QUALITY ASSURANCE (QA) SOLO vs GROUP
There are numbers of engagements I have had with different 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.
So the assertion is they all do quality dentistry. 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 for solo practices.
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 or service to ensure standards of quality are met. Tell me, what program do solo practices have in place for quality assurance? What standards have been established for quality in dentistry? When it comes to quality in solo practice, it is "all in the eyes of the beholder."
Yet, the greatest accusation that dentists throw at managed group practices is hey do poor quality dentistry. But many managed group practices are actively working on quality assurance. Because of their size and revenues, the depth of group practices, their ability to have dentists peer reviewed and their charts reviewed. Because of their IT structure they can now start to accumulate data sets that ultimately will reveal best practices with the give the best results. The are powerfully moving forward aronud QA.
If I were an insurance company, or an employer or a patient, I'd sure they'd want to know which dentists does the highest quality
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 am working 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? Given the absence of being able to generate legitimate QA program, solo practice will continue to loose market share.
So my advise is stop complaining about their quality and do something about your own.
“Those
who spend their time looking for the faults in others usually make no time to correct
their own.” – Art Jonak