By David R. Rice, DDS 

I’m guessing your practice is a whole lot like mine. People can be challenging. Patients are people. Ergo, yes, patients often bring us challenges. With that and 29 years into dentistry, there are a few challenges I’m willing to admit and, like you, work to overcome.  

Our great patients get great dentistry.
Our challenging patients get our best effort.
Our job is to understand who each is, what each wants,
and how we do our best to deliver it. 

As you and I learn the best techniques and technology, we have to understand that many of our patients see the world differently. They see it differently than each other, and they see it differently than we do. At first glance, yes, this is an obstacle. But for those of us willing to spend time focusing on their views, this is a massive opportunity.  

About 20 years ago, the treatment planning and presentation mantra our team developed was: Pizza by the slice or the whole pie? 

 A talented and curious team with character, plus a well-defined process,
always equals complete care and profitable production. 

 Here are the four keys: 

1. Understanding who of our patients wants complete care—the whole pie right now. 

1. Knowing who of our patients isn’t ready for the whole pie today and needs us to serve that complete care one prioritized slice at a time. 

1. Recognizing that some patients love pepperoni, some love veggies, some are all NY and thin crust, some love that Chicago deep dish, and so on. 

1. Delivering each individual patient’s pizza the way they want it without yielding on our quality. 

All our patients come with a story. Some are ready for a whole pie. They want complete care and they want it now. Other patients are overwhelmed by the whole pie. Right or wrong, some past experience makes their yes to the complete care we know they need challenging. We can push them, or we can appreciate where they are and work with them one slice at a time. 

I’m not proposing we compromise our care. I’m offering us all an opportunity to elevate it. Whether you’re scanning and milling, 3D printing, injection molding, direct bonding, or prepping and temping long-term, the materials and technology we have at our fingertips today afford us an incredible ability to segment care. 

Complete-care case acceptance at 90%+ is a reality when we add great communication skills to the clinical skills we’ve worked so diligently to achieve. Today, I challenge you to assess, calibrate, and elevate your ability to deliver pizza by the slice…or the whole pie. 

Like many aspiring students on a track toward dental school, I studied Latin with the hope that someday my understanding of Latin root word forms would translate into a greater value to me as a dentist.

That day never really came as an obvious epiphany, but rather as thousands of subtle moments later while reading, listening, or learning.

Not Your Standard Definition…

And it also came the day when that I started to attend The Pankey Institute and saw the tag line was “quid pro quo,” and it confused me. It confused me because all standard definitions of quid pro quo sound transactional – something is given or taken in return for something else, so it did not line up with the Institute’s preferred definition: “Give before receiving,” which has a much different tone…a much different intention.

Even today, due to my Latin training when I see “quid pro quo,” I have to stop myself and insert the Pankey definition when thinking about my profession. And I would argue that it is deeply important that we all do so, because viewing dentistry primarily as a transactional business is to devalue it down to a highly skilled trade. And this totally neglects the spiritual and more holistic aspects of our work which are the true source of joy, fulfillment, and meaning over long careers – a lesson Dr. Pankey routinely taught.

The Pankey Institute’s definition of quid pro quo is more aligned with words like Scott Peck’s “love” (selflessly giving to another with the sole agenda of helping them to grow and to become healthier and more fully functioning). The Institute’s definition is more aligned with trust and investing…investing in the sense that we believe that if we selflessly facilitate in others’ greater self-knowledge, self-understanding, and personal empowerment, they will reciprocate by gifting us an opportunity to help them achieve their goals.

What is the quid? What is the quo?

In other words, we offer our true and sincere caring as the “quid,” and if done in the right way, at the right time, with the right person we get the “quo” in return, as a reward experienced as a new trusting and deeply helpful relationship which yields respect, admiration, and appreciation in an ongoing fashion.

We get emotional confirmation in return. As dentists serving patients in our professional capacity, we get proper financial compensation in return as a SYMBOL of how much the person values the relationship and what it has brought into their life.

“Because I care.”

In a recent sermon, our minister said: “The summons for us as people of God…those who are called to be full of compassion, mercy, and love, is to live in such a way that people ask ‘Why’? Why do you feed me? Why do you clothe me? Why do you visit me when I am sick? Why do you do these things for me? And our response will be, simply, because I care…because I love you.”

Quid pro quo…THAT is what it means to me.