What is Dentistry?
If you ask the above question to any number of people, from general dentists, to patients, to dental educators, dental technicians, and specialists, you will get different answers. There is an old Indian story which has spread through many cultures over the ages. In the story, six blind men are asked to describe an elephant. Each man is told to feel a different part of the elephant, but only one part, such as the leg or the tusk. Predictably, each man offers a vastly different assessment. One says an elephant is like a rope (tail), while another says it’s like a pillar (leg), or a fan (ear). They argue. Each man is convinced that his experience is the correct one.
All of the men are correct. Each part is described in explicit detail. The problem arises when each individual point of view is mistaken as describing the whole truth. By taking too narrow a focus, we can miss the forest through the trees. The problem comes when people become attached to their very narrow points of view.
This parable is a great example of one of dentistry’s biggest problems … fragmentation. Dentistry is not unique in this regard. Many industries are compartmentalized and reduced to their individual components. How we define something determines how we treat it. As they say, in order to tame it, you must name it. Since this is a book about leadership in dentistry, I will explain how fragmenting this profession can be a source of major problems for a dentist.
Most dentists know that patients truly don’t understand dentistry. Most, when asked, will tell you it is the science of teeth and gums. The language that patients use is enough to know that even the most astute patient doesn’t have a firm grasp of dentistry. Their dental IQ is generally insufficient to understand the entire scope of dentistry.
Dental offices regularly take calls from patients asking for a cleaning when they need much more involved treatment. Barbara R. called the other day, reporting to my front desk person that she had a cavity. We asked her how she knew she had a cavity, and she reported that she was having some pain. When Barbara came in for her appointment, we determined that she had a abscess under an existing crown. Barbara, like many patients, does not understand dentistry or its language. What they do understand is what concerns them. They understand what dentistry means to them: cosmetics, comfort, health, cost, fear, time. Those are the general benefits of dentistry and the main objections to dentistry. Patients depend on us for our leadership to guide them toward better health, hygiene and cosmetics. Yet dentists who lack leadership and communication skills get caught up in more confusing scenarios.
There are others parties whose points of view affect the way dentistry is practiced. Insurance companies and dental service organizations claim that their view of dentistry always puts the patient first. Veteran dentists who have worked with third parties and have had disputes about treatment know that fees and covered services are what drive the third parties. Their view of dentistry is driven by the business side of dentistry, but dentistry, as you will see, has a human side as well. When any business only looks at the financial side, rather than the human side, something must suffer – especially when it comes to health care.
Then there is the government. They, too, have an agenda. The government’s role is to help all people have access to health care. Obviously, this has not worked very well, considering all of the bickering that has been going on in Washington. Dental educators want their students to graduate on time with the skills necessary to do a good job. With all of these varying points of view, it’s no wonder that dentists truly don’t understand what dentistry is all about.
Take the National Football League as an example of an organization that falls under the heading of professional sports. Once again, there are many points of view about football. Fans, like patients, have their own selfish way of looking at football. Players have their points of view, and the way some football players conduct themselves these days, it’s a good thing that there are higher powers. Those higher powers would be the owners and the NFL Commissioner. Hopefully, these leaders are there to protect the integrity of the game, for the future of the game. In other words, leaders are mostly concerned with integrity and long‐term values.
The Latin root of the word integrate is integrare, which means “to make whole.” One of the themes of this book is that dentistry is a complex field. Psychologist Mihalyi Csikszentmihalyi [1] tells us that evolution has always favored complexity. By complexity, he means highly differentiated and integrated at the same time. If the components are not highly differentiated and integrated, then the result is too simple and not destined to hold up over time. If the components are not integrated, or do not properly communicate with one another, then the result breaks down due to being overly complicated. If dentistry is to survive as a dignified and noble profession, it can only do so with integrity – organizational integrity, as well as individual integrity. I will discuss how to deal with this issue throughout this book. The very best leaders think in terms of sustaining values through integrity.
Wholism vs. Reductionism
In the Prologue, I mentioned that my entire world changed when I was exposed to the Pankey Philosophy. The question to ask is, what made my world change? Was it that I was understood dentistry a deeper level? That I understood the role of occlusion and that, for the first time, I could treat disorders that I could not even diagnose before? Or was is that I now took a more comprehensive approach to dentistry? Maybe it was all of those things, or maybe it was that I now had a model to look at that I could copy. The model or paradigm that I was exposed to was the first model of dentistry that I had ever been exposed to, and it made me feel comfortable. It put an order to what I was doing where none had existed before. Things made more sense to me. That’s what paradigms do.
One of the most influential books ever written on leadership is Stephen Covey’s 7 Habits of Highly Effective People. Coincidentally, this book was published just as I was going through my deepest issues in my life and dentistry. Covey questioned the way we think, or our lens of perception [2].
Some of the greatest thinkers of our time were systems thinkers. Einstein, Leonardo and the great Greek philosophers like Plato, Socrates and Aristotle were big picture thinkers, who started with mental models that clarified their thought processes. These models, perceptions, or frames of references are known as paradigms – the way we see the world, as Covey says, “not in terms of our visual sense of sight, but in terms of perceiving, understanding, interpreting.” [3] For me, this is a starting point. My whole career up until that point was compartmentalized into subjects like form and fu...
