Setting Fees Based on Your Expertise

I love this simple analogy. The challenge is getting our patients to understand this especially when there are so many lower fee, tooth based dentist and third parties promoting the concedpt of high quality at low fees.

Micheal, The key to this is having confidence in yourself. Valuing yourself and the type of care you can deliver. And, the only way to gain confidence in providing comprehensive dentistry is to educate yourself as much as possible. You have to get engaged in a CE program and stay consistent with it. You may already be doing that... Secondly, worrying about what other dentists are doing or what they are charging is the wrong mindset. I was taught at an early age never to compare myself to others. You have to find out what your values are and then operate from that mindset. If you truly value comprehensive dentistry and what it can do for your patients, don't worry about he doctor down the street. There will always be patietns who want comprehensive care just as there are people who want a mercedes or BMW. When the economy tanked, those car companies still made it because there is always going to be people who want this for themselves. I recently heard a statistic that 75% of people shop on price. The great thing about this is that there are 25% who shop on value and service. They are willing to pay more for great service, care, and or quality. I try to keep this in mind and realize that for every 4 patients that walk through the door, 1 of those is really going to be a GREAT patient. Then with the others, I look at it as an oppurtunity to turn them into patients who value great dentistry. Many times, I may be unsuccessful but it doesn't keep me from trying. Lastly, one of the biggest things I have found for myself is to live modestly in the beginning. This has given me the confidence to know that if I don't do that big case, or if I have a slow day, I am not going to be worrying about paying the bills. If a patient leaves because our fees are too high, that's still OK. It frees your mind and lets you practice the dentistry you want to practice. I think many dentists get into huge personal debt for cars and houses, and then they have to work more and harder to maintain that lifestyle. It causes stress and worry and really drives their practice into a more production based practice. They don't have a choice. By keeping personal expenses down, It has gives dentists the freedom to control the way they practice and the patients they see.

The overwhelming majority of dentists believe that their skills are better than average if not much better than average. The majority of dentistry that dentists see is well below average. The question that I always ask myself is how does my work compare with what Frank Spear's or Newton Fahl's work. When compared to those standards, most dentists fall in the bottom 1/3 on the excellence scale. It is impossible for the majority of patient's to know which dentist is indeed excellent and which profess to be excellent. The definition of arrogance is confidence without competence. As long as patients and insurance companies view dentistry as a commodity ie a crown is a crown then it is a challenging task to convince the dental consuming public who actually have the skills, knowledge and technology to produce excellence

I have to disagree with most of the last statement.. Honestly, that is a very arrogant statement if you ask me... I would hate to know I lived my life talking about my fellow colleagues like this.. Even if some of it's warranted, it does nothing positive for dentistry. I would disagree with the definition of arrogance... I think you can be arrogant whether you are competant or not... Even if you are very competent and an excellent dentist, you can be arrogant... Here is a definition I googled... Arrogant: having or showing an exaggerated opinion of one's own importance, merit, ability, etc.; conceited; overbearingly proud Bascially you can be arrogant even if you are an excellent dentist... You can still have an exaggerated opionion of yourself no matter what competancy level you are... I don't think it's fair to say that most of dentistry we see is well below average... Most of the dentistry I see from fellow dentists here in NC is fairly well done. It's more single tooth dentistry but they have generally done a good job for their patients. It may not be the type of dentistry I strive to achieve but it has served the patients well for the most part. And, it has gotten them into my chair ready for comprehensive dentistry. Frank Spear and Newton Fahl are amazing dentist's, I agree. But, there is no objective way for every dentist to really compare their work to these guys. In my opinion, they shouldn't compare themselves to these guys. Secondly, if every dentist in the world was doing this type of dentistry, we would have a massive access to care problem because there would not be enough dentists to do that type of care on everyone. When you compare yourself to others, you either become very prideful or you become disappointed in yourself. Either way, It's bad and it is only relative to your own experience and opinion. It's like an imaginary fairy land where you look at that composite you did and go, "whoa that looks amazing. I'm sure that's as good as Newton would have done ". It's just not real. Nor does it matter in the grand scheme of things. What matters is that you did the best you could with what you know... It may sound cliche, but we should try to do our best each day with what we know and our ability. I want to do the very best that I am capable of. Not necessarily what someone else would have done. As my journey towards excellence continues, It will also change the way I judge myself and will be solely based on that growth. Not someone else. Frank is a mentor of mine and I use what he teaches to drive me towards becoming my best. This comment also struck a nerve with me because this attitude could discourage other dentists to improve. As dentists, we should want to encourage others to grow, learn, and make an effort to provide better dentistry. It's what's best for the general public and it can make a much larger impact on the world than thinking that you are God's gift to dentistry. One of the reasons many dentists fail to embark on a CE journey at Spear or Pankey is because of these types of comments they hear from dentists who are engaged. It' negative and it hurts the profession in my opinion. As leaders in dentistry, we should encourage our peers to improve themselves and do whatever we can to help them grow and learn. Not tear them down to make ourselves feel better. I just hope that the thousands of dentists that attend Spear or are considering coming to Spear for the first time don't see that comment. Furthermore, I hope my colleagues who are fully engaged with Spear education are more encouraging to their peers than this so that we may set a good example for them and hopefully, help them take the next step. Thanks, John John

Michael-- I agree with everything John Sweeney wrote in the above comment--I could not have said it better. I just want to add one thing because I agree that at times a dentist can get pretty down because he feels he isn't reaching the patient. Throughout me career, other dentists have said how "lucky" I was to have such a great practice---but it was never luck--- nor was it expertise (surprised?)--- no it was that I was committed to a structure--- I never wavered in my beliefs about comprehensive care---and yes I see exactly what you are saying but I have the faith that my very next patient will accept the best dentistry -- and you know what---it works out---consistently. Others call that luck---I call it preparation, faith and opportunity.

Just to clarify -- I was referring to John's first comment above, not the comment about "arrogance" in dentistry. But to weigh in on that second subject--I do agree---we need less arrogance in dentistry--it may be one of the biggest reasons for stopping dentists from getting better. I see very little "brotherhood" in dentistry -- and I do see a lot of arrogance...we need to clean that up (that's a problem in a lot of industries). As John says-- dentistry is a journey --- our work goes from shitty to sucky to good to great. Some days are better than others for everyone...the key is to make sure we continue to grow and continue to get better. Nice seeing Imtiaz at the recent AADPA meeting.