Viva La Revolución!

It has been brewing for decades now. First it began as a slow simmer, then as we were squeezed further and further away from our Golden Years of practice, the waters began to boil.

Finally, as things have gotten progressively worse for us, an eruption is imminent.

If there were one key that we could use to reverse our fortunes for the better, what would that be?

I think it is obvious that the key to unlocking all this is to truly understand patients and always take their best interests to heart.

Without patients, no practice would exist. Dentistry wouldn’t exist. No patients means no practice.

I’m afraid that the way we as a profession have treated our patients has declined over the years, and the way our patients treat us has declined equally. As third parties have gotten in the way of our classic doctor/patient relationship, the way we interact has suffered.

I Cringe When I Hear Someone Who Claims Authority on the Subject of Practice Management Reference the Dollar Value of a Patient.

It’s against all we stand for in this profession to place a dollar value on a person who needs our help and has chosen our practice to receive that help.

I’m afraid that many factors have played a role in reducing patients to a dollar sign. Patients losing their former loyalty to us due to third-party interference has contributed. Our perceived need for finding more and more new patients at any cost has led many dentists to pressure patients to do more comprehensive dentistry on the front end of the relationship. Overall, dentistry has become a much more transactional relationship than ever before.

The focus on big case diagnosis early on has resulted in short-term success in some practices, but at what cost? What about the long-term relationships that every dentist should be seeking?

It has been said in our profession that nothing happens until the drill meets the tooth. I would like to take that back a step.

Those who would have you believe that you should center your practice on the patient have gotten some of this right, but I think we all know the true answer can never be to give in to every whim and desire of every patient.

That would be pure insanity.

No, the answer to our shared dilemma is not to give the patients exactly what they want all the time; it is to create something special and lasting that stands the test of time.

Nothing Good Happens Until You Have a Relationship With the Patient

It must be the focus of every dentist to build a lifetime relationship with each patient and also with the local communities where we practice.

We should all show patients respect. We should focus on their problems and also on their values, wants and long-term desires.

Let me recap bluntly.

The answer to our problem is NOT blindly giving money to Marketing Messiahs or Management Messiahs to draw in who-knows-what-kind of patients or, more likely, not draw in any more new patients at all.

The answer is NOT over-diagnosing just because you have a patient in the chair who you think might go ahead with a big treatment plan.

The answer is NOT bashing every dental insurance plan to the patients, who will take offense, by the way, no matter how terrible their coverage.

The answer is NOT branding yourself as such a great dentist that you inevitably create impossible expectations for your patients and ostracize your friends and peers.

The answer is NOT letting your staff become the defacto CEO of your practice just so you can hide in your office and avoid making the tough decisions.

The answer is NOT focusing on money in the short term. This hurts team morale and will devastate your reputation in the community.

The answer IS something so simple that I hesitate to write it.

It seems like this is such a simple formula that every dentist out there should be using it. In fact, if I had written this 50 years ago, it literally would have been seen as something there was no need for and a waste of time.

Dentists Practicing 50 years Ago Already Had This Formula Figured Out

I suppose that’s why the mid-1900s were considered the Golden Era of Dentistry. Dentists who practiced back then were the true lifestyle doctors.

They were the dentists who created the atmosphere in which any dentist could walk into any bank in America and likely leave with whatever sized loan he or she needed to open a practice. It took a couple of decades of today’s dentists abusing that reputation for banks to flip to the opposite side of the spectrum, to the point that it is very difficult for any new graduate to get a loan big enough to open a practice.

It took decades for dentists to besmirch their good name to the point that in 2003 one of the most highly respected dentists of the modern era, Dr. Gordon Christensen, sounded off in his famous article, “I Have Had Enough.” Ten-plus years have passed, and the same issues that so upset Dr. Christensen still cling to our profession as a dark stigma.

The dentists of the Golden Era didn’t have to fight public perceptions of deceit or charlatanism. They were the dentists who had such high integrity that they fought hard to get fluoride put into the public water systems, even though many at the time thought they were crazy because the decrease in tooth decay would eventually run them out of business. Those dentists could walk down the street and hold their heads high. Everyone knew that dentists’ character as a group could not be questioned.

When those dentists counseled their patients, they spoke from a place of authority. Not only with the expert authority of their profession, but also with moral authority. Patients had no doubt that these dentists were coming from a place of honesty and that the interests of the patients and their health were first and foremost in any discussion about treatment plans.

We must learn to focus on patients first and then create plans for their long-term care. Our role should be that of trusted expert advisor, just like our predecessors. Only then can we hope to achieve our own personal and professional goals.

That was the missing key to my career that I discovered during my 13-month exile. The missing key was that I had to recreate my relationship with my patients from one of just being a “good doctor” to one of being their selfless and trusted expert advisor.

We Should All Aspire to Become Every Patient’s Selfless Trusted Expert Advisor Even If They Don’t Immediately Accept Our Help.

When it became clear that everything that went on in our practice was intended for the patients’ well-being, the pendulum swung in our favor once and for all, and it affected every single aspect of our practice for the better.

When you have that kind of trust, authority and expertise, you can make your office hours whatever you want.

You can have the respect of your team that you want.

You can have the respect of your community that you want.

Your patients will almost always accept and respect your treatment presentations, even if they don’t immediately schedule. They know that you are looking out for them, and they won’t go looking for a second opinion.

In July 2014, Dr. Howard Farran wrote in Dentaltown Magazine that two out of every three cavities that get diagnosed in dentistry go untreated. That is a pitiful statistic. Let me repeat:

Two of Three Diagnosed Cavities in America Are Never Treated

To think that dentistry’s reputation has deteriorated to the point that we, as a profession, cannot get our case acceptance up over 33 percent shows just how far we’ve fallen in all those areas of trust, respect and authority that our predecessors fought so hard to establish.

If you don’t believe that statistic, just do me a favor. Go to your practice management software and see how many diagnosed cases left untreated are lurking inside your own practice. If you have been open for any amount of time, the dollar value of those cases will likely be in the millions.

What would your life be like if you not only could turn back the clock and actually help those patients who needed those millions of dollars’ worth of dentistry, but also could find the way to fix the broken cycle once and for all? What would it be like if you could find a way to help your patients accept your treatment plans at a much higher rate than 33 percent every day, every week, every year?

If Your Patients Trusted You to Perform Dentistry on the Other 66 of Diagnosed Dental Need, What Kind of Life Could You Expect?

It would be the life that you wanted when you signed up for your first day of dental school.

It would be the life that you and your family envisioned when finances were tight as you went through school and those really tough first years of practice.

You would have the means to become the true lifestyle doctor that you deep down have always craved to be, with an army of loyal patients who have no doubt that you, as their doctor, have their best interests at heart.

In 2003, Dr. Christensen sounded the alarm. There have been underground rumblings ever since, but no real change has broken through.

Today, I’m asking you to join me and ignite the revolution.

This is the revolution to regain the faith of our patients.

This is the revolution to reforge the accomplishments of our fathers.

This is the revolution to retake our image and our place in society.

It Will Take a Revolution in Dentistry to Reverse the Trends and Reclaim Our Rightful Place.

Will you be a part of the revolution?

I am excited about the coming revolution and what the transformation in my practice has already done for me and my life. I am so excited that I am devoting a major portion of my schedule this year to helping other dentists who are frustrated and may be experiencing some of the things that I went through.

Deciding where to start the transformation is not easy. Many different areas need to be addressed, but we must start somewhere. It seems to me that if we could choose one problem in dentistry to spearhead the changes we need to make, it would be to solve the lack of early interception of dental disease.

The best way to intercept the progression of dental disease is to find a way to increase the amount of dentistry that is accepted by patients and delivered by dentists.

Increasing Case Acceptance in America Must Be the First Step in the Revolution.

I don’t believe there is a problem with the amount of dentistry being diagnosed in America. The true problem lies in the patients’ acceptance of those diagnoses and the real and perceived obstacles to delivering the needed care.

We must find a way to deliver dentistry in a way that is good for patients and for doctors. If we can meet that challenge, the good will trickle down and make the practice environment better for every single team member.

Then we will fulfill our true mission of making everyone’s lives better, including our own.

Otherwise, Viva La Revolución!