Who Wants the Whole Pie? 

May 27, 2024 David Rice DDS

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. 

  

Related Course

Creating Financial Freedom

DATE: March 6 2025 @ 8:00 am - March 8 2025 @ 2:00 pm

Location: The Pankey Institute

CE HOURS: 16

Dentist Tuition: $ 2795

Single Occupancy with Ensuite Private Bath (per night): $ 345

Achieving Financial Freedom is Within Your Reach!   Would you like to have less fear, confusion and/or frustration around any aspect of working with money in your life, work, or when…

Learn More>

About Author

Default Avatar
David Rice DDS

FIND A PANKEY DENTIST OR TECHNICIAN

I AM A
I AM INTERESTED IN

VIEW COURSE CALENDAR

 Ask Questions About How Your Patient Feels 

May 13, 2024 Paul Henny DDS

Paul Henny DDS

I wrote about this topic last October in The Never-Ending Interview and wanted to revisit it to connect the timeless teachings with my most recent thoughts. Bear with me as I recount some of the history from that previous article. 

Dr. F. Harold Wirth had a very successful restorative practice in downtown New Orleans but he always felt that something was missing until he met Dr. L.D. Pankey and was influenced by his teachings. Dr. Wirth became a missionary for Dr. Pankey’s philosophy of dentistry and life, and he gave Dr. Pankey most of the credit for developing a deeper understanding of people, both physically and emotionally.  

One of Dr. Wirth’s key messages from the podium was that dentists are always presenting the case, even from the beginning of their first encounter with the patient. Another key message was that the patient’s feelings matter in accepting care and the patient interview should be forever ongoing. 

He said, “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.” 

He said, “Ask questions that have to do with how the person feels. A case history is exploring what happened. An interview is about how they feel! You need to understand the difference!” 

We might ask, “Since I last saw you, have you noticed any changes in your oral health? How do you feel about these changes?” We might ask, “How do you feel about the appearance of your teeth?” or “How do you feel about the restorations we did?” We might ask, “At your last visit, you talked about the possibility of doing ortho; how do you feel about that now?” We might ask, “You mentioned last visit that you weren’t looking forward to Thanksgiving because it was difficult to eat all your favorite foods. Would you feel good about revisiting the possibility of replacing your denture with something more stable?”  

Do you feel better after a long conversation with someone who knows you well on the emotional level? I know I do. Over time, those kinds of conversations cause us to feel more positive and hopeful. They occur when a person gifts us their full attention while making no attempt to judge. And because we experience no judgment, we share more feelings, which leads us into an even deeper level of self-understanding. 

Doctor-patient conversations that tap into how a patient is feeling on an emotional level enable patients to grow in trust and to become more open to the possibilities we offer.  

In her recent blog series, Mary Osborne has encouraged us to journey toward health with our patients as fellow travelers because we all have health issues we hope to resolve. We can make connections over shared feelings and hopes. These connections bond us so we can pursue a mutual, positive goal with our patient.  

What I love and sticks with me from Mary’s blog is that the medical health review during each preclinical interview is an ideal time to check-in about feelings regarding health in general. So, if you and your team are not doing that now, you might want to add a question about the patient’s feelings about their current health. It’s ideal if the doctor or hygienist  asks the question. It may be as simple as “How do you feel about your overall health?” Wait for the patient to think and speak.  

One of my favorite quotes is this: 

Any kind of gesture that pulls another living soul out of despair is indistinguishable from magic. – Michael Xavier, Author 

The medical history review is a prime opportunity to demonstrate we care. Expanding our preclinical interview to routinely ask one or more questions that surface feelings related to health will give us opportunities to touch hearts on a deeper level. This will engender greater trust so patients more readily accept us as partners in their health.  

Related Course

Mastering Treatment Planning

DATE: October 2 2025 @ 8:00 am - October 4 2025 @ 1:30 pm

Location: The Pankey Institute

CE HOURS: 25.5

Tuition: $ 4795

Single Occupancy with Ensuite Private Bath (per night): $ 345

 MASTERING TREATMENT PLANNING Course Description In our discussions with participants in both the Essentials and Mastery level courses, we continue to hear the desire to help establish better systems for…

Learn More>

About Author

User Image
Paul Henny DDS

Dr. Paul Henny maintains an esthetically-focused restorative practice in Roanoke, Virginia. Additionally, he has been a national speaker in dentistry, a visiting faculty member of the Pankey Institute, and visiting lecturer at the Jefferson College or Health Sciences. Dr. Henny has been a member of the Roanoke Valley Dental Society, The Academy of General Dentistry, The American College of Oral Implantology, The American Academy of Cosmetic Dentistry, and is a Fellow of the International Congress of Oral Implantology. He is Past President and co-founder of the Robert F. Barkley Dental Study Club.

FIND A PANKEY DENTIST OR TECHNICIAN

I AM A
I AM INTERESTED IN

VIEW COURSE CALENDAR

What I Brought Back from Napa (and it wasn’t wine!)

February 2, 2024 Robyn Reis

What I Brought Back from Napa (and it wasn’t wine!) 

Robyn Reis, Dental Practice Coach 

A while back, I made a business trip to Napa Valley. I was enjoying lunch on the patio of the Ottimo Café which is attached to a shop featuring wines, gourmet provisions, and culinary tools. It was a lovely day, and I was out in the beautiful California sun by choice. A nearby covered area provided shade, and there were multiple diners inside the shop waiting for those shaded tables. 

The maître d’ had given me a choice of tables and made sure I was comfortable. The food, wine and service were excellent. 

A family of four wandered over and sat down at an empty table in the sun. One of the waiters approached them and must have told them there was a line inside because they got up and went into the building. A few minutes later, they came out escorted and sat with menus at the same table they had left. There was obviously a system in place and it was working. Not long after, the two children became unhappy sitting in the sun. 

Being a parent myself I empathized with the parents as they struggled to keep the kids entertained. The little boy put his shirt over his head to block the sun, and I watched the dad looking at the covered area to monitor those shaded tables. As people from the shaded area got up, the tables were cleared, and the maître d’ seated more people.  

There was a lag between one table being bussed and people being seated because in a flash, the family left their table and sat down at a shaded table. The maître d’ approached them again. The family was speaking a different language and the father was using hand gestures. Obviously, communication was difficult. Ultimately, the family remained seated at the shaded table. There was no doubt that “good” customer service for this family was out of balance with “good” customer service for the people inside waiting to be seated. 

It was fascinating to observe the maître d’ having a conversation with the waiter who had been serving the family. My guess is that he was saying something like, “Hey, stay alert to maintain the seating system.” The waiter only nodded. It reminded me of a dental practice where you may have a patient in the hygiene chair and think to yourself, “Oh, it’s a small filling. Let’s go ahead and take care of that today.” Unbeknownst to you, someone may have walked in the front door hoping to be seen, and the front office thinks the walk-in can be accommodated based on the schedule.  

In both situations, it’s best not to make assumptions and communicate, communicate, communicate! In the back, check with the front to see if that filling can be done now. In the front, check with the back to see if the walk-in can be accommodated now. And in the case of a scheduled patient waiting in reception, you don’t want to keep them waiting unless it is really unavoidable.  

Sometimes we’re going to disappoint someone, however, we want to plan our schedule so no one is left waiting. We’re not in the restaurant business where customers are willing to wait in line for a seat at our table. Despite a fine reputation, if you cannot see new patients within a reasonable timeframe, they are going to call elsewhere.  

Look at your own schedule and converse with your team. Do you have an adequate number of new patient appointments available? Are you allotting sufficient time for each type of procedure? How good is your back-to-front and front-to-back communication? Do you keep patients waiting? 

My meal and business trip were a success in Napa. And while I didn’t bring back any wine, I did bring back the importance of having systems in place to ensure a great experience for every patient at every visit. 

Related Course

The Pankey Assistant’s Experience

DATE: June 12 2025 @ 12:00 pm - June 14 2025 @ 7:00 pm

Location: The Pankey Institute

CE HOURS: 17

Regular Tuition: $ 2050

Single Occupancy Room with Ensuite Bath (Per Night): $ 345

This “can’t miss” course will empower Dental Assistants to bring their skills to excellence! During this dynamic hands-on course, led by Pankey clinical team member, Sandra Caicedo, participants will learn…

Learn More>

About Author

Default Avatar
Robyn Reis

FIND A PANKEY DENTIST OR TECHNICIAN

I AM A
I AM INTERESTED IN

VIEW COURSE CALENDAR