Philosophy has to do with the relationship between belief and action. In the end philosophy is what gives meaning and purpose to our lives. As dentists who are consciously aware of our own beliefs and what holds meaning to us, our daily work and our routine are not merely unrelated actions and episodes, but integral parts of our personal lives.

There is an important distinction to be made between having a philosophy and living a philosophy. “Having” a philosophy implies having an idea or set of ideas, but it doesn’t necessarily mean that those ideas are being acted on. Learning can best take place when we are “living” a philosophy—that is, living in a state of inquiry—based on our personal values, our knowledge of ourselves, and our individual goals.

Questions lead to answers.

According to Jim Dyce, a British dentist/philosopher and good friend of L.D. Pankey, “Philosophy can do no more than initiate questions.” When Dr. Pankey decided to devote his life to saving teeth, he was forced to ask himself a difficult question, “How can I help people keep all of their teeth for a lifetime?” In 1925 L.D. didn’t know the answer. Out of that question he was able to uncover and develop many principles which have proven instrumental in the understanding of comprehensive restorative dentistry and patient education. Therefore, Philosophy, in its most valuable form, is more about asking right questions than with right answers.

How useful the Pankey Philosophy will be to you depends on how willing you are to put yourself in the questions. In the process of moving toward the answers to your questions will help you clarify your goals and ways to accomplish them. Questions can open the floodgates to new insights and information for you.

How do you define and measure success?

The Pankey Philosophy itself seems simple enough at first glance. Each one of us must decide for ourselves what and how to measure our success. Once we have conceived an idea of success, we must believe in it, and then work out ways to achieve it. Achieving the greatest success in dentistry–both gratitude from our patients and financial and spiritual reward, requires a commitment to always give the best you can. This involves knowing yourself, knowing your patients, knowing you work, and applying your knowledge conscientiously.

Dentists can fall into a rut of boredom and frustration.

This sobering statistic may have been attributed to two main factors related to the practice of dentistry. First, dental work is usually confined to a small office, where dentists go day after day, week after week. Second, once dentists become good at what they are doing, their work becomes very much the same. The result could be developing a feeling of not being appreciated by their patients and staff. Or maybe feeling being trapped in their small office. They may think they are not achieving much in the way of mental stimulation, and start wondering to themselves “Is this all there is to dentistry?”

Now, this is not to say that all or even most dentists live lives of “quiet desperation.” Yet most dentists have felt they are in a rut at one time or another, at which point it becomes increasingly difficult to see the real rewards in this great profession of dentistry. Reviewing your questions again can pull you out of the rut.

Dentists can climb out of the rut through increased service to mankind.

In 1947 L.D. began teaching the Philosophy of the Practice of Dentistry which he had been developing since 1932. His purpose was to help dentists confront and move past feelings of frustration and boredom. L.D. wanted to move dentists toward higher levels of excellence in their technical work, improve their communication skills with their patients, and achieving greater satisfaction in their lives through increased service to humankind.

Are your goals clear and well-defined? Are you willing to pay the price to achieve them?

L.D recommended dentist look more closely and objectively at themselves and their individual situation. He would suggest asking his class to really think about their goals. He would ask them,” Are your goals clear and well-defined? Can you measure your goals so you can measure your success? Do your goals belong to you or are they someone else’s goals? Are you willing to pay the necessary price to achieve them? Are your goals and objectives in line with your circumstances and temperament?” Satisfaction is achieved not only in reaching your goals, but also by understanding the progress you are making during your journey as you move slowly and steadily toward them.

As poet and musician Bob Dylan wrote, “He who is not busy being born is busy dying.”

Understanding the Pankey Philosophy can help you transform your experience of practicing dentistry, increase predictability, profitability and fulfillment. The Essentials Series is the path we urge you to take. Essentials 1: Aesthetic and Functional Treatment Planning is where your journey begins.  Following a system of risk assessment, patient ownership and risk management creates technical excellence and predictability.

Over the past few months, I’ve had a series of coaching sessions with frustrated dentists due to many of their exchanges with team members not being as effective as they had hoped. The dentists were confident they had been clear about their expectations, and yet there was still lagging or even absent implementation of the anticipated behavioral and system changes.

“Maybe this is not the right team member! How can they not just do what I ask them to do?”

Of course, I appreciate how disconcerting this can be, AND I want to challenge the notion that a single conversation can lead to effective change.

I imagine we can agree that most of your patients are in the midst of their own developmental process, as dental offices have quality systems in place to support this idea. A patient comes in for a hygiene appointment and they are routinely scheduled to return in 3 or 6 months to follow up, monitor for changes, and (hopefully) celebrate new levels of health. We are used to the idea of having a return date, better known as a “recall appointment.” More often than not this system works. Over time, as the recall appointments continue, trust levels increase along with deepening relationships and even case acceptance.

The question I pose is this: How can you as a leader apply this same principle to coaching your team members? I like to call this system a Conversational Recall.

What if at the end of a coaching conversation, even a short one, you create an opportunity to revisit with the team member to assess progress, problem solve any obstacles, and set a time for yet another Conversational Recall? My own experience tells me that sustained change typically occurs by implementing small changes over time. Staying connected with a team member by offering ongoing feedback and support may very well be the difference between you being frustrated by unmet expectations and your ability to celebrate high performance and heightened levels of engagement.

One aspect of leadership is setting each team member up for success. You can do this by investing time and energy, walking alongside them, and committing to following up as a pathway to letting each person know that you care. One of the greatest ways to inspire change is to demonstrate to your team members that you both value what they have to bring and that you believe in them…sometimes even more than they believe in themselves.

Another aspect of quality leadership may just lie in your ability to be congruent in all areas of your practice; do for your team what you do for your patients—if not more. Care for your team like you care for your patients—if not more. The rewards for everyone involved could be incredible!

One of the greatest challenges of dentistry is developing a conceptual framework for how to approach complex cases. We leave dental school bright-eyed but unfamiliar with the personal and professional tools that help us get to know patient needs and provide optimal care over a lifetime.

Phased therapy is a skill that takes time to develop but creates the mental space to build relationships and techniques simultaneously. How do you follow through on a treatment plan over the course of many years, phasing out the process to improve the patient’s experience, your experience, and their ability to afford it?

Single tooth dentistry may seem simpler than a full mouth reconstruction, but it still poses its own set of challenges. You’ll be able to gain skills without requiring patients to commit to a heavy financial burden, but you’ll still need to manage esthetics and deal with unforeseen issues with occlusion.
A dental career is one marked by introspection that necessarily leads to improved patient care as you gain greater self-knowledge alongside technical skills. Here are 2 tips you can use to develop your love of both simple and complex cases, your long-term relationships with patients, and your passion for dentistry:

1. Approach Learning as a Layered Process

It’s easy to get hung up on technical prowess and let your communication skills or personal development suffer. The mountain of knowledge that exists in dentistry is formidable, especially the way it is presented early on in our dental educations.

But you don’t have to build Rome in a day. Start with single tooth dentistry so that you have time to learn the technical and behavior skills along the way that will build your confidence to tackle bigger cases.
Longevity in a career as physically and emotionally demanding as dentistry requires that we approach learning as a layered process. Each case deepens our understanding of how to evaluate and succeed at the next one. Along the way, we can find joy in each incremental improvement.

2. Build Trust Through Patience and Demonstrable Success

Nothing works without the patient’s trust and acceptance. They will be more likely to say yes to a simpler restorative case. What you’ll find is that as they get to know you and you get to know them, their willingness to engage in future dentistry will improve.

With patience, you’ll put in the work to improve their health and esthetics. The fruits of your labor will naturally result in greater trust.

Later this year, I’ll be hosting my course “Think Global, Work Local,” at Pankey Online. During this course, I’ll dive deeper into the concepts I’ve brought up here.

I’ll be covering three cases that stood out in my career, including the details on preparations, impressions, fee presentation, treatment planning, restorative care, and case results.

I can’t wait to see you there for this opportunity to dive into a Pankey-infused approach to learning over a lifetime!

After about ten years in practice, I had “one of those days” when I sat down at the end of the day and said to myself, “Is this what it’s going to be like for the next thirty years?” I was working hard, making money, and considered successful by my friends and peers. But, patients were not saying yes to the dentistry I was capable of delivering. 

I had a long talk one evening with Dr. Loren Miller while at The Pankey Institute. His parting comment stuck with me, “Son, it’s time for you to do some straight-line thinking.” I then realized that I needed to change if I wanted my patients to change. I needed to practice in a manner that allowed me to be happy and serve my patients well. In order to do that, I needed to define what I wanted out of my life – personally and professionally – and start living that life.

Starting Point 

Each of us will find our core philosophy in our own way, but you don’t have to reinvent the wheel to get there. There are many resources to help you get started. What follows is a list of ideas from Jim Rohn that I like as a starting point.

1. Set some key goals for life – personally and professionally. Then be like a sailor. No matter where the wind is blowing from, keep tacking toward the goals. 
2. Learn from both success and failure. Don’t take everything personally. Analyze when things go right and wrong, and learn from your mistakes. Success is a series of small steps toward your goals. 
3. Read. Reading requires concentration and focus. These are skills we need to find success. Reading allows you to learn from the experience of others. The brain functions differently when you are reading and writing than when you watch a YouTube video. 
4. Keep a journal or write a blog. Keep track of your path to clarifying your philosophy. You don’t really have a personal philosophy until you are able to explain it to your team and others. 
5. Practice the art of active listening. It is a learned skill that is valuable in your practice and your family. Surround yourself with people you admire. Observe and listen to them.  
6. Be disciplined. Every day is filled with a myriad of choices. We know the difference between good and bad options. It takes discipline to make good choices and stick to that path. 
7. Don’t neglect your personal and practice life. If you don’t take care of yourself, your relationships and your business no one else is going to do it for you.  

This all sounds similar to what L.D. Pankey wrote and said, doesn’t it? 

Moving to Fee for Service Care 

I had many mentors on my path to change: Avrom King, Sandy Roth and The Pankey Institute. It was neither quick nor easy, but these sources came together for me to help me have the courage to commit to change. That change was not driven by money. It was driven by the desire to help people willing to commit to seeking outcomes they desired that were within my capacity to facilitate. That may seem “fluffy,” but from a client perspective, it is a really big deal. We asked our clients to take ownership of their own health. If that was not within their capacity, we chose not to be involved in their care. Our philosophy evolved over several years and allowed me to move from insurance dependence to fee for service care. We called our practice an “outcomes-based” practice, thirty years later, and three years out from handing off my practice to my former partner, it is still a successful fee for service practice. 

Moving from insurance dependence or mixed dependence to a completely fee for service care takes commitment to a special kind of practice philosophy. The listed seven steps above can start you on the way to clarifying your own. 

According to Markus Zusak, author of The Book Thief, he had to rewrite his book 150-200 times until he was happy with it. And he began by imagining the end of the story, then the beginning, then the chapter headings, then the writing…over and over again. In the end, Markus had a New York Times Best Seller, with 8,000,000 million copies sold and a movie deal. 

One might be tempted to view Markus Zusak as an overnight success but knowing what I have just told you allows you to understand that’s not the truth.

So too is the case with relationship-based/health-centered dentistry. The creation of the practice takes years, starting much like Zusak’s book—beginning with the end in mind. From there, each aspect is assembled from finding and forming the right care team, to developing them, and to finding better and better ways to connect with patients: truly hearing them, understanding their struggles, and sensing their desire to feel better about themselves. 

Along the way, you will make mistakes, have misunderstandings, and outright fail. This will prompt you to rethink, revise, and redo. This is the true nature of success. We learn and move upward with better understanding. 

It has been said that the main difference between a vision and a dream is the work involved.

The later requires none. The former’s work never ends. A true vision is a principle-centered thought capsule aching to be validated by reality. It has an inherent truth built into it which must be realized. And as with Zusak, if it takes 200 revisions to make it happen, then it takes 200 revisions. So be it! 

The simple secret to success is the willingness to be flexible and to accommodate new understandings combined with a sheer force of will and perseverance that only a few are willing to make. 

Many years ago, when I was first trying to create a successful dental practice, I fell in love with the word “production.” I believed that production was the key to success, so I read everything I could to become more productive.  

I took courses.

In the early years, there were so many courses that centered around how to efficiently double and triple book, how to bring in more “warm bodies,” how to sell more dentistry, and how to utilize more staff to get more done. I never felt like these strategies were the answer to my production issues. I barely became more efficient, and I never became more effective as I just ran myself down. 

In my books, I have written about my issues with stress, which I believe eventually initiated adult-onset diabetes. Through it all, I continued my quest to be productive. In those years I truly learned to become more effective rather than more efficient. Reading Stephen Covey’s First Things First was extremely helpful to prioritize my work and life. But I found that was only part of the solution. The real problem for me was not managing my time. It was managing my energy.  

Diabetes became my blessing and my curse.

In my quest to control high blood sugar and the fatigue that comes with it, I found more energy. I found more mental and emotional clarity as well. A fog was lifted. My diabetes forced me to eat better and to exercise.  

I remember listening to some of Anthony Robbin’s tapes in which he tells the story of living in a small apartment in southern California, being extremely overweight and feeling like a loser. The first thing he did was to exercise. I did too. Slowly at first, I began to run. I built up my time and distance. Now, twenty-five years later, my routine includes six hours per week in the gym, running and lifting and six hours per week doing hot Yoga. The results have been nothing short of amazing. My diabetes is under control, I lost weight, I multiplied my energy level and mental clarity went way beyond what I expected. 

My moods improved, I enjoyed my work more, patient behaviors didn’t get to me as much, my work improved, I learned new techniques and took more continuing education, and most importantly, I had the energy to have a life outside of work.  

Viktor Frankl believed the key to the successful creation of a happy and successful life was to aim toward a deeply significant and meaningful life purpose. On this, he commonly referenced Friedrich Nietzsche’s quote, “He who has a Why to live for can tolerate with almost any How.” Suffering is no fun, but suffering for a deeply significant purpose becomes much more tolerable when you know that the end will justify the means.

Loving Others

On love, Frankl said, “Love is the only way to grasp another human being in the innermost core of their personality. No one can become fully aware of every essence of another person unless they truly love them, because by love we are enabled to see the essential traits and features in the other person; and even more importantly, see that which is potential in them—that which is not yet actualized, but ought to be actualized.” So, this begs yet another challenging question: Do we love our patients enough to suffer with them, as well as help them to become more of what they are capable of becoming through our collaborative work in dentistry?

Finding Courage in the Face of Adversity

The practice of true relationship-based / health-centered dentistry represents a counter-cultural decision with regard to mainstream thinking and behavior, as corporate dentistry is rapidly moving the profession in the exact opposite direction. Consequently, dedicating oneself to a truly patient-centered philosophy requires courage, commitment, and perseverance. Additionally, one is likely to experience tepid local support for it, as most peers will be following a very different philosophy – a philosophy focused on what they want or need to get out of dentistry, and not what life expects of them. Regardless, the striving for a cause greater than oneself, allows us to experience more meaning in a month than most corporate dentists find over their entire career.

Regarding Success

Regarding the achievement of material success, Frankl wrote, “Don’t aim for it, because the more you aim at it and make it a target, the more you are going to miss it. For success, like happiness, cannot be pursued; it must ensue, and it only does so as the unintended side-effect of one’s dedication to a cause greater than oneself, or as a by-product of one’s surrender to a person other than oneself.”

Personal Meaning

As you can see, meaning and personal relevance can’t be bought, copied, or transferred. Rather, it’s an inside-out process which must be discovered within ourselves and then refined over time. If this is the kind of challenging, growth-oriented journey which motivates and inspires you, then The Pankey Institute represents the very best place to both begin it, as well as nurture it all along the way.

Viktor Frankl wrote his famous memoir, Man’s Search for Meaning, over a period of nine days in 1946, and it has become an indispensable meditation on the wisdom Frankl gleaned from his gruesome experience at Auschwitz. The horrific circumstances he faced – circumstances which caused many others to surrender their very will to live, caused Frankl to focus his energy on a pursuit of meaning. He sought to find a deep sense of personal relevance in the face of incomprehensible evil, helplessness, and hopelessness. This, in turn, led him to discover personal relevance could be found through the cultivation of:

· Purposeful work

· Developing a clarified, values-driven Vision and Goals

· The intentional loving of others

· Courage when confronted by extreme challenges

· Choosing not pursue material success, and instead, focus on allowing it to ensue

As we advance toward and through our purposeful work, as well as through loving others, we will inevitably be confronted by circumstances which require tremendous courage and perseverance. Frankl felt these situations – these periods of courageous suffering were key to our ability to progressively discover the deeper meanings to life and to positively change as a result of new realizations and perspectives. On this, Frankl commented, “Without suffering and death, human life cannot be complete.”

What Does Life Expect of Us?

During his time in Auschwitz, Frankl fundamentally changed his perspective toward living, as he observed that what he wanted from life didn’t matter in the grand scheme of things. Rather, what truly mattered was: What did life expect of him, and could he live up to it all, in spite of the horrible circumstances which surrounded him each and every day?

Purposeful Work

Trying to apply Viktor Frankl’s other-centric philosophy today requires us to turn the current egocentric culture on its head, as implementation begs even more potentially life-changing questions such as:

· Why am I here?

· What have I been called to do?

· How can I make sure I will be able to achieve it?

By sincerely answering these questions, it’s my hope you will discover, like Frankl, that your work in dentistry isn’t just about what you want from life; rather it’s about much more. It’s about a “calling” driven by your desire to significantly help others.