Whenever we purchase anything, be it good or service, we make a choice. This choice is a dichotomy. We ask ourselves, "Is this a commodity, or is it bespoke?"
Now, we don't actually use those exact words. Though I'd like to induce you to. But the question, usually not expressed as a conscious thought at all, is one we always ask when we purchase a good or a service.
The word "bespoke" may be unfamiliar and give you a little trouble. Here's why I use it.
Have a look at these words:
What word in the English language stands as their opposite? I wracked my brain for a long time over this and I finally settled on bespoke. It means custom-made, created to individual order, unique, remarkable and personal.
A commodity, on the other hand, is an article of trade or commerce--an undifferentiated article. Merriam-Webster in fact is astonishingly anonymous in its primary definition of a commodity: "something that is bought and sold." Something. No hint of any particular, delightful, unique thing. Just the anonymous something.
They go on in the full definitions to say:
"an article of commerce especially when delivered for shipment"
"a mass-produced unspecialized product"
"a good or service whose wide availability typically leads to smaller profit margins and diminishes the importance of factors (as brand name) other than price"
"Mass-produced" and "unspecialized" help us get to the core of what a commodity is all about.
By contrast, then, the bespoke is the realm of the custom-made, the personal, the unique and remarkable. And, presumably, always the more expensive. So many examples come to mind. One envisions a particular piece of furniture, and engages a skilled artisan to create it. A gourmand couple remodels their kitchen, and spares no expense in bringing to life a splendid space in which they can conceive and execute their culinary magic. A man engages a dressmaker to make a unique, one-of-a-kind dress for his wife of twenty years. A wine or tea or coffee or even Brussels sprouts aficionado seeks out a particular organically grown, handcrafted example of their taste buds' glorious desire.
And so on. We do see something interesting here: almost everything, it seems, can be bespoke or commodity, depending on how we look at it. Furniture, home improvements, clothing, food, landscaping, massages--all can be bespoke or obtained as commodities, where lowest cost is the primary consideration.
Many goods and services do blur the line of the dichotomy I try to draw. An Apple iPad or iPhone, for instance. Technically, these are commodities--amalgamations of metal, glass and rare earth elements that are mass-produced by the hundreds of millions. Hardware and software engineers were stressed to the max. Miners were exploited. Incalculably complex distribution networks were created and U.S. taxes strenuously avoided. (Something to do with Irish tax law...)
And yet, to many an end user, their smart phone or tablet is practically a member of the family. Their connection to and guide through the world around them. Their pathway to share their joy in times of accomplishment and triumph, and their succor when trouble comes calling.
Hardly a "mass-produced unspecialized product."
Same with cars. They are certainly mass-produced, but we still manage to have love affairs with them, at least in America where our entire infrastructure is built around individual motorized transport.
Back to my original assertion, then, and now with an awareness that the dichotomy is, at times, somewhat blurred. Life is messy that way.
Having observed human purchasing decisions for a long time now, I'd say that we can determine the realm the person is aiming for--commodity or bespoke--by asking one simple question:
"Is low cost the primary, overriding consideration?"
Thus, we obtain the Gasbuddy app and, casting any sort of brand loyalty aside, always seek out the lowest price gasoline when it's time to fill up our car. Makes sense, right? Gas is gas. And we very well might buy the lowest cost paper towels, as long as they aren't too rough and papery and non-absorbent. We tend to edge up the price in order to avoid inconvenience. But that's about it. When we seek the lowest price, what we want is a commodity. These days, in a world of six-sigma quality control, we expect our commodities to work as advertised, thank you very much, and they often do. But there's nothing custom or human about them. There can't be, for the simple reason that in a capitalistic system, adding bells and whistles and wonderful delightful features and a human touch adds cost.
These consumer decisions often make perfect sense, don't they?
Would you pay more percentage points for your mortgage because the broker was nice, and even made you lunch? I doubt it. A mortgage is a mortgage is a mortgage and no amount of bonhomie at the time of the deal can possibly justify higher payments for all those thirty years it runs. (Hint: try to do it in fifteen.)
So when, then, do we seek the bespoke? Ah, that is the question about ourselves that it pays to understand. I would say--
-When we wish to be delighted, and
-When we need a serious problem solved.
That explains the new car thing. New cars delight us. They smell great, they don't have any dirt or chips on them, and their controls are slightly unfamiliar. It's great fun to drive them for a time, even though we might be going to all the same places we went before. Computers and smart phones delight us, too. And they can help solve our problems. We can navigate in unfamiliar cities with GPS-driven maps and restaurant apps and it's easy to discover all the local events and businesses that stand a chance at delighting us. Delight and endless problem-solving, all in the palm of our hand. Now that's bespoke! Even though the device was mass-produced.
With this new understanding of how we think when we make a purchase, let us now turn to dentistry. This is a realm in which I'm always amazed when someone asserts, "Low cost is my primary consideration. Where can I go where the dentistry is cheapest?"
After all, this is our body we're talking about. We only get one.
In dentistry today, cheapest usually means corporate dental practice. Corporate even asserts this themselves. "Economies of scale," "pooling of resources," "reduced lab and materials costs," "reduced labor costs," and "managerial expertise" are all corporate dental catchphrases that guide them on their course of racing to the bottom on cost.
Corporations are, by definition, legal instruments designed to maximize profits for their shareholders. That's fine as far as it goes, and corporations often create amazing things that benefit society, advance technology, and cause shareholders to prosper. In the realm of medicine and the treatment of the human body, however, things get dicey. In their race to the bottom on cost and their relentless grasping at More with a capital "M" when it comes to profits, dental corporations give in to temptation and over-diagnose, over-treat and skimp on materials, laboratories and labor.
So yes, corporate dentistry's tempting low fees for any given procedure are often less than they are in private practice. But, in corporate dentistry, patients will be seriously over-diagnosed and over-treated. Thus, patients will end up paying far more in the end. In money. And in their precious oral health.
As in any field, in dentistry there will always be the two realms: commodity and bespoke. A portion of consumers will always make their purchasing decisions based primarily on low cost. They mystify me, though. The risks to oral health, and the odds of expensive over-treatment, are immense.
A bespoke dental practice will comprise doctors and staff who listen. Real and lasting human connections will be made. Emotional labor will be willingly expended to ensure patient comfort and successful treatment outcomes. When controversies over treatment or finances arise, solutions will be worked out. And in our increasingly transparent world, localite public opinion will drive bespoke dental practices to ever higher standards of solving problems for and delighting their patients. It cannot be any other way.
A dental practice is, in a very real sense, the sum total of all the individual interactions it has with its patients. And a bespoke dental practice is worth its fee because the human beings who are responsible for those interactions truly care about the well-being of those other human beings who are their treasured patients.
If you really want to explore the concepts of commodity and bespoke, there's my novel, The Man Who Wore Mismatched Socks. It's on Amazon in both print and Kindle versions:
Here's a standalone short story set in the novel's universe, which is respectful, since you can see if you wish to tackle Socks itself before purchasing:
Oh. And Socks comes with a warning label.