Orthotown November 2023 - 10

A VOICE IN THE ARENA
Additionally, when there's turnover, the new
orthodontist-even if he or she is a talented
and caring clinician-will most often be overwhelmed
by the adoption of hundreds of new
active cases. Very simple cases on autopilot can
be managed well, but more challenging cases or
ones that were questionably handled to begin
with can go south in a hurry or, more often, just
get stalled in a treatment going nowhere.
Nowadays, some of my hardest cases are
patients who came from corporate/chain offices
seeking to be treated elsewhere. Doing your best
to unwind these types of cases and trying to land
the plane safely with patients who are already
upset and burned out is most often not a fun
experience. These aren't rare occurrences in my
office in Phoenix; in any given month, I can count
on three to five of these patients making their
way into the consult room.
The one exception
During the first few years of owning my practice,
I would never offer a critique of the state of the
treatment, or the office a patient was transferring
from. I first encouraged such patients to seek a
resolution with their original office and continue
treatment there if possible. Only if they declined
that option would I offer my opinion of where the
treatment could reasonably expect to go in our
office, with little or no comment on what had
occurred previously.
That's still how I handle transfer patients
today ... with one exception. If I recognize the
name of the corporate/chain clinic as one that's
notorious for its carousel approach, I will tell
the patient, " I think you're doing the right thing
considering transferring your orthodontic care,
whether it's with our office or any other competent
orthodontic practice in our area. The one
you're at now has earned a reputation for not
having consistency behind the wheel. "
I do something similar for new patients seeking
second opinions before starting treatment.
If they inform my treatment coordinator that one
of the offices in their consideration is a notorious
carousel clinic, I'll use the same wording to warn
them about that specific practice and encourage
them to limit their search to practices that
don't have a history of orthodontist turnover and
where they have strong reason to trust they'll
have the same orthodontist from beginning to
end of treatment.
If I do make such statements regarding these
more notorious corporate/chain clinics, I always
further explain that the doctors working at that
practice are very likely highly skilled orthodontists
with good intentions, but the structure
of the clinic does not allow for consistent,
high-quality orthodontic care. The problem is
not the doctors, who very well could be top-level
clinicians-it's the carousel.
That message resonates with some patients
immediately; for others, it doesn't. Even if the
patient doesn't ultimately follow my advice, I still
know I've been as honest as possible with them
and have tried to steer them in the best direction.
New corporate model ... same old challenges
To be clear, this is not a competitive tactic to try
to secure the start. I'm fortunate to have an office
that does better than I ever thought it would,
even in the ultracompetitive Phoenix market.
I don't lose sleep over the prospect of losing a
patient to another excellent orthodontist in my
area (and there are many).
But I have grown tired of the same faces and
stories coming into my office from the carousel
clinics. I picture my wife bringing one of my
children (Calvin, Sadie and, soon, PJ) into one of
those offices if life were different and I weren't
an orthodontist. I'd hope one of the other, decent
offices she visited would care enough to ask her
to think twice about opting for treatment with
a practice that's notorious for having no one
behind the wheel.
I can hear the argument now that this-orthat
corporate/group model is different, or less
affected by the challenges discussed. Those of
us in Arizona and other competitive markets
have already seen the evolution and iteration of
NOVEMBER 2023 | 10 | ORTHOTOWN.COM
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Orthotown November 2023

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