10.23.09 Issue #398 Forward This Newsletter To A Colleague

David Clow
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Model-T Dentistry

Henry Ford was the industrial giant whose mighty assembly line created a new Model T every three minutes. The first car built with interchangeable parts, it was everyman’s vehicle, an affordable taste of luxury previously available only to the wealthy. In its day the Model T owned America’s roads, with millions of them instantly recognizable thanks to Henry’s firm policy on color: “Any customer can have a car painted any color that he wants,” Ford said, “so long as it is black.” It goes without saying that there’s vast utility in assembly line thinking, uniform procedures and cost-cutting measures that streamline processes and make them more economical for everyone. But it’s also worth mentioning that there might be some things - dentistry, for one example - that might not lend themselves to the ruthless task-oriented focus of the assembly line.

Online Dental Auctions: How Should We Feel About Them?
Online auction sites like eBay invite competitive buyers to outbid each other in pursuit of something they want. Reverse auctions work in the opposite way, permitting sellers to compete in offering the lowest bid for a product or service. One of the latest is a site that dentists can use to offer any number of dental procedures from simple drill-and-fill to root canal, gum surgery, braces, etc., all with a price tag listed beside them. Patients can comparison-shop to see which of their local dentists offers a given service for the lowest price, and then, with just a click of the mouse, buy that service and set an appointment to have it done.

Welcome to the 21st century. On one hand it’s impossible to argue with it - patients like me want that pricing transparency, and I like getting a chance to set dentists up one beside the other so I can compare. But that’s the problem - I can’t compare them except on the dollar cost. I’m not a dentist, so I’m not competent to diagnose myself, nor to understand the differences between one dentist’s quality, training and skill and those of any other dentist. Some procedures might sound simple - a “Fluoride Treatment” seems innocuous enough, and I might safely guess that it’s more or less the same from practice to practice. But a “Bone Graft?” “TMJ Services?” Am I, or is any average patient, competent to assume in the first place that I understand these things, in the second that they’re all alike, and finally that I can choose a provider based only on the dollar cost?

Does “One Size Dentistry” Fit All?
Obviously, the inference of Web services like this is that all dentists can provide these procedures with uniform skill and outcomes, and that patients can rely on the absolute minimum of information to make a sound choice. No sensible dental patient would believe that, not completely anyway. Dentistry very quickly moves out of the realm of mechanical tasks and into craftsmanship, even into art. Block to block, street to street, a patient can avail himself of a very wide range of skills, experience and raw talent among the many providers, so imagining that it’s all just about the dollars and cents is a fantasy that might be painfully dispelled at the hands of an inexperienced practitioner. There’s no mention on the Web sites I looked at about the dentists’ education, CE, certifications, years in practice, etc. They look as uniform as Model Ts. One color might be enough for me when I’m picking out a car, but I know that not all dentists are the same, and moreover that involved dental procedures - even fluoride treatments - don’t suit themselves to assembly line thinking.

Tempting as it might be to bargain-hunt, patients need to keep in mind that price must be one of the least reliable indicators for quality dental care. And this presents a dilemma for both dentists and patients. This trend isn’t going away, especially in an economy more attentive than ever to squeezing dollars for every penny of value. Dentists have to find ways to communicate what real value means, and patients have to find the time to learn more as vigilant, responsible consumers.

We’re looking at the future here, and we all need to adapt to it because it’s not going away. Caution is called for from both sides. Dentists don’t want to be mechanics; patients don’t want to be machines. When you look at these Web sites, you can’t help but feel as though you’re looking at a massive thoroughfare jammed with Model Ts. They’re all the same color, all the same under the hood. But the drivers at the wheel aren’t machinery. Some of them drive like experts, and others not quite so well. In which of these cars would you want to be the passenger?

On behalf of McKenzie Management, David Clow consults with dental professionals on practice culture, case acceptance, and patient expectations.

David Clow is a writer/consultant for Fortune 100 companies. His book, A Few Words from the Chair, is the first book written by a patient for dental professionals and students and is available here.

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