Bread and butter is good!

When I was 10 years old, my friends and I rode our bikes down a steep hill that was still steaming from a fresh layer of tar. Warm tar flew up from the tires, soaking my pants, then my shirt. When I hit the brakes on my bike, I fell and came up nasty and hurt.

Paul Homoly, DDS

"Knock, knock."

"Who`s there?"

"Orange."

"Orange who?"

"Orange you glad you`re a `bread and butter` dentist?"

When I was 10 years old, my friends and I rode our bikes down a steep hill that was still steaming from a fresh layer of tar. Warm tar flew up from the tires, soaking my pants, then my shirt. When I hit the brakes on my bike, I fell and came up nasty and hurt.

So, I limped home. When my mother saw torn, tarry pants - with my bleeding knees imbedded with tar, gravel and blood - she asked, "Why did you do this?"

"Well, all my friends did it," I whimpered.

"If all your friends jumped off a bridge," my mother snapped, "would you do that, too?"

I`d like to say I learned a lesson that day, but it took me three decades to realize that just because a lot of people are doing something, it may not be the smart thing for me.

It`s not tough to notice how many people - dentists and consultants - are talking about new and better ways of practicing: boutique cosmetic practices, front desklessness, high-tech offices, insurance independence, metal-free practices, Ritz Carlton practice-management models, etc. In fact, the inference in some of the talks I`ve heard and in articles I`ve read is that if you`re not on the bandwagon of high-tech, cosmetic dentistry, and big fees, then you`re doing something wrong and you`ll be left behind.

A more subtle theme surfacing from a quiet, yet enormous, number of dentists is that it`s OK to have a general "bread and butter" practice. They talk to me at seminars and send me e-mails saying how they appreciate my honesty when I say profound success, fulfillment, and happiness can be found in the general "bread and butter" practice.

"I have a life outside of dentistry," said Howard, a dentist from Kansas City. "Sure, I don`t do a lot of big rehabilitative cases, but I do well financially, and I have time in my life to do the things I love. I enjoy dentistry, but there are things that I enjoy as much or more. So much of what I hear at meetings is not for me. It`s like I`m being told how to cure a disease I don`t have."

We`ve all seen trends in dentistry consume the interest of journal authors and podium speakers - occlusion, nonsurgical periodontics, implants, cosmetics, TMJ. I watch general practitioners latch onto a trend; spend an enormous amount of time, money, and energy promoting it; and build their entire practices around it - the all-cosmetic, implant, or TMJ practices. For some, it works. For most, it doesn`t.

You could argue that the reason most don`t have a "boutique trend" practice is that they don`t make the commitment or pursue excellence hard enough. Another explanation is that they discover they are happier and more successful blending trends into their "bread and butter" practice, while making commitments to friends and family and pursuing excellence in their overall lifestyle.

In dentistry, as in life, playing "follow the leader" only makes sense if the leader is going in the direction that`s best for you. And "bread and butter" just might be the best for you.

Dr. Homoly coaches dental teams to implement reconstructive dentistry through his continuing-education workshops, private consulting, and seminars. This column is an excerpt from his new book, Isn`t It Wonderful When Patients Say Yes? - Case Acceptance for Complete Dentistry. Dr. Homoly can be reached at (704) 342-4900 or via e-mail at phomoly@mindspring.com. Visit his Web site at www.paulhomoly.com.

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