When I got out of school in 2004 I was obsessed with efficiency. To be clear I was interested in efficiency in orthodontic mechanics because that is the only thing I’d been taught about and about which I thought I knew a great deal … despite the fact that we only get to treat a few dozen cases in orthodontic residency at most. So when I graduated, I wanted to make sure I used the latest technology in the best possible way to solve any tooth problem that arose in the most efficient way possible. Again this assumed that I knew a great many things that I didn’t and disregarded even more things of which I was totally unaware. Like most new grads I believed that the latest (aka most expensive) technology was the only way to go and to treat patients with anything “less” was tantamount to malpractice. It took a while but I learned differently.

Efficiency is great and, and all things being equal, efficiency should be one of our top priorities. That being said, pursuit of efficiency at all costs is not smart for many, many reasons. I watched this video on why vertical farming is failing and it did an excellent job of explaining the issues that can arise out of the pursuit of efficiency despite what appears to be a great strategy and having the best of intentions. Have a look. Vertical Farm Failure Video

Let’s go through the issues I see here one at a time:

  1. Paying more for efficiency is NOT smart when you are not at capacity.
  2. Paying more for efficiency is NOT smart when it raises your costs and you must pass those costs on to customers. The exceptions being that it is worth it if:
    • Enough customers are willing to pay far more than your increased cost and come to you specifically for your efficiency
    • Customers can readily recognize and appreciate the difference your efficiency makes and are willing to pay for it
    • The pursuit of efficiency doesn’t make your product or service cost prohibitive to the majority of the marketplace
  3. If something is too expensive then almost no one will buy it
  4. If something other than the “most advanced technology” (read most expensive) can do a job and do it well it is probably not a good idea to invest the capital in the more expensive products just because they are cool and we want them.

I know what you’re thinking. You’re thinking that I’m suggesting we shouldn’t do our best for patients or treat them to the best of our abilities. I am doing nothing of the sort. Just as a KIA and a Ferrari will both get you where you are going so will the various forms of orthodontic appliances do what needs to be done. In the car example there is generally a speed limit that can be reached by almost any car which minimizes the efficacy of the Ferrari. In the orthodontic appliance example there are affordability limits that make the KIA braces the better choice.

As I’ve said for decades, if you are happy with your results then by all means keep it up. However if you’d like to be attractive to more patients and be more profitable while still providing excellent care, service and affordability it may be time to rethink your supply spend and prioritize things that to the job but cost the least. FWIW