Posted on May 7, 2013

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Hi Paul

 

Thanks so much for your continuing efforts to promote and advance the concept of the relationship based practice.  I really like the site and am glad to see the blog format for Codiscovery.com!

 

All the best

 

jim

 

james otten dds
930 Iowa Suite One 
Lawrence KS 66044 

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Paul,

Thank you for Co-Discovery.com.  While we have never met, I feel as though we’ve have a history of long conversations. The names involved and the themes touched in your work have been significant in my 36 year in dentistry. I see many friends, and a forum for further sharing is so very welcome.

You asked for contributions, and I’ve attached a simple one.

All the best,

Bob

Robert Spreen [mailto:rwspreen@comcast.com

________________________________________________________________________

This is an awesome site you have developed! It is an unbelieveable resource for anyone who is priviledged to use it.

If you would not mind, I would love to be a contributor to the site. I was not even aware that this resource existed. Thank you for sharing.

Warmest regards,

Matt

Matthew Steinberg, D.D.S., FAGD FACD FICD

_______________________________________________________________________

Dr Paul

i really enjoyed that… wow

is Bill Lockhart's book on excellent practice still available?

if so where

thanks

arnie rothman

_______________________________________________________________________

Hi Paul,

I have finally taken the time to read the articles on this site, and I am really enjoying it. What a great forum for sharing the wisdom we have been privileged to gain from those who came before us. Hearing that wisdom expressed in the language of today is so important.

Well done, my friend.

Mary

Mary Osborne

1564 Alki Ave SW #303

Seattle, WA  98116

206-937-5851

www.MaryOsborne.com

_______________________________________________________________________

Dear Paul,

Thank you so much for the invite. I am somewhat isolated here in the BC wilderness and have not been to Pankey for a while because I finished the program! Not that my development has ground to a halt. I am still as excited about dentistry as I was when I started practicing after graduation. I will most definitely put a few thoughts on paper in the next while.

Cheers

Rudy Wassenaar, DMD,MAGD,DICOI

_______________________________________________________________________

Paul:

Thank you for the kind invitation. I have in the past “wandered” over to the co-discovery site and was encouraged. I will be happy to contribute.

Dr. Wirth was a frequent lecturer in our class all four years at LSUSD. He was well respected and always greeted us on the elevators with a “How’s your P.M.A.?” The only acceptable response in his eyes was, “Terrific!”

Once a female lab partner of mine was on a crowded elevator with Dr. Wirth. She seized the moment and said, “Dr Wirth, we need you to come and speak to our class soon. I am afraid that our class morality (meant to say morale!) is low!”  He smiled and agreed to return assuming both to be true!

Blessings,

John

_______________________________________________________________________ 

Paul,

Sounds like fun. I have been doing some writing from time to time. Most recently I have been writing on Clifton's work which I believe is very congruent with LD's.

Rich Green

rich@evergreenconsultinggroup.com] 

239.222.9200

_______________________________________________________________________

From: TJBOLT@aol.com [mailto:TJBOLT@aol.com] 

Hi Paul,

This will be very cool.  I have lots of things that i can put out there.  By non-clinical do you mean technical dentistry?  I love the behavioral aspects as well.  I will submit something that I wrote after I read Andy Stanley's ' "The Principles of the Path".  It was an excellent book with many pearls that are for sure related to relationship based dental care and the communication of such. See what you think and let me know if this would be what you are looking for.

Thanks,

T.J.

__________________________________________________________

Dear Dr. Henny,

I just finished reading your e-mail. I am shocked and excited to read you articulate what I have been feeling for years! I have been practicing since 1984 and have finally developed some hard earned confidence in providing dental healthcare to our patients. I am excited to think that you have a forum that will help us learn what the is the right care and the best care and how to get it to the patient.

Please let me know I can help

Best Regards,

Daniel S. Geare, DMD

Bellevue, Wa.

_______________________________________________________________________________________

Wow! Can I count on continued emails? This edition deals with every aspect of what I am going through personally and professionally. Oh, wait a second – aren't they the same thing? I look forward to having something to contribute soon.

Glenn j. Chiarello,D.D.S

________________________________________________________________________________________

This is a very noble aspiration! I feel honored to be invited. I am the only pankey-trained dentist here in the Philippines. For years, I have taken the long, difficult and oh-so-winding road towards that ultimate goal of achieving the so-called optimal oral health for and with my patients.I have been very faithful to the Pankey Philosophy for all of these years since I came back from my life and training in the US but that is not to say that life's been a bed of roses. I had to and still am educating my countrymen here, one patient at a time in my dental chair. My country is a thirld world where Dental health is an elective that is far from any list of any priority whatsoever.Some days are long and arduous when I would love to touch base with someone  who lives the same philosophy in the practice of dentistry- – – if only to renew my faith or be validated for it.

Please keep me posted. More power to you!

Agnes B. Claros, D.M.D.

dentalspamanila@yahoo.com

_________________________________________________________________________________________

On Personal Branding Article:

This is right on target.  You need to gain feedback on how you are percieved by others and then create a development plan for your personal brand.

Dan Schawbel,

www.personalbrandingmag.com

_________________________________________________________________________________________

Paul, Congratulations on your co-discovery launch. More voices like co-discovery.com are needed to spread the word on health-centered/relationship-based dentistry

Best,

Lynn Carlisle, DDS Editor and Publisher of In a Spirit of Caring

www.spiritofcaring.com

_________________________________________________________________________________________

Congratulations Paul. Nice job. Keep up the good work.

Sandy Roth

www.prosynergy.com

________________________________________________________________________________________

Paul, This is great. Congratulations and thanks for your contributions to Relationship-Based, behavioral dental caring.

• Commenter name: Bill Gregg
• Commenter email: wygdds@hotmail.com

Posted on May 2, 2013

By Paul Henny, DDS

Idabelle came from a small farm just outside of Norman, OK, and was the oldest of five children.  At age 14 her father died in a wood stove fire and circumstances demanded that she assume the leadership position in the family. She ran the farm, bailed the hay…you name it, she could do it.

 Idabelle loved her father, but had a rather contentious relationship with her mother, and at age 17 decided it was time to leave.  She boarded a train in 1912 and headed to Chicago with her 8^th grade education and Oklahoma farm wisdom.

 Upon arrival, Idabelle decided that she wanted to become a lawyer, so she applied and was accepted to Law School.  For reasons which are currently unclear, she did not complete her studies and next moved to Detroit, another Midwestern boom town. There, Idabelle worked as a clerk for a prominent lawyer. Because of her training, and the fact that he was a drunk, she tried most of his cases in court, winning many.

 Later, she met Ralph and they married. Ralph was a gregarious insurance salesman who had climbed the ladder to middle management. Together they studied the insurance agency business and eventually started one of their own in Flint, Michigan.

 There seemed to be nothing that Idabelle could not do. Give her a scrap of fabric and her sewing machine and a beautiful outfit would appear…. She even took up bowling at the age of 65 after Ralph died, just to get herself out of the house. After joining a bowling league, she soon had a room filled with trophies, commonly bowling over 200.  A few years later,  her arthritis was so severe she could no longer bowl with her right hand.  Her solution? Start bowling with her left hand! And she soon started to dominate the league once again.

 Idabelle was short, barely five feet tall, soft spoken and humble. When she laughed it was from the belly, and never at you, just with you. She had this look…this twinkle in her eye that said…”I believe in you”.   She was my grandmother, and in my young world, she walked on water and could make it too. She shared her strengths with my mother who could have easily run GM with one hand tied behind her back. But instead, she (in spite of a Masters Degree in Early Childhood Education) chose to raise her three children instead. Two of us became dentists and my sister, became the CFO of the Indianapolis Zoo.

 To me that was a truly liberated woman looked like… powerful, confident, in control, but never needing to show it. From them I learned that I was loved, but also that I was nothing special. And that the only way I was going to get ahead in life was to try twice as hard and to never give up.

 Avrom King liked to call this aspect of character “grit. And grit is made not born. It is often born out of failure and the confidence which arises through overcoming it time and time again. It is also emerges from a strongly clarified self-concept facilitated by exceptional parenting. And it makes life easier,  as it eliminates a lot of bad choices right out of the gate.  “No, that simply does not work for me”…those kinds of choices.

 Not that long ago, grit was everywhere, but  I did not realize it until I started to tell others about my amazing grandmother.And when I did,  people would say…”Wow!  That’s pretty amazing!  Now, let me tell you what mine did!”

 Our culture has gotten off-track to a very significant degree…And by choice. But with just a little bit more grit, the corner can still be turned and the sun will shine again. And in spite of it being unfashionable to take chances, work hard, and assume responsibility for our decisions and actions, it is still the surest way to the top.

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                                             Thoughts for Living

Go Places amid the noise and haste, and remember what peace there may be in silence.

As far as possible, without surrender, strive to be on good terms with all persons.

Speak your truth quietly and clearly; and listen to others, even the dull and ignorant; they too, have their story.

Avoid loud and aggressive persons; they are vexations to the spirit.

If you compare yourself to others, you may become vain and bitter; for always there will be greater and lesser persons than yourself.

Enjoy your achievements as well as your plans. Keep interested in your own career, however humble; it is a real possession in the changing fortunes of time.

Exercise caution in your business affairs; for the world is full of trickery. But let this not blind you to what virtue there is; many persons strive for high ideals; and everywhere life is full of heroism.

Be yourself. Especially, do not feign affection. Neither be cynical about love; for in the face of all aridity and disenchantment it is perennial as the grass.

Take kindly the counsel of years, gracefully surrendering the things of youth.

Nurture strength of spirit to shield you in sudden misfortune. But do not distress yourself with imaginings. Many fears are born of fatigue and loneliness. Beyond a wholesome discipline, be gentle with yourself.

You are a child of God. Find peace through accepting that His plan is unfolding as it should. Yours is not to know why, as only He knows the greater context and reason for everything.

Therefore through acceptance, be at peace with Him, and whatever your labors and aspirations, in the noisey confusion of life keep this peace and be assured, Strive to share His love and Peace with others.

               Adapted from Desiderata by Max Ehrmann  (1872-1945)

Posted on April 29, 2013

Jeffery N. Trester, DDS, MAGD is a 1973 graduate of Northwestern University School of Dentistry. He has a broad and deep professional background, including: A General Dentistry residency with the USPHS Indian Health Service, Director of Pedodontics at Mt. Zion Hospital and Medical Center San Francisco, CA, Master level of the Academy of General Dentistry, Board President of the Southern California Academy of General Dentistry, Member of the LD Pankey Dental Foundation, and Member and President of the LD Pankey Study Club of Southern California.

Jeff has authored several articles which have appeared in A Manual of Hospital Dentistry, General Dentistry, GP News, and Dental Economics. He has a solo private practice focused on complex restorative dentistry & orthodontics in Ventura, California.

By Jeffrey Trester

Contributing Writer

George, my patient of 15 years, was in a wheelchair, a whisper of the man he was five years ago. He was not more than a skeleton with skin, really. Cancer does that to a person. His legs had braces because they were too weak to support his body alone, and his back was hunched over, I suspect from the invasion of the disease into his spinal column, or maybe he was just too weak to sit up straight. 

The old George I used to know always wore a western belt with a big silver buckle, and a smile. But that day, he was too bent over for me to even tell if he was wearing a belt at all. The boyish face that had remained young even after we had both watched his children grow up, was drawn and tired from too much suffering. The bone cancer, like the bullets of a hidden sniper, had put holes in his bones; holes that now leaked their poison into the other parts of his body.

Before multiple myeloma struck, our conversations were of Indians, sand-cast silver buckles and rings, turquoise and places in the Southwest we had both visited; places such as Flagstaff, Sedona, Betatakin, Canyon de Chelly and Winslow, where I lived for awhile. He would tell me about his travels to Utah and Arizona on vacation with his family, and he would take delight in my stories about Navajo children in Chilchimbito, Dilkon, and Dinehotso. We’d talk about how blue the sky was and how clean and sweet and dry the air was to breathe.

At one time, I had been a dentist on the Navajo Indian reservation – sort of a southwestern “Northern Exposure” on the “res.” George’s love of the Southwest created an immediate interest and affinity when we first met. But this particular day, he talked only about the shunt in his left arm that they had been using for dialysis. 

These shunts are large tubes to which the dialysis machine is attached; they are inserted into veins and protrude through the skin. He had shunts in both arms, but the shunt in his left arm wasn’t being used, and he lamented how bad it looked and how he wished they would take it out. He had asked, but been ignored. I wished I could do it for him. 

The reality is that the medical establishment of today often places little or no value on patients’ emotional needs. Those who were once “doctors” have now become “providers.” Those who were once “patients” have become “subscribers.” Words are powerful forces that change the way we think about people: If you are just a provider, why care if a subscriber loses his dignity? “He probably won’t live long, anyway.” 

I think of George sometimes when I see a piece of Navajo jewelry or a rug, or when I revisit the Southwest – as I sometimes do – and I am sitting on a Utah plateau in a quiet, red–rocked, remote cliff dwelling while looking down into a sand-washed ancient canyon laced with a silver stream and dotted with spring-green cottonwood trees. I think of him, too, when I am tired and out of patience and have to restrain myself from treating patients as subscribers instead of people.

When he left on that last day, I wanted to hug him because I knew I would probably never see him again. But I did not. I will always be sorry about that.

Jeffrey Trester, DDS, MAGD, has been in private practice since 1979. Prior to receiving his Mastership in the Academy of General Dentistry, he served in the U.S.P.H.S. and completed a two–year general practice residency. Dr. Trester has studied at the Pankey Institute. He is the father of UCSF pharmacy student Marissa Trester. Contact him by e–mail atjeffreyventura@earthlink.net.

This article first appeared in the October 14, 2010 issue of Synapse.

 Editor’s Commentary:

This is a wonderful story, certainly one that we can all relate to as well. Personally, I have a handful of patients in an “end stage” situation in their life. I am always impressed by their courage and resiliancy. These are typically older patients who are of “the greatest generation”, those who survived WWII experiences at home or abroad and so forth. Some are younger, but they all have “grit” and tremendous character.

These are attributes which I see less and less often today, as our culture is much more “me centered”. As a result, these people are a true breath of fresh air, and – I believe- are showing us a much more virtuous way to live.

On another note, I can relate to Jeff’s comment about his regrets about not hugging his patient. Many of us were raised in homes where hugging (particularly among the males) just did not happen. We habitually learned that touching of that nature was inappropriate….perhaps even a violation of our own or the other person’s boundary. In those cases, we need to become more self-ware and re-learn some new patterns of interaction.

I also think that today’s culture has moved too far in the other direction, where hugs are often given to those who are not ready to recieve them. Finding the middle ground is the key….being sensitive to readiness for a little bit of authentic love. And we all can use more of that.

Thanks Jeff. 

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                                                                                Clear Thinkers

Joy in looking and comprehending is nature’s most beautiful gift.
Albert Einstein

When I was a  resident in general dentistry 35 years ago, I was lucky to have as my orthodontic instructor Dr. Donald (Skip) Ferguson.  At the time he was a relatively new orthodontist in private practice who, besides running the orthodontic portion of the residency program at Mt. Zion Hospital in San Francisco, was also doing research on bone biology at the University of the Pacific under Dr. Gene Roberts.  Skip eventually went on to publish a number of papers of his own and to head orthodontic programs at Boston University, Marquette University, St. Louis University, and now is Dean of Post Graduate Dental Education at a university dental school in Dubai.  Gene Roberts, D.D.S., PhD is now Professor Emeritus of Orthodontics at Indiana University and is highly respected in the field of bone physiology and treatment planning. At the time I knew Skip, he regarded Gene with an almost reverential awe.   Skip was a great teacher; we had about 3- 5 selected literature articles to read and discuss each week, and each resident (there were just 3 of us) saw several orthodontic patients needing a variety of major and minor orthodontic treatment. By the end of my second year we had covered a lot of territory in the orthodontic literature on everything from bone physiology and healing as it relates to tooth movement, to diastema closure, rapid palatal expansion, and the roles of muscles in malocclusion; and had done a number of minor types of orthodontic tooth movements suitable for the general dentist, and at least one full banded case. 

I tell you all this to give you a picture of the background of how I came to learn about the concept of “clear thinkers”. Skip and I spent many evenings after the clinic closed and after making hospital rounds discussing a number of clinical and more esoteric topics.  Skip taught from the Socratic model which is that you may have the knowledge to know the answer, or at least what should be your next step; you just have to be led to discover it. The Socratic Method teaches disciplined thinking.  Questions were often answered with another question, the goal being to get you to think rather than just talk.  I’m reminded of the scene from the movie, “The Paper Chase” where, at the Harvard Law School, Professor Charles W. Kingsfield  tells the brilliant young law student Hart, who comes from Minnesota, “You teach yourselves the law. I train your minds. You come in here with a skull full of mush, and if you survive, you’ll leave thinking like a lawyer.” One of those esoteric topics was the topic of what constitutes a “clear thinker”.  “Clear Thinker” was a term Skip used to describe certain gifted colleagues. Gene Roberts was one of those that Skip regarded as a “clear thinker”.  As a side note, the Socratic method is best used in a one on one teaching environment.  It is not well suited for a lecture paradigm.  I hope that every young dentist is blessed to find a mentor who is a clear thinker, even if for a short time. Becoming a clear thinker helps in learning to learn.

What is a “clear thinker”?  This, as it turns out, is difficult to define, but not too difficult to recognize.  Basically a “clear thinker” is someone who can see through a mass of details and information and focus in on the essence of a problem. This is important because you cannot find a solution until you identify the problem.  These seem to be people with knowledge, wisdom, and perhaps a genetic gift of a superb analytic mind that can combine to problem-solve and teach in a way that simplifies, rather than complicates those tasks.  You know who they are: they’re the Frank Spears, Jay Andersons, Irwin Beckers, Ray Bertolotti’s and others. Although I didn’t know them, it sounds like L.D. Pankey and Henry Tanner were “clear thinkers” also. I have personally known only a handful of these people in my lifetime.  My ex-brother-in-law was one. He started 2 or three companies in the high tech medical fields and took one public.  My chief of staff at Mt. Zion Hospital where I did my residency was another.  Besides Skip, there have been only 5 or 10  other teachers in the almost 4 decades since I graduated. In my private, practice I think I’ve only known only two specialists who were “clear thinkers”.  

“Clear thinkers” are usually not young (it takes a decade or two to accumulate the knowledge and suffer the slings and arrows of experience necessary); they usually have a sort of quiet patience and understanding.  You wouldn’t be surprised to see them in the robes of a priest, rabbi, or Buddhist monk. Clear thinkers often have a non-professional knowledge base and interests outside the profession that keeps them “anchored”, mentally, and emotionally strong, and provides the link between the professional and non-professional life.  They are aware of universal “truths”. “Clear thinkers” are rarely condescending and get great enjoyment in helping others to “see the light” and achieve understanding. They don’t laugh, ridicule, or make fun of their students’ questions. They like doing what they’re doing.  In psychological parlance, they’re “self actualized”. “Clear thinkers” are humble; they don’t see themselves as “special” but merely dedicated to the task or project(s) at hand. “Clear thinkers” are sure of the principles underlying whatever they do, but also know the boundaries of their expertise, and are not afraid to tell you they don’t know the answer to this or that.  Clear thinkers are often teachers.  Unfortunately, few clear thinkers become politicians, which explain the sad state of affairs in the world today. Clear thinkers rely heavily on making decisions based on experimental data, and therefore read the literature a lot. Clear thinkers listen more than they talk.  They’re disciplined and resist the temptation to talk just to talk to impress or brag.  But when they do talk, every word is loaded. Clear thinkers, I suspect, spend a lot of time just thinking.

To those uninitiated into the ““clear thinker”” paradigm, clear thinkers are sometimes mistakenly categorized as “smart”.  But “clear thinkers” are a sub-group of smart people. When you ask a clear thinker a question, there will usually be a pause before they answer.  I don’t know what they’re thinking, but it seems like they’re pouring all the facts through a sieve in their mind, and out the bottom comes a few of the elements crucial to the answer.  That sieve is what makes a clear thinker more than smart. There are lots of moments of silence when you talk to a clear thinker.  Those moments of silence are exciting because often what follows is something that will be epiphanous for you.

Attempting to arrive at clear thinking makes your own questions clearer and easier to understand. Organizing, simplifying, and giving thought to data and confusions in your own mind before formulating questions, is probably the first step to being a “clear thinker”.  Answers from clear thinkers are often more concise and easier to remember; and therefore progress in learning takes place quicker. I don’t know if I’m a clear thinker. But I’m a clearer thinker than I was back when Skip and I talked.  Like the practice of dentistry as a whole, clear thinking is a worthwhile process of continuous improvement through practice, study (in and outside the profession) and intentional effort.  As Albert Einstein said, “If you can’t explain it simply, you don’t understand it well enough.”

Posted on April 28, 2013

By Jeffery Trester, DDS, MAGD

Contributing Writer

Clear Thinkers

Joy in looking and comprehending is nature’s most beautiful gift.
Albert Einstein

When I was a  resident in general dentistry 35 years ago, I was lucky to have as my orthodontic instructor Dr. Donald (Skip) Ferguson.  At the time he was a relatively new orthodontist in private practice who, besides running the orthodontic portion of the residency program at Mt. Zion Hospital in San Francisco, was also doing research on bone biology at the University of the Pacific under Dr. Gene Roberts.  Skip eventually went on to publish a number of papers of his own and to head orthodontic programs at Boston University, Marquette University, St. Louis University, and now is Dean of Post Graduate Dental Education at a university dental school in Dubai.  Gene Roberts, D.D.S., PhD is now Professor Emeritus of Orthodontics at Indiana University and is highly respected in the field of bone physiology and treatment planning. At the time I knew Skip, he regarded Gene with an almost reverential awe.   Skip was a great teacher; we had about 3- 5 selected literature articles to read and discuss each week, and each resident (there were just 3 of us) saw several orthodontic patients needing a variety of major and minor orthodontic treatment. By the end of my second year we had covered a lot of territory in the orthodontic literature on everything from bone physiology and healing as it relates to tooth movement, to diastema closure, rapid palatal expansion, and the roles of muscles in malocclusion; and had done a number of minor types of orthodontic tooth movements suitable for the general dentist, and at least one full banded case.

I tell you all this to give you a picture of the background of how I came to learn about the concept of “clear thinkers”. Skip and I spent many evenings after the clinic closed and after making hospital rounds discussing a number of clinical and more esoteric topics.  Skip taught from the Socratic model which is that you may have the knowledge to know the answer, or at least what should be your next step; you just have to be led to discover it. The Socratic Method teaches disciplined thinking.  Questions were often answered with another question, the goal being to get you to think rather than just talk.  I’m reminded of the scene from the movie, “The Paper Chase” where, at the Harvard Law School, Professor Charles W. Kingsfield  tells the brilliant young law student Hart, who comes from Minnesota, “You teach yourselves the law. I train your minds. You come in here with a skull full of mush, and if you survive, you’ll leave thinking like a lawyer.” One of those esoteric topics was the topic of what constitutes a “clear thinker”.  “Clear Thinker” was a term Skip used to describe certain gifted colleagues. Gene Roberts was one of those that Skip regarded as a “clear thinker”.  As a side note, the Socratic method is best used in a one on one teaching environment.  It is not well suited for a lecture paradigm.  I hope that every young dentist is blessed to find a mentor who is a clear thinker, even if for a short time. Becoming a clear thinker helps in learning to learn.

What is a “clear thinker”?  This, as it turns out, is difficult to define, but not too difficult to recognize.  Basically a “clear thinker” is someone who can see through a mass of details and information and focus in on the essence of a problem. This is important because you cannot find a solution until you identify the problem.  These seem to be people with knowledge, wisdom, and perhaps a genetic gift of a superb analytic mind that can combine to problem-solve and teach in a way that simplifies, rather than complicates those tasks.  You know who they are: they’re the Frank Spears, Jay Andersons, Irwin Beckers, Ray Bertolotti’s and others. Although I didn’t know them, it sounds like L.D. Pankey and Henry Tanner were “clear thinkers” also. I have personally known only a handful of these people in my lifetime.  My ex-brother-in-law was one. He started 2 or three companies in the high tech medical fields and took one public.  My chief of staff at Mt. Zion Hospital where I did my residency was another.  Besides Skip, there have been only 5 or 10  other teachers in the almost 4 decades since I graduated. In my private, practice I think I’ve only known only two specialists who were “clear thinkers”.

“Clear thinkers” are usually not young (it takes a decade or two to accumulate the knowledge and suffer the slings and arrows of experience necessary); they usually have a sort of quiet patience and understanding.  You wouldn’t be surprised to see them in the robes of a priest, rabbi, or Buddhist monk. Clear thinkers often have a non-professional knowledge base and interests outside the profession that keeps them “anchored”, mentally, and emotionally strong, and provides the link between the professional and non-professional life.  They are aware of universal “truths”. “Clear thinkers” are rarely condescending and get great enjoyment in helping others to “see the light” and achieve understanding. They don’t laugh, ridicule, or make fun of their students’ questions. They like doing what they’re doing.  In psychological parlance, they’re “self actualized”. “Clear thinkers” are humble; they don’t see themselves as “special” but merely dedicated to the task or project(s) at hand. “Clear thinkers” are sure of the principles underlying whatever they do, but also know the boundaries of their expertise, and are not afraid to tell you they don’t know the answer to this or that.  Clear thinkers are often teachers.  Unfortunately, few clear thinkers become politicians, which explain the sad state of affairs in the world today. Clear thinkers rely heavily on making decisions based on experimental data, and therefore read the literature a lot. Clear thinkers listen more than they talk.  They’re disciplined and resist the temptation to talk just to talk to impress or brag.  But when they do talk, every word is loaded. Clear thinkers, I suspect, spend a lot of time just thinking.

To those uninitiated into the ““clear thinker”” paradigm, clear thinkers are sometimes mistakenly categorized as “smart”.  But “clear thinkers” are a sub-group of smart people. When you ask a clear thinker a question, there will usually be a pause before they answer.  I don’t know what they’re thinking, but it seems like they’re pouring all the facts through a sieve in their mind, and out the bottom comes a few of the elements crucial to the answer.  That sieve is what makes a clear thinker more than smart. There are lots of moments of silence when you talk to a clear thinker.  Those moments of silence are exciting because often what follows is something that will be epiphanous for you.

Attempting to arrive at clear thinking makes your own questions clearer and easier to understand. Organizing, simplifying, and giving thought to data and confusions in your own mind before formulating questions, is probably the first step to being a “clear thinker”.  Answers from clear thinkers are often more concise and easier to remember; and therefore progress in learning takes place quicker. I don’t know if I’m a clear thinker. But I’m a clearer thinker than I was back when Skip and I talked.  Like the practice of dentistry as a whole, clear thinking is a worthwhile process of continuous improvement through practice, study (in and outside the profession) and intentional effort.  As Albert Einstein said, “If you can’t explain it simply, you don’t understand it well enough.”

Posted on April 14, 2013

Dr. M. William Lockard, Jr. graduated from Northwestern University Dental School. He has been involved as an associate faculty member and currently advisor faculty at the Pankey Institute, Key Biscayne, Florida for 39 years; a clinical instructor in Fixed Prosthodontics at the University of Oklahoma Dental School; dental intern advisor at St. Anthony Hospital, Oklahoma City and a teaching faculty member with The Pride Institute.

            He is a former member of the Academy of General Dentistry Foundation board of directors, L.D. Pankey Dental Foundation board of trustees, and Oklahoma Board of Governors of Registered Dentists. He has published in The Journal of Prosthetic Dentistry, Esthetic Dentistry Update, Texas Dental Journal, Oklahoma Dental Journal, Dental Economics, Dental Management, and G.P.(Practice Expansion Through Clinical Specialization).

            Dr. Lockard is the author of two books, The Winning Combination – A Philosophy; and his latest book, The Exceptional Dental Practice – Why Good Enough Isn’t Good Enough is sold on five continents.

       He has presented seminars and in-office consultations on practice systems, structure, communications, comprehensive restorative dentistry, and team development process throughout the United States, England, Japan, and Canada.                                                                             Dr. Lockard has presented at the Yankee Dental Congress, Boston; Hinman Dental Meeting, Atlanta; Chicago Mid-Winter; American Academy of Restorative Dentistry, Chicago; Southwest Dental Conference, Dallas; Greater New York Dental Meeting; Greater Houston Mid-Winter; Southwest Academy of Restorative Dentistry, Dallas; Society for Occlusal Studies Symposium, Vancouver, B.C.; ADA Annual Sessions; California Dental Association; The American Academy of Dental Practice Administration; The European Dental Conference, London; the CPA Financial Planning Association Retreat, Orlando, Florida; the Academy of Practice Administration, Tokyo, Japan.                                                        

M. William Lockard, Jr. DDS

www.billlockarddds.com

Bill,

I feel the need to write you and tell you again how much I appreciate the opportunity to work with you…even on this limited basis.  Just the re-exposure to your thinking, clear-headedness, strength of faith, and philosophy toward people and life are truly inspirational.

This past Sunday, I was in Church listening to a sermon by a minister I had not previously heard before. I would guess he is around 60, and in a temporary position in a small country Baptist Church. Most of the congregants were elderly, and the prayers were focused on recent deaths, illnesses, and tragedy.  This once vibrant church, is clearly struggling to survive. And if it were not for a couple of very generous members, it likely would not be open.

Regardless, in this almost empty church, I heard the best sermon of my life to date. And as I say this, I realize that this is one of those “when the student is ready, the teacher will appear” moments.  But I thought I should share it with you, now that I know a little bit more about you.

The sermon was centered on the idea of Perspective, something that I personally struggle with often. In this hurried-up world of over-scheduled-ness, constant interruption, widely disseminated biased information sources, pressure to constantly do more with less…and so forth,  I was struck like a deer in the headlights with his simple message.

The sermon was focused on the Book of Acts and more broadly on the life of Paul the Apostle. But the central message was that we do not have the capacity to know what God intends for our life, so it is essentially impossible for us to know whether what is currently happening to us is a good or a bad thing. Rather, it is what God intends to be happening now. Whether it is the most glorious and happy moment or the most gut wrenching experience…it is what He intends.

We are not to know why right now. Therefore,  pursing “why” is fruitless and frustrating on many occasions. It is just is. And that is the end of the story.

Knowing that God is guiding us is the key to Faith. And when I run across someone who clearly knows this and lives it is both refreshing and reassuring. For whatever reason, God has brought me back into contact with you, and I am grateful for this.

Paul A. Henny, DDS

Posted on April 10, 2013

Dr. Herb Blumenthal has been in active practice for more than 48 years. He has always sought out knowledge that would help him better serve his patients. That quest has led him to study the relationship of TM Disorders to medicine, occlusion, chiropractic medicine, kinesiology, restorative dentistry, biofeedback, neurophysiology, muscle physiology, nutrition, sleep disorders… and other areas outside of dentistry. He has applied this multi-disciplinary information to the diagnosis and treatment of TMD patients for more than 38 years. He has partnered with a wide range of professionals and developed a unique perspective of the interrelationship of TMD treatment as a multidisciplinary therapy involving many professionals who work in concert to best treat these very special patients.
He has directly and positively impacted the lives of countless patients with his ability to listen, observe, and understand. That number has been exponentially increased by his sharing of what he has learned over the years with other dentists as a teacher, mentor and advisor. The quest led him to The Pankey Institute 38 years ago and he continues that relationship today. He began to give back as a member of the visiting faculty 28 years ago and has served as one of the lead faculty for the Bite Splint and Temporomandibular Evaluation course.

On The Critical Nature Of History-Taking

Let your patient talk. The patient has lived with the problem for an extended time and has information that can help solve the mystery. Many times I will ask the patient, “If you had the ability to do anything you needed to do, what would you do to fix the problem?” Sometimes I have been surprised by the answer. It is the practitioner’s quest to assimilate this information and put it into a usable format to piece together the puzzle. Allow your history taking to be flexible enough to explore unexpected avenues presented by the patient.

Posted on March 27, 2013

 By Paul A. Henny, DDS

August 13, 2013 marks the thirty fifth year anniversary of the passing of one of the greatest innovators, leaders, and teachers in the history of dentistry, Robert F. Barkley, DDS. This article is presented to honor his life and work as well as share some of his contributions with the current generation of dentists – many of whom are unfamiliar with the impact he had on our profession.

Robert F. Barkley was born August 23, 1930 and grew up in the small farming community of Ipava, Illinois – population 600. Bob later entered and graduated from Northwestern University Dental School in downtown Chicago. After some deliberation, he decided to practice in Macomb, Illinois a larger community that Bob described as being “the largest town between Ipava and the Mississippi River”. Bob established his practice in the style of the time – a family practice – and like most newly minted graduates; he thought he was practicing a superior brand of dentistry.

Within a fairly short period of time however, Bob noticed that much of his dentistry was failing. He concluded that his techniques and materials were the cause, so he set about to learn more about cast gold restorations. As a result, he included more of this approach in his treatment plans and was fairly sure that this new strategy would work. “I assured myself that better quality repairs were the answer”, he said.

While this change helped increase Bob’s income, it came with an unanticipated side effect. Many patients were turned off because they believed that Bob’s dental solutions were too elaborate and too expensive. Many left the practice as a result. Persistent in his new strategy, Bob soon developed a reputation as a “gold” man. While this would not be a negative description in dental circles, the citizenry in tiny Macomb developed a decidedly negative tone when they described Bob in these terms. Bob, in their eyes, had gone “big time” and left their needs behind.

About that time, Bob attended a lecture by Dr. Clyde Schuyler, a close friend and colleague of Dr. L.D. Pankey. Dr. Schuyler told Bob that he needed to learn more about a broader range of clinical dentistry and that he already knew “how to sell more things than he knew how to do”. Dr. Schuyler’s words struck home and set Bob on a path of learning even more about clinical options. From that point on, the more Bob learned, the more he saw in each patient’s mouth – but this time he knew what to offer and how to more strategically approach their care. This new-found confidence and knowledge lead Bob to develop even more elaborate treatment plans, resulting in even higher case fees. It was easy to see that this should lead to a more successful practice, but it didn’t turn out that way at all.

While Bob’s recommendations were sound, his patients could not understand the value behind what he was suggesting. Was there really that much wrong? Was there that much to do? Obviously, there was a flaw in this new strategy as well. Here was Bob, an accomplished dentist with skills and treatments that would clearly benefit his patients, yet few seemed interested. It was back to the drawing board.

It was at this point that Bob identified the tug between how he felt dentistry should be practiced and the way the people of his community seemed to want him to practice. He summed it up by commenting “…it seemed that a decision had to be made whether to work for the classes or the masses. Reluctantly, I chose the former. I would offer what I knew was best for the patient and let the chips fall where they might.”

And fall they did. Some patients left disgruntled, and others just left. Even some childhood friends refused to associate with him. During this time of turmoil, a high school classmate (one of his favorite cheerleaders at that time) came to his office seeking help for her debilitated mouth. Four children had been birthed since high school and she was convinced that between her family heritage of “soft teeth” and the well known “drawing out of calcium” from the teeth during pregnancy, her dental future was dim. Bob was cautious. He was fully aware of his failure to sell proper dentistry to many others. Taking this into consideration, Bob recommended that she improve her hygiene habits as well as address some basic needs in the most affordable way. Certainly, surrendering to this more pragmatic approach would win the day. After all, he did not want to compromise his long-standing relationship. The appointment was set, but on the scheduled appointment came and went. She did not show up. What had happened?

Bob recalled that he nearly cried when he saw her next – this time in public and not in his practice. She had, in his words, “committed dental suicide” in another office and was now wearing full dentures. This event was catalytic and changed Bob’s practice life forever. It set the stage for changes that that he would make and ultimately share with thousands of dentists to whom he would eventually speak.

It was at this point that he committed himself to “make prevention pay off”. He wanted to be certain that – especially for those who could not afford extensive care – a preventative strategy would be both more successful and less expensive than extracting teeth and inserting dentures.

Bob committed to becoming a student of an even wider range of concepts. From Dr. Sumter Arnim he learned how to successfully treat and manage dental caries and periodontal disease. From Dr. L. D. Pankey he learned about creating a principle-centered philosophy of practice as well as the inter-relationship between behavioral and clinical dentistry. And through Dr. Nathan Kohn, a PhD Psychologist, Bob deepened his understanding of interpersonal communication, the requirements for behavior change, and on how people learn.

Bob Barkley’s most recognized legacy is based on his advancing of what is commonly known today as “Preventive Dentistry” – a concept that rarely existed outside of academia. He developed a program and toured the country teaching a five-day learning and skill development program that dentists used with their patients. This approach was often augmented with phase-contrast microscopes and bacterial samples taken from the patient’s mouth.

His most overlooked legacy is related to his development of what is known today as co-diagnosis or co-discovery. These were concepts that Bob pioneered and taught extensively as well. (Anyone who has had a chance to see videos of Bob working with patients can testify to his masterful ability to engage people and lead them though a facilitated learning process). This co-diagnostic process became the linchpin of his practice success as it allowed people the opportunity to value proper dentistry and consistently request it.

As you can see, Bob’s influence on dentistry was both broad and deep considering his premature passing at the age of 46. His death in a private airplane accident brought a tragic end to a highly influential career. Fortunately, Bob’s influence lives on through the work of many others who continue to be amazed at the progressive nature of his thinking (he even wrote about his suspicion that heart disease and periodontal disease were likely associated in the 1970’s). Those who routinely give direct credit to him for influencing their practice as well as the way they view dentistry, life, and relationships are too numerous to count. The short list would most certainly include Avrom King, Bob Frazer, Omer Reed, Lynn Carlisle, Rich Green, Doug Young, Sandy Roth, Doug Roth, Mary Osborne, Mike Schuster, Paul Henny, Charley Varipapa, M. Johnson Hagood, among others.

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Greetings! In 1970 as a sophomore dental student I organized the 12:07 study club. We met once a week to review the works of that weeks learning block. Having studied so much during my first two years I found myself doing my own studies in the library. That is where I learned about the late and GREAT ROBERT BARKLEY!. The short version of the story was to contact him and invite him to my dental school for a full day conference.With the full support of my dean he agreeded to present. I could conclude even as a sophomore student that this man was a master in the art of living…….What an amazing experience then and now.

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Dear Dr. Henny,

I enjoyed your article about Bob Barkley in DENTISTRY TODAY very much.  I was in the first class at the Medical College of Georgia, School of Dentistry and our class was so small that the local dental society allowed us to attend Dr. Barkley’s two day lecture in the spring of 1971 when he was in Augusta, Georgia.  Since I was a Sophomore in dental school, much of my time had been spent waxing teeth and doing some of the more technical aspects of dentistry.  We had had a lecture from the Chairman of the Department of Oral Surgery and I found the material he presented to be very exciting.  I had already decided to go into oral surgery and I was well on my way to achieving that goal when Dr. Barkley came to town.  At the end of the two day program, I told my wife I was going to be a general dentist and I was not going to be going into oral surgery.  She was shocked since I had been so committed to specializing in oral surgery.  Dr. Barkley taught me, as he taught many dentists, that dentistry is more than the technical aspect that we were learning in dental school.  Later in my career I became interested in dental implants and I have actually enjoyed a career where I have been able to be involved with implant dentistry as well as restorative dentistry and I have been able to lecture quite a bit on the topic of dental implants.  When I wrote a book about implant prosthetics in the 90’s, I made sure that the first reference in my book was Dr. Barkley’s book.  I seem to have misplaced my copy of Dr. Barkley’s book so if you would let me know how I could purchase a copy of the book that his step-son will be republishing, I would certainly appreciate it. 

Again, thank you for writing this article as it was very uplifting for me.  As a sidebar to this, my son will be joining me in my practice next summer as he has been practicing in the Atlanta area for the past three years or so after finishing dental school.  I have made arrangements for him to go to the Pankey Institute in January.  I attended the Pankey Institute starting in 1974 and before I started  the continuum, I actually went through P1, P2, and P3.  These “philosophy” series were actually Dr. Pankey himself lecturing for three straight days.  Dr. Pankey never used a slide the entire nine days that I heard him and it was certainly an inspiration to get to hear Dr. Pankey early in my career.  There are probably very few dentists still practicing that had the opportunity to hear Dr. Pankey and Dr. Bob Barkley early in their careers so I feel very blessed to have heard them both during the early years of my dental experience.

Again, thank you very much.

Sincerely,

Douglas P. Clepper, DMD

Posted on March 22, 2013

As I look back over the past 20 years of so-called "innovations" in dentistry, a very odd list of products comes to mind.  (posterior composites tooth colored inlays, air abrasion, lasers, cosmetic imaging, tooth whitners and so on.)  They all have been heavily marketed to us.  Bold, aggressive salesmen urge us to buy their better mousetrap becuase, if we don't, the guy down the street will, and all our patients will leave us.

The problem is that we can be lured into believing this stuff if we lose perpective.  Some folks would have us believe that the latest trends in technology should define our practices.  In fact, I've seen a lot of practices whose raison d'etre is the use of a particular technology.

It seems that some of us have indeed, forgotten that the most important tool in helping our patients save thier oral health is the trusting, caring relationships we cultivate with them.  The truth is that there is no product, no technology, and no magic bullet that can displace a skilled practioneer doing the right thing for individual seeking good care.  The truth is that the best results occur when patients seek the right dentistry at the right time by the right dentist for them.

I have realized that few, if any of these “better mousetraps” of dentistry are bad things.  Some of them may, in fact, help us in delivering good care to those who trust us.  However, it is also abundantly clear that they will never push aside L. D. Pankey’s Cross of Dentistry: know patient, know your work, know yourself, and apply your knowledge.  The well-trained, ethical practioner knows where and when to use the lastest innovations for the benefit of the patient.  None of these innovations is worth anything without a caring dentist who takes the time to know what is right for each individual seeking help.

Our rapid growth in technology will fuel more innovations at a binding pace, as companies try to appeal to our fast-paced, quick-fix society, more and more attempts at bypassing dentists will come our way.  With this, will come more questions about whether the dentist really needs to be consulted before the lastest miracle product is purchased.

I hope that all of us reading this realize that no product or technologies can subsititute for a well trained dentist to help people attain their oral health goals.  The challenge that innovations pose to us is to continually stirve for clinical excellence and to work to strengthen the caring relationships with those we serve.

Technology and innovation are great.  They are meant to be used with wisdom and discretion.  Let us strive to apply our knowledge so that we can use tomorrow’s technology with yesterday’s values to do right by those we serve.

Posted on July 28, 2007

Dr. Alan Stern received his Doctor of Dental Surgery degree from the Medical College of Virginia School of Dentistry in 1981. He taught and served as Chief of Restorative Dentistry at Monmouth Medical Center’s Dental Residency Program. A gifted teacher and speaker, Dr. Stern’s lectures have been enthusiastically received by dentists and other professionals throughout the region.

Dr. Stern practices adult restorative and cosmetic dentistry in Ocean, New Jersey. He has completed the Continuum at The Pankey Institute as well as Dr. Michael Schuster’s management program. He has been published in the Pankeygram, the Journal of the New Jersey Dental Association, and other national dental news letters. Dr. Stern is also an adjunct clinical instructor at the University of Medicine and Dentistry of New Jersey. He is a member of the Jersey Coast Dental Forum, a comprehensive care study group, the Academy of R.V. Tucker Cast Gold Study Clubs, and the Academy for Sports Dentistry.

Alan is an advisor and contributing author to Co-discovery.org and lives in West Long Branch, New Jersey with his wife, Fran, and children Neil and Tracey.

Dr. Alan Stern is available to speak to local dental societies and study clubs on Team Building and other topics. He can be reached at www.alansterndds.com