There are numbers of engagements I have had with dental societies and study clubs over the years. I often ask the question; “How many in this room do not do quality dentistry?” No one has ever raised their hand. Not once.
Then I ask; “How do you know you do quality dentistry?” I then bring the hand-held mike to an attendee, hand them the mike. I repeat my question. “How do you know you do quality dentistry?” The nearly universal answer I get is, “I just know.”
There is very little if any measurement in solo practice that assures quality. There is no peer review. There is no routine chart review. There is no error data collected. And most importantly there is no comparison between practices. In other words, there is no quality assurance. It’s all anecdotal. It’s all subjective. It’s all fiction.
Read Deming, read Juran. Quality is measurable. Quality is quantifiable. Quality is calculable. The definition of quality assurance is a program for the systematic monitoring and evaluation of the various aspects of a project, service, or facility to ensure that standards of quality are being met. What programs do solo practices have in place for quality assurance? What standards are really there?
How can any solo practice have systemic monitoring and evaluation when you don’t have a neutral 3rd party examining and comparing your work? When there are no parameters for quality. When it’s all “in the eyes the beholder.”
And yet, the greatest accusation that dentists throw at managed group practices is they do “poor quality dentistry.” Well, how would they know? Most important, managed group practices are actively working on quality assurance, because of their size, their money, their IT, their depth of data, their ability to have dentists peer reviewed and their charts reviewed, they are moving forward in QA.
Now if I am an insurance company, an employer or a patient, don’t you think I’d want dentists that are fully engaged with QA – and are willing to be measured in this domain?
Given that dentistry follows medicine, and QA is beginning to dominate how hospitals and physicians are compensated, the same soon will have significant influence in how 3rd parties and patients pay dentists.
I work with several DSOs who are actively engaged in QA. As reimbursement moves from pay-for-procedure to pay for those who have quality assurance programs and demonstrate measured quality improvement, what will solo practice do? When solo practice can have a QA program and monitoring system in place, they shouldn’t point their fingers but get to work of a QA program for themselves.
“Those who spend their time looking for the faults in others usually make no time to correct their own.” – Art Jonak