Learning the Essentials 

January 27, 2023 North Shetter DDS

In his recent book Subtract–The Untapped Science of Less, University of Virginia professor of design Dr. Leidy Klotz points out many instances where we allow ourselves to be overwhelmed with information and complexity. He argues and demonstrates that subtracting the extraneous often leads to greater clarity and efficiency.

Reading Klotz’s book, brought to my mind the Pankey Institute’s Essentials continuum that begins with Essentials 1 (E1). Dentists arrive at E1 overloaded with information taught in their dental schools and other CE programs. All that information may have some value but the role of the Essentials courses is to subtract the extraneous and focus on what is essential.

We arrive at E1 thinking everything is important, and we discover that there are essential elements of dentistry that are key to effectively working with patients, performing a complete exam, diagnosis, and technically excellent, predictable care. From these key elements, we can build practice systems that are clear and efficient.

What Is Essential?

We aren’t born with complete wisdom like Athena born from the forehead of Zeus. We learn wisdom (what is essential) faster by being in the company of others who have traveled the same road, asking, “What is essential? What do I NEED to know?”

The Pankey Essentials continuum exposes dentists to the clinical, behavioral, and financial aspects of practice. And goes beyond exposure to exercises and exploration. The courses invite dentists to understand themselves, their patients, and their work exceptionally well. The courses invite dentists to focus on and develop essential skills.

Our profession has undergone a technological explosion over the past few years. Some of this is wonderful. But how much of what we invest in are we fully utilizing? What is the best technology to invest in? What is the best way to implement it? The Institute’s faculty help us cut through the clutter and determine what works best…what we can implement with our teams and patients that will improve our dentistry and the patient experience. But first, the Essentials courses peel away the layers of hype and technology to help us grasp the core skills we must attain.

The core skills are behavioral as well as technical. And because the behavioral aspects of dentistry are not discussed to great extent in dental school curriculums, one of the roles of the Essentials continuum is to fill in this gap. In the Essentials courses, we learn the importance and skills of behavioral science. We learn how to most effectively lead and affectively influence. We dig deeper into understanding ourselves and our patients…our emotions, our motives. We discuss the behavioral concepts that were taught by Dr. L. D. Pankey because they remain valid today. These concepts are straightforward and help us develop lifelong patient relationships and personal skills.

The business aspects of dental practice are overwhelming. Dental schools do not have time to teach business essentials. In the Essentials, dentists learn essential financial skills such as how to understand their financial statements. If we are not making a profit in our practice we can’t stay in business.

Self-Examination

When I first attended an Essentials course (then called C-1), I worried that I might not know enough. I discovered that I knew a great deal but I had not clearly defined what was essential. I learned I needed to be more assertive about asking myself why questions. For example, I found myself asking:

  • Why am I doing this? Does this step add value to the final result?
  • Why is my final result not stress free and predictable? What step did I miss?
  • Why am I “telling” my patients rather than “asking” for their input and values?

An Intentional, Essential Community of Support

The Essentials faculty and my fellow students helped me understand that getting rid of what is not needed is not simple. Determining what is essential and building my practice systems around the essentials takes time, thought, and effort but was made easier for me because I had the help and constant encouragement of the Pankey faculty and community in shaping my approach to dentistry and my career.

My friend and colleague Dr. Richard A. Green has always said, “Intentionally becoming both more affective and more effective is essential to excellent patient care.” So often we intend to do something but don’t have the encouragement we need to remain intentional. As my friend and colleague Dr. Barry Polansky says, “We humans tend to slip, slide away. It is by developing habits intentionally and self-checking our assumptions that we stay alert to the possibilities of how we can become more.”

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E4: Posterior Reconstruction and Completing the Comprehensive Treatment Sequence

DATE: May 15 2025 @ 8:00 am - May 19 2025 @ 2:30 pm

Location: The Pankey Institute

CE HOURS: 44

Dentist Tuition: $ 7400

Single Occupancy with Ensuite Private Bath (per night): $ 345

The purpose of this course is to help you develop mastery with complex cases involving advanced restorative procedures, precise sequencing and interdisciplinary coordination. Building on the learning in Essentials Three…

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North Shetter DDS

Dr Shetter attended the University of Detroit Mercy where he received his Doctor of Dental Surgery degree in 1972. He then entered the U. S. Army and provided dental care at Ft Bragg, NC for the 82nd Airborne and Special Forces. In late 1975 he and his wife Jan moved to Menominee, MI and began private practice. He now is the senior doctor in a three doctor small group practice. Dr. Shetter has studied extensively at the Pankey Institute, been co-director of a Seattle Study Club branch in Green Bay WI where he has been a mentor to several dental offices. He has been a speaker for the Seattle Study Club. He has postgraduate training in orthodontics, implant restorative procedures, sedation and sleep disordered breathing. His practice is focused on fee for service, outcomes based dentistry. Marina Cove Consulting LLC is his effort to help other dentists discover emotional and economic success and deliver the highest standard of care they are capable of.

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A Reflection On Personal Growth in Learning

December 1, 2021 Richard Green DDS MBA

A Reflection: Although most of our early educational classrooms have not often fostered it, an essential participatory experiential exercise can help ground our discoveries and anchor our adult learning, in which we can be “known through” an experience with self and others, more than knowing anything by our own thought. An authentic encounter with a teacher/mentor can foster, in time, our discovery toward a feeling of true knowing, in our heads, our hearts, our hands, and our bodies, as well. This understanding, authentically discovered, can emerge, in unique ways with each individual, and becomes an opportunity for True-Self seeing. It is quite unlike the intellectual “knowing” most of us have been taught to rely on. This experiential kind of “seeing,” can take away much of our anxiety concerning figuring it all out fully for ourselves or requiring ourselves to be “right” about our formulations beforehand. At this point, a teachers’/mentors’ facilitation can become more like a verb than a noun, more a process than a conclusion, more an experience than a dogma, more a personal relationship than an idea.

Life then becomes more like a verb than a noun…We were not put on this earth to describe life, rather we are invited to actively live it,,,! In time, there often can be someone dancing with us (maybe sitting on our shoulder), and we are not afraid of making mistakes. We learn through experience, mistakes, doubt, while allowing a reviewing process to become an intentional part of our experiential learning. It is often best, if we are not told first… Rather, we can be invited to discover it for ourselves! Hmmm…Isn’t that interesting?

“The true wonder of learning is discovering for ourselves!” Carl Rogers, PhD

Through our own experience we can discover while having many encounter’s in which family, patients, team members, friends, and colleagues become our teacher’s / mentor’s. Even when we are doubtful, we can look in the mirror, at our authentic self and say, “Yes” – knowing full well, there is much more to be experienced and it is bound to add layers to our understanding and learning on the job! What ever the “Job” may be or become! Learning becomes a “Two-Way Street” and our teachers and mentors can become participants, team members, patients, spouses, parents, grandparents, adult children, children, and grandchildren, in all age groups. Success then, is a moving target… Not a fixed destination; instead, it can be a becoming!…Isn’t that wonderful…!

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night with private bath: $ 290

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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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Three Profitable Tips to Simplify Dental Billing for Obstructive Sleep Apnea

May 10, 2021 Mark Murphy DDS

When I speak with dentists who have dipped their toe in the waters of treating obstructive sleep apnea (OSA) in their practice, the number one reason they say they quit doing it or are not doing more is …

“I couldn’t get paid!”

You may be committed to helping patients achieve better health through treatment of OSA, but it’s challenging to make it financially possible. Here are three tips that will make dental billing for obstructive sleep apnea more consistent and predictable:

Use Practice Management Software to Simplify Dental Insurance

Understanding how to succeed in the complicated system of medical billing is a game-changer.

We have all figured out how to streamline our approach to making sense of dental insurance, but the rules are different for Dental Sleep Medicine (DSM). You should use a segment-specific software platform (DS3, NiermanDentalWriter, or other) for your SOAP notes and communication with physicians and payers.

These platforms ensure that you include the right notes, tests, patient status, and history to get paid. DSM and medical reimbursement are under the jurisdiction of rigid documentation of processes, protocols, and standard practices. Choosing the most effective DSM practice management software is the first step to payment because it will not let you forget to harness critical information.

Make It Easy for Patients to Say Yes to Treatment

My second piece of advice is the most difficult to implement because it requires a change in behavior. Talk less about co-payments, deductibles, and the patient’s responsibility than you may be used to in dentistry when dealing with obstructive sleep apnea.

As an example, consider this: When you visit your doctor and they suggest an x-ray, draw blood, or order a specific test, do you usually say, “How much will that cost?” No, you don’t. We know that tests and medical treatment recommended by our physician are necessary and not usually optional to achieve optimal health.

Plus, we know that their treatments will be covered by our medical insurance (after the deductible and with certain co-payments). As dentists, we are expected to have significant upfront financial discussions about how much the patient will have to pay out of pocket because of the different nature of dental insurance.

Unfortunately, this same approach when applied to a sleep apnea appointment may backfire. Treatment of sleep disorders can be life-changing, so it’s beneficial to the patient if you focus less on dollars and more on care outcomes.

When we get detailed about the financial arrangement, upfront copayments, and deductible discussion, patients think we are still treating them as a dentist, not as a medical care provider. Make it easy for patients to say yes by leaving out the money talk. Many will have good coverage and can make the treatment a possibility.

Outsource the Details to a Competent Billing Company

Hire a billing company to do the dirty work. Third-party billing companies (Four Pillar, Nierman, Pristine, Dedicated Sleep, GoGo, Brady) typically charge a small per claim fee around $50 and 8-12% of the paid amount. This fee is worth every penny.

I have seen far too many revolutions from the administrative teams in dental practices when they were forced to try to figure out the weird, ever-changing rules of insurance reimbursement.

Billing companies are experts. Plus, the cost as a percentage of sales works for medical practices, so why shouldn’t it for dentistry?

Treating patients for OSA with Oral Appliance Therapy (OAT) is easier clinically and technically than making bite splints in centric relation. And yet the minefield is littered with the remains of dental teams who tried to do the billing themselves.

If you only did one case per month, subscribed to a cloud software solution, paid a billing company their fair share, and risked not talking so much about money, you would still help patients get healthier, feel very fulfilled, and make more money than you are now.

That success can breed more success. You just might add $100,000 to your annual revenue! Curious how you can start incorporating treatment of sleep apnea into your practice workflow?

I’ll be holding a live, three-hour virtual course, “Treating Sleep Apnea In Your Practice With Oral Appliance Therapy,” on Friday, May 21st, 2021. Registration for my course is easy at Pankey Online.

Join me from 2 pm to 5 pm EST to learn more about the medical background of sleep conditions, marketing sleep appliance therapy, and more in-depth techniques I implement to transform medical billing.

Can’t wait to see you there!

Sign up for free at Pankey Online to access complementary and paid CE-granting webinars spanning hot dental topics like sleep apnea treatment, equilibration, and indirect bonded anterior restorations. 50+ cutting-edge courses at your fingertips …

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Mark Murphy DDS

Mark is the Lead Faculty for Clinical Education at ProSomnus Sleep Technologies, Principal of Funktional Consulting, serves on the Guest Faculty at the University of Detroit Mercy School of Dentistry and is a Regular Presenter on Business Development, Practice Management and Leadership at The Pankey Institute. He has served on the Boards of Directors of The Pankey Institute, National Association of Dental Laboratories, the Identalloy Council, the Foundation for Dental Laboratory Technology, St. Vincent DePaul's Dental Center and the Dental Advisor. He lectures internationally on Leadership, Practice Management, Communication, Case Acceptance, Planning, Occlusion, Sleep and TMD. He has a knack for presenting pertinent information in an entertaining manner. mtmurphydds@gmail.com

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2 Transformative Tips to Leverage Phased Therapy for Single Tooth Dentistry

April 23, 2021 Kevin Muench DMD, MAGD

One of the greatest challenges of dentistry is developing a conceptual framework for how to approach complex cases. We leave dental school bright-eyed but unfamiliar with the personal and professional tools that help us get to know patient needs and provide optimal care over a lifetime.

Phased therapy is a skill that takes time to develop but creates the mental space to build relationships and techniques simultaneously. How do you follow through on a treatment plan over the course of many years, phasing out the process to improve the patient’s experience, your experience, and their ability to afford it?

Single tooth dentistry may seem simpler than a full mouth reconstruction, but it still poses its own set of challenges. You’ll be able to gain skills without requiring patients to commit to a heavy financial burden, but you’ll still need to manage esthetics and deal with unforeseen issues with occlusion.
A dental career is one marked by introspection that necessarily leads to improved patient care as you gain greater self-knowledge alongside technical skills. Here are 2 tips you can use to develop your love of both simple and complex cases, your long-term relationships with patients, and your passion for dentistry:

1. Approach Learning as a Layered Process

It’s easy to get hung up on technical prowess and let your communication skills or personal development suffer. The mountain of knowledge that exists in dentistry is formidable, especially the way it is presented early on in our dental educations.

But you don’t have to build Rome in a day. Start with single tooth dentistry so that you have time to learn the technical and behavior skills along the way that will build your confidence to tackle bigger cases.
Longevity in a career as physically and emotionally demanding as dentistry requires that we approach learning as a layered process. Each case deepens our understanding of how to evaluate and succeed at the next one. Along the way, we can find joy in each incremental improvement.

2. Build Trust Through Patience and Demonstrable Success

Nothing works without the patient’s trust and acceptance. They will be more likely to say yes to a simpler restorative case. What you’ll find is that as they get to know you and you get to know them, their willingness to engage in future dentistry will improve.

With patience, you’ll put in the work to improve their health and esthetics. The fruits of your labor will naturally result in greater trust.

Later this year, I’ll be hosting my course “Think Global, Work Local,” at Pankey Online. During this course, I’ll dive deeper into the concepts I’ve brought up here.


I’ll be covering three cases that stood out in my career, including the details on preparations, impressions, fee presentation, treatment planning, restorative care, and case results.

I can’t wait to see you there for this opportunity to dive into a Pankey-infused approach to learning over a lifetime!

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Transform your experience of practicing dentistry, increase predictability, profitability and fulfillment. The Essentials Series is the Key, and Aesthetic and Functional Treatment Planning is where your journey begins.  Following a system of…

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Kevin Muench DMD, MAGD

Dr. Muench started his private practice in February, 1988. Graduated from Boston College in 1980 with a B.S. Degree in Biology. In 1987, he graduated from New Jersey Dental School with honors and was elected into the Dental Honors Society, OKU. He received the Quintessence Operative Dentistry Award and the Dentsply Fixed Prosthodontics Award. In 1993, he received a Fellowship in the Academy of General Dentistry and in 2002 received a Masters in the Academy. He has completed greater than 1500 hours of continuing education since Dental School. He is an alumnus, visiting faculty, and an Advisory Board member of one of the most significant continuing education groups, The Pankey Institute. Kevin resides in his family home in Maplewood where he was born and raised. Kevin and his wife Eileen have three boys; Colin, Tommy, and Michael. They strongly believe that participation in community efforts are what make the difference in Maplewood NJ.

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Bring on the New Year! It’s all about Growth.

January 4, 2021 Paul Henny DDS

If I were to select one word most strongly associated with a successful relationship-based, health-centered practice, it would be the word growth.

What kinds of growth? The kinds I am thinking of are growth in knowledge and growth in sophistication of attitudes toward people and dentistry. As I meditate on this, I am enlarging my hope for and commitment to fostering personal growth … interpersonal growth … care team growth … patient growth … and, of course, practice growth. I welcome you to come along with me as I breathe fresh energy into leaving 2020 behind and growing in 2021.

Notice I didn’t mention a single word about teeth or techniques. I didn’t mention a word about technology, or what you must physically own to achieve growth. And that’s because growth isn’t a material thing; it’s a spiritual thing.

Growth can be promoted, or it can be impaired by the way we think, and consequently the things that we do and say day-in and day-out. And what we do repeatedly is driven by what we believe … what we believe about ourselves … what we believe about others … and what we believe about the purpose of dentistry.

What is your purpose in dentistry?

Each of us have a purpose that is driven by our philosophy … our world view … our perspective of things … and therefore what it all means to us. This changes as we grow in knowledge and sophistication of attitudes.

Avrom King said that it all boils down to these three questions:

  1. Who am I?
  2. Why am I here?
  3. What is it that I am trying to achieve?

All three of them are philosophical questions, and all three lead us to answers which directly influence almost everything else. If we do not understand who we are on a values and beliefs level—what Mac McDonald likes to refer to as “the deep structures of ourselves,” we cannot predictably lead ourselves in any desired direction. And as a result, we cannot predictably lead others in a desired direction either.

Growing with Purpose

Growing with purpose requires Hope and Agency. If we do not hope for something of greater meaning to ourselves and we think we have truly little personal agency, we flounder.

In a world where we believe we have minimal personal value, everything around us starts to look scarce, and everything around us starts to look scary, so we’re tempted to take short cuts. We’re tempted to just grab what we can get for ourselves as quickly as possible. After all, who knows what tomorrow will bring? If we “stay on shore” with feelings of disempowerment and a little too much wine and whining, we ultimately achieve very little with our lives.

If we “stay on shore,” we will attract others who similarly think and behave. Like attracts like. Avrom King liked to call this “King’s Law.”

We tend to create our practice in the exact image of what we believe about ourselves, and consequently, that could be some version of heaven or hell. All of this happens because we choose to grow or to not grow.

Growth requires hope, courage, attitude, energy, and action, i.e., self-determination and self-control. Talk is cheap, so what will you do to master these? Surround yourself with a vision of your preferred self … your preferred career … your preferred dental practice. Acting on that vision leads to a next step and a next. In doing this, you will attract “likes,” and this positive reinforcement will help keep you on the road of your personally purposeful life. How much growth is happening in your practice today?

Can you see the green shoots of enthusiasm and creative change all around you, evidence of constant renewal? Or do you see an ossified structure struggling to maintain the status quo? Are you surrounded by people who are down, frustrated, and thinking that they have no other choice but to keep plodding on as they are?

Who are you?

Why are you here?

What is it that you are trying to achieve?

Philosophy Matters.

And that’s why L.D. Pankey, Bob Barkley, and other of our dental heroes constantly talked about it.

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DATE: February 27 2025 @ 8:00 am - March 3 2025 @ 2:30 pm

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About Author

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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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Many Don’t Realize Their Pain Is Abnormal

November 20, 2020 Kelley Brummett DMD

When working with participants at The Pankey Institute, I help them analyze dental cases to assess the risk for joint and muscle problems. I often hear, “The patient is not reporting any pain.” Yet, the dental records indicate the patient is at high risk of experiencing pain.

I have discovered a question to ask my patients that reveals their personal pain tolerance. “When you have a headache or muscle pain, at what level of pain do you take an Advil?” Some patients say at level 1 or 2. Others say not until it is a 12. Patients are all up and down the scale.

This one question leads to the patient’s self-discovery about how they perceive pain and potentially tolerate abnormal pain when they are “diseased.” Further conversation helps the patient understand symptoms they have been dismissing indicate abnormalities that can be “treated” for a healthier, longer-lasting dentition and more comfortable life.

And this brings me back to how we diagnose and plan treatment in general. Sometimes the questions we ask our dental patients aren’t structured to get us the information we are hoping for. If we gather inaccurate impressions from their responses to our questions, we go down the wrong path clinically. Asking more powerful, well-crafted questions allows us to better know the patient and get more complete information to better understand their situation.

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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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Investing in My Team

August 7, 2019 Jennifer Davis, DDS

The original owner of our practice recently retired.

Although he had been planning on retiring and a new associate had been identified by both of us months in advance, this transition was very profound and stressful for the entire team. So, with a long term game plan in place, we began the transition between associates. It became evident that each individual within the practice was struggling with this change in their own unique way. Supporting others through change became my part-time passion.

While some team members were engaged in the process, no one was fully comfortable with the transition to this unknown “new practice.”

We had 1.5 years of an office atmosphere that was taking us to this destination with new team members that we did not fully know. We were wondering if it was going to be an office environment with which each person would want to identify. Thankfully, one of the values that binds us—education, came into play in a positive fashion.

In recent years, our team has attended continuing education together, locally.

However, it has been a long-time goal of mine to travel greater distances with the team. Coincidentally, The Pankey Institute unveiled the first Pankey Learning Group for hygienists. The effect that this had on my practice has been amazing thus far.

Although I offered the opportunity to the entire hygiene department, only one hygienist chose to attend.

She attends this learning group, and it has been meaningful to her personally and professionally. She has become highly engaged with her patients, and while leadership and gratitude had not been her most prominent attributes in the past, they certainly are now.

Upon her return, she begins to pull the rest of the team enthusiastically through this transition that embraces a new associate and has us enthusiastically embracing our new unknown. This one hygienist has been embedded in my leadership for twelve years, and now it turns out she has always been absorbing my vision and philosophy. She just needed a little bit of investment from me to become a leader within the team.

The value of having a team member learn, from the colleagues who have helped frame my personal and professional growth, has been priceless.

With more education planned for each of my team members at The Pankey Institute, I am thinking this will be the foundation for a cohesive group of similarly minded professionals working together to provide the best comprehensive dental care for our community.

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Jennifer Davis, DDS

Dr. Davis started her career in dentistry in 1988 as a dental hygienist. After receiving a certificate in dental hygiene from the University of Pittsburgh, she worked as a dental hygienist while pursuing a Bachelor of Chemistry degree at Lebanon Valley College, where she received numerous awards in organic chemistry and served as a research assistant under the guidance of Dr. Carl T. Wigal, PhD. Dr. Davis has also published in The Journal of Organic Chemistry. Subsequent to a 10-year career as a dental hygienist, Dr. Davis entered dental school at the University of Pennsylvania. Again, doing research was an important part of her educational process; she received a grant from the National Institutes of Health for work in the area of bone formation. Upon graduation from the University of Pennsylvania, Dr. Davis joined the practice of Dr. Frederick S. Johnson. Together, they practice a philosophy of comprehensive and esthetic dentistry in Cleona, PA. Dr. Davis is a member of the American Dental Association, Pennsylvania Dental Association, American Academy of Cosmetic Dentistry, and American Academy of Dental Sleep Medicine. She is an alumna and Visiting Faculty Member of The Pankey Institute.

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Reflections on the Last 30 Years

July 15, 2019 Michael J. Scherb, DMD

As I lay here and reflect on the last 30 years of my life, I cannot help but wonder and imagine what my life would be like had I not been given the gift of being a part of The Pankey Institute. Today marks my 30 year anniversary of walking through the doors of what was then called The L.D. Pankey Institute for Advanced Dental Education. I was seven weeks shy of my 27th birthday, and I had nothing but a lot of debt and dreams of doing great dentistry.

Back Then and Now

I am no different than many, if not most, of the students of today, who are saddled with what seems to be an insurmountable amount of debt. At the time, we were charging about $300 for a crown and paying a $70-$90 lab fee, a percentage of over 20%. I never even considered that percentage high, because I was just happy to be taking care of people.

Many people say, “It was different back then,” but was it? People were waking up with mouth or jaw pain. They were seeking an individual that could take care of their needs. Some wanted to feel better. Some wanted to look better. Some were willing to lose teeth. Some wanted to keep teeth. It is the same now as it was then, and it will continue to be this way for decades to come.

The fact that people will need or want to be taken care of will never change. The fact that some will have money to pay for your services and some won’t will never change. The question is “What type of dentist will you want to be?”

The Road Less Travelled

Thirty years ago, I wanted to be the best. Having been given the book The Philosophy of The Practice of Dentistry by L. D. Pankey, in dental school, I felt this was the way to care for patients that needed us. You see, it is all about the choices we make. I wasn’t going to be guaranteed a salary by a corporation, but I was going to have the opportunity to keep a portion of all I earned. It was up to me to make the decision about how I wanted to care for people, and this philosophy became my driving force.

The office I was in and peers in my area at the time did not seem to have the desire to take this path, as no one else had been to The Institute. I guess you could say I took “the road less traveled.”

The choice of committing to this philosophy has impacted my life beyond measure. For 30 years I have been able to learn from some of the greatest educators this profession has to offer, who have given their time, treasure, and talents to the 30,000 students who either have flown or driven to the beautiful island of Key Biscayne, Florida. I have established lifelong friendships with individuals from all over the world, who had and still have aspirations and dreams just like me. I have made mistakes, and I have done great things. All along the way, I had a group of individuals I could count on to get me through the ups and downs of the practice of dentistry, as well as life itself.

The Pankey Institute Community Is There for You

As you finish reading this, whether you are 26 or 56, realize there are people willing to help you get to where you want to be. I am glad it was The Pankey Institute for me. The Institute has now been here for over 50 years, and I feel immensely grateful for the 30 years that have been mine.

I want to thank all of those individuals who have given me so unselfishly their gift of priceless knowledge. And, if you have just begun your journey with The Pankey Institute or thinking you might like to, let me assure you that The Pankey Institute community is there for you.

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About Author

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Michael J. Scherb, DMD

Dr. Michael J. Scherb is on the Visiting Faculty of The Pankey Institute and a Pankey Scholar, an honor which has been conferred on less than 50 dentists in the world. He has been awarded Fellowship in the Academy of General Dentistry. A graduate of the University of Alabama School of Dentistry, he has practiced dentistry in Jupiter, FL since 1989. He is a certified member of the American Dental Association, Florida Dental Association, and former president of the North Palm Beach County Dental Association.

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Building a Culture of Agreement

July 10, 2019 Denison E. Byrne, DDS, MAGD

Enabling Your Team to Bring Their Best to Collaborative Problem Solving

One day, several years ago, our dental practice was facing an imminent snowstorm. We could see that the storm would play havoc with our professional and personal schedules. Decisions had to be made about our response. Should our plan be the same as the last time the office had been closed by weather? People were beginning to get nervous about how this was going to play out. A clear decision and well thought out plan were called for, but there was no one right answer. We needed to quickly make a collaborative plan (an agreement) to distribute power and communicate with our patients.

Planning for Contingencies

As in the case of the imminent snowstorm, I believe there are frequently practice decisions to be made for which there is no one right answer – no one strict plan that we can establish ahead of time and not expect to modify. Many variables need to be considered each time as the circumstances of owners, team members and patients change.

Collaborative planning takes “high engagement,” insight and practice. If you have preplanned team agreement on how to handle special events, you are ahead of the curve, but you will find it helpful to visit these agreements periodically, and you can anticipate you may need to collaborate “on your feet” when contingencies arise.

Role-Playing

Last year, at “Inspired Team Facilitation” with Joan Unterschuetz, we did role-playing that helped the team develop a collaborative plan for which every member of the team had buy-in and agreement. Role-playing has helped our team huddle in an emergency to clarify what needs to be done, who can best take the lead on each task, and acknowledge the compelling reasons why we are doing this as a team. It also has been helpful to prepare each department leader to motivate team members who will help them make sure we effectively communicate with patients, assure patients, and shut down if we need to do this swiftly; then in reverse, open up the practice and zero in on what needs to be done to open the schedule and reschedule patients as priority dictates.

Agreeing to Agree

From the earliest time possible, work on building a culture of agreement around:

  • Team meetings with high-engagement of all stakeholders
  • Understanding problems to be solved and why they must be solved
  • Respecting all team members who would be affected by giving them a voice in the planning
  • Understanding that department team leaders will be accountable for execution
  • Coming to joint agreement and celebrating that fact at the time the agreement is made

The goal of these “coming to agreement” exercises (even about the small stuff) is to set a standard of collaboration that is in alignment with your practice philosophy. When an emergency arises, the team knows from experience that they can quickly collaborate and come to agreement on a plan of action…even when there is no one right answer and you need to kick start action immediately. If your collaborative meeting goes off track, the dentist as practice leader needs to remind everyone of the compelling reasons why they need to come to agreement now.

Can’t Involve Everyone?

Sometimes involving everyone is not possible in a crisis, but the goal is still the same. The goal is to be on the same page and united in decisions. All team members need to be informed of decisions, so if you and your department leads need to quickly create an agreement, the leaders will report back to other team members for implementation and keep them in the loop. Keeping everyone in the loop honors them and combats the human response of making false assumptions and experiencing energy-consuming emotions. In a culture of agreement, there is less opportunity for negative energy to accumulate—less “drama.”

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About Author

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Denison E. Byrne, DDS, MAGD

Dr. “Denny” Byrne graduated from the University of Maryland Dental School and has been in restorative practice in Baltimore for 40 years. He is a member of the Pankey Faculty and Co-Director of Pankey Learning Groups. In addition to being the husband of a dentist, father of a dentist, and grandfather, he is keenly interested in facilitating small group learning, golfing and sailing. He enjoys cooking and is a fan of C.S. Lewis.

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Embracing Digital Technology

April 17, 2019 Pankey Gram

On day one of the 2019 Annual Pankey Meeting, Dr. Gary Severance and Angela Severance will explore how digital technology continues to expand the opportunities dental professionals have to know their work and to provide better dentistry and ultimately better care.  Preliminary to this presentation, we share this quote with you.

“Be not the first to try the new or the last to leave the old aside.”

This is a statement from Dr. L.D. Pankey in his 1985 interview with the International College of Dentists. As a well-read and literary man, Dr. Pankey was familiar with Alexander Pope, an 18th-century English poet who is best known for his satirical verse and translation of Homer. Because Pope is the second-most frequently quoted writer in The Oxford Dictionary of Quotations (after Shakespeare), it is highly likely Dr. Pankey was inspired by the following famous couplet from Pope’s Essay on Criticism.

Be not the first by whom the new are tried,
Nor yet the last to lay the old aside.

We offer this conjecture, because Pope’s couplet is often used across the professions in the context of evaluating and adapting to technological change.

Pushing Forward Mindfully

Dr. Pankey was on the forefront of the technological and methodological changes that rapidly occurred in dentistry during the 1950s and onward. He was internally driven to be and do his best for his patients and profession. He urged dentists to “know your work” to provide better dentistry and ultimately better care.

Digital technology in dentistry has advanced to address special needs, just as Dr. Pankey advanced in his systems of thought and practice to address special needs. He did this mindfully.

His genius, in concert with those of Dr. Arvin Mann and Dr. Clyde Schuyler, had produced the “P.M.S. Technic.” They had selected the best of the procedures that had been developed by outstanding practitioners in their special fields and assembled them into a system that functioned well for addressing full mouth rehabilitation. They applied their intelligence to “try” new techniques and new materials. They gained knowledge through carefully doing their best for patient, after patient. They then stepped out to share what worked successfully for them. Along the way, Dr. Pankey was mindfully developing his philosophy of practice. He intentionally set out to learn from many great minds, and the composite of principles he lived by and generously shared through his lectures, publications, and ceaseless conversations with other dentists have rippled into our lives today.

Learn, Converse, Lead with Confidence

As a community, you can share your knowledge, immerse in conversation, and lead with confidence. The L.D. Pankey Institute from its beginning was a radical departure from dental school settings of the day. The Institute pioneered a training clinic with overhead cameras and closed-circuit TV, anatomical simulators (which had heretofore only been developed for training in medical schools), and it’s characteristic “hands on” learning process. The Institute’s founding leaders conceived of novel ways to fulfill their goals. But—building the unique learning environment and learning process involved tens of thousands of hours of research, thought, and conversation. A group of “top” minds in dentistry worked together to close the gap between what was known (the science) and what was practiced.  Adaptation to emerging digital technology is no different.

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Pankey Gram

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