The assumption in orthodontics is that those who have practiced longer are wiser and know more than those of us who have only practiced a few years. Furthermore, having practiced a couple decades or more is used as evidence of one’s prowess at the drop of a hat in almost any discussion about anything to do with the practice or business of orthodontics. We all accept this assumption almost daily without question. Why?

For the same reason we do tons of other stupid things. Because it’s always been that way!

I certainly am not implying that we should never listen to an orthodontist just because he says things like, “I’ve been in practice 22 years…”, because he believes that anyone who has practiced less time must submit to his judgement. I am saying that we should look at the orthodontist’s results and use better metrics than “years since graduation” to evaluate the quality of advice we are offered by our elders . Crazy metrics like, 1) # of cases treated per year, 2) # of different appliances or techniques used and mastered, 3) financial success of his business (as in seeing tax returns – feelings don’t count) 4) is his business growing or declining 5) production per orthodontist FTE (as in production per orthodontist per day worked), 6) how many dollars of revenue are produced per dollar of staff salary?, 7) is his office reliant on PCD referrals or not?, and so on…

The world has changed and dentistry has changed radically. The old days of learning and repeating feel good, nebulous answers when it comes to business are over along with our ability to take “trust me son” advice from those who “have done it for decades”.  If those of us under 50 want to have a successful career in orthodontics, we must stop blindly following the advice of our elders. What worked for the last 22, 32 or 42 years is not necessarily guaranteed to work for the next ten or even the next 5 years. Be smart, be tough, work hard, assume nothing and enjoy what you you do. Modern orthodontics is not for whimps but there is plenty of opportunity still out there for those who are not trapped by tradition.