By Paul A. Henny, DDS 

As a dental professional, you’ve dedicated countless hours to honing your skills and knowledge. Yet, beneath the polished exterior, many dentists grapple with a hidden enemy: shame. This destructive emotion, often rooted in self-doubt and negative self-perception, can significantly impact your professional and personal life. 

I’ve personally experienced the debilitating effects of shame in my dental career. After graduating dental school, I felt a sense of inadequacy and confusion about my place in the profession. The transition from a structured academic environment to the demands of private practice was overwhelming. I struggled to connect with patients, build a successful practice, and find my footing in the dental world. 

Shame, as John Bradshaw describes it, is the “painful exposure of the believed failure of self to the self.” It’s a deep-seated belief that you’re not good enough or worthy of success. This toxic shame can manifest in various ways, including self-doubt, perfectionism, and difficulty forming healthy relationships. 

Overcoming shame is a challenging but rewarding journey. It requires self-awareness, self-compassion, and a willingness to confront your inner critic. Here are some strategies that have helped me and other dentists: 

• Challenge Negative Thoughts: Recognize and challenge negative thoughts and beliefs about yourself. Replace them with positive affirmations and self-compassionate statements. 

• Practice Mindfulness: Mindfulness techniques, such as meditation and deep breathing, can help you become more present and aware of your thoughts and emotions. 

• Seek Support: Connect with other dentists or mental health professionals who can provide understanding, support, and guidance. 

• Engage in Self-Care: Prioritize self-care activities that nourish your mind, body, and soul. This might include exercise, hobbies, spending time in nature, or seeking therapy. 

• Set Realistic Goals: Break down your goals into smaller, achievable steps. Celebrate your successes, no matter how small. 

Remember, you are not alone in this journey. Embrace the strength of the Pankey community and its collective insights and stories. Many dentists have faced similar challenges and have emerged stronger and more resilient.  

By Deborah E. Bush, MA 

How I Came to Know the Word “Eudaimonia” 

During the Covid pandemic, retired dentist Barry F. Polansky, DMD, noticed a shift in people’s perspectives, with many becoming more thoughtful about life’s purpose and values. This period of reflection inspired him to encapsulate his own views in a story aimed at guiding young dentists. This story became his 2021 book, The Porch: A Dental Fable.  

The Porch is the tale of a young (new) dentist who is guided by a philosopher mentor, learns to integrate eudaimonia into his practice, and regularly discusses dental philosophy with colleagues in a porch setting. Dr. Polansky hoped the book would help new dentists discover how to practice virtuously, foster responsible relationships focused on well-being, and lean on mentors and study clubs to encourage them. While authoring the book (before ChatGPT), he asked me to help with the writing, and I was pleased to assist in refining the narrative, ensuring it resonated with readers. 

Eudaimonia in Patient-Centered Dentistry 

“Eudaimonia,” rooted in Aristotelian philosophy, translates to “human flourishing” or “well-being” and is integral to a comprehensive approach to dental care. It extends beyond clinical outcomes, considering the broader impact on patients’ overall health and life satisfaction. For example, here are some of the principles shared by Aristotle’s philosophy and patient-centered care. 

• Holistic Approach: Embracing eudaimonia means addressing not just the physical, but also the emotional and psychological well-being of patients. This includes understanding their aspirations and fears related to oral health and aligning care with their life goals. 

• Empowerment through Co-Discovery: Involving patients in exploring their health and treatment options to foster informed decision-making, aligning with their values and aspirations. 

• Personalized Care: Tailoring treatment to each patient’s unique needs supports their journey toward their own fulfilling life. 

• Mutual Growth: Collaborative patient-provider relationships lead to mutual professional and personal growth, contributing to a shared pursuit of well-being. 

Eudaimonia in Ethical Practice 

Integrating virtue ethics—compassion, honesty, integrity—into practice fosters trust and well-being for both dentists and patients, leading to professional fulfillment. This sounds easy but we know it is not. 

In The Porch, Barry Polansky’s protagonist is initially hindered in his attempts to lead patients to treatment by (1) patient resistance and (2) his internal frustration with that resistance. The young dentist goes to the brink of giving up. The philosopher-mentor helps him off the cliff’s edge and back onto comfortable footing as the young dentist learns relational behaviors that lead to positive results. 

Eudaimonia in Work-Life Balance 

Polansky’s book emphasizes the importance of balance between work and personal life, continuous learning, and maintaining physical and mental health for a fulfilling career. Polansky draws on his deep roots in the Pankey philosophy as he persuades his colleagues to support young dentists in study club communities focused on well-being. 

His Take-Home Message  

A long fulfilling career in dentistry is based on developing a systematic approach to practice that enhances the doctor-patient relationship for the benefit of patients, living purposefully with balance, striving for personal holistic health, and being in community with colleagues to nourish the wellness and careers of younger dentists—all hallmarks of The Pankey Institute. 

Note: You might find this interesting…I’m learning to learn from AI. My first draft of this blog was nearly 2,000 words. Then, I ran it through ChatGPT, knowing it needed to be shortened, and voila! I liked the concise results (620 words). In my line of work as a dental writer, I sometimes use CoPilot AI for research, Gemini AI for drafts, and Grammarly AI for polishing, but overall, I think ChatGPT does the finest job of critiquing what I write, suggesting revisions, and explaining why.  

By Barry F. Polansky, DMD 

These thoughts were first published in May of 2021 on my blog Stoic Dentistry. Parts one and two of this blog series tell the story of how The Pankey Institute provided me with inspiration that shaped my career and provided me with purpose to live a meaningful life. 

———————- 

According to the findings of motivational researchers Deci and Ryan (discussed in Part 1 of this blog series), when we are the masters of our own destiny, we are more focused, productive, optimistic, resilient, creative and healthy. 

In retrospect, this is what I found I was experiencing on my Thursday mornings reserved for practicing “the Pankey way.” 

Autonomy as an intrinsic driver works—so starting slow to install fee-for-service just one morning per week is a sound idea. 

The Riddle of Mastery 

And then there is the riddle of mastery. Mastery sits atop L. D. Pankey’s Ladder of Competency. The question is how does one achieve mastery? It could be reduced to “Just do it,” but there is more science. 

In a 1953 paper by Harvard psychologist, David McClelland, a leader in achievement and motivation theory, he wrote an original thesis titled “The  Achievement Motive.” Deci and Ryan acknowledged that this thesis may have described an intrinsic driver even more important than autonomy. They called it competence, but it now is known as mastery. 

The pursuit of mastery has been the subject of numerous scholars and authors from Theresa Amabile and Robert Greene to George Leonard. Most agree that mastery is the desire to get better at what we do. It is the need to continually get better, to improve and to make progress. It is the royal road to growth and flourishing and the opposite of languishing and drudgery…the low rung on Pankey’s Ladder of Competency. 

Working toward worthy goals is pleasurable. Making progress produces the neuro-chemical dopamine. According to Daniel Pink, author of the popular book Drive, “the single biggest motivator by far, is making progress in meaningful work.” 

At my lowest point in dentistry, I felt stuck. Hopeless. My work had lost its meaning. Today we call that burnout. Those Thursday mornings turned on the light…the light of hope. 

We need the freedom to chase mastery. That freedom comes from autonomy. Without the intrinsic driver of autonomy, it is difficult to sustain the drive necessary to achieve mastery…this is based on our biology, not just some story, fairy tale, or business myth. 

Driven by Dopamine and Progress 

After installing the Pankey Thursday mornings where I could practice autonomously, applying the lessons I needed to learn, I slowly put the complex elements of comprehensive relationship dentistry together. I started with the comprehensive examination and built on that by learning all of the components from the mundane mounting of models to the nuances of advanced occlusion. It took time…but driven by dopamine and progress, slowly I was installing my model practice. 

I realized that learning the softer behavioral skills were just as important as the technical, so in time I learned about case presentation. Through the years I learned new skills like digital photography and Power Point. Today’s dentists are mastering digital 3D treatment planning. 

I am retired now and looking back I see how that moment when Dr. Becker suggested the Pankey Morning changed my life. 

Today things are different. There is pressure on young dentists to dive into corporate dentistry or adopt practice models focused solely on extrinsic rewards. Many of these newer models undermine autonomy, which, in my view, is a critical error. The Pankey Institute continues to thrive because it champions the principles of autonomy and mastery that are essential for a fulfilling and sustainable career. By embracing a fee-for-service approach and fostering an environment where personal growth and patient relationships take precedence, dentists can build practices that not only endure but flourish.  

As I reflect on my own journey, I see that the true essence of a rewarding career lies in balancing professional excellence with the autonomy to pursue one’s own vision—a hallmark of L. D. Pankey’s philosophy of practice. 

By Andrea Beerman, DDS 

The late Dr. Andrea Beerman (1978-2013) was a beloved member of the Pankey Institute community. She contributed this to my CoDiscovery blog years ago. I think she would be glad her words will inspire our Pankey community forever. – Paul A. Henny, DDS 

Nothing is at last sacred but the integrity of your own mind. ~Ralph Waldo Emerson 

I love this quote from Emerson and understood it with greater depth as it reconnected me with one of my personal Core Values – originality. 

It reminds me that it is my natural state to follow my own mind – my own unique ideas. Personally, I know I struggle when I try to do things like others. In these instances, I feel like I am not being my authentic self. Sometimes, I have found myself conforming or doing something “the way it’s always been done”, because it seems quicker or easier. 

I don’t have to face the truth or something that may take me to my learning edge if I do things in a rote way. I do not have to make time to enter the “classroom” of silence to know more clearly the path to choose. In these moments, I know I am not realizing the sacredness of my own mind and spirit. With this quote, I am reminded to continue to trust and tap that potential – the beautiful, unique spark of life within me. 

A friend and mentor of mine encouraged me to find a picture of myself when I was a child and put it somewhere I would see it every day. So, now I have a picture of myself at age four on my desk. I keep it in front of me, because sometimes I forget who I am in the midst of my busy days. Of course I am a dentist, but the truth is, deep down – I am still that little girl. That same bright spirit, eager to live fully, and embrace life. All I wanted then was to be loved, accepted and understood. What do I want now? If I answer honestly, I’m not sure the answers are different. 

When I see her picture it makes it really easy for me to forgive myself for all the times I came up short and for the mistakes I’ve made along the way. I see her innocence when I look at this picture, and remember I am truly doing the best I can with what I know. 

So, I have this picture on my desk – to help me remember who I am and what I really want from life. What I’ve learned – it also reminds me of the truth about others – you, my patients, family and friends. 

Beneath the layers of life, lie our bright spirits. I am at my best – in patient interactions and with my friends and family- when I can see others for who they truly are. I think e.e. cummings said it best, “It takes courage to grow up and become who you really are.” 

I wish you my very best in your journey. ~Andrea 

By Paul A. Henny, DDS 

Coping with Stress and Trauma 

If you hang around me long enough, the conversation will eventually turn toward the amazing work of Gabor Maté, MD. Maté is a Canadian of Hungarian decent. He is also Jewish, and barely survived the Nazi invasion of Budapest. He has spent his life studying the effects of trauma on the body, both physical and emotional, and he has authored several books. WHEN A BODY SAYS NO is a favorite of mine. 

All of Maté’s work has a common theme: how we individually cope with stress, and when it’s severe enough, trauma. He also advances the bold theory that most of our diseases and dysfunctions today are self-inflicted, even cancer and autoimmune disorders. They are self-Inflicted in the sense that our body does it to itself in its dysfunctional attempt to cope with chronic stress.  

Maté maintains that chronic stress, particularly in a young child, causes the child to dial back their sensitivity to the environment, to stop paying close attention, because it is or might be too painful. 

If you can follow this line of thought, then you will be led to better understand Mate’s theory regarding the common mental dysfunction ADHD, and even some of the milder forms of autism. Maté states that a stressed mother releases stress hormones into the placenta, and when chronically present, these can negatively influence brain development resulting in autism in some cases.* 

Note: Stress can also originate externally from toxins in the environment and food, and from working and living in toxic cultures. 

Today’s Toxic Culture and It’s Impact on Dental Practice 

Those of you who have heard me speak, have heard me say this before. We live in a very toxic culture today. We all try to cope with too much information, too many decisions, and too many stressful issues lingering in the back of our mind left unresolved. And the outcome is similar: we tend to dial back on our sensitivity to the environment. 

Consequently: 

• We start to think of others as being problems to be resolved instead of people. 

• We stop sensing other people’s feelings. 

• We stop paying attention to our gut and intuition. 

• We start blaming instead of understanding. 

• We start manipulating instead of listening. 

Combine all of these together, it isn’t hard to imagine the daily functioning of the average dental practice: 

• Detached 

• Unauthentic 

• Reductionistic 

• Money-centric 

• High stress 

Hence, lots of personal dissatisfaction occurs among staff and patients. 

Getting Back to Whole-Self, Whole-Person Dentistry 

Whole-person dentistry takes into consideration the whole person physically and emotionally. It requires us to be sensitive to our patients feelings, expectations, and experiences. It also requires us to be sensitive to our own feelings, because without them, we can’t sense others and the world around us accurately.  

Without sensitivity, we work through the day like an autistic child in a bubble, and then wonder why our patients don’t listen to us or take our advice. Thus, the road to true person-centered care must first run through us. And that needs to be a life-long pursuit —the process of getting back in touch with who we truly are inside and how we feel. THAT is what L. D. Pankey was trying to tell us when he said, “Know Yourself.” 

By John C. Cranham, DDS  

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

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

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

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

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

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

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

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

By Paul A. Henny, DDS 

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

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

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

R – Relationships 

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

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

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

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

M – Meaning 

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

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

A – Accomplishments 

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

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

An Easy Acronym to Remember: PERMA 

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

• Positive Emotion 

• Engagement 

• Relationships 

• Meaning 

• Accomplishments 

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

By Paul A. Henny, DDS 

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

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

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

Seligman’s Five Core Elements: 

P – Positive Emotion 

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

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

E – Engagement 

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

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

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

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

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

By John C. Cranham, DDS  

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

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

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

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

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

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

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

Paul A. Henny, DDS 

Oftentimes, perspective is everything. Our thoughts influence our emotions, and then our emotions influence our behavior. How we view our situation as challenging but surmountable, impossible and insurmountable, or somewhere in-between, influences the outcome itself. 

When challenged with a difficult situation, for example, chronic intra-staff turmoil, how we view the problem makes all the difference in the world. A conclusion of “That’s just the way people are and I can’t change it,” yields a very different outcome than “I’ve got to do something about this right now, because it is holding my practice back.” 

In 1960, Bennet Cerf made a $50 bet with Theo Geisel. Bennet, the founder of Random House Publishing, bet Geisel, already a well-known author, that he couldn’t author a successful book that only had fifty different words. 

Bennet lost the bet because Geisel saw the imposed limitation as a creative opportunity. The outcome was a book that would sell over 200 million copies. He titled it “Green Eggs and Ham.” 

It’s old news that dentistry is rapidly changing—and in some ways not for the better. But if we focus on the negatives, we automatically shut down the creative solution-oriented side of our brain. 

When we are locked into a glass-half-empty mindset, we think the glass will surely be even more empty soon. Einstein, Jobs, Edison, and Tesla avoided such thinking. That’s why they just kept on creating and overcoming seemingly impossible odds along the way.  

Thomas Edison said, “Opportunity is missed by most people because it is dressed in overalls and looks like work.”  

Putting on our overall and going to work is precisely how we should approach our challenges. We need to stop ruminating over what we think can’t be accomplished, because chances are quite good that they can be. Failing to do so will cause another day to be lost spinning our wheels instead of moving forward. 

Looking for inspiration and examples of creative opportunities in dentistry? My CoDiscovery book—available on Amazon and in the Pankey Institute’s online store, is full of them.