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. 

A Reflection: Although most of our early educational classrooms have not often fostered it, an essential participatory experiential exercise can help ground our discoveries and anchor our adult learning, in which we can be “known through” an experience with self and others, more than knowing anything by our own thought. An authentic encounter with a teacher/mentor can foster, in time, our discovery toward a feeling of true knowing, in our heads, our hearts, our hands, and our bodies, as well. This understanding, authentically discovered, can emerge, in unique ways with each individual, and becomes an opportunity for True-Self seeing. It is quite unlike the intellectual “knowing” most of us have been taught to rely on. This experiential kind of “seeing,” can take away much of our anxiety concerning figuring it all out fully for ourselves or requiring ourselves to be “right” about our formulations beforehand. At this point, a teachers’/mentors’ facilitation can become more like a verb than a noun, more a process than a conclusion, more an experience than a dogma, more a personal relationship than an idea.

Life then becomes more like a verb than a noun…We were not put on this earth to describe life, rather we are invited to actively live it,,,! In time, there often can be someone dancing with us (maybe sitting on our shoulder), and we are not afraid of making mistakes. We learn through experience, mistakes, doubt, while allowing a reviewing process to become an intentional part of our experiential learning. It is often best, if we are not told first… Rather, we can be invited to discover it for ourselves! Hmmm…Isn’t that interesting?

“The true wonder of learning is discovering for ourselves!” Carl Rogers, PhD

Through our own experience we can discover while having many encounter’s in which family, patients, team members, friends, and colleagues become our teacher’s / mentor’s. Even when we are doubtful, we can look in the mirror, at our authentic self and say, “Yes” – knowing full well, there is much more to be experienced and it is bound to add layers to our understanding and learning on the job! What ever the “Job” may be or become! Learning becomes a “Two-Way Street” and our teachers and mentors can become participants, team members, patients, spouses, parents, grandparents, adult children, children, and grandchildren, in all age groups. Success then, is a moving target… Not a fixed destination; instead, it can be a becoming!…Isn’t that wonderful…!

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.

How can a patient trust you, if you don’t even trust yourself? Let’s dive in:

Trusting Yourself

The last frontier of trust is trusting yourself. Most people would say that trusting themselves is by far the most difficult.

When you have decided to place your trust in another person, you have surrendered some control to them that you previously held. When you decide to trust yourself, who or what are you giving up control to?

The answer, in my view, is a four letter word called ‘fear.’ Nothing gets in the way of human progress and performance more than fear. Often our fear is grounded in the inaccurate internal assumptions we use to organize our identity, define how we see ourself, and define our relationship with the world.

When fear dominates our inner world, meaning, happiness, achievement, and our relationships suffer.

Performance and Attention

In pursuit of high achievement, ancient philosophers, theologians, and modern brain science all agree: “We become what we give our attention to.” Our first option is simply to give our attention to the fear that lives within us and the possibility and consequences of failing.

It often sounds like this: “What will happen….What does it mean…How bad will it hurt…What will people think…If I fail.” It is uncertain, unknown, improbable, and anxious. The other option is to create all of the certainty that I can and attack the fear head on.

In this approach, I study my performance as much as possible in order to learn. I structure a plan and rehearse every sequence. I practice this plan for as many hours as needed. I identify and create solutions for each potential problem in advance.

I create a very clear picture of the final result that captures my attention and focuses my energy and creativity. By spending the time and energy in advance to prepare myself, I have created all the certainty for success that I can.

At that point, it is all about trust. Trusting in my preparation to create certainty. The certainty of success.

The white hot center of human performance is trust. There is no substitute for a deeply held trust in yourself. As Covey said, that kind of trust changes everything!

What is trust and why does it matter in the relationship-based practice? 

Writer and public speaker Steven M. R. Covey says that trust is the one thing that changes everything. Trust lives at the intersection of competence and character. In other words, great skills alone are not enough because you might use them to benefit yourself and not your patient/client.

Trust in Relationships

Character alone is not enough because you might not be able to deliver great clinical results. When character and competence are both present, then what is possible within that professional relationship becomes different.

A strategy to establish and build high trust working relationships in a professional practice is equally as essential as developing high clinical competency. In fact, they are synergistic and will provide energy for one another.

Trust then is not just a philosophical construct. It is not just a means to bring your personal mission to life. It is also a critical business strategy in building a relationship-based professional practice. This is the face of the trust that lives between a dentist and their patient.

Strong Leadership

Much research has shown observable trust to be the number one factor in a patient’s decision to trust the practice as a whole and the dentist in particular. This is simply a measurable function of leadership and the culture that results when great leaders are at their best.

A high performing leader will have strong relating competencies, high integrity, courageous authenticity, self-awareness, and a focus on achievement. These competencies will attract like-minded team members, establishing a culture of respect, appreciation, accountability, and trust.

When this happens, trust will flow in both directions and be visible and experienced by all. This entire process is nonlinear. It is very interdependent and, by necessity, simultaneous. Much like each biochemical system in a cell is necessary for proper cellular function, each complex biochemical unit is also necessary for the other systems to form in the first place. Together, they ensure the entire cell functions properly.

Similarly, while the dynamics of respect, trust, appreciation, and accountability are essential ingredients to establish a healthy practice culture, they also rely on one another to sustain a successful system. They are necessary for the entire practice to function at its best.

Check out this article for quick and easy body language tips that develop trust! What’s your take on this oft-debated topic? 

Our behavior directly influences the results we see in our life and career. In the dental practice, recognizing the need for conscious change and following through requires true self-discipline.

We all know what we need to do to improve our situation, whether that be in working on patient care or engaging in more education. The hard part is that even once we’ve gotten the information we need, we still have to implement change consistently.

Conscious Change & Practice Success

Discipline goes counter to human nature. In the practice, we know we should always be on top of things like scheduling a patient’s next hygiene appointment or asking the patients we trust most for referrals. These are the behaviors that require diligence and more attention than we may have on any given day.

It’s not easy to change. It’s not easy to commit to using intraoral cameras more often or anything else you have as a goal. The difficulty lies not in an individual failing, but in the structure of our brain.

Conscious change is a fight against our natural inclinations. It requires holding ourselves accountable to the behavior changes we want to implement.

Self-Doubt and Commitment

We also have to face the self-doubt that comes with change and handling any hiccups that occur. It’s painful to make mistakes, but even more painful to stay mired in old, stale behaviors.

One thing that helps is transparency and being held accountable by an external source. Project management software already does this well. It keeps track of our successes and failings for us.

We should be using this tool to identify our weaknesses and thereby improve our results. Once we notice what behaviors aren’t driving success, we can replace them or find avenues toward heightened performance.

How do you support behavior change in yourself? Let us know your thoughts!

Dental failure and being ‘perfect’ in patient care is a key stressor for dentists. In her first blog on this topic, Dr. Brummett talked about deciding to work toward perfection rather than feeling frustrated about not achieving it. Read on for the rest of her story:

Stop Trying to Be the Right Kind of Perfect

The next morning after my revelation about perfection, I woke up, had coffee, and realized the patient who had been the focus of my upset (over a mistake I made) had texted me. She wrote, “Good morning Dr. Brummett! I just wanted to let you know that I am doing well and have not had any pain.”

What? My patient was doing well, texting me to tell me how well, and she was thanking me?

A quest to provide myself with a new perspective and a reminder acronym began. This perspective would hopefully take shape so that I could share it with my team, my children, and anyone suffering from the punching match of perfection.

Perfection can be the root of depression and upset, which is why becoming perfect will be my focus and acceptance of the process my goal. Perfect will stand for seven perfect words:

P is for position, as it’s good to remain humble about one’s status.

E is for effort, not the result.

R is for resilience, as I will fall, get back up, and grow from the failures.           

F is for facing the fear, embracing the challenge, and striving in the face of fear.

E is for empathy, treating myself and others with compassion.

C is for courage, as though I might not have a cape, I can still use my whole heart.

T is for trust, because with perseverance I can trust that everything will work out.

Later that day, my patient contacted me again and wanted me to know one last thing. She said, “I forgot to thank you for your gentle touch.”

This acknowledgment really drove home the point to me. I will attempt to stop looking through my rearview mirror and look forward through the front window of my life. I will allow myself, and encourage others, to become.

I am thankful for Dr. Pankey’s courage to share his failures and for our patients that believe in us and show us gratitude and appreciation. Now, isn’t that perfect? 

Failure is a hard thing to accept in dentistry. This is especially true because what constitutes ‘failure’ can mean different things to different patients and different dentists.

Keep reading for an anecdote that puts failure in the dental practice into perspective:

Changing Your Perspective on Dental Failure

On my way home from work one day, I turned the radio off, looked through the rearview mirror, and thought, what a day! I had just left my dental office dealing with a “dental failure.” I felt disappointed that this sort of difficult situation had occurred.

Then, this question came to the forefront of my mind: Why do I think I can or should be perfect? With that question, a wonderful reminder appeared out of the blue.

Bill Davis had conversations with LD Pankey about his philosophy and wrote an amazing book that I refer to often. The story I remembered was about Dr. Pankey sharing his own failures. He had worked five cases out on the Monson articulator and said that he basically obliterated the patients’ occlusion.

He shared how all five of the cases failed. He then stated that four of the five patients stuck it out with him because they felt he was conscientious enough to see them through. That’s when it hit me! I realized I had been thinking about this perfection thing all wrong. And, in the voice of Richard Green in my head, I could change my perspective. 

What if I didn’t focus on being perfect, but on becoming perfect?

In my own personal religious growth, I am learning how to develop my physical, mental, and spiritual health. I can learn the principles and values inherent to my faith and develop my character, but I can never truly be perfect. What if I approach my dental life in the same way? On becoming.

To be continued…