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!

I bet many of us feel like we are living in a movie these days.  I’m sure you have compared this pandemic to any number of movies. The first movie that comes to mind is  Jaws. In that movie, everyone wanted to know when it will be safe to go back into the water. And now, forty-five years later, people are asking a similar question: Is it safe to go back to the dentist?

Let’s explore the parallels.

The year Jaws came out, 1975, I was serving as a Captain in the Dental Corps at Ft. Dix N.J. During my time there I came down with Hepatitis B. I became infected from working on a patient…without gloves. Remember kiddies, this was 1975…there were no rules. It was The Wild Wild West in health care. As we all know, hepatitis is caused by a blood-borne pathogen. I became quite jaundiced and severely ill. I spent two weeks in the hospital. I started feeling better after one month.

I felt good enough to go back to work, but the U.S. Army had other plans. I couldn’t go back into the clinic until my liver enzymes were back to normal. I was tested frequently not only by the military, but also by the county Board of Health. I remember how diligent they were about the testing. They were serious…I couldn’t go back to work until I was cleared. That was mostly to protect anyone I would come into contact with. I was a known carrier, unlike the infamous Typhoid Mary who carried her disease covertly. I’m sure the public was grateful that the government was acting so responsibly. Like today, the public health department’s job is to protect the public. That trust must exist for us to function as a society.

Fast forward to 1981. I was practicing full-time in my own private practice when the AIDs epidemic arrived in the U.S. By then I had learned my lesson and I was one of a small number of dentists who wore gloves on a routine basis. But I was in the minority. AIDs changed our entire profession. By the time it was over (if it ever truly was over) the life of every dentist changed forever. This time around I learned how serious government could be in enforcing public health regulations. They meant what they said. (For those who are interested look up the case of Kimberly Bergalis). This was a classic example of the combination of bloodborne pathogens and dentistry.

One thing I noticed during that period was the public awareness of dental practices and sterilization techniques. AIDS changed everything. It wasn’t the isolated patient who wanted to see how instruments were being sterilized. Many people stayed away during the height of the crisis. In time the fear eased up but not before more stringent rules and regulations were enforced. And once again the public was grateful.

Now… almost 40 years after AIDS we have a new pathogen – the coronavirus– Covid-19. The biggest difference is that this one is an airborne pathogen. And that makes all the difference in the world. Fear is ubiquitous. There is a new shark in the water. Like Typhoid Mary, it does not show its fin.

Safety is a big concern for most humans.

Behavioral psychologist Abraham Maslow formulated the Hierarchy of Needs. At the very base of the Hierarchy are physiologic needs like food and sleep followed by safety and security needs. His theory stated that people would not seek satisfaction of higher needs (love, belonging, self-actualization), until the basic needs were met.

Forty-five years after Jaws roamed the ocean it is generally safe to go back into the water, but rest assured, we do know one thing… there will always be new and more dangerous sharks to worry about, and when it comes to humans, safety is a basic need after food and sleep.

Patients have been deciding on the essential nature of dentistry forever.

As long as fear remains and people do not have the absolute certainty of safety, they will not return to dental offices except for services they perceive as essential. If your client base is full of people who are truly health-centered and trust you, your routine dental services will thrive in the pandemic. Your patients won’t wait until they are in pain to book an appointment.

But that’s the test of what you are all about, isn’t it?

If your routine services are not thriving, then your practice has had a history of attracting a broader market of people. How is that working out for you now? Beyond COVID-19, if you are in private practice, pay extra attention to targeting individuals who want the finest health and give them ample reason to trust their safety with you… no matter what.

Dr. Crete discusses an anterior esthetic case from the initial conversation to finished treatment plan for a patient who lacked smile confidence.

Patient Profile

Drew became a new patient at my practice as a 20-year-old junior in college. His reasoning was: “Just to get my teeth cleaned.” During his initial hygiene appointment, he mentioned the “spot” on his front tooth (#9 – small pit filled with composite 10 years prior).  

He asked: “Can you put some new bond on there and make it match better? Even when my dentist did it the first time, it was always obvious.”

I heard his question as a window to ask further questions and find out a little bit more about him. At Pankey, we call this, ‘knowing your patient.’ It can start with an introduction to a new patient during a hygiene examination.  

Asking the Right Questions for Case Acceptance

I began by asking, “Do you know why you had the bonding done?” and “Did you have a cavity?”  

His answer was, “No, I have been playing hockey since I was really little. I was not always good about wearing my mouth guard and I chipped my teeth a lot.”   

Further questioning revealed he was referring to the enhanced mamelons and pitted enamel areas of his anterior teeth as “chips.”

His parents had elected not to have the chips repaired because they were told it was cosmetic treatment and their insurance would likely not pay anything.  

The Value of Open Dialogue

I then asked a few more open-ended questions like, “Is there anything about your smile you would change?”  

His answer: “Well, I always feel like I have little teeth and it makes me look like a little kid. I wanted braces when I was in junior high but my dentist told me I had a good bite and braces wouldn’t fix all the spaces I have.”  

Further dialogue with Drew revealed a significant concern he had about graduating from business school in a year and having to go through interviews looking like a little kid. He said, ”I worry no one will want to hire me because I look so young.”

To be continued…