I am the first to admit that in the not too distant past I fell for the orthodontic groupthink that is the rush to add new services to our offices. I have since wised up as have many others who’ve tried offering non-traditional services in their orthodontic offices but the push to add services other than orthodontic alignment of teeth seems to be gaining steam. I’ve had some time to wonder about this and would like to offer a few theories as to why we would even consider getting away from what we know best, what we do best and what is most profitable in our practices in favor of trying to expand our services in the hopes of helping others avoid the mistakes I’ve made. Let’s look at a few possibilities:

1. A general lack of new patients – We see these other services (Botox, sleep apnea, TMD, etc.) as a way to attract patients but are they really? Do we really believe that there is a bigger demographic of better funded people who find these non-traditional services more desirable than orthodontics with braces or aligners? I think not.
2. A lack of understanding of the difference between fixed and variable overhead – Adding fixed overhead is bad unless you are certain that you’ll get massive return and positive that you have exhausted all other options first. Adding variable overhead costs money as well but is much better than adding fixed overhead because it can come and go as we see fit. Adding new offices, adding new systems, adding new equipment… these are fixed overhead expenses and they tend to snowball. In other words, you don’t just add a new office, you have to staff it and put supplies in it and insure it and run power to it and on and on. If, instead of buying stuff we engage a professional to create a comprehensive marketing plan we can receive much greater return for far less money with much more control. To be very clear, it seems that we orthodontists would be much better off spending our money on effective marketing to bring in more orthodontic patients than we would spending money on some new gizmo or system or a new office in the hopes of attracting an unknown and unproven demographic. You could double or even quadruple your marketing budget and generally come out ahead vs adding fixed overhead.
3. An unwillingness to modulate service – Every case is not a hard case so why do we charge for them like they are. Instead of offering new products/services outside of our wheelhouse why not offer modulated orthodontic services? The vast majority of people don’t see orthodontists because their teeth aren’t that bad. Why would they pay 5-8 k for teeth that aren’t that crooked? But they will pay 2-3 k for straightening. This has been clearly demonstrated to us so why not offer this service? What’s the difference in doing so vs offering one of the aforementioned nontraditional services in your office? EVERYTHING! When offering a modulated orthodontic alignment product know what to do, you know how to do it and you are already prepared (no additional purchase required).
4. Boredom – This is the killer. Even when we have it going great we start thinking we are missing something. I’ve been guilty of this more often than I care to admit. If you’ve got it made, don’t risk it!

People want what we have. Braces and aligners are the most profitable and most desirable thing we do. After dabbling unsuccessfully in alternative services, I’m more convinced than ever that we will be much better off as a profession and as individuals if we stick to what we know. If you do what you do best while constantly upgrading/modifying the delivery of orthodontics to maximize appeal, convenience and affordability I can’t imagine anything but a bright future for orthodontists.