Partnering in Health Part 2: There Is No Suffering We Cannot Care About  

May 6, 2024 Mary Osborne RDH

By Mary Osborne, RDH  

Think for a moment: Is there a change you think you could make in your life that would contribute positively to your health? Is there anything you could be doing—or not doing—that could improve your overall health and wellbeing? Most of us can think of something we could do, or do more consistently, to improve our health. Next, ask yourself if the reason you have not made the change you need to make is because you do not have enough information. Our clinical training taught us that if we give people the right information they will change their behaviors. It’s easy to get disappointed in ourselves and our patients when that turns out to not always be true.   

Reflecting on our own past and current health challenges is a way to remind ourselves that health is a journey, not just a set of strategies. What makes perfect sense to us now, may not have been relevant 20 years ago. Often we have heard the relevant information before but were slow to act on it. We may have conflicting priorities, such as time, or money. We may have had fears or doubts. When we can look at our own journey with understanding and compassion we are better able to see our patients that way.   

I remember a patient who came to us with a lot of dentistry that needed to be done. As we talked with her about recommendations for treatment, her eyes welled up with tears. “It’s nothing,” she said when I asked her what the tears were about. Eventually she shared with us that she and her family had been saving up to build a deck on their house. Doing the dentistry she knew she needed would mean they could not build the deck. There was a time when I might have thought, “What’s more important, a deck or your dental health?!?” But I was moved by her struggle. I can’t judge what a deck may mean to her and her family, but I can relate to her sadness in letting go of something they had been saving toward.   

As you advise patients, it’s helpful to share that are you on a path to better health yourself, and that it is not always easy. In this way we can step outside of the role of “expert” and come to our conversations as fellow travelers. And when we do come as fellow travelers, we bring our empathy, our humanity, and we allow ourselves to feel compassion. We are likeable.  

One of my favorite books is Dr. Rachel Naomi Remen’s Kitchen Table Wisdom: Stories That Heal. She quotes the psychologist Carl Rogers, who said:  

Before every session, I take a moment to remember my humanity. There is no experience that this man has that I cannot share with him, no fear that I cannot understand, no suffering that I cannot care about, because I too am human. No matter how deep his wound, he does not need to be ashamed in front of me. I too am vulnerable. And because of this, I am enough. Whatever his story, he no longer needs to be alone with it. This is what will allow his healing to begin. 

Because we are on a journey of becoming healthier just like everyone else, we can sit side by side with a patient. We can say, “I get it. It’s not always easy.” We can allow ourselves to feel compassion—that urge to genuinely help someone, and gently invite them to understand they are no longer alone.

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About Author

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Mary Osborne RDH

Mary is known internationally as a writer and speaker on patient care and communication. Her writing has been acclaimed in respected print and online publications. She is widely known at dental meetings in the U.S., Canada, and Europe as a knowledgeable and dynamic speaker. Her passion for dentistry inspires individuals and groups to bring the best of themselves to their work, and to fully embrace the difference they make in the lives of those they serve.

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L. D. Pankey’s Philosophy Starts to Unfold

December 5, 2022 Bill Davis

When L.D. Pankey returned to Coral Gables from the International Congress of Dentists in Paris, in 1931, knew he needed additional education if he was going to follow his personal commitment of not extracting any more teeth. With a recommendation from his new friend in Paris, Dr. Daniel Hally-Smith, the dentist, L.D. wanted to emulate, he signed up for a three-month summer course at Northwestern University in Chicago.

The program was designed to cover all the phases of modern dentistry including how to interview patients and do a proper clinical tour of the mouth so the student could determine what was really needed to give their patients optimum dental care. They were saturated with topics both technically and psychologically related to diagnosis and treatment planning concepts. Most of the information presented was focused on clinical procedures.

The patient psychology course was taught by George Crane PhD. During that summer, George Crane, a trained psychologist, was between his freshman and sophomore years in medical school at Northwestern. He had been hired to teach a summer course to physicians and dentists on how they could better understand and communicate with the patient.

At that time, there were no definitive textbooks about doctor/patient communications. During his lectures Dr. Crane brought in loose-leaf handouts for the class. The handouts later became the framework for his first book on applied psychology. Crane’s course was the highlight of L.D.’s summer, and it turned out Dr. Crane’s course became the foundation of what became the Pankey Philosophy.

Crane’s lectures were centered around psychology to be used by doctors to develop interpersonal relationships between the professional and the patient. The course included an overview of Carl Jung’s work, defining Jung’s four personality types: the introvert, the extrovert, the ambivert and the compensated types. The students also looked closely at the 1905 Binet-Simon Scale to determine the intellectual capacity of children. They studied the first “mental horsepower” test – otherwise known as the IQ test.

Later, when L.D. developed his own philosophy, he used much of the Crane course ideas for his Dental IQ, patient intellectual, sociological, and economic classifications. After finishing the George Crane course, L.D. felt confident that he had taken a giant step toward gaining the knowledge and communications skills that were needed in his practice.

Dr. Crane was a strong proponent of the balanced life and spent a great deal of time discussing Cabot’s “Cross of Life” which emphasized the need to balance work, play, love, and worship for a truly fulfilling life. The cross diagram was developed by Richard C. Cabot (1869-1939), who was a physician, philosopher, and Unitarian minister.

Following his graduation from Harvard University Divinity and Medical School, Cabot started his clinical work at Massachusetts General Hospital where he established a hospital based Social Service Department and became the first Chairman of the Department of Social Ethics at Harvard. Over the years, Cabot wrote twelve books on Medicine and Ethics.

Cabot also became a major educational leader in medicine by publishing monthly “Cabot Cases” in The New England Journal of Medicine. Each month physicians in local study clubs throughout the county would read and study the information provided by Cabot. They would try to determine the diagnosis for the patients in the case. The final diagnosis was provided the following month in The New England Journal of Medicine.

Crane assigned one of the Cabot books, What Men Live By, to L.D. and his classmates to read. The book explored how to achieve personal happiness. According to Cabot, happiness could be achieved by striving for balance in personal life. When explaining this concept to his patients and other professionals, Cabot recommended drawing a simple diagram with Happiness in the middle and four arms labeled Work, Play, Love, and Worship.

What Men Live By was published in 1913 and has long been out of print. Many of the references seem archaic; however, the basic principle of balance has stood the test of time. There are needs for all of us to be productive, to enjoy daily life, to have people in our lives that we care about, and to extend our interests beyond ourselves. An excess or a deprivation of any of these basic needs of life can set our lives out of balance, destroy our sense of self-worth, dull our enjoyment of life, or alienate us from our fellow human beings.

When L.D. Pankey developed his philosophy, he uses the Cabot Cross as a starting point for dentists on their journey to fine personal happiness.

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About Author

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Bill Davis

William J. Davis DDS, MS is practicing dentist and a Professor at the University of Toledo in the College Of Medicine. He has been directing a hospital based General Practice Residency for past 40 years. Formal education at Marquette, Sloan Kettering Michigan, the Pankey Institute and Northwestern. In 1987 he co-authored a book with Dr. L.D. Pankey, “A Philosophy of the Practice of Dentistry”. Bill has been married to his wife, Pamela, for 50 years. They have three adult sons and four grandchildren. When not practicing dentistry he teaches flying.

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The Four Burner Theory

May 16, 2020 Paul Henny DDS

Imagine your life depicted as a metaphorical four-burner stovetop, with each burner representing a major quadrant of your life, and those quadrants being:  

FAMILY        CAREER 

HEALTH       FRIENDS
 

This thought experiment is called “The Four Burner’s Theory,” and it is similar in some ways to L.D. Pankey’s Cross of Life. Both concepts imply that the pursuit of life balance is a process, not an event, and that each quadrant represents a cluster of related values-based decisions that  lead us into our future. 

Obviously, there are many times in life, during which by choice or circumstance, we find our life is severely out of balance, for example, dental school, parenting children, starting a practice, and so on. 

The Four Burners Theory tells us that to be successful in business we need to initially “turn down” two burners to establish an initial beachhead. But frankly, we don’t want to hear that kind of message. Rather, we would rather hear that we can have it all and soon.  

This impatient, short-term mindset has now permeated our culture, even to the point where many people seem to think that somehow “having it all” is their birthright. But viewing life balance as a birthright is a problematic perspective, because it can never be fully realized, and if we cling to it too firmly, it becomes easy for us to start to feel like a victim. 

And victims don’t act. Instead, they blame-shift. They sulk. They over-think. And they fail to act in ways that will move them toward greater life balance. A much more realistic perspective is to acknowledge that our life is full of seasons, around which we need to be aware, adapt, accept, and respond appropriately. 

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About Author

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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.

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