The Real (Orthodontic) World

ROW-Image1In 1992, MTV ushered in a new era of voyeuristic indulgence when they aired what at the time, was a truly bizarre program called “The Real World”. Absent any script or actors, the opening sequence of the show promised to reveal “what happens… when people stop being polite… and start getting real.” Using concealed cameras, unscripted dialogue and demographically representative participants, the show absolutely captivated the public. Almost overnight, “The Real World” shattered the rules of television and ushered in a new era of entertainment.

The observational nature of “The Real World” was new to most of the public, but not all. Using concealed cameras to capture the unscripted interactions of non-actors was, and is, standard operating procedure in focus groups. Of course, capturing what happens when people stop being polite and start getting real isn’t without risk and companies don’t always get complimentary feedback. But then, insult has always been the price of clarity.

Because companies don’t want to tip their hand, focus group findings are usually kept close to the chest. However, DENTSPLY GAC recently commissioned a study to take the temperature of the orthodontic community. There was no agenda or hypothesis behind the study. No specific product or process to explore. They simply wanted to find out what the orthodontic community said behind closed doors. When they stopped being polite…and started getting real.

Before presenting their (your) comments, and some brief setup and clarification commentary, we’ll take a quick look at some of the methodology driving this 2015 Real World, Ortho Edition.

Find Your Voice
The “Voice of the Customer” (VOC), is an analytical concept that’s used to access the wants and needs of the individuals using select products. It’s typically used to guide new product development and improvements to existing product lines. While there is no right or wrong way to collect VOC information, most start out in a focus group setting. For those not familiar, focus groups place customers and companies on opposite sides of a one-way mirror. Each session is guided by a professional moderator who is skilled at reading the ebb and flow of discussion. This type of session typically involves a series of open-ended questions designed to let the customers provide frank feedback.

DENTSPLY GAC is a firm believer in the VOC process, using it to guide their thinking on everything from new product design to shaping their Continuing Education process. The aforementioned VOC focus group was made up of 19 orthodontists and 4 orthodontic assistants.

The questions were broken into a few sections: economics, practice at a granular level and the future of orthodontics. Their answers weren’t always rosy, but they were honest. It’s up to you to decide if their comments resonate with your reality. Remember that a single piece of data does not make a trend. But it does make a point.

Editor’s Note: Brief edits that are consistent with the speaker’s intent have been made to enhance the readability of some comments.

The Economy
When it comes to the economy, most orthodontists feel like “the Great Recession” lasted a lot longer than the 19 months (December 07 to June 09) than economists said it did.

“I’ve seen a decline in new patients. Revenue wise it’s been flat. I’d say this is the first year we’ve really felt the recession.”

“From the recession years ago, it’s gotten better. But it’s definitely not what it was years ago.”

“Since the recession it’s been quite slow.”

“The last three or four years my revenue is down 30%. I attribute that to the consumers. They’ve become smarter because of the internet and social media.”

“I think that money is still very tight and I find there are people that are postponing treatment. They may put it off for a year; they may put it off for two years. We’re seeing later starts instead of earlier.”

“Never before has anyone asked me to negotiate a fee…then in the past five years, it’s ‘can you do better’ or ‘what if I paid you in cash’?”

The Competition
But it’s not just the economy that’s putting a drag on practices. Orthodontists are also seeing more competition from a couple of sources.

Question: Are you competing with GP’s?

[Group] Yes. Yes. Yes.

“I’ve found that a lot of general practices, the men and women are doing orthodontics as a profit center.”

“I think realistically we need to recognize the impact of Invisalign on general practices, and how it’s effecting referrals. I’ve seen a (steep) decline as a result.”

“In addition to everyone else’s problems with Invisalign and the economy, I think most pediodontic practices have their own orthodontist working for them. I used to get referrals from three pedio-practices, now everyone has their own orthodontist working for them. Nothing comes out of it, so who do I call?”

ROW-Image2The Social Network
Marketing is a mixed bag, but the one thing most everyone was agreed upon was the rising importance of social media.

“Since our office [started] social media, we started seeing our percentage go up 24%.”

“We have a large social media campaign with Facebook. It’s not so much that people are searching for an orthodontist…they’re looking at their friend’s pages…who do you go to, where do you go, so it’s the friends referring friends via Facebook.”

“We’ve seen what happened in medicine and with the big pharmaceutical companies. The corporations are now trying to dictate how we all practice. They end up taking control of the marketing…funneling patients. Invisalign has doctor locators. Now everybody’s getting into doctor locators and things like that.”

“My biggest challenge is marketing. I like [doing it]. I like orthodontics. I like educating people…I think the whole population coming in and the parents are very driven by social media. I need to get up to snuff with that [since], my younger competitors are…”

“The biggest challenge is the marketing area. I’m kind of resigned to the fact that you need one dedicated person who’s going to just focus on that area. Marketing is not a one shot proposition. It has to be ongoing and consistent if it’s going to be effective.”

ROW-Image3The Future of Orthodontics
Looking forward, the only thing everyone can agree on is that change will be the only constant.

“I think the biggest challenge is the security of the patients and their [wondering if] they can put out the money…it’s really difficult to do an ortho-case and justify spending thousands of dollars when you can’t put tires on your car.”

“I think the day of the solo practitioner [has] come and gone because of technology. I have the digital [technology]. I take home equity loans out to buy those things. If I’m sharing them with other orthodontists, it would make them more affordable. I’m thinking of looking for a group.”

“Everything has changed. You could do whatever you wanted. You were elitist, you were up there. Now you’re like the gardener to most people. I feel like everything has changed. People don’t treat doctors as doctors anymore.”

This article was published in OrthoWorld Spring Issue 2015
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