Professional Courtesy: Disruptive Behavior by Thomas Giacobbi, DDS, FAGD

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Disruption. I suspect this word is uttered at least 100 times a day in MBA programs around the world. The greatest benefit technology provides is the ability to disrupt old-school business models. How many stories have we heard about a change that, in a short time, tosses the entire model on its head? It seems nothing is safe from this wave of innovative thought.

This is about dentistry, at the end of the day, and we know that dentistry has enjoyed a life that's 20 years behind the general progress of mainstream society. In the early years of my career, I heard it described as the "last great cottage industry." Now that we've had the internet for 20 years, our time has come.

Setting the scene
Let's start by outlining a few of the easier-to-recognize services that have been disrupted.
  • The U.S. Post Office and the entire marketing profession were disrupted by email.
  • Email has become so cumbersome for basic communication tasks that it's in the process of being disrupted by text messaging, Facebook Messenger, Snapchat and a host of other communication platforms.
  • The taxi industry was disrupted by Uber and Lyft, with more coming.
  • Meeting in person has been disrupted by Skype, GoToMeeting and other video-conferencing options.
  • Buying music in record stores was disrupted by Napster and iTunes.
  • Shopping in a physical store or buying books at Barnes & Noble was disrupted by Amazon.
If you're thinking that none of the aforementioned examples is remotely similar to dentistry, you're right—except for the fact that dentistry is a service business, and the services are related to oral health.

How does it affect you?
Now, back to dentistry. You'd be hard-pressed to sit with colleagues, visit a dental meeting or participate online at Dentaltown.com without someone making a comment about "corporate dentistry" large group practices, or entities that have purchased multiple practices around the country and provide services under a single corporate umbrella.

This phenomenon is not limited to the U.S. There are versions of "corporate dentistry" all over the world. So … how have we been disrupted, or are we in the process of being disrupted? It is no longer a matter of "if."

In many ways, progress related to the delivery of care has made it possible for these entities to exist—practice management software was just the start. Technology that allows chairside fabrication of restorations allows a large group to cut lab costs and provide homogenous service in multiple locations; this is one of the tenets of a franchise or corporation.

The vast improvements in dental materials allow more dentists to provide an acceptable result, and this is necessary for the large group model to work effectively. The disruption of our industry depends on the ability of more people able to provide the same level of service.

What's the future for dentistry? The disruption will continue in how we deliver care, how we run our practices and how our practices are organized. Consolidating small businesses into large groups has been a bedrock of business since the Industrial Age. The need for dental services will remain and quality health care will continue to be a highly sought-after service. As with medicine, the best will become harder to identify and find.

Technology is certainly a blessing, but it can also be a burden, because of the complexity of "keeping up" and the lack of scale that exists in a small business. Technology is often at its best when it can be leveraged to help many people at the same time. We don't use paper appointment books and there are no longer any corner drugstores staffed by independent pharmacists, because it just wasn't an efficient model.

Looking ahead, we should be open to alliances—or at least the fact that the next owner of your practice might be a faceless corporation.

I've written this column to deliberately spark discussion and debate. Please share your comments on the digital version of this article at Dentaltown.com. I can be reached by email at tom@dentaltown.com. Or find me on Twitter:@ddsTom.




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