Many years ago, when I was first trying to create a successful dental practice, I fell in love with the word “production.” I believed that production was the key to success, so I read everything I could to become more productive.  

I took courses.

In the early years, there were so many courses that centered around how to efficiently double and triple book, how to bring in more “warm bodies,” how to sell more dentistry, and how to utilize more staff to get more done. I never felt like these strategies were the answer to my production issues. I barely became more efficient, and I never became more effective as I just ran myself down. 

In my books, I have written about my issues with stress, which I believe eventually initiated adult-onset diabetes. Through it all, I continued my quest to be productive. In those years I truly learned to become more effective rather than more efficient. Reading Stephen Covey’s First Things First was extremely helpful to prioritize my work and life. But I found that was only part of the solution. The real problem for me was not managing my time. It was managing my energy.  

Diabetes became my blessing and my curse.

In my quest to control high blood sugar and the fatigue that comes with it, I found more energy. I found more mental and emotional clarity as well. A fog was lifted. My diabetes forced me to eat better and to exercise.  

I remember listening to some of Anthony Robbin’s tapes in which he tells the story of living in a small apartment in southern California, being extremely overweight and feeling like a loser. The first thing he did was to exercise. I did too. Slowly at first, I began to run. I built up my time and distance. Now, twenty-five years later, my routine includes six hours per week in the gym, running and lifting and six hours per week doing hot Yoga. The results have been nothing short of amazing. My diabetes is under control, I lost weight, I multiplied my energy level and mental clarity went way beyond what I expected. 

My moods improved, I enjoyed my work more, patient behaviors didn’t get to me as much, my work improved, I learned new techniques and took more continuing education, and most importantly, I had the energy to have a life outside of work.  

In 2003, I was fortunate to dine with Pete Dawson and he spoke about his friendship with Dr. Morty Amsterdam and how he so enjoyed coming to Philadelphia. He spoke about L.D. Pankey. At one point he said something I will never forget, he said, “You know, L.D. was no fluke.” I asked what he meant. He told me, “L.D. really loved dentists and loved the dental profession. That is what drove him.”  

Dr. Dawson was no fluke, either.

Through his writings and teaching of over 50 years, he was a warrior for meaningful, excellent and dutiful dentistry. When news Pete’s passing came, tens of thousands of dentists all over the world wrote about how much he meant to their lives and careers. He had carried the torch of meaningful comprehensive dentistry into the hearts and minds of dentists for as long as I can remember. 

I carry a coin in my wallet which reads, Memento Mori. The Stoics used that phrase to remind themselves that everyone is mortal. “You could leave life right now.” When the news of his passing came, I was shocked. Joan Forest reported that Pete was prepared and yet on the Tuesday before he was still preparing lectures and writing a chapter for a new book. I guess that is what the keepers of meaning do right to the end. 

Excellence, duty, and meaning are the primary sources of Stoic joy.

Not the surface cheerfulness and pleasure that we have come to know on social media. The essence of what L.D. and Pete taught led to real inner happiness. I know it did for me.  

Erik Erikson, the developmental psychologist and psychoanalyst known for his theory on the psychological development of human beings, described the last tasks of adult development as generativity and keeper of the meaning. Erikson claimed that if one completed these tasks, the reward would be a full life. 

As the Pankey Institute continues passing on the knowledge of meaningful comprehensive dentistry to younger dentists (from one generation to the next) and to never waiver on the meaning of dentistry for patients and dental professionals, there is true potential for a new generation to become keepers of the meaning. And this makes me smile. 

Fifteen years after graduating from dental school I was searching for answers.

I barely knew what questions to ask because there was no guidebook to learning how to practice dentistry and live the life I imagined. I read every book including Juggling for Dummies. Then I stumbled across The Pankey Institute, and I knew my search was over. Back then the program consisted of five continuums. At C1, I was lucky enough to meet Dr. William Davis, the co-author of the then recently published book A Philosophy of the Practice of Dentistry, with Dr. L.D. Pankey.

At the end of classes one day, I stayed behind to talk with “Bill” about philosophy.

I always had an interest in philosophy, but Bill discussed how Dr. Pankey applied philosophy to a dental practice. We spoke into the evening and through the week. I told him that this philosophy sounded a lot like a garden variety of personal development. It was loaded with quotes from Napoleon Hill and Dale Carnegie, yet I felt there was more to it; after all, Pankey had studied “real” Aristotelian philosophy at Northwestern University.

I was never satisfied with the explanation of the philosophy consisting of the graphical “Pankey Crosses.”

From that week on I took my studies deeper. My search for answers continued, but now I was on a path. I realized that if I was going to apply philosophy to my practice it required behavioral changes. The Pankey Philosophy was more than a moral philosophy which is projected and leads to judgements about the way others do dentistry. I realized that this philosophy was a personal and practical philosophy which was designed to direct my own behavior.

The examination process became very important to me, because by continually perfecting it, I could focus on my behavior and the changes it made. Those personal changes lead to more success and more enjoyment. Slowly I began to appreciate dentistry. I focused on the “apply your knowledge” arm of Dr. Pankey’s Cross of Dentistry. Then, while taking courses in positive psychology, I realized that in order to make real changes I would have to focus on my “character strengths and virtues.”

“Dr. Pankey and the Greek philosophers used the word virtues.”

Dr. Pankey and the Greek philosophers used the word virtues. I never truly knew what that meant. Somewhere I read that a virtue is a habit of the mind that is consistent with nature and reason. It can be argued that when L.D. Pankey spoke about care, skill, and judgement, he was speaking about virtues. Not surprisingly the positive psychologists have written about character strengths and virtues.

They have defined twenty-four separate strengths divided into six virtues: wisdom/knowledge, courage, humanity, justice, temperance, and transcendence.

By studying these strengths and virtues and working them into my daily habits, a funny thing happened. Not only did I become a better dentist, but I became a better leader for the first time in my practice. Leadership was the answer I was searching for, and character was the answer to leadership. It has been a long and worthwhile journey that may have ended differently without understanding Dr. Pankey’s philosophy was a personal and practical philosophy that had real meaning for my life.

When dentists are asked to use their imaginations to create a vision of the future, they usually see themselves as achieving their dreams, becoming successful and living the happy American dream. Using our imagination gives us a sense of control over our lives. I myself used the term “master of my own destiny” as my battle cry to create my practice philosophy. Was I accurate? Well, not to the degree I thought I would be. The old saying, “Man plans, and God laughs,” applies.

At the start of my career, I didn’t realize the effect that technology, the economy, advertising, and insurance would have on my plans. My definition of success at the start included words like accomplishment and achievement of a worthy goal. I learned the sense of well-being was to become an integral part of this.

Over four decades of practice, I learned that in order to live a life well-lived, certain components would be required. I could not have survived forty years if I had to go to work every day without the ingredients of a happy life.

The Ingredients of a Happy Life

The positive psychologists tell us that our well-being is dependent on five components. Dr. Martin Seligman, from the University of Pennsylvania, uses the acronym PERMA to describe these five.

P – Positive Emotion. For us to experience well-being, we need positive emotion in our lives. Any positive emotion such as peace, gratitude, satisfaction, pleasure, inspiration, hope, curiosity, or love falls into this category – and the message is that it’s really important to enjoy yourself in the here and now as long as the other elements of PERMA are in place.

E – Engagement. When we’re truly engaged in a situation, task, or project, we experience a state of flow. Time seems to stop, we lose our sense of self, and we concentrate intensely on the present. This feels really good! The more we experience this type of engagement, the more likely we are to experience well-being.

R – Positive Relations. As humans, we are “social beings,” and good relationships are core to our well-being. Time and again, we see that people who have meaningful, positive relationships with others are happier than those who do not. Relationships really do matter!

M – Meaning. Meaning comes from serving a cause bigger than ourselves. We all need meaning in our lives to have a sense of well-being. We need to create our own meaning with a sense of intent and purposefully design our own lives and practices accordingly.

A – Accomplishment/Achievement. Many of us strive to better ourselves in some way, whether we’re seeking to master a skill, achieve a valuable goal, or win in some competitive event. Flourishing in this way adds to the sense of wellness.

Happiness Is Subjective

All of the components together can be measured and hold the key to our well-being. Happiness, however, is about semantics. It’s about a subjective feeling.

Aristotle said it is “an expression of the soul in considered actions.” He called those actions virtues and said one could only measure the degree of happiness in a person’s life at the end of one’s life.

Freud said happiness can be found in lieben und arbiten—to love and to work.

And, Charles Schulz, the creator of the Peanuts cartoon said, “Happiness is a warm puppy.” In truth, we cannot completely describe happiness, but we all know when we are happy.

Because the state of happiness is a present tense phenomenon, I have chosen what will make us happy in the future by what makes us happy now. That is why I have chosen Martin Seligman’s definition of well-being as defined by PERMA as a guide to a sustainable career and a life well lived. All of the PERMA components of well-being — positive emotions, engaging work, positive relationships, meaningful work and achievement, can be built into our practices.

Why Is Happiness Like a Warm Puppy?

Having an experience or two a day of true connection with patients can make all the difference in being satisfied at work. This simple definition of happiness is a good way to measure how you are feeling about your chosen career and practice life, because, if in the present of your everyday practice life, you feel moments of warmth (like holding a warm puppy), you will hold up well against the difficult moments, and you will have a rewarding career in dentistry.