“Pigs get fat. Hogs get slaughtered.”– Business lesson #1

The other day, I showed a method of treatment that our private OrthopreneursRD group had seen in one of our monthly webinars. It was designed by a PhD in Biomechanics and is a very different and interesting concept in tooth movement. Of course, many were skeptical, and that’s to be expected until results of many cases are seen. But some had seen a clip of the inventor saying that he might sell this product to restorative doctors and of course, that caused great concern. Many orthodontists are worried about general practitioners (GPs) doing orthodontics and their concern is that it will cut into their business growth.

I’m here to tell you not to worry about restorative doctors doing lots of braces.

I was a GP for 20 years and I know that space. I still have many close friends who are restorative doctors and most of them do not want to be involved in orthodontics beyond the occasional clear aligner case. I was at a lecture where a representative from Align showed that only 10% of their annual cases are submitted by GPs. When I occasionally go into my referring GP’s Invisalign accounts to help them with their cases, they rarely do more than 10-15 cases/year, which equates to one case per month. Sure, if you add up all of the “10-15 cases per year” it can be a big number, but it’s been that way for a while.

The overwhelming majority of GPs don’t want to do tooth movement beyond the occasional clear aligner case. Maybe you know those one or two docs who love to do in-house braces, but they are not the norm and many of that group do it for a few years and then give up. Their practice software isn’t set up for long-term payment plans and most restorative assistants aren’t trained in ortho. Tell me why a restorative doctor would rather dabble in ortho when they could do quadrant and implant dentistry, which is far more profitable with way less headaches when done properly. It’s only when one scales orthodontics that it becomes profitable and most GPs don’t want to do that. Don’t believe me? Think back to your first several years in practice. How profitable was your ortho practice?

Many DSO’s have in-house orthodontists to capture restorative cases, and corporate orthodontic chains can certainly attract a fair part of the population, but most aren’t looking to implement the latest and greatest approaches to tooth movement.

I remember when many of my oral surgeon buddies were worried about GPs doing in-office implants and they were right. Since I graduated in 1992, GPs have certainly embraced doing implants in their offices instead of referring them to oral surgeons or periodontists, but somehow, the oral surgeons have continued to do well. It appears that the sky is not falling after all.

We should be looking at technological innovation as a place for us to set ourselves apart from everyone else doing tooth movement. Sure, new techniques and technology need to prove their worth, but we should be far more concerned with learning how to master them than whether or not GPs will be using them.

As the opening quote of this post infers, it’s alright to want orthodontists to do most of the ortho cases out there, but we also need to acknowledge and accept that a percentage will be done by restorative docs, and that’s OK.  Let’s focus on becoming the best clinicians we can become and help the cereal public understand why our dedication and training set us apart.

All the best,

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