Cogito, ergo sum is a philosophical proposition developed by René Descartes translated as “I think, therefore I am.” The proposition went on to become a fundamental element of a developing secular Western philosophy. Descartes asserted that the very act of doubting our own existence served as proof that we exist. 

But that’s pretty thin gruel.  

I believe Descartes got it backwards. I contend that he should have said, “I am, therefore I think.” Each of us has been given an amazing gift. In fact, we’ve been given many gifts such as life itself, but I am referring to the gift of thought and contemplation. And it’s a gift which can either “make us” or paralyze us into a state of inaction and failure. 

Success in practice today comes down to one thing and one thing only. Those of us who master the ability to think and solve problems quickly and efficiently with foresight will ultimately win the game, set, and match. The rest will be marginalized, consumed, controlled, oppressed, and limited by third parties. 

Our brains work like an executive committee of three members, each with its own primary purpose, which either work in harmony to achieve great things or which work at counter-purposes on a level that is counter-productive or even self-destructive. 

Our executive committee is made up of: 

1. A primal “reptilian” brain which is focused on very basic functions and maintenance.  
2. A rapid pre-cognitive information gathering, analysis, and response system designed for the purpose of self-preservation, known as the limbic system. 
3. A super-computer information processing system that can take new and stored information, reorganize it and then CREATE things like the Declaration of Independence or the Toccata and Fugue in D minor. It’s called our “prefrontal cortex.” It’s our brain’s CEO. 

How well we are able to coordinate these three aspects of our mind largely defines our future. And that coordination is only possible when we are clear about our central purpose in life and practice. Have you become clear about who you are…what you want for yourself…what you want for others? What are the sacrifices you are willing to make to achieve them? And how will others benefit from it all? These are the kinds of questions that help keep our executive committee on the right course, allowing it to be adaptable, as well as progressive in a rapidly changing marketplace. 

L.D. Pankey taught us that creating a written practice philosophy was the most important step in building the practice of our dreams. Why? Because it puts our executive committee on-task and keeps it there.   

“I think, therefore I am,” or “I am, therefore I think?” Understanding the distinction and leveraging it will make all the difference in the world. 

Positive psychology and dentistry are closely linked, especially for professionals who own their own practices. Human beings are all too good at focusing on what’s going wrong at any given moment. But the key to experiencing maximum success is determining what’s going right, and how to take full advantage of those strengths. 

What’s the tie in with dentistry? Dental patients come in all stripes and shapes, and the success of dentistry is dependent upon understanding people and strategies for dealing with what happens in your practice and personal life. During my study of positive psychology, I focused on: 

• Understanding how and why people tick from studies on human behavior and how the brain and body are wired. I thought a lot about the implications for my practice of dentistry and personal pursuits. 
• How to effectively communicate with and lead/teach others. 
• Research-based tools for interacting with people from a variety of backgrounds and experiences 
• Understanding happiness through personal fitness, gratitude, cultivating relationships, mindfulness, and savoring what is going right. 

During my study, I found my personal happiness was increasing through greater feelings of personal and professional success, improved physical health, and stronger social networks. So much so, that I proceeded to earn a Certificate in Applied Positive Psychology (CAPP). Having Type 2 Diabetes and having experienced significant treatment for cancer, living my life in the healthiest way I can physically, mentally, spiritually and socially has become of increasing importance, not for my career aspirations alone, but for me personally. I believe all four of these aspects of life go hand in hand for total wellness–and a life well-lived. 

Beyond Positive Psychology 

As many of you know, reading is one of my favorite pastimes, and I do it with alacrity and joy every day. Studies from the fields of positive psychology and emotional intelligence played heavily into my reading throughout my career, and lately, I have been immersed in studying the philosophy of Stoicism which, when rolled over with the above, has naturally taken my passion beyond the soft skills (behavioral skills) of life to a philosophy of “total wellness.”  

This philosophy and enjoyment of it have made my transition from practice to a “retirement” life outside of practice an enlightening and wonderful experience. I have not left Dentistry in total, because I have a lot more to share and say that I will be writing about in the future.  

For Every Problem…a Spiritual Answer 

Wayne Dyer used to say, “For every problem, there is a spiritual answer.” Now that I am retired with much more time to think about my practice, aging, longevity, and philosophy—and when I see young dentists online writing about their issues and problems, I am more convinced than ever that the answers lie in philosophy. And so, it has come to pass that all roads of my life have led back to philosophy, since my first consideration of it, when I began The Pankey Institute continuum almost 30 years ago.  

With a few exceptions, The Pankey Institute being a major one, the dental community continues to undervalue and neglect the role of philosophy in being the best health care provider and wellness influencer one can be. The fields of positive psychology, emotional intelligence, and success in dentistry are undeniably linked. There is scientific evidence to support this. Your philosophy of life and practice (or lack of this) impacts how you go through life and your career, how your life influences others, what you achieve, and how well you feel about the life you are living. To me, the fields of psychology, dentistry, and philosophy are inextricably linked. I’ll write more on this later. 

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?” 

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

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

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

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

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

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

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

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

Hard Skills/Soft Skills Combination 

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

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

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

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

A Balance 

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