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ePaper created 2016-04-19, 11:44:05 | version 1.38.0
successful business practice management | 07 ortho 1 2016 achieving “straighter” teeth. Indeed, some may consider STO as an emerging entity competing with specialist orthodontics, but should it be? The specialist training pathway for orthodontics involves a competitive-entry three-year full-time course linked with the achievement of a master’s level qualification that many may feel daunted by. Indeed, navigating the pathway from start to finish can be difficult academically and financially when factoring in fees and loss of earnings during train- ing. Once qualified, the majority of these specialists reside, like the majority of all specialists, in the south-east of England. With this skewed distribu- tion of specialists and assumed need for access, it mightseemprudentforgeneraldentalpractitioners to contribute to meeting the need for orthodontics. Indeed,thelong-citedmanagedclinicalnetworks have yet to be fully realised, although all planning and documentation related to managed clinical networksidentifygeneraldentalpractitionersasin- tegraltothefunctionofthenetwork.Thenumberof orthodontictherapistshasgraduallyincreasedover the last ten years or so since inception of the first courses in Wales and Leeds. Therapists are allegedly more cost-effective to train and employ in a large orthodontic practice; however, unlike their hygiene ortherapycolleagues,theycannotpractisewithout a specialist’s treatment plan and supervision. Patients who qualify for orthodontic treatment under the UK government-funded system need to be assessed according to the index of orthodontic treatmentneed.Therewillbeanobviousshortfallof adults or adolescent patients with minor malocclu- sions who do not meet the cri teria who would like their teeth straightened. This cohort may have to seek treatment privately from orthodontic special- ists or general dental practitioners. As such, these minor or straightforward cases may be managed in a number of different settings utilising various techniques with the advent of STO. This may have resulted in some territorial paranoia between the two camps of traditional orthodontics versus STO systems. Conversely, it may be that differing scien- tific, technical and ethical ethos on managing the same problem is the source of the debate. Quick and easy? Commercialisation has modified the provision of orthodonticsintheUK.Indeed,therearenowortho- dontic brands with courses attached and a faculty ofindividualswhopromotetheirparticularproduct. Companies tend to boast that their product is the best with limited complications and treatment be- ing low risk, predictable and easy. Somewhat sur- prisingly, courses are being run on how to convert patients into orthodontic clients. There are books describing strategies on promoting and increasing revenue.Theyoutlinedetailedstrategiesonattract- ingmorepatientsthanone’slocalcompetitor—oris that colleague? Sounds more like capitalism than commercialism to many interested observers. TherapiddevelopmentofSTOhasnotescapedthe venture (or some may say vulture) capitalists. In the same vein as DIY whitening and sports guards, one can now have one’s teeth straightened via online companies using products delivered by Her Majes- ty’sRoyalMailandsocutoutthemiddleman(i.e.the dentist).Tomyknowledge,STOhasyettomakeiton to the price list of Samantha’s, a beauty salon in Peckham. What may cause fear and worry is that the provi- sion of tooth movement set against a backdrop of a focusonincreasingrevenueandpatientconversion may detract from the real reasons we are providing the treatment. The risk and benefit of treatment must remain balanced or be rebalanced in favour of the patient. The best things in life are rarely quick, easy and without reflection. While learning or training, one gains stature from one’s mistakes and learns by way of osmosis from those of individuals one hopes to emulate. Becoming an expert in many a field requires time, effort and experience. Ortho- dontics is a complicated discipline that is difficult to deliver optimally and efficiently. Treatment planning should be performed in person not only to appreciate the challenges the patient presents with but also to develop a lasting patient rapport. Equally important, patients need to be diligent duringtreatmentandforevermoreforpurposesof retention. Is it possible that a one- or two-day course with a treatment plan lasting half a year or less can provide equally op timal results to a spe- cialist orthodontist utilising traditional means? In any case, placing a time limit on any treatment couldbeconsideredcontentious.Patientsaskmeall the time ‘How long is this treatment going to take Doc?’ I always reply ‘I’ll tell you when its finished’. As such I am rarely wrong. “Orthodontics is a complicated discipline that is difficult to deliver optimally and efficiently.” 12016