Bob Barkley had a mindset relative to time, that many dentists simply will not accept, particularly with today’s tremendous push for “same day dentistry.”
(I make this argument fully recognizing that there is a time and place for same-day-dentistry, with particular emphasis on emergency situations, or for previously well-planned work. )
Bob Barkley’s behavioral orientation recognized that going faster often was less productive and less health-enhancing. This perspective was founded on the simple truth that health can not be given to others, and that only the momentary removal of disease-causing agents, forces, and the employment of man-made substitutes can be given to others. The removal of disease-casing agents and employment of man made substitutes- a crown to substitute for a broken down tooth for instance- represents a stabilization of the situation- not true health.
This is because health is not just the absence of disease. The World Health Organization defines health as, “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.”
In other words, heath is not the ABSENCE of something, rather it is the PRESENCE of something….growth, development, movement toward a higher level of integration mentally, physically, and spiritually.
This of course was what L.D. Pankey was referring to when he created his graphic cross with “happiness” in the middle. Happinesses is the OUTCOME of heath, an ongoing and perpetual process, not a place in time. And certainly not something that someone else can give to another person.
Bob Barkley understood this on a very deep level, as he was a serious student of Dr. Pankey, and even served on the Board of Trustees of the newly formed LD Pankey Dental Foundation.
Hence, Bob understood that sustainable health has to involve personal growth – growth in a patient’s understanding of their situation, growth in their ownership of it, and growth in their willingness to course-correct, and to restore and maintain their oral and systemic health on a higher level.
Bob also knew that personal growth took time, so he had a developmental mindset, and not a “same-day” mindset. And that mindset was an active representation of his practice philosophy.
On this, Bob said, “About 80% of my practice is rehabilitative dentistry, done in many cases in the third to fifth year of working together. That is because it takes many patients that much time to really trust me enough, and to become sophisticated enough relative to understanding their choices, that they are ready to choose the finer kinds of services that I have to offer. In other words, it takes some people 3-5 years to change their operational values enough that they start to want the same things for themselves that I would want for them. It sometimes takes 3-5 years for our values to start to align enough that a full-scale, goal oriented collaboration can begin.”
(It is important to read Bob’s statement within the context of 1972 and in reference to the average person living in Macomb, Illinois at that time. Consequently, Bob’s starting point with his patients was in many cases much lower than what we see today with the significant increase in standard of living and due to our evolving cultural orientation toward heath. Consequently, in today’s timeframe, Bob’s 3-5 years might be more like 1-3 years or sooner.)
Regardless, growth still takes time. And when we elect to not take that time with people – and to instead just grab for ourselves what “production” is immediately available today, then we are often robbing both our patients and ourselves of heath. And isn’t dentistry supposed to be a health-promoting profession?
Paul A. Henny DDS
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