Making the office a sanctuary

Dr. Rich Mounce offers advice for calming a stressful environment

Recently, a good friend and I were discussing patient behavior. He expressed concern about the accumulating negativity and frustration he was experiencing from the frequent complaints, bad behavior, and lack of cooperation from some people. He is slowly starting to burn out. My friend summarized his feelings and thoughts with one sentence, “Rich, I don’t want to end up hating people, and I feel like I am starting to.” Many of us can relate.

We live in a strange era culturally. Some feel entitled to say or do whatever they want without filters and/or respect for those around them. In a world where some patients are texting during treatment, choosing not to listen, placing blame, or wanting to use the bathroom every 10 minutes (among a host of similar behaviors), we are being challenged emotionally as never before.

How do we remain calm, confident, professional, and clinically excellent without letting the above issues weigh on us?

Here are my thoughts for maintaining a healthy attitude when such issues arise:

We must first realize there will always be some level of conflict and friction in practice. People are people, and bringing people together means conflict, miscommunication, and challenges. Expecting calm seas all the time is unrealistic. The best we can do is to be positive, maintain perspective, and be calm in the face of histrionics. Making sure our own actions and words are appropriate and professional provides confidence that we do not own the problem, which makes it easier to let go of.

In baseball terms, it is important to see the anticipated curve of the pitch as it arrives. In essence, to ask oneself with every patient where the personal and case risks might be, and whether those risks are worth taking. Can you meet the patient’s expectations? We never need the fee enough to be “beat up” by a case or patient’s behavior. If we can’t meet the expectations or don’t want to perform the case, it has value to simply tell patients that you cannot meet their expectations and let them see someone else that can. In essence, we swing only at pitches we can hit.

Practice less; practice long. There are no medals at the end of a career for the endodontist who treated the most teeth, did the most surgeries, or made the most money. Living less large and practicing longer in a state of better health is a prescription for a happier life in and out of the office.

People regret what they said more than what they did not say. Our tongues, like the rudder of a ship,  have an outsized influence on our actions and the reactions of others to us. When in doubt, be silent, and evaluate what is happening. Very few are the situations where we must immediately speak or act. Being able to step away from the situation in the heat of the moment gives us time to gain our composure and respond ultimately. Losing one’s temper is never productive, ever.

Create a firewall between home and work. Leaving the office at the office and being fully present at home creates a safe space to recharge. Such a firewall potentiates a more well-rounded and positive conversation outside the office. As a part of our “out of office” health, the value of being physically fit and burning off stress through regular, programmed, and sustained exercise cannot be overstated.

As much as possible, make your private office environment your sanctuary, a place that energizes, comforts, empowers, and buffers us from the stresses of the day. Creating a sanctuary can take the form of artwork, smells, music, furnishings, colors, among many possible domestic elements.

I listened to my friend and did not offer solutions to his problem. And perhaps that is the answer for our patients as well — to observe, empathize, listen, and help only where, when, and if we really can. Listening has great value to the one being heard.

I welcome your feedback.

Rich Mounce, DDS, has lectured and written globally in the specialty. He owns, an endodontic supply company also based in Rapid City, South Dakota (605-791-7000). He can be reached at and

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