Clayton Davis, DMD 

Hint: It wasn’t because I was cold. 

A First Impression I Will Not Forget 

One of the activities my family enjoyed on our vacation to Ireland 25 years ago was visiting the famous McGee tweed factory in Donegal. They had a loom set up so visitors could pick out threads, weave with the shuttlecock, and make a pattern. My children were at an age when that was very entertaining. 

On our last day in Ireland, we walked the main street of Sligo and stopped in the Mullaney Brothers haberdashery. While my wife looked for a few things, I waited with no intention of buying. An elderly gentleman walked up behind me, and with a charming Irish brogue asked, “I say, sir, are those your children over there?” I said, “Yes.” And he said, “Oh, they’re fine looking  children. They are a credit to you, well behaved.”  

As the conversation proceeded, he introduced himself as Mr. Johnny Mullaney. He inquired about where I lived and what we had done while in Ireland. He mentioned how he enjoyed watching the Olympics in my hometown of Atlanta. He knew a lot about Markree Castle, our accommodation for the week, and Rosses Point, a golf course I played at. He enthusiastically shared his opinion of its famous 18th hole. He was immensely proud of the golf course. Then he mentioned the pride they had in their tweed jackets made from tweed from the McGee tweed factory.  

He pointed to the jackets and asked which of the tweeds I liked best. I pointed to one and he said I appeared to be size 41L (exactly right), and before I knew it, he had slipped the jacket over my shoulders. As he brushed his hands over my shoulders and down the sleeves and tugged at the cuffs and bottom of the jacket, it felt tailor-made for me. I told him I liked the way it fit, but our luggage would be tightly packed for our trip home. I expressed my concern the jacket would end up badly wrinkled. He said, “Oh, it’s tweed, sir. We can fold it very nicely and have it ready for you to pack and it will unfold without wrinkles when you get home.” 

I liked the look of the jacket, yes, and I appreciated the quality of McGee tweed. But ultimately, what I appreciated most, what made me want the jacket, was Johnny Mullaney, himself; the consummate haberdasher, a master at his craft, who won me over by becoming my friend in a mere five minutes.  

I thought, “I don’t have a memento of this trip. This jacket will always remind me of our wonderful trip, our day at McGee factory, and this endearing Irish businessman.” I said, “Mr. Mullaney, I will take the jacket.” 

What I Learned from that Lasting Impression 

There are four elements from meeting Johnny Mullaney that I apply to meeting every new patient in a preclinical interview: 

1. Make a friend. (How can you trust each other if you don’t become friends?) 

1. Make an invitation. (Accepting an offer to be examined makes co-discovery exams flow.) 

1. Make it easy. (Find out their concerns, and address them.) 

1. Connect the feeling to the choice. (People do business with people they like.) 

You see, we always make choices based on our feelings. The preclinical conversation allows the new patient to feel good about my desire to genuinely help them and understand their feelings and needs. This is how we can move forward toward optimal care.  

A Series of Invitations Lead to the Treatment “Yes” 

When dentists ask me how they can do more cosmetic and restorative cases, they are usually surprised when I tell them it begins with doing pre-clinical conversations at the first visit.  

• You can’t do comprehensive cosmetic and restorative treatment until you’ve presented a treatment plan.  

• You can’t produce a treatment plan until you’ve done a good diagnosis.  
• You can’t produce a diagnosis until you’ve done a thorough exam. 
• And that thorough exam is incomplete when it doesn’t start as a good preclinical conversation with the new patient. 

The preclinical conversation sets the tone for trust and healthy open communication. It is the essential first step in creating a lasting good impression that leads to the first “yes” in a series of invitations on the way to treatment.  

Gary M. DeWood, DDS, MS 

As an associate dentist, you may be fortunate to learn from the instruction and observation of a senior dentist, but over your career, you will gain innumerable benefits from outside consultants, coaches, and mentors. 

One of my mentors, Dr. Richard A. Green, told me that one of the keys to my success would be to surround myself with a Board of Directors. He was correct. My board is composed of people who are willing and able to see my vision and hold me accountable for going to it. Some are consultants, some are coaches, and some are mentors. Sometimes they are all three in one person but no one person has all the answers. 

Consultants, coaches, and mentors help us in different ways. 

In dental practice, I often hear the words mentor, coach, and consultant used interchangeably to describe the activities of someone assisting the doctor with the management of his or her practice. I believe that these functions, while not mutually exclusive of the same individual, are different in their roles with regard to all three of you. 

What do I mean by that? “You #1” is the entrepreneur and leader of the business you have established. “You #2” is the manager of that business. “You #3” is the dentist working in the business. Each you possesses a different level of training, understanding, and ability. Each you benefits differently from consulting, coaching, and mentoring. 

Early in practice my partner and I hired consultants to see what escaped us and to give us solutions.  

Consulting is all about being an outsider looking in. The adage that consultants are individuals who are paid a lot of money to tell you what you already knew but couldn’t see, does not diminish their effectiveness or necessity, particularly in offering solutions.  

I met Jim Pride while I was still in dental school. In the early years of our relationship, following the acquisition of our practice, Laura, our Pride consultant, consulted us by telling us what to do. I was directed to employ systems that were developed by Jim Pride and his team while working with many Pride Institute clients. I did as we were “consulted” because I had no reference for individualizing the systems, something that changed as we found the parts and pieces that delivered and left behind parts that did not resonate for us.  

As my partner (who happened to be my wife) and I changed, our expectations changed, and our needs changed, we continued to need that outsider looking in to see for us that which we could not see. We did not, however, need or want to be offered solutions. The best consultants understand that their ultimate goal is to empower and develop their clients’ skills and abilities so that they can eventually operate independently. 

When we no longer needed a consultant, we needed a coach. 

Unlike consulting, where solutions with precise instructions are offered, coaching offered us a process out of which our vision for our practice developed. Dental practice coaches ask questions rather than give answers. They are observers. They take us inside ourselves and assist in our development as leaders. They draw out what is already within and empower us to act on it. 

What, then, is a mentor? 

For me, mentors are individuals who have traveled the path we seek to follow. They may fill the role as a consultant and/or a coach depending on our needs and their comfort with the things that are challenging us at any given time, but frequently their primary role is that of an example. The Pankey Institute community abounds in them. 

I have observed that dentists who develop a relationship with a mentor are able to move more quickly and clearly toward their preferred future. It is precisely for this reason that one of the goals of participation in a study club is to build groups with a broad range of experience and experiences. It is the third YOU, the practicing dentist, who gets the most from being mentored.  

Dentistry is a tough job. It’s demanding and stressful to perform highly technical, intricate procedures continuously on a daily basis. Our mentors show us that we can do it because they did. Often there is peer-to-peer collaboration in “surfacing up” the mindset, approaches, and solutions that will work best for us. Always there is encouragement. 

Sometimes mentors listen. Sometimes they challenge. Always they support. Their map is not always the map we choose to follow, but their example–as individuals who continue to see their vision and map their future accordingly–inspires us to do the same. 

Gary M. DeWood, DDS, MS 

Learning begins from our first moment of awareness as our eyes open and we have a response to something external to us that is brand new. That experience and all the ones that follow until the moment awareness leaves us to shape our reactions to and our actions in the world. 

Experiential Learning 

The brain is a dynamic and ever-changing organ, constantly adapting to new experiences and knowledge. 

When our youngest daughter Katie was a child, I was cooking dinner one night–my turn–and Katie was sitting at the island where the stove was. I turned around to get something from the cupboard and heard a loud inhale followed by a whimper. Upon turning quickly, I saw her move her hand rapidly behind her back. No more sounds came forth, but I saw a tear and I asked her what was wrong. She said in a wavering voice, “Nothing,” and then looking at the stove burners, “Mom told me those were HOT and never to touch them.”  

I gently took her hand from behind her and saw the blisters rapidly forming on her fingers. She started crying and said to me, “Please don’t tell mom.” I’m certain she never felt the need to verify the information her mother had given her again. THAT is learning. 

All of us have experiences like that every day. Some are memorable and become part of us, embedded in a manner as yet not fully understood inside our brains for almost instant access. Some “learning” seems to fade quickly or never even get recorded. I “touched” a lot of biochemistry information over the years without burning much of anything into my brain. Maybe I should have been touching the stove at the same time. Learning is not simply having an experience of something and then being able to view the recording later.  

The Definition of Learning 

In nearly all of the definitions I have located in my research I see that CHANGE and PROCESS are prominent parts of learning. For example: 

• A change in disposition or capability that persists over time and is not simply ascribable to processes of natural growth. 
• Relatively permanent change in a person’s knowledge or behavior due to experience. 
• A transformative process of taking in information that, when internalized and mixed with what we’ve experienced previously, changes what we know and what we do. 

Choice & Focus 

My personal experiences have shown me that a big part of lifelong learning is what you believe about it and how you embrace it. It’s driven by some measure of choice and focus. 

Cheryl and I have sought out new ideas in dentistry wherever they took us. One of my friends in dental school, a wonderful man whom Cheryl and I still hold close, took a different path. Sometime around the 10th anniversary of our graduation we were visiting, and he told us that he had been able to get all the continuing education he needed without traveling.  

I discovered that his feelings around need and learning as it pertained to dentistry meant satisfying the requirements to stay current with licensure. He is NOT a bad dentist, but like many of the dentists I have come to know in the last 48 years, a hunger for dental learning changed once school was finished.  

A Drive for Learning 

I am reminded of one of the most original and influential thinkers on the creativity process, Robert Fritz, who believed you can create your life in the same way an artist develops a work of art. He said, “If you limit yourself only to what seems possible or reasonable, you disconnect yourself from what you truly want and all that is left is a compromise.” 

As a philosopher and scientist-physician, Dr. L. D. Pankey intentionally observed processes and their results (change) with the goal of becoming better at helping others. The embodiment of compassion, he was highly curious and actively sought ways to alleviate the sufferings and misfortunes of patients and colleagues. He traveled long distances to learn from others’ experiences. He inspired others to know themselves, their patients, and their work on a continuous road of mastery. As a lifelong “leisure” learner, he was interested in a wide range of subjects outside of dentistry as well. Through reflection, he often discovered he could apply this outside learning to his work. 

Seventeen is young to decide what you want to do with the rest of your life. Deciding you want to become a dentist means that you are making a huge decision before you are aware of all the knowledge you will have to attain and the multiple skills and micro-skills in which you will need to become proficient.

It was a long time ago when I made that decision. I can’t even remember how I made it. I remember I was under pressure to decide from my parents and their friends. I remember telling others I thought dentistry was a good career because I had spent so much time in dental offices growing up.

That’s because I had malformed supernumeraries blocking the eruption of my centrals when I was seven years old. The dentist who suggested the supernumeraries should be removed, proceeded to remove the two good centrals by accident. This was followed by surgery to remove the supernumeraries and alas no centrals. This was traumatic to me at the time, but early in life, I learned to adapt to a dental prosthesis, having that replaced as I grew, and so on.

I wish now someone had set me down when I was in high school and given me real-world career advice like I did for my kids as they were growing up. Hoping they could avoid some of the mistakes I made, I would begin those conversations with Stephen Covey’s habit #2: Begin with the end in mind. And I would disqualify money as an end. Because money only buys people what they really want. I’d get my kids to think about what they really wanted to spend their lives doing.

Warren Buffet says he wanted to make money so he could be independent. In his biography, The Snowball, Buffet wrote, “It could make me independent. Then, I could do what I want to do with my life. And the biggest thing I wanted to do was work for myself. I didn’t want other people directing me. The idea of doing what I wanted to do every day was important to me.”

There’s truth in that for me. Independence is a universal thought that drives many of us, yet we are unique in our own lives…in how we ultimately determine and design our game plan to live independently.

If we had understood what we wanted to do for the rest of our lives when we were seventeen, then we could have better designed our careers to meet our adult desires. But that isn’t realistic, is it? It sometimes takes decades to a lifetime to understand ourselves.

Adam Grant in his book Think Again questions the unreasonable question kids are asked, “What do you want to be when you grow up?” In his book, he uses his cousin Ryan as an example of someone who chose to go into medicine because that’s a profession parents applaud. Once Ryan made his decision, he spent years staying on track.

Once you start, there is no turning back…financial debt…sunk costs…physical, mental, and emotional. We hit a certain milestone like owning our own dental practice and we tell ourselves we will be happy… that we will have all the things we want. But positive psychologists confirm that this is a poor prescription for happiness.

Positive psychologists say the road to happiness includes mastery, autonomy, positive relations, engaging work, and accomplishments. It’s a never-ending road. But each person takes their own road. There are many roads of mastery, freedom, positive relations, engaging work, and accomplishments.

Don’t get me wrong. I am not saying dentistry was a bad career choice for me. It is a great profession. The message of this blog is twofold. One, at the start of my predoctoral and doctoral education, at the start of my career in dental practice, and even midway through that career, I didn’t understand the complexity of what was before me–including getting to know myself well. And two, everyone needs to find their own happiness.

If you are reading this, you likely chose a career in dentistry. On your road of your own design, I believe you will find happiness in the continual act of mastering more, working with autonomy, fostering positive relations, and setting out to achieve new accomplishments. Money will be just a way to fund the things that really matter to you, and for many of you that will be making a profound difference in the health and lives of your patients. And when you segue, as I did, away from hands-on dentistry after practicing for four decades, you will find that new ways to use your people skills keep emerging. Your road to happiness continues.

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.