When luck is not a trick

April 1, 1997
Many old sayings tell us that luck is an illusion. One saying tells us that luck often is disguised as plain, hard work. Another tells us that luck is nothing more than a prepared mind meeting an opportunity.

Forego managed care? You can if you`re prepared to satisfy the desires of patients, not just needs

Thomas E. Hughes, DDS

Many old sayings tell us that luck is an illusion. One saying tells us that luck often is disguised as plain, hard work. Another tells us that luck is nothing more than a prepared mind meeting an opportunity.

I often think about these axioms as I read articles and listen to discussions about the changes that managed care is bringing to dentistry. I also think hard about my own experience of successfully shifting a dental practice away from managed-care types of needs-driven procedures and into the much more satisfying and lucrative realm of desires-driven procedures.

When I think about the journey that allowed me to side-step the managed-care system, my thoughts invariably return to the age-old wisdom about luck being hard work and the ability to see what is in front of you.

That there is a place for managed care in dentistry is not at issue. What is at issue, however, is whether those dentists who prefer not to participate in a managed-care system will have the option not to, while still having the opportunity to enjoy professional, personal, and financial success.

I believe that dentistry is at a critical crossroads, and we have before us an opportunity to make decisions that can change the course of our profession. I am concerned that the dentists who already have resigned themselves to the fact that managed care will be imposed on them, will not be able to see that we are at this crossroads.

I fear that they won`t see this opportunity, because they are too busy making plans to offset the loss in revenue that comes with managed care whether, it be plans to cut overhead, reduce inventory, extend office hours, or otherwise protect themselves against the inevi- table.

The heart of our opportunity is needs vs. wants. Medical-managed care developed due to the proliferation of technological and pharmaceutical innovations over the past 40 years. These advances eventually put the cost of medical care beyond the reach of most Americans and the insurance companies as well; yet, people still needed them. Thus, managed-care systems were created to deal with these escalating costs.

Dental services are based on wants and desires, not needs. We also provide services that are relatively affordable. Many patients will use cash or credit cards to pay for our services. Others will make private-payment agreements.

Learn New Technologies

Those of us who choose to can fore-go managed care. Many of the new innovations in dentistry-especially those in adhesive/cosmetic and restorative procedures, are based on wants. These are exactly the types of services that will allow us to position our profession farther away from the managed-care system!

These innovations could not have come at a better time, because it rapidly is coming down to a basic choice for dentists:

- Do nothing, continue to practice needs-driven dentistry, and wait for managed care to arrive.

- Or take control of your future by training in the latest desires-driven procedures.

Fortunately, there is a strong societal element that complements the rise of this new technology. It is the single, most- important force driving the new dentistry.

Once people learn about the new services available, they want them. They are willing and able to spend money to look and feel their best. Look at the proliferation of gym memberships, diet centers, spa vacations, and cosmetic surgery.

Cosmetic dental treatments are a perfect complement to these other services that consumers are buying. And, unlike many of the others, the results of a dental procedure can be immediate and long-lasting.

However, most people are unaware of the options available to them because needs-driven dentistry does not address these services and that is all most people know. Another problem is the old idea that a cosmetic procedure requires that natural teeth be ground down. The very thought of this prevents many patients from even considering any form of treatment. This lack of knowledge on the patient`s part is our shortcoming.

We have not done a good job of promoting our services, probably because promoting professional services was once viewed as highly unprofessional. The fact is that our patients don`t know what we can offer them because we aren`t telling them! Again, it will be up to us to get the word out; no one else can do it for us.

The first thing you must do to prepare yourself to take advantage of this opportunity is to get trained in the latest adhesive/cosmetic and restorative procedures. These are offered now at seminars throughout the country. Take as much training as you can possibly get. If you go to a seminar, don`t shortchange yourself by leaving early. Stay for the entire session. You`ll find unexpected rewards when you invest in yourself.

You also must understand the marketplace in which these services are offered. If the new focus is on providing desires-driven services, then that means we will be contending with other businesses which compete for the consumer`s discretionary dollar. Our competition then becomes the travel agent, the department store, the plastic surgeon, the car dealership, etc. The days of merely waiting for patients to come in for needed procedures are long gone; we must actively market our services!

Give Patients Information

We also have to inform our patients about the variety of services available to them and the high degree of quality care that we can provide. A good way to begin is by directly telling patients about the constraints that managed care imposes on dentists.

If they then choose a managed-care practice, that is their prerogative. We have done our part in providing them with the information needed to make that choice. If they choose a desires-driven practice, they then will be making the conscious decision that the dental services they want are worth paying for.

One of the most highly effective ways for us to show patients what we can do for them is to take before-and-after photographs. If you don`t want to take your own photographs, purchase some. Hanging pictures of patients on the walls and putting informational photo books and videos in waiting areas and treatment rooms are some of the best ways to educate patients.

As you can see, this is a different way of doing business. It requires hard work and changes in many areas. Change in dentistry is difficult because our profession has done so little of it over the past 75 years.

When I began taking the path to desires-driven dentistry 10 years ago, I didn`t understand how these changes would fit into the larger picture of health care. But, with each degree of change came a clarity of vision about just how logical it is to move toward desires-driven dentistry.

The biggest mistake any of us can make is to sit around and wait for leadership to emerge that will "fight the good fight" against managed care. It`s not going to happen! Managed care is here to stay. We now are at a crossroads and dentistry is going down two divergent paths. The choice of which path to take is not a collective one. The choice is up to each individual dentist.

If you don`t want a managed-care practice, you must take the road less traveled and begin to practice the new desires-driven dentistry. I can tell you that if you commit yourself, the rewards will far surpass your expectations. I hope to see you on the journey

In conclusion, I want to share the names and phone numbers of people who have helped me stay out of the jaws of the managed care system. They can help others pursue a course that is fee-for-service and `what the patient wants.`

- Ray Bertolotti, DDS, (510) 483-2411.

- Bill Blatchford, DDS, (800) 626-3978.

- Bill Dorfman, DDS, (310) 277-5678.

- Howard Farran, DDS, (602) 893-1223.

- Linda Miles, (800) 922-0882.

- Planned Marketing Associ-ates, (800) 486-8839.

Thomas E. Hughes, a dentist and photographer, has taken more than 27,000 high-resolution photographs of cosmetic and restorative procedures since changing to a desires-driven practice. He and his wife, Barbara, founded High Impact Image, a company dedicated to the concept of using photographs to enhance the practice of dentistry. High Impact Image offers a number of before-and-after atlases, photo-recall cards, slide presentations, videos and wall photos. To contact High Impact Image, phone (719) 488-0808.