Gary M. DeWood, DDS, MS 

Challenging what you think you know will pique your curiosity and lead to pursuing more information and interactions from which you learn. Challenging what you think you know leads to learning with the benefits of brain development, longer life, emotional wellbeing, and inspiration to share yourself in new ways with others. Simply said, challenging what you know prompts intentional learning to BE more expansive, to grow. 

My hope is that after reading this blog series, you will take time to reflect on the following statements from three of the many people who have influenced me over the years. 

Quotes from Daniel J. Boorstin, historian and Pulitzer Prize winning author of The Americans: 

Education is learning what you didn’t even know you didn’t know. 

The single largest obstacle to discovery is NOT ignorance; it is the illusion of knowledge. 

Quote from Herbert E. Blumenthal, DDS: 

Don’t believe everything you think. 

Quotes from William J. Davis, DDS, co-author with L. D. Pankey of A Philosophy of the Practice of Dentistry: 

Learning best takes place when we “live” a philosophy, meaning living in a state of inquiry based on our values, knowledge, and goals. 

When the late Dr. L.D. Pankey decided to devote his life to saving teeth, he was forced to ask himself, “How can I help people keep all of their teeth all of their lives?” In 1925 L.D. didn’t know the answer or even if there was an answer. When he decided to never extract another good tooth, he was taking an enormous professional and economic risk. He was able to uncover and develop many principles that have proven instrumental in our understanding of restorative dentistry and patient communication.  

Philosophy, in its most valuable form, is more concerned with the right questions than the right answers. 

Now that I am back actively within the Pankey community of learning and inspiration, I have four wishes for you: 

• May you come face-to-face daily with something that you don’t even know you don’t know.  
• May you not be blinded by what you think you do know when it shows up and fail to see it because you believe everything you think.  
• May you ask questions and intentionally seek answers. 
• May intentional leisure learning be not just what you do but how you live. 

Gary M. DeWood, DDS, MS 

We might define leisure learning as “Anything that is taught in an organized formal or informal plan of education to assist an adult in learning something about his or her occupation, occupational opportunities, personal happiness, or social enhancement and into which that adult engages him or herself for the purpose of learning about it.”  

I’d like to rename it “Intentional Learning” for the purpose of our discussion. My best guess is that your intent in coming to The Pankey Institute is to learn something about dentistry that will help you do what you do better. The incentive for that goal, being better, is why you come. You are choosing to use leisure time to learn dental stuff with intention. 

Any information you perceive as other than about being “better at clinical dentistry” you might be less interested in retaining and consequently likely to forget quickly. You will not really learn the stuff for which you have limited curiosity. Interestingly, that stuff that is not about the “dentistry” is the most important part of what The Pankey Institute sends you home with. At least I and countless others have found this to be true. 

Intentional learning is essential if you want to live a longer life. 

In the absence of Intentional Learning, defined as “actively seeking out new information that you WANT to integrate into your experience and understanding of the world,” certain parts of your brain will shrink. Your capacity for learning and your critical thinking/problem-solving skills will diminish. A reduction in neurons and neurotransmitters will affect your memory, your concentration, your mood, and your physical movement. Blood flow to parts of the brain can even be reduced–use it or lose it is a common thread in nature.  

So, Intentional Learning is GOOD for your brain and necessary if you wish to thrive. Synapses continue to form and re-form if you are acquiring new information, experiences, and knowledge with intent. Intentional Learning reduces stress levels. Stress reduction not only helps us perform better in our professional life, but our personal lives as well. 

Intentional learning opens social possibilities. 

Homo Sapiens are social creatures, we crave interaction, in fact we require it. Intentional learning encourages us to take risks, adjust, and adapt as we go. It sparks social engagement which leads to happiness in so many aspects of our lives. It enhances motivation, creativity, and innovation. It provides an opportunity to open our minds, challenge ourselves, and appreciate new opportunities. 

Intentional Learning fuels even more learning
as it stimulates curiosity, renews our purpose,
and moves us toward problem solving actions.
It has the potential to keep us young. 

My mother’s desire for Intentional Leisure Learning, never left her; she was and is a voracious reader, and to this day at the age of 90, she loves nothing more than sharing something she has read recently and is busy integrating into her view of the world and how it works. Her beliefs are open to what she experiences in her life, to what she learns.  

The day will come, sooner than I wish, when “dental” learning will not be as applicable to my daily life as it is today. I will still want to be part of a dental study club, still challenge what I think I know, and offer whatever wisdom I’ve been able to store to the conversation.  

Once found, intentional lifelong learning is something one does not easily lose the desire for. 

I will never forget Dr. Parker Mahan’s words, “I know I too can never live long enough.” Some might hear those words as limiting. I hear them as liberating. The well of knowledge will never be dry. It is and will remain an infinite source of things that I can still learn. 

I am so grateful to be back home at The Pankey Institute after spending my intentional learning (and teaching) time for the past fifteen years in a place that has made a choice to focus on “dental” learning. The behavioral aspects of dentistry and developing understanding of oneself and others have always had equal focus at Pankey. And since that “other stuff” is not something that can ever be checked off as “learned” no matter how many years I have left to be here, my intentional learning can and will always be young and new. It’s why The Pankey Institute is not a place you DO, it’s a place you learn to BE. 

The Institute is a place where learning never stops because, when you learn to BE, you have learned to act. Being is an ongoing and continuous process. It’s something that is lived. It is community. It is home. It is still The One Place.  

Gary M. DeWood, DDS, MS 

Adults have a wealth of experience to draw on and they like to do so as part of their learning. Adults are not used to taking direction in education; they choose what they want to learn. When my friend (in Part 1 of this series) lost his active interest in seeking out dental education, he had made a choice to learn other things he hoped to know.  

One of my heroes, Doctor Parker Mahan, told me once that one of the harshest lessons of mortality for him was the realization that he could never live long enough to learn everything he wanted to know. 

Adults need to create specific opportunities to self-reflect and internalize what they are learning in order to integrate it with what they already know. Adults have preconceived notions about education, learning style, and subject matter that interfere with their learning. Adults are often afraid to fail so they frequently guard their learning process by telling themselves why what they are hearing is wrong. 

Where children are sponges when it comes to learning, as adults our brains adapt to experiences and interactions that occur “on purpose.” We acknowledge a reason to remember that experience…to have that new knowledge. 

Here’s an example. 

Our eldest child, Patricia, entered a world in which those charged with her immediate care had barely learned to care for themselves–a world to which she adapted very quickly. In no time she had taken control of the lives of two sentient beings who proudly professed their independence and right to make decisions about their own lives but nonetheless jumped through the hoops of her creation as soon as they were offered. 

After the grandmothers had departed and Cheryl and I were now totally responsible for this baby FOR REAL, her training of us began in earnest. Turns out Cheryl and I CAN be taught, proven by our immediate response to Patricia’s guidance in managing her universe. A visit by Uncle Toby and Aunt Patsy presented us with an opportunity to learn from another source. 

Following a hearty meal, a very sleepy baby was laid in her crib for some sleep. Almost immediately upon our return to the living room Patricia realized she was no longer being held, and realized she was no longer where the “party” was happening. Being WITH the party is very high on Patricia’s list. When she “called out” in response to that situation, two very well-trained parents immediately stood to head for the emergency that was happening for the helpless baby. Uncle Toby looked at us as we simultaneously rose and said, “What are you thinking?” 

That might sound like a question, but it was really a statement that meant “stop.” So, when Uncle Toby asked his “question,” Cheryl and I stopped as we were instructed. Uncle Toby then asked, “What are you teaching that baby if you go in there and pick her up every time she cries?” 

As brand-new, first-time parents, this thought was alien to us. Being so well trained, we thought our only mission in life was to keep the baby from crying. With some angst in our stomachs that tightened each time Patricia’s wailing reached a new crescendo, we sat in the living room and pretended to ignore what we were hearing.  

Suffice it to say that when our second child Dale came along, he learned, and reasonably quickly, that we were not necessarily coming every time he rang the bell.  

Every day, we hear and see a lot of information that never makes the transition to “learning” because it does not produce change.
Change can only occur for adults when we enter into an agreement with ourselves that there is something we want to learn in what is being said or shown to us. We ACT on it. 

The truth is EVERY interaction we have with any other person or situation is a potential learning experience if we reflect upon it and internalize its meaning for us and act on it. It’s impossible not to learn. We do it all the time. Lifelong learning is thus a forgone conclusion.  

One of the greatest joys in dental practice is creating learning moments for patients by providing intentional opportunities for them to experience their oral health and interact with us in a way that provokes their curiosity, internal reflection, and acknowledgement of needs. Just as we are lifelong learners, we can trust that they are lifelong learners, too. 

It seems we all have things I call “touchstones” that we keep around to help us feel grounded and to remind us of who we are. We also have items around us simply because they make us smile.

A good friend of mine used to talk about having a garage sale for her thoughts and behaviors, and I love that idea! My own experience has taught me that the people, belongings, and structures I surround myself with have an enormous impact on my thoughts, feelings, and behaviors.

A few years back, I downsized to an 800 square foot mountain home in Black Mountain, North Carolina that I lovingly call the “Tiny Mansion.” When I made this move, I got rid of so much stuff! I literally touched everything I owned and made a thoughtful decision on what would stay and what would go.

I found that I kept things that connected me in a concrete way to different people, places, and experiences that had special meaning. I let go of lots and lots of things that were not essential tools as well as things that were related to people, memories, or parts of my life I was ready to release. I’ve learned that growth is not only about adding to our lives, but maybe even more importantly, it’s about letting go of that which no longer serves us.

Now what I do is intentionally surround myself with what encourages me to be the person I want to be, and to feel the way I want to feel when I’m in the world. All the books I have on my shelf are purposefully there. I scan through them on a regular basis to make sure they are still books that have special meaning. Another habit I’ve created is to get rid of something every time I make a purchase. Buy shoes…get rid of shoes. Buy a shirt…get rid of 2 shirts. It’s a deliberate choice designed to keep me from becoming overwhelmed by a whole bunch of stuff that I no longer want or need.

To live that intentionally was new to me when I decided to make my move to the Tiny Mansion. Necessity drove me to become highly selective about what I would see and touch in my day-to- day world. This idea became part of my updated philosophy…my living, thinking approach to curating positive things, people, actions, and experiences in my life. I am in a dynamic process of becoming my best self (almost) every day.

What inspired me to share this is the realization that I was smiling when I poured a smoothie in one of my Pankey cups. This particular piece of my “Pankey merch” collection was a gift from Dr. Lee Brady, and I love (on many levels) what it means to me.

I feel absolutely uplifted by being surrounded by things I love. The ability to see and touch these “stones” is a positive force in my life. I wonder what you might surround yourself with that is intentional and has meaning for you. I also wonder what you might be ready to let go of. Which things do you choose to be visible touchstones in your life?

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.

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.

In Part 1, I discussed combining Hard Skills and Soft Skills to wisely and intentionally produce the best outcomes. Soft skills are necessary to establish rapport, work with emotional intelligence, listen actively, and do outcomes based thinking. Hard skills are necessary to produce excellent clinical results. 

In Part 2, I would like you to consider “there is no single specific thing that will differentiate your practice and make it successful.” Our work life and personal life are based on balance. Whether you use the Pankey model of Work, Play, Love and Worship or Stephen Covey’s model, balance is the key.   

As a professional, there is an expectation among your clients and peers that you and those around you will own and maintain excellence in the hard skills of your calling, but the aforementioned soft skills are also essential. Our family, clients, and staff also deserve to be part of the other three parts of the cross of life. For example: 

• Pre-block days off in the schedule just like you book productive time at work. Your most productive time will be when you come back to work after a vacation.  
• Take the staff to a Study Club event for fun.  
• Support your staff having a volleyball team just like you support your kids’ soccer team.  
• Be respectful of personal events in your employee’s family lives. Support from you when times are tough will be repaid many times over.   
• Whether formally or in private take time to be thankful for the blessing of your family, your career and those who trust and support you.   

James Allen, in his book As A Man Thinketh, emphasized the incredible power of positive attitude and abundance thinking. When we find our staff doing something good and we compliment them, there is ten times the power of “constructive criticism.” When we hear laughter in the office, it is a good thing. Stress is lower among happy people. When we take time to train staff to take intra-oral photos and then trust them to do it right, we are all winners.   

The leader in your life and practice is you. Think deeply about the life you want to live and how that will affect those around you. When you learn to see the glass of life as half full and not half empty, you are making progress. When you then are willing to share your glass with others, you are ready for success. 

There have been numerous articles lately about the growing importance of “soft skills” (behaviorally adept process) in the development of a successful dental practice. Where have these writers been living for the past forty years?  

In the early 1980’s one of the key points of The Pankey Institute Continuum courses was the proper balance of skills at work and in life. L.D. Pankey learned that from studying the Greek philosophers. L.D. often said, “You can’t deliver what you don’t have on the shelf.” He was talking about more than occlusion and crown margins. He was talking about the ability to understand and work with our family, clients and our staff. So, what is more important – Hard Skills or Soft Skills? 

Hard Skills/Soft Skills Combination 

Over the course of my career, we have been blessed with a myriad of technical breakthroughs. Does anyone remember the joys and frustrations of early composites like Adaptic? Today the strength, color, and marginal integrity of resin restoratives gives us the ability to do dentistry we never imagined in 1976. Our diagnostic and imaging tools have made life better by being both user-friendly and patient-friendly. We have implants that really work, bone regeneration, and much more.   

This generates some hard questions. Are we as a professional staying current and taking advantage of these breakthroughs? Are we doing a thorough diagnosis and comprehensive treatment plan on all our clients? Are we taking the time to understand the outcomes desired by our patients and then educating them on the options that exist today? These are Hard Skills/Soft Skills combinations. Well managed, they will make any practice “special” in the eyes of clients new and old. 

We do not have to be able to provide all the technical aspects of our profession.  We should, however, know about them and be able to understand where they might be used to our client’s advantage. We must then be able to educate our clients about the potential value of a service and know where to send them to have it delivered with care and quality should they choose to do so.   

If you own a CEREC unit does that mean you will never again do a cast gold onlay? Truly mastering the capacity of your CEREC is a daunting task. It is a hard skill you can be proud of. However, if your practice begins to revolve around only Emax restorations you have missed the point. Your clients deserve a comprehensive exam and diagnosis. Their treatment plan should be based on the whole field of dentistry and the outcomes that they desire at this point in time. This is a hard skill and soft skill combination. 

A Balance 

If you and your staff develop the soft skills necessary to establish rapport, work with emotional intelligence, listen actively, and do outcomes based on thinking, then delivering the hard skills with excellence will be easier and more fun.