Choose Your
Practice Model

Tip 4: Choose Your Practice Model

If you want small changes in your life, work on your attitude. But if you want big and primary changes, work on your paradigm.
- Stephen Covey

When I first started practice in 1973 there were just a few ways to practice dentistry. Group practices were just beginning to form. Public health clinics and the military were another option. For the most part, private practice was the way to go. Insurance was just getting started and most everyone paid cash for dental services. Boy, have times changed. Those options are certainly still available, but with the growth of group practices, corporate dental offices, and the infusion and influence of insurance and advertising, the dentists of today have an unlimited choice in how they want to set up their practice lives. The free market has changed everything. Is it possible that with so many choices we have actually entered into an age of scarcity rather than an age of abundance? In other words has this overabundance of choices left us with a scarcity of resources and time—and saddled us with more constraints?

My preferred way of practicing has not changed. I chose private practice because I went into dentistry to maintain my freedom and autonomy. That choice may not be as easy for today's younger dentists. There are other considerations to make even after the one about creating a private practice such as whether or not to take insurance, or participate with HMOs and PPOs. You need to think about what to focus on if you are a general dentist and what procedures you will or won't do. You have lots of decisions to make. But what will guide you? Ultimately, the choices you make come down to one thing: the quality of life you will create for you and your family.

Back when I started practice, I leaned on the guys who worked for the dental supply houses. But, good advice from them doesn't seem to be available today, and I have to admit that back then, they didn't give me the best advice. I learned most of my model building by going to lectures by practice management companies. I did a lot of that. And it got a bit confusing. I wished I had a mentor. I never did…I slugged it out alone. Today, my best advice is to get a mentor. Find a dentist in your general area who is willing to allow you to come in and observe his or her practice. Look at everything. Watch the way he or she does technical dentistry. Observe how the business and staff are managed. Watch the way he uses his time. Watch how he relates to his patients. All components will be guideposts on the road.

Remember the story about my friend who was traveling from Tulsa to Oklahoma? From his point of view, positivity and optimism determine how long it will take to get to his destination, but he still must pay attention to the roadmap—the signs. The signs are the direction that our mentors point us toward. If my friend has the wrong map, he never gets to Fort Smith, Arkansas. Our mentors act as our GPS. Most dentists work day to day, staying busy without ever thinking about a roadmap.

There is no guarantee that we will ever reach our vision. It is hard to predict the future for many reasons. Things happen. We aren't the same person we were when we started out, and conditions change. But, imagine what happens without a roadmap, without a model. The model gives us a sense of control. Humans have a passion for control. We feel better when we believe we have a say in our destiny. When we go through life without any plan, we relinquish any sense of control to outside forces. When we lose that sense of control, we subject ourselves to burnout, depression and other health issues.

Remember, the more control we put into our future, whether it turns out the way we anticipate, or not, the healthier and happier our lives will be. This is one of my main themes for creating a sustainable career.

Our culture has created a situation where we have more choices than ever before. Most of us think this is to our advantage, but author Barry Schwartz in his book The Paradox of Choice writes that having too many choices is a curse on our happiness. This not only goes for the model of practice we choose but even in our day-to-day dentistry. There are many times when I long for the days of only two or three choices of composite resin. These days, I find myself reading through the massive guide for dental materials, Reality, just to find the best choice. Many find this an advantage, but with so many choices comes a lot of stress, especially in the dental community where there seems to be a lot of perfectionists. Choosing dental materials and dental equipment is small potatoes compared to choosing a model of practice. The former will leave you a little stressed out, but the latter can be one of the most crucial decisions a dentist makes in his or her life. Choose wisely.

How do you make the choice? As I already mentioned, surround yourself with good personal mentors. Create a list of your criteria for success. What will it take for you to be happy? What is your preferred future? What outcomes are you trying to reach? Go over your list with your mentor. He or she should have enough experience to act as a guide. This isn't a perfect solution, but it is a good way to help create your better future. One caveat though, make sure you choose your mentors according to your criteria. If you ask someone who practices in a model that you wouldn't choose, they will probably tell you how great it is.

Dan Gilbert, author of Stumbling on Happiness writes that our brains naturally justify our choices and actually create positive sentiment about them —but only when we perceive that a choice is complete and can't be reversed. This is what he calls the psychological immune system. If you are an older dentist who has already made an irreversible choice, this is something to think about.