By Bill Davis, DDS 

My academic goal in the early 1980’s was to be promoted to full professor at the Medical College of Ohio in Toledo. The Dean of the College of Medicine where I worked was my patient. We had been able to do a complete restoration for him using the Pankey Mann Schuyler technique, including the Functional Generated Path. Over the eight weeks it took to do his dentistry, he allowed me to take three hours a week out from his very busy schedule. During our time together, he developed a great deal of gratitude and appreciation for the complexities of restorative dentistry. At the end of his treatment, he told me he was about to retire as the Dean.  He said he wanted to get me promoted to full professor before he left. go beef up my CV for the promotions committee, he recommended I write ten more scientific articles or a book. 

I had no idea what it would take to write a book, but it seemed easier than writing ten more articles. So, off I went to find something to write a book about. The very next week I was at the Pankey Institute, as a visiting faculty member, helping in a C3 class. C3 was the heavy restorative week. The students would equilibrate their models, develop the anterior guidance, do onlay preparations on two opposing quadrants, do wax-ups, and finally cement gold castings.  

Once the student had completed posterior mandibular wax-ups, the visiting faculty would spend most of the night casting the wax-ups into gold in the in-house laboratory. The next day the student would seat the mandibular restorations, prepare the maxillary posterior teeth, do the FGP, and wax-up the maxillary preparations using the stone FGP. The nighttime castings were done by the visiting faculty, and I had volunteered to help with the castings. 

At that time, Christian Sagar was the executive director of the institute. I told Chris I was looking for a topic to write a book about, maybe something for or about the Institute. He told me he had just hired a professional writer to help Dr. Pankey write his philosophy. I told him if there was anything I could do related to the book project, I would be happy to help. As it turned out, Dr. Pankey liked the writer very much, but he became frustrated because the writer knew nothing about dentistry. For example, the writer asked, “What is a facebow?”. This made communication difficult between them. 

It was about a month later when Chris called me and asked if I still wanted to work with Dr. Pankey on his book. I said, “Absolutely.” Again, I had no idea what I was signing myself up to do. The next week, I flew back to the institute for a quick meeting with Chris and Dr. Pankey. We all agreed that I would come down one Tuesday a month and interview Dr. Pankey. I planned to tape all our conversations and then have a local court reporter type them up. I would use the typed transcripts as working documents as we developed the book. 

To be continued… 

By Mary Osborne, RDH  

The late Dr. Bob Barkley said your dental degree gives you the right to practice dentistry, but you have to earn the right to influence your patients. How do we earn the right to influence? How do we get that invitation we need to be invited into influence? 

There is a powerful tool you already have in your practice that can enhance your relationships from the initial visit through continuing care: a Health History. The Medical History forms most offices use are designed to efficiently gather information from patients about existing and previous conditions and diseases. Patients quickly check boxes. But it can do so much more. If you use health histories as opportunities to begin a dialogue with your patients you can also connect with them in the context of a mutually interesting topic — their health! 

I might begin a conversation with a new patient by saying “In this practice we believe that the health of your teeth is related to your overall health. I know you filled out this health history form and we can talk about the specifics of that, but I wonder if we could begin by taking a few minutes for you to tell me a little bit about your health in general.” Beginning with a conversation in that way it takes us out of focus on disease and opens the door to talking about health; what they know about their health, how they feel about it, and what they do to maintain health. Similarly, when a patient comes in for a hygiene visit instead of asking if there are any changes in their medical history, I might ask, “How has your health been since I saw you last?”  If we listen carefully to their stories about health, we will gather important clinical data, and we will also begin to understand their values. We will begin to co-discover what is important to them. 

The concept of co-discovery is frequently seen as having to do with helping the patient see current clinical conditions that we see. In that way, it’s a very useful tool. But I’d like you to begin to also think about co-discovery as a way of being in relationship with your patients. When you take a few minutes to have a dialogue about health you learn about your patients, as they learn about themselves. It is an opportunity for you to learn about their experiences, concerns, and perceived barriers to health—and it’s also an opportunity for patients to learn about themselves. 

In her book, “Kitchen Table Wisdom,” Dr. Rachel Naomi Remen says, “When you listen generously to people they can hear truth in themselves, often for the first time.” If you’ve had a conversation like this you know the magic that occurs as a patient realizes things about themselves they’ve never thought of before. As they speak out loud they hear themselves for the first time. I have found that if I show up as an understanding fellow traveler with a desire to learn, it opens the door for them to begin to see me as a trusted advisor.