It seems hard to imagine. Almost every week, dentists from around the country shut down their practices and converge at the Pankey Institute in Key Biscayne, Florida for a week of professional education — and they don't even bother to bring their golf clubs. In fact, they're lucky if they get a chance to dip their toes into Biscayne Bay. Instead, they spend eight hours in class each day, honing their clinical skills.
There are plenty of programs for dentists who want to keep pace with the latest technical advancements. Pankey has a second purpose: For 28 years, the institute has taught dentists how to assess the quality of their professional lives, maintain self-esteem in a profession that is almost universally hated, and develop more meaningful relationships with their patients. Dr. Douglas McDonald, 33, who shares a practice with his wife in San Diego, attended his first Pankey course in June. "My intention was to become a better clinician," he says. "But as the week went on, it was the philosophy in the Pankey curriculum that was having the most impact on me."
"Most dentists arrive here asking themselves, 'Is this all there is?' " says Christian B. Sager, 55, executive director of the institute. "They're trying to find more meaning in their work." It sounds like the setup for a bad dentist joke. (What do you call a dentist who's depressed? Down at the mouth.) But the lessons to be learned from the Pankey Institute will surely resonate with anyone who's been wondering why work is just not as inspiring as it used to be, and what can be done about it.
Is Your Job Killing You?
Burnout among dentists is surprisingly common. Isolation is a big factor: 80% of dentists are sole practitioners. And the profession is physically demanding: Dentists are on their feet all day, and they spend most of their time with their hands inside a nervous patient's mouth, which is a very small place. For a dentist with a busy practice, the stress can be relentless.
No wonder a lot of dentists get divorced or develop emotional problems, says Dr. Irwin M. Becker, 57, Pankey's education-department chairman. So the first thing new students are asked to do upon their arrival is answer a set of very blunt questions, which were first posed by the institute's founder, Dr. L.D. Pankey, in a treatise he wrote back in 1952: "Are you happy in your work? ... How is your home life? ... Do you have inner peace? ... Is Dentistry killing you?"
Have Closer Encounters.
It's a common midcareer syndrome: Your company has matured, you're pounding out 12-hour days — and then you wake up one morning and realize that you hate your work. "We spent a lot of time talking about very basic questions, like figuring out how we really wanted to practice," says McDonald. "The instructors asked us whether we wanted to have relationships with our patients or just have encounters. And I realized that I'd been having a ton of encounters with my patients, and that it was just really empty."
Indeed, Pankey studies show that over time, patients tend to build better relationships with their dentist's receptionist than they do with their dentist. How can this be? "Too many dentists work in a crisis mode," Becker says. "They just jump in and fix what's broken, because that's what they think their patients want."
But there's a lot more that dentists have to offer over the course of a 20- or 30-year relationship, Becker says. The relationship with a patient should be more holistic. Pankey instructors refer to this as getting people to "accept dentistry," and despite the cultish sound of that goal, they believe that it is crucial to the health of a dentist's career. "The best patients are the ones who want comprehensive, individualized care," says Sager. "And that's what makes the profession fun. Dentists can do their best stuff on people who really appreciate it."
What's in a Tooth?
One staple of the Pankey curriculum for first-time students is Becker's Thursday-morning philosophy lecture. "We're trying to get them to see the big picture," Becker says. "The dentist mentality is to look at the little details. That's what they've been trained to do."
Turning to big thinkers for insight on how to work in small mouths is not a new idea at the institute. In fact, Dr. Pankey, who died in 1989, often invoked Aristotle in his writings — in particular, Aristotle's belief that happiness is the ultimate end, for which everything else exists. Pankey surmised that in dentistry, if patients are sick, "it's health that creates happiness. If disfigured, it is esthetics that creates happiness. If it is pain, it's comfort that creates happiness. It is for the creation and preservation of all of these that [patients] seek dental services."
That was nearly 50 years ago. Today, of course, insurance companies and HMOs are focused on less spiritual concerns, like quantifying services rendered or products delivered. But Becker believes that such a focus is misplaced. "The crowns and bridges get built by technicians and ceramics specialists who work with us," Becker says. "But what ultimately makes our work valuable are the things that revolve around these commodities, like judgment, and skill, and care."
Visit the Pankey Institute on the Web (www.pankey.org).
Sidebar: Do Your Meetings Have Bite?
For dentists (and their patients), the preclinical interview is an important part of the treatment process. For many interviewers, however, initial client meetings can often be underchoreographed events. Here are some tips from Dr. Irwin M. Becker, education-department chairman of the Pankey Institute, on how to make first meetings more meaningful.
Set the tone. Close the door. Hold your calls. Turn off your email dinger. The person you're meeting with should be the most important person in the world to you at that moment, so you ought to make every effort to give that person your undivided attention. Make a lot of eye contact — but don't stare.
Ask fewer questions. Sure, you're the expert. But don't do more than 20% of the talking. The idea here is to distinguish real needs from perceived ones, to get a sense of the entire range of problems that might cause someone to seek you out.
Let your customers do the talking. People make more decisions when they're doing the talking than when you're doing the talking. At the same time, they need to be able to see, at the end of the conversation, why you're the right person to help them. Make sure they understand that you're there to help them neutralize future risks, not simply to solve acute problems that they're having at that moment.
A version of this article appeared in the October 2000 issue of Fast Company magazine.