"I Never Saw a Tooth Walk into My Office”

By Dr. C. Roger Macias

"I Never Saw a Tooth Walk into My Office”

There have been several quotations and one title that have created the biggest impact in my life as a dentist. The quotation above by Dr. L.D. Pankey and one I will reference later; the other, a title of an article by Dr Peter Dawson… “How to Put Your Practice in the Top 10%”

I was a fledgling dentist of 7 years who had just started a nice solo practice here in the beautiful city of San Antonio after having been an associate prior to that. During those early years of my practice, I sometimes l felt like I was selling commodities versus delivering comprehensive patient care. Many times, I needed that patient to say yes to that crown, so I could just be able to make my financial responsibilities. I had bills to pay. I diagnosed that way without even thinking about it. I thought I knew how to diagnose I just needed the patient to say YES!

I thought I knew quite a bit about practicing dentistry until I read the “top 10%” article by Dr. Dawson in the May 1990 issue of “Dentistry Today” magazine. This article cited that “Management must be focused on the control of QUALITY and the continuous upgrading of diagnostic and clinical expertise.” I wanted to be in the top 10%!

It was soon after reading that article that I began my studies with Dr. Dawson in San Antonio, St. Petersburg, and finally in Highlands North Carolina. It was here that I had many “aha” moments on how much I didn’t know!

My clinical skills, although excellent from my dental school education, lacked a deeper knowledge base of that needed to deliver comprehensive care. So, I was now on the quest for more and more education in clinical based dentistry. Once I finished Dr. Dawson’s programs, I asked him, “now what Dr. Dawson?” He told me, “Now you need to go to the Pankey Institute!”

My journey began at the Institute in October of 1993, and it led me to more than just clinical based dentistry. This is where I first heard the quotation I mentioned in the title of this article. Dr. Pankey was so ahead of his time in his philosophy of dentistry, that he was the shoulder of the giant I needed to stand on! Piggybacking what I had learned with Dr. Dawson, I was committed to learning this philosophy of “patient centered care and relationship-based dentistry” from the amazing Pankey faculty there. I felt I was always a caring dentist and my parents had reared me to know that putting others first was a most important virtue.

Along this journey, I heard another giant, Dr. Loren Miller from Dallas speak at a conference. He was one of the first members of the original “Pankey Cadre” that helped set up the Institute. We were having dinner once in Dallas and he told me, “When I was young and I needed patients to say yes, they said no now that I am older and I didn’t need them to say yes, they said YES! They probably saw the dollar signs in my eyes!” This was exactly what I needed to hear.

So, this leads me to today and what we as members of the American College of Dentists can offer today’s “fledgling” dentists. Life as we know it has changed for those of us that have been in the profession of dentistry for a while. It is now our opportunity to be the “giants” that our younger dentist can look toward for advice and help.

The model of providing dental care is changing. The demographics of those providing that care is changing. We as a profession and specifically us as a College, can sit around and bask in our glory days or we can step up and provide leadership in our expertise in how we deal with relationship-based dentistry.

Society, especially the young adult, is moving at lightspeed away from relationship-based “anything” to computerized, phone centered, “I don’t need to speak or socialize with you” to be relevant. This in my opinion creates a danger of taking dentistry from a profession, to strictly business without concern for the person on whom this business is being performed on. Ethics in this type of “business” comes into question. It might be ethical, or it might not be.

So, what can we do? The American College has always been at the forefront of ethics. We as a College need to look at innovative ways to help our younger dentists celebrate “relationship- based” dentistry and ultimately this model, (what the Pankey Institute calls “knowing your patient”) of patient centered care which hopefully will continue to cultivate an ethical model.

This is not to say other models of care are not ethical or unprofessional, but modern dental business models of providing care all have the Dentist to ultimately provide that care.

In future editions of this Newsletter, I will continue to address these concerns on how we can be the giants that keep our profession, something we can all be proud of.

I pray that more of us remember and can help spread the notion that: “I never saw a tooth walk into my office It was always connected to a person.”