Posted on November 24, 2017

How do we get our practice to produce great results, year-in and year out?

As we are all aware, this can be a challenging goal, even when our Care Team is full of strong, smart, highly skilled, and well-intended people. And this is because it’s hard to keep everyone aligned and moving in the same direction over time when their environment is constantly changing…distractions constantly occurring, and limited resources require instantaneous reallocation to best meet the demands of the moment.

Most of our Care Team members spend the majority of their time executing their day-to-day responsibilities in an exacting fashion, so it’s easy for them to lose sight of the bigger picture…the preferred  trajectory of the practice over time.

Our daily practice demands present us with a challenging paradox – they are critical to our functioning while at the same time can maintain our attention on lower level goals too much of the time.

On the other end of the spectrum, it can also be challenging for us to keep our heads out of the clouds. Dreaming big is important, but unless our lofty aspirations are backed by a concrete plan to achieve them, they’ll remain dreams.

Consequently, a significant part of our leadership responsibility as a Relationship-based, Health-centered Dentist lies in keeping things in the proper perspective -even when the “weeds” of every day life predominate.

One way to do this is to graphically create a ‘Pyramid of Clarity’. The Pyramid visually shows how our longer-term aspirations are only possible when they are built on top of our shared values, which then infuse our short-term goals.

In other words, we must have a synchronization of our Practice Philosophy with our daily actions. And that is only possible when we have invested the time in co-creating a written practice philosophy with our team.

When we co-own a written Practice Philosophy with our Care Team  – a “practice constitution” if you will – we can regularly use it as a touchstone to stay focused, bolster our commitments, and facilitate spur-of-the-moment decisions which are always in line with the bigger picture.

When entire practices have clarity of purpose, plan, and responsibility, they’re able to do their best work even in the middle of the thickest of weeds.

Does your practice have a written Practice Philosophy Statement? You should, Bob Barkley felt it was the one single most important task you need to accomplish with your Team.

Paul A Henny, DDS

Thought Experiments LLC, ©2017

Posted on November 22, 2017

The Path of a Master…..Dr. Pankey’s Journey

The path of a master is a lifelong commitment to learning – doing – and applying what was learned. It is the discipline of clarifying the things that are most important to us and what truly gives our life meaning. Through continual learning we create the person we were destined to become and realize our impossible dream. ​​This is a story of one such man, a very uncommon man, whose commitment to a purpose greater than himself changed the course of dentistry and the reason there is a Pankey Institute today. Our story begins with the man who greatly influenced Dr. Pankey.

Enter Daniel-Hally Smith
• Daniel-Hally Smith was born in 1879 in Jamestown, Illinois on his parent’s farm where they bred and raised horses.
• As a young child he thought he wanted to be a physician like his relative.
• One day Daniel and his cousin argued over the last cookie in the jar, they decided to cut the cookie in half. So, naturally, the best thing to use would be a hatchet.
• His cousin held the cookie – Daniel swung the hatchet – yes, you guessed it; he severed his cousin’s finger. He was so horrified at the sight of blood he decided never to be a physician. Later, as he grew older, he became attracted to working with gold and porcelain in restorative dentistry and avoid surgery.
The Summer of 1899
• Daniel attended Northwestern University Dental College from 1898-1901, when G.V. Black was Dean.
• During the summer, after his freshman year, the family finances reversed making it doubtful that he would be able to return to school in the fall.
• He worked in the office of Dr. Frank Davis on Michigan Avenue doing odd jobs.
Enter Mrs. Murphy
• One day while Dr. Davis and family were on vacation, Daniel was cleaning the office when he hears music coming from Michigan Avenue below. He looked out the window and saw a circus parade. He went down to the street to watch the parade pass by.
• Down on the street the parade stopped – Mrs. Murphy, a chimpanzee was in the cage in front of him.
• He noticed that the chimp’s upper lip was severely swollen, and there was swelling under both eyes.
• He went to the trainer and asked what the matter was with the animal’s face. The trainer said they shortened the long “eye teeth” and could not get anyone to treat the animal now.
• Daniel told the trainer he was a dental student and he could help her if he would bring Mrs. Murphy up to the office after the parade. “I’ll bet she has abscessed teeth.”
• Both of Mrs. Murphy’s cuspids were abscessed – Gently, ever so gently, he opened the nerve canals to drain, releasing the pressure. Next day she returned with almost no swelling.
• Several appointments later he filled the canals and placed gold crowns on both cuspids (most likely – gold shell crowns) constantly being careful not to cause pain.
• At the last appointment – Mrs. Murphy jumped into Daniel’s lap and gave him a big hug. The trainer said she only did that with people who were especially nice to her.
• Daniel said, “My reward was enormous! At that moment I felt so enriched. I knew that I could experience these feelings and help mankind through my profession.”
• “As they left, the trainer handed me a box. The gift was enough money to assure my re-enrollment at Northwestern. We hadn’t discussed money at all. I hadn’t done the work with money in mind. What a lesson I had learned, and at the right time in my life.”
• For several years the circus advertisements included a picture of Mrs. Murphy, the only chimpanzee in the world with gold teeth.
Starting in Practice
• Daniel graduated from Northwestern University Dental College in 1901.
• He became an associate to Dr. Goode – famous esthetic restorative dentist on Michigan Ave. Daniel learned advanced technical dentistry and was impressed by how much he didn’t know.
• He met many wealthy patients and liked the life style money could buy.
• Daniel and the French dentist who had come to learn Dr. Goode’s advanced techniques became friends. He invited Daniel to visit him in France. Daniel’s vision was enlarging and wanted to see how people in Europe lived.​
Moving to Europe​

• In 1902 Daniel went to France to visit and decided to stay. It took 6 years to learn French and acquire a European dental degree and license to practice in Paris.
• He traveled widely. In a dental office in Germany he met Kaiser Wilhelm who invited him to his estate to see his horses and spend time.
• As he progressed he met many leaders of the world who became his patients. Years later, the Aga Kahn gave him a Rolls Royce as a token of appreciation for his excellent care.
• Dr. Daniel Hally-Smith married a former Russian Countess and lived a life of the rich and famous.
Enter Lindsey Dewey Pankey

• L.D. Pankey was born in 1901 in Shawnee, Illinois. His father owned a dry goods store. Working in his father’s store taught him the importance of keeping the overhead low to increase the profits. He also liked working part-time in a local dental office.
• The High School in Shawnee was not accredited. The family moved to Evansville, Indiana so he could graduate from an accredited school. He worked part-time for an advertising dentist.
• Dr. Pankey went by the name of “L.D.” He graduated from the University of Louisville Dental School in 1924,
• L.D.’s first main goal was to make money to pay his dental school loan.
• L.D. wanted to practice in Louisville. Dr. Crutcher, his advisor and owner of a dental supply company, said that he needed experience and advised him to go to the small town of New Castle, Kentucky for a few years and then come to Louisville.
• Dr. Crutcher knew that Dr. Hamilton was retiring to Coral Gables, Florida. He offered to loan Dr. Pankey $5,000 to buy Dr. Hamilton’s practice in New Castle. Dr. Pankey accepted his offer.
• He worked night and day – patching teeth, few small bridges and removing teeth. The large percent of his practice was making dentures and “hooked partials”.
• He met and later married his first wife, Anna Pearce.
• His practice thrived, but he was unhappy. Patients only wanted extractions and dentures. He tried to diagnose and sell them on a treatment plan; they didn’t want it. People with money went to Louisville for their dental care.
• Dr. Hamilton wrote to Dr. Pankey several times encouraging him to relocate to Coral Gables, Florida where many people were wealthy.
A new Vision for His Practice

• A letter from his mother changed Dr. Pankey’s life forever.
• She wrote, “I am happy that you are doing so well in your practice but I hope you are not doing to your patients what has been done to me. I have had all my teeth out and now have dentures. This has been the unhappiest experience of my life.” She was 42 years old.
• In his book with Dr. Bill Davis, Dr. Pankey wrote, “She had lost the four things that I have spent the rest of my life trying to learn, use, and teach dentists to give to their patients: Comfort, Function, Health, and Esthetics.” It opened the door to a vision that the goal should be to save patients’ teeth for a lifetime – if at all possible.
The Commitment

• “I made a commitment to myself. I would never take out another tooth as long as I lived.
I had promised myself that I would devote the rest of my life to learning how to save people’s teeth. Some way, somehow, I was going to learn to communicate to my patients the importance of saving their teeth. At that moment, a peace came over me that I have never experienced before or since, as though I was having a religious experience. I came to peace with myself; a weight was lifted from my conscience. I did not know how I was going to do it, but I had decided to dedicate my life to saving people’s teeth.”
• He contacted Dr. Hamilton and went to Florida. He passed the dental boards and rented space in a building under construction.
• After 18 months in New Castle, Dr. Pankey paid his school debt of $3,300 and the practice loan of $5,000. He had $800 to buy a Nash coupe and $1,000 in reserve for his trip to Florida.
• He left New Castle on a Monday in December, 1925at 2:00 p.m. after extracting 81 teeth for 12 patients at $1/tooth.
Move to Coral Gables, Florida
• In Coral Gables his patients were from a higher social-economic class but their dental IQ was similar to his patients in New Castle.
• September 1926 a hurricane blew the top off his office building and he could not work for 3 months. Married Anna Pearce in New Castle. When he returned to Coral Gables, the real estate boom was over in South Florida.
• The building manager had a toothache and wanted the tooth extracted. Dr. Pankey said he didn’t extract teeth. However, he would take x-ray and if it can be saved he will. If not he can go to exodontist.
• The x-ray shows the tooth has deep decay. Dr. Pankey offered to place ZOE and amalgam temporary filling. He wouldn’t charge him if the tooth was not comfortable. The man still wanted the tooth out. Dr. Pankey said, “OK but don’t come back until you want to save your teeth.
• Owner of the building came in because the manager said Dr. Pankey “kicked me out.” After Dr. Pankey explained his commitment about extractions and what really happened with the manager, the owner, his wife and children became patients. They became good missionaries for the practice. Dr. Pankey said, “The Philosophy started in that office in Coral Gables”
• In 1928 he learned to use the Munson articulator to produce the Curve of Spee and the Curve of Wilson. Every case was restored to a 4 inch curve. Dr. Pankey completed 5 cases in a few months. He considered all to be failures because he didn’t understand occlusion. He started back doing “patch-work” maintenance dentistry which later he called a “holding program.”
Enter Mrs. Blanchard – 1930
• Mrs. Blanchard, a 65-year-old, widow of a wealthy New Englander was referred to “the dentist who did not believe in pulling teeth” by her neighbor in Coral Gables.
• Mrs. Blanchard was born and raised on Beacon Hill in Boston and graduated from the Sorbonne in Paris. She spent winters in Coral Gables and summers in Maine.
• She walked in the office without an appointment and wanted to speak personally with Dr. Pankey. She would not sit in the reception room. She said two dentists in Boston and Maine said she needed all her teeth extracted and full dentures made.
• She was in pain and agreed to a complete examination. Dr. Pankey advised her to have two teeth removed by a Miami Exodontist. He made a treatment plan and quoted a $1,000 fee. She accepted.
• He did operative procedures on the upper anteriors; restored the lower posteriors using the Munson articulator carving the cusps compatible with incisal guidance by the cuspids.
• He built the upper posteriors using the “chewing in” technique (FGP) Dr. Taggart described in 1912. Used copper band impression of prepared teeth with modeling compound. Made an amalgam die on which a wax pattern was made. Heat the occlusal with hot spatula, do a chew-in, carve, and cast.
• She enjoyed her teeth until she died at 81and never lost another tooth.
• Mrs. Blanchard always waited in Dr. Pankey’s private office before her appointment. One day she read the ADAJ in his office and asked him if he was going to Paris for the International Dental Conference.
• He said, “I haven’t given it much thought. Why do you ask?”
• Her reply was “I think you should go. You will meet the outstanding dentists in the world and learn the new techniques.”
• The next time she was in the office, she asked him again if he had giving thought to attending the Dental Conference. He asked why she was interested in him going.
• “You could learn something there. I really think you have great potential.”
• “Frankly, I can’t afford to go. I have a new practice and a young child.”
• She insisted – saying, “I want you to go, and I want you to travel first class. I would like to pay all your travel expenses, as well as compensate you for the time you will lose from your practice while you’re gone. Now will you go?”
• He replied, “That certainly will put a different complexion on it.” She also wanted him to travel to London, Florence, Rome, Vienna and Heidelberg.
Enter Dr. Frank Davis
• A few weeks before he left for Europe, Dr. Frank Davis, creator of the Davis
Crown, from Chicago entered his office to have new upper and lower dentures made.
• During one of his visits, Dr. Davis said he knew L.D. was going to Paris and suggested that he should look-up a dentist who was his lab clean-up boy when he was going to dental school at Northwestern. Also, he heard he now has the most outstanding dental practice in the world. His name is Daniel Hally-Smith.
• Dr. Davis sent a letter introducing Dr. Pankey to Dr. Hally-Smith.
London 1931

• Dr. F.R. Broderick wrote a textbook on dental medicine which Dr. Pankey’s study group had used to study nutrition. Dr. Pankey spent one week studying with him in London.
• Dr. Pankey and Dr. Broderick traveled to Paris together.
Paris 1931

• Dr. Pankey spent two days seeing the sights of Paris.
• .Dr. Pankey had difficulty finding Dr. Hally-Smith’s office. “His only sign was a gold plaque about the size of my two thumbnails with “D. H-S” engraved on it. The door was locked. I pulled the tassel at the end of a long rope by the door. The door was opened by a gentleman wearing a cut-away coat and striped trousers and holding a silver platter asking for my card.” He didn’t have a card so he provided the slip of paper on which Dr. Davis had written Dr. Hally-Smith’s name and address.
• Dr. Hally-Smith greeted him warmly and gave him a personal tour of the office. He had five dental technicians and three associates.
• The two men spent much time together following the meeting. Dr. Pankey learned about hydrocolloid impression material and gave the first clinic on its usage at the Florida West Coast Dental Society meeting in October 1931.
• They talked about patient communications and Dr. Hally-Smith asked, “So you took the Bosworth course?” “Isn’t that the dental supply man who suggests we offer one price for a good job, another price for a halfway job, or I’ll louse it up for you at a very reasonable price?”
• L.D. asked, “What am I going to do for those people who come to me and say they can’t afford me?”
• Dr. Hally-Smith said, “You should tell them the optimum way their dentistry should be done, and then what they do is their own decision. If you’re going to make a compromise with them, then compromise on the basis of their 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.”
• Dr. Hally-Smith told Dr. Pankey he needed to know more about examination, diagnosis and periodontal disease. He suggested that he attend Northwestern to learn more. He gave Dr. Pankey a paper with a handwritten verse, The Power of Thought, by James Allen. He said, “Read it every week of your life.”
Switzerland – Italy – Austria

• Dr. Pankey traveled with two other men to Lucerne. Next to Zurich, where they met
o Dr. Alfred Geysi, Dean of the Zurich Dental School and inventor of the Geysi articulator.
o Dr. Weston Price, author of Nutrition and Physical Degeneration and
o Dr. Carl Gustav Jung, world renowned psychiatrist.
• They then to Lake Como, Italy and the Villa d’Este to find a dentist to treat Dr. Pankey’s travelling partner’s toothache. After this, they went to Salzburg, Innsbruck and finally Vienna, Austria.
• In Vienna at the American Express Office a cablegram was waiting. It informed Dr. Pankey of his wife’s death in an automobile accident. Dr. Pankey left immediately for the three week trip to the United States. His friend Jimmy Klock accompanied him.
• Dr. Roy Bovard joined Dr. Pankey’s practice in Coral Gables and L.D.’s sister came from Chicago to care for his daughter, Kitty, which enabled Dr. Pankey to take Dr. Hally-Smith’s advice for post graduate education.
• He signed up for the three month course at Northwestern during the summer of 1932. Courses included: Diagnosis/Treatment Planning and Patient Interviews. Also, a course in Psychology with Dr. George Crane who stressed the “Cross of Life” and the need to balance work, play, love and worship for a truly fulfilling life.
• He studied the work of Carl Jung learning about personality types: introvert, extrovert, ambivert. Also the Binet – Simon scale developed in 1905 to determine the intellectual capacity of children. This gave him the idea for “Dental I. Q.” as well as the patient’s intellectual, sociological and economic classification.
• Dr. Crane’s course gave Dr. Pankey the knowledge and communications skill needed for his practice and the basic elements of his “A Philosophy of the Practice of Dentistry.”
• He first heard the word “occlusion” in the summer of 1931 while at NUDS. He asked the librarian for all the papers on occlusion. There was only one by Dr. Clyde Schuyler reprinted from the 1926 New York Dental Journal.
• After speaking with Dr. Schuyler he began to understand the principles. He used
these principles for 20 years without saying anything about it to anyone.

• In 1933 property values were such he was able to buy enough land for ½ the unpaid taxes to build his 22-room “dental bungalow” in October 1934.
Enter Dr. Arvin W. Mann -1947

• Dr. Mann moved to Ft. Lauderdale and came to Dr. Pankey to learn his technique of occlusal rehabilitation, diagnosis/treatment planning and how to use the Philosophy to get to know the patient and educate them to accept treatment.
• He would bring models and x-rays of patients to LD’s office and they would diagnose the case together. Dr. Pankey would present the case to Dr. Mann as if he were the patient.
• Dr. Mann wanted to present the information to the dental profession. They wrote the Pankey-Mann Technique Manual.
• They then selected 11 dentists from various parts of the country who had taken the Philosophy course at least three times. They met with these dentists and formed the Occlusal Rehabilitation Seminars (ORS).
Enter Dr. Clyde Schuyler

• They had difficulty teaching occlusion from a lecture format. They persuaded Dr. Schuyler to join them in teaching occlusion. It became the Pankey-Mann-Schuyler Seminars. Rose Quick was the coordinator of the seminars.
Enter Drs. Loren Miller and John Anderson – 1958

• Four years after first learning Dr. Pankey’s Philosophy and technique, John and Loren began to dream of working together in dental education. They had become best friends as they learned the Philosophy and techniques from Dr. Pankey and with the ORS.
• John was on the short list to become Dean at Northwestern and Loren was on the short list to be Dean at Baylor. John encouraged Loren to join him in Chicago if he became Dean at NUDS. Loren said, “No way could I live in Chicago.” They decided regular academia was not the best venue to learn the new techniques. It must be a different approach.
The Conception of the L.D. Pankey Dental Foundation

• At the 1969 Florida Academy of Dental Practice Administration Meeting, Jack Wilkens, Jim Cosper, Billy Anderson discussed a gift or gesture to show their appreciation to Dr. Pankey for his contribution to their lives and to dentistry. After much discussion, Rose Quick suggested, “Why don’t you start a foundation in his name. Surprise him in this manner and allow him to be a part of the decisions relative to the use of the money raised?”
• Many ideas were discussed:
o Should they endow a chair at a dental school?
o Should they be part of a dental school or a medical school?
o Should they be a separate post-graduate school not like academia?
• After much discussion and advice from dental leaders around the country, the decision was made to create an Institute with a new and radical departure from conventional academia.
• Harold Wirth, Dr. Pankey’s close friend from New Orleans, was asked to chair a new group – the planning committee. Jack Wilkins, Billy Anderson, Bob Barkley, Peter Dawson, Jim Cosper, John Anderson, and Loren Miller.
• Dr. Pankey told the committee that if they could raise one million dollars he believed they would be successful.
• The committee pledged $200,000 among themselves. They called on the many study clubs and former students for donations. After all sources were exhausted they were $40,000 short.
• Billy Anderson excused himself from the meeting and called Hal Pearson, president of Den-Tal-Ez Company. Mr. Pearson had praised John Anderson for helping design the dental chain for which his company was named. He was pleased to pledge the $40,000.
• Formation of the L.D. Pankey Dental Foundation was announced at the
​Florida State Dental Meeting 1970

• In his book about the beginning of the Institute, Dr. Loren Miller aptly wrote,
“The Dream Had Become Reality”

• In November 1970 the ORS met on a large schooner in the Bahamas.
• Loren Miller and Harold Wirth had discussed the possibility of Loren devoting full time to this project. Loren agreed only if Dr. Pankey was pleased –and Dr. Pankey was very pleased.
• While at anchor, Harold made the announcement that was well received.
• John Anderson said, “If Loren will do this, so will I” which was met with great applause.
• Loren served as Executive Director – John was Director of Education.
• The first class of the Pankey Institute was held in October 1972.

References: M. William Lockard, Jr. DDS
!. Personal communication with Dr. L. D. Pankey, Dr. John Anderson, Dr. Loren Miller.
2. The L.D. Pankey Institute, Dr. Loren Miller.
3. A Philosophy of the Practice of Dentistry, Dr. L.D. Pankey and Dr. W. J. Davis.

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Posted on November 22, 2017

Credit goes to he who strives to do the deeds; who knows great enthusiasms and great devotions; to he who spends himself in a worthy cause, and to he who knows that if he fails while daring greatly, that his place will never be with those cold and timid souls who neither know victory or defeat.

Theodore Roosevelt