Know Your Work: Examination & Discovery

January 29, 2018 Edwin "Mac" McDonald DDS

The best dentists I know mastered the art of examination and discovery first. They learned to understand their patients’ conditions and how they relate to one another.

Leadership Through Discovery & Complexity

In that process of discovery, highly competent dentists learn to navigate complexity by confidently using reference points. These guide their understanding of what they discover. They train their eyes to see the details of esthetics, tooth structure, function, and periodontal type and status. Their fingers learn to feel the dynamic nature of the patient’s functional system.

They use every available form of imaging and records that add meaning to their discovery. Ultimately, they intentionally, systematically, and thoroughly develop a diagnosis that can determine the treatment plan. They manage complexity by moving toward simplicity.

Absolute and relative reference points serve as guides in designing the optimal scheme for the patient. When the patient’s teeth, gingiva, bone, functional scheme, and esthetics have been lost, those reference points tell you where to start and where to end. They both establish and limit what needs to be created.

Managing Complex Cases

Dentists at this level possess a very sound understanding of the dental functional system and a very detailed understanding of dental esthetics. They specially focus on how these two systems relate to one another.

They also understand their role in coordinating, guiding, and leading their interdisciplinary team in managing the complex case. To be certain, every member has a strong voice in developing and executing the treatment plan. Leadership in knowing your work really becomes visible in this process.

Someone has to decide where the case is going and how it is going to get there. There are many voices in the process, but at the end of the day that someone has to be you the leader, who also happens to be the first and final designer of the beautiful smile that is being restored to health.

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Edwin "Mac" McDonald DDS

Dr. Edwin A. McDonald III received his Bachelor of Science degree in Chemistry and Economics from Midwestern State University. He earned his DDS degree from the University of Texas Dental Branch at Houston. Dr. McDonald has completed extensive training in dental implant dentistry through the University of Florida Center for Implant Dentistry. He has also completed extensive aesthetic dentistry training through various programs including the Seattle Institute, The Pankey Institute and Spear Education. Mac is a general dentist in Plano Texas. His practice is focused on esthetic and restorative dentistry. He is a visiting faculty member at the Pankey Institute. Mac also lectures at meetings around the country and has been very active with both the Dallas County Dental Association and the Texas Dental Association. Currently, he is a student in the Naveen Jindal School of Business at the University of Texas at Dallas pursuing a graduate certificate in Executive and Professional Coaching. With Dr. Joel Small, he is co-founder of Line of Sight Coaching, dedicated to helping healthcare professionals develop leadership and coaching skills that improve the effectiveness, morale and productivity of their teams.

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Know Your Work: Complex Clinical Skills

January 26, 2018 Edwin "Mac" McDonald DDS

Clinical competence is a requirement of a successful practice. If people are going to seek you out rather than just going to someone who is contracted with their benefit provider, they need a reason. Clinical results are clearly one of those reasons.

Leadership Through Knowing Your Work

That being said, how well do you know your work? How well does your team know their work? Do the specialists and technicians that you work with make you better? Becoming highly competent in clinical dentistry begins with a decision. Have you made it?

If you have, are you maintaining that decision in the midst of all the resistance that you encounter as you try? Leadership, at its core, is about making a decision and maintaining that decision in the midst of pressure to do otherwise. Your clinical competence begins with a decision to be competent. How well it continues and develops depends on how important being highly competent is to you.

8 Complex Skills of Clinical Dentistry

Although clinical dentistry is not always complex, it requires a variety of complex skills. This includes:

  1. Examination, Diagnosis, and Treatment Planning
  2. Spatial Relationships & Esthetics
  3. Biologic Principles
  4. Local Anesthesia
  5. Tooth Preparations
  6. Provisionalization
  7. Materials Application
  8. Patient Management

You can add many more to my list. All of these skills are important in uniquely different ways. This is why continuing education and professional development in dentistry is so vital.

It is just plain difficult to develop so many skills and move them toward competence and mastery. Dentistry is both extremely rewarding and extremely demanding. So how are we going to develop competence that is moving toward mastery?

We need a plan that develops specific habits. We need the habits to serve our WHY. We need great teachers, leaders, and institutions that help us pursue the limits of our possibilities. It is a journey that never ends as long as we are given the gift of caring for another human being.

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Edwin "Mac" McDonald DDS

Dr. Edwin A. McDonald III received his Bachelor of Science degree in Chemistry and Economics from Midwestern State University. He earned his DDS degree from the University of Texas Dental Branch at Houston. Dr. McDonald has completed extensive training in dental implant dentistry through the University of Florida Center for Implant Dentistry. He has also completed extensive aesthetic dentistry training through various programs including the Seattle Institute, The Pankey Institute and Spear Education. Mac is a general dentist in Plano Texas. His practice is focused on esthetic and restorative dentistry. He is a visiting faculty member at the Pankey Institute. Mac also lectures at meetings around the country and has been very active with both the Dallas County Dental Association and the Texas Dental Association. Currently, he is a student in the Naveen Jindal School of Business at the University of Texas at Dallas pursuing a graduate certificate in Executive and Professional Coaching. With Dr. Joel Small, he is co-founder of Line of Sight Coaching, dedicated to helping healthcare professionals develop leadership and coaching skills that improve the effectiveness, morale and productivity of their teams.

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Treatment Planning Your Dental PracticeTransition

January 24, 2018 Mike Crete DDS

What does it mean to treatment plan your transition? It’s all about thinking strategically when it comes to the future of your career and the important relationships you will inevitably align with your goals.

Many dentists in the prime of their career decide it’s time for an associate to join the practice. Often it is because there is an overflow of patients or the senior doctor is interested in slowing down, taking more time off, and eventually planning for their retirement.   

Over the course of my career I’ve had four associates. One who took over a satellite practice I had purchased and three who moved on for various reasons. Even one who walked away from the “altar” when we had spent months planning to formalize the legal documents for a partnership.   

Lessons From a Professional Transition

What I’ve learned is that although the legal documents are important, it’s really the Core Values and Philosophy of the potential partner that form the glue capable of binding a solid long-term relationship.  

Once you have determined (usually with the help of a good practice management expert) that your business can financially support another dentist, it’s important to then reflect and put into writing the core values that are unique to you, your practice, and your philosophy of practice and life.

Share your core values with all potential associates and future partners. Make sure you are aligned in your principles and ideals. With a shared set of values you now have the blueprint for a successful future.  

I eventually found a partner to transition my practice to. It is our shared core values of Excellence, Relationships, and Balance that solidified our future and kept us on course for a successful transition.

What professional skills have you acquired over the years that have helped you throughout your career? 

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Mike Crete DDS

Dr. Mike Crete lives and practices in Grand Rapids, MI. He graduated from the University of Michigan dental school over 30 years ago. He has always been an avid learner and dedicated to advanced continuing education., After completing the entire curriculum at The Pankey Institute, Mike returned to join the visiting faculty. Mike is an active member of the Pankey Board of Directors, teaches in essentials one and runs two local Pankey Learning Groups in Grand Rapids.

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4 Cornerstones of Successful Dentistry: Team & Growth

January 22, 2018 Mary Osborne RDH

There are four cornerstones of dentistry that determine a balance essential for true success. In Part 1 of this series, I discussed Clinical Services and Patient Care, which have an external focus on patients. They guide how you and your standards are viewed by your community and presented to them.

Now, I’ll dive into Team Participation and Practice Growth and Development. These two cornerstones have an internal focus that shape quality of life and internal direction.

All four of the interrelated cornerstones will impact success in dentistry, especially if one is out of balance with the others. Use them to identify your current reality, vision for the future, and action plan.

Cornerstones of Dentistry: Team Participation and Practice Growth and Development

Team Participation

Team participation is a tacit feature of all dental practices. Team members have a huge impact on the practice atmosphere, as well as the collective success of patient care. Individually, the level and quality of team participation must be cultivated and supported based on your practice vision.

You can seek out and hire team members who are passionate and keen on raising the practice up. You can also determine standards for teamwork built on healthy expectations, the fair exchange of ideas, and support of insights. You can design a culture that enables different opinions to thrive in light of shared values. You can share the ups and downs, as well as the pride and purpose, of working together.

Practice Growth & Development

You have the ultimate say in defining and instituting a standard for growth. In your practice, you create and have responsibility for meeting goals related to finances, size of patient base, size of practice team, and your schedule.

Your personal and professional growth is your decision. You can seek out opportunities that fit your educational desires and sense of monetary value. It’s not helpful to compare yourself to other practices, because their goals and how they achieve them will not be the same. The ‘return on investment’ for CE and other professional development can only be gauged by you.

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Mary Osborne RDH

Mary is known internationally as a writer and speaker on patient care and communication. Her writing has been acclaimed in respected print and online publications. She is widely known at dental meetings in the U.S., Canada, and Europe as a knowledgeable and dynamic speaker. Her passion for dentistry inspires individuals and groups to bring the best of themselves to their work, and to fully embrace the difference they make in the lives of those they serve.

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4 Cornerstones of Successful Dentistry: Clinical Services & Patient Care

January 19, 2018 Mary Osborne RDH

Success in dentistry centers on four cornerstones that focus both externally and internally. Though they provide a clear foundation, of course every dentist and dental team will have a different sense of how to measure their success.

Part of what makes your practice unique are the standards you set in each of the four cornerstones: Clinical Services, Patient Care, Team Participation, and Practice Growth and Development.

In this blog, I’ll discuss the first two cornerstones and in Part 2 I’ll discuss the final two essential pieces of the practice puzzle. Together, they create a critical balance, especially in how they interact dynamically.

Cornerstones of Dentistry: Clinical Services and Patient Care

Clinical Services

Each dentist will have their own individual sense of what services they wish to provide and how they want to structure their practice system. With this kind of freedom, the clinician decides what standards of care are enforced and how they are applied to practice services.

Part of why dentistry is such an exciting and opportunity-filled profession is that this kind of flexibility exists. You can say what matters to you and design a practice that embraces your values. You are the only one who can determine your level of commitment.

Patient Care

It’s up to you how you will care for your patients. You are able to pursue aspirational paths of continuing to seek education, empowering yourself and others, and partnering with your patients and team.

You can also guide your patients and support them in reaching the highest levels of health they can. Along with your freedom to set standards for yourself, you can also decide how much trust you will share with your patients. Then, you can create relationships built on that degree of trust.

To be continued…

How do you define your values and vision in your dental practice? 

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Mary Osborne RDH

Mary is known internationally as a writer and speaker on patient care and communication. Her writing has been acclaimed in respected print and online publications. She is widely known at dental meetings in the U.S., Canada, and Europe as a knowledgeable and dynamic speaker. Her passion for dentistry inspires individuals and groups to bring the best of themselves to their work, and to fully embrace the difference they make in the lives of those they serve.

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Work Life Philosophy: Play Part 2

January 17, 2018 Bill Davis

This blog is a continuation of an excerpt from Dr. Bill Davis’ upcoming Pankey Insider article. Here, Dr. Davis explores the concept of ‘play’ as a key facet of Pankey Philosophy:

Artistry, Dentistry, and Play

Anthropologist Ashley Montagu, in his book, Growing Young, lists what he calls “neotenous traits,” characteristics of a youthful attitude toward life. These include curiosity, love, friendship, taking pleasure in problem-solving, exploration, invention, imagination. All of these are facets of play.

Another dimension of play is that of creation. There is an element of artistry in dentistry itself, but many dentists also find pleasure and satisfaction in other forms of artistic creation, such as gardening, making stained glass windows, cabinet-making, restoring antique automobiles, sculpting.

Creativity can be therapeutic, as well as fun. A man in Michigan took up playing the bones when he was past 65 to try to reverse an arthritic condition in his hands. Today, he plays at folk festivals, concerts and other gatherings, and his hands are even more supple than ever. His spirit is supple as well.

Is there enough play in your life? Do you enjoy leisure activities with your family and friends? Or do you find yourself talking shop even while playing golf? When was the last time you asked a waitress or mail person if she or he had heard any good jokes? What activities do you do for the sheer pleasure of doing them?

Have you seen any good sunsets lately? Is there something creative that you’ve always wanted to do but “never had time?” Do you have an urge to ask your children to teach you skate-boarding or hacky sack? The longer you wait, the more you will miss.

What keeps you spirited and engaged in your dental career? Please share your insight with the Pankey community in the comments! 

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Bill Davis

William J. Davis DDS, MS is practicing dentist and a Professor at the University of Toledo in the College Of Medicine. He has been directing a hospital based General Practice Residency for past 40 years. Formal education at Marquette, Sloan Kettering Michigan, the Pankey Institute and Northwestern. In 1987 he co-authored a book with Dr. L.D. Pankey, “A Philosophy of the Practice of Dentistry”. Bill has been married to his wife, Pamela, for 50 years. They have three adult sons and four grandchildren. When not practicing dentistry he teaches flying.

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Work Life Philosophy: Play

January 15, 2018 Bill Davis

In this blog excerpted from an upcoming Pankey Insider article, Dr. Bill Davis explores the contributions of Richard C. Cabot to Pankey Philosophy. Here, he focuses specifically on the concept of ‘play’ and how it can improve your work life:

The Philosophy of ‘Play’

Play is not merely recreation—it is “re-creation,” the child-like spirit that helps people renew themselves through all of their activities, including work. In his book, What Men Live By, Cabot compares the way a child walks to school—alive, aware, wandering, wondering—and the way many adults trudge to work—solemn, self-absorbed, head down, unaware of their surroundings.  

Notice how you walk down the street. What “background music” might accompany you? If it’s a dirge, experiment with smiling, breathing deeply, noticing your surroundings—even if you don’t feel like it. You might be amazed at how positively people respond to you.  

“Play,” Dr. Cabot says, “keeps the soul alive.” Play can be revitalizing, particularly in situations of overwork and stress. Dr. Carl O. Simonton, the noted oncologist, uses juggling to relax.

Some dentists enjoy the use of humor. One dentist, for example, invites his patients to send him relevant cartoons, which he laminates and posts on his bulletin board. He says seeing them reminds both him and his patients to “lighten up.”

Play is a means of expression. “All work and no play makes Jack a dull boy.” But play is more than “dull boy” insurance. It is an end in itself, a way of expressing yourself in the world.  

A friend tells of an old man who spent his days on a park bench talking with and entertaining people who passed by. No matter how poorly he was feeling, he shared with others “the jewels of daily life,” the gifts of humor and playfulness. Youngsters in particular were attracted to him, as they loved his stories and good humor.  

To be continued …

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Bill Davis

William J. Davis DDS, MS is practicing dentist and a Professor at the University of Toledo in the College Of Medicine. He has been directing a hospital based General Practice Residency for past 40 years. Formal education at Marquette, Sloan Kettering Michigan, the Pankey Institute and Northwestern. In 1987 he co-authored a book with Dr. L.D. Pankey, “A Philosophy of the Practice of Dentistry”. Bill has been married to his wife, Pamela, for 50 years. They have three adult sons and four grandchildren. When not practicing dentistry he teaches flying.

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Treatment Planning For Future Implant Cases

January 12, 2018 Lee Ann Brady DMD

Approaching implant reconstruction as an all or nothing situation ignores the reality of future patient needs. Often it is too expensive for patients, who will not be able to proceed fully with treatment. They then receive only part of the complete treatment plan.

For example, with an edentulous arch the difference between a lower denture with two implants and locators as opposed to five implants with a fixed restoration is significant.  Alternately, it’s common for patients with two implants and a lower denture with locators to be dissatisfied with their function and esthetics. They may wish to move to a fixed restoration if they can now afford it. But does the clinical situation make this possible?

Implant Treatment Planning for the Future

It’s a good idea to create a treatment plan for a patient that doesn’t eliminate their ability to select different treatment in the future that could lead to improved esthetics, health or function. Certain planning decisions must be applied when placing implants to ensure necessary spacing and vertical room for a fixed restoration.

Ideally, the plan would include fixe fixtures between the mental foramina for a fixed restoration. If the patient currently wants a removable with two implants, the ideal placement can be planned for five. The 2 and 4 spots can then be used for placement of fixtures with locators.

This gives enough room for three potential implants later on that are spaced correctly. Though the placement choice can be based on a clinician’s preference for where locators would be, the 1 and 5 locations allow for ideal placement of five future fixtures. Still, many patients will have two fixtures between the mental foramina that negatively impact proper spacing for a fixed restoration. On top of this, the lower ridge position is another important factor to consider. It must be managed to account for vertical space.

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Lee Ann Brady DMD

Dr. Lee Ann Brady is passionate about dentistry, her family and making a difference. She is a general dentist and owns a practice in Glendale, AZ limited to restorative dentistry. Lee’s passion for dental education began as a CE junkie herself, pursuing lots of advanced continuing education focused on Restorative and Occlusion. In 2005, she became a full time resident faculty member for The Pankey Institute, and was promoted to Clinical Director in 2006. Lee joined Spear Education as Executive VP of Education in the fall of 2008 to teach and coordinate the educational curriculum. In June of 2011, she left Spear Education, founded leeannbrady.com and joined the dental practice she now owns as an associate. Today, she teaches at dental meetings and study clubs both nationally and internationally, continues to write for dental journals and her website, sits on the editorial board of the Journal of Cosmetic Dentistry, Inside Dentistry and DentalTown Magazines and is the Director of Education for The Pankey Institute.

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Fostering Long Term Study Club Relationships: Part 2

January 10, 2018 North Shetter DDS

Fostering long-term relationships with other clinicians is an admirable goal. In my last blog, I talked about a study club I’ve been part of for forty years. How we’ve kept it going this long comes down to timing and commitment. We were brought together by Pankey and continued to develop our clinical and personal interests throughout our careers. Read on to learn how we’ve kept our study club going this long …

Relationships, Friendships, and Support From Study Clubs

During our regular study club meetings, we argue dental techniques, philosophy, and technology. We discuss our business successes and failures and share ideas on how to improve. Individually we offer to mentor our younger colleagues. We have provided solace and support after death and divorce, as well as tough love in situations where a member needed honesty as well as support. 

We continue to come to meetings even though several members drive sixty miles or more to attend and several others are now retired. Although we refer patients to one another, we seldom see one another except for at our meetings. We challenge each other to think critically, demand proven research before adopting new treatment modalities, and continue on a path of learning.  

Other members of the group are now approaching retirement. In fact, one member of the group just celebrated his eightieth birthday. We know these facts will force us to consider disbanding. However, when we poll the members we find that no one wants to quit meeting. We may have to meet less often, but we will not give up on the relationships, friendships and support.

For those considering joining or forming a study club, we encourage you to take the risk and commit to making your group one of perennial sophomores.

What do you love about study clubs? Let us know your thoughts! 

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North Shetter DDS

Dr Shetter attended the University of Detroit Mercy where he received his Doctor of Dental Surgery degree in 1972. He then entered the U. S. Army and provided dental care at Ft Bragg, NC for the 82nd Airborne and Special Forces. In late 1975 he and his wife Jan moved to Menominee, MI and began private practice. He now is the senior doctor in a three doctor small group practice. Dr. Shetter has studied extensively at the Pankey Institute, been co-director of a Seattle Study Club branch in Green Bay WI where he has been a mentor to several dental offices. He has been a speaker for the Seattle Study Club. He has postgraduate training in orthodontics, implant restorative procedures, sedation and sleep disordered breathing. His practice is focused on fee for service, outcomes based dentistry. Marina Cove Consulting LLC is his effort to help other dentists discover emotional and economic success and deliver the highest standard of care they are capable of.

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Long Term Dental Study Club Relationships: Part 1

January 8, 2018 North Shetter DDS

Dental study clubs can be incredibly valuable for fostering long-term relationships with other clinicians. Curious what that looks like? Keep reading …

Forty plus years ago, a group of dentists in the Green Bay Wisconsin area had the opportunity to meet Dr. L.D. Pankey. In his presentation and discussion, Dr. Pankey told us one of the secrets to success in life was to become a “perennial sophomore.” This means never stop studying and asking, ‘Why?’ 

Forming a Pankey-Inspired Study Club

After meeting Dr. Pankey, a number of us took advantage of attending The Pankey Institute. The Institute was, at that time, in downtown Miami in the DuPont Plaza Hotel. We were lucky enough to learn from, and rub shoulders with, other legendary dentists like Loren Anderson, Harold Wirth, Henry Tanner, and Alvin Filastre.

Although our group did not attend The Institute all at the same time, we soon found one another and started a study club. We decided to meet for dinner at The Union Hotel in De Pere, Wisconsin and discuss dentistry once a month during the fall and winter.

This month we celebrated the study club’s thirty-ninth year of existence with dinner at the same hotel dining room where we have met monthly during all that time. Over the years we have all been back at the Institute and celebrated its new venue. We have continued efforts to remain at the forefront of postgraduate dental education and private fee for service care.  

Our initial group of about a dozen members has grown smaller as we have aged. We have added a few new members over time and lost some members due to age or illness. In our early years, we invited speakers in and sponsored CE programs in the area.  

As we all developed more mature practices and our relationships within the group moved into higher levels of trust, we decided not to try to grow larger. Some may consider that to be self-serving. However, we see our group as having moved from a dental study club to a study club and support group.

We have never given up the goals of continuing to ask ‘why’ and continuing to learn.

To be continued …

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North Shetter DDS

Dr Shetter attended the University of Detroit Mercy where he received his Doctor of Dental Surgery degree in 1972. He then entered the U. S. Army and provided dental care at Ft Bragg, NC for the 82nd Airborne and Special Forces. In late 1975 he and his wife Jan moved to Menominee, MI and began private practice. He now is the senior doctor in a three doctor small group practice. Dr. Shetter has studied extensively at the Pankey Institute, been co-director of a Seattle Study Club branch in Green Bay WI where he has been a mentor to several dental offices. He has been a speaker for the Seattle Study Club. He has postgraduate training in orthodontics, implant restorative procedures, sedation and sleep disordered breathing. His practice is focused on fee for service, outcomes based dentistry. Marina Cove Consulting LLC is his effort to help other dentists discover emotional and economic success and deliver the highest standard of care they are capable of.

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