Gary M. DeWood, DDS, MS 

Learning begins from our first moment of awareness as our eyes open and we have a response to something external to us that is brand new. That experience and all the ones that follow until the moment awareness leaves us to shape our reactions to and our actions in the world. 

Experiential Learning 

The brain is a dynamic and ever-changing organ, constantly adapting to new experiences and knowledge. 

When our youngest daughter Katie was a child, I was cooking dinner one night–my turn–and Katie was sitting at the island where the stove was. I turned around to get something from the cupboard and heard a loud inhale followed by a whimper. Upon turning quickly, I saw her move her hand rapidly behind her back. No more sounds came forth, but I saw a tear and I asked her what was wrong. She said in a wavering voice, “Nothing,” and then looking at the stove burners, “Mom told me those were HOT and never to touch them.”  

I gently took her hand from behind her and saw the blisters rapidly forming on her fingers. She started crying and said to me, “Please don’t tell mom.” I’m certain she never felt the need to verify the information her mother had given her again. THAT is learning. 

All of us have experiences like that every day. Some are memorable and become part of us, embedded in a manner as yet not fully understood inside our brains for almost instant access. Some “learning” seems to fade quickly or never even get recorded. I “touched” a lot of biochemistry information over the years without burning much of anything into my brain. Maybe I should have been touching the stove at the same time. Learning is not simply having an experience of something and then being able to view the recording later.  

The Definition of Learning 

In nearly all of the definitions I have located in my research I see that CHANGE and PROCESS are prominent parts of learning. For example: 

• A change in disposition or capability that persists over time and is not simply ascribable to processes of natural growth. 
• Relatively permanent change in a person’s knowledge or behavior due to experience. 
• A transformative process of taking in information that, when internalized and mixed with what we’ve experienced previously, changes what we know and what we do. 

Choice & Focus 

My personal experiences have shown me that a big part of lifelong learning is what you believe about it and how you embrace it. It’s driven by some measure of choice and focus. 

Cheryl and I have sought out new ideas in dentistry wherever they took us. One of my friends in dental school, a wonderful man whom Cheryl and I still hold close, took a different path. Sometime around the 10th anniversary of our graduation we were visiting, and he told us that he had been able to get all the continuing education he needed without traveling.  

I discovered that his feelings around need and learning as it pertained to dentistry meant satisfying the requirements to stay current with licensure. He is NOT a bad dentist, but like many of the dentists I have come to know in the last 48 years, a hunger for dental learning changed once school was finished.  

A Drive for Learning 

I am reminded of one of the most original and influential thinkers on the creativity process, Robert Fritz, who believed you can create your life in the same way an artist develops a work of art. He said, “If you limit yourself only to what seems possible or reasonable, you disconnect yourself from what you truly want and all that is left is a compromise.” 

As a philosopher and scientist-physician, Dr. L. D. Pankey intentionally observed processes and their results (change) with the goal of becoming better at helping others. The embodiment of compassion, he was highly curious and actively sought ways to alleviate the sufferings and misfortunes of patients and colleagues. He traveled long distances to learn from others’ experiences. He inspired others to know themselves, their patients, and their work on a continuous road of mastery. As a lifelong “leisure” learner, he was interested in a wide range of subjects outside of dentistry as well. Through reflection, he often discovered he could apply this outside learning to his work. 

The Pre-Clinical Interview – Part 1 

Laura Harkin, DMD, MAGD 

I am a third-generation, restorative dentist in New Holland, Pennsylvania, which may be best known for its blue, New Holland tractors. I own my grandfather’s and father’s dental practice where I am the sole provider for approximately 1,000 patients. My dental team consists of two hygienists, two assistants, and two front office administrators. 

I graduated from dental school in 2008 after short careers both in the actuarial sciences and as a stay-at-home mom. In 2010, I purchased my practice and signed up for my first course at The Pankey Institute. Note, my father also studied at the Institute when it first opened its doors in the early 70’s. One of my greatest challenges, early in my career, was learning how to diagnose oral conditions, develop and present treatment plans, and execute that treatment via phases. I found it quite overwhelming to simultaneously manage multiple, complex cases. Now, I love sharing my experience and the approach I’ve found works best for me. 

Above all, I’ve learned that in the midst of daily pressures in dentistry, we need to maintain our own health and strength to properly treat our patients and lead our teams. Surrounding ourselves with knowledgeable, positive, and compassionate colleagues helps! 

Knowing ourselves is as important as knowing our patient. 

Dr. L. D. Pankey’s Cross of Dentistry supports the belief that knowing oneself is of equal importance to knowing a patient whom we choose to treat. This challenge forever evolves because no person remains unchanged with time. I frequently evaluate my strengths and weaknesses as a provider, team leader, and mentor. At the same time, I ask myself what aspects of patient care and business management I excel at and most love to do. I can then choose my specialist team accordingly and empower my office team to best support me. 

Together we ultimately provide a better product and higher level of care. 

To prepare specifically for the treatment planning process, my team helps me gather key information and clinical records from a patient for a comprehensive evaluation. After a thorough analysis, I carefully craft written documentation which will help educate my patient, my team, and the specialist team I’ve chosen. An added benefit is its ability to serve as legal documentation.  

I always ask a team member to join me during treatment plan presentations. They bring another set of ears and eyes so that we may better understand a patient’s motivating factors as well as the challenges they may face in receiving treatment. We encourage open and honest conversations and understand that treatment plans evolve to fit the needs of individuals. 

How do we get to know our patients? 

In addition to gathering a thorough health history and dental history, we are seeking to learn more about our patient’s chief complaint, perception of their current state of oral health, desires for treatment, and barriers to care. 

We listen intently for clues to identify a patient’s communication style. I’ve always heard that we have two ears and one mouth for a reason. I practiced with my father for two years and once, after observing me, he said, “Laura, you do far too much talking. You need to really listen to what your patients are sharing.”  

I’ve had to develop the skill of active listening. To stay in the question and become comfortable with silence takes practice. Some observations that I try to make in order to effectively communicate and build a relationship with a patient are as follows: 

• Do they seem to enjoy conversing or are they responding with short answers in order to get through the interview quickly? 
• Do they readily ask questions and express thoughts, or are they quiet and need to be invited and prompted to share? 
• Are they amiable? 
• Are they distrustful or fearful due to past dental experiences? 

We need to intentionally verbalize our empathy when we’re in conversation with a patient to help them recognize that they’re being both heard and understood. 

It is beneficial to understand a patient’s background. For example, what have they done in life? What do they love to do? Who is important in their life? Sharing in these conversations will help build a rapport, lead to improved doctor/patient communication, and can help to begin a trusting relationship. 

Does the patient have limitations such as the ability to drive to appointments, afford dentistry, or find time for treatment? Do they need to discuss their oral health condition and treatment options with a trusted family member before making a decision? 

Understanding these answers helps us to not only provide respectful and resourceful solutions but also limit inaccurate assumptions. This knowledge is especially helpful in my third-generation practice, where I have many elderly patients who are dealing with health issues, multiple medical appointments, and scheduled drivers. Their desire is to simply make a careful decision for an oral rehabilitation which fits their objectives and abilities. 

Do we hear the desire for treatment? When speaking with an existing patient, I can often recognize signs of interest to move forward with previously recommended treatment. At that point in time, I often ask, “Why now?” The answer helps me clarify their chief concern(s) so that we can move forward fittingly. 

In Part 2 of this series, we will explore additional techniques to clarify our patient’s desire for oral health and long-term, oral stability. 

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. 

In the year 1958, Dr. L. D. Pankey asked one of his most devout students to join him and teach the Pankey philosophy about dentistry and life to dentists around the world. And that’s precisely what they did. F. Harold Wirth, DDS, was one of the most dynamic speakers in all of dentistry. He rivaled Drs. L. D. Pankey and Bob Barkley in his ability to engage an audience and make his points clear using real (often funny) stories from his practice and life experiences.

Harold understood people on a very deep level—physically and emotionally. For this, he gave Dr. Pankey most of the credit. He had a very successful restorative practice in downtown New Orleans prior to meeting Dr. Pankey, but always felt that something was missing. L.D. Pankey showed him what that was, which turned Harold Wirth into a missionary for whole-person dentistry from that point forward:

“Give the case presentation to the person who makes the decisions,” Dr. Wirth said. “If I ever get to the point where I’m explaining what I’d like to do…If I’m not already about 90% into gaining their agreement, then I have messed up! Because I should have already won them over with the interview, the aura of my office, the literature that I’ve given them to read, and whatever else I’ve done before that time.”

Dr. Wirth said, “The case is constantly being presented: Every time the patient comes in, you’re doing a presentation. As a matter of fact, I think the interview is forever ongoing. It might only be one word, but every time the patient comes into your office, you should be interviewing them. Are you comfortable? Does your bite feel good? Are your teeth sensitive?”

These are questions that have to do with how the person FEELS. A case history is exploring what happened, but an interview is about how they feel! You need to understand the difference! How do you feel about your restorations? Are you comfortable? Are you satisfied with the appearance of your smile? Can you chew everything you want to chew?

I’m sure there are many aspects of your work that are really fulfilling, and I’m sure there are aspects of your daily work that you wish could be easier, maybe even less stressful. What about your work brings you joy? What would it take for you to provide your best work? What would it look like? What would it feel like?

I took an informal survey of dentists and hygienists about what they would need to have an ideal day. When I examined the dentists’ answers, I realized the answers would resonate with every member of a dental team.

The top five answers from dentists were:

1. Having the appropriate instruments to provide excellent care.
2. Opportunity to gain knowledge and skills.
3. Excellent performance/execution of their work.
4. Opportunity to implement new learning.
5. Working with patients who are grateful for their care.

All hygienists desired “time to provide appropriate care for each patient.” Specifically, they asked for:

1. Time to select and sharpen instruments for each person and for the specific procedures they will be doing.
2. Time to properly assess each person’s unique periodontal condition, including time to accurately measure gum pockets and recession, minimal attachment/thickness, and to assess bleeding (blood thickness, how much bleeding, and where it is coming from—is it systemic or localized?).
3. Time to explore possibilities with patients regarding their current condition, past condition, and potential future.
4. Time to debrief and collaborate with the doctor to explore the next steps for the patient.
5. Supportive teamwork across the practice to provide the best care.

Speaking of collaborating with team members, I invite you to ask your team members what their ideal day would include. Discuss, as a team, your shared ideals, and expectations. Consider where expectations do not match and discuss why this is and what must change to meet shared agreements.

Understanding and affirming the needs of others will have a positive impact. The exercise of writing down what works, what could be better, possibilities, goals, and a pathway towards implementation of superior supportive teamwork is likely to increase your practice joy factor.

In a world driven by media hype and often false narratives, how can we convey, and deliver, that we are a trusted resource and provider of care? The answer is worth contemplating.

Slick websites and media ads may drive patients to contact your office but they are only a tiny fraction of what is needed for someone to schedule an office visit or commit to allowing you to physically intervene with care on their behalf. A far better resource is the recommendation of an existing client. But even that is only a crack in the door to the development of trust.

Dr. L. D. Pankey often used the phrase “Know yourself. Know your patient. Know your work.” In other words, are you trustworthy? Is your patient able to express the outcome they are looking for so you can help facilitate their health? Are you the right provider, and is this the right time? Are you capable and competent to deliver the desired outcome?

Our client’s sense of trust will be built from a series of experiences. Some items we can control; others we cannot. We can’t control their prior life and dental experience. We have an impact on, but cannot really control what others say about our office or our skills. We can control our behavioral skills and level of accountability. We can create a client experience that allows for the development of a relationship based on trust and mutual respect. This will require a philosophy shared with our team that is implemented at every point of client contact. If we want our clients to trust us, we must be worthy of trust. We must have mutual trust in our team and among team members. When this situation exists there is an unspoken aura that exists within your business. We don’t have to talk about it because our clients can feel it.

Creation of a climate of trust in our office takes time and effort. The return on the investment is lower stress for everyone involved, and the elimination of having to sell dentistry or worry about third parry concerns controlling patient decisions. Cost will always be an issue for some patients. However, in a trust based relationship we can find ways to overcome that barrier. Some people will not choose to trust and should be guided to another office. For those who choose to participate in a trust-driven relationship, we will be able to provide care, skill, and judgment that will be satisfying to all involved.

Discover more of the Pankey Philosophy and learn how to build a thriving dental practice with The Essentials Series. This comprehensive 4-part course starts with Essentials 1, diving deep into the core principles that will transform your approach to patient care and practice management. Trust is a cornerstone in building strong patient relationships, and The Essentials Series will equip you with the knowledge and skills to establish trust from the very first interaction.

🌟 Trust. Transform. Thrive. The Essentials Series awaits you! 🌟
Click here for more information and to get started.

An essential technique in effective listening with new patients involves an interviewing discipline known as “bracketing.”

Psychiatrist and author M. Scott Peck described bracketing as “the temporary giving up or setting aside of one’s own prejudices, frames of reference, and desires so as to experience—as far as possible, the speaker’s world from the inside, stepping inside his or her shoes.”

True listening requires a setting aside of ourselves. It also requires acceptance of the person as they are in the moment.

In his book Ways of Being Unconditional, Carl Rogers defined “unconditional positive regard” as accepting and supporting another person exactly as they are, without evaluating or judging them. At the heart of this concept is the belief that every person has the personal resources within to help themselves. They simply need to be offered an environment of acceptance that can foster their own recognition of this.

The goal is to create a safe psychological space where the patient senses acceptance, and therefore feels less vulnerable and thus more inclined to open up to share their fears and concerns regarding dental issues. This is challenging, particularly in the middle of a busy schedule, as most of the time, we lack the capacity to truly listen while other responsibilities and distractions are present.

We need to set the environment with intention.

To do this well, uninterrupted times in the schedule must be established as well as a comfortable non-clinical location. The battle seems to always be between structuring our schedule for efficiency versus creating more open-ended opportunities for trust to develop and knowledge conveyed.

We need to truly listen.

Are you able to turn your focus to orchestrating an interview in which you actively listen? Yes, well, then good but how easy is it for you to maintain that focus?

Even though we may feel we are truly listening, what we are often doing is listening selectively, with a preset agenda in mind…thinking about what we want to happen next…procedurally or financially, wondering as we listen how we can achieve a certain desired result by redirecting the conversation in ways more satisfactory to us.

Even though we may feel we are truly listening, we often respond to what the patient is saying by assuming our interpretation of the question they ask or the concern they relate is actually what the patient is attempting to say. And this is why Mary Osborne’s Staying in the Question Part 3 blog is so on point that I recommend others read it. 

True listening, no matter how brief, requires effort and total concentration. This means we cannot truly listen to another person and do anything else at the same time. While in the middle of a busy day at the office, this is challenging—very challenging.

The first step is willingness.

Our willingness to truly listen is the most tangible form of esteem we can give to another person. And if we give a new acquaintance our esteem, they will feel less ashamed or embarrassed. Consequently, they will start to feel less threatened and more valuable. And it’s those who feel valuable to themselves, who are most likely to be interested in taking better care of themselves through fine dentistry.

Carl Rogers helped us see there is no better way for our patients to learn they are valuable (rather than deficient or flawed) than by our valuing them first through careful listening.

• When we offer no judgement, they feel less fearful, and they can share their thoughts and emotions more freely.
• As we accept them, they feel encouraged to find self-acceptance and think for themselves.
• As we invite them openly to share, instead of asking questions designed to illicit certain answers, we give them space to think for themselves, and with such space, they can begin to cultivate their inner resources and rise to our expectations for what is in their best health interest—on their own.

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 his recent book Subtract–The Untapped Science of Less, University of Virginia professor of design Dr. Leidy Klotz points out many instances where we allow ourselves to be overwhelmed with information and complexity. He argues and demonstrates that subtracting the extraneous often leads to greater clarity and efficiency.

Reading Klotz’s book, brought to my mind the Pankey Institute’s Essentials continuum that begins with Essentials 1 (E1). Dentists arrive at E1 overloaded with information taught in their dental schools and other CE programs. All that information may have some value but the role of the Essentials courses is to subtract the extraneous and focus on what is essential.

We arrive at E1 thinking everything is important, and we discover that there are essential elements of dentistry that are key to effectively working with patients, performing a complete exam, diagnosis, and technically excellent, predictable care. From these key elements, we can build practice systems that are clear and efficient.

What Is Essential?

We aren’t born with complete wisdom like Athena born from the forehead of Zeus. We learn wisdom (what is essential) faster by being in the company of others who have traveled the same road, asking, “What is essential? What do I NEED to know?”

The Pankey Essentials continuum exposes dentists to the clinical, behavioral, and financial aspects of practice. And goes beyond exposure to exercises and exploration. The courses invite dentists to understand themselves, their patients, and their work exceptionally well. The courses invite dentists to focus on and develop essential skills.

Our profession has undergone a technological explosion over the past few years. Some of this is wonderful. But how much of what we invest in are we fully utilizing? What is the best technology to invest in? What is the best way to implement it? The Institute’s faculty help us cut through the clutter and determine what works best…what we can implement with our teams and patients that will improve our dentistry and the patient experience. But first, the Essentials courses peel away the layers of hype and technology to help us grasp the core skills we must attain.

The core skills are behavioral as well as technical. And because the behavioral aspects of dentistry are not discussed to great extent in dental school curriculums, one of the roles of the Essentials continuum is to fill in this gap. In the Essentials courses, we learn the importance and skills of behavioral science. We learn how to most effectively lead and affectively influence. We dig deeper into understanding ourselves and our patients…our emotions, our motives. We discuss the behavioral concepts that were taught by Dr. L. D. Pankey because they remain valid today. These concepts are straightforward and help us develop lifelong patient relationships and personal skills.

The business aspects of dental practice are overwhelming. Dental schools do not have time to teach business essentials. In the Essentials, dentists learn essential financial skills such as how to understand their financial statements. If we are not making a profit in our practice we can’t stay in business.

Self-Examination

When I first attended an Essentials course (then called C-1), I worried that I might not know enough. I discovered that I knew a great deal but I had not clearly defined what was essential. I learned I needed to be more assertive about asking myself why questions. For example, I found myself asking:

• Why am I doing this? Does this step add value to the final result?
• Why is my final result not stress free and predictable? What step did I miss?
• Why am I “telling” my patients rather than “asking” for their input and values?

An Intentional, Essential Community of Support

The Essentials faculty and my fellow students helped me understand that getting rid of what is not needed is not simple. Determining what is essential and building my practice systems around the essentials takes time, thought, and effort but was made easier for me because I had the help and constant encouragement of the Pankey faculty and community in shaping my approach to dentistry and my career.

My friend and colleague Dr. Richard A. Green has always said, “Intentionally becoming both more affective and more effective is essential to excellent patient care.” So often we intend to do something but don’t have the encouragement we need to remain intentional. As my friend and colleague Dr. Barry Polansky says, “We humans tend to slip, slide away. It is by developing habits intentionally and self-checking our assumptions that we stay alert to the possibilities of how we can become more.”

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.