Moving away from Mediocristan

Build your relationships first….then your dentistry. ~ Bob Barkley

Moving away from Mediocristan

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-Heartland dental currently employs around 1200 dentists, and plans to expand to 4000 with future locations already selected.

-Aspen Dental is collaborating with Walgreens to place offices in their buildings.

-25% of all practices are contracted with a DSO including 15% of all dentists.

-80% of all dentists are projected to be working under a DSO contract in the next 15-20 years.

“It was the best of times, it was the worst of times, it was the age of wisdom, it was the age of foolishness, it was the epoch of belief, it was the epoch of incredulity, it was the season of light, it was the season of darkness, it was the spring of hope, it was the winter of despair.”

So opens Charles Dickens’ ‘Tale of Two Cities.’

One could read into current market trends that the end of individually owned private practices in dentistry is near. And you would be 80% correct and 20% incorrect.

Such projections aren’t new. Avrom King famously talked about this 40 years ago. He said that the market would differentiate into three tiers: Closed Panel, Retail, and Relationship-based / health-centered.

The “middle” of the market will be dominated by corporations seeking ROI for their investors. The bottom tier (Tier 1) will be various direct and indirect versions of government financed treatment.

The top tier, Tier 3, will be the only place that money-centric agendas do not rule the day. And consequently, will primarily be the only place where health is truly facilitated and promoted. The other two tiers will be focused on the efficiencies of treatment delivery.

And there is a difference between treatment delivery and facilitating health – believe me.

To this point, Bob Barkley said, “It is impossible to create health with burs, prophy cups, or surgical instruments.”

Heath in dentistry emerges only through self-responsibly and commitment. Yes, treatment is sometimes part of the equation, but treatment alone can not sustain health in most patients.

Oh, but there is money to be made with burs, prophy cups, and surgical instruments! And lots of it as the corporates better learn how to efficiently convert dental health care professionals into day laborers, and become more and more emotionally disconnected from their patients.

Nassim Taleb, author of ‘The Black Swan’ described middle market places like Tier 2 as ”Mediocristan,” where the size of the faculty is average, the quality average and highly repeatable, and the operators – average, because they are easily replaced, like cogs in a giant wheel.

But “average” care delivered in an average facility, by an average person does not serve the “average” patient well – IF the goal is the promotion of health.

So, what is your goal? What is your purpose? How will you thrive in the future if Mediocristan is not where you want to live?

“Only a totally new health-centered philosophy of dentistry at all levels of society can avert a collision with mediocrity on a world-wide basis.”

Robert F. Barkley, DDS

Paul A Henny, DDS


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