40 years on M.K. still asks hard questions.

Forty years ago I was four and a half months in to my first job as one of the two “Resident House Surgeons in the Dept of Oral Surgery” at The London Hospital, now The Royal London. I am still amazed that I got the post, the story of my interview is worth hearing if only for the informal way the “second half” of the interview was conducted.

I was on the lowest rung of an impressive ladder at the London, with an SHO, three registrars, two senior registrars, a senior lecturer, two consultants, a Reader and the great Professor Gordon Seward at the top of the ladder.

It was the most intense period of my career, rivalling the first 18 months of practice ownership. At the London I was learning clinically whilst as the owner of two squats I was painfully cutting my teeth on business. I was privileged to see a huge variety of work, to straddle the divide between in and out patient care and to be on the “staff” of a major dental school and hospital.

One of the individuals from the Dental Hospital I encountered in the tea room was a young Irish registrar from Athenry with a great sense of humour who questioned everything and went on to great success.

It is no surprise then, that Martin Kelleher (for it was he), is now questioning the current explosion of tooth moving encouraged by American Corporations with an eye on the bottom  line. In this blog post from Kevin O’Brien (adapted from an article in Dental Update) he eloquently seeks answers to questions that seem to have been overlooked amidst the sales and marketing hysteria.

Worth a read and a touch of reflection.

“The race to the bottom for the quickest, allegedly ‘great’ or bargain deal in orthodontics has reached a place that few would have thought possible even five years ago. This gradual ‘uberization’ of orthodontics
 has produced a raft of new and largely unproven claims for treatments. These are promoted with gushing enthusiasm and superficial short-term evidence of their supposed long-term benefits for patients.”

Continues here.



Tales from Phoenix #1 – Orthodontics

logo_scuba diver_vert_FINLast week I spent two days in Phoenix Arizona at the excellent ConationNation conference organised by Kolbe Corp. The conference was as inspiring and educational as usual and, as ever with these things, one learns much during the breaks.

One of the great conversations was with someone who works for a brokerage that sells orthodontic practices and therefore finds suitable purchasers for them. The costs involved means that it is rare for anyone to be able to buy a practice upfront and a period of associateship / purchase is involved. (That’s another conversation with relevance to the current UK market). What she didn’t know about the finances of orthodontics wasn’t worth knowing; so that’s treatment patterns, types, costs involved, etc etc. She has 12 years or so experience purely in the orthodontic business (and a background in dental management prior to that) and Initiates in Fact Finder and really knew her stuff.

She has watched the rise of General Practice led orthodontics and the effect that it has had on both specialist and general practices amongst other phenomena. Invisalign has led and promoted, and continues vigorously to promote, the commoditisation of orthodontics – so people are buying a thing first and foremost, not a personalised service. In the USA people are more often buying purely on price – a price that is reducing all the time. The numbers that need to be seen would make the NHS look like a doddle – one orthodontist seeing 120 patients a day – sure they are delegating to assistants but….

We agreed our conclusion by saying the same phrase at the same time, that in view of the widespread availability of treatment, “it’s a race to the bottom”.

OK in the (USA) it’s a more mature market, but there are significant lessons to be learned ahead of the same thing happening on the eastern side of the Atlantic – or is it too late? The only people making real money are the ones who sell the tools, toys and systems or perhaps the ones who put right the treatments that go wrong and there are plenty. And let’s not forget the lawyers who chase them.

Bonded v Vacuum formed retainers? Kevin O’Brien’s blog.

screen-shot-2016-09-12-at-10-06-20It was interesting that there were no differences between the retention regimes.  As a result, I think that our patients should decide on their retainer.  We should  outline the various risks and benefits of wearing and maintaining these two different types of retainer and explain that there is no difference in their effectiveness. Most of our patients should then be able to take an informed decision on their retainer.

Full article here.

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