The Information Revolution and Orthodontics

For all their utility and ubiquity, however, comput­ers have not changed the way orthodontists make deci­sions. We still rely on our knowledge, skill, and experi­ence, along with the examination and the patient's chief complaint, to decide on a diagnosis and treatment plan. In fact, the technological advancements of the past 35 years of orthodontics--stainless steel appliances, preadjusted brackets, titanium wires, and bonding, to name a few--have only mechanized the production of the same ser­vices that orthodontists have performed since they first started moving teeth.

Actually, orthodontists have only begun to experi­ence the most dynamic feature of the Information Revolution: electronic commerce. Peter Drucker tells us in a recent Atlantic Monthly article that back in the '50s, only two or three consultants besides himself saw much future for computers in ordi­nary business transactions. And even these opti­mists failed to envision how the new technology would ultimately become a conduit for goods, services, and jobs via the Internet.

With his wide and unique perspective on the history of management, Drucker sees e-com­merce becoming for the Information Revolution what the railroad was to the Industrial Revolu­tion. Like the railroad of 170 years ago, ecom­merce has been totally new and unexpected. The steam engine improved and patented by James Watt was originally intended only for pumping water out of coal mines. Watt never imagined that his engine might one day power textile mills and other industries. Neither did he see the pos­sibility of combining the steam engine with a vehicle on rails. Although rails had been used to move minerals out of mines for decades, it was­n't until 1829 that rails and the steam engine were combined for moving people and later freight. As the railroad did in the 19th century, e­commerce is creating a boom that is rapidly changing our economy, society, and politics.

The railroad shrunk geographic boundaries, but ecommerce promises to erase them altogeth­er. As an example, a midsize Midwestern compa­ny made ceramic dinnerware for 60% of the restaurants in its area--until one of its customers went surfing on the Web and discovered a European manufacturer that offered better-quali­ty merchandise at a greatly reduced price, includ­ing air shipment. Almost overnight, this once-­solid company lost half of its customers.

Orthodontic patients are not likely to travel long distances for treatment (although I wouldn't totally discount the idea, considering the feasi­bility of eight-to-12-week intervals between appointments). Still, I will be astonished if some enterprising orthodontic manufacturer doesn't latch onto the idea of offering high-quality ortho­dontic supplies via the Internet at much lower costs, with overnight delivery.

Like the railroad, ecommerce promises to transcend more than geographic limits. The dynamic of a liberating new technology often shifts in unexpected directions, resulting in wholly new industries that may have little to do with the original invention. Immediately follow­ing the development of the railroad, we saw the appearance of photography, the telegraph, sophisticated optics, and modern farm imple­ments. Almost simultaneously, public health contributed major advances such as vaccines, sewers, safe public water supplies, and quaran­tines, which, for the first time in history, made cities safer than rural areas. Horace Wells dis­covered the use of nitrous oxide for anesthesia, ushering in a new era of painless dental services.

These new technologies made possible new social institutions: the modern postal service, daily newspapers, investment banking, and com­mercial banking. None of them was a direct result of the steam engine or the Industrial Rev­olution, but they were all made possible by the expectancy and mindset that the revolution had created, as well as the skills it had built and nur­tured.

In America, unlike in England, the Indus­trial Revolution also created new social values that made heroes and role models out of inven­tors such as Eli Whitney, Samuel Morse, Thomas Edison, and Alexander Graham Bell. These peo­ple were greatly instrumental in making the country dominant in technology, commerce, and science. We see a similar willingness to accord wealth and prestige to present-day captains of e­commerce: Jeff Bezos, Michael Dell, Bill Gates, Scott McNealy, and others. Indeed, America has always been willing--even eager--to shower riches, honor, and fame on those who make our lives more comfortable, safer, and better. While orthodontists ride a wave of prosperity docu­mented by the JCO Practice Studies, they would be well advised to pay attention to the new revo­lution, and to stay ahead of the information curve.

LWW