My Patient Ron

April 1, 2022 Paul Henny DDS

We had another interesting week at the dental office when a patient (I’ll call Ron) came in. Ron has been a patient of mine for over 20 years and is nearing 80. Whenever I saw him, we would have interesting conversations about what he was doing and thinking about doing next. He was the kind of person I love to be around, always positive with a “can-do” attitude.

This time was different. I hadn’t seen Ron in over three years, because he suffered a heart attack which led to some other complications. He came in using a cane.

When it was time for my hygiene check, Julie came to me and said, “I don’t know what’s going on with Ron, but he was really hard for me to work with today. I tried to get as much accomplished as I could. I’m sorry.”

Ron was previously very health-centered but now he was behaving like he wasn’t. Do values change in that short a period? No, but a person’s priorities might, particularly when they have developed a distorted perspective due to some traumatic events.

When I entered the room, Ron’s attitude perked up. He was positive and respectful — he was honoring our long history of mutual respect. He updated me on what happened and how he was doing. Not only were his physical disabilities frustrating, but he had rarely left the house for over a year.

Following my exam, we discussed an area of decay and several cracked teeth — all restorable with crowns. He responded that he was old and wasn’t sure how much longer he would be around. He asked, “Is there an inexpensive way to fix this? I don’t want to spend a lot of money on my mouth.”

Dentists hear this every day, but in this case, I knew the REAL Ron. I knew it was his depression speaking to me. I told him it would make sense for us to develop a Phase 1 plan, meaning, “Let’s remove the decay and get everything stabilized like they would do for you in the ER if you had an emergency, and then we can talk later about restoring things back to the way they need to be — strong and secure.”

“I don’t think I want any restoration work,” he replied.

Then, I said, “Ron, I know how much you love to eat fine food, and it would be tragic if, in your last decade, you were limited to eating only soft food or you had to fumble around with a partial denture that catches food around it all the time. Like I said, let’s focus on Phase 1 and then talk about restoration later. We have time on our side.”

“Ok,” he said, “I can go along with that.” He needed to feel like he was in control.

I finished by using words that would resonate with him, “You know Ron, despite these things that need to be addressed, you have great bone around your teeth and a great smile, so there are good reasons to restore things and finish out strongly. If you were an old, uninspiring ‘84 Oldsmobile, I’d say there is no point in restoring things, but you’re like a 1956 Corvette barn find that’s still in good condition. You’re worth it. Let’s save the conversation about restoration for another day when you are feeling better. I’m so glad that you came in, I miss talking to you.”

Ron’s eyes lit up. He smiled and said, “Yea, maybe you’re right. I can’t move like a Corvette any longer, but I understand what you are saying. I really appreciate it.”

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Paul Henny DDS

Dr. Paul Henny maintains an esthetically-focused restorative practice in Roanoke, Virginia. Additionally, he has been a national speaker in dentistry, a visiting faculty member of the Pankey Institute, and visiting lecturer at the Jefferson College or Health Sciences. Dr. Henny has been a member of the Roanoke Valley Dental Society, The Academy of General Dentistry, The American College of Oral Implantology, The American Academy of Cosmetic Dentistry, and is a Fellow of the International Congress of Oral Implantology. He is Past President and co-founder of the Robert F. Barkley Dental Study Club.

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The Wonder of Relevant Examples – Part 2

March 21, 2022 Richard Green DDS MBA

One evening I was seated next to a new acquaintance at a dinner party. As we began the conversation, I learned Bob was a retired CFO of a manufacturing company with $250 million in sales. He had traveled extensively and had had many experiences in dental offices.

In our conversation, Bob discovered I was a dentist teaching at The Pankey Institute. I thought I would move the conversation off of dentistry and have the opportunity to climb into the mind of a CFO of a $250 million dollar company, so when he asked what I taught, I responded with “I teach Finance.” He looked surprised and a bit disinterested, but he said, “You know, the thing that impresses me most, about dentists, is how quickly they make decisions.”

Trying to find the compliment in the statement, he had just made and hoping he thought dentists to be of high intelligence, I queried, “Quick decisions?” He went on to tell me, and sometimes show me between bites of food, the crowns I had already noticed. He said, “It always impressed me, when I went into the dental office with a broken tooth, how the dentist would have a quick look around and then tell me I needed a crown. Sometimes he was ready to do it on the spot!”

Other things had come out in our conversation. He was an accomplished golfer with a six handicap. He had three homes, and each home had an identical set of golf clubs. All were recently updated, matched, swing-weighted custom sets. My mind was spinning as I thought about the gap between those matched sets of clubs and his unmatched set of teeth! How could I get his attention?

Doctor Pankey would often say to me, “Communicate with others by making your examples relevant to the other person’s experience or frame of reference.” The light bulb came on, and I said, “Tell me about how you made decisions as a CFO in your business.”

“Well, I take a good look at the short and long term impact of the decisions, the cost of capital necessary – both short and long term, and the risk/reward potential to the bottom line of the company.”

Now I was in full swing, “Sounds like you study the problem and/or opportunity with reflection and quite a bit of detail. You slow down and take the necessary time to uncover the best decision.”

“Well, yes, of course, they would be important decisions, and they would take time!” Bob replied.

“Quite honestly, Bob, that is exactly what I and others are attempting to teach dentists at The Pankey Institute. We are asking dentists to intentionally slow down and become more reflective, affective, and effective with their patients.” I could see he was thinking about this.

“Bob, let’s compare you and your teeth to your sets of golf clubs.” He was intently listening. “It’s as if, when you were a young man, God gave you a set of new golf clubs. We, as dentists, call them teeth. You used them through the years as you refined your golf game and in time you broke the 9-iron. You went to the pro shop and tried to get a new one. It was a 9-iron, of course, but the grip, the shaft and the swing weight were not quite the same as your original set. It was okay, because you knew how to adjust if you remembered to accommodate for the differences.

“As time went on, you had the same experience with your 7-iron, the 4-iron, the pitching wedge, and your favorite wood. In time, you were adjusting your swing and muscles every time you swung a club. You noticed there were times when certain muscles would get sore and even the soreness would get in the way of your swing chewing. Finally, you decided to get refitted with a whole new set of clubs. You went to a professional who put you through a whole series of tests and thorough evaluations to diagnose and plan the best solution, which fit your uniqueness. And, you not only got one completely new set of golf clubs, you got three.

“Many dentists would see you as a very busy man who wants to get out of the dental office with dispatch. They respond in a crisis mode to your crisis events. But, like clubs, teeth need to be customized and “matched” to work together so you aren’t constantly accommodating as teeth break and are restored. What we are encouraging dentists to do is to slow down and be as thorough as you would be in your decision making in your business. It’s better for you—actually better for all concerned.”

Bob’s face lit up, “So that’s what you teach?” “That’s what I teach,” I responded

With that “aha” smile, Bob said, “Would you be so kind as to give me your business card with the name of a dentist who thinks like you do? In fact, I’d like three – one for each of the locations of my golf clubs!”

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Richard Green DDS MBA

Rich Green, D.D.S., M.B.A. is the founder and Director Emeritus of The Pankey Institute Business Systems Development program. He retired from The Pankey Institute in 2004. He has created Evergreen Consulting Group, Inc. www.evergreenconsultinggroup.com, to continue his work encouraging and assisting dentists in making the personal choices that will shape their practices according to their personal vision of success to achieve their preferred future in dentistry. Rich Green received his dental degree from Northwestern University in 1966. He was a early colleague and student of Bob Barkley in Illinois. He had frequent contact with Bob Barkley because of his interest in the behavioral aspects of dentistry. Rich Green has been associated with The Pankey Institute since its inception, first as a student, then as a Visiting Faculty member beginning in 1974, and finally joining the Institute full time in 1994. While maintaining his practice in Hinsdale, IL, Rich Green became involved in the management aspects of dentistry and, in 1981, joined Selection Research Corporation (an affiliate of The Gallup Organization) as an associate. This relationship and his interest in management led to his graduation in 1992 with a Masters in Business Administration from the Keller Graduate School in Chicago.

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The Wonder of Relevant Examples – Part 1

March 18, 2022 Richard Green DDS MBA

Doctor L.D. Pankey would often say to me, “Communicate with others by making your examples relevant to the other person’s experience or frame of reference.”

Years ago, I had been asked by a young dentist to come to his office and help him with the implementation of his new learning with occlusion applied to bite splints and equilibration. I suggested he line up a few patients for us to work on together during my visit. When we arrived at his office early in the morning to talk about the patients we were going to see together over the next two days, I asked him to bring me up to speed on where he was in treatment with the patients and the conversations he had had with them. We also looked at full mouth models, models of bite splints, and radiographs. I asked him what he wanted me to do with the first patient who was coming in that morning.

He said, “I want to watch you sell him a bite splint!” A little surprised, I asked him to tell me about the patient. He said he was a new acquaintance. They played golf together and occasionally gambled as they played to keep their interest up in the game. They also gave each other a hard time about handicap ratings. He mentioned he felt a bit embarrassed because he thought he knew what was best for his new friend and had kind of hustled his friend on the golf course to be a patient. Now he was feeling a bit guilty about having his new friend come in as a patient, and he could not bring himself to a have conversation concerning the benefits of a bite splint.

Charlie (the friend) appeared, and the dentist introduced me. Charlie and I stood about the same height. We looked each other in the eye, and we smiled at each other – a good beginning. In my mind, I was repeating slowly to myself, “Find a relevant connection.”

I said, “Thanks for taking the time to come in and meet me on such a beautiful Spring day, as I pointed to a comfortable chair for him to sit in.”

He offered something about how golf could be a bit boring if you played it too much. Still looking for a relevant connection, since my “stated task” was to sell him a bite splint, I asked him about his work, and he said he was retired from directing filmed commercials. I asked him what he did with his new found time aside from golf. He smiled a big smile and said he ran about five to seven miles a day. I smiled as I remembered the years when I ran three to five miles a day during the week and seven to ten miles on weekends. A light bulb went on, in my head, and I knew a question I could ask to engage him and tweak his curiosity.

I asked, “How often do you buy new running shoes?” And without hesitation, he said, “Every four hundred miles.” I then asked, “How did you discover that interval?”

He reached down with his right hand and rubbed the lateral surface of his right leg from the mid-thigh, across the lateral surface of his knee, to the lateral surface of his calf, while telling me of the discomfort he would experience in his muscles when the bottoms of his running shoes became worn.

I made the statement, “You must run with the traffic!” Surprised, he asked, “How do you know that?”

I told him I experienced the same thing when I ran on a road with the traffic, especially when the road had a bit of a “crown” on its surface. I thought I had found a relevant connection, and I let it sink in a bit. Then, I told him his dentist friend wanted to offer him a new pair of shoes for the top of his teeth in the form of a removable bite splint. It would be like getting a new pair of running shoes. It would be professionally custom fitted to the tops of his teeth, which would please your chewing muscles and create greater comfort, just like a new pair of running shoes pleased his leg muscles and knee joint.

Charlie looked at his dentist friend and then at me before standing up. With a big smile he said, “I will make an appointment with the receptionist.” Hmmm… Isn’t that Interesting!

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Richard Green DDS MBA

Rich Green, D.D.S., M.B.A. is the founder and Director Emeritus of The Pankey Institute Business Systems Development program. He retired from The Pankey Institute in 2004. He has created Evergreen Consulting Group, Inc. www.evergreenconsultinggroup.com, to continue his work encouraging and assisting dentists in making the personal choices that will shape their practices according to their personal vision of success to achieve their preferred future in dentistry. Rich Green received his dental degree from Northwestern University in 1966. He was a early colleague and student of Bob Barkley in Illinois. He had frequent contact with Bob Barkley because of his interest in the behavioral aspects of dentistry. Rich Green has been associated with The Pankey Institute since its inception, first as a student, then as a Visiting Faculty member beginning in 1974, and finally joining the Institute full time in 1994. While maintaining his practice in Hinsdale, IL, Rich Green became involved in the management aspects of dentistry and, in 1981, joined Selection Research Corporation (an affiliate of The Gallup Organization) as an associate. This relationship and his interest in management led to his graduation in 1992 with a Masters in Business Administration from the Keller Graduate School in Chicago.

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Staying in the Question – Part 1

February 7, 2022 Mary Osborne RDH

The art of helping our patients develop ownership of their present condition and their desires for their dental health is built on the foundation of listening. But much of the time, we do all the talking and provide all the information.

Several years ago, my friend and I were coaching a young hygienist when her patient asked how she could get her teenage son to spend more effort caring for his teeth. I was ready to dazzle them with all the tips I had learned over my 20+ years in Hygiene but my friend Linda cautioned us to “stay in the question.” She was curious to know what the mother in the chair was really asking. That was the first time I became aware of the concept of staying in the question.

The model I learned in my clinical training—the model of teach and tell, really isn’t enough to help patients make choices about their dental care. And over the years, I learned that when I assumed I knew what a patient meant by a question and gave information I thought they wanted… I was wrong. My assumptions got in the way of my ability to really help my patients.

Are our patients asking for help or for information?

When I learned to combine the ability to stay in the question with my knowledge about dental health and dental care, all my conversations became a bit easier. I have come to realize that that mother with a teenage son, like so many of our patients, was asking for HELP but not information.

Today I can think of several questions I might have asked that mom before I jumped in to giving her information. I might have asked, “Well, what have you tried so far?” Or I might have asked, “What motivates your son in other areas of his life?” I might have asked, “What is he doing to care for his teeth?” I might have asked all those questions but asking even one of those questions, might have enabled me to better help.

Sometimes asking just one question before offering information is enough to open the door to real learning.

Staying in the question is both a skill and an attitude.

We need to skillfully ask authentic questions that are not designed to manipulate people into doing what we want them to do. If the questions help us understand our patients better, they are authentic questions. If the questions help them talk through and move through any barriers they perceive, they are authentic questions. If the questions open their minds to possibilities, they are authentic questions.

But staying in the question is not just about asking questions. It’s about an attitude of curiosity, of coming to the conversation with a desire to know more. It’s about releasing the attitude that we know everything we need to know to help the patient move forward.

Staying the question requires a genuine belief that our patients have information that we need to help them better.

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Mary Osborne RDH

Mary is known internationally as a writer and speaker on patient care and communication. Her writing has been acclaimed in respected print and online publications. She is widely known at dental meetings in the U.S., Canada, and Europe as a knowledgeable and dynamic speaker. Her passion for dentistry inspires individuals and groups to bring the best of themselves to their work, and to fully embrace the difference they make in the lives of those they serve.

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Discussing the Topic of Anti-Inflammatory Foods with Patients

November 1, 2021 Lee Ann Brady DMD

Both periodontal disease and TMD are inflammatory disorders.

We have lots of dental patients who are suffering from the effects of inflammation, and one of the things we can do is help them look at inflammation not from just a local perspective but also from a systemic perspective. Our goal is to help them reduce inflammation where it occurs in the mouth and, also, throughout their bodies in general.

In addition to the first line dental treatments, we can work with our patients at higher risk to manage their general inflammatory response by advocating and discussing dietary changes. I have had great success with some patients by giving them nutritional guidelines.

I know some of you are “rolling your eyes” when you read this because you have had little impact on dietary changes. But we can throw it out there, and some of our patients will latch on to that information and try hard between their dental appointments to make a visible difference when we next see them. These are patients who want to be proactive, and this is something over which they can take control, much like the percentage of patients who accept fluoride varnish and implement the Sonicare devices we recommend.

We don’t need to hold ourselves out there as nutrition experts. We can explain that periodontal disease and TMD are inflammatory processes and one of the things we are learning today is that the foods we eat can increase or decrease inflammation in general. We can suggest this is something they could become curious about, do some internet research, and use the anti-inflammatory foods information they find to affect positive changes in their total health and the oral health issues we are observing.

I tell patients there are great books on anti-inflammatory diet guides and anti-inflammatory cookbooks on Amazon. Dr. Joel Fuhrman and the Forks Over Knives publications are two I mention. If you delve into reading on this topic yourself, you will find you can easily converse about the impact this reading has had on your own diet and the health of other patients.

Be as general in the information you provide or as specific as you are comfortable, but by starting this conversation with patients, you are doing your best to help them.

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Lee Ann Brady DMD

Dr. Lee Ann Brady is passionate about dentistry, her family and making a difference. She is a general dentist and owns a practice in Glendale, AZ limited to restorative dentistry. Lee’s passion for dental education began as a CE junkie herself, pursuing lots of advanced continuing education focused on Restorative and Occlusion. In 2005, she became a full time resident faculty member for The Pankey Institute, and was promoted to Clinical Director in 2006. Lee joined Spear Education as Executive VP of Education in the fall of 2008 to teach and coordinate the educational curriculum. In June of 2011, she left Spear Education, founded leeannbrady.com and joined the dental practice she now owns as an associate. Today, she teaches at dental meetings and study clubs both nationally and internationally, continues to write for dental journals and her website, sits on the editorial board of the Journal of Cosmetic Dentistry, Inside Dentistry and DentalTown Magazines and is the Director of Education for The Pankey Institute.

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Conversational Recall

June 4, 2021 Sheri Kay RDH

Over the past few months, I’ve had a series of coaching sessions with frustrated dentists due to many of their exchanges with team members not being as effective as they had hoped. The dentists were confident they had been clear about their expectations, and yet there was still lagging or even absent implementation of the anticipated behavioral and system changes.

“Maybe this is not the right team member! How can they not just do what I ask them to do?”

Of course, I appreciate how disconcerting this can be, AND I want to challenge the notion that a single conversation can lead to effective change.

I imagine we can agree that most of your patients are in the midst of their own developmental process, as dental offices have quality systems in place to support this idea. A patient comes in for a hygiene appointment and they are routinely scheduled to return in 3 or 6 months to follow up, monitor for changes, and (hopefully) celebrate new levels of health. We are used to the idea of having a return date, better known as a “recall appointment.” More often than not this system works. Over time, as the recall appointments continue, trust levels increase along with deepening relationships and even case acceptance.

The question I pose is this: How can you as a leader apply this same principle to coaching your team members? I like to call this system a Conversational Recall.

What if at the end of a coaching conversation, even a short one, you create an opportunity to revisit with the team member to assess progress, problem solve any obstacles, and set a time for yet another Conversational Recall? My own experience tells me that sustained change typically occurs by implementing small changes over time. Staying connected with a team member by offering ongoing feedback and support may very well be the difference between you being frustrated by unmet expectations and your ability to celebrate high performance and heightened levels of engagement.

One aspect of leadership is setting each team member up for success. You can do this by investing time and energy, walking alongside them, and committing to following up as a pathway to letting each person know that you care. One of the greatest ways to inspire change is to demonstrate to your team members that you both value what they have to bring and that you believe in them…sometimes even more than they believe in themselves.

Another aspect of quality leadership may just lie in your ability to be congruent in all areas of your practice; do for your team what you do for your patients—if not more. Care for your team like you care for your patients—if not more. The rewards for everyone involved could be incredible!

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Sheri Kay RDH

Sheri Kay started her career in dentistry as a dental assistant for an “under one roof” practice in 1980. The years quickly flew by as Sheri worked her way from one position to the next learning everything possible about the different opportunities and roles available in an office. As much as she loved dentistry … something was always missing. In 1994, after Sheri graduated from hygiene school, her entire world changed when she was introduced to the Pankey Philosophy of Care. What came next for Sheri was an intense desire to help other dental professionals learn how they could positively influence the health and profitability of their own practices. By 2012, Sheri was working full time as a Dental Practice Coach and has since worked with over 300 practices across the country. Owning SKY Dental Practice Dental Coaching is more of a lifestyle than a job, as Sheri thrives on the strong relationships that she develops with her clients. She enjoys speaking at state meetings, facilitating with Study Clubs and of course, coaching with her practices.

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Check-In and Debrief at the Dental Visit

April 16, 2021 Mark Kleive DDS

When I think of the small things my practice does on an everyday basis that have a big impact on patient relationships, patient satisfaction, and case acceptance, the first thing that comes to mind is what we call check-in and debrief.

Early in my practice years, way back when I was practicing corporate dentistry, when I walked into the operatory, the patient already had topical in place and my job was to get them numb. There wasn’t much of an opportunity to have a conversation. Over time, I learned the concept of check-in and debrief, which is really about how you can use the time at the beginning and end of the appointment to influence the relationship you have with the patient.

These are ideal times to build value for what the patient has agreed to do at that appointment and to tie the goals of the patient to the value of the treatment the patient is receiving, or you hope the patient will accept.

Usually, the check-in and debrief each take about two minutes. My assistants participate in this process with me, so they have increased understanding as well.

Previous Conversations Inform Me

I can be mindful and successful with my conversations if previous conversations with the patient were documented. My assistants take notes for me during my conversations with patients. I need to know:

  • What is important to them,
  • What they are hoping for, and
  • What could get in the way of accomplishing what they believe is best for themselves?

My Check-in Conversation

During the check-in, I aim to converse about what we have planned to do and how this fits the overall goals of the patient. Usually, I enter the room and there is a little chit-chat. Then I ask, “What is your understanding of what we are going to do today?” The response helps me gauge the patient’s awareness. Following this conversation, I may ask, “What is your understanding of how this is part of your long-term health plan?” Or, if the patient has a stated a good understanding of what we are going to do, I say, “Yes, and this is how it fits into your long-term goals for your teeth.” They should now have a good sense of why the appointment time is of benefit to them.

My Debrief Conversation

During the end-of-the-appointment conversation, I aim to thank the patient for being cooperative, talk about what they can expect as a result of today’s appointment, and what they can expect as we move towards their preferred future. No matter what happened during the appointment, I want my patients to hear how much we appreciate them being our patients and being there today. When we talk about what to expect from today’s appointment, we can go over any post-op instructions, which are also presented in written form. Lastly, I want to give them hope that we are accomplishing steps on the road to their preferred future and that we can get there with their continued cooperation. I want to see the rays of hope register on their faces.

I believe all of this is of high value to the patient personally and in building value for the practice. It is well worth the time, and for me, it is a standard part of every patient visit.

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Mark Kleive DDS

Dr. Mark Kleive earned his D.D.S. degree with distinction from the University of Minnesota School of Dentistry in 1997. Mark has had experience as an associate in a multi-clinic setting and as an owner of 2 different fee-for-service practices. For the last 6 years Mark has practiced in a beautiful area of the country – Asheville, North Carolina, where he lives with his wife Nicki and twin daughters Meighan and Emily. Mark has been passionate about advanced education since graduation. Mark is a Visiting Faculty member with The Pankey Institute and a 2015 inductee into the American College of Dentistry. He leads numerous small group study clubs, lectures nationally and offers his own small group programs. During the last 19 years of practice, Dr. Kleive has made a reputation for himself as a caring, comprehensive oral healthcare provider.

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The B-A-G Reflection Process

February 8, 2021 Bill Gregg DDS

For years now, I have followed this simple reflective process. I hope it proves to be helpful for you in your personal and professional growth. My reflection BAG contains Blessings, Accomplishments, and Goals. 

Blessings  

List all the blessings you are grateful for; family, friends, satisfying work, freedom to worship, health, warm home, living in America, etc. Give thanks for the blessings of life. Gratitude is essential to the journey, and too frequently in our “push” to “get ahead”, we forget our core blessings. Compared to these Blessings, getting ahead isn’t the most important thing. INVOLVE YOUR FAMILY THIS YEAR…even your two-year-old will feel the gratitude. 

Accomplishments 

Summarize all things you accomplished throughout the year. This is such an important step to write down because it never ceases to amaze me, when I reflect, just how much I have accomplished. I always need my calendar for this one because I find I forget all the little things I did do throughout the year. The journey can be so (apparently) slow and frustrating, that seeing how far you progress each year is very important. 

Goals 

Now that you are grateful for the mess you have gotten yourself into, write down your goals for the coming year. Come up with 20-30-50 ideas. Many times, the “best” ones are the last few that pop into your head. Remember the Pankey Cross and plan in all areas, Work, Love, Play, and Worship. Know Yourself, Know Your Patient, Know Your Work, and Apply Your Knowledge (this is a part of that). Spend as much (or more) time and money on the behavioral - communication aspects of care as you do the technical aspects of dental care. Plan to integrate Joy, Wonder and Relationships into your work. 

Set Aside Quiet Time to Reflect

Please set aside quiet time to do this. The first time it may take several struggling hours. I reflect several times a year and still set aside a few hours, but it has become almost like meditation for me and is one of the most important things I do for myself. I do this to continually refocus my efforts and to enhance gratitude. This has become part of my personal Peace process.

Thinking Beats Regurgitation

Throughout our education process we dentists are taught to memorize and regurgitate…not to reflect nor to think (I believe, at times, thinking is beaten out of us). We look to others to provide us the “answers” we might be missing that will guarantee our passing the tests (success). Sometimes we glance at someone else’s success and, thus, we let others define success for us — and we all are obsessive enough to bust our butts for an “A” to please someone else. If we just miss being perfect, we feel like such a failure. And for those of you paralyzed by needing to be perfect…Perfection is a disease. The goal is excellence, not perfection. John Wooden said it best:

“Success is the self-satisfaction in knowing you did your best.”

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About Author

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Bill Gregg DDS

I attended South Hills High School in Covina, Denison University in Granville, Ohio and the University of Redlands in Redlands, California prior to dental school at UCLA. My post-graduate education has included an intensive residency at UCLA Hospital, completion of a graduate program at The L.D. Pankey Institute for Advanced Dental Education ; acceptance for Fellowship in the Academy of General Dentistry (FAGD); and in 2006 I earned the prestegious Pankey Scholar. Continuing education has always been essential in the preparation to be the best professional I am capable of becoming and to my ongoing commitment to excellence in dental care and personal leadership. I am a member of several dental associations and study groups and am involved in over 100 hours of continuing education each year. The journey to become one of the best dentists in the world often starts at the Pankey Institute. I am thrilled that I am at a point in my professional life that I can give back. I am honored that I can be a mentor to others beginning on their path. As such, I have discovered a new passion; teaching. I am currently on faculty at The L.D. Pankey Institute for Advanced Dental Education devoting 2-3 weeks each year to teaching post-graduate dental programs. In other presentations my focus is on Leadership and includes lifestyle, balance and motivation as much as dentistry.

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On Addressing Traumatic Experiences

September 4, 2020 Paul Henny DDS

When we have experienced a deeply traumatic event, such as an emotionally laden death, or the near-death of a family member, what is often left behind is emotional debris with the potential to follow us around indefinitely. Subsequently, we can become haunted by memories of what happened, or what we should have done to make things better. These kinds of recurring thought patterns can easily bleed over into our daily lives and negatively influence our behavior—and our future.

On a neurobiological level, this occurs as our brain is designed to keep self-preservation as its highest priority. Thus, possessing the ability to quickly recall traumatic events protects us from similar things happening in the future. But commonly, this constant re-remembering can lead us into a state of psychological paralysis, depression and/or chronic anxiety, and poor decision-making.

At the present time, many patients live in fear of going to the dentist, because they believe there is too high of an infection risk. Concurrently, they consider the process of addressing their dental needs as being a lower life risk. These shadows of fear can remain strong in their mind, particularly when they have a family member who is in a high-risk category. Simultaneously, some dental team members have made the decision to leave dentistry for similar reasons. However, both challenges are happening at significantly lower rates within relationship-based / health-centered dental practices, as these practices have already built strong, enduring bridges of communication within their patient pools.

The Shadow

A contagious virus is a concept most people understand. The level of anxiety this virus has generated world-wide is something many cannot successfully manage alone. We have all had patients whose past dental experiences were so negative and their thinking about it so distorted they cannot recall why certain situations trigger their dental PTSD. Carl Jung referred to the source of these recurring thoughts as “the shadow.” Buried memories and their emotional associations can be so strong that they take complete control over a person’s behavior.

Letting Go

The brain does not stop maintaining its focus on traumatic memories until it has come up with a rational explanation for why they happened and a plan for how to avoid them in the future. On this, Jung stated, “Until you make the unconscious conscious, it will direct your life and you will call it fate.”

CoDiscovery was designed to address the influence of the shadow’s influence on current behavior patterns, in much the same way as psychotherapy facilitates the exploration of the past and associates new meanings with those memories. It is intended to help patients associate new meanings with what they are learning about their dental past.

The “Rogerian” therapy model of unconditional positive regard, congruence, and non-judgementalism is an ideal format for patients to safely explore their fears, beliefs, values, and priorities. And that’s why Bob Barkley and Nate Kohn, Jr., Ph.D., leaned so heavily on Carl Rogers’ work. Bob Barkley put this re-experiencing process under an umbrella he called, “Three Phase Adult Education,” and the rest became history.

The Future

As optimistic as the future appears to be regarding the successful management and treatment of COVID-19, this pandemic experience has reshaped our thinking—our “shadows,” forever. How we manage these memories, conscious and subconscious, will have a lot of influence on our success going forward. If we demonstrate we are on the same side as our patients in preventing COVID-19’s negative impact, we create yet another strategic advantage we can leverage against our transaction-oriented competition. On the other hand, if we allow our patients’ fear-driven “shadows” to drive their decision-making, we will rue the day we allowed this proverbial cart to be placed in front of their psychological horse.

Bob and Nate had it right. CoDiscovery is the pathway to deeper understanding, hence better decision-making. And better decision-making is exactly what our profession needs right now.

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Paul Henny DDS

Dr. Paul Henny maintains an esthetically-focused restorative practice in Roanoke, Virginia. Additionally, he has been a national speaker in dentistry, a visiting faculty member of the Pankey Institute, and visiting lecturer at the Jefferson College or Health Sciences. Dr. Henny has been a member of the Roanoke Valley Dental Society, The Academy of General Dentistry, The American College of Oral Implantology, The American Academy of Cosmetic Dentistry, and is a Fellow of the International Congress of Oral Implantology. He is Past President and co-founder of the Robert F. Barkley Dental Study Club.

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Visit Your Dental Lab

August 26, 2020 Kelley Brummett DMD
Recently I went and spent time at the lab of my dental lab technician. I had heard that this was a good thing to do, but the value I got was far more than I expected when I scheduled the visit.

One of my labs is out of state and one is close by. I don’t frequently visit my labs, even the one that is close by, as I find many reasons not to go. However, whenever I have visited the local lab, I experienced them differently than when speaking with them over the phone. Early this year I set aside some time to visit my local lab.

Chairside Challenges With Patients

We have challenges chairside with our patients… It could be the size of their tongue, how they open, the frequency of how little they open, and just like us, our labs run into problems. Oftentimes, they don’t have the whole picture. The patient isn’t sitting in front of them. They only have an impression, a scan, or a model. So, I went around to each person in the lab and asked them what they are looking for when working with a dentist, their concerns, and the roadblocks they come up against. How easy is it for them to pick up the phone and call us about some of the challenges they are experiencing while working with a case?

The visit accomplished a few things. One, we established a more open relationship. This means I’m going to call them as frequently as I need, and they are going to call me as frequently as they need. Two, we reviewed the case and they assisted me with my wax-up. We had an open and honest conversation in which they helped me understand how I can improve my work. We also got to know each other. This is important to me because I strive to have a relationship based practice. I want to be able to speak honestly with my patients and lab, to laugh, and to celebrate the things that are going well.

Conversations With Your Lab Technician

What you do chairside with your patient can be enhanced by conversations with your lab technician. I know that sounds obvious, but what I heard from my lab is that dentists are so busy, they don’t pick up the phone and reach out. And when the lab calls dentists about the challenges of a case, these busy clinicians frequently don’t want to be interrupted by the call. Typically, they don’t want to redo something.

The reality is that we are not perfect, and it is challenging for the lab to make decisions when they don’t have all the information. In my relationship-based practice, it is important for me to freely exchange feedback with my lab. We get feedback forms from labs so we can tell them how well they did. I want feedback from my lab, so I can learn how to improve what I do and understand the challenges they had. I’ve never had a lab willing to give me written feedback, but by developing relationships with the employees of my lab, I have learned some things that improved what I do. And it has made phone conversations with them easier to do.

Regular Laboratory Visits

When was the last time you stepped into the laboratory you use? Have you ever asked them how they can help you improve what you do? I urge you to visit your dental laboratory technician and open the conversation.

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About Author

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Kelley Brummett DMD

Dr. Kelley D. Brummett was born and raised in Missouri. She attended the University of Kansas on a full-ride scholarship in springboard diving and received honors for being the Big Eight Diving Champion on the 1 meter springboard in 1988 and in 1992. Dr. Kelley received her BA in communication at the University of Kansas and went on to receive her Bachelor of Science in Nursing. After practicing nursing, Dr Kelley Brummett went on to earn a degree in Dentistry at the Medical College of Georgia. She has continued her education at the Pankey Institute to further her love of learning and her pursuit to provide quality individual care. Dr. Brummett is a Clinical Instructor at Georgia Regents University and is a member of the American Academy of Cosmetic Dentistry. Dr. Brummett and her husband Darin have two children, Sarah and Sam. They have made Newnan their home for the past 9 years. In her free time, she enjoys traveling, reading and playing with her dogs. Dr. Brummett is an active member of the ADA, GDA, AGDA, and an alumni of the Pankey Institute.

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