“How Soon should I do this, Doc?”

That was the question I heard last week from Sam, a very successful entrepreneur and business consultant  whose open proximal contact between a large, wide and  fractured composite restoration and a healthy tooth was causing chronic irritation to his periodontium. The tooth is clearly in need of a full coverage crown.

Now, we’ve all heard that line a million times in our practices. Back  in the 80s, gurus and consultants told us to give patients a sense of urgency to do their dentistry. “Get em to commit right then and there, while you have ‘em in the chair”, they’d say. “That way they can’t back out. And you know they need the treatment” When I heard this in the beginning of my career, I became agitated. And I still get agitated when a speaker, writer , or  one of my colleagues talks about getting a commitment from a hesitant or nervous person on extensive treatment during a brief chairside conversation.

I’ve always been uncomfortable with this blanket, one-size-fits-all  strategy for profitability. You see, wellness is elective. And, whether we like it or not, sometimes life throws other urgencies at people. Having teeth is elective. And maybe, just maybe, that seemingly successful person who lives in the great neighborhood may have more serious priorities in their lives, whether we think so or not!

If we are to have a meaningful, healing , nurturing relationship with people, we have to keep it real. Dr Pankey’s first rule was know your patient. In an era when people formerly known as patients have become consumers and we dentists are motivated to make their lives better,  it is absolutely critical that we behave in an open honest, nurturing manner and make them feel safe in expressing their concerns in the same way (yes, those we serve can nurture us every bit as well as we can nurture them).

Instead of establishing urgency to dental treatment, why not take a moment with that person and explore how it fits into their lives. Lead them to make THEIR best decision on that crown, that implant, that full mouth rehab that we are chomping at the bit to do. Because when the receiver of the service is in control of how and when they receive the treatment, we all benefit.

And if and when that person comes into your office with a condition that absolutely cannot wait, like early endodontic pain that’s about to become a full blown abscess, your sense of urgency will be quite real and credible.

It turns out that the company Sam is consulting is in a bit of trouble, but will be paying him a huge sum of money next month. So he asked if he could call us in a few weeks to schedule his work without any financial anxiety. We listened, we understood, Sam appreciated it, and the work will get done at a time that makes sense for him. After all, it’s HIS life we’re looking to make better.

Mission accomplished


Serving with Heart

There are times when the power of science is so seductive that we may come to feel that all that is required to serve others is to get our science right, our diagnosis, our treatment. But science can never serve unless it is first translated by people into a work of the heart”

 Rachel Remen from My Grandfather’s Blessings


No one can disagree that the technological and scientific advances of the last 50 – 60 years have improved the lives of countless people. And no one can argue that the pace of our advancement is accelerating faster than ever. Let us not forget, however, that compassion and care of another human being can easily get lost in the maze of technological advancements, both inside and outside of our dental world.

A few months ago, I found out that my social security account had been breached. With a sense of urgency, I moved a few patients in my schedule and went to my local Social Security office. What I encountered was nothing less than dehumanizing and nauseating. After a nearly two- hour wait, I encountered a clerk who took my complaint, looked at the co worker sitting next to her and said “we got another one” and proceeded to process my information at a snail’s pace. Not once did she express concern for my well being. Not once did she address me by name, or even “sir”.  She even scolded me for politely asking how long the process would take, only responding when I firmly told her that I am a practicing dentist , had been waiting for two hours and that a patient in pain was in my office waiting for emergency help. Civil service is a good thing. Heartless, unaccountable arrogance in any service is not. The clerk failed to realize – or had been conditioned not to even bother thinking of- each human being is a story of hope, fear, happiness, and sorrow. Empathy is clearly not in her job description. But shouldn’t empathy be in ALL of our interactions?

I am reminded of the debut of over-the- counter home tooth whitening products back in the 1990s. A salesman came to my office and touted the wonders of his product , telling me, among other things, that patients will not get the level of whitening from his product that they can get from a dentist and that they will seek additional whitening services once they try the OTC products that we should recommend. He also told me that patients would want to replace their anterior crowns and composites once their teeth become whiter. This phenomenon is an example of Dr Remen’s point. How heartless is it to manipulate a person to do something that could begin a cascade of overtreatment? How can we justify applying the latest and greatest technique or technology without understanding the needs, the wants, the lives of the people who are trusting us AND helping them understand how these technologies can impact their lives both positively and potentially negatively?

As we enter the very exciting digital era of dentistry, huge opportunities are unfolding before us. Scanning, digital smile design, digital recording of Centric Relation, and 3-D printing are here. But how will we use it all? Will we apply the latest technology each time a human being walks into our offices before a thorough evaluation? Will Third Party Payers, Electronic Health Records and algorithms supersede the care, skill, and judgment that only a human being can give?

My team and I are reviewing our core values in the process of  updating our Mission Statement to reflect our uniqueness,  what we value, and what we have to offer to people with our skills and with our hearts Practicing from the heart brings joy, fulfillment and prosperity to us and gives the people we serve a unique and valuable service unavailable in many other aspects of their lives. Let us never forget to keep this important element in our practices and, I dare say, in as many of our human interactions as possible.




Six Things to do Every Day



Let’s start with the understatement of the year- Dentistry is demanding. Focusing on small objects and doing our best work for six to eight hours a day can be physically draining. Dealing with the people attached to those teeth can and should be a joy. But staying focused on people as well as small objects just doubles the amount of energy we need during the day. Add to the mix the occasional difficult patient, a case that doesn’t seat, and perhaps a bit of business management, and your day could either be incredibly energy draining or equally rewarding.

We cannot avoid the imperfections of dentistry and life and we cannot dodge the many responsibilities that come with the privilege of owning a practice. But we can hedge our bets and be prepared for the things that get thrown at us every day. Here are a few things that have helped me over the years. I hope you find them useful.


Eat a good breakfast

You’ve heard it a million times but many people (perceive that they) don’t have time for breakfast. A high protein, moderate carbohydrate start to a day is an instant energy boost. My wife and I love our vegan protein shakes, but there are many other ways to get a great, tasty, essential energy surge for your mornings. Consult a nutritionist or a health coach or do some reading to find what works best for you. But please do not skip that morning fueling of your body’s engine!

Look in the mirror

Take a good look at yourself. What do you see? Do you see a living, vibrant, productive human being endowed with skills that few others have? I don’t care how successful or unsuccessful you (think you) are; you are, at a minimum, those wonderful things! Pause for a moment and see something great in the mirror.

Do you see something about yourself that you’d like to improve? Embrace it. Use it as a vehicle to be just a little bit better today. If you’re not what you want to be physically, think of ways to make yourself better. If you’re not what you want to be clinically, think of things you can study or learn. And if you’re not what you want to be personally, think of little things you can do to improve your relationships. We ALL have flaws. We are ALL imperfect. We do not have to accept those flaws as unchangeable. And we most certainly need not beat ourselves over the head over our imperfections. It feels great to have made improvements in all aspects of our lives, but remember that it takes a long time to become an overnight sensation and that change comes about as a result of a sustained effort, beginning with baby steps. Whatever it is you want to improve, take that baby step today!



We are hunters and gatherers by nature. By moving, we tell ourselves down to the cellular level that we are fulfilling a purpose. By moving, we are strengthening our hearts and developing collateral circulation. A general guideline is to do 150 minutes a week of cardiovascular exercise; that is, brisk walking, light running, cycling, elliptical machine use, etc. You can do five 30- minute sessions, ten 15- minute sessions, or any formula that works for you. The more days you do some cardio, the better.

By using some form of resistance training, we are toning our muscles to avoid the ill effects of aging. I like to get at least two resistance training sessions a week to stay toned. Try some push-ups, wall-sits, or planks at home.  Better yet, engage a personal trainer to show you things you can do for yourself. It’s a great investment!


Years ago, someone told me that gratitude is currency. That is SO true! Just about everyone walking this earth can think of something to be grateful for. You are blessed with, in the very least, a skill set that few others have. You have the ability to help people and earn an above-average living. Are your parents living? Are you healthy? Do you have a spouse? Children? Friends?  A roof over your head? Did at least one good thing happen to you today? I challenge you to think of at least three things to be grateful for every time your head hits the pillow each night. Do that and you will wake up prosperous each morning.

Change a life

Sometime during my morning routine, I put the following thought into my head: “Whose life will be better because of me today?” When you think about it, isn’t that what we are here for? I submit that even the simplest task we do for patients is really a powerful change to a sensitive part of a person’s moment-to-moment existence. And how do you think you can impact the life of the letter carrier or the UPS or FedEx guy when you greet them by name or offer them a cup of coffee or bottle of water when they come in? How about that team member you thank in a special way? Every interaction we have offers us the opportunity to enhance the life of another human being. For me, that’s more than enough to get me out of bed, happy to be alive, no matter what else is going on in my life.

Arrive early

Get to your office early. Ask the same of your team Walk into your office see what your patients will see when they come in. Look over your charts and have an idea of what you’ll be doing. Try to remember something about everyone you’re seeing today. And have a morning huddle to discuss it all. It only takes 10-15 minutes. Being prepared and punctual prevents that awful feeling of falling behind and gives you a greater sense of control of your day.

You can attain fulfillment in an imperfect, demanding, rapidly changing world. Take care of your health. Eat well and exercise regularly. Stay positive- remember that there are many good reasons to do so. And approach your work and everyone around you with enthusiasm. Prosperity happens when you make the world better for yourself, your families, and for those you serve. Take a few simple steps to assure that it happens in your world!