Every one of you knows from your own experience with care providers that you want to have complete trust in them before accepting their recommended treatment. Your dental patients are no different, and that trust is affected by their entire experience with everyone on your care team. The dental experience in relationship–based practices increases this desire, because listening well to others is one of your priorities. Patients become at ease confiding their concerns with you and celebrating high points in their life with you. In your dental practice, listening well and acts of kindness generate positive emotions and positive memories of their dental experience.  

The Golden Rule 

Under daily situational stress, personal psychological stress, and oftentimes lingering physiological stress from the day before, preoccupation with internal concerns gets in the way of being truly present for the patient. The benefits of discussing this occasionally within team meetings foster a continuing positive culture of everyone striving to intentionally apply the Golden Rule with patients.  

When that aspiration is sustained and everyone on the team “takes care of” patients by “treating others as you would want to be treated,” the emotions experienced by patients are positive and support treatment acceptance. And, the genuine care you give others has a way of stepping down your own stress with the release of oxytocin.  

I’m speaking to all team members from the front to back when I say, “Practicing being truly present for patients until it becomes a natural habit is one of the greatest things you can do for them, yourself, your fellow team members, and the business.” 

A Few Extra Minutes  

If appointment times are increased by five to ten minutes, the clinical care team has more opportunity to converse with patients without stress developing, and in just a few more minutes a lot can happen. Conversations between care team members and patients help establish trust. These conversations also disclose patient feelings, concerns and unanswered questions. The sharing of this information with other team members can be used to create an optimal patient experience in this and future appointments.  

It takes just a minute more to share this information appropriately in handoffs to tee up the doctor-patient conversation about treatment and to support scheduling the next visit before the patient leaves. By the latter, I mean the business team at the front and the patient always need to be prepared for the end of the appointment when the follow-up treatment fee is presented and scheduled. This preparation includes communicating the why behind the treatment and true concern for the patient’s welfare.  

Same Page, Same Language 

Patient confidence grows when every team member is on the same page, is aware of the patient’s expressed goals and concerns, supports the treatment plan with why it is recommended and enthuses about the expertise of the practice. Using the same language helps too.  

In a relationship-based practice that focusses on these details, this is possible, and more treatment is accepted. If team members stop occasionally to ask themselves, “How was that handoff,” you will discover ways to improve how everyone “takes care of” patients through shared knowledge, empathy, and language. And knowing the Pankey community as I do, I see in my mind’s eye care teams around the world coming together at the end of the day to say, “Nailed it!” 

When the art and science of dentistry are reduced down to primarily being about production and code mining, its spiritual dimension is easily lost. Spend a few minutes on some dental social media sites, and you will quickly see this truth in black and white. 

Dr. L.D. Pankey warned us about this problem.

The key to becoming a truly successful professional isn’t just about mastering the technical skills and endlessly chasing after the siren songs of our materialistic culture. Such narrow pursuits are ultimately hollow and do not represent enough to carry us through life as a fully developed person. And they do not represent enough to carry us through life’s inevitable tragedies and periods of significant suffering.  

Creating a habit of connecting with our patients in deeply meaningful ways, helps us to form the emotional antibodies we will need to carry us through the inevitable not-so-good times, the times when all the money and material possessions in the world can’t solve our problem. These are the times when only love, support, and reciprocated empathy can start the process of healing our wounds. 

Never forget this central truth.

Chasing after the next new and shiny object may not be the best solution for our challenging situation today. The best solution may very well be sitting right in front of us in the form of a deeply caring patient.
 

Every message a person tries to convey to another person has two components to it, the content of the message, and the feeling or attitude associated with the content. Both are critically important, as both give context and meaning to the information being shared.  

In some instances, the content of a story is less important than the feelings associated with it.

In fact, sometimes the content may be a complete distortion or a fabrication. Regardless, the person may believe the story because the story has a specific meaning to the person. Consequently, it is critical that we try to catch the full flavor of meaning underlying the story. 

Do they believe that they are going to lose all of their teeth no matter what they do? Do they believe that it is normal to lose all of their teeth? Do they believe that they are not worthy of investing in themselves through dentistry? Do they believe that all dental work fails and is a bad investment? Do they believe that most dentists are dishonest? Do they believe that their problems cannot be resolved?  

To discover meaning, we must respond to the feeling component of their communication:

“You seem really upset about this, can you tell me more about it?” “I can see that you are really anxious, can you help me to understand why you feel this way?” “You seem really frustrated – even angry about what happened. Can you tell me more about it? Do you think you will ever be able to work with another dentist?”  

We are attempting to discover is what their story really means to them. How do they see this story and their current situation affecting them going forward? How important is it to them that they resolve their current situation? Do they even know what their situation really is? 

Patients gravitate toward and stay loyal to dental practices in which the dentist and care team love what they do.  

When you are enthusiastic about your work and how you do it, you can’t help but talk about it, can you? You can’t help but show it.

This enthusiasm affects patients in multiple ways. 

• Your happy office is a delight to visit under most circumstances. 
• The confidence you exude makes potentially stressful visits more comfortable and allows patients to trust in your care.  
• Their curiosity in dentistry and what you can achieve together is peaked. They ask more questions. This, in turn, sparks the patient’s desire to make changes in their health and smile. 
• Because your happiness has spread throughout your care team, the support patients receive throughout their experience is exceptional. 
• You surround them with so much positive energy they feel free to get to know you too. 
• Consistent happy experiences lead to patients feeling like they are among family and friends. 
• And, you’ve all seen this. Patients want to emulate your happiness in their own lives. They want to be like you. 

What is happiness anyway? The definition that I like is “the ability to feel satisfied with your life, to enjoy yourself and others, and to have fun in the present.” This certainly is what your patients enjoy when they visit. 

So, what brings about happiness in dental practice? Perhaps, you’ll agree: 

• Doing what you love to do most of the time, applying your talents and strengths 
• Being outwardly focused on the well-being of others 
• Effectively motivating and leading others to optimal health 
• Being true to your own personal values 
• Ever be it dynamic–Pursuing your own vision of practice (in the case of the dentist) and a coherent practice vision to which you contribute (in the case of team members) 
• Working in a care team that is high functioning with high EQ 
• Effective systems that facilitate doing what you love most 
• Ability to successfully problem solve and adapt with confidence 
• Patients who appreciate what you do together  
• Continuously mastering higher standards of care 
• Multiple moments of true connection with others every day 
• Understanding of yourself and others 
• Satisfaction with your life outside the office 
• Optimism and gratitude 

Some time ago, I was listening to a person speak about love and replacing the word “love” with “forgiveness.” His argument was that if you truly expressed forgiveness, then you are a loving person. As I thought about it, I decided “acceptance” was a better word for me. I felt that if I could accept a person for who they are, then it would be easier for me to forgive, and thus love. This started me thinking about the present and past relationships in my life and how I could apply acceptance.

After intentional self-work in this area, I have found that life is more understandable and pleasant when I practice the art of acceptance.

Consider Relationships

We all have had concerns about relationships. We all wonder why others act a certain way towards us. We benefit emotionally, physiologically, and strategically by understanding where they are coming from and how their past experiences have molded them. Stephen Covey would use the phrase “seek to understand, before trying to be understood.” In other words, accept the person for where they are, before you feel you should be influencing them to be what you perceive is correct. In a bad situation, understanding the other person would be a big step towards forgiveness.

Consider Situations

Acceptance of situations has emotional, physiological and strategic benefits as well. It comes down to understanding what is happening instead of trying to control everything. I find this so true in my practice life when my patients have some sort of moderate to severe dental issue. Until they accept what is wrong and “take ownership” of the situation, there is very little that I can do to help them. Often, the worst thing you could do is to try to fix a bad situation without the patient having ownership of the problem, because if things go astray, it becomes your fault.

For Both Ourselves and Our Patients

The art of waiting for when the patient is ready to accept treatment—and the art of understanding, accepting, and positively influencing the patient during the waiting—have both become easier for me over time. Sometimes we need to have difficult conversations with patients to help them accept the truth. But oftentimes we simply need to better understand what they are thinking and why. And, the gentle way to get at this is to inquire why they are reluctant to move forward without a tone of judgment—instead, with genuine care.

One of the great discoveries of working with the public and patients so closely is that most of what we apply to them we can also apply to ourselves. Therefore, we can benefit from accepting who we are, our personal situation, and how those around us are trying to help us. These can be important keys to moving forward in our own lives. Remember, we all travel the same journey.

When it comes to diabetes, let your patients know about the impact oral inflammation can have on their health. Explain what you can do to help them and what they can do to help themselves. Clarify what they can do to take control so that they can live happier, longer lives.

Give your patients optimal assistance.

Include questions in your health interview about whether the patient has been diagnosed with diabetes, has been counseled about being at risk (prediabetic), and/or has a family history of diabetes. If your patient affirmatively answers to any of these questions, inquire about what they know about the link between gum inflammation and systemic diseases, such as diabetes.

Gently, explain why you are concerned.

Even if it is slight, gum inflammation is harmful when chronic. Let them know that among other health problems, persistent inflammation exacerbates diabetes and development of diabetes. It would help to tell them a story about an anonymous dental patient whose blood sugar decreased over a matter of six months and improved again within a year due to the elimination of gum inflammation.

Invite your patients to begin a new oral health regimen.

Let them know that you will partner with them to track their compliance, evaluation, and improvement. Inspire them with a story about another anonymous patient whose oral health and diabetes was improved by starting a healthier regimen.  They too can experience the healing power of making healthy choices and developing healthy habits throughout their life.

Your patients will start to report to their physicians, family, and friends about the conversations you have had with them. They will all be able to see the efforts you are making to control inflammation in their mouths, and the evidence of improved health. You might begin to see referrals from these patients and their doctors start to follow.

When I was a young dental student, the voice of “right from wrong” came from my instructors. Their voices annoyed me, and I didn’t think that the dental school approach could ever work in the real world. When I got out of residency I began to learn “real world” dentistry from employers and insurance companies. They became my voice of right from wrong. I concluded that cutting corners was the way most dentists practiced—no face bows, no articulators, models or comprehensive examinations.

I found that I had a knack for selling dentistry. I was blessed with patients who allowed me to perform some rather complex dentistry…without articulators, face bows or comprehensive examinations. I became a master at making excuses for my dentistry:

• “You’ll get used to your bite…”
• “The temporaries really can’t approximate what the final will look like….”
• “Your jaw pain is stress. You need to relax…”

I was lucky! Most of my dentistry worked, but it was never predictable. Dentistry became stressful and honestly downright scary sometimes. So, I studied at the Pankey Institute. I heard voices of honorable people. What was right and good and decent for my patients…and me…and my family! I thought that I can’t do this type of Dentistry; it’s like dental school! No one practices like this.

Then, a Voice Appeared

One day I was fabricating a provisional and left an open margin. “So what?” I thought. I became aware, however, of a very faint voice that said, “Do the right thing; close the margin.” Hmm, close the margin. “Why should I?” I thought. “The new crown will be here in two weeks. What’s the big deal?” Again, I heard a whisper, “Close the margin.”

Annoyed, I explained to the patient that I wanted to work more on the temporary in order to make it fit better. The voice stopped whispering. The patient said, “Thank you for caring and being so thorough.”

The voice, once a sheepish whisper, began to speak in clear tones:

• “Carve the restoration the best that you can.”
• “Let specialist perform the procedures that they do best.”
• “Restore that patient only when you really know that person both clinically and behaviorally.”
• “Treating a patient is not about you; it’s about them, always.”

I was really starting to feel that I was going insane until one morning a poem came to me. I titled it “The Voice.”

THE VOICE

Who was this voice that I couldn’t see? It pushed and prodded and bothered me.

The voice was strong and judgement free, and I began to like its philosophy.

As time went on its words rang true, and I began to see the good I could do.

The voice which spoke of doing things right, began to be my guiding light.

I began to live with genuine care, with genuine love, a genuine air.

Who is this voice that I can’t see, that stirs my soul and bothers me?

This voice lives in me deep and strong.

It guides my path. It sings my songs.

It is so much a part of me

Who is this stranger I can’t see?

One day the voice said loud and clear:

“I’m always with you. I’m always near.”

I asked the voice to give its name,

to show its face, to stop playing games.

The voice just laughed. It said with glee.

It’s always been you, yourself, you see!

To the many participants who come to The Pankey Institute to study, I hope that you all let your best inner voice become your guiding light throughout your journey. That voice, that wonderful voice will never let you down!

I’d like to tell you about my neighbor up here on Bent Mountain. His name is Mike Stockton. He personally designed the house we live in. He drew every line of it and then supervised, as well as participated in its construction. Mike had no formal training in architecture or construction. He just loved it and then studied it long enough to master it. His history is that of an artist.

We are all born with certain gifts and talents.

The key is to discover them, develop them, find ways to connect them with others in a fashion that they will be valued, and then to share them. Of course, applies to dentistry as well. We will only be willing to invest the time, energy, and attention necessary to master something if it brings us joy and satisfaction. That’s the pay-off—the ability to step back and say to ourselves, “That was pretty good, but next time I think I’ll try this instead and see if I can make it even better!”

But that’s not enough to be successful. To be a masterful and successful dentist, you also must be able to connect and inspire others to become better versions of themselves. And that, of course, includes team members and patients alike.

What else do you need?

You need to be able to promote yourself. You must be willing and able to share what you know and can do with others in a way that they feel it will be helpful. And there’s a word for that. It’s called “marketing.” Marketing is not a dirty word if it’s done from your heart and you deliver on your promises. No, let me correct that. You over-deliver on your promises.

When you go into that private coffee shop and they take a moment to create a heart in the froth of your latte, that’s marketing too. That’s caring enough about what you do to take the extra steps that demonstrate you sincerely care about what you are doing and how other’s feel about it.

So, now we have five key things:

1. Gifts and Talents

2. Mastery

3. Inspiration

4. Communicating What You Can Do to Help Others

5. Extra Steps that Show You Care

How others perceive how well you do these five things, will determine your financial future, because people will give you their money in exchange for your gifts, talents, skills, and caring when they perceive that you do the above five things exceptionally well and they benefit significantly as a result.

Passionately practice these things, and you will have a bright future ahead!

It’s early in the morning and the first sip of coffee full of that fresh aroma just went down with a sigh, a sagging of the shoulders and a feeling of here we go for another day. My mind is starting to run the list of what is on the day’s agenda…work deadlines and meetings…the kids’ schedules…what is my spouse doing today? Did I pay that electric bill or not? Then it hits. Oh, that’s right! I have a dental appointment today!

The morning life puzzle pieces all start to come together as they always do.

Everyone and everything are in their place. And off I go to the dentist with that fearful thought, “I hope they don’t hurt me today.” Parking in a rush and taking a breath before entering the dental office door, I worry, “Am I just in time?” A gentle face looks up, smiles and greets me by name. With that kind hello, I begin to relax and mentally whisper to myself, “I’m safe here. They know me. They want to take care of me. They’re happy to see me. I’ll be okay.”

The reality is this kind of personalized attention and care is slowly going away.

In medicine and dentistry, consolidation of practices into corporate entities has forced doctors to “run” on a patient-number schedule and production list. Statistics and numbers are slowly pulling their want and desire to give personalized care away from them. And I, the Patient, don’t want to be treated this way.

I’m glad my dentist takes time to know me and my concerns, spends time diagnosing and planning treatment that is individualized and best for me, and doesn’t let insurance companies limit my choices and the quality and quantity of care I receive. What’s important to me is I trust this type of dental care, I think I deserve this type of care—and the comfort I feel during my dental visits is priceless.

While communicating, we can learn to become more mindful of the emotions which are rising up in our body and the sensations we are feeling on an intuitive level. We can begin to notice what has happened that has triggered our initial response, as well as feeling the sensations it has created in our body.

This requires us to remain in a state of curiosity and observation rather than in assessment and judgment. And when we treat these thoughts and sensations with equanimity, we are less likely to react inappropriately during stressful situations.

When I mention staying curious, I mean to approach the experience with the curiosity of a child.

When we remain curious, we are inspecting our experience like a child who has seen a flower for the very first time. This helps take the power away from the strong emotions we might be feeling in that moment. To paraphrase Mary Osborne from this past weekend at The Pankey Institute Annual Meeting, “You are standing on the balcony, and not on the floor.”

This whole mindfulness practice is extremely important as it gives us a chance to hit the pause button.

And when we pause, we’re able to respond rather than simply react. Reactions are often what our limbic brain wants us to thoughtlessly do. And if we have developed an insensitive pattern of reacting over the years, it can lead to regret and suffering. Hence, by developing an ability to pause our limbic brain’s instant impulses, we become more capable of responding in a much wiser fashion.

Mindfulness is at the epicenter of a truly relationship-driven practice.

And it’s a skill which can be developed and enhanced over our lifetime. Hence, it’s at the epicenter of “knowing ourselves” as well.