Care Q/A, Part I
Featuring Dr. Robert Chianelli, DMD
This is the first in a series of questions and answers with healthcare professionals about how they care for others and themselves.
The American Foundation for Suicide Prevention estimates there are between 300-400 suicides among doctors every year. The total number of suicides among medical professionals is unknown.
Throughout the 1990’s and continuing to 2010, many studies cited dentistry as the profession with the highest rate of suicide in the country. Business Insider published a listing of high-rate occupations, with dentists topping the list as 5.45 times more likely to die by suicide than average.
Despite this widely held belief, recent analysis of these studies and reports suggest the number is skewed. According to National Institutes of Health (NIH), these studies lack the correct scientific weight and demographic variables.
While we may not know the actual rate, we do know the dental profession has unique stresses that must be managed for dentists to give the best care to their patients, and take care of themselves.
Today’s Care Q&A features Robert Chianelli, DMD, a general and cosmetic dentist who owns and operates a family practice in Montoursville, Pennsylvania. Following in the footsteps of his uncle and grandfather, Dr. Chianelli is a third-generation dentist who earned his degree from the University of Pittsburgh and has practiced dentistry since 1990.
A lot of people don’t realize the connection between your oral health and your overall health. What is the connection?
Exactly. Gum (periodontal) diseases; being unable to chew properly from broken teeth leads to digestion problems; liver conditions; rampant bacteria in the mouth can actually infect the heart valve and cause severe endocarditis. People can actually die from it.
Did you always want to be a dentist?
Yes. Had to write an essay in 10th grade for an assignment called Futurography, about what I wanted to do with my life, and where I’d be 20 years from today. I actually wrote about being a dentist. And here I am.
What was it like going through dental school?
It was difficult. You went to class like a job from 8 o’clock in the morning to 5 o’clock in the evening, every day, for the first couple of years. After that, we started getting into clinic work and a lot of rotations with the hospitals. It was tough, tiring.
How do you manage stress?
Stress is a funny thing. It’s a proven fact, that if you give somebody an injection of lidocaine (or other anesthetics), your heart rate goes up.
You mean as the practitioner, your heart rate goes up?
Yes. So I deal with that every day. But you can’t let it get to you. You have to be your best with your patients. Plus, not only being in a clinical setting and provide healthcare, you have to run your business, too.
So, I have to have my A Game when I’m doing a crown or a bridge on people, or root canals, and I have to be savvy and have my A Game about running my business. Have to watch overhead, overtime; figure out if people are working too many hours – or not enough. In addition, being self-employed, you have to take care of your own retirement. I’m the only dentist in this office. If the drill doesn’t go around, we don’t get paid. It’s like being in the restaurant business, if nobody’s cooking, nobody’s making any money.
Does it just come natural for you, or did you have to learn techniques to help you manage stress?
I go to the gym. I had a trainer for many years. That’s a big stress-breaker. At the end of the day, I’d go and see my trainer for an hour and half. Three days a week. That was really good. Once a week I try to get a massage. That’s another stress release.
So is it all about breaking it off – the stress — giving yourself time at the end the day to break it off, reset?
Some dentists, this is all they do. They just practice and don’t have outside interests.
I started getting like that. I was working 6 days a week for a while when I first started. Uncle Eugene (also a dentist) told me, “Don’t burn yourself out. It’s easy to do when you start working 5-6 days a week.”
What helps you stay focused?
I try to stay in a routine. I wake up at approximately the same time every day. I do the same routine almost every morning —very methodical. That way I stay focused. I workout at the gym three days a week and I get massages at least once a week. I try not to let small things bother me. I focus on my work and my patient’s well being which gives me great satisfaction. I take time off to go to NYC and Canada and travel to other cities and go to rock concerts – that is a big stress relief for me. I have a lot of cool friends around the country that I visit. I own a house in Canada and I spend time up there fishing and relaxing, traveling from lake to lake.
Do you know anybody that you went to college with, or anybody in your professional network that has struggled with stress or mental health?
I don’t know anybody personally. We had a professor at dental school attempt suicide. Nobody liked him. I liked him. We used to hang out. He asked me once, “Hey, Chianelli, how’s come you want to hang out with me, when no body else does? “Because you know your shit, buddy. I want to learn from you.”
What is your advice for other people, say college students, about to embark on a medical profession, especially one in dentistry?
Go into dentistry. Don’t go to into medicine at this point. With the way the insurance companies are now, you’ll be working your ass off for nothing. Go into dentistry and set your own hours. Work 4.5 days a week. Don’t be tied to insurance companies. That keeps your stress down. Don’t over-extend yourself. Work hard. Stay healthy.
What is the most rewarding aspect of your job?
Providing relief of pain. I don’t like people having any pain issues. Restoring patient’s oral health to optimum condition. And doing a cosmetic makeover. It changes people’s lives. You’d be surprised how many people are walking around with broken front teeth.
I had a kid come in here about 10 years ago. He was a guard at the (local) prison. You would sit there and talk to him, and he’d give you one and two word answers: “Yes. No. I don’t know. Maybe.” And he’d never look at you. We sat him down, pulled his lip back, and saw his teeth were all rotted. Terrible. After I got done fixing him, he got a promotion at work, he’d come in and have a conversation with you, his love life increased tremendously – he was like a new person.
That’s what it’s all about. Changing people’s lives.
Interviewed December, 2014 for Power of One: Preventing Suicide in America Project Blog by author and documentary filmmaker Alivia Tagliaferri.
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