The Story of Dr. Daniel Hally-Smith Part 2—Tell Your Patients the Optimum Treatment, so They Can Decide Based on Knowledge

October 24, 2022 Bill Davis

When L.D. Pankey visited Dr. Hally-Smith in Paris, Hally-Smith was curious about how L.D. could afford to come to the International Dental Congress in Paris. L.D. told him about his benefactor, Mrs. Blanchard. Hally-Smith said, “That is wonderful, just wonderful!” Turning serious, he then said, “You know of course that you will make it. Your benefactor has started the process for you but there are many things you will have to do before you will be there.”

Hally-Smith gave L.D. a personal tour of his office. The office had five dental technicians and three associate dentists. His personal dental assistant was a White Russian woman dentist who had been driven out of Russia during the Russian Revolution. She was wearing a long, highly starched nurse’s gown that went all the way to her ankles. L.D. began to understand what Mrs. Blanchard, his benefactor, was talking about. She wanted him to know some of the outstanding dentists in the world! When she suggested he take the trip, she said, “I think you have the potential of becoming an outstanding dentist.” This was after he had completed her dental work.

L.D.’s time at the Dental Congress was a busy one. There was so much to learn! Even though Taggart had cast the first inlay nineteen years earlier in 1912 by the “lost wax” technique, investments and casting techniques were far from perfect. Many slides were shown, and many papers were given on new techniques in restorative dentistry. New impression materials and impression techniques were shown in lectures and table clinics. Much of the denture information did not interest L.D. because he was mainly interested in saving teeth.

After their first meeting, L.D. made rearrangements to spend an additional week in Paris with Dr. Hally-Smith. Hally-Smith was old enough to be L.D.’s father. One morning, they were talking about patient communications, and Hally-Smith asked, “Did you ever take the Bosworth course?” L.D. said he had taken the course.

Hally-Smith said, “Isn’t Bosworth the dental supply man who suggests dentists say this when speaking with their patients, “I can do a good job for so much, do a halfway job for this much, or I louse it up at a very reasonable price’?” L.D. answered by saying, “That is not exactly what Bosworth says but pretty close.”

Hally-Smith then asked, “L.D., do you like that approach?”

L.D. said, “No, I’ve never liked it, but I have tried it.”

Dr. Hally-Smith became serious and said, “L.D. it all starts with communication. You should tell your patient the optimum way their dentistry should be done. Then what the patient decides is their own decision. If you’re going to make a compromise with them, then compromise based on your patient’s knowledge, not because you have prejudged them. You should tell every patient what optimum dental care would do for them. If they decide to go elsewhere, leave the door open for them to come back later. I have found over the years that a lot of these people return after they’ve lost half their teeth.”

They discussed this premise for a while longer, and L.D. realized how right Hally-Smith was. Tell patients about the best treatment plan. Then, if there were any compromising to be done, let them decide. L.D. realized Dr. Hally-Smith’s way of communicating was easier said than done.

When L.D. returned home from Paris, he never felt comfortable using the Bosworth Plan again. Instead, he presented patients with the optimum treatment plan. If they resisted, he would compromise and do only what they would allow or just put off the work, except for emergencies. After a while, L.D. began calling this compromise time a “Holding Program” – a time of doing only what had to be done until the patient chose to move on to optimum care. With enough time, patients would usually follow through with optimum care, but not always.

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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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