Using the right systems is the "secret sauce" to successfully implement an orthodontic program in a general or pediatric dental practice.
Choose freedom over paying some corporate CEO’s country club membership...
Benjamin Franklin warned of the kind of situation where little compromises sacrifice such freedoms; “Make yourself a sheep and the wolves will eat you.”
Opt into a free market medical model - and YOU decide what your missionary work will be instead of being a member of the unpaid robot dental collective.
Dr. David Gesko, in a recent interview, notes, if you're concerned about dental therapists from a competition standpoint, dentistry as a whole is changing, and you may have to get used to new technologies and models of care. (emphasis mine)1
Choose freedom over being required to change your “model of care” (How about if you go out of business, and two dental therapists with high school educations replace you?) Use a free market model, instead, that makes you independent of big insurance, big government and big corporations.
It seems the biggest advocates for cheaper dental (medical) care are executives of huge corporations, receiving very generous salaries. The young dentist out of school with a half-million dollar debt needs his/her profession, his/her job, his/her ability to proceed with a career, take care of a beloved family and get out of debt.
Dr Gesko is Dental Director and Senior Vice-President of HealthPartners, a corporation which reports “serving over 1.5 million members.” 2 His biography says, “Dr. Gesko is passionate about integrating medical and dental care and applying growing evidence-based research to care delivery.” (emphasis mine)2
Dr. Gesko, a Minnesota Board of Dentistry member, and now President of the Board, says he has worked alongside dental therapists since their inception. So far, he's had “positive experiences and so have the low-income patients at HealthPartners' dental clinics.”1
Use a model to create a life where you are free, prosperous, and happy. You can use situations and systems which, if implemented, will give you the interesting, wonderful, and prosperous practice you deserve. You can take better care of your patients, family, staff, and be a better member of the community, by implementing the systems we teach.
At Love & Orthodontics, we are here to help the dentist have the practice of his/her dream. You, the dentist can have a happy career that is prosperous and free of harassment from insurance companies, big corporations and government over-regulation.
Fear knocked at the door
No one was there.
In our heart of hearts (for the most part) we pediatric dentists want to help our patients more through prevention than through restorative procedures. Unfortunately, pediatric dentistry has, partially by necessity, become way too focused on restoring a child's mouth.
Medical Drama on TV
From 1969 to 1976, a favorite American television show was one of the early medical drama programs, the popular Marcus Welby M.D.
Medical drama has continued to be a well-watched topic, beginning in the early 50’s, and includes Dr. Kildare, Ben Casey, M*A*S*H*, Dr Quinn Medicine Woman, City of Angels, Grey’s Anatomy, E.R., House and many others. The main characters are usually kind and loving, dedicated folks. After all, it is all about doctors and nurses taking care of people.
Medical Drama in Real Life
But another drama has changed the face and function of medicine. It’s been a slow, insidious, now dramatic change that has allowed big corporations to wedge themselves between the kind, loving, dedicated doctor and the patients who need medical or dental care.
Beginning back in the 40’s, the drama of insurance company/corporate involvement in medicine began. The 1945 McCarran–Ferguson Act, created a United States federal law that exempts the business of insurance from most federal regulation, including federal antitrust laws to some extent.
Anti-trust laws apply to doctors, but insurance companies are exempted in some ways. Insurance companies, corporate dental, Medicaid, Medicare, calling themselves healthcare (insurance-speak for we-want-you-to-pay-us-for-your-disease-care), began the drama which has resulted in:
1. Reduced quality of patient care as the time per patient is reduced, fee schedule charges for care are reduced, then split between corporations and doctors, certain treatments are “denied” (insurance-speak for we-won’t-pay-you-for-providing-that-care-to-your-patient), corporations recommend changing your delivery system (insurance-speak for reducing time, quality, materials, etc. in your care), and perhaps most egregiously, corporations are now defining what periodontal disease is, or what is medically necessary, etc. (insurance-speak for diagnosis- diagnosis that should be done by the professional, educated, licensed, experienced, wise doctor);
2. And, all the while, untold dollars in the coffers of the smart corporations, and great reductions in the doctors’ ability to make a living while they scramble to care adequately for patients.
The real-life, shall we say, soap-opera drama has evolved. Your “provider” (insurance-speak for doctor) contracts with the corporations are regularly changed to the benefit of the corporations, though you of course sign them and agree to abide by them.
The insurance companies re-contract with the employers who buy the coverage for their employees, and each new contract has the potential to “save the employer money“ by removing coverages and limiting payments out. These various changes further pour your profits into the corporate coffers.
A New and Wonderful Medical Drama
Doctors, we are here to change the world. We are here to love, to care, to transform lives, and through those transformations, the lives of related and others.
Avrom King, a psychologist and health-care “futurist” pointed out, orthodontics is not about teeth actually, but about how the result of the treatment affects a person’s self-image.
This is true across the spectrum of dentistry. Ours is a behavioral art, where love and caring are far more important than the mechanics of the dental and orthodontic treatments.
Dr. F. Harold Wirth, who was Dr. L.D. Pankey’s closest friend and speaking partner for many years, considered hugs to be a key metric on how well we are connecting with - and therefore truly helping - our patients.
It is time to understand that your calling in your life, in medicine, is best undertaken and advanced, outside of the corporate world. If this speaks to you, then you know you are here to change the world. Your love, your strength, your relationships, are your gifts. You can engage with your patients and the world in a new way.
To do anything less, is to sacrifice yourself and the gift.
For us dentists, we have been guided by a need, a dream, to help others. Going to dental school, and to residency and further training, takes a whole lot of “get-up-and-go” and a whole lot of “stick-to-it-iveness.”
Our schooling and hard work was (and is) driven by our need and dream to help others AND to make a good living for our families and ourselves.
Sound familiar? Then, in practice, you start working, working, working, calling on your “get-up-and-go” and your “stick-to-it-iveness.” You take more continuing education. You believe in education.
You work long hours, after your staff has gone, and sometimes before your staff arrives in the morning. You take time away from your family. For some of us, probably especially us girls, we have the children at the office frequently because that’s where we are. Still, your family time and routines are centered around your job, your practice. After all, it’s how you take care of the family, right?
You do whatever you can for the patients, because you want them to be happy, to like you - to love you - to become part of your “family.” You do whatever you can for your staff because you want them to be happy, to love you, to be part of your “family.” And they are. Often the staff see you as the benevolent “parent” in this purported family. Your immediate family may not see you enough.
And somewhere along the way, it feels all mixed up. Do you feel significant? You feel tired.
Do you feel capable? You feel confused.
Do you make enough money to support your family the way you want? The practice overhead is huge, eating you up.
Do you have enough time with your family? For yourself? Do you feel appreciated, loved?
What is missing in your picture?
Why doesn’t your life work better? Why doesn’t your practice grow?
Because YOU don’t.
How will you solve your dilemma?
The only way is by reinventing your system to solve it.
Start by identifying what is missing. Certainty? Security? Love? Significance? Growth?
Each element or core human need has a corollary that holds you back. Certainty - stability, security, consistency - is hidden by your fear. Fear of what patients, staff, family, even strangers think of you. (Read recent blog, “Way too.”) Fear about your capability.
Love may be hidden by your being too “busy” to notice, to participate. While doing for others is the way you give love, your need for love may be so depleted that there’s not much to give.
Significance may be so hidden by your exhaustion, your need, that you cannot see it. Your life is just way too hard.
And growth? Who has time or energy for growth when you are THIS busy?
What is missing in YOUR picture?
What does the most important person here need? YOU!! What do YOU need?
To solve your dilemma, begin creating a system that will free your time, your energy, your emotion. Believe it or not, growth is what’s needed.
“Wha-a-a?” you say. “How can I have time or energy for more education?”
This education will help you find the tools, the methods, the processes to begin the system that will free you from the whirlwind of your life.
You are too valuable and too wonderful to keep being vulnerable to your fear, your whirlwind and your exhaustion.
Why not now?
Why not you?
Books to read ASAP:
Dalio, Ray, Principles
Gerber, Michael E., The E-Myth Revisited
Baker, Chris, Real
The languages dentists have to learn!
Do you-speak 'insurance company-speak'? Do you speak 'parent-speak'? Do you-speak 'child-speak'?
Today I am looking at insurance company-speak.
And btw (by the way - that's 'text-speak') - “corporations” here refer to insurance companies, big box and other corporate dental practice owners, and government entities including Medicaid and Medicare, all of whom skim your money off the top, so you do not get paid what you have earned.
What on earth are you paying them for?
The privilege of keeping some of your money after you spend more money paying staff to file claims for the patient, to wait on hold on the phone for hours, literally, waiting to talk to the “corporations” to evaluate how much of your money they will send to you, file appeals, and then find out the appeal reached the corporation after the “deadline”. Why is there a deadline on getting your money?
I am a dentist, not a provider.
Provider sounds like a waiter.
Provider, they say, as if somebody has to help you do your job.
Provider means anybody can do it – it does not imply many years of school, experience, professionalism, licensing, board examination and wisdom.
“Provider” is insurance-company-speak, just like;
“Usual and customary” - whose usual? whose customary? Not yours, for sure!
“Acceptable” - to whom?
“Estimate of benefits” (EOB) - that is the patient’s benefits - it should have NOTHING to do with you. they are not be YOUR benefits. Because they are not benefits at all, but rather the “spoils” left after the corporations took a lot of your money.
“The network” - a list of doctors whom the corporations have convinced should share their income with the corporations.
“Participants” - see “the network” above
“Network providers” - see “the network” and “participants” above. Amazing how many names you are being called.
“participation” - the act of becoming a “network provider” or “participant” and reaping the losses as you pay the corporations.
“Healthcare” - insurance-speak for disease care; the acts and services of restoring diseased organs in the body, of addressing adverse growth and development, and at disease care’s best, of working to help the patient PREVENT disease and adversities of growth and development.
“Healthcare” is also the name the corporations use for themselves, and not for the practice of medicine that you provide.
As Dr. Paul Henny reminds us, we don’t make health; that is something that cannot be bought by the rich nor given to the poor. It is something the patient maintains and works on and with.
Interestingly, the corporations have successfully made the education of patients and parents as to how they can take responsibility for their health, a “non-reimbursed” “service.” In insurance-speak, this means it looks completely worthless to the corporation and relatively worthless to the patient. This leaves the impression that the doctor who is dedicated to helping the patient learn prevention can just do it for free.
And now, the corporations are taking on the diagnosis of your patient. They are defining what periodontal disease is, for example. (Insurance-speak parameters for periodontal diseases may not even include the presence of calculus, or pockets of a certain depth.)
It’s amazing that an administrator/clerk/bureaucrat working for an insurance company/corporation in another state purports to know your patients’ conditions more than you, even though you’ve been treating the patient for many years.
Think about it - do you really want to continue contributing to the corporation executives’ seven-figure incomes out of your pocket? Do you want to continue working for that?
The story of the frog comes to mind, who finds himself in cool water and doesn’t understand there is a burner under his pot of cool water. As the water gets warmer and warmer, the poor frog doesn’t realize he is being cooked and will soon be dead.
Are you serving yourself and your patients? Or are you serving the corporations? ...and their executives and stockholders? (And some of their CEOs with seven-figure incomes?)
“Choose this day whom you will serve.“ ~ Joshua 24:15
“The past does not equal the future - unless you live there.” ~ T. Robbins
Why on earth do we choose to allow the insurance companies to come between us and our patients? (Because of fear.)
Why does it feel as if you are just “another run-of-the-mill” dentist? And what is that anyway? It’s a feeling stemming from fear, from the desire to be worthy, and not realizing you ARE.
It is all too easy to let our thinking be limited by what we think we are, by what we think we see, and mistake our simply ordinary-seeming lives for ordinary.
But - you are a precious, unique individual, here in this earth, with an extraordinary mission.
OMGoodness, your life is actually quite extraordinary!
Life’s ebb and flow of day-to-day routines hold the key to happiness. (It’s truly not what the storybooks - or the movies - or the media - tell you. That wished-for sudden pile of cash, a new relationship, a dream vacation, surely seem as if they hold happiness.) Yet, it’s finding enjoyment in the family meals, the soccer games, the day in the office loving people, exercising, discussions, your morning coffee, even the traffic, that make life good. (Traffic? I know, that seems crazy!)
"For most of life, nothing wonderful happens. If you don't enjoy getting up and working and finishing your work and sitting down to a meal with family or friends, then the chances are you're not going to be very happy. If someone bases his/her happiness on major events like a great job, huge amounts of money, a flawlessly happy marriage or a trip to Paris, that person isn't going to be happy much of the time. If, on the other hand, happiness depends on a good breakfast, flowers in the yard, a drink or a nap, then we are more likely to live with quite a bit of happiness." ~ Andy Rooney
These are truly the extraordinary gifts of your life. Enjoy it all now. Those, and your actions toward your dreams are where happiness lies.
Remember, you are looking into the reality of who you REALLY ARE. You, an image of the Creator. Who, as creator, can innovate, and as innovator, you lead, and as a leader, you can love. Grab this moment.
So, what to do?
Take your awareness and understanding of the love YOU need (everyone does!) and your awareness and understanding of your extraordinary gifts - each person’s are somewhat different - and start now. Create your life anew.
ELEMENTS™ Seminars remind us that orthodontics -- and dentistry in general -- is all about love. Your success as a dentist relies on your abilities to put love into action in your practice, made effective with certain systems. Dr Chris talks about this and more, with our upcoming ELEMENTS Seminars, beginning July 13, 2018.
Pain: a distressing feeling caused by intense or damaging stimuli.
What stimuli, you ask?
* Trying to Survive
* Being in the crosshairs of
- the insurance companies -Insurance has become overwhelming to impossible
- Medicaid administration and paperwork
- other dentists and other specialists
- dental suppliers and costs of supplies
- patients, some of whom are happy and some who are not
- costs in the practice, including taxes
* Leading the team is challenging - frustrating - confusing
* Patients don’t seem to believe I care and want and do the best for them.
* Being out of energy
* Working too many hours a day, a week, a month
* Trying to keep up
* Trying to find a balance between personal and professional life
* Sleep difficulties
Even making more money doesn’t deal with the pain.
Your clinical and technical skills get better and better. Still distressed.
Have you ever felt that you might have chosen the wrong profession? Have you beat yourself up because you can’t fix it all?
Have you even felt like you were in a nightmare? Stressed? Nervous? Looked at others who don’t seem to be experiencing what you are? Blamed yourself for the difficulties? For not being good enough?
What keeps you stressed?
It isn’t supposed to be this way.
It’s time to transform your life.
“Insanity is doing the same thing over and over again and expecting different results”
How do you start doing it differently? What do you change?
Short answer: Your beliefs. Your deepest beliefs.
For Heaven’s sake, how do you change your beliefs?
Understand how your thinking locks you into doing the same thing over and over.
In some circuses, baby elephants are trained with a strong rope around their ankle, linked to a strong pole. When they try to walk away, they are stopped by the rope. All their pushing and pulling doesn’t work. They stop resisting and stay put.
Eventually, when the rope is put around their leg, it doesn’t have to be attached to anything. You can see elephants in the circus with a chain or rope around their ankle, not attached to anything, and they are now convinced the rope/chain holds them. They are very powerful. But they do not know it.
Our beliefs enslave us, hold us back, keep us where we are, doing the same things over and over - that is INSANITY.
"The possession of anything begins in the mind." ~ Bruce Lee
Both the negative beliefs and the new positive ones began and begin in the mind.
It’s hard? Sure! Life begins OUTSIDE your comfort zone.
Think differently. Reboot and replace those negative beliefs.
You are Valuable. Precious. Capable. Worthy.
Yes, your mind, your beliefs hold the power to take you to joy, or to sabotage your life.
Dr Chris Baker
Dr. Chris Baker is Past President of the American Orthodontic Society, a pediatric dentist and teacher of orthodontics, An author, dental practice consultant, mentor, and a current or former faculty member of three U.S. dental schools, Dr Chris practices and blogs in beautiful Abu Dhabi, UAE, and glorious Texas, USA.
Text and images
© 2018 Dr Chris Baker