A message to young dentists.
This, the first in a series of three posts, is for students, residents and young dentists. Anyone, of course, can read it and I hope it is useful to all.
I've hit a point in my career where I'm concerned more than ever before about the stewardship of our dental profession. You see, I've never been more proud of my colleagues who are serving their patients and making a difference in their communities. At the same time, there are dentists who are only concerned with the selfish pursuit of More, with a capital "M." More money, more new patients, less costs... Corporate dental practice is especially mired in a “race to the bottom” on cost. Corporations are legal instruments designed to maximize profits for their shareholders. That’s fine to an extent, but in dentistry they start doing inappropriate things to maximize profits and cut costs. Corporate practices push their employees to over-diagnose and over-treat. “Every new patient needs periodontal treatment regardless of their actual diagnosis” is one all-too-common example of how they operate. Starting root canal treatment when a well-bonded composite resin restoration would do just fine to keep a tooth healthy is another corporate tactic. And yet there are also solo practitioners who take more than one page from the corporate playbook and practice in the same manner. Further, many consultants and practice management gurus are running around teaching dentists to be selfish, compounding the problem of focus on More.
I’m afraid that students, residents and young dentists look at all this bottom-line, lowest-common-denominator selfishness and get to feeling like a they're just a cog in a vast machine. And nothing could be further from the truth. There’s a powerful way for you to stand on your own and fight the race to the bottom, which is technically referred to as Bertrand Competition.
Do you know Bertrand Competition?
http://en.wikipedia.org/wiki/Bertrand_competition
It's an oversimplification, but a useful one because it shows us the mistakes we might easily make. Essentially, Bertrand postulated that for goods and services with a geographic limitation—like dentistry as opposed to online sales—given two or more equivalent products or services, consumers would overwhelmingly choose the one with the lowest cost. Thus, each competing business races to the bottom on cost until one is offering the good or service at just above the marginal cost of production. The profit margin becomes tiny and the business "makes it up in volume." In dentistry, this is what corporate practices do, and perhaps to an extent it is what large group practices tend to do.
Well, the problem with a race to the bottom is that you might win. It’s not a pretty place to be.
Further, the problem with applying the Bertrand assumption to your own future in dentistry is: YOU ARE NOT EQUIVALENT!
You are Unique. Remarkable. Bespoke.
If I could get every recent grad to believe this, I would set you on a course of changing our profession.
I understand your fear. But what you fear is actually the most powerful lever you’ve got. Let’s break it down.
We now live in a world where it's almost impossible to buy attention. Consumers are smarter, more connected and more self-involved than ever, and they've gotten masterful at ignoring interruption advertising. The response of marketers has been predictable: the less we pay attention to their interruptions, the more they interrupt us. That means they yell louder at us in a desperate attempt to be paid attention to. And of course we ignore that, and so they yell even louder in a vicious feedback loop. The upshot is that interruption advertising is now so loud and pervasive in our culture that we dentists have no chance to cut through the clutter. Even if we could make it work, the cost is prohibitive. (Think of those few dentists or corporate practices that advertise on a massive scale. Perhaps you've seen their messages at sports arenas and on billboards or radio. Think of the expense of such an ad and the sort of patients it may attract, and ask yourself what it would truly cost you to do such a thing. Especially, what it would cost you in non-monetary terms.)
Turning to the consumer/patient side of the issue, then—How can we reach these folks who need us?
Hint: that’s actually the same question as—What do they want from us?
Our patients crave Certainty, and they desire simple human Connection. They rarely find Certainty and Connection in their experiences with corporations or (gasp) the government, so there’s a tremendous opportunity for us if we provide these scarce things for them. Scarcity is always valuable.
I agree with Seth Godin, and break it down this way:
1- Our patients want to be delighted. (Perhaps where they don't expect it. Perhaps they don't expect to be delighted in the dental office.)
2- Our patients want to have their problems solved. The more interesting the problem, the better. In dentistry, this tends to mean physical pain or esthetic pain.
Our most logical choice—our only choice—is to race to the top on the value of our services. That is long-term, strategic thinking. Racing to the bottom is short-term, profit-focused thinking. Many patients want a dentist who focuses on their problems and who delights them. The irony ends up being that more and more, the dentist who does not directly think about profits, but who thinks of their patient primarily—is the one who actually experiences the profits. There are notable exceptions, but nowadays many consumers are informed and connected (and selfish) and they figure out faster than ever when they are being taken advantage of. And they walk away from selfish businesses faster than they ever did before.
And so the irony and the existential paradox is that the path to More for us in dentistry is not to be selfish, as the consultants and practice management gurus would have us be. Idiots. The path to More is to be generous. To focus on our patients. To spend emotional labor in our practices. To listen.
Emotional labor is a concept we as a profession need to have a conversation about but to me it can be summed up in four simple words: "Caring and showing it."
Listening to patients, really listening, is the key to all this. Surprisingly, racing to the top does not involve all that much financial expense, once one has excellent equipment and technology in the office. Racing to the top involves emotional labor more than anything else.
To be generous, to actually listen to patients, to put total focus on solving their problems—that's interesting, and worthy of their attention. Always remember: Generous businesses are more interesting than selfish businesses.
My assertion is that each and every one of us who listens to our patients, solves their problems and races to the top on excellence of care will enjoy a long and prosperous career, and is making a vitally important contribution to the future of our dental profession.
*****
Next post we will discuss racing to the top (and bottom) from the patient's standpoint. Then we shall follow with a post on specific steps you can take in your dental practice that lead to success.
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