Breaking away from Managed Care

We practice dentistry.  Practice doesn't make perfect, but persistent
practice and lots of continuing education makes you a better
dentist.  I graduated from UMKC dental school back in 1987 and
posterior composites seemed like Russian endo roulette.  But
persistence paid off and I was able to throw away the amalgam
triturators in 1991.  The first implant I ever surgically placed
failed and I paid an oral surgeon to redo it.  But a 100 surgical
implants later they are starting to become predictable.  In 1987
molar endo took me three one-hour appointments.  Today, 15 years
later, with Profile .06 tapered nickel titanium rotary files from
Tulsa Dental Products that same procedure usually takes about an
hour.  Removing third molars used to make me sweat and make my hands
shaky!  Back in 1987, on several occasions, I had to call my buddy
Bob Sundberg and tell him that I removed the crown, and would he mind
removing the root tips.  Today I would list removing impacted wisdom
teeth as my favorite procedure.  I can still remember back in 1987
when mom used to ask if her child would need ortho.  I can still
remember saying, "I don't know!  What do you think?"  And of
course mom would say, "Well I thought you would know since you're the
dentist!"  And I would be thinking I don't have a clue!  Today, after
studying with Harry Green, Jack Sheridan, Richard Litt, and Brock
Rondeau, I love to not only answer all of mom and dad's ortho
questions, I actually love to do the case!  In fact when ever someone
says "Cosmetic dentist" I start thinking of ortho and bleaching long
before veneers even enter my mind.

So why do some dentist grow professionally while others stagnate.  It
could be many reasons.  Fear!  Risk!  Self-labeling!  Becoming
successful take a very positive mental attitude and a love for risk
and adventure!  Many people get intellectually stunted in life by
parents, siblings and teachers who inflict negative attitudes and
self defeating labels.  You not only believed the labels, you still
act them out every day as a self fulfilling prophecy.  Your mother
told you that your older sister was good in math and you were not
good in math but good in sports and you believed her.  To this
day you think you are bad in math!  I have heard more than a 100
dentists say, "My dental school instructor said I was horrible in
surgery and I haven't pulled a tooth since!"  Someone gave you a
label and you believed it to this day!  How many dentist can you
count who are personal friends of yours who still claim they are
horrible in endo yet haven't done a molar root canal in ten years.
In fact they have never even done a root canal with Profile .06
tapered nickel titanium rotary files with a Root ZX apex
locator from J. Morita, so how would they even know if they were good
at molar endo?

If you are going to label yourself, make them positive!  Create
a "Think and Grow Rich" Napoleon Hill positive mental attitude!
Inside the front page of the IBD (Investor's Business Daily) they
always list the "10 Secrets to Success."  The #1 secret "How you
think is everything: always be positive. Think success not failure.
Beware of a negative environment."   Label yourself for success!
Tell other people your self described labels so that they become
daily affirmations for your own positive mental attitude!  Tell
yourself and others that you love the challenge of molar endo!  Tell
yourself and others that their is no way you will retire from
dentistry until you have surgically placed at least a dozen dental
implants such as Imtec, Bicon, Paragon, or Sterioss.  Tell yourself
that you fully intend to do at least your own children's ortho!

The #4 secret to success from the IBD is "Never stop learning: Go
back to school or read books.  Get training and acquire skills."
Cross training is the key to success in any endeavor whether it be
sporting or intellectual. For the same reason dental school made us
take undergraduate courses in English, History, Math, Science, and
Psychology, cross training in dental continuing education will be
your key to success in graduating your practice from managed care to
fee for service.  Deciding to earn my F.A.G.D. (Fellowship in the
Academy of General Dentistry) and my M.A.G.D. (Mastership in the
Academy of General Dentistry) was single handedly the best dental
decision I ever made.  The forefathers of the A.G.D.. (Academy of
general Dentistry) set up a well balanced curriculum of 16 different
categories. Just like the Dean of your undergraduate college forced
you to take  classes that you never would have taken on your own, the
same holds true with the F.A.G.D. and the M.A.G.D.

L.D.. Pankey said you can't sell a product if it's not sitting on the
shelf. To be a well rounded family practicing dentist you need to
know a lot about almost everything.  As a family practicing dentist
we will never be a specialist in anything, but we need to know a lot
about everything.  And the more that you learn in one area of
dentistry, the more you start to understand other areas of
dentistry.  Carl Misch says it was his background in removable
prosthetics that allowed him to master implantology.  Brock
Rondeau swears that you could never master TMD if you do not
understand orthodontics.  How could you say you are a cosmetic
dentist if you can't do minor orthodontic teeth straightening before
some of your veneer cases?

Cross training is the key to dental success!

The #2 secret to success from the IBD is "Decide upon your true
dreams and goals: Write down your specific goals and develop a plan
to reach them." Getting your F.A.G.D. and/or your M.A.G.D. is a sure
fire way to build your dream dental practice!  With your new found
dental knowledge you will have so much dentistry to do on your
existing patients and on all of your new patients, how would you ever
possibly have enough time to do managed care?

Howard Farran DDS, MBA, MAGD