And I know you're speaking on the access point from the state board side of things, trying to de-stigmatize getting help.
Upcoming Wellness Summit
00:05:03
Speaker
And not mean you know that not have that translate to mean you're gonna lose your license. And I think for my state board regulator friends and colleagues out there, you know, we're so reactive in nature. We often end up dealing with things once they've happened.
00:05:21
Speaker
And what I like about this issue and the American Dental Association, you and I are going to be participating in a wellness summit where they're getting together people from the American Medical Association, people throughout the state board environment, people like yourself who is a wellness ambassador.
00:05:38
Speaker
We've got the Federation of State medical boards. We've got the the dental board organization Just people coming together and say how do we help solve this problem in dentistry? What do you want? dental students new dentists and experienced dentists to know about the regulatory environment and how it's changing hmm
00:06:00
Speaker
I think our medical colleagues are much further ahead on this and I'm hoping we started something here in Texas and a couple other states to make some change happen. We want to get out of the way of people seeking the help that they need to get.
Normalizing Anxiety and Finding Support
00:06:20
Speaker
And I guess to back it up even further, just to say, hey, let's de-stigmatize people talking about it. If you need help, you really need to get it. From a regulatory standpoint, it becomes a patient safety issue. Because if you're not a safe practitioner, a physician, a nurse, a dentist, then that's not going to be safe for patients. So we all have something to win here.
00:06:39
Speaker
Yes, and on the note of getting help, I think it's a normal thing to have certain levels of anxiety, depression, having any kind of negativity. It sometimes comes along with growing up and becoming who you are or who you're meant to be. And you and I have talked a lot about that on recent episodes, too. Right. And so all of that is good. One of the analogies I use when I'm talking to people is,
00:07:07
Speaker
It's okay to take a dive and get to the depths of despair but make sure you come up for air or make sure you're around people that bring you up to the surface and it's not good to stay there. Totally agree. Anxiety is a normal part of life. That was one of the episodes we did before about screening tools and whether if you screen too heavily or the wrong people are screening that can be a bit of a challenge.
00:07:31
Speaker
Sadness, being unhappy, that's a normal part of life, but it can spin out of control. And not to mention the issues that, the separate issues, mental health issues that men and women have. And I think this is something that is very distinct to a male versus a female, is that they have different issues based on their emotional capacities.
00:07:56
Speaker
Right. And I know the American Dental Association, for instance, just had a webinar pretty recently about postpartum depression and things that can be problematic and challenging and just the nuances involved in that.
00:08:08
Speaker
As a new dentist, I'm excited to hear that the state board is making strides to try to de-stigmatize health and wellbeing, or health and wellbeing, getting help for any kind of mental health issues. Yeah, part of it is having that discussion. I know with what we try to do with between two teeth, we're trying to figure things out just like everybody else's. I don't have the answers, I don't have the questions, let alone the answers most of the time.
00:08:35
Speaker
I didn't realize that burnout was a thing. I was raised in a family where that doesn't exist. Like you don't get toughen up. Yeah. So I was raised in a family where you don't get burnt out. You just deal with it and that's, that's scary to just deal with it because everyone's going to deal with it differently. You're rolling the social dice, uh, so to speak. And I think a nice thing is you mentioned that a state board tends to be reactionary in nature, but trying to be proactive.
00:09:02
Speaker
Where can you go to get really good proactive help? And it starts with you and it starts with the people you choose to be around. Sometimes your family or spouse isn't always a great place to start with that. It doesn't mean that you can't find those good positive vibes with your significant others, but just recognize who you need to kind of be with you on that mental health journey because not every family is ready for that.
Alcohol Consumption and Healthier Coping
00:09:29
Speaker
I would agree and you get online, there's all kinds of resources that you can get out there.
00:09:37
Speaker
And it's crazy that someone has to kind of go through suicide, for instance, for everyone to notice. To me, that's the real disparity. That's the tough part. We shouldn't have to reach a therapeutic endpoint. It's kind of like if you have diabetes, you don't have to have end-stage renal disease.
00:10:01
Speaker
We can get there before. And so Steph, that's actually a really good point because mental health issues is a continuum. And that's part of the problem when regulators like me, when you ask a question, there's this big gray area.
00:10:18
Speaker
And a couple years ago is actually two thousand eighteen through the federation state medical boards and some other groups in the am a kind of got together to try to figure out what is a what's an appropriate thing on licensure things either don't ask a question at all.
00:10:33
Speaker
or ask a question, and the question verbiage, and this is what we ended up doing in Texas, are you currently suffering from any condition for which you are not being appropriately treated that impairs your judgment or would otherwise adversely affect your ability to practice dentistry in a competent, ethical, and professional manner? Basically it just says, hey, if you are not safe right now,
00:10:56
Speaker
To treat patients, you shouldn't be treating patients, and we need you to get the care that you need to get. And you gotta put the oxygen on yourself first, and that's your professional responsibility.
00:11:09
Speaker
I hear you and you know, from, from my perspective, I try to tell dental students, especially as a wellness ambassador, I try to tell them that it's not normal to drink every night. Yeah. And it's not normal not to at least go for a walk or see the sunshine. Yeah. And unfortunately, when you go through dental or medical school or farm school, PA, whatever it is nursing, uh, what happens is you normalize some pretty maladaptive behaviors.
00:11:38
Speaker
That's a really good point. And that's actually what I brought up in our licensing meetings was we have great data specific to dental students that they're actually drinking more than college students.
00:11:51
Speaker
If you had a very honest exit interview from each professional student as they graduated, and you had some way to have like a non-punitive method to show, okay, how many people, how many drinks did you have when you started dental school a week versus how, when you ended? Or, you know, what was the...
00:12:11
Speaker
What was the drug and alcohol intake? This was actually a great, it was a self-report survey, but it was through the American Student Dental Association and it really had a fair number of respondents. But it's a challenge and I'm glad you brought that up because you got to look at it and say, you know, take care of yourself. What's helping you? What's hurting you?
00:12:30
Speaker
And I agree with you on that. And for the reason it's a chump question when I was getting back to that on the state board is I remember what it's like still filling out my dental license. And it's a chump question because you just went through the most insane four years of your life. You just, you survived. Not sure there are people that thrive in
Pressures on New Professionals
00:12:49
Speaker
that environment, but there's, there's a lot of people there that they're the first in family. Yeah. I didn't come from like a crazy, you know, uh, connected,
00:13:00
Speaker
family of physicians or dentists. A lot of financial pressure. There's financial pressure. There are questions that you have to answer about what are you going to do for work when you get out. It's the first time that you're going to be out in the world without a plan.
00:13:15
Speaker
lot of pressures. And from my perspective, when you sit down to do that initial licensure application, or for people in hospitals, the credentialing applications for the hospital or your renewal, you're asked questions and that that's on your mind that prevents you from doing certain things. Yeah, it's definitely on your mind. And in another another point on this, as we were just kind of thinking out loud, is
00:13:43
Speaker
Coping mechanisms are have a social function to them too. And so what do you mean? So if you're there's this whole I was reading some philosophical.
00:13:54
Speaker
We're getting big into philosophy. Article on the use of alcohol in different civilizations in history and the good and the bad. And there have been examples in history where social drinking was considered a good thing. Now there wasn't like mixers in it. It was like pure, it was pure grain alcohol, but it's a very small dose. It was only in a social situation.
00:14:17
Speaker
people didn't go home and isolate themselves and drink and i you know i've been to those dental school parties those boat parties it is hard not to feel included and not pick up a drink it is super tough especially when your parents cope that way too so i think for you and i both on our own journey of well-being we've looked at it and said
00:14:39
Speaker
or at least I have, I can speak for myself, you know, there's really no non-toxic dosage of alcohol. It's not that we don't drink alcohol, but I think we've both been really mindful of it.
00:14:51
Speaker
Yeah, I'm not hating on alcohol. I think it's great in a social environment for some things. We both play in beer league hockey teams. Yeah, it's fantastic. We literally just came from a hockey game. And my point for new dentists when they get out is try to make graduation the first step in a new behavioral pattern because life gets harder than dental school.
00:15:15
Speaker
Surprise! Surprise, new Dennis! No, you're not wrong about that. And I think looking at the wellness levers of sleep and nutrition and exercise and substances like drugs and alcohol, all those things come into play. Life is not easy at times.
00:15:36
Speaker
That's why we want you to join our journey quite frankly. And once again, we don't have the answers. We like to take adventures. We like to see things and kind of dissect and dive into information to figure out what's going to make sense. I want, I want Newton is to know that there are people like you on the state board who are trying to at least de-stigmatize because people, the state board represents the public at the end of the day. We are here to protect the public.
00:16:03
Speaker
And I think there are people in the state board that recognize that when you help the dentists, you're helping the public.
Personal Well-being Approaches
00:16:11
Speaker
Yeah. And I guess that's my push for people in the regulatory environment. If we keep stigmatizing people getting the help they need, then we're kidding ourselves. People aren't answering the questions appropriately, and we're preventing them from getting help.
00:16:26
Speaker
Well, I love that advice. What else do you have to give for new docs out there? I want new docs to know that you've got to figure out your own path in life and it doesn't have to be what everybody did in dental school. If your path is doing a lot of CE right when you get out, great. If your path is just surviving,
00:16:47
Speaker
taken a beat, say you travel like crazy. Take a beat, you travel a lot. Yeah, that's okay and super cool. And by the way, you can do everything you want and travel. There's an article in the Wall Street Journal today talking about reverse retirement and normalizing reversal or reverse retirement. It's a European approach to life and it talks about taking trips in the middle of your lucrative years.
00:17:14
Speaker
And man, there is just, the pie gets bigger, you're gonna have plenty of money at the end of the day. You gotta figure out, you can't take it with you. And we did an episode on being intentional on how you recharge. And they actually, it was a Harvard Business Review article, I think, that looked at the data.
00:17:35
Speaker
when you do take a break and you know we've been known to take some breaks we're getting ready to climb Machu Picchu Inca Trail hopefully I do well with that but we're gonna be gone for two weeks we're gonna come back hopefully recharged
00:17:50
Speaker
I've been impressed by how much our patients love it. They connect with it. They connect with our Ukraine mission trip. They've connected with our Guatemala mission trips. When I go to Texas Mission to Mercy, they love that. And there's something where we stop becoming kind of just strictly doctor patient and because of family. And we have family experiences that everyone shares in. We have patients that want to contribute.
00:18:16
Speaker
Yeah, and we have fun with it. You actually design these really cool shirts, and we have staff for wearing the shirts. I wear those shirts all the time from the Ukraine mission trip, because I just love how they feel. But it lets people, and frankly, part of why we do that, part of why we do this, is to push you guys. Get out there. Get out there and do something. We're getting ready. We're actually doing Thailand through, what is it? It's the AHI, which is a travel program through Adebay, which is one of the perks of being a member of the ADA.
00:18:45
Speaker
of the American Dental Association. So if you want to join us in Thailand in like sometime in November, we're doing that too. We're not going to pay your way, but you can like figure out how to get there and you'll see us and we'll go, Hey, how's it going? We're between two teeth.
00:18:59
Speaker
and you know if you have anything that you're always able to you know DM us and just try to figure out what do you need yeah we want to hear what you want us to talk about so once again thank you for joining us this is a serious discussion i appreciate what's happening i am so looking forward to the
00:19:20
Speaker
American Dental Association wellness summit that is coming up in September. It's like September 8th or 9th. We leave the next day to Peru. There's a lot of important people that are going to be at this. Seriously. I'm impressed by the guest list. There's a lot. The Federation of State Medical Boards will be present. The American Medical Association representatives will be present. A plethora of people within the dental realm of things. I think we're going to show up in our satin jackets, aren't we?
00:19:47
Speaker
I think that's appropriate. I'm still a little bit nervous because I'm going to be on like a panel discussion. I'll be the only one in satin. You know, one of the takeaways here is Bobby and I, we love talking about wellbeing. That's why we started this. And the cool thing is, is both of us have very unique journeys of wellbeing and we've had unique challenges. And so that's the cool thing is finding someone that
00:20:10
Speaker
you can relate to.
Engaging Listeners in Well-being Journey
00:20:12
Speaker
And if you find that you can relate to either of us, we're here to help with open arms. And if we come across as though we have all the answers and have it all figured out. We do. We don't at all. At all.
00:20:27
Speaker
But that's part of the fun, that's part of the journey of life. You just hurt yourself hockey player. You know what? That's the universe. My muscle is involuting right now. That's the universe giving you a change. Anyways guys, thanks again for joining us. We love that you're with us here on this journey and live your journey. And if you like what we're talking about, please hit the subscribe. Bye.