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How Dentists Lost Dentistry

October 16, 2013

Filed under: Business of Dentistry — Tags: , , , — Barry @ 1:12 PM

Friends having having a drink in a bar-784467


I recently attended the 2013 Pankey Alumni Meeting in Orlando Florida.  One night, while sitting around the bar with fellow alumni members, throwing back a few, I realized that after all these years our practices had evolved similarly.

All very different but quite similar.

I began to reminisce about the first time I went to the Pankey Institute.  It was the late eighties and I was at the lowest point in my dental career.  After fifteen years of practicing without a clue…I was ready to be saved.  What I learned was a way of doing dentistry that covered not only technical dentistry, but the business of dentistry and the behavioral components as well.

Dentistry is about way more than tools and techniques.  As a practicing dentist, an educator a coach and an owner of a dental laboratory, I find most dentists run into problems because they over-emphasize the technical component.

Meanwhile…back at the Alumni Meeting…one of Pankey’s elders, an original cadre member made a speech.  He said, “The Pankey philosophy is needed now more than ever.”

I disagree.  What is needed now more than ever is a philosophy…any philosophy, that teaches dentists a way to work their way through this incredibly complex field of technical dentistry, human behavior, business ethics, sales and marketing…in an ever changing world.

Honestly, I got lucky.  I could have continued to learn more and more fragmented technical courses without any sense of coherence.

Back then there weren’t many choices—today there are many institutions that offer a continuum of philosophical dentistry.  Many dentists have benefited from taking their programs.

But too many have not — and that is a problem.

Dental schools do not prepare dentists for the real world (an ever changing domain).  Today’s young dentists do not have the same opportunities that were available years ago.  Their student loans are higher and the cost of opening their own practices have skyrocketed. 

Between those obligations and an enormous amount to learn…they are looking for other options.

Dentists are doing more marketing than ever before.  Dentists are joining insurance plans in order to get new patients and fill their chairs.  Dentists are joining DSOs (dental service organizations-aka corporate dentistry).

Along the way dentists are losing their autonomy.  Some would argue that we always have our freedom of choice, and that is true, but to exercise it takes a lot more “philosophical training.”

Someone once told me that philosophy was a tough sell.  And I might agree…What?  Do we really need Aristotle?

But if Aristotle were alive in the nineteenth century he would have been William James—a psychologist, and if he were alive today he would be Anthony Robbins…a lifestyle coach.

After all he did train Alexander to become great.

The paradigm for how dentistry is delivered has changed.  There is no going back.

As the Affordable Care Act and DSO’s  become prominent, only those dentists who understand the complete concept of dentistry will survive with their autonomy.

And the philosophy teachers?  That role will be filled by government and corporate dentistry.  They will tell dentists how to practice.  They will take over all of the other domains that we used to call philosophy.  They will infuse the practice of dentistry with their mission…their vision and their purpose.

There are plenty of advantages of the old way of doing dentistry.  Everyone preserved their freedom of choice,  Dentists, as much as people would disagree, had to have the patient’s best interests at heart in order to survive…their goal was to help people keep their teeth rather than just watching numbers and bottom lines.

That’s how dentists have lost dentistry…by not paying attention to learning a “way” to practice. 

That is also how I came to sit at a bar with dentists who all practice very similarly…yet differently.








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  1. Funny… I had the SAME conversation with a fellow dentist at lunch YESTERDAY.

    I don’t know the answer for everyone. But, I know I can’t abide by the corporate or “managed care” philosophies. I MUST be true to myself and true to my patients.

    Here’s the future I see:

    A two-tiered system with a majority of dentists in the “Obama” tier. They will either work for DSOs or toil away in their own HMO-oriented practices. I am not here to disparage those who choose that path. It can be lucrative and fulfilling. It’s just not for ME. I can’t do it. I won’t.

    The other tier will be private care. There WILL always be those patients that understand and value the difference. I have spent my entire career positioning myself for those patients and that market.

    If I am to see a silver lining, I see a DECREASED level of competition for MY market. Not to put too fine a point on it, but it takes BALLS to go the private care route. BIG BALLS. And, most people simply don’t have the testicular fortitude to build a practice based SOLELY on reputation and service. This becomes more true, as the corporate or insurance-based practice is simply much easier in terms of getting warm bodies in the chair. They just show up!

    I look forward to the day when there are very few private care practices. I will be one of them.

    Comment by The Dental Warrior — October 17, 2013 @ 10:49 AM

    I totally agree–and your straight forward response is exactly how I feel. Like you I have fought for my right to practice as I wish. I am saddened and sickened by the number of dentists who cry about the way things are and yet, don’t DO anything to improve their lives and practices. Times were different for me–but I still had to make the sacrifices and face the same fears that these younger dentists face. Most of this is a result of fear…to stand up for what they truly believe in. How many times have we gone to a lecture about some sophisticated technical dentistry and we hear the same questions about — will insurance cover that? or How will I ever get my patients to accept that?
    Makes you wonder what kind of world we would live in if everyone had that attitude.
    Thanks for your input Mike.

    Comment by Barry — October 17, 2013 @ 11:02 AM

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