Th 266729

Mission based

Nov. 1, 2007
I don’t treat many kids these days. I never specifically ruled them out, but as my practice matured fewer children showed up.
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by Barry F. Polansky, DMD

I don’t treat many kids these days. I never specifically ruled them out, but as my practice matured fewer children showed up. Some years ago I began to focus on comprehensive dentistry with an emphasis on restorative and cosmetic procedures. I did that for many reasons that benefited not only my patients, but also my own selfish needs - to enjoy my work and give my life at work more meaning. It’s not that I don’t like kids, but soon after I began practicing, I developed a tin ear and an uncontrollable twitch when I felt that I was losing control. But I do see some children. The good ones.

When little Chris came in a few months ago I put him in the “good” category - at least that was my first impression. And so when I placed two simple composite resin fillings, quiet little Chris stayed cool and calm ... until he realized that his lip was numb. Without saying a word, his eyes began to tear and a frightful look came over him. Within seconds Chris was transformed into a screaming, crying, out-of-control monster. Mom entered the room promising him everything from a Big Mac to three nights at Walt Disney World. Nothing worked.

The procedure ended on a sour note, but I have to admit I did a couple of pretty good composites. I felt victorious. The following week we scheduled Round Two. Considering the successful result, I had little to fear. At the next appointment Mom reported Chris was fine. As a matter of fact, Chris looked happy to see me as he sported his brand new Luke Skywalker lightsaber. I could only guess that he brought it because he had me confused with Darth Vader, but Mom explained that it was his prize for being such a great little dental patient. All evidence pointed me in a forward direction.

This time the tears came just after the numbness set in. Thoughts of Ivan Pavlov filled my mind. I figured Chris’s “bell stimulus” was the numb feeling rather than the actual needle. This visit was a little more stressful, but manageable ... but the fillings weren’t quite as good as the first ones.

I wasn’t looking forward to Round Three as Chris entered with the lightsaber and his brand new Boba Fett Blaster. Now I was really worried. This time Chris had it all together. He knew the numbness was caused by the needle, and further he knew that I was the one who held the needle. Hence the Blaster. This time Chris began to break down when he looked at me. I was the stimulus. I had become the Pavlovian bell. I had Chris scheduled for a one-hour appointment, and I began to think an Anthony Robbins firewalk would be a better way to spend the hour. It was time to invoke Plan B. Whenever I have to invoke Plan B, I rethink my mission:

To help people keep their teeth for their whole life, in optimal health, comfort, function, and esthetics, and to do it appropriately.

My mission may sound vaguely familiar to you. I plagiarized it. Took it right out of Dr. Pankey’s original philosophy. Hey, call me a thief, but some of my best stuff comes from other people. As a matter of fact, maybe I have never really had an original thought, and that’s OK. What’s really important is that I try to live my mission, and guess what? It’s easy when your mission is based on your values. Health, comfort, function, and esthetics are really important to me. That’s why I spend an inordinate amount of time, money, and energy on diet and exercise. Someone once said, “When you find a good enough reason why, then the how gets real easy.” Understanding your values is the first step in understanding what motivates you.

I dislike the terminology “clarifying values.” It sounds as if you are playing some kind of active role in creating your values. Discovering and understanding your values sounds like a more worthy activity. Elvis once said, “Values are like fingerprints ... you leave ’em all over everything you do.” I believe that. I believe that you are a physical expression of everything you hold dear in life. Let’s take a closer look at Dr. Pankey’s mission statement and those four reasons that drive people to the dentist: health, comfort, function, and esthetics. I use those same four drivers when I create all habits of good diet and exercise.

Health → I exercise and eat right for cardiovascular health. I want great health because I love life and want to be here for a very long time. That’s a strong, driving motivational force for me.

Comfort → No one likes pain, and I exercise and eat well because I want to feel good, and I want to have high energy. Now that’s a good motivator for developing great, healthy habits.

Function → When I became a diabetic, I was mostly worried about living with some disability. I not only want to live a long life, but also a very active functional life. Something about being disabled bothers me.

Esthetics → Of course many people get on the bike and eat right because it makes them look good. Whatever floats your boat. Sure, it motivates me, too, but the outer expression of health is just part of it for me.

Dr. Pankey’s mission statement for dentistry struck a chord for me because it is complete. It is comprehensive. I discovered that “integrity, harmony, and order” are also strong values of mine. That may be why I gravitated to the Pankey Institute and why others who share those values do, too.

Let’s not get too far along with the discussion of values before we get back to that moment when I had to make a choice about what to do with Chris. If my values were more centered around me and my survival issues, or winning issues, then if I followed my usual protocol it would have proven disastrous for me and made little Chris into a lifelong dental phobic. And that is not my mission. If my values were wrapped up in some daily production goal, or how beautiful my direct composites can be under the most adverse conditions, I would win a battle and lose a war. Chris would lose the battle and the war.

In a situation like this, there is only one way out. By understanding your values and concretizing them with a mission statement, you create daily habits that are mission based. You become the proverbial “man who walks his talk.”

Too many dentists - for whatever reasons they have (usually survival issues based on some scarcity worldview) - create too many bad habits. Enough bad habits lead to a lot of stress and anxiety. When the stress and anxiety come, these dentists turn to ways to alleviate the pain. Sending Chris to a pediatric dentist may sound like a no-brainer to you, but understanding why to send the patient is what Dr. Pankey meant when he said “Know yourself.” Sure, I lost the hour, I didn’t get to do those composites, but I felt good when I told Mom that we were sending Chris out because I want to see Chris keep his teeth in optimal health, comfort, function, and esthetics for the rest of his life. She wanted that too. Most people want that.

In order to fulfill that mission, we need to build better patients ... early and late in life.

Barry F. Polansky, DMD, practices in Cherry Hill, N.J. Author of the book, The Art of the Examination, and publisher of “Dental Life,” he is on the visiting faculty of the Pankey Institute. E-mail him at [email protected].

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