Authentic Sustainable Practice Growth

[DentinBond]

Not a single one of you signed up for dental school and residency because it was easy.

At the moment, I'm facing multiple severe challenges (interestingly, none are financial or issues with patients) in practice and I am being acutely reminded of that fact. Many times per day.

The thing is, pretty soon, many of you are going to start receiving get-rich-quick long sales letters, that promote practice growth through mechanistic, industrial processes.

You may also be influenced in this way by consultants or, even, employers.

Be strong and resist these ridiculous in-the-moment schemes that focus on money now, and that relentlessly seek after More with a capital M, just for its own sake. The authentic way to More is through making a difference for real human beings, one by one. The person in your chair, the one right in front of you at this moment in time.

I'm deeply concerned with this issue. It's because the "dark side" is so incredibly awful. Between what new patients tell us with some regularity, and now with what I hear as I interview candidates for the position I need filled in my office, I am increasingly appalled by those (few) members of our noble profession who view their patients as interchangeable objects from which to extract cash. Yes, it's really that bad at times. Churn-and-burn.

Yet the world has changed in profound ways. Those methods of the 19th century industrialist (and many global corporations today) are increasingly hard to follow in the world of the local, bespoke business. And it's about time! The online review alone is enough to reward a relationship-based dental practice, and viciously punish one that is based on viewing every patient as an interchangeable, temporary, disposable source of income. The Internet is the greatest connection machine ever created, and people in your community will connect over your dental practice. How they do it and what they say to each other is largely up to you.

Of course, the irony is that we are at the cusp(!) of an era where we stand to make more income through respect and long-term relationships and permission than through embracing the industrialist's interchangeable mindset.

To summarize: In business, "I'll see you again soon" is ever so much better than "Let me extract all I can from this person right now and damn the consequences."

And it ain't easy. It takes a long time. Success requires Starting, it requires sustained effort, and it requires emotional labor. But that's ok. You get great at things by doing them. A lot. There are no shortcuts.

A path of authentic, sustainable practice growth also requires you to be bold. And that is actually hard, in part because you've been conditioned (is brainwashed too strong a word?) by the industrialists who want you to keep your head down and behave, obey the rules, and be an ideal (meaning "voracious") consumer of what they create. The very word consumer tells you all you need to know! From fear-mongering and anger-mongering media to caries-causing obesity-and-diabetes-inducing sugar-water drinks, More is the industrialist's mantra. And they tell us that we regular folks can't do this or that or the other thing because we're just not supposed to; that's for the big kid's table.

But success in these matters comes down to a triangulation of natural ability, practice and focus. And of the three, natural ability (in all walks of life) is by far the least significant.

Do not be confused by the fact that modern American culture (especially sports and entertainment culture) glorifies natural ability. That's simply because the industrialists don't want us to create too much; they want us to consume what they make. Just buy a shiny new car, drink more Coke and Fanta and your life will turn around... Do not be taken in by their myths.

Be bold and create. And share your creations with your colleagues when you do.

We need you.

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[jay47]

Very well said. I don't think I could have said it better myself.

 

[DentinBond]

A report in the August 5 ADA News highlights a relevant issue that I had heard about previously.

At the urging of the ADA and consumer advocacy groups, the U.S. Senate (often a rather useless body, but occasionally they do step up to the plate for us) recently looked into the subject of unnecessary procedures and patient harm in the realm of corporate dentistry. This was a bipartisan effort of the Committee on Finance and the Committee on the Judiciary of the United States Senate. They crafted the report:

JOINT STAFF REPORT ON THE CORPORATE PRACTICE OF DENTISTRY IN THE MEDICAID PROGRAM

It is here, under the date 6/28/2013, Print 113-16, and available for .pdf download.
http://www.finance.senate.gov/library/prints/

Here is an excerpt from the Executive Summary. (Like everything the government does, it's a long document. But the summary is good.)

I'd say that this document speaks to the dangers of the pursuit of More rather than the pursuit of Making a Difference as a primary business focus, wouldn't y'all?

*****

II. Executive Summary

Across the country, there are companies that identify themselves
as dental management companies. These organizations are typically
organized as a corporation or limited liability company. They
work with dentists in multiple states and purport to provide general
administrative management services. In late 2011, whistleblowers
and other concerned citizens came forward with information
that some of these companies were doing more than providing
management services. In some cases, dental management companies
own the dental clinics and have complete control over operations,
including the provision of clinical care by clinic dentists.
While there is no Federal requirement that licensed dentists,
rather than corporations, own and operate dental practices, many
states have laws that ban the corporate practice of dentistry. In
those states where owners of dental practices must be dentists licensed
in that state, the ownership structure used by some dental
management companies is fundamentally deceptive. It hides from
state authorities the fact that all rights and benefits of ownership
actually flow to a corporation through contracts between the company
and the ‘‘owner dentist.'' These contracts render the ‘‘owner
dentist'' an owner in name only.

Notably, these clinics tend to focus on low-income children eligible
for Medicaid. However, these clinics have been cited for conducting
unnecessary treatments and in some cases causing serious
trauma to young patients; profits are being placed ahead of patient
care.

In one case, the corporate structure of a dental management
company appears to have negatively influenced treatment decisions
by over-emphasizing bottom-line financial considerations at the expense
of providing appropriate high-quality, low-cost care. As a
consequence, children on Medicaid are ill-served and taxpayer
funds are wasted.