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Either This, or That, or Both?

Speed and accuracy?  Speed versus accuracy? Accurate speed?  I was reading a shooting article that was going back and forth on whether one is more important than the other.  I find that it has a very important lesson for Dentistry also. Most of my friends know I shoot.  I shoot a lot.  Read on.

“Speed and accuracy:  There are so many ways to phrase these two elements in shooting.  However, as in anything critical, both components are always a priority (even in Dentistry).  Think about it.  Racecar drivers have to be fast and accurate to win.  All professional and Olympic athletes have to be accurate and fast to win.  Most of us are not accurate without practice.  Speed comes with repetition.  Again, as all professional athletes must do, perfect practice makes perfect (repeating the wrong action does not a master make).  A pitcher can throw a ball fast when he is young, or he can be accurate, but to go to the major league, both are mandatory.  Mandatory speed and accuracy take years of practice.”

The majority of the best dental professionals out there are over 35 years of age.  It has taken practice and study to stand out in Dentistry.  Yes, I know there are exceptions, but the majority is what I am referencing.  As I said before, I shoot, and by most measures of practice, I shoot a lot.  I take courses in shooting and shoot 3 or 4 times a week.  I’m not the best shot in the world, but I’m probably better than most of the readers of this article.  I’m not a natural.  I just work at it.  I am intentional about shooting a bow, or pistol, or rifle at distance.  I have made a lot of mistakes, but make fewer today.  I used to worry about hitting the target, now I would be surprised if I missed.  A strange thing happened decades ago.  I realized that I could get off three or four accurate shots hitting the target every time when the folks shooting with me were struggling to get their weapon on target.  I got faster as I got more accurate.  It just happened.  It was easy to hit the mark and with ease came speed.  By making it easier through perfect practice, it got consistently predictable.  Dentistry is that way too.  I used to struggle with root canals until for almost two years I did two root canals at lunch every day on extracted teeth in stone.  I got better at opening the canals, then better at getting to length, and finally got better at filling.  Along the way I must have run up against a lot of weird problems that got easier to solve.  There was no longer an attitude of “prep and pray,” hoping things would go better.  The ripple effect was that my diagnosis got better as well as my estimation of the time I would need.  That led to being on time so often that I just never ran late.  This allowed my staff to engineer a schedule for maximum productivity which allowed us to slip in thousands of dollars of production a day without running late on patients that were already scheduled while still being able to check multiple hygienists all day.  After a time, I didn’t have to really work at it or think about it, it just became habit.

I think there is a lesson in this for dentistry.  I was speaking in Seattle, Washington, last month when a doctor told me in front of a crowd of 250 that he kept his practice small so that he could control the quality of the dentistry coming out of his office.  I knew this practice’s numbers and it truly was small, with few new patients, low production, no referrals, and limited profit.  “I keep the practice small so that I can do quality dentistry”.  Are you kidding me?  If this doctor was producing quality anything, he would have more clients.  If he had such great quality, why wasn’t he getting any referrals?  Why wasn’t he growing?  In a way, his small practice size was simply the patient’s way of telling him that they didn’t like what he had to sell.  He just wasn’t listening.  It takes both quality and speed to compete and have a successful dental practice today.  The only way to compete against managed care is to “out gun or out run them”.  In other words, you have to do it faster with quality, or sell your patients something that managed care doesn’t cover.

How about being efficient or effective.  Leadership and management require both.  You have to get the result you want with as little motion as possible.  It’s just not enough to pick one or the other.

Over and over we are faced with a decision when the best solution is both.  The problem I see is that dentists as a group tend to think that going with “this or that” is the best way.  A choice that, at best, is a 50% solution will not cut it in today’s market place.  As L. D. Pankey said:  “Average is being the best of the worst or the worst of the best.”  No one graduated from dental school wanting to end their lives as almost average.

In any consumer business, success, quality, efficiency, and effectiveness, is defined by the client, not by the doctor.  Patients expect excellent dentistry, but buying is an emotional decision that no amount of logic can overcome.  That’s why the best offices focus on hiring staff that have people skills and are perceived as being caring and compassionate with their clients.

In any business there are winners and there are losers.  Today the winners are more often the big, corporate practices, insurance companies, and probably the soon to be infamous National Health Care Program.  The losers are going to be solo dental practices that have failed to embrace change and consumerism.  Too soon we will find our profession, like pharmacies, turning into a corporate profit margin notation on some large company spread sheet.  We have to take back our profession with wise choices made quickly and implemented rapidly or dentistry as we know it will be gone.  We can’t be average.

Every one of us has a born on date and a use before date.  Private practice dentistry is the same way, and I’m afraid that we may be a lot closer to our “use before date” than any of us realize.

What would the Private Dental Practice Obituary look like?

  • It would probably begin by telling of our accomplishments in treating diseases of the oral cavity, strides in prevention, and how technology has almost eliminated decay and discomfort for our patients.  It might also say that for years we were the third most respected profession behind members of the clergy and a family medical practitioners.
  • Next comes the fact that we were Preceded in Death by:  Relational care, compassion, integrity, and consumerism.
  • The Cause of Death will probably be procrastination, “change” aversion, lack of business training, and complications resulting from greed.
  • Finally, it will likely say that we were Survived by: managed care, corporate practices, national health care, and a general lack of personal touch.

On every tombstone is the born on date and the use before date.  When it comes to an individual the only thing that matters is the small dash separating the two dates.  It’s that small dash, how you lived your life, that is important.  I am afraid that this part of our dental life will be recorded with less than stellar reviews. It is time to wake up and take action while there is still time.


Michael Abernathy, DDS
[email protected]