Written by: Robert H. Maccario, MBA
Change has changed! The future is not an echo of the past. New science and technologies have finally shown how oral care can impact overall health. This has accelerated the convergence of dentistry and medicine as the consumerization of health care has amplified both. These facts require a critical rethinking of all clinical and business protocols for dental practices and vendors/suppliers. Dentistry needs a new business model.
FIGHTING UNCERTAINTY
Does leadership perceive healthcare as being in a state of disruption, creating uncertainty and fear, or does it see the current environment as natural evolution? Based on our accumulated experiences, mental models can be a limiting factor; previous strategies may no longer be a pathway for success. The only thing that stops evolution is extinction.
“Pride of ownership” is a key factor in consumer motivation. Consumers want more than just the absence of disease; they want wellness. Overall health is all-inclusive—appearance, physical, mental, emotional, and social—in the quest for well-being, both physical well-being and judging life positively. The World Economic Forum estimates that global wellness is a $4.4 trillion market. Wellness is one of the few offerings in dentistry in which a consumer can take pride of ownership. Sustainable success will depend on a practice/vendor relationship that can synchronize with consumer demand.
THE EVOLUTION OF DENTAL/MEDICAL CARE
A popular and influential book for many in health care is Dr. Peter Attia’s Outlive: The Science & Art of Longevity. Inspired by the book, this article focuses on the evolution of medicine: Medicine 2.0 and 3.0. In this article, they are dissected and discussed in 2 parts: Vision and Implementation.
Medicine 2.0
- Vision is lifespan, staving off death. It is a “fees for disease” philosophy; the sicker the patient, the greater the revenue potential for the practice.
- Implementation is utilizing science and technology to maximize procedures.
Medicine 3.0
- Vision is health span, quality of life. It focuses on prevention.
- Implementation is utilizing science and technology to diagnose prior to the onset of disease or destruction of tissue.
A 3.0 practice is more aligned with professional ethics than a “fees for disease” approach, which is forever tied to the rpm’s of the handpiece. Recognize the fact that just bolting 3.0 science and technology onto a 2.0 practice will never maximize the full value for the consumer, the practice, or the vendors.
HOW DO WE GET THERE?
1. The Absence of Disease Is Not Wellness
In a 2.0 procedure-based practice, the patients’ perception of the practice is that “they look for procedures, and that’s how they make money.” This prompts illogical behavior: resistance, resentment, embarrassment, and even denial.
A medicine 3.0 practice sends a different message: “The best value in healthcare is staying healthy.” Invite the consumer on a pathway to wellness. Prior to the appointment, offer a complimentary pre-optimization screening to identify and manage risk in order to improve potential outcomes. A well-designed screening needs to be science-based, medical-grade, consumer-friendly, and seamlessly integrated into the practice. Select salivary diagnostic screenings meet these requirements. This enhances the patient’s experience and prompts more logical behavior.
2. The Scope of Care and Services Must Broaden
Convenience care, or “same-day” care, is a consumer demand. But the pressure to satisfy the consumer can create “diagnostic fatigue” in providers; there’s too little time to absorb too much clinical data. Both the care and patient relationships can suffer. Utilizing 3.0 science and technology, salivary diagnostics, AI-filtered x-rays, intraoral scans, and CBCT can increase confidence and minimize this stress point no differently than using spellcheck assist in a Word document.
In the delivery of care, practices need to critically re-examine the concept of multitasking in time management. Evolving AI and machine learning, such as in-practice milling and printing, such as Lux Creo, is now considered a must. Today’s consumers want to start treatment today, not in 2 weeks. Convenience care supports treatment acceptance. Forget about “going to the next level.” It’s time to evolve into the new era of consumer healthcare.
3. Throughput Economics, Not Cost Accounting
Throughput economics measures the rate at which profits are generated as value/sales increase. But dentistry has 2 obstacles preventing implementation: First, dental teams are ethical, outstanding caregivers and service providers. Most compensation/incentive plans, however, are based on the volume of procedures produced. This creates a cognitive dissonance among and within teams; the pressure to “sell dentistry” conflicts with their natural behaviors as caregivers and often results in demotivation and burnout. Second, no one entity has all of the resources to deliver the most value to the consumer. Practices are service-focused, not sales-focused, while the vendors possess complementary marketing expertise and are sales-focused. It’s really about allocating capabilities. Together, they must build a single integrated system. It’s called seamless integrated partnering (SIP), an operational business model inspired by the principles outlined in the theory of constraints. No one sells anything until the consumer decides to buy.
4. Emotional Loyalty, Not Transactional Loyalty
When a patient feels “sold to,” especially with verbal gymnastics, it most often results in mere transactional loyalty, a simple stimulus-response based on dollars. He or she is loyal to the price and not to the practice. Having an emphasis on price, as many in-house discount plans do, can erode the practice brand.
When a patient decides to buy on value, however, it creates emotional loyalty to the practice. Loyal patients purchase, repurchase, and refer. It’s about creating a great experience and converting it into patient engagement, enrolling him or her as a lifetime member of the practice. This applies to both practices and vendors, which is why SIP is so important. Get off the new-patient treadmill! Stop selling dentistry; create a buying environment.
5. Reward Wellness Outcomes, Not Procedures
Attracting and retaining the best team members is about motivation: Extrinsic motivation is driven by external forces such as money, while intrinsic motivation comes from within (ie, the joy one feels after accomplishing a challenging task).
Wellness is not static. Consider utilizing both pre-optimization and ongoing post-optimization screenings as the basis for team incentives. If the test results show the patient gets healthier, that behavior should be rewarded.
The patient needs to be an active participant to experience better outcomes. He or she is a consumer; let’s use proven consumer motivation and incentivize patients to comply with loyalty rewards, not on purchases (discounts). Again, post-optimization screening can be an excellent tool for measuring and monitoring outcomes. The patients want their desired outcomes, and the team wants a meaningful career. It’s all about motivation. It’s time to up-serve, not upsell.
CONSUMER DEMAND
Thanks to some dental and medical all-stars who have been leading the charge, dentistry has made some progress over the years as “integrative,” “collaborative,” and “holistic” care has worked its way into the lexicon. Despite this progress, there are still “unmet needs” for the healthcare consumer.
HEALTHCARE 4.0
“Every situation can be substantially improved; even the sky is not the limit.”—Eliyahu Goldratt, PhD
The current “silo” (stored in one place) mentality in health care is that the dental profession, medical profession, and vendors are not meeting consumer demand. These silos need to be managed as elements of a single system, one that optimizes one strategic leverage point (called a constraint) that delivers the most value to the consumer (treatment acceptance). Seamless, integrated partnering is based on the theory of constraints. It is a unique style of collaboration to meet consumer demands.
The burden is on dentistry. In many instances, dentistry already outperforms the medical profession when it comes to patient/guest services. Still, most importantly, it’s time for dentistry to re-evaluate clinical protocols to meet or exceed medical standards.
OUR PRACTICE IS A PRIME MOVER
The steadfast, unmoving driver for us is a commitment to clinical excellence and professional ethics. As a team, we guide and facilitate our patients/guests into wellness as a lifestyle choice and as lifetime members of our practice.
It’s no longer about dentistry or medicine. It is called Healthcare 4.0. Dental practices that adopt a Healthcare 4.0 philosophy will not just be thrust to the forefront of dentistry; they will be thrust to the forefront of healthcare.
ABOUT THE AUTHOR
Mr. Maccario is president of Dental Management Sciences, LLC. He earned his MBA from Pepperdine University and has worked with more than 1,500 practices in the United States and Canada, focusing on restorative, cosmetic care with an emphasis on oral-systemic health. His programs include “The Dental Concierge: Turn Your Patients Into Guests” and the “Dental MBA: Good Dentistry is Good Business.” He has been an adjunct assistant professor at the University of the Pacific School of Dentistry. Mr. Maccario is a charter member of the American Academy of Oral Systemic Health. He has been a speaker at major dental meetings and consulted with national dental companies. He is collaborating with Dr. Doug Thompson from the Wellness Dentistry Network and will be writing a monthly column for Dentistry Today. He can be reached at maccario@dental-mba.com or dental-mba.com.
Disclosure: Mr. Maccario reports no disclosures.
FEATURED IMAGE CREDIT: Joshua Jay Koppelman/Shutterstock.com.
