By John C. Cranham, DDS 

Every dentist finds it challenging to take time to train their team members.

Here are a couple of examples of how I’ve added time to my own day by advancing my team’s skills:

 I fired myself as the practice photographer. My goal was to have multiple people in my office who know our intraoral and extraoral image protocols and who can take the photos at the same high level of quality. To do this, I built “training time” in our schedule to teach photography. Now, while the patient is in the chair, I have the “photographer” show me the photos. We look at them quickly. Occasionally there is one that needs to be retaken, and I will explain why. The quality has become consistently high. By having multiple photographers in the office, my primary dental assistant can focus on something else when needed.  When I am working up a case, I often show them why I needed a specific photo. They take interest in their part of the process and the case. Engagement in their work rises. Always clearly share the why. 

I’ve also trained my team on how to fabricate deprogrammers. I’ve trained them all, checked their work, and explained the why behind our standard. We now have four people who can do that, too. This means we have a good product we offer patients and get it out in a timely manner when my primary assistant is busy.  When it comes to training your team, you will set a standard, and your team needs to know you are serious about it, but you can do this without being stern or making them feel bad. For example, in my office, if they take a bad photo or make an unacceptable deprogrammer, I explain why and ask them to retake the photo or remake the deprogrammer. As they redo something, they learn from their mistakes. I am patient with them. I tell them I made the same mistakes while I was learning. 

By Bill Davis, DDS  

A Culinary Surprise 

After about 18 months of working on the Pankey book, Pam and I were headed to a Club Med Vacation on the Eleuthera Island in the Bahamas with our three sons. This Club Med (now closed) had a circus theme. The boys would be able learn how to dress up like clowns and train to be a performer on  flying trapezes. 

Pam suggested on the way to Club Med that we stop in Miami and take Dr. Pankey and Betty out to dinner. I had been wanting to do something for him to show my gratitude for his willingness to help me fulfill my dream of becoming a full professor by writing his life story and the Philosophy. 

Part of the information gathering process for the book was for me to visit Dr. Pankey one full day a month. On several occasions we talked about Miami as a vacation destination with it’s restaurants and resorts. He said, of all the places in the area, he and Betty liked the Ritz Carlton Hotel and Joe’s Stone Crab in Miami Beach the best. 

Before we left Toledo on our way to Club Med, I went to my bank and drew out $800 in cash so we could go anywhere L.D. and Betty wanted to go in the Miami area. The boys and Pam were all excited to go out to dinner with L.D. and Betty because they had heard so much about them. 

I rented a large rental car to accommodate all of us, and I drove to the Pankey home to pick them up. I told L.D. that Pam and I wanted to take them anywhere in Miami for dinner to thank him for collaborating with me on the book project. L.D. said, “Betty and I are not used to eating big dinners. We spend a lot of our time trying to eat only enough to keep us going because we both have a hard time keeping our healthy weight. Many times, we will even split a meal when we go out.” 

Betty was standing next to L.D., and she said, “We do have a place we love to go on a regular basis, and they even serve burgers for the boys. Maybe we can go there. They have the best, all-you-can-eat salad bar in Coral Gables.” 

I said, “Wow, that sounds great.” I asked, “What is it called?” 

Betty said, “Wendy’s,” so, we all loaded into the rental car and went to Wendy’s. The bill was under $800.00 dollars. 

By John C. Cranham, DDS  

Sometimes you can see clearly where you want to go with your dental practice. I can vividly remember driving my car to St. Petersburg for my first class taught by Pete Dawson. It was 1989. When the class was over, I drove my little car all the way back to my 800-square-foot office in Portsmouth, Virginia, and arrived at four o’clock in the morning. I had just bought the office from a doctor who did mostly silver fillings—maybe only four crowns in the entire year. I remember I could visualize what I wanted to do with “my” practice but deciding the first steps was overwhelming.  

A dental office can be the loneliest place in the world. I had to figure out the attainable steppingstones. We didn’t have the internet back then. Finding mentors and connecting with supportive, sharing colleagues was more difficult. In dentistry today, it’s easier to find those steppingstones. One of the most rewarding things I do today is helping dentists develop. 

I caution dentists to not assume they will achieve their big goals fast. There is a temptation to give up when progress is slow. You’ve got to stay on the path to get to where you want to go. Think about your goals and steppingstones every day but be kind to yourself if it takes more time than you visualized.  

Remember that everyone is different. All your buddies are going to be in different cities, different socioeconomic areas, and different practices. They’re going to have different opportunities. Social media can be your enemy when it comes to self-confidence and determination. There will be certain people that develop faster.  

I can remember being very frustrated the first year or two in my little town of Portsmouth. There were dentists going through the same classes I was and were already doing the kinds of cases that I wanted to do but wasn’t doing yet. During the first two years in practice, I sometimes wondered if I would ever do the kind of dentistry I wanted. But I kept in conversation with my patients, eventually they began accepting treatments, and the floodgates finally opened.  

One of the greatest things about this profession is we can always strive to be great. I don’t think I’m there yet. It’s the striving part—the working at it and seeing things improve that makes it so fun and rewarding. I love it.  

People ask me, why are you setting BHAGs at this stage in your life? You’ve already accomplished so much. Why are you totally reinventing your practice systems? Why are you going fully digital after practicing on analog articulators for 35 years? 

What I’ve been able to do in dentistry is constantly reinvent myself, and I feel like I am growing in what I can do. So, I say it’s because reinvention is awesome. It’s fun. And my staff knows that if I get something working well, I’m going to find a way to make it even better tomorrow. 

By Paul A. Henny, DDS 

How are you doing in your quest for a “positive” life? 

Martin Seligman PhD spent most of his career at the University of Pennsylvania advancing the concept known today as “Positive Psychology.” He states that Positive Psychology is “the scientific study of what makes life most worth living.” Along the way, Martin identified five core elements highly associated with psychological well-being and happiness. He believes understanding these five elements helps us to create more fulfillment, happiness, and meaning in our life. 

In Part 2 of this two-part series, we’ll pick up where I left off with the third core element in Seligman’s model. 

R – Relationships 

Relationships and social connections are essential for the creation of meaningful lives. Human beings have been social animals since the earliest of times, hence we are hard-wired to bond and depend on each other. That worked particularly well when we functioned in small social units or “tribes.” The tribal unit allowed us to easily ascertain who was friend or foe. It also allowed us to know who to pay attention to, ignore, and with whom we should invest our time and energy. 

In our modern-day world, the historical notion of tribes has largely been broken and replaced by sub-sects of people who are clustered together around common interests, agendas, and values, brought together in new and different ways. Social media now connects people from around the world in ways we never could have imagined 20 years ago. So, this has created a situation where we don’t know our neighbors, but we do know intimate details about our friends in Australia, Tampa, and Kansas City. 

Since we are less tribal in the historical sense, we have lost our ability to easily trust those who are around us, as we can no longer assume they share our values and priorities. That is WHY the relationship-based practice model is so valuable today.  

The relationship-based practice model is a vehicle of connection that can be used to co-discover our similarities as well as areas of disagreement. Alignment of values, goals, perspectives, and efforts are key to successfully advancing health. Strong interpersonal relationships are the key to the door which opens up all of those possibilities. 

M – Meaning 

Some people work to live, while others live to work, with the latter meaning that a person has been successful at merging their life purpose with their daily work. And when work becomes meaningful on a deeply personal level, it evolves into becoming much more than just a “job.” 

With the ever-expanding discovery of connections between oral health and whole health, dentistry now stands at the forefront of a huge new opportunity – the opportunity to help others to grow, develop, and maintain whole health over their entire life  

A – Accomplishments 

Living a values-driven, purposeful life, integrated with how we practice, aligns ourselves with the achievement of deeply meaningful accomplishments on a daily basis. Helping others in deeply meaningful ways, and then being rewarded with appreciation and appropriate compensation, establishes a self-sustaining cycle, and a successful model for living.  

That’s why you will commonly see relationship-based dentists practicing into their 70’s. Their sense of purpose as they continue to accomplish meaningful work is what motivates them to return to the office and continue striving to help patients, coach younger dentists, and create an-ever-happier positive environment. 

An Easy Acronym to Remember: PERMA 

A great to start your day might be to remember what each letter of PERMA stands for: 

• Positive Emotion 

• Engagement 

• Relationships 

• Meaning 

• Accomplishments 

How will these five elements of Seligman’s model fit into your quest for a sense of wellness and happiness today? How will these fit into your quest to serve and help others? 

By John C. Cranham, DDS 

Even today, after decades into family life, dental practice, and continuing dental education, I sit down every January to outline my BHAGs (Big Hairy Audacious Goals) for the year. I block out the first Monday after Christmas to do this, but for the previous month, I’ve been thinking about what new goals will excite me most. I commonly do this type of thinking while I am exercising and driving.  

It’s during these alone times that I can intentionally mull over the things I could do next. I pay close attention to which possibilities excite me most. Oftentimes, these are goals that I feel will benefit others. 

Successful people have the ability to create daily behaviors that direct themselves towards their goals and take them forward on steppingstones. One of the simplest, yet powerful things I witnessed Dr. Pete Dawson do is how he started each day. He would go to his desk and spend 15 to 20 minutes writing six things on a 3×5 card. These weren’t a To Do list. These were six things that would direct him toward his next BHAG. He would place the card in his breast pocket. He did this day in and day out. 

Two weeks before he passed, Pete came to my lake house on oxygen. When he arrived, I had to help him out of the car and into the house on his walker. I looked at his shirt pocket, and there it was, the 3×5 card.  

We don’t have to use 3×5 cards to make notes for ourselves. We can use our phones. But it is powerful to reflect daily on steps that will take us in the direction we want to go and record those steps to lock them in our memory.  

In dentistry, we need to carve out habitual time to think about our goals and steppingstones. We need to carve out time to take the identified steps. The point is to have a system in place where you are thinking about it every day, because there is so much coming at us all day long that we are at risk of drowning in the noise.  

When we get caught up in the mundane, life is less interesting and less fulfilling. At least that has been my experience. When you sense you are becoming bored, you might just need to identify the next big goal that excites you. The challenge of getting there will bring you back to full life. 

By Paul A. Henny, DDS 

Martin Seligman PhD spent most of his career at the University of Pennsylvania advancing the concept known today as “Positive Psychology.” He states that Positive Psychology is “the scientific study of what makes life most worth living.” Along the way, Martin identified five core elements highly associated with psychological well-being and happiness. He believes understanding these five elements helps us to create more fulfillment, happiness, and meaning in our life. 

One of our Pankey colleagues, Barry F. Polansky, DDS, spent a lot of time and energy studying Seligman’s work. In his last decade in practice, Polansky turned his attention to writing books to help new dentists find wellness and happiness in dentistry. Polansky’s 2017 book The Complete Dentist: Positive Leadership and Communication Skills for Success is an excellent guide to starting and running an effective and meaningful dental practice. 

In this two-part series, we’ll take a look at Seligman’s positive psychology model in relation to how we feel about our work in dentistry. 

Seligman’s Five Core Elements: 

P – Positive Emotion 

This represents a “glass-is-half-full” perspective toward life, commonly called an “abundance” perspective. This positive world view is critical because it has a heavy influence on how the brain functions. Our brain is a memory-driven cybernetic solution-seeking organ, with a primary purpose of creating and supporting a successful life. When our mind is in a positive orientation towards our environment, we are typically in a very observant and creative mode of living. In this mode, we constantly scan our environment for relevant bits of information and experiences that are potentially useful in the advancement of our desires.  

When our desires are positive and life-affirming, we are co-creating our experience: We see and experience to a large degree what we expect to see and feel. That is why having a clarified positive vision and purpose for our life and practice is essential for well-being. 

E – Engagement 

L.D. Pankey famously said, “Know Yourself.” What interests us most? What worries us most? In what circumstances are we most comfortable? Under what conditions are we most productive? What are our personal strengths? What are our habits? What are our triggers? What do we aspire to do? What about ourselves would we like to change? 

We all direct most our attention toward the things that interest us or we fear. And it is what we pay the most attention to, whether at work or elsewhere, that we develop the most while engagement with things of lesser importance wither away. It’s healthy to go into ever deeper relationship with the things we value. Clarifying what we believe we are good at and what we will enjoy is a key first step to successful practice development. 

Defining our values is essential so we know when to keep “first things first,” as Stephen Covey likes to say. 

Mac McDonald is a Visiting Faculty member at Pankey, his 2017 book Unchanging Points of Light: Finding Your Way in the Dark is an example of the positive power of values clarification. 

My discussion of Seligman’s five core elements will be continued in Part 2. 

By John C. Cranham, DDS  

Having BHAGs (Big Hairy Audacious Goals) has been important to me for my whole life, whether it was the Ironman triathalon, getting the opportunity to teach with Dr. Peter Dawson, finishing my book, or setting big goals for my practice. The biggest things in my life that were important to me from a professional standpoint started with an idea that got me excited but seemed impossible. 

A BHAG has a way of motivating you when you think there’s a sliver of chance that you might be able to do it. You set it as a goal and proactively discover steps to work towards it; then you get out of bed each day intent on moving forward.  

People are “wired” differently, but I do think extremely successful people do this. Pete Dawson was like this. He died four years ago, and I remember being with him at my lake house two weeks before he passed away. He talked about a BHAG he was working on–a new book, and he showed me the layout he had in mind for it.  

If you don’t have a BHAG (the next big goal that’s exciting to you), it’s easy to get caught up in the day-to-day routine. I can think of times in my life when dentistry became mundane. 

One of the most amazing times in my life was right after I was invited to teach with Pete Dawson. I was on the faculty before I was the clinical director. After I was teaching there, there was a six-month period when I was a little depressed. I didn’t understand the feeling. One night at dinner with Pete, I told him I was struggling. We talked about it for a few minutes, and then he said, “It sounds like you need a new goal.” 

That hit me like a ton of bricks. Once I have attained a goal, I need a new aspiration to chase.  

BHAGs are our reasons to get out of bed every morning and be fulfilled by our efforts. Even if we don’t quite complete everything we visualize, we still end up in a completely different place. And in my experience, it’s always a better one. 

By Bill Davis, DDS 

During the first two years of the book project, the institute was still at the DuPont Plaza Hotel in Miami. My schedule was simple. I would fly down on the red eye from Detroit Monday night after my practice time and stay at one of the apartments used by the visiting faculty next to the hotel. Dr. Pankey and I would meet for breakfast at 8 a.m. Then, we would go over to a room in the Institute to talk and I would record everything. 

At our very first meeting, I realized why everyone was taken with Dr. Pankey and his philosophy. We sat down for breakfast and started with the usual small talk. Then L.D. looked me directly in the eyes and asked, “Bill, may I ask you a couple of questions?”  

I looked back at him, and I said, “Yes, of course”.  

He then asked, “Do you tell your wife you love her every day?”. 

I was a little taken aback by the question and said, “I think I do”. 

L.D. then said, “You should.”  

From that day forward, I made it a point to tell Pam I loved her every day. If I was out of town, I would always call long distance and now I text her. That question made me realize how important Dr. Pankey felt it was for us to stay closely connected to our loved ones. I am sure that gesture has helped me during my 57 years of marriage to my best friend Pamela.

L. D.’s second question was, “Do you save regularly for your retirement?”

I told him, “Yes, I do. At the end of the year, when all my bills and taxes are paid, I send most of the remaining money to my Merrill Lynch investment account”.  

Dr. Pankey told me that was okay, but not a good way to save real money. He recommended that when I got my paychecks, one from the university and one from my private practice, I immediately sit down and write a separate check for 10% of my total net income for the week and put it in the investment account.  

Then he said, “Live on the budgeted remaining 90%.”  

I realized he was following his philosophy and wanted me to be sure I could take care of my family. Over the years, his advice has been spot-on. These first two questions were my introduction to his philosophy. 

To be continued… 

By Paul A. Henny, DDS, and Deborah E. Bush, MA 

The traditional rational economic model used in classical decision-making theory routinely fails to predict patient behavior because it fails to consider the psychology of decision-making and the inductive neuro process necessary to change one’s mind about what is best for oneself. 

Classic Decision Theory 

Classic Decision Theory (CDT) models a decision-making process that involves a fixed set of alternatives about which a person knows little. In response, they relate their limited knowledge to the situation at hand, use their beliefs and expectations associated with the options to project an outcome, and then use logic to make the final decision based on their goals. 

According to this theory, people primarily make decisions based on their desire to maximize gains and minimize losses, an objective. This deductive process is largely driven by a heuristic known as “scarcity bias.” However, anyone who has practiced dentistry for more than a day outside of a teaching institution knows that CDT fails to explain many of the decisions patients make when they’re confronted with a complex problem they don’t fully understand.  

Simple decisions such as “Should I get this filling replaced because it’s broken?” or “Should I allow Dr. Smith to help me make this tooth stop hurting?” are predictable. What’s much less predictable is whether a person will allow us to equilibrate their occlusion or leverage restorative dentistry to reestablish proper form, function, esthetics, and neuromuscular modulation. Why? Because these are complex issues that require an understanding of how the stomatognathic system works before the proposed solution makes sense and appears to be the logical best option to the patient. 

Neuroeconomics is an interdisciplinary field that aims to explain human decision-making. By integrating psychology and neuroscience, this discipline can help us better understand how humans process alternatives to make choices and follow through on a plan of action. Neuroscience affirms that re-evaluating perspectives is a right-brain activity and an inductive process. 

The Dentist’s Challenge  

In practice, we often see patients making decisions we think are unwise for their long-term oral health. A person’s values and belief system influence their decisions. Not only may the person’s understanding and belief system be underdeveloped in relation to the value of properly planned, designed, and executed health-centered restorative dentistry, but their memories may be distorted. In this case, the person makes what we perceive to be unwise decisions because their memories do not align well with our understanding of the situation. They don’t know what we know.  

Helping Patients Think and Feel Differently Through Inductive Reasoning 

Reassessment, modification, or outright replacement of beliefs is a right-brain process known as inductive reasoning. The purpose of Co-Discovery is to take the patient through an inductive reasoning process. Oral health providers who understand how and why Co-Discovery works have experienced how it can change the trajectory of a person’s decision-making process. 

Our challenge is to create an optimal learning environment in which people can safely reevaluate their beliefs, values, and priorities. Being patient with patients and taking our time to guide them through the inductive process of Co-Discovery will comfortably provoke new thinking, new beliefs, and new emotions. Through the process, a great many patients come to realize that their historical perspective is not serving them well, and they decide to have that equilibration or restorative dentistry that will serve them best in the long-term.  

They may not choose treatment the first time it is recommended but will subsequently realize it is in their best interest. We just have to stay in conversation with them in Co-Discovery mode and guide them through the inductive process to arrive at their new goals.  

Long-term, this is healthier for dentists and their care teams as well. The conversations we have with patients change the trajectory of our dental practices. Better conversations result in better decisions, which in turn result in better outcomes. Better outcomes result in lower stress and a thriving practice that is much more fulfilling for dentists and care team members.   

By Bill Davis, DDS 

My academic goal in the early 1980’s was to be promoted to full professor at the Medical College of Ohio in Toledo. The Dean of the College of Medicine where I worked was my patient. We had been able to do a complete restoration for him using the Pankey Mann Schuyler technique, including the Functional Generated Path. Over the eight weeks it took to do his dentistry, he allowed me to take three hours a week out from his very busy schedule. During our time together, he developed a great deal of gratitude and appreciation for the complexities of restorative dentistry. At the end of his treatment, he told me he was about to retire as the Dean.  He said he wanted to get me promoted to full professor before he left. go beef up my CV for the promotions committee, he recommended I write ten more scientific articles or a book. 

I had no idea what it would take to write a book, but it seemed easier than writing ten more articles. So, off I went to find something to write a book about. The very next week I was at the Pankey Institute, as a visiting faculty member, helping in a C3 class. C3 was the heavy restorative week. The students would equilibrate their models, develop the anterior guidance, do onlay preparations on two opposing quadrants, do wax-ups, and finally cement gold castings.  

Once the student had completed posterior mandibular wax-ups, the visiting faculty would spend most of the night casting the wax-ups into gold in the in-house laboratory. The next day the student would seat the mandibular restorations, prepare the maxillary posterior teeth, do the FGP, and wax-up the maxillary preparations using the stone FGP. The nighttime castings were done by the visiting faculty, and I had volunteered to help with the castings. 

At that time, Christian Sagar was the executive director of the institute. I told Chris I was looking for a topic to write a book about, maybe something for or about the Institute. He told me he had just hired a professional writer to help Dr. Pankey write his philosophy. I told him if there was anything I could do related to the book project, I would be happy to help. As it turned out, Dr. Pankey liked the writer very much, but he became frustrated because the writer knew nothing about dentistry. For example, the writer asked, “What is a facebow?”. This made communication difficult between them. 

It was about a month later when Chris called me and asked if I still wanted to work with Dr. Pankey on his book. I said, “Absolutely.” Again, I had no idea what I was signing myself up to do. The next week, I flew back to the institute for a quick meeting with Chris and Dr. Pankey. We all agreed that I would come down one Tuesday a month and interview Dr. Pankey. I planned to tape all our conversations and then have a local court reporter type them up. I would use the typed transcripts as working documents as we developed the book. 

To be continued…