Editor’s Intro: Dr. Kozlowski recognizes that measuring treatment time can help dental professionals improve office efficiency.
I find it incredibly interesting to hear orthodontists discuss the role that products play in their practice. The “discussion” is often more charged than it is collegial. The topic of twin versus self-ligating bracket systems is the most contentious, but it doesn’t stop there. Extraction versus non-extraction, braces versus aligners, pan/ceph versus CBCT, impressions versus intraoral scanning — the list goes on and on. In an issue devoted to “practice and patient management systems,” I’d like to share the one system that I believe would help any practice improve.
Reduce your treatment time!
That’s right! Reduce your treatment time. Rather than arguing with one another about which system is best, or which treatment is best, or which software is best, let’s focus on taking better care of our patients. And I believe this focus starts with reducing the time that our patients are in treatment.
We can all agree on one thing — patients prefer less time in treatment. The problem is that, generally speaking, our profession is not focused on the same things our patients are focused on. In numbers reported by Gaidge from 2017 across more than 1,000 practices in the United States, the average estimated treatment time was 24 months. 2 years! But the real problem is that the average ACTUAL treatment time was 27 months. This means that, on average, we as a profession are not living up to the promises that we make to our patients. And we as a profession are left scratching our heads wondering why patients are searching out short-term ortho solutions and DIY orthodontics. We can and we must do better! But how?
Follow the advice of Peter Drucker — “If you can’t measure it, you can’t improve it.”
However, we can measure treatment time in our practices with a simple spreadsheet. I encourage every orthodontist to do this exercise. Look at your last 50-100 cases of each treatment type (braces, aligners, Phase I). Track your estimated treatment time versus actual treatment time. Look to see if you are living up to the promises that you make to your patients. While you are at it, you’ll find it helpful to track the number of appointments it took you to complete the treatment — how many total visits, how many regular visits, and how many emergency appointments. Whenever I lecture on treatment efficiency, I ask the audience to raise their hand if they track any of these data points. In every lecture, it’s less than 5% of the people who do. My guess is that the most proactive orthodontists attend CE on a regular basis, so it’s likely a smaller percentage of the total orthodontic profession that actually knows its average treatment time. So I’ll change Peter Drucker’s quote to “If you DON’T measure it, you won’t improve it!”
Given the technologies we have available to us today — imaging and diagnostic tools, superelastic wires, efficient bracket systems, early light elastics, bite correctors and bonding resin, which allow for bonding of all the teeth and elimination of metal bands, we should no longer be aiming for a treatment average of 24 months. Let’s band together as a profession and make 18 months the new 24 months when setting goals for treatment. Who knows — maybe the next generation of orthodontists will then be able to aim for 12 months — further helping us keep orthodontic patients in the hands of trained orthodontists. And while we are at it, let’s start living up to the promises we make to our patients. To do this, some of us will need to change — change our mechanics, attend CE, and learn what experts are doing in all types of bracket systems or treatment philosophies. Change our office systems — engage our teams in helping us reduce appointments and treatment time. And finally, change our mindset — because “If you don’t measure it, you WON’T improve it!”
Dr. Jeff Kozlowski
Measuring treatment time is just one way to increase office efficiency. Read Dr. Mark McDonough’s article, “Efficiency by design” to learn how to improve effectiveness through education, experience, and honest treatment options.