The concept in economics known as Bertrand Competition goes like this: Two or more firms are producing equivalent products or services. The various firms do not cooperate in any way. The various firms compete by setting prices simultaneously. There is often a geographic restriction; in other words, the various firms are localite. Dentistry is like this. While I can very well go on Amazon and order an exotic product that's made three continents away, my dentist has to be within reasonable travel range of my home and my business. Thus, dentistry is, for the most part, geographically limited. Then, the key assumption of Bertrand Competition is that consumers will buy from the firm with the lowest price. And why wouldn't they? It's only logical. When firms engage in Bertrand Competition, they engage in a race to the bottom on price. And thus, on cost. The firm with the lowest unit cost of production can offer the lowest price per product or service sold, and thus will, theoretically and often practically, totally win on volume. This, as you will have concluded already, is corporate dentistry. More than that, many dentists in private practice also engage in a race to the bottom because they see others doing it; and further, they observe so many large corporations racing to the bottom in all sectors of the economy that they start to believe this is the normal state of capitalism. They see Walmart ruthlessly kill their local Al's Hardware, and they start to race to the bottom themselves. After watching what happened to good ol' Al, they can't help it. It feels like the only way to avoid the same horrible fate. Of course, the problem with a race to the bottom is: you might win. It's actually surprisingly unlikely, though. There's always someone more merciless, more brutal, more willing to abuse employees and over-treat patients and cut costs with cheap labs and do a thousand other beastly things that are quite simply unacceptable to you. That's the brutal person, or the brutal faceless corporate business entity, who wins the race to the bottom--not you. (Hint: Coming in second in the race to the bottom is probably the absolute worst outcome we can achieve.) We know that industrialists seek to squeeze every penny out of every market. We know that corporate dentistry wants to drive their costs as near to zero as they can get so that they will be the obvious commodity choice. We also know that corporate dentistry aims to over-treat in the pursuit of maximum profit. Should you be afraid of all this? Should a young dentist give up on their dreams of independent business ownership because, in essence, they see the game as one of Bertrand Competition, which is one they cannot win? The answer is a resounding NO. The answer is NO because, as I reviewed at the beginning of this post, a race to the bottom assumes that: "Two or more firms are producing equivalent products or services." That's the part you probably missed. My colleagues, each one of you here is *NOT EQUIVALENT*. You are unique. You are a highly trained professional, each with your own special, unique, irreproducible, bespoke contributions to make to your community and to our profession. You are not equivalent. We need your contribution. We need your innovation. We need your generosity. Go forth and be confident. Race to the top.