[MASTERY] Change

CHANGE

Change is the only constant.
- Proverb

Dentists in private practice often feel threatened by change; HIPPA, OSHA, lowering state requirements for practicing dentists to secure a license in multiple states, independent hygienists, computerization, lasers, PPOs, and the list goes on. Every time there is some form of change in dental practice, dentists resist. Well, who can blame them?

Change means whatever you were doing in the past will no longer carry the day in the future, whether its government regulations or new technology. But then again, change increases risk. If you make a change and it's not necessary, then you spend time and money on something that's needless and maybe even harmful. But if you wait, and the change is necessary, then you're playing catch up and that will cost you time and money and you've let the competition get ahead.

Change is disruptive. Change undermines predictability and clouds your ability to forecast. Change causes uncertainty, doubt, and suspicion. Change leads to hesitation to take action - "should I or shouldn't I? Is this the right time, or should I wait? Will this really be essential to my practice or will it be a passing phase."

Change causes fear. Fear stimulates flight or fight. Since dentists are heavily invested in their practices, flight is out of the question. How they fight is by pressing their representatives to battle for them. They charge their representatives to stand up to the agents of change, to do what dentists want which is to have the future be like the past. "Do not embrace this change, resist, fight, do not surrender."

What dentists fail to realize is certain changes are unstoppable. In 1987, when I told the Northern Nevada Dental Society that in 10 years computers would run their practice, they laughed. When I told a group of periodontists in 1996 that in 10 years they wouldn't be practicing periodontics anymore they laughed. When I told a group of dentists last year that mid-level providers were a certain future in dentistry, they laughed. Here are excerpts from a recent editorial. It is a classic response to how dentists are responding to today's changes.

"We are writing regarding the March JADA editorial by Drs. Michael Glick and O.T. Wendel, "Lessons Learned: Implications for Workforce Change" (JADA 2008;139[3]:232, 234)."

"Lessons learned. Dentistry is no longer health care that works. Dentists should no longer be cutting restorations or extracting teeth, and it isn't clear as to what else the general dentist should abdicate to 'emerging groups of oral health care providers,' whom JADA advocates we "invite ... into our midst."

"How can the ADA be a credible advocate for dentistry when it condones DHATs in one state, condemns ADHPs in another, decries hygienists working unsupervised in two other states, claims there is no need to increase enrollment in dental schools and then editorializes that there are too few dentists to provide care to a growing number of Americans and, therefore, dentists should welcome mid-level providers?"

"Is there a true need for mid-level providers? Or is it an attempt by politicians and policy advocates to allocate less funding to dentistry? How can mid-level providers charge less for a filling than a dentist? Are their chairs, equipment, plumbing, malpractice insurance and supplies less expensive? Are they to be employed by private dentists and be subsidized by fee-for-service patients? What incentive is there for dentists to employ a mid-level practitioner? Has this type of cost shifting improved access for medical treatment? Are they to be employed in government-subsidized clinics? Have we declared the Federally Qualified Health Centers and public health models failures, hence the need for these mid-level practitioners? Before accepting the inevitability of mid-level practitioners, a critical examination of the current system is in order."

In the case of mid-level providers it's fairly straight forward, as a health profession we simply can't leave 25% to 30% of children in this country without access to routine dental care. That's the real issue that dentists aren't addressing. That's the issue that actually could be solved at the local level if dentists took responsibility instead of pointing fingers at the ADA, or Dr. Glick, or the government or mid-level providers. In fact, the creation of mid-level providers would not have occurred if dentists were more responsible for the lack of access for children.

The link below will take you to an interview I recently completed with Dr. Steve Bradway, a dentist who took responsibility. Steve developed a volunteer organization with 91 local private practice dentists that has treated 19,000 children in Pierce County, Washington. INTERVIEW

Given there are 140,000 private practice dentists, if the ratio holds with Steve's group, we could solve the access problem for children.

As I've always said, people would rather be right than happy. By making others wrong, you make yourself right. I suggest you consider stop pointing fingers, take on the issue of access and solve it. If Steve can, you can.

Dr. Marc B. Cooper
The Mastery Company
MasteryCompany.com

ANNOUNCEMENT

Dr. Cooper will be traveling to Dubai and Abu Dabi to work with The American Clinic from January 16th to the 25th. Given his schedule he will be unable to post a new eNewsletter on the 21st but we will post a previous newsletter that generated very strong interest.

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Dr. Marc B. Cooper
President and CEO
The Mastery Company