Think about all the things that are withdrawn from your account automatically each month: your cell phone payment, cable and Internet service, and so on. That discretionary money is gone before you even see it. Then there are the "one-click" instant purchases: on-demand movies, iPhone apps and music downloads. You can even buy coffee now by waving your smartphone at a scanner.

A good portion of discretionary income nowadays is gobbled up incrementally and electronically. It's never been easier to spend money.

Obviously, dentistry isn't a player in this new paradigm of easy spending. Neither does it figure into the average person's household budget alongside the mortgage payment or the groceries. And as much as we might wish differently, dentistry is seldom seen as a long-term investment on the scale of a home or car purchase.

Significant discretionary dentistry belongs in a different category of spending – the few-hundred to few-thousand category – and this is a very competitive battlefield to fight on. People don't make purchases at this level very often, and when they do it's usually either something they absolutely must do (the water heater or washing machine needs replacing) or something they really want to do that becomes a need (the trip to Mexico, or that iPad they've had their eye on).

This is why the development of your value creation skills must go hand in hand with the development of your clinical skills. The higher you go in the level of dentistry you can deliver, the more sophisticated the challenge you face from competitors in this category of spending – competitors with seductive products and huge marketing budgets.

But you have an advantage they don't have. You have a business model that practically requires your patients to return regularly and you get extended one-on-one, face-to-face time with each and every one of them. That's a situation that is custom built for developing trusting relationships and creating value over time. It's a huge competitive advantage – if you do everything you can to optimize it. I would suggest even adding extra time to hygiene visits for certain selected patients so you can take the time to fully communicate the value of comprehensive care. At this level, in this category of spending, that's where the battle is won.


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