I did a talk last week for a very nice group of orthodontists who reminded me of how far we have to go in our profession. As I always do, we spent a good bit of time talking about access to care because I am a huge advocate of increasing access to care AND I’ve built my practices by finding and serving the underserved. It’s good for society and it’s good for business to be inclusive, but we orthodontists are far from inclusive by and large. I don’t know why I was shocked by the amount of resistance I received when the topic of accepting Medicaid and offering flexible financing came up. I guess I feel that I speak and write about this stuff so much that everyone should know better by now? Obviously I’m not as widely known as I’d like to be because I haven’t come close to overcoming the generalized brain damage and prejudice we orthodontists are taught in residency about those who differ from us in gender, race, economics, language, religion or geography. We orthodontists are judgmental and tend to decide who is worthy of braces and our time and who is not – even before we meet them – because that’s the behavior our professors modeled. Pre-judging people and patients is not right and being taught to be this way is not an excuse but I know that the majority of orthodontists still think this way so I guess I should expect it. I have no problem raging against the machine and I expect pushback from the established norm, but I have to admit that when a minority, female orthodontist said, “I don’t want those people in my waiting room running off my regular patients,” I was taken aback. The irony was so thick that even Guy de Maupassant would have been thrown for a loop!

But don’t you dare think this is an isolated event or feel superior where you sit and read because “you would never” do or say such a thing. It’s a rare orthodontist who doesn’t fall into the “those people” trap. It’s a mindset and “those people” go by many names but it’s the same sickness: “quality new patients”, “ranking patients, A, B or C”, and “the right kind of patient” are but a few examples of the “those people” mindset with updated terminology.

Shame on us.

Don’t you dare judge people or their motivations to get braces for themselves or their children. Don’t you dare deny access to those who would have a better life for their kids. Who are you to judge whether or not someone else can pay or will show up or will brush or will comply? Who are you to say who will and who won’t have access to care? Don’t “those people” love their kids every bit as much as you? Doesn’t everyone deserve a great smile?

Pre-judging patients is being prejudiced. Period. It doesn’t matter the trait you choose to discriminate against, when you judge individuals based on characteristics you’ve assigned to any group, you’re wrong! What do I mean? Let me give you a few more examples of the “those people” mindset in action.

  • “The people that Dr Smith refers never show up”
  • “Medicaid patients don’t comply and have bad hygiene”
  • “Those people who come from advertising are low quality new patients”
  • “People from that part of town are not the kind of people we want in our practice”
  • “We spend less time with a type C patient than with a type A new patient. We rate our new patients when they call and appoint accordingly”

All of these activities are STUPID, prejudiced, inhumane and bad for business!! Are you at capacity? What else do you have to do? Consider every new patient a blessing and thank them for calling you! New patients are the lifeblood of an orthodontic practice and you cannot afford to discount a single one of them.

I’m sure you still know better and think this is a load of malarkey because I’ve had this conversation many times and watched the arms of the audience cross as they lean back and snarl.

Let’s think about this logically and with an open mind for 30 seconds. When one of “those people” calls your office and you and your team already KNOW they are terrible and won’t show up, how do you think that new patient is treated on the phone? Do you think the “type C new patient” or the patient from Dr. Smith gets a warm fuzzy feeling during that encounter with your team member who is already unhappy this “low quality patient” is bothering them? When “those people” try to make an appointment to come to your office and give you money, you and yours treat them poorly based solely on who referred them, where they live or how much money they make and then cannot understand why they don’t show up. Looking at it from this perspective, do you think it’s possible that “those people” being treated badly by your people on the new patient call may have something to do with them not showing up at your office and, instead, choosing another orthodontist? I do. Because it’s my office they come to when you run them off.

Do the right thing. Be inclusive. Stomp out prejudice in your office. Your patients, your community and your bank account will thank you.


Related Reading:

Find An Underserved Population

Wanna Bet?

Smile for a Lifetime Foundation

Market Share & Mindset

Better is Better – The Argument for SmileDirectClub

4 thoughts on “Those People

  1. Onward and upward Louie! See you in a few weeks.

  2. The attitude you refer to is bad,bad ,bad and unworthy of a health care professional.
    On another note I am very impressed by your reference to Guy de Maupassant —-and they say a well rounded education is a thing of the past !Andrew Thompson
    PS FYI—Guy was also known for his avid love of promiscuity

  3. Didn’t know that about Guy. His short story, The Necklace, had a huge impact in my formative years and defined irony and honestly for me.

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