Thursday, March 31, 2011
“A human being is part of a whole, called by us ‘Universe’; a part limited in time and space. He experiences himself, his thoughts, his feelings as something separated from the rest--- A kind optical delusion of his consciousness. This delusion is kind of a prison for us, restricting us to personal desires and to affection for a few persons nearest to us.” Albert Einstein One of the biggest problems we have is our personal myopia. The more we know the less we know. The more we confine our thinking to smaller and smaller portions of the Universe; ( myopia) the less we understand the ‘bigger picture’. An example might be the thinking of a dentist and what resides on the top of a single tooth! The more we break things into smaller and smaller pieces the less we recognize or understand the whole. And so this is especially true of us dentists. It is even more true of those who teach the technical aspects of dentistry. “From a very early age, we are taught to break apart problems, to fragment the world. This apparently makes complex tasks and subjects more manageable, but we pay a hidden, enormous price. We no longer see the consequences of our actions; we lose our intrinsic sense of connection to a larger whole. When we try to see the ‘big picture’, we try to reassemble the fragments in our minds, to list and organize all the pieces. But as David Bohm says, the task is futile—similar to trying to reassemble the fragments of a broken mirror to see a true reflection. Thus, after a while we give up trying to see the whole altogether.” Peter Senge (MIT) The 5th Discipline The more we know about smaller things the less we are capable of seeing the bigger picture. Of how things fit together; of how one element impacts the other elements of any system. It would take a mind such as Einstein to remind us of the smallness of our thinking. He also wrote: “I want to know God’s thoughts, the rest are details.” As one thing rules, the less other factors are taken into consideration. There appears to be many forms of intelligence. The most predominate seems to be to study and identify small things, and in this process lose the image or picture of the whole. This leads to linear, left brain, break things into pieces mental framework, but that is not how we humans have been taught to function, , but it’s NOT how the Universe works! So it is with those who teach us clinical or technical dentistry. There was, and I emphasize was, one exception that I’m aware of and that was LD Pankey. Pankey had an understanding of the big picture. LD was more concerned about the patient, the whole person than he was simply what constituted one part of the oral system. He knew and taught that there was a patient attached to the teeth. There was a real, live person whose value system, needs, wants and aspirations needed equal consideration when completing an examination and diagnosis of the patients’ oral system. There has been much advancement in technology, materials and delivery of dentistry for patients since Dr. Pankey’s time as a practicing dentistry, but there has been painfully little advancement in the perspective of seeing and experiencing the whole patient. Practicing true systems based dentistry is more of fiction than a reality. People talk in vague terms regarding the Pankey Philosophy but I can tell you that there has been little to no advancement in ‘philosophy’ of dentistry since his time. In fact, dentists and dentistry have never caught up with his message. Within Dr. Pankey’s philosophy was imbedded the principle of Universality and that a human being is a whole system, not just an assemblage of parts. The thing that separates the human being from the rest of animals is her soul. We are ‘spiritual beings’, ‘emotional beings’ as well as ‘physical beings’; and because human beings are partly spiritual that they needed to be treated with the highest ‘dignity’ and ‘respect’ we can possibly render. Human beings need to be respected, honored, revered, prized and cherished. The education of dentists before and after dental school is limited by the people, instructors and faculty in the schools; by clinicians in their private schools after. Dentists are not taught in a holistic or comprehensive manner. The technical teachers who influence dentists generally know little or nothing about: · The financial condition of the dentists in their classes · Whether their family or home life is stable and healthy. · Whether or not the dentist has any personal philosophy · Whether their practices are organized to deliver this higher level of care · Whether the dentists has the ability to translate what he is learning into actual care within the practice. · Whether or not the dentist’s team appreciates the level of care the dentist aspires to deliver · Whether or not the spouse comprehends what the dentist is attempting to do. · Whether the dentist is a good enough communicator to actually help patients make healthy decisions for themselves. · Whether the dentist has a self-image, self-esteem and self-belief strong enough to translate what he is learning into reality. · Whether the dentist is healthy mentally, emotionally, physically and spiritually. So the principle of least effort takes over. In spite of spending their kids education money and their retirement savings on advanced technical education a very few (the top 1% or less) ever get off the shelf with consistency what they are spending precious time and money learning how to do. This has been the case ever since I’ve been working one-on-one with dentists, seeing the inside of their ‘financial statements’; getting inside their practices and interviewing the dentist, spouse, the team and observing how the practice actually works. The dentist is a pawn, used unintentionally by those who are busy promoting their own technique or building their own schools with little or no understanding or knowledge as to how to help dentists truly practice what they are being taught. We are victimized by well intentioned but very small thinkers who lack the understanding and awareness of educating dentists in a more universal and general systems manner. The more we know, the tendency is to know less and less about less and less. We lose site of the big picture. We lose sight of the full human condition. We lose sight of the forest while we contemplate the trees. We are not taught in a systemic, holistic manner, so how could we possibly learn to see the whole when all we are taught is pieces. No, it is not only the insurance companies and dental schools that are at fault, it is the clinicians who teach us dentists how to repair the body parts of a human being and not take into consideration the totality of the human being in the first place. We get the bragging rights of telling our friends of what Guru we follow or what courses we take. We get out badges of completion. We join the various groups (factions) and wear the various pins and yet inside we feel separated; we feel alienated; we feel that we are deficient somehow because we can’t do what our guru’s have taught us; we often end up feeling less than we were before we gained all this new information that we can’t or won’t use or apply. We fail because we fail to comprehend the wholeness of each human being we are interacting with. We often make far less money and have far fewer rewards than our classmates who are delivering single tooth dentistry. Don’t you find this interesting? Aren’t you a bit P.O.’d about this? Why do you put up with this? We join our various academies and share the ‘words’ and ‘concepts’ we learned in the various schools and somehow we hold out hope that if we stay with it long enough, hang onto (as John Anderson Dr. Pankey’s protégé and my mentor said to me: “Mike, they think if they just get next to me and touch me that they are going to get it!”) the hope that some wealthy patient is going to walk into our office and want us to fix them the way we’ve been taught to fix. This is the world we live in. It is a fractured, piecemeal world in which from grade school on we learn and study about individual things and learn to break things apart, but in the very breaking apart we lose the capability to comprehend the whole. In the process we become fractured human beings focusing on fixing this or that part of a human being and we call it the lie that it is ‘health care’ when in reality in the best of definitions it is ‘disease care’. The smartest minds that God ever graced His planet see what the rest of us fail to see. We are part of something bigger. Yes, we are limited. We are limited by the eyes (the mind) that we see with. We are limited by the teachers we learn with. We are limited by the conditions we have surrounded ourselves with. We are limited by keeping up with the Joneses. We are limited by having to take in $100,000 a month just to pay the bills in our practices and personal lives. We are limited by the very conditions we have created in our own lives and practices. But, truly we only limited by ourselves. Better we begin again by seeking the ‘whole’; better to see the ‘big picture’ and then see how the parts fit together. Better we begin with a picture of what’s right; what’s healthy; what’s beautiful; what’s functional; what is lasting; what’s whole; what makes the most sense; what is ethical; what is honest; what is true; and then work backwards to re-assemble; restructure; renew what has been broken back to a whole. Maybe as Einstein suggests, if you read deeper into his thought: maybe it’s our job to make sense out of a fractured world; to make sense out of all the events that occur in our lives; it’s never too late to have a whole, happy fulfilling life and practice. Never! These are trying times. Times we were never prepared for. I know I was not prepared and yet, things break apart for a reason and only a few comprehend that Entropy is a law of the universe. We are dying to something old as something new is being born. Our world is broken; it is fractured and yet the Universal Power, God is still holding court. To have a different life we must learn to think differently. More systemically; in a more holistic way; in a more health-centered way. We will learn that everything is related; that everything we do impacts every other person on the planet. We will learn that everything is connected. When we will learn that everything is important. When will we learn that we cannot separate one aspect of a human being from the totality of the human being’s experience. On a more local level, we would learn that education must inform and bring the all aspects or elements of the human system into consciousness, into effect and leave nothing out. Dentistry is a fabulous and unique profession. I first heard Dr. Pankey talk about HEAD-HEART-HANDS in 1970!! I heard Peter Senge at MIT talk about HEAD-HEART-HANDS in a lecture at the Babson School of Entrepreneurial Management in 1988. Our patients are BODY—MIND—SPIRIT. If we really believed this then what would our offices look like? Maybe like Fred Arnold’s or TJ’s Bolt’s or Mike Robichaux’s. They wouldn’t be factories would they? If we really believed in BODY-MIND-SPIRIT then how would our practice’s be structured. What might our new patient process be like? How would we interact with our patients? I remember Bob Lee saying to me once at lunch: I think about my accountant. He meets one patient at a time and 10 minutes before he finishes one person, another is met in his reception room. When I meet with my financial planner, he doesn’t have 4 other people waiting in 4 other rooms. It’s only when I go the office of a physician or dentist that the doctor is running from room to room, from chair to chair keeping with his expenses both at home and in the office. Do you find this interesting? The highest profit pediatric dentist I have ever known had less than 1,000 patients of record. The wealthiest orthodontist I have ever met (more than $5 Net Worth by age 42) had 2 chairs and 3 total staff people. It’s not what you gross, but rather what you net that counts. (Do I sound like a preacher!) I had another lunch with Bob Lee and he talked about the ‘virus’ in dental schools. He was really pulling my leg when he said that a ‘virus’ is passed on from one generation of teachers to the next. The virus, you see, he said, is in the dental school and every instructor gets it. He was talking about dental repair, not dental health. But, there is a ‘virus’ in the profession of dentistry and it’s passed on from one dental generation to the next. Somehow, some way Frederick Taylor and Scientific Management got into dentists and dental consultants and manufacturers and dental equipment suppliers who profit by the virus of volume, speed, and sell dentists on the idea that more is better even if they are losing money on every patient and procedure. Well, times are changing. We are moving into the generation of less is more and away from a generation of more is less. The worm has turned. The tide had shifted. That’s why I wanted you to read FLIP. FLIP really means CHANGE YOUR PARADIGM because it isn’t working any more. So, if your rent is up, or close to being up, I’d do what Patti’s friend in Salem has done; a Chiropractor moved from 3700 square feet into 1,000 square feet and is loving it. He works less and makes 3X net what he made before. His patients love him and he loves them. He’s having the time of his life! One the wealthiest dentists I’ve ever known, a long time student (died and left an estate of more than $50M) said to me; Mike will you tell them for me when you lecture that their ‘butts’ can only be in one room at a time. You are going to laugh at this; the orthodontist that was in my practice in Dubuque worked 2 days a week in my office, using ONE CHAIR and ONE ASSISTANT (we scheduled and made FA’s for him) produced around $50,000 a month in 1977 and netted around $20,000 a month!! He was a happy camper and so was I!! So also were his and my patients. They got the best. A gnathologically trained technical who became an orthodontist. How could it have been any better for everyone. He saw every patient. Bracketed and banded every tooth, and he loved his patients and they loved him. He had a ‘personal relationship’ with every patient and family. We are RE-INVENTING THE FUTURE. I’m not suggesting that we will re-invent the past. The future will be different, very different. This is called RIGHT SIZING. Right sizing for the present and future. Are we having a difficult time living with less? Less material acquisition. Will our children have less than we have had? Will they really have less? We are dealing with a generation of children whose parents both worked and were raised by TV’s babysitting them, computer games and parents who believed that making money was more important than raising their kids. Thanks for listening.