By Perhaps your experience in dentistry has been similar to mine. After several years of practice, things simply were not working out as planned. I had entered dentistry under the assumption that I would be received as a respected professional. Based on this, I thought that most people would value my services. I also assumed that the public viewed dentistry as being associated with health, but my assumptions were soon proven wrong on many occasions.
This led to a lot of soul-searching, even wondering if I should continue in the practice of dentistry (a very dark moment for the son of a dentist). But after much reading, and reflection, I began to better understand who I was, where I was, and what I wanted for myself. I came to realize that my ‘problem’ with dentistry had a lot more to do with me than with the profession of dentistry itself.
I did not feel that what I wanted was particularly radical or unreasonable. I envisioned practicing in a fashion that was congruent with my dental school training, a practice centered on promoting and advancing dental health. At the time, the idea seemed simple and straight forward, but after listening to Peter Dawson for a couple of days in 1994, I realized that I did not yet possess the skills or understanding to do so. Stunned by the clarity of this “reality check,” I thought, “This is going to take a while,” and I was right.
So I put my shoulder down, and began to study at the Dawson Center, Pankey Institute and with Frank Spear. I involved my staff, and together we began to implement significant changes. The most essential of these was the integration of a proper complete examination process. I learned how to carefully check the health of my patients’ teeth, periodontium, TMJ’s, muscle system, and their inter-relatedness by assessing the functional occlusion. To enhance this process, I mounted study models on semi-adjustable articulators, started taking photographs, designated time to review the diagnostic information, developed diagnostic wax-ups, and crafted treatment recommendations. I felt certain that my efforts would lead to a practice full of people who valued what I had to offer, but it really didn’t happen that way.
Many patients showed no interest in learning about how to improve their dental health. Some didn’t even want to see what their mouth looked like. Others sat quietly as I carefully explained my findings and the logic behind my elegant solution to their complex problems. A few accepted my philosophy and plan, but many more left, never to be seen again.
I began to wonder if I was practicing in the wrong place. Were people in my town particularly disinterested in optimal dental health, or was there something wrong with the way I was doing things? Having committed myself to a significant amount of debt to set up the office, the former was something I could not easily change (this later turned out to be a blessing), but the later was something that kept eating away at me. How could it be that some dentists had practices brimming with patients, while I struggled to find individuals who were even remotely interested in the best that dentistry had to offer? It felt depressed.
It was not until I became a student of the late Bob Barkley that my “new” practice finally started to take form. This happened rather serendipitously after reading an article about Bob written by Avrom King. Soon I became a voracious reader of all things Barkley and King, as well as the lifelong works of L. D. Pankey, Harold Worth, Lynn Carlisle, Carl Rogers, and Scott Peck. Through their wisdom and insight, I gained a better sense of world of dentistry – as my patients’ saw it. I soon realized that most people had a significant “emotional heritage” connected to their memories of not-so-optimal dental experiences. Finally taking the time to listen, I learned that they had stories to tell; stories full of skepticism, pain, distrust, and fear. And even though these same people had great needs and great desires for better dental health, most had no concept of how to pursue it.
Closing the gap between the initial preconceptions of my patients and what was truly possible became my passion. Barkley said, “Build your relationships first – then your dentistry.” This simple but infinitely valuable piece of wisdom became the central focus of my practice. And like Barkley and Pankey before me, I became a student of how to build successful working relationships with patients. Naturally and concurrently, I abandoned trying to convince virtual strangers of what was wrong with them and what they needed to do about it and I committed myself to exploring solutions to their non-urgent needs after our relationship had matured a bit more.
These changes had both an immediate and profound impact on my practice. Patients began to drop their façades, and began to share with me how they felt, what they feared, and what they really wanted. For the first time, I found that I was communicating effectively on a consistent basis. I listened intently and helped my patients to understand that “what was” did not have to dictate, “what will be.” Moreover, through open, honest, relationships we learned more about each other, the possibilities, and their choices. The outcome of this “people-centered” process was better dentistry, dramatically increased productivity, a fulfilled care team, happier / healthier patients, and of course one very satisfied dentist.
Today, I practice comprehensive esthetic restorative dentistry four days a week in a low volume, high quality setting. Virtually without exception, every patient who enters my practice today knows who we are, what we do, is eager to learn more about it, and over time – enthusiastically proceeds toward what they want for themselves. And that is something I have found is good for everyone.
Paul A. Henny, DDS practices esthetic & restorative dentistry in Roanoke, Virginia. He is CEO of Mark 4 Associates, a dental practice development consultancy for comprehensive restorative dentists. He is Publisher and Managing Editor of Co-discovery.org, a non-profit e-forum for health-centered restorative dentists and is a visiting consulting faculty member of the Pankey Institute. Contact Paul by email at paul@Mark4Associates.com or by calling 540 314-6657.
Paul A. Henny,DDS