Let’s say that you were in a car wreck – you went to sleep and ran into a tree out on some deserted highway – and you were injured to the point of incapacitation. Let’s imagine not a living soul was around for miles and miles and miles… except for this one guy who happened to be sitting on a fence right next to the tree you smacked into. You call out to the guy and ask for help, as he is your only option. The guy is nice enough but proceeds to inform you that he only finished half of the EMT training class he attended during his attempt to become an emergency responder. He tells you, sadly, that it turned out that he was not smart enough to complete the course and was asked to leave the program. You’re immobile and bleeding out and you need help and no one else is around. Being an orthodontist you don’t know the first thing about real doctors and real medicine (despite all the seasons of ER you have watched) BUT even you can tell that this guy is not “well-qualified”, credentialed, experienced or prepared and he has told you so himself. He doesn’t have the proper training or tools or setting to deliver “ideal care”, render “proper treatment” or deliver “excellent results”.

So, my question to you is, “Do you ask for and/or accept his assistance? Do you allow this person to render medical treatment on you knowing that you would be better served to visit a hospital with a proper trauma center and see a real doctor in person?”

Let’s up the stakes. Let’s say that you, yourself, are a real doctor – an emergency room doctor who works in a trauma center. A doctor who knows exactly what it takes to treat people who have been in a car wreck and have suffered the injuries you sustained. Based on your credentials, experience, wisdom and knowledge, you KNOW FOR A FACT that this bozo on the side of the road cannot render “proper care” for what ails you. With that knowledge I would ask you again, do you dare ask for or accept his help knowing the care he renders will be substandard according to everything you know and believe? Or do you still think that no treatment is better than treatment you deem inferior to what you would do or how things should be done? What if the guy was a certified EMT or what if he offered to take you to the local-yokel county hospital? Neither of these options are “the best” or “optimal care” but if there is not a trauma center near you, is what you can get good enough when YOUR care is on the line? Is something better than nothing when it comes to access to care?

What’s that you say?

“Burris this is stupid and has nothing to do with SmileDirectClub, Invisalign or the supply deal they announced. It’s a wholly different situation and unrealistic besides. This car accident scenario is life and death and what we orthodontists do is just teeth.” I can hear you explaining. Oh really? So what we do is not that important and not life threatening and we are not real doctors and orthodontics is just cosmetic and not a real medical procedure in 98% of cases? Well, I’m glad you agree that what we do isn’t that complicated. Your assertion is another point in favor of SmileDirectClub’s viability though!

Let’s be honest here. Every time something new comes out orthodontists rail against it and say it’s the devil, it represents substandard treatment and it will result in the end of the specialty or possibly even the world as we know it. You disagree? Well let’s look back for a few examples of new-fangled devices that were evil when they were introduced and then, after enough time and usage, became the gold standard:

  • Steel wires
  • Prefabricated bands
  • Prefabricated archforms
  • Stick on brackets for anterior teeth
  • Pre-angulated, stick on brackets
  • Molar and premolar brackets
  • NiTi wires
  • CuNiTi wires
  • Orthopedic/growth modification devices
  • Invisalign
  • Self-Ligating brackets
  • TADs
  • And on and on and on and on….

Of course the Tweed boys still rail against most of these things but the vast majority of orthodontists now embrace what was taboo only a few years ago. What does that say about us as individuals and as a profession? Nothing good. And I haven’t even listed out the practice management advances that have been demonized at first only to be embraced.

Get over yourselves. Change is the natural progression of things. Not to mention, with all that is going on in the world, THIS is what you choose to get all worked up about???

One thought on “An Access to Care Fairytale

  1. Couldn’t agree more. People who successfully influence the world see change, embrace the reality of the change, and react to it according their best judgement.

    Many people in many walks of life choose to whine and cry in their cereal about any change. It is not the way of success. That is not to say all change is good, but all change that is not good eventually becomes either weeded out or ordered. Moaning and fretting about change is a waste of time.

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