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 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… 

By Bill Davis, DDS 

When Dr. L. D. Pankey was developing his Philosophy, he studied with many early American business authors and teachers. One such person was Napoleon Hill (1883 -1970). Hill was considered one of the earliest producers of the modern genre of personal success literature.  

Hill’s Early Life 

He was born in a one-room cabin near the town of Pound in the Appalachian area of Southwest Virginia. Unfortunately, his mother died when he was 9 years old. At the age of 13 he began his writing career as a “mountain reporter” for his father’s local newspaper. Later, he moved to Pittsburgh to work for a big city newspaper as a reporter. 

A Career-Making Assignment 

In 1908, the editor of the newspaper assigned Napoleon, who was the papers newest and youngest reporter, the job of interviewing the industrialist and philanthropist Andrew Carnegie. At the time Mr. Carnegie, known for his steel business, was among the most powerful men in the world. Napoleon was warned that Mr. Carnegie did not do interviews. Undaunted, Hill went to Andrew Carnegie’s office and told the receptionist he was a reporter and asked to speak to Mr. Carnegie. When he was turned down for the interview and told again that Mr. Carnegie did not like to do interviews, Napoleon didn’t give up. He came back daily and sat in the reception area. 

Persistence Paid Off 

During the second week of going in and out of his office, Andrew Carnegie asked, “Who is that young man waiting in the reception room.” Carnegie was told it was a newspaper reporter waiting to see him. That evening, at the end of the day, Mr. Carnegie went out to the reception room to see if the young newspaper reporter, who had been waiting quietly for over a week to see him, was still there. 

After they introduced themselves, Napoleon told Carnegie he had been sent by his editor to get a story. Napoleon told Mr. Carnegie he hoped to interview him and other wealthy people to discover a simple formula for success. Carnegie was so impressed that he took Napoleon to dinner to continue their conversation. 

This was the beginning of a great friendship, and over the next year they met regularly to develop the formula, as Carnegie also wanted to know the formula. Carnegie presented Napoleon with a letter of introduction to Henry Ford. Ford, after his series of interviews, introduced Hill to Alexander Graham Bell, Elmer R. Gates, Thomas Edison, John D. Rockefeller, and others. 

Hill’s Bestselling Book 

In 1937, Napoleon Hill published a bestselling book, THINK AND GROW RICH, which emphasized a positive attitude and having good communication skills. After reading the book, Dr. L. D. Pankey was very impressed by Hill’s statement: “Whatever the mind of man can conceive and believe, it can achieve.” Conceiving and believing are just the first steps to achieving your goals. According to Hill, you must take serious action. 

Every innovation, every invention, and every work of art begins with an idea. Long before the Wright brothers ever flew, Leonardo Da Vinci had sketched and designed an aircraft. Da Vinci conceived of mechanized flight, but the Wright brothers believed it was possible, they acted on that belief, and thus achieved flight.  

Hill’s Lasting Impact on Dentistry 

In 1929, L. D. Pankey had the idea that teeth could and should be saved, although at first, he didn’t know how. His belief was strong enough to motivate him to do some research, study what was known at that time, and do the necessary experimentation to make his idea a reality. One of the people he was most inspired by was Napoleon Hill. His model of ambition and teachings about how others achieved innovations spurred L. D. on. Belief in himself and his idea helped L. D. persist despite some uncertainty, blind alleys, and many other frustrations. 

The ambition and growing ability to save teeth was arguably the biggest change ever to occur in dentistry. From this concept, innumerable innovations have been born and are accelerating today. 

Where Would You Like to Go? 

There is an old Chinese saying, “If you do not know where you are going, you are likely to end up somewhere.”  

Too many people end up “somewhere” because they have not clearly defined where they want to go. The first step in moving toward greater satisfaction is to set specific goals. Vague goals such as, “I’d like to be a better dentist,” “I’d like to be happier,” or “I’d like to make more money,” are common.  

Napolean Hill would say that more specificity will take you somewhere purposeful. Perhaps, “I would like to learn about implant placement,” “I want to have more fun with my children,” or “I want to earn 15% more this a year.” Then, be evermore specific and set definite time frames so you can measure your progress. For example:  

• “I would like to begin training in implant placement this coming September and be placing implants successfully in June. Tomorrow, I will begin by investigating continuing education programs in the science of implants.” 
• “I would like to have more fun with my children. At dinner tonight, I will ask my children about ideas they think would be fun activities, and we will start by doing one of the activities each week.”  
• “I would like to increase my income by 15% this year. I will meet with my accountant and a dental practice coach this month to look at ways to increase my profitability. I will also do some more reading in practice management.” 

Believe in Your Goals and Your Ability to Achieve Them 

Once you have conceived your ideas, you must believe it is possible to achieve them. Without the power of belief, you will not take your ideas seriously; nor are you likely to weather the many setbacks and frustrations that will probably come along with you on your journey. 

A History of the Pankey-Mann-Schuyler Method 

By Bill Davis 

During his three-month summer course at Northwestern University in 1931, L.D. Pankey was introduced to the principles of occlusion. This was a new term for him and many of his dentist colleagues. The students were assigned an article by Clyde Schuyler and published in the 1926 New York Dental Journal. Dr. Schuyler was a promenade prosthodontist from New York City. The article talked about the basic principles of occlusal function, its dysfunction (malocclusion), and the basic requirements for restoring occlusal harmony. 

1931: Dr. Clyde Schuyler Prompts Considerable Thinking 

At first, L.D. did not understand what Dr. Schuyler had written. He was not alone because most of his classmates had the same problem. L.D. eventually made personal contact with Dr. Schuyler and, after a series of conversations, understood Schuyler’s work.  

Schuyler told L.D., “Those in the field of dental reconstruction must have and cultivate the creative mind of the artist and the accuracy of the engineer.”  

That was easy for Schuyler to say, but he did not explain to L.D. how to approach and visualize a dental reconstruction. Before L.D. met Dr. Schuyler, he had restored posterior occlusion using a Munson articulator and a chew-in technique. The Schuyler article pointed out the importance of anterior teeth guidance. This made L.D. start thinking about approaching occlusion in a more logical step-by-step manner. 

1947: Dr. Arvin Mann Looks Up Dr. L.D. Pankey 

In 1947, Arvin W. Mann moved to Ft. Lauderdale from Birmingham, Alabama. Dr. Mann had graduated from Western Reserve and moved to Alabama to do nutritional research at the University of Alabama before he moved to Florida. L.D. also had an interest in nutrition. His first published article in the Florida State Dental Journal was related to the connection between carbohydrates and dental decay. 

While in Alabama, Arvin became interested in occlusal rehabilitation and the relationship between periodontal disease and restorative dentistry. A periodontal faculty member told Arvin, “When you get to Florida and want to do a restorative work where you won’t have to do all this grinding to correct occlusal restorations, look up Dr. L. D. Pankey in Coral Gables.” 

As soon as Arvin got to Florida, he went to Coral Gables to meet L.D. They became fast friends because they realized they had the same goal of helping their patients keep their teeth for their lifetime. Over the next ten years, they worked together to develop a predictable diagnostic and treatment method for restoring patients’ teeth to health, comfort, function, and esthetics that would fit into the Philosophy of doing their best to help patients keep their teeth. 

1947: Drs. Mann and Pankey Begin Collaborating on Cases 

Arvin began bringing a set of mounted diagnostic casts and an intraoral series of radiographs to L.D.’s office. Arvin and L.D. would review the case together and develop an optimum treatment plan. L.D. would then present the case to Arvin using Arvin as the patient. This was a way to demonstrate to Arvin how to use the Philosophy, get to know the patient, explain what needed to be done, and educate patients to accept the treatment plan.  

Arvin would practice the presentation on L.D. He would then return to his office and explain the treatment plan to his patient. When the dentistry was finished, Arvin would have another appointment to “resell” the case to the patient and make them a missionary for his practice. Within a short time, Arvin had a busy and successful practice. Arvin eventually helped four young dentists from outside his office like L.D. had helped him.  

Mann and Pankey Replace the Munson Articulator with the P-M Articulator 

They used L.D.’s Munson articulators when they started working together on their new restorative method. But soon, they found Munson articulators had limitations for their 3-dimensional approach, including a functionally generated path. Along with an engineer from the Ney Gold company, they designed their own — the P-M instrument and face-bow.  

Arvin became excited about their restorative technique and wanted to share this information with the profession at a Chicago Mid-Winter Dental Meeting. L.D. felt that it would be best to work with a small select group of dentists interested in occlusion and comprehensive restorative dentistry. By now, L.D. had been teaching the Philosophy for a few years.  

L.D. and Arvin selected eleven dentists from various geographical locations around the country who had taken the Philosophy course at least three times and were already using a conventional method to do restorative dentistry. They asked them to try the new P-M technique and articulator for a year. At the end of the year, the group got together in Dallas. The reports from the eleven dentists at the meeting were positive and gratifying. L.D. and Arvin then started the Occlusal Rehabilitation Seminars to teach other dentists the P-M technique and how to use their articulator and face bow.  

1959: The P-M Method Is Presented to the AARD 

In 1959, they presented the P-M therapeutic method to the American Academy of Restorative Dentistry at the Chicago Mid-Winter. They were then asked to write up two articles describing their new process showing the use of the P-M articulator for publication in the 1960 Journal of Prosthodontic Dentistry.  

1960: The Occlusal Rehabilitation Seminars Begin 

Arvin and L.D. wrote the Pankey-Mann Manual for the Occlusal Rehabilitation Seminars and started teaching the restorative technique to other interested dentists. The seminar schedule was coordinated by L.D.’s long-time secretary, Rose Quick.  

One of the most significant difficulties in teaching the P-M technique was the inability of dentists to understand occlusion. At that time, no dental school in the United States taught occlusion. L.D. and Arvin realized it was essential to have Dr. Clyde Schuyler present his work on occlusion at their seminars. Also, they did not want Clyde to go to his grave without the profession appreciating his contribution to dentistry.  

L.D. asked Clyde if he would help them teach occlusion. Clyde was reluctant because he anticipated much opposition to this new method and articulator. Also, he didn’t want to upset his friends and colleagues who had authored books or conducted clinics with him about occlusion. 

Eventually, Clyde agreed, and from that point forward, the P-M technique became the Pankey-Mann-Schuyler Technique for Oral Rehabilitation. 

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.

In the 1960s, L.D. became so busy traveling to present three-day courses that traveling started negatively affecting his private practice. He decided he would no longer travel to make presentations. Instead, he would hold classes in Miami.

L.D. never had to advertise his courses. Instead, dentists would call his office and ask where and when the next course would be. So, when he decided to hold them in only Miami, Rose Quick kept a list of dentists who called. When 20-30 doctors were on the list, she rented space at the DuPont Plaza Hotel in Miami and invited them to come.

The Idea

James Cosper, Billy Anderson, and Jack Wilkins were talking with Rose Quick during a break at one of L.D.’s courses. They asked her, “What can we do for Dr. Pankey? He has done so much for us in our practices and personal lives.”

They wanted to do something meaningful for him. Out of their discussion came the idea of developing a foundation to continue to teach the clinical Pankey-Mann-Schuyler Technique and L.D.’s philosophy of the practice of dentistry which was known as “the Philosophy.”

It was fitting that they included Rose Quick in their discussions as she had played a major role in L.D.’s courses and would play a major role in the formation of the Institute. She had been L.D.’s right-hand person for over 35 years, smoothly managing his practice finances and the details of his courses.

When Rose first came to Florida from Iowa, she taught business courses in the Ft. Lauderdale high school system. She had become a good friend of L.D.’s sister Georgia who worked in L.D.’s office as a dental hygienist. Both women belonged to the same women’s business and professional groups. When L.D. found himself overwhelmed with the details of a thriving practice plus his work on the State Dental Board of Examiners, Georgia suggested L.D. interview Rose for the position of secretary-business manager. He then hired Rose.

L.D. was known to say, “Hiring Rose Quick was one of the best decisions I ever made in all my years in dentistry.”

The Proposal

The idea of the Institute was first suggested to L.D. in 1970 by his best friend and traveling companion, Dr. F. Harold Wirth, from New Orleans. Harold asked L.D., “How would you like to have a teaching institute named after you?” He continued, “It would be a place where dentists from all over could come to learn the PMS technique and Philosophy. It wouldn’t be like a typical graduate school where students were graded, but a place where they could learn to evaluate themselves. It would be a place where dentists could relax, enjoy themselves, and reflect on their personal lives and practices.”

L.D. thought it was an interesting idea. However, before he said yes, he told Harold there would be two conditions. First, everything would have to reflect up-to-date, high-quality dentistry; second, it had to be financially successful.

The Start

The Pankey Institute opened at the DuPont Plaza Hotel in Miami in 1972. It was more successful than anyone could have imagined. Although the Institute carried his name, L.D. never had anything to do with running it. Dr. Loren Miller from Texas was the first Director, Dr. John Anderson from Illinois was the first Director of Education, and Dr. Henry Tanner from California came to assist Dr. Anderson. It was mainly due to their energy and farsightedness that the Institute became so popular.

In 1985, the Institute moved to a new home on the island of Key Biscayne. Under the strong leadership of Executive Director Mr. Christian B. Sager and Director of Education Dr. Irwin M. Becker, the institute continued to help serious dentists in their quest for technical excellence and philosophical understanding, which is now–and always will be, the objective of the Institute.

The Original Curriculum

The original curriculum consisted of four one-week continuum courses. The Philosophy was studied and discussed during each of the four:

• Continuum 1 (C1) – The Comprehensive Examination
• Continuum 2 (C2) — Occlusal Equilibration and the Tanner Appliance
• Continuum 3 (C3) — The Curves of Spee and Wilson and the Functionally Generated Path
• Continuum 4 (C4) — Treatment Planning Complex Cases Using the Pankey-Mann-Schuyler Technique

Today

Over the years, the Institute has profoundly affected thousands of dentists and continues to do so today. Dr. Lee Ann Brady started at the Institute in 2005 as an instructor and became the Director of Education in 2017. In 2019, she was asked to become Executive Director. Under the capable leadership of Dr. Brady, the current curriculum is much broader than it was in the beginning to better match the current needs of dentists.

For many, The Pankey Institute has meant becoming more proficient and efficient as clinical dentists and finding the balance essential for personal wellness and fulfillment in dentistry. True to the L.D. Pankey Dental Foundation’s original mission, the Institute is still “The One Place” where dentists come to study the Philosophy of relationship-based practice and advanced dental techniques.

The Pankey Philosophy evolved slowly as L.D. built his practice and solidified in his mind which elements of his philosophy worked and which did not. L.D. served on the Florida State Board of Dental Examiners from 1932-1944. During that time, many dentists started hearing about his philosophy. Some dentists had a problem with the State Dental Board and needed to get their licenses back. Others were dentists who came to Florida to take the state board exams. L.D. always encouraged them to go out and do the best possible dentistry they could for every patient. Dentists from Tampa, Orlando, Jacksonville, and other areas of the state heard about L.D.’s work and would spend a week in his office to see what he was doing.

In 1947, L.D. was asked by the Florida State Dental Society to talk about how he ran his unique group practice. The presentation went well but it was evident to L.D. that few participating dentists had heard what he said. The transcript was printed in the Florida Dental Association Journal following his presentation. L.D.’s philosophy of dental practice, known as “The Philosophy,” had evolved as L.D. used it to build a practice. He knew from his own experience the elements of the philosophy that worked. Five years after the Florida Dental Association meeting and journal article, L.D. received invitations to present his philosophy to other groups.

Early in 1952, L.D. was invited to participate in a workshop on practice management at the University of Michigan, where a hundred dentists of various persuasions would be invited. At first, L.D. declined the invitation until the event’s general chair explained that he had been invited because he owned a group practice in Florida. At the time, group practices were not common in the profession. The facilitators of Michigan’s practice management workshop wanted to know how he had structured his practice. L.D. had three associates and fourteen staff members. Since he had experience running a group practice, he decided to attend.

During one of the breakout sessions at the Michigan meeting, L.D. was asked, “How do you run your group practice?” L.D. answered, “That would be like asking a golf pro to sit down over lunch and tell you how he plays golf.” He continued, “Managing a group practice while still practicing and using my philosophy involves much more than learning to play golf.” Just as not everyone has the natural talent to play golf, some dentists may never learn to become highly competent practice managers. L.D. told the session group that if they gave him at least three months to prepare and three days to present the information, he could answer their questions.

Some group members gave him five months and arranged a meeting in Milwaukee the following February, just before the Chicago Mid-Winter Dental Meeting. The Milwaukee seminar, “A Philosophy of the Practice of Dentistry,” was successful. Soon, he received many calls to give additional seminars.

Even before the class in Milwaukee, L.D. had many requests from dentists asking to visit his office to observe how the group practice worked and learn the philosophy, which was working well in the practice. For several months, Rose Quick, his private secretary, was glad to arrange these visits. However, the demand was so heavy that it became obvious that other arrangements would have to be made. Not only was it interfering with his ability to treat patients, but The Philosophy also had too many components to teach under these circumstances.

As an alternative, L.D. and Rose decided to set up two- and three-day lectures. When requests came to the office, it was explained, and classes were organized according to demand. For the first several years, L.D. traveled to various cities and offered three-day philosophy courses at the invitation of the study clubs. Those were the days before color slides and sophisticated projection equipment, so he used the blackboard and hand-outs. Then, Rose gave him the idea of having the material printed on roll-up window shades. The roll-up shades were portable and could be easily hung from the classroom ceiling or the top of a blackboard.

Eventually, the demand for classes became so great that L.D. did not have the time and energy to travel that extensively. Arrangements were made for a meeting room and housing accommodations at the DuPont Plaza Hotel in Miami. Rose took on the monumental task of coordinating the classes. A new course manual was developed, and the equipment necessary for conducting the classes was purchased.

A friend suggested that an evening of relaxation and fellowship should be included. Class participants and their spouses were taken by chartered bus to see L.D.’s first bungalow office built exclusively for dentistry in Coral Gables, followed by a buffet dinner in his home.

When L.D. Pankey returned to Coral Gables from the International Congress of Dentists in Paris, in 1931, knew he needed additional education if he was going to follow his personal commitment of not extracting any more teeth. With a recommendation from his new friend in Paris, Dr. Daniel Hally-Smith, the dentist, L.D. wanted to emulate, he signed up for a three-month summer course at Northwestern University in Chicago.

The program was designed to cover all the phases of modern dentistry including how to interview patients and do a proper clinical tour of the mouth so the student could determine what was really needed to give their patients optimum dental care. They were saturated with topics both technically and psychologically related to diagnosis and treatment planning concepts. Most of the information presented was focused on clinical procedures.

The patient psychology course was taught by George Crane PhD. During that summer, George Crane, a trained psychologist, was between his freshman and sophomore years in medical school at Northwestern. He had been hired to teach a summer course to physicians and dentists on how they could better understand and communicate with the patient.

At that time, there were no definitive textbooks about doctor/patient communications. During his lectures Dr. Crane brought in loose-leaf handouts for the class. The handouts later became the framework for his first book on applied psychology. Crane’s course was the highlight of L.D.’s summer, and it turned out Dr. Crane’s course became the foundation of what became the Pankey Philosophy.

Crane’s lectures were centered around psychology to be used by doctors to develop interpersonal relationships between the professional and the patient. The course included an overview of Carl Jung’s work, defining Jung’s four personality types: the introvert, the extrovert, the ambivert and the compensated types. The students also looked closely at the 1905 Binet-Simon Scale to determine the intellectual capacity of children. They studied the first “mental horsepower” test – otherwise known as the IQ test.

Later, when L.D. developed his own philosophy, he used much of the Crane course ideas for his Dental IQ, patient intellectual, sociological, and economic classifications. After finishing the George Crane course, L.D. felt confident that he had taken a giant step toward gaining the knowledge and communications skills that were needed in his practice.

Dr. Crane was a strong proponent of the balanced life and spent a great deal of time discussing Cabot’s “Cross of Life” which emphasized the need to balance work, play, love, and worship for a truly fulfilling life. The cross diagram was developed by Richard C. Cabot (1869-1939), who was a physician, philosopher, and Unitarian minister.

Following his graduation from Harvard University Divinity and Medical School, Cabot started his clinical work at Massachusetts General Hospital where he established a hospital based Social Service Department and became the first Chairman of the Department of Social Ethics at Harvard. Over the years, Cabot wrote twelve books on Medicine and Ethics.

Cabot also became a major educational leader in medicine by publishing monthly “Cabot Cases” in The New England Journal of Medicine. Each month physicians in local study clubs throughout the county would read and study the information provided by Cabot. They would try to determine the diagnosis for the patients in the case. The final diagnosis was provided the following month in The New England Journal of Medicine.

Crane assigned one of the Cabot books, What Men Live By, to L.D. and his classmates to read. The book explored how to achieve personal happiness. According to Cabot, happiness could be achieved by striving for balance in personal life. When explaining this concept to his patients and other professionals, Cabot recommended drawing a simple diagram with Happiness in the middle and four arms labeled Work, Play, Love, and Worship.

What Men Live By was published in 1913 and has long been out of print. Many of the references seem archaic; however, the basic principle of balance has stood the test of time. There are needs for all of us to be productive, to enjoy daily life, to have people in our lives that we care about, and to extend our interests beyond ourselves. An excess or a deprivation of any of these basic needs of life can set our lives out of balance, destroy our sense of self-worth, dull our enjoyment of life, or alienate us from our fellow human beings.

When L.D. Pankey developed his philosophy, he uses the Cabot Cross as a starting point for dentists on their journey to fine personal happiness.

While L. D. Pankey was practicing in Coral Gables, he continued to follow his personal commitment “to never taking out another tooth.” When teeth needed to be removed or needed a root canal, he would refer his patients to an oral surgeon or endodontist in Miami. So, his practice consisted of mainly doing periodontal procedures, restorative dentistry following the Pankey Mann Schuyler method, and complete, and partial dentures.

One day a 90-year-old retired dentist from Chicago came in to see him to have a new upper and lower denture made. His name was Frank Davis. Frank was the creator of the Davis Crown back in the 1920’s. L. D. learned about the Davis Crown when he was working in high school as a lab assistant in an Evansville, Indiana dental office.

The Davis Crown was a solder facing on a gold post. The doctor would cut a tooth off even with the gum, do a root canal, put a post in the root space, and followed with a pick-up impression. The dentist would then sedge 24k gold into the post on the master model and fit a facing. The hard part was to solder these crowns without breaking the porcelain facing. You had to heat the invested crown very slowly and after soldering, you had to cool just as slowly. If you were successful, this would keep the porcelain facing from cracking.

Now, here was the famous Frank Davis in Dr. Pankey’s office wanting new dentures!

Dr. Davis had been one of the most successful dentists in Chicago but had made most of his money in areas other than dentistry. L. D. supposed Frank must have followed his own technique and had all of his teeth cut off at the gum line. At some point, his teeth must had become infected because now he had a complete set of dentures.

At the initial interview, Dr. Davis told L. D. his dentures did not fit anymore, and he wanted L.D. to make him both new maxillary and mandibular denture.

So, L.D. followed his normal denture technique, made the impressions. fabricated bases, and set all the teeth himself. In L.D.’s mind’s eye at try-in the teeth looked pretty nice.

When Frank Davis saw the set-up, he took a hand torch, warmed the wax, and with his thumb started pushing the front teeth all over the place. Finally, he said, “I want you to finish the dentures just like that.”

Surprised, L.D. said, “They’re going to look kind of grotesque.” Frank said, “That’s the way I want them,” he insisted. “Then people won’t know I wear dentures.” So, L.D. finished his dentures just the way Frank had pushed the teeth around.

At the delivery appointment, they were both pleased with the result.

When L.D. Pankey visited Dr. Hally-Smith in Paris, Hally-Smith was curious about how L.D. could afford to come to the International Dental Congress in Paris. L.D. told him about his benefactor, Mrs. Blanchard. Hally-Smith said, “That is wonderful, just wonderful!” Turning serious, he then said, “You know of course that you will make it. Your benefactor has started the process for you but there are many things you will have to do before you will be there.”

Hally-Smith gave L.D. a personal tour of his office. The office had five dental technicians and three associate dentists. His personal dental assistant was a White Russian woman dentist who had been driven out of Russia during the Russian Revolution. She was wearing a long, highly starched nurse’s gown that went all the way to her ankles. L.D. began to understand what Mrs. Blanchard, his benefactor, was talking about. She wanted him to know some of the outstanding dentists in the world! When she suggested he take the trip, she said, “I think you have the potential of becoming an outstanding dentist.” This was after he had completed her dental work.

L.D.’s time at the Dental Congress was a busy one. There was so much to learn! Even though Taggart had cast the first inlay nineteen years earlier in 1912 by the “lost wax” technique, investments and casting techniques were far from perfect. Many slides were shown, and many papers were given on new techniques in restorative dentistry. New impression materials and impression techniques were shown in lectures and table clinics. Much of the denture information did not interest L.D. because he was mainly interested in saving teeth.

After their first meeting, L.D. made rearrangements to spend an additional week in Paris with Dr. Hally-Smith. Hally-Smith was old enough to be L.D.’s father. One morning, they were talking about patient communications, and Hally-Smith asked, “Did you ever take the Bosworth course?” L.D. said he had taken the course.

Hally-Smith said, “Isn’t Bosworth the dental supply man who suggests dentists say this when speaking with their patients, “I can do a good job for so much, do a halfway job for this much, or I louse it up at a very reasonable price’?” L.D. answered by saying, “That is not exactly what Bosworth says but pretty close.”

Hally-Smith then asked, “L.D., do you like that approach?”

L.D. said, “No, I’ve never liked it, but I have tried it.”

Dr. Hally-Smith became serious and said, “L.D. it all starts with communication. You should tell your patient the optimum way their dentistry should be done. Then what the patient decides is their own decision. If you’re going to make a compromise with them, then compromise based on your patient’s knowledge, not because you have prejudged them. You should tell every patient what optimum dental care would do for them. If they decide to go elsewhere, leave the door open for them to come back later. I have found over the years that a lot of these people return after they’ve lost half their teeth.”

They discussed this premise for a while longer, and L.D. realized how right Hally-Smith was. Tell patients about the best treatment plan. Then, if there were any compromising to be done, let them decide. L.D. realized Dr. Hally-Smith’s way of communicating was easier said than done.

When L.D. returned home from Paris, he never felt comfortable using the Bosworth Plan again. Instead, he presented patients with the optimum treatment plan. If they resisted, he would compromise and do only what they would allow or just put off the work, except for emergencies. After a while, L.D. began calling this compromise time a “Holding Program” – a time of doing only what had to be done until the patient chose to move on to optimum care. With enough time, patients would usually follow through with optimum care, but not always.