THE EDITOR'S CORNER
There is a hidden potential in every orthodontic practice which may be one of the richest resources that we have and it is largely overlooked. It is simply a longer interval between patient visits.
It is not a revolutionary thought to devise and use treatment procedures that permit longer intervals between patient visits. The need was created by a combination of high volume, low fee practices and dispersal of patients over a wide geographic area. Begg therapy and the monobloc are examples of treatment systems said to have originated at least in part because of these practice conditions. I am not suggesting that everyone switch to Begg therapy or to the monobloc. I am suggesting that those who have not had the same practice pressures have overlooked the benefits of increasing the interval between patient visits. What are these benefits?
1. You can see more patients. If among your active patients 100 are on headgear and/or rubber bands and if you are seeing this group, on the average, once in four weeks, you can see most of them once in five or six weeks with no ill effect on their progress. The difference in seeing 100 patients every five weeks instead of every four is that you can treat 25 more patients. The difference in seeing 100 patients every six weeks instead of every four is that you can treat 50 more patients. You can increase your number of patients by 25 or 50 with no increase in overhead, without hiring additional professional or auxiliary personnel, without increasing your own hours of work. Multiply these additional patients by your average annual fee and you have a most significant increase in your gross income just by making a rather minor and permissible change in your average treatment interval.
If an orthodontist were to feel defensive or insecure about continually raising his fees to keep pace with inflation, here is a way to increase his income without increasing his fees.
2. You can see fewer patients. If your present workload is too heavy, this will provide instant relief. On the other hand, you may want to work one or two days less per week. You can do so without reducing your income. It is even possible that your office overhead could be reduced at the same time by hiring employees on the basis of the shorter work week and/or by subletting your office when you are not there.
Time intervals between patient visits have often been arrived at by habit or custom and may not be related to the specific needs of treatment. They may be a holdover from earlier times when treatment procedures may have required more frequent adjustments. They may be a part of our anxiety to see how things are going, particularly in the early years of our orthodontic careers. Sometimes they are suggested by the syllabus of a particular course without reference to the ability of the operator and the cooperation of the patient.
A big contributor to the four-week interval is the open-end fee. A fee that is based on an initial amount plus so-much a month practically requires that the patient be seen at least once a month.
The time interval between patient visits should be re-evaluated in every practice. If we can determine that we are merely seeing our patients more often than our treatment procedures require, it is simply a matter of scheduling appointments at longer intervals. If we determine that the intervals between patient visits cannot be increased for our present treatment procedures, it would be worthwhile to consider changes in treatment procedures that will permit the increase. If it is adherence to open-end fees that is dictating the treatment interval, then this fee arrangement should be re-evaluated.
Careful consideration should permit every practice to take advantage of some of the benefit of increasing the treatment interval. How much depends on the nature of the orthodontist, of his practice, and of his individual patients. 
