Context is decisive. The current context of organized dentistry is self-preservation. No matter how righteous their mission statements or how altruistic their public speaking, the obvious context from which they operate is self-preservation: it’s an obvious attempt to hold on to the past by attempting to impede the future. But you can’t stop the future, and you can’t continuously rewind the past — it’s never worked that way. The future always wins.
But organized dentistry is made up of members who do not want the future to happen. Most of their current membership has done exceptionally well operating out of the past. Members made good money; they basically worked the days and hours they wanted; they could be their own boss; they had no oversight, meaning they could do what they wanted to do. This way of operating is threatened by the coming changes.
Organized Dentistry
When we talk about “organized dentistry,” we talk about its political organizations, whose trustees and members do not want the future to occur. We talk about state boards and examiner boards, which do not want the future to affect their view of how dentistry “should” be practiced and delivered. They all fight the very fact that things are changing — but the future doesn’t care, and the future refuses to change course.
Uber didn’t care about taxis. Cell phones didn’t care about pay phones. Amazon didn’t care about shopping malls. The future doesn’t care — the future is going to happen anyway. And the future in dentistry, like most futures, will not be an extension of the past.
Forces shape the future. For example, the force of social media changed dental marketing. The force of implants changed clinical dentistry. The force of driverless vehicles will change commuting and trucking. The definition of force is strength or energy exerted or brought to bear: cause of change.
There are multiple heavy forces that are reshaping dentistry and how it is delivered. Simply put, when forces are applied, things change.
The Eye of the Hurricane
These forces are becoming hurricane-like in power, growing in intensity, and mightily exerting their impact on dentistry. The eye of the hurricane is the profound shift in context; from small business to big business. The eyewall of the hurricane consists of the tremendous influx of venture capital and consolidators and continuously growing DSOs. The rainbands of the hurricane are horizontal integration, vertical integration, artificial intelligence, robotics, cloud computing, Big Data, electronic patient records, and genomics. Other rainbands of the hurricane are lack of access, connection to systemic diseases, dentistry becoming part of primary care, midlevel providers, dental therapists, shifts in reimbursement from the fee-for-service model to the pay-for-performance model — all driven by the seemingly uncontrollable increase in spending on healthcare combined with an increasing population.
How to Prepare?
In many states, organized dentistry is trying to desperately to stop DSOs from entering the state, or exerting such onerous control that they won’t come to their state. But the force of the future will trump this resistance. DSOs have the leadership, money, and can create the conditions that will adapt to the changes these forces are producing. Solo practices cannot.
The future cannot be stopped. The train has left the station. The future is going to happen regardless of how you feel about it. My recommendation to organized dentistry? Get on board. Educate your members. Create pathways for them to succeed in this new future. The past is quickly eroding as the new future emerges.
Advice for the Future
My coaching for organized dentistry: If you’re not helping make it right, then stop complaining about it being wrong. If you are refusing to light any candles, don’t complain about being in the dark. If organized dentistry cannot adapt to change and help their membership succeed in the new future, they will eventually lose power and become extinct. Relevance is necessary in order to exist.
