Not the average orthodontic patient seen in the traditional orthodontic office, the average consumer. There is a huge difference between the two but we orthodontists are generally unaware of the discrepancy or even that there is a distinction. Orthodontists mistakenly believe that the average patient seen in our offices represents the median malocclusion in the population at large.
“So what? Why does this matter?” I can hear you saying.
It matters because our perception of how difficult the average case is confirms our biases when it comes to setting our fees and our beliefs about how to maintain a profitable orthodontic business.
Traditionally we have charged far too much for easy cases and far too little for hard ones. Our attempts to normalize fees is a result of our perceptions of the average case. The consequences are detrimental both for our practices and for access to care because our unwillingness to offer an appropriate fee for the much more common easy cases means that we almost never see those simple cases in our offices. It’s simple logic however difficult it is for us to grasp based on our orthodontist’s world view – if a consumer’s teeth aren’t that bad then why would they spend 5500 dollars for orthodontic treatment? The vast majority of the 320 million Americans have very simple tooth alignment issues and would like a better smile but it’s not a big enough deal to them to merit spending 5500 dollars. They don’t have much of a problem so they won’t spend that kind of money to address it and that’s why we generally see people with very bad teeth, a great deal of money or access to a government sponsored treatment program day to day in traditional orthodontic offices. If you add up these segments of the population who do show up in our offices, it begins to become clear why only 1% of the population receives orthodontic treatment annually despite the US population growing by .7% a year AND a lack of business being the primary issue facing orthodontists. Remember that this lack of business is happening in the midst of one of the hottest economies ever and the implications are clear.
So what is the solution? You don’t have to look far or be terribly creative… If you’re as busy as you want to be then don’t change a thing. If you’re not then perhaps it’s time to consider focusing your business model, pricing, services and marketing on the majority of the population instead of continuing to fight it out over the tiny percentage of our fellow Americans who traditionally visit an orthodontic office. As I’ve said many times the two easiest ways of accommodating the majority of the population in terms of time and money are:
1) Incorporate teledentistry in your practice to the degree to which you are comfortable with it… then figure out how to become more comfortable!
2) Modulate service to fit the price point that will make your services wildly desirable in your area. What’s that fee? I don’t know – you’ll have to figure it out but again I’d look at new delivery channels and take a clue from that.
Sitting in your office with all your free time (because you don’t have enough patients) and making yourself feel better by moaning about the lack of fairness and quality in the world with your FB friends (who also have time on their hands because of a lack of patients) may numb the pain but it is not useful or productive and it certainly will not help you when the next economic downturn happens (and it will).

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