Level I, II, III and IV Dental Practices
ByPart 1: What kind of a dentist do you want to be?
• Level I – mostly a quick fix, in and out practice. This dental practice reacts to patients’ problems and generally treats one tooth at a time or one problem at a time. There is little or no time spent in diagnosis and treatment planning. Volume is the focus to this type of practice. Generally, the training of this type of dentist is dental school only or minimum CE after dental school.
• Level II – dentist has more technical training, but the perspective of the dentist (his/her vision) is limited to fixing and repair. Patients will only do what insurance will pay for. Level II dentists will have considerably more technical training than Level I dentists but treatment vision is driven by the patient’s need and the dentist’s need to fix things.
Level I and II dentists and dental practices amount to 95% of all dental practices in the United States. Why? Because this is how we’ve been trained, to fix things.
• Level III – focus is more pro-active or creative than reactive. The dentist and patient co-discover and co-diagnose the health of the mouth to predict the future health or disease of the entire oral system. Level III dentists are more ‘systems based’, looking at the cause of disease and treating the entire ORAL SYSTEM rather than simply teeth, periodontal disease, or cosmetic occlusion. All new patients have a complete examination of all components of the oral system, not just the teeth. Patients will have a Written Master Plan for Prevention and Repair. The central difference is that both dentist and patient are interested in the cause of the problems not just the treatment of the symptoms. This is a lower volume, relationship and trust-based practice.
• Level IV – focus is similar to Level III but the cases and problems patients present are more complex. Missing teeth, periodontal disease, occlusal disease, TMD may all be involved. Dentists involved in Level IV dentistry are ‘whole mouth dentists’ as are Level III but they are also ‘whole person’ dentists.
Level III and Level IV dentists are ‘systems thinkers’, not piecemeal thinkers. They look at the ‘big picture’ as well as the ‘small picture’.
Our dental education prepares us to be Level I dentists.
Advanced technical training prepares us to be Level II dentists.
Our ‘quick-fix’, busy, I have to have it now culture, prepares the patients for Level I and Level II practices. The majority of management promoted in the professions comes from a ‘business model borrowed from manufacturing’. Turn out as many widgets as you can and things will turn out just fine.
Problem is dentistry is a ‘service, relationship and trust-based model’, not a manufacturing and production model. A production model is perfect for a Level I and II practice because it focuses on treating as many people as possible and delegating as much to adjunct staff as possible. The focus of both Level I and II is efficiency and is measured by production and collection. More patients equal more production.
Most dentists today understand the ‘production model’ because their first ‘job’ as a dentist is usually in a ‘production clinic’ or ‘dental mill’.
Production models have a broad mix of services so they can do everything on everybody. No discrimination, just give me a warm body is the code.
A Relationship, Service and Trust-based Comprehensive model is less known in dentistry because there are fewer of them (far fewer) and because volume and production models are promoted by consultants and management companies or manufacturers or accountants who aren’t dentists.
The reality is there are very few ‘consultants’ and ‘management firms’ who know how to create this type of practice because they never created one for themselves.
Which perspective fits you? Here are a few questions that may help:
• Do you want to form significant relationships with your patients?
• Do you sincerely want to make a difference in their lives?
• Do you like to work on a few people and make a big difference in their lives or on many and make a small difference?
• Do you feel like you have to be busy, busy, busy or do you like to work at a more normal, sane pace?
• Are you motivated more by how much you produce or how much you net in profit, fulfillment and enjoyment?
• Are you motivated by doing really high quality technical work, or does it make a difference at all?
• Are you a constant student and interested in becoming the best dentist and human being you can become?
A Level III, systems thinking dentist creates a Level III practice. (See Part 2)
