The Perfect Storm: The Orthodontic Version – Or A Tsunami ??

POSTED: 11/4/13 6:25 PM


Most of us have seen the movie “The Perfect Storm” where a fishing vessel in search of a large catch of fish goes to the “outer banks” and beyond to find fish. The good part is that they do find an incredible catch. The bad part is that they find themselves in the middle of a convergence of multiple weather elements almost unknown in seafaring history. This convergence makes it impossible to escape in any direction. They are trapped. Over the last 7 years I believe that orthodontics has been in a situation just like that fishing boat was. I have been practicing for more than 45 years. During that time there have been choppy seas; there have been some ill winds; there have been several “mutinies”. However, there has never been the combination of all of these events and certainly not in the severe intensity that now exists.

What is it now that has created this foreboding climate for the orthodontic profession? Let us enumerate them:

  1. Pediatric dentists are “hiring” orthodontists in very significant numbers.
  2. General dentists are doing much more orthodontics than ever before (aligners and six-month braces).
  3. The dental group practice has been increasing significantly.
  4. Orthodontic manufacturing and supply companies are now being run by dental/business types and not those with orthodontic backgrounds who also were great business people.
  5. Residents are coming into the marketplace with enormous debt and are unable to obtain bank financing for starting a practice.
  6. In spite of what the government tells us the Recession is not over.
  7. We don’t know yet what “Obamacare” will mean for orthodontic practices.
  8. We are now dealing with an entirely new and in many ways unknown generation…the Gen Y or Millennials.

We are dealing with a Tsunami!

The initial signs of the Tsunami have been out there for 6-8 years. It was the earthquake. I have been warning of this major problem since 2008. We have already seen the changes in the landscape (practices) in many areas. However, since this problem seems to be affecting only various small islands far away from us we think that the effect on our practices will be minimal and we can ride out this storm like we have in the past. WRONG!

What are the answers? What, if anything should we do? Going to high ground to simply wait out the storm will save us from immediate doom…but the landscape will still be changed, forever.

So there you have it. Those are the major waves, storm clouds, winds, etc. all upon us at the SAME time. I believe that orthodontics will never return to the way it has been in the past. So what should we do? Give up? Retire? The answer is “No”! Some of the things which should be done will be described below. But first I would like to warn you, especially if you are over 50 and consider yourself traditional, that my suggestions may not sit very well with you. Also remember that not every orthodontist will be affected in the same way by this Tsunami.

Maneuvering your way out of the problems previously mentioned will require a multi-pronged response:

  1. Everything possible must be done to quickly reduce overhead in a very significant way. 40% should be the target. Many of you will look at that number and think that it is impossible to reach. It is not and it must be achieved very quickly. This has to be accomplished within 2 years.
  2. Incredible efficiency must be brought into the management of your practice. This is especially true in your clinical area.
  3. You must gain financial mastery of your practice.
  4. Marketing must change from what has been the norm to something that is appealing to the Gen X and Y group.
  5. The Internet must play a large part in your marketing but in a way that will not cost a significant amount of money (remember 40% overhead).
  6. Any assistance from consultants should be reasonable and measurable in return on investment.
  7. You will be performing services which include more than just tooth moving.
  8.  A heart wrenching decision will need to be made concerning fees. Either very high fees with a select small number of patients or significantly lower fees with large volume. Remember, many orthodontists will not have a choice. We are now dealing with different times, different circumstances, and different people.
  9. Because of the above, practices will need to have superbly trained, small staff size.
  10. It will now be necessary to develop much better diagnostic skills and determine which technological advances are necessary versus those which are nice to have. What is best for the patient? What is best for superb diagnostics? What is best for efficient, effective treatment?

Roncone Orthodontics International has been working for more than seven years to provide answers to the above problems and to assist orthodontists in achieving, in their own individual way, the ten pronged reconstruction of their practices.

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