Over the last year I’ve struggled with the culmination of several decisions I’ve made. It’s not the first time that I’ve found myself in a tight spot but it doesn’t make it any easier! Championing speciality care, taking on dentists and the state dental board, battling it out in court and dropping my speciality license combined with going multi-speciality and multi-location have created a very hostile environment on several levels. We will continue to fight through it and come out stronger – as I have in the past – but I will admit that taking all this on wears on me. I bring this up only to remind myself of the good that has come out of the risk taking and struggles I’m enduring. Let’s have a look at a few:

  1. We have created an awareness among orthodontists to the fact that patients are totally uneducated as to what we do and why they should see us for braces and aligners. It also seems that most orthodontists now realize that it’s important for us to educate patients efficiently and effectively. We, as a specialty, have no greater mandate.
  2. We have started asking the AAO questions and holding your member association to a higher standard when it comes to spending member money. The changes are slow but the AAO has changed and the idea that we can question the AAO is wholly new and healthy. Keep it up.
  3. We have created a truly interconnected orthodontic community to discuss practice management and clinical aspects of orthodontics. This unprecedented interaction has changed the fabric of how orthodontists communicate and learn what’s going on around us. Awareness is the first step to any significant change and orthodontists are no longer isolated.
  4. The new interconnectivity protects individual orthodontists from being taken advantage of, bullied or fooled into doing something that may not be good for their practice. The AcceleDent fiasco is a great example.
  5. We have learned to share failures as well as successes. We orthodontists are still slow to talk about things that didn’t go well for us but it’s becoming acceptable to admit that every case doesn’t finish perfectly and to admit that all our deals don’t work out. I feel that sharing my failures is the most valuable thing I have to offer and it doesn’t look like I’ll run out of failures to share any time soon!
  6. We have learned there are many, many ways of doing things and we have learned that the way we have always done it is not good enough unless we know why we do it that way and the reason is good.
  7. We are beginning to question even the most basic tenets of orthodontic theory and practice. I know this is scary but it’s necessary and I encourage you to question everything all the time.
I’ve learned a lot over my short 12 year career. Mostly through failure! I hope that in sharing my failures I’m able to help many of you avoid the pitfalls I’ve encountered and continue to deal with. I would further encourage you all to be relatively conservative in your approach to practice – let those on the bleeding edge test out ideas for you BEFORE you jump in! As I’ve told many of you who have asked about doing what I do, it’s not all it’s cracked up to be. Be very careful about upsetting referrals. Be cautious about expanding before you fully utilize your existing capacity and maximize your profitability and have a good deal of money in the bank! Demand that your member organization fight the PR battle and aggressively educate the public about why they should see a specialist so that you can stay out of it in your local market. Focus on what you do well and stick to it. I’ve leaned a lot over the last decade and the most important lesson of all, the one I hope to share with you, is that the vast majority of us are good at running a practice but we know nothing about running a business. What’s the difference? A practice is something small enough that the owner/operator can keep their hands on everything and a business requires delegation of critical tasks. This is and important distinction that I wish I’d known years ago!

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