An overview of the Pankey Philosophy for dentists

Dr. L.D. Pankey lived in a different time. When L.D. graduated from dental school and started his dental practice, there were no computers, no cell phones, and no Internet. To continue his education, he read journals, went to professional meetings, and studied how people behaved both in and out of the dental practice environment. He soon learned being a dentist can be an all-consuming profession. Many dentists have found the profession difficult because of the technical complexities of the work and the psychological pressures from family, staff, third party payers, fellow dentists, and patients. Because of a series of personal experiences, and the fact he wanted to help his profession, L.D. developed a way of thinking and looking at life. He called his program, “A Philosophy of the Practice of Dentistry.”

As practicing dentists, we rarely consider ourselves philosophers. Yet in an important way, we are philosophers. Day-to-day decisions about our work and lives are based on what we believe, in other words, our own personal philosophy. Philosophy has to do with the relationship between our personal beliefs and the actions we take. In the end, it’s our philosophy that gives meaning and purpose to our lives. For dentists who know their beliefs and what has meaning for them, daily work is not merely unrelated actions and episodes. It is an integral part of their life.

There is an important distinction between “having” a philosophy and “living” a philosophy. “Having” a philosophy implies having ideas, but it doesn’t necessarily mean that those ideas are being acted upon. Learning best takes place when we “live” a philosophy, meaning living in a state of inquiry based on our values, knowledge, and goals.

According to Jim Dyce, a contemporary British dentist/philosopher, “Philosophy can do no more than initiate questions about yourself and your circumstances.” When the late Dr. L.D. Pankey decided to devote his life to saving teeth, he was forced to ask himself, “How can I help people keep all of their teeth all of their lives?” In 1925 L.D. didn’t know the answer or even if there was an answer. When he decided to never extract another good tooth, he was taking an enormous professional and economic risk. He was able to uncover and develop many principles that have proven instrumental in our understanding of restorative dentistry and patient communication. Philosophy, in its most valuable form, is more concerned with the right questions than the right answers.

How useful the Pankey Philosophy is to you depends on your willingness to put yourself into the questions, as this form of inquiry will help you clarify your goals and show you the many ways to accomplish them. Questions can open the floodgates to new insights and information about yourself, your patients, and your surroundings.

Just as questions and uncertainty can be the catalyst for change and success, so too can questions cause crisis. In the Chinese language, the written character that represents “crisis” also means “opportunity.” L.D's first real crisis of his dental career over 75 years ago was when he found out that his mother had needlessly lost her teeth. His mother’s distress over having all her teeth extracted made him question his entire concept of dentistry as a profession. Doubt and confusion followed his mother’s sad news. He saw clearly the damage that dentistry could do, and at the same time he realized the extraordinary opportunity for dentists who understood the magic of “giving nothing less than the best.” Out of this family crisis, the Pankey Philosophy was born.

The Pankey Philosophy seems simple enough at first glance. To start, each dentist must decide what success means to them. Napoleon Hill says once you have figured out your idea of success, you must believe in it and then work hard to achieve it. The greatest success in dentistry is the gratitude and appreciation from patients, enough financial reward, and the commitment to five the best you can to your family, your patients, and your office. This involves really knowing yourself, your patients, and your work, and then applying your knowledge conscientiously.

This is not easy. Although many of the principles Dr. Pankey used have been around for years, how many dentists actually apply these principles to achieve excellence? Based on his work with hundreds of dentists, L.D. estimated that only 2% of the dentists in this country were truly masters, meaning they could do, teach, and write about dentistry. Another 8% were adept at two of those skills, and 36% were constant students of good dentistry, working toward mastery. The remaining 54% were indifferent and uninterested in their work. That’s the bad news. The good news is for dentists who make the sincere commitment, the opportunity to do excellent dentistry and achieve their just rewards is there.

If success does not provide motivation to pay the price for excellence, consider the personal price involved in doing less than your best. Ask yourself, “Is dentistry killing me?” There was an article in the North Carolina Dental Journal that suggested that dentists have a higher suicide rate than other professional groups. This sobering statistic can be attributed to two factors: dental work is usually confined to a small office, where dentists go day after day, week after week, to the same place with the same people. Second, once dentists become really good, their work is very much the same. The result is feeling not appreciated, trapped, not achieving, and wondering, “Is this all there is?” This is not to say that dentists have lives of “quiet desperation.” Yet many have felt in a rut at one time or another, at which point it becomes increasingly difficult to see the real rewards in dentistry.

Looking back at our dental school education, most of us were taught to be technically proficient; however, we were not taught how to develop satisfaction with our work or rapport with our patients. For some, enjoying work and patients is very natural, while others seem to treat their patients as mechanically as if they were repairing dental equipment. Dentists go to professional meetings and take countless hours of continuing education in restorative dentistry and implant placement, yet are unable to use their new knowledge and skill because they can’t explain the benefits of their work to their patients. Not only does this lack of communication deprive them of income, it also deprives their patients of something that could make them happier and more dentally comfortable.

L.D. started teaching his philosophy to dentists who had been referred to him by the Florida State Board of Dentistry in Tallahassee. He was the representative from the Miami-Dade County Dental Society to the State Board. He had been developing his philosophy more than 15 years. In 1947 the Florida Dental Association asked him to present a course related to ethics at their annual meeting. He had gained the reputation as a good adviser to dentists with minor difficulties related to their dental license.

During his first interview with these dentists, he learned that most of them were unhappy in dentistry. Although not all of them had the same concerns, he found there were some common characteristics. He decided the purpose for teaching his philosophy was to help dentists confront and move past their frustrations or boredom, to move toward a higher level of excellence in their technical work, to improve their communication skills with their patients, and to achieve greater satisfaction through community service and their personal happiness. To develop the basic principles of the Philosophy, L.D. asked many of the following questions.

As you read the questions look objectively at yourself and your situation. Take some time and write your answers to discover where you fit or don’t fit into the questions. Develop some personal goals. Write them down so you can measure them later.

1. Are you happy in dentistry? (work)
Do you have enough leisure time? (play)
How is your home life? (love)
Do you have inner peace? (worship)
2. Are you developed to your highest potential?
3. Have you considered your personality factors?
4. Do you have the respect and the cooperation of your employees?
5. Is your office well organized?
6. Have you taken aggressive steps to make it so?
7. Have you obtained outside help to analyze your situation and assess your problems?
8. Do you have the courage to make the necessary changes?
9. Are you a good citizen?
10. Is dentistry “killing” you?
11. Do you understand and use time studies?
12. How is your overall health?
13. Do you have a complete medical checkup once a year?
14. How do you feel about yourself and your profession?
15. Do you have a positive attitude?
16. Do you have a negative attitude?
17. Do you have clear, well-defined goals?
18. Are your goals written down?
19. Do you have a way to measure your goals?
20. Are these your goals rather than someone else’s?
21. Are you willing to work to achieve your goals?
22. Are your goals and objectives in line with your circumstances and temperament?

Happiness is achieved not only in reaching your goals, but by realizing and calibrating your progress toward your goals. Always keep in mind you are in charge of your goals. You can change, adapt, modify, or forget your goals anytime. Bob Dylan wrote, “He who is not busy continually being reborn is busy dying.”

Following his success with those first groups of dentists, L.D.'s office started getting calls every week from dentists around the country wanting to study with him. So in 1952 he decided to share his knowledge of the Philosophy with the dental profession in a more formal format in Miami at the Pankey Institute.

This article first appeared in DE's Expert Tips & Tricks. To receive enlightening and helpful practice management articles in this e-newsletter twice a month, visit dentistryiq.com/subscribe.

Bill Davis is the Chief of the Dentistry at the University of Toledo Medical Center. He is practicing dentist and a professor in the hospital-based GPR program. In 1987 he coauthored a book with Dr. L.D. Pankey, “A Philosophy of the Practice of Dentistry.”