By John C. Cranham, DDS 

Even today, after decades into family life, dental practice, and continuing dental education, I sit down every January to outline my BHAGs (Big Hairy Audacious Goals) for the year. I block out the first Monday after Christmas to do this, but for the previous month, I’ve been thinking about what new goals will excite me most. I commonly do this type of thinking while I am exercising and driving.  

It’s during these alone times that I can intentionally mull over the things I could do next. I pay close attention to which possibilities excite me most. Oftentimes, these are goals that I feel will benefit others. 

Successful people have the ability to create daily behaviors that direct themselves towards their goals and take them forward on steppingstones. One of the simplest, yet powerful things I witnessed Dr. Pete Dawson do is how he started each day. He would go to his desk and spend 15 to 20 minutes writing six things on a 3×5 card. These weren’t a To Do list. These were six things that would direct him toward his next BHAG. He would place the card in his breast pocket. He did this day in and day out. 

Two weeks before he passed, Pete came to my lake house on oxygen. When he arrived, I had to help him out of the car and into the house on his walker. I looked at his shirt pocket, and there it was, the 3×5 card.  

We don’t have to use 3×5 cards to make notes for ourselves. We can use our phones. But it is powerful to reflect daily on steps that will take us in the direction we want to go and record those steps to lock them in our memory.  

In dentistry, we need to carve out habitual time to think about our goals and steppingstones. We need to carve out time to take the identified steps. The point is to have a system in place where you are thinking about it every day, because there is so much coming at us all day long that we are at risk of drowning in the noise.  

When we get caught up in the mundane, life is less interesting and less fulfilling. At least that has been my experience. When you sense you are becoming bored, you might just need to identify the next big goal that excites you. The challenge of getting there will bring you back to full life. 

By Bill Davis, DDS 

During the first two years of the book project, the institute was still at the DuPont Plaza Hotel in Miami. My schedule was simple. I would fly down on the red eye from Detroit Monday night after my practice time and stay at one of the apartments used by the visiting faculty next to the hotel. Dr. Pankey and I would meet for breakfast at 8 a.m. Then, we would go over to a room in the Institute to talk and I would record everything. 

At our very first meeting, I realized why everyone was taken with Dr. Pankey and his philosophy. We sat down for breakfast and started with the usual small talk. Then L.D. looked me directly in the eyes and asked, “Bill, may I ask you a couple of questions?”  

I looked back at him, and I said, “Yes, of course”.  

He then asked, “Do you tell your wife you love her every day?”. 

I was a little taken aback by the question and said, “I think I do”. 

L.D. then said, “You should.”  

From that day forward, I made it a point to tell Pam I loved her every day. If I was out of town, I would always call long distance and now I text her. That question made me realize how important Dr. Pankey felt it was for us to stay closely connected to our loved ones. I am sure that gesture has helped me during my 57 years of marriage to my best friend Pamela.

L. D.’s second question was, “Do you save regularly for your retirement?”

I told him, “Yes, I do. At the end of the year, when all my bills and taxes are paid, I send most of the remaining money to my Merrill Lynch investment account”.  

Dr. Pankey told me that was okay, but not a good way to save real money. He recommended that when I got my paychecks, one from the university and one from my private practice, I immediately sit down and write a separate check for 10% of my total net income for the week and put it in the investment account.  

Then he said, “Live on the budgeted remaining 90%.”  

I realized he was following his philosophy and wanted me to be sure I could take care of my family. Over the years, his advice has been spot-on. These first two questions were my introduction to his philosophy. 

To be continued… 

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 Barry F. Polansky, DMD  

An excerpt from Spare the knives…save the dental souls! published in Dental Economics, March 1, 2002 

For many in our profession, the daily onslaught of difficult procedures, rejected treatment plans, assistants who just don’t get it, the end-of-the-month cash-flow crunch and other office “fires” can lead to a fate not unlike the victims of the Chinese torture. 

The ancient Chinese employed a form of slow execution called “The Death of a Thousand Cuts” in which the victim was sliced repeatedly with a knife. Each individual wound was superficial and nonlethal, but the accumulation of hundreds of cuts proved fatal and caused much more pain and suffering than one sure stroke. 

Henry David Thoreau said, “The mass of men lead lives of quiet desperation.” I’ve come to believe that, in dentistry, there are a higher proportion of people in that category than normal. We start our dental practices to give ourselves more life; yet, inevitably, our practices slowly suck up the lives we have. 

Ironically, it wasn’t the dentistry that caused my distress. It was the “business” of dentistry that devoured my soul. All things being equal, I love the clinical side of my profession. But all the problems that confronted me in my practice—social, financial, and physical, during the normal day-to-day routine were overwhelming. The business of dentistry is hard! Unfortunately, I didn’t quite recognize that at first. 

Like many people, I studied philosophy at college, enjoying the sense of order that a well-constructed framework of ideas could bring to an otherwise indecipherable argument or problem. So, when faced with such a myriad of problems in the early days of my practice, quite naturally, I began to search for a philosophy of dentistry that would help me make sense of the issues at play. 

I looked to successful dentists to find my mentors, and, at the time, there were some great ones—Pankey, Dawson, Reed, Becker, Barkley. What I learned was a real eye-opener! I thought the antidote to my woes would be advanced clinical skills; however, these dental gurus were talking just as much about staff management, financial control, and the philosophy of running a business as they were about how to cut a great crown prep! I was surprised, but it made sense. I put these ideas into effect, and my practice turned the corner from that time on. 

Gary M. DeWood, DDS, MS 

Challenging what you think you know will pique your curiosity and lead to pursuing more information and interactions from which you learn. Challenging what you think you know leads to learning with the benefits of brain development, longer life, emotional wellbeing, and inspiration to share yourself in new ways with others. Simply said, challenging what you know prompts intentional learning to BE more expansive, to grow. 

My hope is that after reading this blog series, you will take time to reflect on the following statements from three of the many people who have influenced me over the years. 

Quotes from Daniel J. Boorstin, historian and Pulitzer Prize winning author of The Americans: 

Education is learning what you didn’t even know you didn’t know. 

The single largest obstacle to discovery is NOT ignorance; it is the illusion of knowledge. 

Quote from Herbert E. Blumenthal, DDS: 

Don’t believe everything you think. 

Quotes from William J. Davis, DDS, co-author with L. D. Pankey of A Philosophy of the Practice of Dentistry: 

Learning best takes place when we “live” a philosophy, meaning living in a state of inquiry based on our values, knowledge, and goals. 

When the late Dr. L.D. Pankey decided to devote his life to saving teeth, he was forced to ask himself, “How can I help people keep all of their teeth all of their lives?” In 1925 L.D. didn’t know the answer or even if there was an answer. When he decided to never extract another good tooth, he was taking an enormous professional and economic risk. He was able to uncover and develop many principles that have proven instrumental in our understanding of restorative dentistry and patient communication.  

Philosophy, in its most valuable form, is more concerned with the right questions than the right answers. 

Now that I am back actively within the Pankey community of learning and inspiration, I have four wishes for you: 

• May you come face-to-face daily with something that you don’t even know you don’t know.  
• May you not be blinded by what you think you do know when it shows up and fail to see it because you believe everything you think.  
• May you ask questions and intentionally seek answers. 
• May intentional leisure learning be not just what you do but how you live. 

Few people have worked as tirelessly to advance the thinking of L.D. Pankey and Bob Barkley as Rich Green DDS, MBA. Recently, I ran across some of Rich’s quotes that truly capture the nature of his experience in dentistry.

A behaviorist’s definition of learning is changed behavior demonstrated. As my personal growth allowed, I relaxed and thought more about creating an experience in which my patients had the opportunity to learn something, which would challenge them to change behaviors that had negative impact on their life and health. The more I looked at those “learning moments,” the more they appeared. The learning occurred as I helped patients clarify what was most important to them and what they wanted to learn. As I facilitated a learning process with my patients, they were able to discover for themselves those two things, and then they were able to take their own steps in personal growth…People tend to support what they help to create.

Below Rich is speaking of his long-term work with Don Clifton and The Gallop Organization.

As we studied the uniqueness of individual private practices, one finding was the tendency of a dentist and team to unwittingly create barriers to the patient’s progress when what they really wanted was to create pathways to greater health. The barriers were typically caused by an impatient or judgmental attitude and the “teach and tell” method of attempting to change behavior.

In this last passage, Rich speaks to the central theme Bob Barkley taught across the country following the publication of his book, Successful Preventive Dental Practices. In the mid 1960’s, Bob worked closely with Nate Kohn Jr, PhD to dramatically reorganize how he interacted with his patients. In so doing, he largely abandoned what Rich refers to here as “teach and tell,” in lieu of what Bob called “CoDiscovery.” Because Nate Kohn, Jr. had his PhD in Educational Psychology, he exposed Bob to the latest thinking in learning science – and much of it had been influenced by the work of Carl Rogers, PhD.

It fascinates me that we can now go back and understand how all of this evolved, as well as why Bob chose to do things in a very specific way. Perhaps most important is how it all evolved through the hearts and missions of both Bob and Rich. And this last point is key, because if the motivation behind a person’s use of CoDiscovery doesn’t emanate from their heart, from a deeply sincere desire to help others grow and realize greater health through that growth, it won’t work. Instead, it will be perceived as being manipulative and thwart the desired outcome.

The “unwittingly created barriers” will block the passage of the relationship to the next interpersonal level — the level necessary to establish enough trust to proceed to the needed care. CoDisovery is an intentional practice, born out of a personal philosophy toward life and practice. This heartfelt way of interacting with others sometimes feels slow, but it is the fastest way I know to truly help others.