Tribute to Dr. Robert Barkley

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The WCMID named Dr. Robert F. Barkley the recipient of the 2010 Lifetime Achievement Award, posthumously, at the annual congress in San Diego on August 20th. The award was accepted by his son Jonathan Barkley, who gave a moving presentation about his father, his career, as well as re-introducing us to Dr. Barkley’s family including his first wife Phyllis and their five children Jon, Kevin, David, Ann, and Sarah. Dr. Barkley’s two sisters, Virginia Doxtader and Carolyn Van Order, still reside in Macomb, Illinois.

Robert (Bob) Barkley practiced dentistry in the small western Illinois town of Macomb, with a population of 13,000 people. Many of his patients were people he had known growing up there. He was heavily influenced by the teachings of L.D. Pankey and personally created an unparalleled awareness in the dental profession for human behavior. He proposed a humanistic approach to educating dentists and teaching them to nurture their relationships with patients to have the greatest impact on their lives. He published a book on his philosophy of dental practice, Successful Preventive Dental Practices in 1972 and became an influential speaker in dentistry prior to his tragic death in an airplane crash in 1977. He influenced tens of thousands of dentists worldwide with his teachings. He was highly esteemed and well loved by all who knew him. While he practiced in a small town, his influence on dentistry was truly global.

Dr. Barkley spent a great deal of his own education learning about human behavior and developed a philosophy of care he labeled “humanistic”. In his own words “To me, it denotes a person whose relationships with others are highly inter-dependent, a person whose purpose is to help others get in touch with their own strengths, and develop their own capacities to become more effective human beings. It draws upon the spiritual, not merely the mortal, resources which are available to all of us." He focused on understanding each patient and helping create a safe environment where they could choose to be independently healthy, with the dentist acting as their health advocate, in a partnership, not a traditional doctor/patient hierarchical relationship. His personal philosophy he developed in part from L.D. Pankey, and he believed “the health of the relationship between you and your patient is always more important than the health of the patient." He believed to be the best dentist meant that he needed to be able to connect with his patients and develop a long term relationship with them. By stressing the importance of good communication skills coupled with a focus on true prevention, his goal for each patient was to help them become independently healthy, and understand that the state of repair and the state of health of their teeth were separate and often unrelated. He noted that in his experience, it was often several years before his patients would elect comprehensive restorative care.

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One of the important contributions Dr. Barkley made to the dental profession came in the philosophy of co-diagnosis. He was the first to coin the use of the term, and he defined it as spending time with a patient examining their diagnostic data together and acting as their advocate, giving them enough information and understanding so that they could make good healthcare decisions for themselves. He believed that we should begin by establishing a solid relationship with patients by coming to know each other first as people and then, together collaboratively look at the individual's dental health, while asking where they will be in the future, what their goals are. Once that is established, then the next step is teaching them to control the biological disease and then ultimately guiding patients through restorative care.

In his last paper before his death, he addressed this philosophy "On Becoming A Humanistic Dentist”. His understanding of humanism came from personal study of human psychology, direct guidance from a psychologist and he was also influenced by two books: Douglas Mac Gregor's, The Professional Manager and Peter Drucker's, The Age of Discontinuity. In his own words “We have come to recognize that changing one's style takes considerably more than lectures and books. The pioneering professionals, who have succeeded, know that work, sacrifice, risk and repeated failure are the price of achievement…Most of all, it takes a change in self-image -- how one sees one's role in the lives of others. Now, during the ebb tide most of the profession faces the difficult, but essential task of role clarification. Many individuals and groups have already made great progress. But a substantial number have fallen short…Their dreams have not yet been realized because they approached a philosophical conversion in a mechanical way. They simply added new techniques and tactics, without adequately redefining their roles or examining their beliefs about dentistry and its relationships with people."

Dr. Barkley was a pioneer in preventive dentistry, an exemplary example of a caring dentist, and a role model as a professional deeply invested in helping his patients become independently healthy. His focus became helping not only his patients, but also his colleagues, "If I truly wish to help, I must become more effective in my aid to my colleagues, so they can get in touch with their own strengths, values and beliefs. I must change my lectures to drastically reduce the promotion of new tactics; and I must convince them to stop frantically seeking quick answers in the wrong places."

Kim Kutsch