I opened the curtains to let the sun in, hoping the tropical storm had passed.  It was still very early but I could get a sense of how the day would unfold.  At 7 A.M. the sky was steel gray and the the tide was high enough to reach the edge of the condo at our St. Maarten timeshare.  Looking down the beach I saw one solitary figure running along the water’s edge, skidding through the surf on his brand new boogie board.

“Josh, is that you?”

He just looked up and kept on going like the Energizer bunny.  Few people showed up on the beach that day, but we couldn’t get my son Josh off the beach till dinner time.  He spent hour upon hour practicing on that board.  He fell off and was swallowed up by the tide more than most people could bear.  Every time he fell, he just laughed and got back on…over and over and over again.  Some would call it crazy, but really I thought it was special.

Years later I would never forget that day.  Josh continued to show that trait whenever he tried to learn something new…like skateboarding.  Same deal, but skateboards and concrete are less forgiving than water.  There were less laughs and more blood, but still the same result…mastering a technique through disciplined practice.

I remember his friends saying how good Josh was at skateboarding because he had good balance…oh, if they only knew.  I am reminded of what Michelangelo told a woman who complimented him on his sculptures: “If people knew how hard I have had to work to gain my mastery, it wouldn’t seem wonderful at all.”

I always thought how admirable that quality was…but it’s actually more than admirable.  It’s not even a quality but more of a habit.  In the book The Power of Habit, author Charles Duhigg says that willpower, or self-discipline is the keystone habit of success.  

The best part about willpower is that researchers have found it is like a muscle…the more one exercises willpower…the more it is available.  Many studies show how willpower leads to success.  The classic study is the one that tempts young children not to touch marshmallows while they wait for a teacher to come back into a room where they were left alone.  Showing the ability to leave the treats alone was carried out later on in life for the successful children.

For Josh things really took over when he was at UCLA’s Esthetic Program.  He went in with less experience than his classmates.  During his two years there he would come in at 8 A.M and not leave till after midnight on most days.  He slowly improved his skills.  He also gravitated toward dental photography and intuitively learned to master the digital photography.  Today Josh is recognized as a leader in the the dental laboratory industry.  His lab, Niche Dental Studio is growing steadily with some of the finest dentists in the country.  He has had his work published in numerous dental journals including the prestigious Journal of Prosthetic Dentistry and the Journal of the Academy of Cosmetic Dentistry.

I am asked “how did Josh do that?”  Talent?  Luck?   I now go back to willpower.  I have seen people with more talent, and more opportunity who didn’t have the willpower to stay the course.

I also find it interesting that Josh has gravitated toward a group of technicians and dentists that seem to share this same habit.  Their success in the profession is the result of hard work, dedication and sacrifice…not some innate talent.  What is interesting is that “doing hard work” is available to everyone.

Lao-tzu said, “A journey of a thousand miles begins with a single step.”  The journey toward mastery is the same way…one step after another.  Some say it takes 10,000 hours of disciplined practice to master a skill.  That’s commitment, self-discipline and willpower.  In the end, who you know, how much you know, pales in comparison to WILLPOWER—the MASTER KEY TO SUCCESS.

A new patient waited for me to do her examination.  She held a book in her hands.  When I entered the room, the first question I asked was, “What are you reading?”  She told me, and so began my preclinical interview.  I learned she was an avid reader and she was recently diagnosed with diabetes.  Audrey H. became my patient.  I completed her dentistry twenty five years ago.

Audrey never missed a dental appointment.  She always carried a book with her, and we traded reading lists.  My first questions to her were always, “What are you reading and how is your blood sugar.”

Through the years she slowly lost her ability to read.  First she went to Large-print, and then to audiobooks.  She had a difficult time controlling her blood sugar and eventually had to go on dialysis.  Through all of this, she never missed an appointment.  Audrey couldn’t drive after a while so she would take a taxi to her appointments.

Eventually she went to an assisted living facility.

She still came for her hygiene appointments.

About one year ago I found significant caries under her fixed bridge.  It would have to be remade.  Audrey explained that her money was running out and she couldn’t do the work.

I just couldn’t see her in a denture after all these years…now more than ever she needed her teeth.  So I told her I would remake the case…pro bono.

And I did.

We put the case on the books, but we never asked her for money.  The lab bill was on us.

Some time went by and I noticed that Audrey hadn’t been in for her appointment.  Seemed strange.  I wondered if she felt bad about accepting charity.  My concerns were soon answered.  A few days ago we received a check in the mail.  The check was for the work we completed…it was from the estate of Audrey H.  Audrey had passed…but she paid her bill.

Why am I writing this?  Because this blog is about trust, appreciation and ownership...TAO, the essence of relationship dentistry.  When it’s there we feel good about doing dentistry on our patients.  When it’s not there…well, sometimes the dentistry is just not worth doing.  It feels good to know that Audrey ate her last meal with her own teeth rather than a denture…and that her family will remember her as she looked for the last twenty five years.

Dental practice today seems to have lost these values…I write this blog to keep the values alive.

About a month ago there was a blog post that got a lot of attention.  It was titled 10 Reasons Your Dentist Probably Hates You Too.  It created quite a stir and wrote a post that I called 10 Reasons Why My Patients Love Me, in response.  The author of the first post wrote it with her tongue firmly planted in her cheek, and I wrote my response to sho

Wild Wild West Dentistry

w that our profession needs more relationship building in an age where the professions have tipped toward business rather than health car

What is the truth about dentistry these days?

There are many ways to practice dentistry.  Every dentist is faced with the problem of balancing the paradox between duty and desire...the desire to live a great life and the duty to be a great dentist.  We live in a material world and as much as we claim that less is more…so many of us still want more.  Yet I truly believe we also want to to find meaning in our dentistry.

It gets confusing for the dentist as he tries to earn his daily bread in an age where the business of dentistry is like the Wild Wild West.

I try to practice in a manner that helps balance the paradox…some might call it “business ethics.”  I am truly bothered when I see the breakdown of ethics in our profession…so I give you these things that I see some of our colleagues doing on a fairly regular basis…that I think patients, and the powers that be should know about.

1. Your  dentist sees you as a profit center rather than a patient.  Everyone gets the business thing.  Football players tell us this all the time…but this is health care and an ethical dentist MUST put the patient first.  That is the real definition of professional.  Dentists who do this usually relate everything to the “time is money” philosophy.  They usually run behind and are over-scheduled.
2. Your dentist just took a weekend course in an advanced surgical technique—-and you are his Monday morning experiment.  Yes, it’s true…we call these dentists gunslingers.  Many procedures dentists do are fairly safe and reversible, but others are way beyond the skill level necessary for performance.  When dentistry is a business and new “profit centers” are available…some dentists go beyond their limitations.
3. Many dentists are nothing more than tooth jockeys.  That means that they don’t look at the whole patient.  Granted, some patients may be satisfied with this standard, but most people go to the dentist for a long-term result.  If a practice is set up to treat single teeth, it’s unlikely that the patient will accomplish anything worthwhile.  You know if your dentist is committed to your comprehensive care and long-term results if he does a comprehensive examination which includes the teeth, the gums, the bite and an oral cancer examination.
4. The dentist uses the cheapest materials available and charges you for “the best.”  Dentistry is a blind service.  Look, every business tries to cut down on expenses but at least it should be disclosed.  When the patient goes to a dentist because of price…duh, how do people really think that works.
5. They use cheap labs.  Just like number 4…this is an area where the dentists can save a lot of money.  These days a dentist can send lab work overseas to China or Thailand.  Google those prices.  Yes…he can pay as low as $50 for a crown and charge the patient or the insurance company up the wazoo.  If you really want to get nervous check out the labor standards in some of those countries.  (Lead in crowns?)
6. The dentist charges patients one fee and charges the insurance company another, or plan patients get a lower fee.  There seems to be a war between insurance companies and dentists on this issue.  C’mon, is insurance fraud something new?  The problem is that the public accepts a lot of these practices.  But what about the patient who REALLY wants the best and is willing to pay for it.  Sorry…”let the buyer be aware” doesn’t work for me.
7. Your dentist hasn’t taken a legitimate continuing education course since he graduated dental school.  Many dentists these days spend a lot of time and money trying to be better.  There are many great lecturers and courses available.  But too many dentists only go to courses that are free or are sponsored by manufacturers that are selling the next new thing (profit centers?)
8. His sterilization techniques are outdated.  Dentistry has changed for the better with the preponderance of disposable supplies, but still plenty of tools need to be sterilized.  This was a hot topic some years ago when OSHA put their foot down hard.  But if you are seeing a trend here about ethics and business, maybe it’s a good time to rethink how patients choose their dentist.
9. They let the dental assistant perform tasks they are not licensed to perform.  Lots of controversy here.  Certain states allow assistants to do more than others.  Making temporaries, taking impressions and even giving injections.  Some dentists however really push the envelope on this one though…
10.  They just don’t like their patients.  Okay, this is where we started with Lolabees blog post.  The truth is the dentist (and his staff) don’t even like some of their patients.  This is what got dentists all over that post.  It’s true!  Unprofessional, but hey, that’s human nature.  The real truth is that the dentist should not treat people he doesn’t like.  Jerome Groopman, author of How Doctors Think,  tells us that mistakes in diagnosis are more likely to occur when doctors treat people they don’t like.
            I try to avoid writing anything that is cynical or pessimistic about the dental profession.  The last thing we need is someone giving the profession bad press.  When Lolabees blog post came ou and I read the comments, I was once again reminded of the elephant in the room.  Just like the Readers Digest article of the nineties…Is Your Dentist Ripping You Off? or the 1970 book, Dentistry and its Victims, these thoughts are out there and they should be addressed….hopefully the guilty dentists will stop their ways, ethics will be restored to the profession and maybe patients will start to apply better guidelines when choosing a dentist or a dental plan.

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This year the candidates seem to be Aaron Rogers, Tom Brady, Drew Brees,Ben Rothlisberger, Eli Manning and Tim Tebow (Yes, his name has been coming up a lot lately).  What I find interesting is not who is the best, but what the criteria are for being the best.  The Aaron Roger’s  and Drew Brees’ fans will cite statistics, but there are other factors...X Factors if you will.  That is where Manning and Tebow fit in.

It’s the criteria that interest me.  So I would like to hear from you regarding who you think is the World’s Best Dentist…and WHY?

In other words, what do dentists consider the most important traits that would contribute to being world-class.

Is it purely technical skills?  Is it the ability to teach?  Is it related to ethics? to business?  or both?

I am looking for your opinion.  You can mention anyone in the world…but please explain “why?”  If you want to mention a local dentist, that’s okay too…just don’t put yourself down.  If you want to give your opinion on the quarterback debate…go ahead.

Here’s my response—

Eli Manning – Super Bowl MVP…The X-Factor— he has ice running through his veins.  He never feels pressure.

My dentist…World’s Greatest—Let’s hear your votes first.  You can probably guess mine.

Does he hate the dentist?

A few weeks ago a blog post ran wild on the Internet.  It was written by a young dentist who had recently left the field and wrote about 10 of her frustrations with patients.  The post went viral because there was a lot of truth in what she wrote.  Check out the post.

I laughed along with most patients and dentists.  For years we have been the brunt of comedians and the media who portray us as dullards who just inflict pain.  Some of the comments on the blog post were actually nasty.  There is no doubt that the image of dentists could use a facelift.  But what really interested me about the post was a comment I read on Frank Spear’s blog, by the author herself.

In the comment she claimed that she never really liked dentistry, and that was the reason why she left.  For that, I commend her courageous decision.  Later in the comment  she said she even took Pankey courses,  ”which I loved, to try to help myself. In the end, it wasn’t enough.”

I will admit that having a successful career in any profession requires at least liking what you do.  I remember being thirty six years old and wanting to walk away from dentistry because of some of the same frustrations listed in the blog post.  Instead, maybe because I come from a different generation, I didn’t.  But I certainly can identify with the frustrations.

So many dentists try to cope with the issues by applying practice management principles…learning communication and language skills as well.  What I really feel helped me the most was developing a philosophy…no, more of a mindset, or if you can handle the word…an attitude toward life and work.  From that mindset, a culture developed, and I felt as if I had more control.  And when I stopped blaming the profession and patients…things changed.

I owe a lot of that change to the Pankey Institute and Dr. Peter Dawson.  I studied and applied the principles…the behavioral and philosophic ones were the ones that changed everything.  And today…my patients love me.

I know because they tell me.  Yep…they say it right out loud…to my face, to my staff, to their friends, online and offline.

Sure, there are those who don’t like me…but they are not in my practice anymore.

So here is my list of 10 reasons my patients love me:

1. Do you know what TAO of dentistry stands for?  Trust, Appreciation and Ownership.  I spend a lot of time getting to know my patients.  By spending time up front we both get to know if we are a match.  Is there mutual trust?  Trust is a 2 way street.  Some of Laura’s frustrations concerned patients who cancelled at the last second or came in with plaque all over their teeth.  Does that happen?  Sure.  It used to really piss me off too.  These days our patients show a higher degree of respect because of the trust that is built early on in the relationship.
2. My patients really appreciate what we do for them.  Not only do they appreciate the effort to provide the best quality we are able to do, but they appreciate us as human beings who care about us as we care about them.  We know them all…just like in the TV show Cheers…our practice is a place where everyone knows your name.  Our patients really are family.
3. My patients own their problems.  We don’t deal in supervised neglect (it’s part of our culture).  When we tell a patient they need treatment it usually gets done.  It may not be the exact treatment we recommend but at least they don’t ignore our  suggestion.  They believe us because their is trust.
4. We are totally committed to their well-being.  We are other-focused, and we preach that at staff meetings.  The other day day a patient came in with a fractured root.  It looked like an implant would be necessary.  Later on that day, I was thinking out of the box and called the specialist to see if he could perform an alternate procedure to remove the root tip (apical third), and save the tooth.  I called the patient, made no promises, but she was so thankful that I heard her say…I love you.
5. My patients understand the cost of dentistry.  We address financial issues up front.  We agree that dentistry can be expensive and we do our best to hold their costs down.  We work with patients and use time and sequencing to appropriately treat our patients.  Money is the elephant in the room…expose it and address the issues early.  We also like to remind our patients years after restoring their teeth how much benefit they have received.  Gladys, our 98 year patient who I restored while she was in her eighties constantly reminds us what a great decision it was for her to fix her teeth.  All of her friends wear dentures (probably hate their dentist too).  We love Gladys and she loves us.
6. I mentioned earlier that we are other focused.  In other words the only agenda we have is the welfare of our patients.  We understand dentistry is a business but we also understand that if we put our patients first, the business takes care of itself.  Ins tudy after study on the quality of service, people mention dependability, reliability, assuredness and empathy way before the glitz and glamour of the physical office.  Our patients love us because they can depend on us.
7. Our patients love us because we respect their time.  We  never over-schedule or double book.  We know how to schedule productively without worrying about cancellations.  Do we get cancellations?  Sure, but it’s not a problem because it’s not common.  The Law of Reciprocity always works.  If you respect their time they will respect your time.  By the was reciprocity comes into play when you take the time to listen to your patients…they will listen to you.
8. Our patients love us because they know we are painless.  In this day and age there is no reason why a patient should feel pain.  Once they know they are safe (and they trust), they will become much more cooperative.  There is a physical response to fear…tight muscles, enlarged tongue and ropy saliva are just a few, not to mention fidgeting.  The blog post suggested patients don’t cooperate…they will if they trust you won’t hurt them.
9. They love us because they can be assured of our quality.  They know we only use the best…specialists, labs, products.  They know we stay on the cutting edge of dentistry with the best in continuing education.
10. Last but not least and maybe the most important is that our practice is run with an attitude of optimism.  To me this is what I find so wrong with the blog post.  Although it was written with tongue in cheek…I find way too much pessimism and cynicism in dentistry today.  Optimism fills the practice with hope for the future.  Our patients feel hopeful about their health…secure that they will keep their teeth.  ”No worries.”  as they say these days.  What surprises me is that the post’s author claims she took courses at the Pankey Institute but it wasn’t enough.  When I went to the Institute…what I saw there from the faculty was optimism.  I saw that and brought it back to my practice to replace the burnout, cynicism and depression.  I used to hear the same, “I hate the dentist” comments, but I ignore them.  I stopped taking things personally and looked at some of those “patients who hate the dentist” as temporary inconveniences…until it all passed.

Chris Peterson, a psychologist from the University of Michigan and one of the founders of positive psychology says that positive institutions facilitate the development and display of positive traits, which in turn facilitate positive subjective experiences.

In the end that positive culture and the optimistic attitudes that go along with it may be the biggest reason why my patients love our practice.

I welcome your comments on this very important topic—maybe we can help patients to understand that it is much better to love than to hate.

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Just to set the record straight, the title of this post may just be a rhetorical question.  I really couldn’t tell you what L.D.Pankey would do if he were alive today, but asking the question might open up some meaningful thoughts on how to live and practice in these difficult times.

History has no shortage of people who have left behind their philosophies on how to live.  Humanity’s very best ideas have been passed down from Aristotle’s Nichomachean Ethics, and Montaigne’s Essays to Aldous Huxley’s Perrennial Philosophy.  These people have given us the tools to help us create happiness and success through core principles that work in any period.

I am often asked the question, you see above, from younger dentists trying to apply Dr. Pankey’s philosophy.  What separated L.D. from the multitude of educators was that he blended this perrennial philosophy with the dental science of his era.  The question, I believe, these students are asking is, “how can we use old wisdom with new science and technology?”

And that is a fair question.

You see what Steve Jobs was to computer science, Thomas Edison was to invention and Peter Drucker was to business management…L.D. Pankey was to dentistry.  Their legacy went way beyond their fields…they gave us more than information and knowledge…they gave us wisdom.

Think about Job’s commencement speech to the graduating class at Stanford.  He didn’t speak about iPods or iPhones…he spoke about life, just as L.D. Pankey spoke to dentists in 1948 at the Florida Academy of Dentistry, in his famous speech, You Are the Future of Dentistry.

That is why Pankey added the arm of “Apply Your Knowledge” to his Cross of Dentistry.  Application…action is not easy…for that we must turn to the perrennialists.  I am sure that is why Pankey himself turned to Aristotle for guidance.  He faced the same problems then as we do today.

The same but different.  Sure he didn’t deal with insurance, advertising or the Internet, but he had his own issues.

I was watching a football show last Sunday.  ESPN’s Chris Berman, Tom Jackson and Bill Parcells were discussing the future of quarterback Tim Tebow with the Denver Broncos.  Berman and Jackson argued that Tebow would do well because of his background.  He had all the tools to make him a winner…all of the character traits.  Parcells wasn’t convinced.  He said the quarterback still needed to throw an accurate pass.  When I heard that I thought of L.D. Pankey.

He knew that the philosophy included more than character.  It included the technical skills as well.  Pankey blended both into his philosophy and that is why, although times have changed…it still works.

Dentists have told me that they are thinking about leaving dentistry, selling their practices and just doing something else.  That would be a shame because there are ways to make things work even in tough times.

I will be using this blog to post specific questions about “What Would L.D. Do Now?”  Please help me by sending questions in… preferably in the comments section so readers can chime in.  I invite everyone to put their two cents in…because together we can can figure it out…because we just can’t ask him.

Throughout the past week the Internet has been filled with blog posts concerning the death of Steve Jobs.  Like  everyone in America, I too am a big fan of what he created.  For years I have been calling him our modern day Thomas Edison.

Everything that needs to be said has already been said as noted by my friend’s blog post at Spear Education.  Most of the references to Jobs have centered around the world of business…what a great leader, and what a great marketer he was.  And yes, that is all true, but just as Edison was primarily a great inventor, Jobs was primarily a great designer who truly understood what humans wanted and needed at a practical level.

And he delivered.

That is his greatest lesson for dentists.

Steve Jobs understood what “design” means.  He understood “form follows function,” where others just give it lip service.

I will never forget his keynote speech introducing the iPad2.  The entire presentation was designed (yes doctors, his presentations were designed as well), around function; how the new iPad worked.  He subtly mocked his competitors because he knew what his audience wanted and he delivered it—so many improvements over the original iPad and yet all he kept saying was “It just works.”

Clear and concise: “It just works.”

Form follows function.

Read what Steve Jobs said about design in a New York Times article written in 2003 titled, The Guts of a New Machine:

“Most people make the mistake of thinking design is what it looks like. People think it’s this veneer – that the designers are handed this box and told, ‘Make it look good!’ That’s not what we think design is. It’s not just what it looks like and feels like. Design is how it works.”

Design is how it works…makes us wonder about the cosmetic dentistry revolution, and about what Peter Dawson has been preaching for the last thirty years.  People really want dentistry that works, that lasts…quality dentistry.

First you have to design it…then you have to sell it ( the idea, I mean).

And Jobs was good at that too.  He was a master presenter, an impressive storyteller who painted crystal clear images with extraordinary graphic design.

So what can dentists learn from Steve Jobs?

Hopefully I have given you two things…become a great dental designer by deeply understanding examination and treatment planning skills and second, take your presentations very seriously.

I have created another blog called Casepresenter.com which explores all the nuances of effective dental case presentation.  Please visit and contribute your thoughts and ideas.

One more thing.  I am a frequent visitor to Amazon.com.  Some months ago I noticed that Walter Isaacson, the author of Ben Franklin’s  and Einstein’s bio’s, was writing the first authorized biography of Steve Jobs.  The publication date was March 2012.  Over time I noticed the date was moving forward.  That combined with his departure from Apple in August should have tipped me off to his imminent death.

I can’t wait to read Isaacson’s book, due out at the end of October 2011…that will surely tell dentists what we could learn from Steve Jobs.

When the King of Queens was popular on television I never watched it.  These days I watch it everyday on reruns.  I love Doug and Cari…and I guess their popularity can be explained by their universal truths.

The other night I watched an episode that portrayed Doug having a difficult time with the challenging problem of selecting a birthday gift for Cari.  This is a quandary I find myself in at least once each year.

Doug was overjoyed when he found the “perfect gift.”  Cari complained about how badly she looked in glasses, so Doug bought her Lasik surgery.  Pure win-win.

Until, Cari almost went blind.

You see,  Doug, true to form, decided to improvise.  Instead of taking the advice of Cari’s boss, who had successful surgery, Doug looked for a deal.  He took a deal that he “couldn’t refuse.”  Gee…I’ve heard that language before.

Lucky for Cari…the procedure was reversed by the real doctor…the original doctor that Doug was referred to.

But this is fiction, right?  Well in today’s world, truth is stranger than fiction.

These days we see anybody who takes a weekend course can become certified to do many procedures that were limited to the most qualified providers just a few years ago.  My last few blog posts were concerned with tooth whitening, but other services readily come to mind, like Botox, and Lasik surgery.

The other day I received an e-mail from a “list site” that seemed more informational than promotional.  It explained that optometrists would soon be able to perform Lasik surgery in some states.  Doug and Cari are starting to look real.

On that same day I became aware of a deal that had to be stopped because too many people had bought it.  The deal was for $20 worth of food for $10 at Whole Food Supermarkets.  How many deals do you think sold?

ONE MILLION…then they stopped it.

Now that’s powerful promotion.

Can you feel it yet?  Where is health care going?  Enough caveat emptor…this isn’t 1954 anymore.  Don Draper couldn’t survive these days.  Today the science of neuro-marketing, and persuasion put the consumer at significant risk.  And it’s a risk that the health care powers should take more seriously.  Cari went blind on television…but how many patients looking for a good deal will suffer at the hands of unscrupulous marketers and professionals?

There was a time when tooth whitening was all the rage.  Everyone wants white bright teeth.  Dental practices focused on bleaching…big companies jumped on the bandwagon and created tooth whitening products from toothpastes to white strips to tooth whitening gels.  Tooth whitening systems  became big business…and dentists considered it their domain.

We bought lights and made deals to buy bleach in bulk.  Tooth whitening in dentistry became as common as dirt.  Today we have created the ultimate dental commodity.  Dental practices still charge upwards of $600 to bleach a patient’s teeth.  This is in spite of the fact that in many states people can go to the local mall and get the same procedure around $99.

Cruise ships began offering whitening services as well.  Through it all dental practices kept charging the higher fee as a “profit center.”

Well things are changing faster than going from A3 to A1.

In my book The Art of the Examination I wrote about the forces in dentistry that have made our services into commodities.  The forces I wrote about were dental insurance and advertising.  Today we have the new social e-commerce sites like Living Social and Groupon that are offering services, especially tooth whitening for as low as $79.

I wrote about this in my last couple of posts.

I always wondered where we would be if no dentists accepted dental insurance…obviously that’s a dream.  So many of our colleagues have used dental insurance as a competitive advantage.

Well the same thing is happening with the Living Social and Groupon fascination.  I mean really…who doesn’t want a great deal?

Dentists all over the country are jumping on the bandwagon.  Patients everywhere are waking up to e-mails offering bleaching for $99 or less.  I know it’s a matter of time before we see Invisalign and veneer deals.

Dentistry’s founding fathers could not have seen this Darwinian competitiveness coming.  The phrase “all’s fair in love and war,”  doesn’t work for industries that are held to a higher standard…industries that are public trusts.

My feeling is that creating price wars through bitter competition can help the individual practice at the expense of the collective profession.

What’s your take?  The way I see it I wouldn’t be investing in a lot of bleaching supplies in the future.

“He who defines the rules, owns the game.”       Barry Polansky…The Art of the Examination

Break through the gates

I wrote that line in my book a few years ago, in reference to the various forces that were controlling the dental profession at the time.  What I was implying was that dentists should do what blogger Chris Brogan calls, “creating your own game.”  Of course he is speaking about using the new media to compete in today’s connected marketplace…I was speaking about insurance companies.

Reflecting on my latest blog post concerning social e-commerce sites like Living Social and Groupon, I made the connection and revealed how these sites may be today’s version of dental insurance companies.  Third parties that enter the market to control the commerce for their own interests.  These forces are what Brogan refers to as “gatekeepers” in his book Trust Agents.

 A gatekeeper is someone or something that controls entry. 

You can see how insurance companies, HMOs and PPOs use their leverage to control dental fees and traffic.  Gatekeepers!  Traditional media, like newspapers, magazines and television, control content and tell us what to read and watch: Gatekeepers.  When professional advertising became “ethical” during the eighties, once again if you had the money you could pay the gatekeepers.

In today’s digital world, the barriers are broken down.  Those of us who understand the game get to define the rules…we can become “gatecrashers.”   Today the real gatekeepers are your social or connected patients…the real power behind connected consumerism that Doc Searles predicted years ago in the Cluetrain Manifesto.

Think about how consumers make their buying choices these days.  Look at the power of reviews and testimonials.  Think about how you peruse the Amazon lists before you make a purchase.  Now look at the numerous ways your practice is reviewed online.  With the advent of unbiased review sites like Angie’s List people are going there more often for trusted referrals.  In other words your social or connected patient is your strongest influencer.

They become the real gatekeepers…they become your trust agents.

The problem is that we are still behind the curve even though the tools are available to us.  Here are some recommendations on using the new tools to stay ahead of the game…become a gatecrasher…and make your own game.

1. Listen to your patient base...ask what your loyal patients want from you and give it to them.  Practices are obsessed with spending marketing dollars on acquiring new patients when the old proverb is much more important:  “A bird in hand is worth two in the bush.”

2. Create the best customer service experience you can… use empathy and listen to your patients and what the market is asking for by listening in on Facebook and Twitter.

3. Extend the conversation by using services like Demandforce to post your reviews and help you stand out with great online testimonials.

4. Understand content marketing and create the exact content that your existing patients require.  Send out timely messages through e-mail, Twitter or Facebook.  Stay on top of your patient’s minds.

5. Structure deals and disseminate them to your existing patient base rather than to strangers…trust me your trust agents will reward your business far more than the newer prospects.  You will not need to subject yourself to the “dealmaking gatekeepers” that are trying to manipulate the market.

Remember this blog’s name, TAO—stands for Trust, Appreciation and Ownership…that takes time. 

You can’t achieve that in a deal.  Stay with the timeless values and use today’s tools.  Old wisdom —New Tools.

Let me hear some of your ways to own the game and become a gatecrasher.