Is There an Orthodontic Myopia?
In a landmark article entitled "Marketing Myopia", Theodore Levitt pointed out that the railroads in this country did not stop growing because of a decline in the need for passenger and freight transportation; and they did not stop growing because the need for passenger and freight transportation was filled by others who could do it faster, cheaper, or better (cars, trucks, and airplanes). Rather, the others were able to step into a void created by the narrow definition that the railroads had of what their job really was. The others were able to take the railroads' customers away from them because the railroads assumed that railroads were in the railroad business, rather than the transportation business. They were product-oriented, rather than customer-oriented. In earlier times, when railroads were still growing, success made them complacent, and they failed to give imaginative thought to their future and to their customers' future needs. I hope that some of you have already substituted the word "orthodontics" for "railroads" and "patients" for "customers".
Take another example in more recent times. History repeated itself in the transportation business. If the railroads had recognized that they were in the transportation business, they might have developed and controlled the airline industry. If the airline industry had recognized that it was in the communication business, it would not have permitted Federal Express and other similar companies to usurp one of the few remaining profitable areas of the airline business.
Let's look at a positive example. In the early 1900s, T.N. Vail, president of AT&T, asked himself what business the telephone company was in, and he had an imaginative and spectacularly successful thought. He said, "Our business is service". Vail recognized that his company was a monopoly and in danger of socialization. The one way that he saw to forestall socialization was in creating community support through community satisfaction. From that time forward, the telephone company has been indoctrinating employees in dedication to service; indoctrinating the public with PR stressing service; engaged in research and technological advance. From Vail's time, the nature of the telephone company's business was determined by the consumer, not the producer, and by a recognition of what needs the consumer is satisfying when he buys a product or a service. Since people are willing to pay for reliable service and technological excellence, AT&T has always been a profitable enterprise. Unlike the United States Post Office, AT&T has been able to handle phenomenal growth and to maintain the quality of its service and operate at a profit.
The orthodontist's true business is building health, building happiness, building confidence, building self-esteem, building success. To see it as tooth straightening is to hold to a narrow view of what an orthodontist's job really is, and what the wants and needs of our patients really are. Orthodontists are not tooth straighteners, we are dream weavers. Does a child dream about having straight teeth? No, he doesn't. He dreams about being attractive, being liked, being accepted. An adult dreams about the same things, plus being good-looking, sexy, confident, successful.
Malocclusions interfere with all of these things, and orthodontists are truly in the business of removing an interference to the realization of patients' dreams.
Up to now, orthodontists have felt--and with some justification--that it was enough to be a good tooth straightener. The main thrust of orthodontics has been to control tooth movement and to straighten teeth. I believe that we can be proud of our accomplishments and confident in our abilities. We can control tooth movement in all directions, and we can treat the vast majority of patients in a creditable fashion. But orthodontics is changing to some extent. It is my observation that the vibrant, healthy, growing practices that I see are run by orthodontists who are excellent clinicians, but who are marching to a different drummer. They are in the van-guard. They are on the leading edge. They invest time, money, and energy in finding out about the most current ideas in orthodontics, and they broaden their knowledge and their orthodontic service for their patients in functional appliances, lingual orthodontics, TMJ, craniofacial pain, occlusion, airway, surgical-orthodontics, and now muscle physiology. Those orthodontists are paying attention to every aspect of management and are finding that it pays off. They work shorter hours and fewer days, have more personnel, delegate more, have more case starts, higher net income, and less stress--and they keep growing.
They probably know all the tricks and use more of them more effectively than others do, but they know that practice building is not tricks. It is a well-organized and continuing effort to apply basic principles of management to the practice of orthodontics; and even more fundamentally than that, it is the evolution of a practice mission that envelops the whole office environment--that this office is dedicated to something beyond straightening teeth in an excellent manner--to a belief which the doctor and the staff and the patients share: that orthodontics is a vital part of the development of the person and contributes to his health, appearance, happiness, self-esteem, and success in life.
