It’s been an interesting couple of weeks. Based on recent polls in Ortho101 it’s become obvious that we orthodontists are nothing more than teeth straighteners who do the bidding of our clientele. The fact that we cannot define “quality treatment” or give a single, solid reason why Class I is better than Class II combined with the FACT that our level of success is determined by the patient’s assessment of our process and product labels us as tradesmen not medical professionals (BTW, much of what patients require to be satisfied has nothing to do with orthodontics). The good news is that there is nothing bad or wrong with our status and embracing who/what we are brings great opportunity and freedom to help our fellow citizens get the smile they dream of!

“How dare you say such a thing, Burris! You’re wrong and destroying the profession with your crazy talk” I can hear you saying.

Well, thanks for the vote of confidence but I’m not nearly that influential and I didn’t make the profession what it is. All I’m doing is asking questions that we should have been asking for decades. Honestly I’m ashamed that I didn’t think to ask before now. Let’s look at the questions we’ve been discussing in Ortho101 so you can see for yourself:

quality tx

If you examine the most popular “definition” you’ll find it’s not a definition at all but a goal. A nice goal, but not a definition and not applicable to more than one orthodontist at a time. In fact, if you think about it, the most popular “definition” is no different than “Quality treatment is what I do”. Think about it. Why does this matter? It matters because orthodontists are always citing “quality treatment” as a reason for or against any given scenario BUT if we use the above definition of quality treatment then none of us has the right or even ability to question another orthodontist as long as they are “Addressing the patient’s chief complaint (making patient happy) under non iatrogenic care that allows you to sleep at night”.

“Ah ha! Got you! Non Iatrogenic is the key here. That’s what defines it” I hear you saying. However, iatrogenic dentistry is situational and there is a great deal of judgement involved in almost all assessments of iatrogenic treatment. Yes there are a few circumstances where all of us would agree something is bad treatment but it’s not as common as you think and you know how often all orthodontists in a room agree on treatment decisions! So we are back to square one. We are unable, as a specialty, to define quality treatment. That’s a fact. Whether or not you choose to recognize this is wholly up to you!

class I or class II

This poll sparked huge discussion on Ortho101 but despite all the talk and heated back and fourth, not one single reason to support the overwhelming belief that Class I is better than Class II surfaced. I was shocked. If you’re not on Ortho101 then join and read for yourself.

pt vs ortho satisfaction

This final poll was the clincher for me. How do we reconcile the fact that patients are in charge with the rest of what we say and believe as a profession? Is there any shame in just admitting that we work at the behest of our employers – the patients? Are we any different from a waiter in a nice restaurant who has some knowledge an experience with the offerings on the menu, knows what he likes and gives recommendations based on that? Like the waiter, we won’t serve the clients poison even if they ask for it but also like the waiter, we are not paying the bill so the final determination of what to order is not up to us!

Look, I know I’m not supposed to ask these question and I know that you’re upset by what I’m saying but these revelations don’t have to be negatives. They are just the reality we have willfully ignored for decades if not longer. Self assessment and self knowledge are difficult but the more we know about who we are and what we do the better we can do what we do and the more people we can help! Think about what this means, how it applies to you, your patients and your practice. There is huge freedom and opportunity in embracing who we are and what we do!





2 thoughts on “Quality Treatment?

  1. Interesting read… I think the next topic could be:
    “The erosion of orthodontics and watering down of profession… Doesn’t the general public deserve better? “

  2. I think yo should write that piece, Chad. Would love to see an orthodontist, any orthodontist, actually do something other than just complain and talk about how someone else should fix it…

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