By Barry F. Polansky, DMD 

These thoughts were first published in May of 2021 on my blog Stoic Dentistry. Parts one and two of this blog series tell the story of how The Pankey Institute provided me with inspiration that shaped my career and provided me with purpose to live a meaningful life. 

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According to the findings of motivational researchers Deci and Ryan (discussed in Part 1 of this blog series), when we are the masters of our own destiny, we are more focused, productive, optimistic, resilient, creative and healthy. 

In retrospect, this is what I found I was experiencing on my Thursday mornings reserved for practicing “the Pankey way.” 

Autonomy as an intrinsic driver works—so starting slow to install fee-for-service just one morning per week is a sound idea. 

The Riddle of Mastery 

And then there is the riddle of mastery. Mastery sits atop L. D. Pankey’s Ladder of Competency. The question is how does one achieve mastery? It could be reduced to “Just do it,” but there is more science. 

In a 1953 paper by Harvard psychologist, David McClelland, a leader in achievement and motivation theory, he wrote an original thesis titled “The  Achievement Motive.” Deci and Ryan acknowledged that this thesis may have described an intrinsic driver even more important than autonomy. They called it competence, but it now is known as mastery. 

The pursuit of mastery has been the subject of numerous scholars and authors from Theresa Amabile and Robert Greene to George Leonard. Most agree that mastery is the desire to get better at what we do. It is the need to continually get better, to improve and to make progress. It is the royal road to growth and flourishing and the opposite of languishing and drudgery…the low rung on Pankey’s Ladder of Competency. 

Working toward worthy goals is pleasurable. Making progress produces the neuro-chemical dopamine. According to Daniel Pink, author of the popular book Drive, “the single biggest motivator by far, is making progress in meaningful work.” 

At my lowest point in dentistry, I felt stuck. Hopeless. My work had lost its meaning. Today we call that burnout. Those Thursday mornings turned on the light…the light of hope. 

We need the freedom to chase mastery. That freedom comes from autonomy. Without the intrinsic driver of autonomy, it is difficult to sustain the drive necessary to achieve mastery…this is based on our biology, not just some story, fairy tale, or business myth. 

Driven by Dopamine and Progress 

After installing the Pankey Thursday mornings where I could practice autonomously, applying the lessons I needed to learn, I slowly put the complex elements of comprehensive relationship dentistry together. I started with the comprehensive examination and built on that by learning all of the components from the mundane mounting of models to the nuances of advanced occlusion. It took time…but driven by dopamine and progress, slowly I was installing my model practice. 

I realized that learning the softer behavioral skills were just as important as the technical, so in time I learned about case presentation. Through the years I learned new skills like digital photography and Power Point. Today’s dentists are mastering digital 3D treatment planning. 

I am retired now and looking back I see how that moment when Dr. Becker suggested the Pankey Morning changed my life. 

Today things are different. There is pressure on young dentists to dive into corporate dentistry or adopt practice models focused solely on extrinsic rewards. Many of these newer models undermine autonomy, which, in my view, is a critical error. The Pankey Institute continues to thrive because it champions the principles of autonomy and mastery that are essential for a fulfilling and sustainable career. By embracing a fee-for-service approach and fostering an environment where personal growth and patient relationships take precedence, dentists can build practices that not only endure but flourish.  

As I reflect on my own journey, I see that the true essence of a rewarding career lies in balancing professional excellence with the autonomy to pursue one’s own vision—a hallmark of L. D. Pankey’s philosophy of practice. 

By John C. Cranham, DDS 

Pete Dawson and I talked about this often. No matter how many years in practice, dentists never have everything figured out. The things that you are doing now are not going to be right forever.  

My advice to young dentists is to be open to new processes and new materials even if you have a predictable way of doing things now. Learning and adapting makes dentistry incredibly fun. Even in my 60’s I am always learning something new—like the digital 3D world of dentistry. I haven’t been this excited about dentistry ever. 

Starting out as a new dentist wasn’t easy for me. I wanted to be known for something in my community. I wanted to be known as the dentist who solved problems that other dentists couldn’t. The first thing I needed was courage to put myself out there and do whatever I needed to do.  

The second thing I needed was training, mentoring, and experience. I went to The Pankey Institute and Dawson Academy. I took all their courses. I took a veneer class with Bill Dickerson back in the day. I listened to Ross Nash and Larry Rosenbaum. At the turn of the millennium, I was trying to take the traditional occlusal information and blend it with the hottest cosmetic information at the time. (Those concepts were diametrically opposed back then. It was blasphemy to put them together.) I prevailed and became better at solving functional problems and improving aesthetics at the same time. Today, dentists do this all the time. 

I and all my colleagues coming up over the last 30 years have had to be open to change. We’ve had to try new things and work at mastering them. I don’t think I am doing anything today in the same way I was trained in dental school.  

My message in this blog is that it’s important to evolve as a dentist to stay enthusiastic about what you do and to provide the best care you can. It’s common for maturing dentists to let go of certain procedures and focus on what they enjoy most and develop specific expertise in niche services. It’s also common for other maturing dentists to continue enjoying general dentistry half of their time and focusing on complex cases the other half.  

Enjoy the relationships you build and take pride in improving your restorative work as you need to redo it. Patients are wowed by what you can do now and how you do it compared to how you did it years ago. They love learning about the advances in dentistry that benefit them.  

The relational part of practice will always be rewarding. Being able to choose what you do and who you do it with will always be wonderful. Passion for what you do is fueled by learning, so keep setting goals to learn something new and be open to that learning changing you. 

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 

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. 

I wrote this article 20 years ago for The PankeyGram, and it is still relevant today.  

As I walked into the room, the nurse was applying medication to a hand wound my grandmother had received from a fall a week earlier. My eight-year-old son, Tim, and I had traveled a thousand miles to say goodbye to my grandmother. At 89 years of age, her body was finally ready to give in to breast cancer, and her mind had fallen victim to Alzheimer’s disease over previous several years. 

I knew she would hardly know who I was, and if she did remember, the memory would be gone moments after I left. However, my father was an only child, and it was important to help him through these difficult times. My son also needed to learn about his roots. 

It was sad to see her unable to hold herself up in a chair, and she seemed so frail and weak. I said hello to her, and she opened her eyes enough to gaze at me. Her air-filled voice repeated, “I’m so tired. I’m so tired.” I held her hand and comforted her the best I knew how. I showed Tim to her, and she struggled out a sincere smile towards him. I told her stories about my family, my job, my tree we planted in honor of my grandfather, and how full and complete our lives were. It was as if I was trying to justify her life through the one, I was able to live now. 

We had brought some cinnamon cookies with us, and I offered one to her. Her dry frail hand reached for a cookie. She slowly nibbled on it.  

As you spend time with someone who is close to death and appears to have lost everything, one naturally thinks about how unimportant much of one’s life can be. I thought about the worldly parts of my life: the cars, the boat, my home, or ability to travel. I thought about the simple function of life: walking, running, feeding ourselves, dressing ourselves…. We have so much when we are healthy. Being a dentist, I reflected on how trivial teeth seem at a moment such as this. I pondered these thoughts as the first cookie disappeared, then another. 

My grandmother’s exhausted manner seemed to temporarily dissipate. She had found pleasure in nibbling the cookies. With her eyes closed and body relaxed, my attention focused on a collage of colorful photographs hanging next to her bed. Looking down at me was a picture of my grandfather, almost as if he approved that I had come. 

My grandfather was a righteous man who always felt it was important to do things the correct way. His home was not large, but it was perfect. Every part of it was neat, crisp, and clean. The saying “everything has a place and every place has a thing” describes how well he took care of his belongings. In the same manner, his and my grandmother’s health had been important to them, including their teeth. They both had most, if not all their teeth until the end. Even at the time of my grandfather’s death at the age of 84, he was scheduled to have some major dental work completed. My grandfather had been comprehensive about caring for his health and life. 

My grandmother was now working on a fifth cookie. I watched as she gently grasped it, lifted it to her mouth, bit and sighed with pleasure at its wonderful taste. Suddenly, I realized that because she had her own teeth at age 89, she was able to find some pleasure in what most would consider horrible existence. She could still eat and experience the pleasure of taste! What had seemed small in the scheme of things a moment ago had renewed importance. 

Many patients judge the competence of a dentist based on whether they are free of pain. However, a dentist’s true competence is measured by whether patients still have the ability to eat at the end of their lives. This can only be achieved with a comprehensive long-term approach to dentistry and helping people understand the importance of this type of care.  

No matter what you do in this world, you need to treat people in a personalized, comprehensive fashion. Now I look at every patient with the hope that when they have lost everything else, including their mind and most body functions, they might enjoy the ability to eat and the sense of taste. 

As her hand reached out, her fragile voice whispered to me, “May I please have another cookie?” 

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

Back Then and Now

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

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

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

The Road Less Travelled

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

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

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

The Pankey Institute Community Is There for You

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

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