For years we have met colleagues who tell us that they have or are thinking of starting a boutique orthodontic practice. In our younger less skeptical days, we would take this at face value believing that “quality orthodontics” could be sold like a luxury Italian leather purse. There are many assumptions that underlie the concept of a boutique orthodontic practice but none is as flawed as thinking that the market has a scarcity of exceptional customer experience or quality treatment in orthodontic practices. For that’s essentially what the proponents of this model are banking on. Service boutiques try to differentiate on customer experience and exceptional treatment in order to justify a high fee. However, it is well established the vast majority of patients and most referring dentists cannot objectively differentiate orthodontic outcomes among different orthodontists so that leaves only level of service as a viable potential differentiator.

Think about service at the luxury car dealership versus the certified mechanic at the local garage. The luxury car dealership will offer you the perks of a free loaner vehicle, a fancy coffee machine in the service lounge, new-ish magazines, and OEM parts. This service comes at a premium. The local garage has you drop off your car and the mechanic politely tells you that he’ll call you when the car is ready. You call Uber and head to the office. No loaner, no coffee machine, no magazines, but the same OEM parts from the same supplier as the dealership. No difference in the end result. New oil, oil filter, and fluids. The only true difference is the price that you have paid for the service.

We have visited hundreds of orthodontic practices in the past 2 decades.  From single office, solo owner-operators to multi-operator corporate owned chains, we have seen them all.  Every permutation of an orthodontic practice has one thing in common, people come to them for tooth straightening. We can hear it now, that’s not why they come to my practice! “It’s the quality of the work. You don’t know my market, I treat highly educated high-income families that only want to have the best! It’s different here…”

And orthodontists in BFE don’t face similar/relative issues in their pracrices?

For a little insight into how truly wealthy people think, we recommend reading The Millionaire Next Door by Thomas J. Stanley and William D. Danko.  All in all, we think that the boutique orthodontic practice is something that exists more in one’s mind rather than reality. Yes, there are some of you who are able to charge a very high fee and your market is currently willing to bear it. To be clear we define “very high” as 100-200% more than the national average. We feel that there are 3 conditions that need to be met in order to truly have a boutique practice:

  1. Your fee must be significantly higher than everyone else’s
  2. A substantial number of consumers are willing to pay your very high price
  3. You are completely indifferent to what others in your area are doing with regard to price

From our experience looking at the orthodontic landscape, many practices achieve two of these conditions but there are just a handful of practices that meet all 3. Are you a boutique practice? Does it matter?

We believe it does. If you truly are a boutique then we believe you can expect to be relatively insulated from the changes currently upending the orthodontic space. If you are not a boutique practice, we hope this piece will help you achieve an accurate self-assessment. Understanding who we are is essential when trying to navigate the new dental landscape!

Self-Assessment can be difficult…


4 thoughts on “The Boutique Mentality

  1. People becoming more and more price concious…seeking out lower prices as most families under financial pressure

  2. I just found out that I was charged over $1500 for a 30 min initial assessment at the Duke Univ Voice Clinic (with an ENT and speech pathologist). My one 30 min speech therapy session following that was over $600. Combined, the provider charged more than 1/3 of a comprehensive ortho fee for two visits totaling 1 hour of care. It seems to me that instead of racing to the bottom of the fee scale, the orthodontic community should be educating the public about what a great value orthodontic treatment is. That was true even before this culture fee cutting took hold.

  3. This is a perfect encapsulation of the traditional mindset. If you’re getting what you want then keep doing what you’re doing.

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