Last year, my prosthodontist friend called to tell me he was referring someone to me to evaluate for an all on four full arch rehabilitation. I thought to myself, “Wow, out of all the dentists in this area, my prosthodontist- the guy I refer to for all my impossible cases- is too busy so he’s sending me his overflow. How cool is that! But my friend  told me not to get too excited yet; the lady was price shopping and asked him for another good dentist in the area and he hoped that perhaps my fees were a bit lower than his specialist fees and that I wouldn’t mind seeing her. Of course, I agreed to see her. And, of course, my friend the prosthodontist was right

When I asked Mrs. Problem to tell me how I could help her, she went on a rant that began with  “ I need implants but I don’t want to have to pay for the prosthodontist’s fancy office”. As you could expect, our initial interview didn’t get too far. I don’t know what happened to Mrs. Problem, but she did give me some good talk points for which I am very grateful. With Mrs Problem in mind, I submit the following:


The emphasis of most of our education, from elementary school through Continuing Education is – perhaps rightfully- how to do things better. After all, reading, writing, math, science, etc are important if we are to advance in life.

In dentistry, our academic and technique classes and our Continuing Education are needed for establishing and advancing our careers. And, of course, it is so cool to get the latest and greatest gizmos, gadgets, and digital stuff so that we can do things more efficiently and be very impressive.

Indeed, people look at our offices with an expectation of our being on the cutting edge of our profession. But there’s a missing piece here, and that is the impact of who we are and what we do. This is precisely why we attract people with values similar to ours and why people like Mrs Problem leave our practices thinking that they are paying for our undeserved luxurious lifestyle

I think that the biggest aspect of learning something new, decorating our offices, or (intelligently) acquiring a new piece of equipment is to calculate, evaluate, project, celebrate and, perhaps, measure the impact that all of this has on the lives of the people we serve.

Think of the self esteem that beautiful set of veneers does for the person who seeks them. Think of the dignity that an all on four restoration restores to a person with malformed, debilitated teeth. Think of the life enhancement and disease prevention that great preventive services give to our fellow human being. And think of how wonderful it is for us and our teams, as well, to give those precious gifts to others in a warm and comfortable environment.

When we think outwardly; that is, when we see how our work can address the challenges faced by those who grace our offices, and project those feelings every working moment, we become a magnet for those who want and appreciate true care. And if we periodically check in with those we serve to see how they’re doing with our work, we reinforce to them and to ourselves that we are here to serve.


Mrs. Problem’s resentment of the prosthodontist’s and my (in her perception) bloated fees and extravagant lifestyles were her attempt to tell me that her values and ours are not in line. The impact of our mindsets was clearly not for her. I am totally fine with that and I know that this is the farthest thing from a judgment on what my or my prosthodontist’s practice are or should be. Our practices simply did not impact her the way she would have liked and that is OK.

The Mrs. Problems of the world will always be among us. With respect and without sarcasm, they will get the care they seek and deserve.

When we clarify our core values, project them in everything we do, and never forget that when our work is outwardly directed, our impact on those who seek, need, and want us becomes profound and life gets a whole lot better.

The Sky is Falling…or is it?

A young dentist (let’s appropriately call him Dr Young ) recently asked to speak to me. He was clearly anxious as he opened an envelope to show me that he had been served with a lawsuit relating to a procedure he had performed a year ago. The details are unimportant here; suffice it to say that from my cursory review of the papers, I am 100% confident that the attorneys for his malpractice carrier will manage the case well with minimal, if any, tangible impact on him.

My concern is for the very promising career of an outstanding young dentist who is also a dedicated public servant. You see, Dr Young is seeing his career coming to a rapid end, envisioning a modern-day tar-and-feathering by his state’s Board of Dentistry. He is also questioning his ability to do anything and is reluctant to do procedures like the one he did in the case we are discussing. Our President would call Dr Young’s mindset fake news. I call it a false narrative.

The recipient of a legal summons is rightfully not happy and Dr Young’s short-term anxiety is not unreasonable. But disgruntled patients and bad outcomes from procedures done well, from the goodness of our hearts, happen every day. We need to not only put it all into perspective, but we also need to grow from them. Here are a few things Dr Young and I discussed.

  1. Never work on a stranger was one of Dr Pankey’s famous sound bites. When we establish a connection as one caring human being with another, outcomes seem to always be better. And even when things go awry, as they occasionally do, fixing the problems is much easier when doctor and patient have a rock solid trust in one another
  2. You will be imperfect 100% of the time despite your best efforts. That is not to say that open margins, periodontal neglect, or gross occlusal discrepancies are to be passively neglected. The point is that we can always find something to improve in our work. That is not a failure; it is a learning experience. We cannot beat ourselves over the head if a procedure of ours isn’t beyond critique, a disgruntled patient leaves our practice or files a complaint, or even if our cash flow is not what the so-called experts tell us it should be. We can only use these experiences as vehicles for self-improvement.
  3. Show me a person without stress and I’ll show you a cadaver is one of my signature lines. Dentistry is stressful. So is anything else we do! We cannot let our problems define us. We need to know that we are capable to rising to the challenges we face Dr Brenee Brown talks about this in her wonderful book, Rising Strong.
  4. Work is important, but there is far more to life. A bad day at work does not mean that you are any less worthy a human being or any less loved and respected by those who know you.
  5. Most importantly- 98% of things we fear never materialize. The great motivational speaker, Earl Nightingale, told us this in his classic book, Lead the Field. A complaint, a disgruntled patient, or even a lawsuit will make you feel awful but will very likely not destroy your career or life.

Remember that the Constitution of the United States guarantees us the right to life, liberty and the pursuit of happiness. That means that no one- not even you- is allowed to make you miserable. Don’t allow it.

I would love to see some feedback on this from the group. Any thoughts? How do YOU handle adversity?

How Strong are You?

Our very rewarding work demands a lot of us. We need to focus on small objects. We need to manage people both in our chairs and around us. We have bills to pay, courses to take, labs and suppliers to deal with, families to support, and on and on.  In dentistry as in life, there is a ton of stress. In fact, show me a dentist without stress and I’ll show you a cadaver!

Stress takes a physical toll on us and we need to be prepared. I’ve seen too many dentists overweight, slouched, with poor core and muscle tone, and barely capable of making it through a long and taxing day. Many dentists have told me that they are too busy to maintain a fitness regimen. I maintain that being physically and nutritionally strong are the two most critical keys to a happy, successful life. Couple that with the reality that, for some of us, working well pat the conventional retirement age of 65 will be necessary, especially if our life expectancy is into our 80s and beyond. So, we don’t want to become, as Dr. Pankey once warned us, “too old to work and too poor to retire”

Let’s take a look at what I’ll call fitness 101

Attaining fitness can be very intimidating for those who have not exercised in a while. Really and truly, though, the only ingredients you need are focus and patience.  A good gym with a good trainer and nutritionist would help, too, but let’s start with some basics.

For those with medical conditions, a consult with your friendly physician would be imperative.

For those who have not done anything in a while, some light walking several times a week would be a great way to work up to a nice baseline as I outline below.

I am trained to do 150 minutes of cardio a week. I do not care how it breaks down, as long as I have a minimum of 15-minute intervals. That is, I can do ten 15- minute sessions, five 30 minute sessions, two 45 and two 30-minute sessions, etc. Although I really enjoy running, my knees and back occasionally will politely request that I walk briskly. I listen to what my body tells me and, although I will occasionally defy it, I am generally attentive to what it tells me. Elliptical machines and stationery or real bicycles are also great.

Once you have your cardio act in order, it’s time to start thinking about resistance training. Toning your abdominal and back muscles; i.e. the core, is critical for flourishing as we age. A few suggestions- try holding a plank (the upward push – up position) for 20 seconds and increase your endurance gradually. And here’s a cute one- one fellow I’m following did some push-ups after each time he went to the bathroom at home

The impact of physical fitness on our focus, mood, self-esteem, and, of course, health is tremendous. The road to fitness begins with some simple steps which almost anyone can do. Of course, if you can engage a personal trainer and/ or a nutrition coach, you will get there at a faster pace.

Any way you choose to improve yourself is great. I did it; you can, too. Let’s take that first step now. As my mother used to say, you’ll thank me when you get older!