While L. D. Pankey was practicing in Coral Gables, he continued to follow his personal commitment “to never taking out another tooth.” When teeth needed to be removed or needed a root canal, he would refer his patients to an oral surgeon or endodontist in Miami. So, his practice consisted of mainly doing periodontal procedures, restorative dentistry following the Pankey Mann Schuyler method, and complete, and partial dentures.

One day a 90-year-old retired dentist from Chicago came in to see him to have a new upper and lower denture made. His name was Frank Davis. Frank was the creator of the Davis Crown back in the 1920’s. L. D. learned about the Davis Crown when he was working in high school as a lab assistant in an Evansville, Indiana dental office.

The Davis Crown was a solder facing on a gold post. The doctor would cut a tooth off even with the gum, do a root canal, put a post in the root space, and followed with a pick-up impression. The dentist would then sedge 24k gold into the post on the master model and fit a facing. The hard part was to solder these crowns without breaking the porcelain facing. You had to heat the invested crown very slowly and after soldering, you had to cool just as slowly. If you were successful, this would keep the porcelain facing from cracking.

Now, here was the famous Frank Davis in Dr. Pankey’s office wanting new dentures!

Dr. Davis had been one of the most successful dentists in Chicago but had made most of his money in areas other than dentistry. L. D. supposed Frank must have followed his own technique and had all of his teeth cut off at the gum line. At some point, his teeth must had become infected because now he had a complete set of dentures.

At the initial interview, Dr. Davis told L. D. his dentures did not fit anymore, and he wanted L.D. to make him both new maxillary and mandibular denture.

So, L.D. followed his normal denture technique, made the impressions. fabricated bases, and set all the teeth himself. In L.D.’s mind’s eye at try-in the teeth looked pretty nice.

When Frank Davis saw the set-up, he took a hand torch, warmed the wax, and with his thumb started pushing the front teeth all over the place. Finally, he said, “I want you to finish the dentures just like that.”

Surprised, L.D. said, “They’re going to look kind of grotesque.” Frank said, “That’s the way I want them,” he insisted. “Then people won’t know I wear dentures.” So, L.D. finished his dentures just the way Frank had pushed the teeth around.

At the delivery appointment, they were both pleased with the result.

One definition of professionalism became the foundation of Dr. L. D. Pankey’s life and a thesis of his teachings. He wrote the definition himself!

“Professionalism is that quality of conduct, which accompanies the use of superior knowledge, skill, and judgment toward the benefit of another person or society prior to any consideration of self-interest.”

Throughout his life, he endeavored to make relevant connections with others, intentionally pay attention to others, share gratitude and appreciation, and offer compassion—even in the midst of reading another person’s lips!

As he was entering the last decade of his life, he remained continuously aware of and interested in others. Until the end, he was a continual student, eager to learn more. He encouraged other dentists to live and love their profession to its fullest at every opportunity.

The Story of Wilbur the Garage Mechanic

Dr. Pankey met Wilbur in the late 1970’s, when Dr. Pankey’s ’76 Fleetwood was not running as well as a relative’s ’72 Fleetwood. Dr. Pankey was able to observe Wilbur do his job and experience the ’76 Fleetwood move down the highway as if it were new. After a trip to Jacksonville and back, Dr. Pankey stopped again at Wilbur’s Garage to extend his gratitude and appreciation. He also wanted to listen to Wilbur’s own story again on a deeper level.

On reflection, Dr. Pankey wrote, “Like me, Wilbur got a few breaks. But of course, he helped make those breaks and took advantage of them by doing his job well and treating people right. Although he had never heard of the Philosophy as such, Wilbur was using it in his auto repair business just as I was using it in my practice.” Isn’t that interesting…

Dr. Pankey always had a smile on his face as he told Wilbur’s story in each Philosophy session he taught in the late ’70’s and well into the ’80’s. Let me encourage you to reread his personal story in the first section of A Philosophy of the Practice of Dentistry by L. D. Pankey and Bill Davis. Read that section of the book at least once or twice a decade. Reflect on your experiences; you just might become aware of new observations and connecting insights, during your decade-by-decade reflections. This exercise often puts a smile on our faces!

“That Quality of Conduct”

The quality of conduct on which Dr. Pankey founded his life’s work (his professional philosophy) not only embodied genuine interest in others as individuals (with uniquely compelling situations, needs, personas, and values). It also embodied genuine concern for others’ welfare ahead of his own. Intentionally sustaining his vision of practice, drove this professional philosophy deeper into his “tissues”—into his thoughts, behaviors, motivations, and emotions. His philosophy did not spring full grown out of his mind. It developed over time.

In my last blog, I wrote that as we look into our life’s mirror (over many decades for some of us), we gain a deeper understanding of ourselves. By reading again Dr. Pankey’s story, we discover a deeper understanding of how it relates to our personal stories and life’s work. Reflections on our own lives (and Dr. Pankey’s life) offer opportunities for new awareness, commitments, and actions. We develop over time, and the beat goes on!

When L.D. Pankey visited Dr. Hally-Smith in Paris, Hally-Smith was curious about how L.D. could afford to come to the International Dental Congress in Paris. L.D. told him about his benefactor, Mrs. Blanchard. Hally-Smith said, “That is wonderful, just wonderful!” Turning serious, he then said, “You know of course that you will make it. Your benefactor has started the process for you but there are many things you will have to do before you will be there.”

Hally-Smith gave L.D. a personal tour of his office. The office had five dental technicians and three associate dentists. His personal dental assistant was a White Russian woman dentist who had been driven out of Russia during the Russian Revolution. She was wearing a long, highly starched nurse’s gown that went all the way to her ankles. L.D. began to understand what Mrs. Blanchard, his benefactor, was talking about. She wanted him to know some of the outstanding dentists in the world! When she suggested he take the trip, she said, “I think you have the potential of becoming an outstanding dentist.” This was after he had completed her dental work.

L.D.’s time at the Dental Congress was a busy one. There was so much to learn! Even though Taggart had cast the first inlay nineteen years earlier in 1912 by the “lost wax” technique, investments and casting techniques were far from perfect. Many slides were shown, and many papers were given on new techniques in restorative dentistry. New impression materials and impression techniques were shown in lectures and table clinics. Much of the denture information did not interest L.D. because he was mainly interested in saving teeth.

After their first meeting, L.D. made rearrangements to spend an additional week in Paris with Dr. Hally-Smith. Hally-Smith was old enough to be L.D.’s father. One morning, they were talking about patient communications, and Hally-Smith asked, “Did you ever take the Bosworth course?” L.D. said he had taken the course.

Hally-Smith said, “Isn’t Bosworth the dental supply man who suggests dentists say this when speaking with their patients, “I can do a good job for so much, do a halfway job for this much, or I louse it up at a very reasonable price’?” L.D. answered by saying, “That is not exactly what Bosworth says but pretty close.”

Hally-Smith then asked, “L.D., do you like that approach?”

L.D. said, “No, I’ve never liked it, but I have tried it.”

Dr. Hally-Smith became serious and said, “L.D. it all starts with communication. You should tell your patient the optimum way their dentistry should be done. Then what the patient decides is their own decision. If you’re going to make a compromise with them, then compromise based on your patient’s knowledge, not because you have prejudged them. You should tell every patient what optimum dental care would do for them. If they decide to go elsewhere, leave the door open for them to come back later. I have found over the years that a lot of these people return after they’ve lost half their teeth.”

They discussed this premise for a while longer, and L.D. realized how right Hally-Smith was. Tell patients about the best treatment plan. Then, if there were any compromising to be done, let them decide. L.D. realized Dr. Hally-Smith’s way of communicating was easier said than done.

When L.D. returned home from Paris, he never felt comfortable using the Bosworth Plan again. Instead, he presented patients with the optimum treatment plan. If they resisted, he would compromise and do only what they would allow or just put off the work, except for emergencies. After a while, L.D. began calling this compromise time a “Holding Program” – a time of doing only what had to be done until the patient chose to move on to optimum care. With enough time, patients would usually follow through with optimum care, but not always.

This is part of a two-part story about L. D. Pankey’s trip to the International Dental Congress in Paris in 1931.

Thanks to the generosity of one of his appreciative patients, Mrs. Blanchard, L. D. was able to go to the International Dental Congress. She had expressed the desire for him to meet with the outstanding dentists of the world, and L. D. was determined to make the most of the trip.

Before he left, another one of his patients, who was a retired dentist from Chicago by the name of Frank Davis, suggested L. D. meet with his old friend Dr. Daniel Hally-Smith who practiced dentistry in Paris.

Before L. D. Left for Europe, Davis provided him with a letter of introduction. Hally-Smith had worked for Frank Davis as his lab clean-up boy when Hally-Smith was going through dental school at Northwestern University. It was following graduation in 1901 that Hally-Smith moved to Paris.

Davis said, “Hally-Smith has the most outstanding dental practice in the world and when you meet him, you will find he’s a real character.” As a senior dental student, Hally-Smith wore a bowler hat, spats, and carried a cane – both when he went to dental school and to work as a laboratory assistant.

On his third day in Paris, L. D. found Dr. Hally-Smith’s office on the top floor of a five-story building. On the street level was the famous Van Cleef and Arpel’s Jewelry Store, a location considered by many to be the best in Paris. When he got off the elevator on the fifth floor, he found himself in a sterile-looking, bright white hallway with high ceilings, no signage, and tall twelve-foot white doors. As he made his way down the hall, he found one door with a small gold plaque engraved with D. H-S. He guessed it was the correct door for Daniel Hally-Smith.

The door was locked. From the ceiling hung a heavy rope with a tassel on it. So, L.D. pulled the tassel. When the door opened, he found standing in front of him, a proper-looking gentleman wearing cut-away coat and striped trousers, holding a silver platter. The gentleman said something to L. D. in French. L. D. said, “I’m looking for Dr. Daniel Hally-Smith.” Then, in perfect English, the gentleman asked L. D. for his card and “Do you have an appointment?” L. D. did not have an appointment or a card, but he did have the letter of introduction from Frank Davis in an envelope with Dr. Halley-Smith’s address written on it. He placed envelope on the tray. The butler invited him in and took me down a hallway lined with fine tapestries. They arrived at a large reception room with a fireplace and original oil paintings on the walls. This was surely the fanciest dental office L.D. had ever seen.

In a short while, Dr. Hally-Smith came in. He took L. D.’s hand and said, “Glad to see you.” Come right in, Dr. Pankey.” That is when L.D. realized that Frank Davis must have written to Hally-Smith to tell him he was going to have a young dentist-friend visit him from Florida.

Hally-Smith was just as gracious as he could be. “We don’t see too many Americans over here these days,” he said. During their first meeting, L. D. learned that Hally-Smith was going to be busy because he was the general chairman of the entire International Dental Congress. L.D. knew right away that Dr. Davis had done him a great favor in sending him to meet Daniel Hally-Smith.

In Part 2, you will read that L. D. soon received Hally-Smith’s best advice and put that advice immediately into practice when he arrived back home.

Often something I read or hear will trigger a cascade of retrospective thoughts about friends, team members, patients, family, teachers, and mentors who have touched my past and present. These memories are constantly shaping my future.

Recent Reflection

Within the past month, I experienced the third session of a six-session Pankey Virtual Study Club on “A Philosophy of the Practice of Dentistry_v2.0.” As a small group, we reviewed the timeline that each of us had created on Dr. L. D. Pankey’s personal story and the timeline we had created on our own story.

As the decades pass, I find this process keeps revealing insights for me and others, and the process is connected to other things as well. Once again, I became more aware of events in Dr. Pankey’s story and the one-on-one conversations we had over twenty-plus years.

Dr. Pankey would often invite us to better understand the depth of processing involved by saying, “It can take fifteen years to get a philosophy into our tissues.”  Some in his tutelage received that statement with some despair and others with relief, as they honestly looked at themselves in their mirror of life and celebrated their slower understanding, in bits and pieces. Years have demonstrated there is a lot to chew on and begin to digest, through experience.

Another one of his favorite statements was a Dr. G. V. Black quote, “No dentist has a moral right to be anything but a continual student.” One of Dr. Black’s many roles was Dean of Northwestern University Dental School. As a dental student there, I saw that statement written in many halls and heard it in many lectures.  It took me a while to understand it as an encouragement for a lifetime of living and learning…hmmm…Isn’t that interesting?

Recent Realization

My most recent reflections on Dr. Pankey’s timeline and the conversations we had brought me to the realization that his formation of “A Philosophy of the Practice of Dentistry” began long before he started talking about it in 1947.

He graduated in 1924 when he was soon to be twenty-three in July. In eighteen months of budgeting his cash flow, he had paid back his school debt and the total cost of his practice debt (new equipment and all). By then, he had received a letter from his mother congratulating him on his success and telling him about the treatment she had received from one of his classmates. She wrote that she hoped he was not doing the same to other people’s mothers and removing all their teeth.

He shared in a conversation with me that he had never been able to talk with his mother about those dental events! Her letter impacted him deeply and caused him to create a Vision Statement, which included “saving people’s teeth and never removing another tooth” for the rest of his life. To me, that is a true Vision Statement because, at that time in dentistry, the process of helping people keep their teeth for a lifetime had not been clearly identified.

Dr. Pankey continued to learn about many things throughout his life, which shaped “A Philosophy of the Practice of Dentistry.” Even though he started talking about it for the first time in 1947, it was twenty-two years in the making and more years in the refining. Hmmm…

Dr. L.D. Pankey, Sr. (“L.D.”) was born on July 31, 1901. He received his Doctorate in Dental Surgery degree from the College of Dentistry at the University of Louisville, practiced in New Castle, Kentucky, for one year, and then relocated his practice to Coral Gables, Florida, in 1926.

The motivation for his decision to leave New Castle came when he received a letter from his mother. She wrote,” I am happy you are doing so well in your practice, but I hope you are not doing to your patients what has been done to me. I have had all my teeth out and now have dentures. This has been the unhappiest experience of my life.”

L.D. had examined his parents while in dental school and was sure they did not need dentures. After reading his mother’s letter, he made a commitment to practice dentistry in a new way, focused on saving teeth. This was a difficult decision because at that time he did not know how to achieve his commitment. In 1926 the typical dental practice provided examinations, cleanings, extractions, silver and silicate fillings, and complete and partial dentures.

His decision to leave New Castle, Kentucky was driven by the desire to have a new, fresh start and to find his own way to practice dentistry without removing teeth. Over his lifetime, he often said, “When I left New Castle, I vowed that I would never take out another tooth as long as I lived.”

Shortly after arriving in Coral Gables, he was lucky to be invited to join a unique dental study club in Miami headed by an oral surgeon. The purpose of the study club was to study ways to prevent tooth loss. He couldn’t have moved to a better place to learn with and from other like-minded professionals.

What made this club unique was they did not pay an honorarium to speakers., Instead, they paid their travel expenses, and they personally entertained the speakers in their homes for the week. The speakers were happy to have a mini vacation with their families in Miami. This gave L.D. the opportunity to meet and befriend them.

Among the visiting speakers were notables such as Winston Price who talked about nutrition as it related to caries, C.C. Bass MD who talked about flossing and home care (the Bass tooth brushing technique and unwaxed floss), Harry Morton who talked about restorative dentistry and showed them how to use of the Munson articulator to create the curve of Spee and Wilson, and Clyde Schuyler who came down from New York City to discuss his ideas on occlusion.

The letter from his mother launched his unique career and influence on dentistry which has been indelible for the last 90 years. Reflecting on L.D., the person who inspired me most to take the career journey I have been on for over 50 years, I realize his philosophy of dentistry and his friendship still inspire and shape me. His mother’s letter is always on my mind as I continue to teach prosthodontics and chair the Department of Dentistry at the University of Toledo. I can’t imagine a more meaningful life than providing others with optimal health, function, and the happiness of having a beautiful smile.

One day an elderly woman came into the office without an appointment. Mrs. Blanchard was a tall woman wearing a large, flowered hat and a black ribbon around her neck. She had the airs of an aristocrat. She had been referred to the office by her next-door neighbor who told her Dr. Pankey was the dentist who did not believe in pulling teeth. When she came in, she refused to sit down and asked to talk to the dentist immediately. When asked why Mrs. Blanchard was there she told the receptionist it was both professional and personal.

L.D. escorted her to his private office. She immediately said, “Dr. Pankey I understand you do not extract teeth.”

L.D. Said, “I do not extract teeth; however, if you need extractions, I will send you to a good oral surgeon in Miami.”

She interrupted, “That is the reason I am here. I do not want to lose my teeth.” She had ready been seen by two dentists and both said she needed dentures. Her plan was to have only Individual teeth extracted when she was in pain. She asked if he would be willing to try to save her teeth. Because she was a walk-in they made another appointment for a proper examination, x-rays, and time for a consultation.

When she came back, he told her he thought she could keep most of her teeth; however, he couldn’t promise all of them. He also told her he had been studying with some of the best dentists in the country and would do his best. Although she did not ask him, he quoted her a fee large enough to allow him to redo work if necessary. She showed no concern about the fee, so they got started.

She needed a couple of extractions and endodontic procedures. During the healing time, he did simple restorative dentistry. Her treatment took three and a half months. L.D. told her everything he was doing and why. She became extremely interested in the process. He used the Munson articulator and followed Taggart’s 1912 “chewing in” technique. All the crowns were done directly in the mouth using compound impressions, amalgam dies, and denture card wax to create a functionally generated path. When everything was completed, he put her on a three-month cleaning regime. Happily, the dentistry lasted until Mrs. Blanchard was 81.

Being a little eccentric, Mrs. Blanchard never wanted to sit in the reception room. When she did come in for her cleanings, she preferred sitting in L.D.’s private office. One day, during the midst of the Great Depression, she was in his office paging through an American Dental Association journal that she had found on his desk. An article about the upcoming International Dental Congress meeting in Paris, France caught her interest.

When L.D. came into the room she asked, “Are you going to this meeting in Paris?” He said, no I am very busy here with my practice and keeping my staff working.”

Two weeks later she returned and asked to see L.D. As usual, she was sitting in his private office when he came in. She said, “I still think you should go to the International Congress in Paris because you have great potential. I want you to go, and I want you to travel first class. I would like to pay all your travel expenses, all your office expenses including your staff, and compensate you for the time lost in your practice. When you go, I want you to travel all over Western Europe because that is where our civilization came from. You need to see London, Florence, Rome, Vienna, Heidelberg, and of course, Paris. Now, are you willing to go?”

L.D. was totally taken aback. Mrs. Blanchard had a great deal of gratitude for the time L.D. had spent learning how to treat her problem and for the care and understanding he gave her during and after her treatment. The enormity of her gratitude and appreciation was whelming.

After talking to his wife and his staff, he did go to Europe, and he did go to the Congress in Paris. Little did he know what a profound impact this gift would have on his life. Mrs. Blanchard had given him the opportunity to expand his knowledge of dentistry and the potential to become a leader in dentistry.

“Whatever the mind of man can conceive and believe, it can achieve.” — Napoleon Hill

When L.D. Pankey was developing his Philosophy, he studied with many early American business authors and teachers. One such person was Napoleon Hill (1883 -1970). In 1937 Hill published a bestselling book, “Think and Grow Rich” which emphasized a positive attitude and having good communication skills.

Every innovation, every invention, every work of art begins with an idea. Long before the Wright brothers ever flew, Leonardo Da Vinci had sketched and designed an aircraft. Da Vinci conceived of mechanized flight, but the Wright brothers believed it was possible, acted on that belief, and thus achieved flight. Likewise, in 1929 L.D. Pankey had the idea that teeth could and should be saved, although at first, he didn’t know how.

L.D. Pankey’s belief that teeth could be saved was so strong it motivated him to do some research, study what was known at that time, and do the experimentation necessary to make his idea a reality. Belief in himself and his idea helped him persist despite some uncertainty, blind alleys, and many other frustrations.

There is an old Chinese saying, “If you do not know where you are going, you are likely to end up somewhere.” Too many people end up “somewhere” because they have not clearly defined where they want to go. The first step in moving toward greater satisfaction, therefore, is to set specific goals.

Vague goals such as “I’d like to be a better dentist” or “I’d like to be happier” or “I’d like to make more money” are common. Be more specific, for example:

• I would like to learn about implant placement.
• I want to have more fun with my children.
• I want to earn 15% more this year.”

Then, be even more specific and set definite time frames so you can measure your progress:

• I would like to begin training in implant placement this coming September and be placing implants successfully in June. Tomorrow I will begin by investigating continuing education programs in the science of implants.
• I would like to have more fun with my children. At dinner tonight I will ask my children about ideas for fun activities, and we will start by doing one of the activities each week.
• I would like to increase my income by 15% this year. I will meet with my accountant and a dental practice coach this month to look at ways to increase my profitability. I will also do some reading in practice management.

Once you have conceived your ideas, you must believe it is possible to achieve them. Without the power of belief, you will not take them seriously; nor are you likely to weather the many setbacks and frustrations that will probably come.

Ask One More Question

One of the ways I have learned to Stay in the Question is to practice asking one more question before I give information. Learning to ask one more question has helped me to be more effective in several ways

1. The practice of asking one more question helps us save time.

My experience is that we spend a lot of time giving patients information they may not want or need. We can waste our time and theirs by giving information they have not asked for.

There was a time when if a patient asked me if x-rays were “really” necessary, I would go on at great length about the value of the radiographs, what we could see on them, and what we might miss if we didn’t take them. But I learned to respond, “It sounds like you might have some concerns about having x-rays,” and ask, “What is your concern?” By asking one more question, I was able to answer the patient’s question or concern very precisely and quickly.

2. Staying in the questions helps us understand what the patient wants from us.

Patients don’t always know how to communicate with us to get their needs met. They ask what they know how to ask. Sometimes their question is “Will my insurance cover that?” Sometimes their question is “How long will it last?” or “Will it hurt?”

Asking a follow up question to any question or concern they express allows us to better understand their needs and expectations. If a patient asks, “Will it hurt?” I could reassure them I will be as gentle as possible. Alternatively, I could say, “It sounds like you are concerned about the pain of this procedure. Have you had a painful dental experience in the past?” Responding to a specific fear will always be more powerful than a general reassurance.

3. Asking one more question allows us to give information clearly, to give information that is useful to them.

After seeing patients over years, it is easy to fall into giving the same information repeatedly. We all have our scripts we fall back on that describe a particular disease or procedure. Having a ready-made script may seem efficient but in the long run it can cause us to miss opportunities to be more effective with our patients. We can spend a lot of time giving them reasons why we think they should have treatment instead of providing more precise information relevant to their needs and their wants.

Aristotle said, “The fool persuades me with his reasons. The wise man persuades me with my own.” We don’t need to guess how to persuade our patients. I’ve learned that, when I stay in the question, patients tell me exactly what they need from me to be able to make decisions.

4. Asking one more question creates an opportunity to build trust.

There was a time when I thought having all the answers for my patients would make me seem competent and gain their trust. I’ve come to understand that I will never have all the answers and that, in dentistry, it is just as important for patients to trust our motives as it is for them to trust our competence. When we take their questions and concerns seriously, follow up with genuine curiosity, and listen deeply to their responses, they are more likely to feel our care and concern. They are more likely to trust that what we want is what is best for them.

More dental leaders are blogging on the subject of leading dental patients to improved health by learning what is important to them. Often, the next words we read are “We need to meet patients where they are.” What exactly does that mean???

To me, this doesn’t mean we meet expectations of low cost, faster care, with immediate results. This doesn’t mean we make promises that all their dental needs are met for the next six to twelve months. It doesn’t me the therapy we provide will solve an incipient or chronic problem for life. It doesn’t mean their insurance coverage dictates the value of the care we deliver. It doesn’t mean we are going to open our office after hours or on the weekend because that’s what someone wants. It doesn’t mean we guarantee a crown or veneers will last and never need to be replaced.

To me, this means understanding the individual patient, not patients (plural) as a population with trending, new expectations in 2022. It means focusing on the things each person thinks are important and relevant to their lives…where their priorities lie. Then, we can attempt to strategically tie what they value to their dental health to help them make a connection to a preferred future self. Most people, it seems, are unable to make these connections on their own.

Two Big Questions We Ask Ourselves

What do our oral health findings–ideally uncovered during a co-discovery exam, mean to a particular person? If our findings don’t have meaning to the patient, how can we possibly motivate the patient to take action? All of us struggle with these types of questions because we can’t force our values, our philosophy of oral health on others.

We can, however, create opportunities to reveal a pre-existing, unrealized value of health the patient has. If we find the patient is not health-centered, we can triage that person appropriately so we spend most of our time with patients who are health-centered.

“Revealing” Unrecognized Value Takes Time

Early in my career, I thought I could educate my patients to see the value of oral health the way I saw it. I found I was often knocking my head against the wall. Some people just didn’t value it. They wanted help when they were in pain, but preventing dental deterioration wasn’t something they felt needed immediate action. Moving forward with treatment was not on their personal agenda.

Gradually, as I read Bob Barkley, L.D. Pankey, Nate Kohn, Jr., and others, I realized they had gone through a discovery process of their own. The first task was to get to know the patient and understand the patient’s value for health and the patient’s oral health objectives. It was also to try to discover if their oral health circumstances were important to them so I could help them envision their preferred health future. But that takes time—time with each patient.

If your practice is primarily insurance dependent, you are underpaid most of the time. How do you compensate for this problem? You find ways to work faster. You find ways to see more people in a day. You delegate more. You look for a way to cut your lab technician’s salary out of your life. You buy in bulk and wake up in the middle of the night wondering why you got into dentistry in the first place.

It doesn’t have to be that way!

Many years ago, when I began spending time with new patients to learn if they are health-centered, I was able to better manage my time with them. If they valued health…if I could connect them with their dental needs on a deeper level, then spending even more time with them was well worth it.

Those who value health are the patients we can easily help understand why we take our comprehensive approach to restoring and maintaining optimal oral health.

You can be more productive per hour than you can imagine, IF you take the time to connect with patients on a deeper level and you strategically find ways to spend most of your time with people who care about their health in the first place.

L.D. Pankey wisely said, “People change, but not very much.” And that’s a critically important life lesson, one that took me years to accept because I thought my philosophy would psychologically trump theirs, and I would therefore win the day. I was wrong – very wrong.