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Don’t Pull My Blockchain

November 15, 2017 by Scott Frey Leave a Comment

What is Blockchain Technology?

‘Blockchain’ technology, which powers things like Bitcoin, has become the hot new thing as of late. The buzz around the technology has gotten so out of hand in fact, that some companies have seen huge increases in their share price just by adding the words ‘Blockchain’ to their company name. Naturally, this has spilled over into the world of orthodontics with many claiming that block chain technology is going to be the next big wave of innovation across the specialty without much understanding about what the technology is or does. I thought it appropriate to take a step back and have a very basic discussion about what Blockchain is and what types of problems it is designed to solve before everyone starts getting drunk on the Kool-aid.

Block Chain is merely a continuously growing list of records, called blocks, which are linked and secured using cryptography to form a ledger. Each block will typically contain a link (has pointer) to the previous block, a timestamp, and relevant data. The encryption used with Blockchain is just like any encryption that we currently use to secure private information, and it is designed to allow for secure digital identities to sign off on any transactions or changes to the digital ledger. The private encryption keys that facilitate these secure digital signatures are vulnerable to theft and hacking, and should be kept secure the same as you keep your password secure. However, these digital accounts are only half of the equation.

In order for a new ‘block’ to be added to the ledger, the request needs be approved and validated in some fashion. In Blockchain, this validation is accomplished through a distributed network of ‘nodes.’ These ‘nodes’ are simply terminals that have administrative privileges to verify changes to the ledger, and any new blocks are simultaneously broadcasted to all the ‘nodes’ in the network for verification. The network of ‘nodes’ then verifies new blocks (as well as confirms the record of previously verified blocks) through a consensus protocol wherein no single user is implicitly trusted to verify all transactions. This is the unique value of Blockchain technology. By having a decentralized ledger, where blocks are distributed across the network and verified by consensus, the ledger is less corruptible and more inherently resistant to modification because any changes to the ledger would require the consensus from the ‘nodes’ for validation.

Blockchain technology also requires that there be a form of incentive for the ‘nodes’ to want to participate in the validation of each block. During the validation process, each ‘node’ is responsible for solving a series of specialized math problems to commit new transactions to the Blockchain through a process that is often referred to as mining. Without the participation of ‘miners’ the ledger the chain cannot continue.

What Value Can Blockchain Offer?

People have begun to look at any process with a growing list of records as something that can benefit from the implementation of Blockchain, but this is not the case. The need for a Blockchain system at all presupposes a degree of mistrust that can be resolved by creating a decentralized ledger. Without inherent mistrust, there is not much value in converting entire industries over to different record keeping protocols. Bitcoin provides a compelling solution for financial transactions because it allows for secure verification of transactions and circumvents potential issues of corruption that can arise from centralized of control over financial systems.

It is also important to note that Blockchain does not actually make any private information contained within the blocks any more secure than achieved by good encryption practices. This is a common misconception, but the consensus protocol is for preserving the security and integrity of the chain/ledger itself and not private data within.

To answer the question of whether Blockchain technology provides a compelling solution for a particular industry, we must first identify areas where there is a lack of trust and then determine in what way miners can be properly incentivized to maintain the integrity of the chain. Otherwise, it is nothing more than current solutions being repackaged under a different name and served up as VCbait.

Invisalign Brick and Mortar, Inc.

November 2, 2017 by Scott Frey 1 Comment

San Francisco Invisalign Store

Invisalign has made huge announcement today that they will be opening a physical store in San Francisco to allow prospective patients and curious minds the ability to interact with and experience their product. They will also be offering patients to have their teeth and bite scanned with an iTero Element to see an Outcome Simulation of their smile. If they would like to move forward with the next step in treatment, they will be connected with an experience Invisalign provider to have their care professionally managed and will be able to choose from special financing packages Invisalign will be offering.

Amazon, Warby Parker, and other eCommerce driven companies have branched out to integrate physical spaces to a broader, omni-channel strategy to connect with their consumers. As it has been described to me, the concept they are piloting is similar to Bonobos’ Guideshops providing customers an opportunity to ask questions about Invisalign outside of a doctor’s office and for the instant gratification of signing up with a local provider of their choice right in the store.

For orthodontists, I am including the details of the pilot that Invisalign has provided below:

The rest of this post is available only to orthodontists and orthodontic residents registered with the Ortho Cosmos

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Inventing Our Future

November 2, 2017 by Chris Cetta Leave a Comment

If you believe that we have to “save the specialty,” we as orthodontists must continue to innovate. Consider that many of the greatest developments in orthodontics have come from within the profession. It was forward-thinking doctors who introduced the Straight-Wire® Appliance, direct bonding of brackets and lingual braces to name just a few breakthroughs.

As we face new competition from corporations, we must rekindle this spirit of innovation within the specialty. In many ways, we ourselves have become “numb” to our own practices – accepting of two-year treatment times, jabbing wires and squealing handpieces as just another day at the office. We must remember that the appliances, instrumentation and products we use on a routine basis play a role in the total patient experience. The challenge is for us to see these from the patient perspective and to recognize them as areas where we can improve the overall experience of orthodontic treatment.

While innovation has been critical to the evolution our specialty, it is not something that is emphasized in our educational upbringing. In an attempt to bring a new idea to market over the past year, I set out to learn about the process of product development. Along the way, I realized how I could protect and monetize my creativity through securing intellectual property.

In the coming weeks, I hope to share how you can turn your ingenuity into innovation that can advance our specialty. I will detail a method of how you can get your orthodontic product ideas into the right hands to get them to market. I will also explain how you can create a secondary stream of passive income by capitalizing on the licensing business model, an ideal scenario for the practicing orthodontist.

Disclosure:

I recently licensed a product I co-developed with Dr. Richard Kaye to MidAtlantic Orthodontics (MAO). The ideas and concepts related to licensing have been adapted from best-selling author Stephen Key’s One Simple Idea and the inventRight consulting program, though I receive no compensation from them. Also, only an attorney can give proper legal advice, which I am not.

How To Make Your Patients Members of AA

October 30, 2017 by Donna Galante Leave a Comment

I know what you are thinking….why on earth would I want to make my patient’s members of AA..isn’t that for people with a drinking problem?

Well, we are not talking about Alcoholics Anynomous here.

We are talking about making your patients members of the Ardent Admirers Club!

So what is an Ardent Admirer?

A look at the dictionary and you will learn that ardent is an adjective and means passionate, loyal or enthusiastic. Admirer is a noun meaning follower, supporter, fan or disciple.

So if you put the 2 together, you get a passionate supporter or a loyal disciple or an enthusiastic follower.

Would any of those descriptions make you happy if they described your patients?

Would you like to know how to get your patients to be members of your practice AA?

In my book, It’s All About Millimeters; How Small Changes Can Make a Big Impact on Your Business and Your Life, I devote an entire chapter to this topic, but for purposes of this article, I am going to summarize it here for you.

There are 3 essential things (what I call the Three E’s) you need to do to get your patients to be passionate, loyal enthusiastic supporters and disciples of your practice.

#1 Provide exceptional experiences.

You don’t need to rent out a movie theater or spend thousands of dollars to provide a huge party (although those are certainly experiences that most patients will appreciate and enjoy). What I am talking about here is the day in and day out experiences they have with your office, with you and your team.

Are you doing the little “millimeter” things that make a big difference and provide exceptional experiences while in your office? What about your follow-up care? How is that being handled in your office.

Something as simple as a thank you card, care card or just making sure to ask each and every patient as they check out, “how was your appointment, did you get all your questions answered and is there anything else we can do to serve you and your family better?”

Why wait to find out via a negative review that they were upset with their appointment or felt their needs were not addressed.

#2 Focus on education

We are so used to our terminology and our big “doctor” words, but our patients do not have our vocabulary. When we present diagnostic findings and a treatment plan, it is imperative that we educate our patients in their language and in a way they will understand the dental problems they have, the proposed treatment plan and what will happen if they delay or decline treatment.

You and your team need to be compassionate and understanding on their need to process this information. Many times we are in a hurry to get to the next patient or we just assume they understand what you just told them. Many people will be overwhelmed and can’t make a decision because we either confused with them with too many options or too much technical details or we did not emphasize the gravity of their situation and the need for immediate action.

Provide the right education in a language and environment that is non-threatening and inviting and you will soon find many of your patients becoming passionate about their dental health and especially the care they are receiving from you and your practice..

#3 Practice Excellence

As Aristotle stated, “We are what we repeatedly do. Excellence, then, is not an act, but a habit.”

The habit of excellence starts with leadership and leadership starts from the top. That means as doctors we need to start building our leadership muscles and provide additional training on leadership to our employees if we expect excellence to be a habit in our practices.

Excellence is a by product of strong leaders who understand that there is no other way to live your life both professionally and personally.

Operating with a mindset of excellence in everything you do for your patients will have patients following you to the ends of the earth.

Everyone loves to follow a strong leader and especially if that leader is also providing them and their family with excellent dental care.

This summary of the “Three E’s” that will start you on your journey to achieving patients who become “AA” members of your practice.

What You Need to Know About Millennial Moms

October 20, 2017 by Donna Galante 2 Comments

It has been widely reported that moms control 85% of household purchases and have a U.S. spending power of $2.4 trillion. Within this segment are tens of millions of millennial moms. In fact 83% of new moms are millennials, according to a study conducted by BabyCenter and they give birth to about 9,000 babies each day.

These new moms spend over eight hours online primarily searching or browsing for parenting advice. They turn to social media, reading product recommendations from other moms. Forty-six percent of millennial moms trust the recommendations of other parents, compared to 39% of generation X moms. These younger moms are happy providing their opinions and recommendations, and are more likely to do so, citing themselves as key advisors among their circle of friends.

Seventy-four percent of millennial moms report they are sought out more often than other friends as advisors on a wide range of topics, and have an average of 24 close friends in which to share product recommendations. Aware of the power millennial mothers have in affecting each other’s purchasing decision, forward thinking companies often connect with those who have a strong digital influence to promote their services or sell their products.

For example, companies such as Invisalign have Gabrielle Reece, millennial mom and influencer actively promoting the Invisalign brand on social media platforms.

Experts who study “millennial moms” and their purchasing habits understand there are 5 important considerations when communicating and connecting with millennial moms.

1. Make the experience about them and their children. Millennial moms want personalization and a relationship with the brands they support — especially for their children.

2. They love brands that get technology

New service brands like Plated and Blue Apron that deliver healthy meals while making life easier for them are extremely popular for these moms. Our use of technology, such as iTero scanners, Invisalign, Sure Smile, CBCT and 3D printing are all a very important part of this appeal to these moms.

3. Millennials expect a seamless experience from the brands they do business with.

Make appointments seamless by offering online scheduling, after school or early evening appointments for those working moms and busy school and sports schedules. Millennial moms prefer to minimize trips to our offices and this is where technology helps support their desires.

4. Businesses should use social media to educate and provide a platform for millennial moms to learn more about your practice.

Invite happy and enthusiastic moms in your practice to post on their social media platforms or post reviews on various sites such as Google and Facebook. Research shows these moms are heavily influenced by their friends and other influencers on social media.

5. Millennial moms are influenced by brands that are community focused.

Think of brands like TOMS shoes that donate a pair of shoes to a needy child for every pair purchased. Something as simple as sponsoring teams, other fundraising events in your community or even setting up your own fundraising events, are all important to these moms.

Understanding this very important demographic will be imperative if we are to continue to grow our practices and provide what these consumers and their families desire.

Seven Strategies for Success in a Digital World

October 16, 2017 by Sean Holliday Leave a Comment

A Unique Value Proposition

The digital world is flexing it’s influence across the marketplace and professions can see the potential effect. When products and services become ubiquitous, there is a challenge in remaining relevant. Corporations, economy of scale and technology buy-in change the culture in orthodontics. There is a general fear that this will commoditize our specialty and bring down the opportunities to a generation that is feeling the increasing costs of education and capital investments in building a business.

A large body of knowledge is being gathered and used strategically with the power of data. Our knowledge database once controlled by the few who put in the time and effort to educate themselves and train as professionals and specialists, to a cloud-based, digital knowledge data set available to many.

In the industrial age, production became exact and cheap. In the digital age, a process can become exact and basically free. This is what has affected so many industries and professions. The correlation into the orthodontic specialty depends on the premise that orthodontic treatment can become exact, which is rarely the case. Although treatment data can augment and facilitate treatment modalities, a repeatable and scalable process is much tougher when you treat a broad range of malocclusions. Assuming a subset of orthodontic cases can be treated repeatedly and exactly, the interesting part is that as things become cheap and virtually free, there is a greater interest in what is unique. Hence the role of a unique value proposition.

Better than Free

I recently read a book by Kevin Kelly, called The Inevitable. In this book, Kelly reviewed technological forces shaping our future. One of those forces, is how in the digital age, whatever can be copied, can be copied for free. “When copies are superabundant, they become worthless. Instead, stuff that can’t be copied becomes scarce and valuable…what can’t be copied? Trust, for instance. Trust cannot be reproduced in bulk. You can’t purchase trust wholesale. You can’t download trust and store it in a database or warehouse….” Trust becomes branding and it leads to authenticity. Authenticity is one of these factors that cannot be copied or faked. The other strategies I found relevant include immediacy, personalization, interpretation, embodiment, patronage and discoverability.

A unique service cannot be cloned, copied, mass produced… it’s better than free. And if you can compete with free, you can compete with anything.

Immediacy

The digital age requests for companies to move away from saving time and efficiency for the business, but to save their consumers’ time. Provide a service within reasonable time and faster becomes better. This unique value proposition is not easy and we all can feel the pressures in delivering results that are faster. Saving treatment time with efficient treatment options and implementing same day starts are two examples of delivering immediacy. Faster is realtime and realtime doesn’t come cheap and certainly not free.

Personalization

Personalization leads to a custom offering. Another concept that is important to consider is avoiding entering a market with a generic service. Not providing a unique patient experience and memorable journey, becomes easily copied and therefore fraught with risk. Taking on the challenging treatment, custom treatment plans, providing unique results, and offering unique experiences with personalized service, become very valuable sources of personalize care.

Interpretation

Software = free, instruction manual = $5,000. This is where the expert advice from interpretation helps in gaining success. Professional training and expertise has a unique value and will become key to the new digital future. In health care, we have this distinct advantage. The dynamic is changing for many, where simple treatment methods are becoming easily reproduced. Another change is coming from the value of those who can best travel the new digital world. In many ways, we are not racing against the machines. Instead of human vs. machine, our value will be heightened when we can work with the machines. The real need for an expert becomes valuable and better than free.

Authenticity

Truth and security lead to authenticity. As stated earlier, you cannot copy and easily build trust. Trust comes from years of reputation. It provides safety and safeguards to consumers. Take as an example free software. Easily accessible and copied a tremendous number of times, but the dark net of piracy is fraught with viruses and damaging software that adds risk. In this example, trust brings peace of mind. Risk to any aspect of our lives adds value to those who can build on the trust that comes from a favorable reputation. Your branding becomes key at this stage where it is invaluable in generating a unique value proposition to lower cost solutions. After all, you can only sell what is true.

Embodiment

The concept of embodiment pivots on the body’s experience that goes beyond the digital realm. In this strategy, you are making the digital into a special experience. A great example of this is the fact that people pay hundreds if not thousands of dollars to attend events in person that can be streamed for free. So many musicians and bands earn most of their living these days from concert performances and not from music sales. In orthodontics, it is so critical to maintain a great patient experience. The journey in the process becomes far more important than the destination.

Patronage

Patronage is a strategy based on building a fan base. There are some unique factors that have to be in play when you want to leverage patronage. People have to care about supporting a real person. A corporation or nebulous provider cannot leverage this factor. Fans want to pay creators and artists because it allows them to connect with people they admire. This is challenging and not easily copied, since it means the provider must be at the center of the patient experience. This provider must also have an appeal and charisma that goes beyond the service we provide. Finding connection is key to this strategy.

Discoverability

The strategy of discoverability is predicated on the fact you have to be discovered. You must be able to be found. Being found is valuable since you don’t want to be the best kept secret out there. Discoverability often relates to the story you are weaving online. Being visible through online search engines and review sites are two examples. This strategy is dependent on many other efforts to develop word of mouth and online relevance.

The next time you start relating to the demise of Kodak or the music industry’s pressures from digital music sales, take into account that many others have succeeded after disruption by finding ways to offer services that are better than free. Kelly states, “success no longer derives from mastering distribution.” We can no longer count on copy protection, technical tricks, hoarding or scarcity. Knowledge and technology are democratizing, so developing skills and services that cannot be easily replicated becomes paramount. Most of those succeeding in this new reality are using the seven strategies of immediacy, personalization, interpretation, authenticity, embodiment, patronage and discoverability.

What’s SWOT?

October 13, 2017 by Sean Holliday Leave a Comment

Business Strategy

The SWOT analysis is a business development tool used is strategic planning. Developing your business strategy and strategic thinking in orthodontics are important methods to improve your business metrics and outcomes. Patient care is a key component in the clinical care we provide, and developing a business strategy is extremely important for the business we support.

S – Strengths
W – Weaknesses
O – Opportunities
T – Threats

The SWOT analysis is encouraged when an initial or a continuous business plan is being developed. This plan is a critical component in setting practice growth in motion and staying on a continuous path of improvement. The key to a strategic plan is to take account of where you are now, where you want to go, and what you will do to get there.

Strengths

The key in identifying your strengths, is placing focus on the positive things you are doing. By acknowledging them, you can work to nurture and expand them. These should come both from your perspective, as well as the perspective of your patient base. Some areas to consider include: Knowledge and reputation, tangible assets, competitive advantage, company culture, quality service, patient experience, and innovative ability

Weaknesses

Recognizing weaknesses stems from the concept of self-awareness. You should be well aware of what you are good at, but be honest and caring in the fact that we all have weaknesses. That gives us the opportunity to improve those weaknesses, and perhaps turn them into strengths. Plugging holes in your organization or your systems allows you to gain tremendous improvement and reduce stress. Take a look at: Your vulnerabilities, market weaknesses, what needs improvement, poor timescales, falling behind competition, are there limited resources, outdated technologies, issues with reliability of data, or poor planning.

Opportunities

Almost any challenge presents you with an opportunity. When focused on strategic thinking, opportunities abound. Take a look at your strengths and weaknesses for inspiration to many opportunities for your practice. Some of these include: Changes in the market, emerging technology, competitor vulnerability, global influences, changes in social patterns, and rapid growth rate.

Threats

Threats are obstacles you face. They are not necessarily bad situations. Especially when you set high standards for your team and don’t compromise on those standards. We should work with threats or work beyond them to make the changes we desire. It is important to acknowledge threats to mitigate any potential damage they could instigate. Some potential threats out there involve: Political or legislative issues, emerging competitors, a shift in consumer behavior, bad debt or cash flow issues, competition for talent, and poor management strategies

When utilizing the SWOT analysis, involve your team in the exercise. It is important to prepare and ensure you are using accurate data and metrics of where your practice is. The analysis should be detailed and not based on guesswork. Accurate and relevant data in orthodontics is an asset. There are data sources out there from advisory groups, consultants, as well as comparison data from third parties that can help your decision making.

Plans without action are but a dream. Remember that once you have setup your strategic plan and reviewed the SWOT analysis with your team, it takes action to make it happen. Set a list of goals and action items from your SWOT exercise. Setting reach goals and manageable goals will help with your success.

The Importance of Self-Awareness in Orthodontics

October 12, 2017 by Scott Frey Leave a Comment

The Importance of Self-Awareness

One of the most important attributes you can possess in life and in business is self-awareness and the ability to accept your shortcomings so that you can focus all of your attention on your strengths.

Perhaps this is stating the obvious, but most orthodontists don’t really know or embrace who they are or what we are as a specialty. Sure, we can all talk about what we do, how we do it, and a good number of us probably have a general understanding what their mission statement and practice culture is about. However, many fail to understand and align every touch point in their practices with their strengths, and they’re not even sure where to focus.

Stop Trying to Be Everything to Everyone

Conventional wisdom tells us that the path to a successful practice is by connecting with a broad and diverse market; however, much like our personal lives, this is simply not reasonable or possible. You cannot be all things to all people, and neither can your practice.

People seek you out for treatment because they connect with you; they believe in you. Without this connection, treatment is nothing more than an impersonal, pragmatic decision based on whoever is offering the least expensive deal.

This simple truth is precisely why understanding who we appeal to and why we do what we do is so important. It is the difference between being marginal and exceptional.

On the road to self-awareness, start by asking yourself these questions:

What are your/your practice’s strengths and weaknesses? Know them and then focus appropriately.
What is your/your practice’s personality? Embrace it and talk about it.
Who relates best with your story? Understand your audience and why/how people connect with it.

Productivity vs. Efficiency in Orthodontics

September 20, 2017 by Sean Holliday Leave a Comment

We all want to be more efficient, and certainly more productive with our time. In orthodontic practice, like any other business, efficiency and productivity can seem as very similar terms. But innately, they are a different mindset.

Efficiency is about doing the same with less.

Efficiency is a great goal when it comes to treatment time and other metrics. We want to achieve the expected results with less time and less resources to minimize the cost of treatment and/or improve treatment profitability. I would caution that concentrating on efficiency in staff utility can limit practice growth.

Some practices work to improve labor efficiency by finding ways to reduce the number of labor hours required to produce the same level of output. This translates into savings because the company spends less on wages and other labor-related costs. Efficiency, then, is about decreasing in an effort to improve profitability.

Productivity is about doing more with the same.

For a practice, it is directly tied to performance. With higher productivity, an orthodontic team can produce more with the same amount of relative work. In contrast to efficiency, productivity is about expanding the output in order to deliver greater growth from the same workforce.

When it comes to practice productivity, implementing better techniques and systems are best suited for doing more with the same amount of resources. The biggest difference from efficiency being that you are driven to grow and leverage increased production to reduce the costs of business and leverage that growth to improve other metrics. This further reinforces the concept of the top line vs. bottom line in orthodontics.

Consider a productivity mindset that is fostered by avoiding bottlenecks in your practice that prevent team members from getting things done. This includes simplifying office systems so an orthodontic team can deliver great care to patients without complex and bureaucratic steps. Every business is fraught with organizational obstacles that prevent growth. Orthodontic practices are no different.

Productivity mindset is also nurtured in organizations that inspire their team’s talent to achieve their best potential. Inspired employees can produce more than 2 times what a satisfied employee does. This comes from a practice culture that promotes inspirational leadership. This leadership style promotes a positive office culture that leads to greater productivity.

In today’s economic climate, developing a productivity mindset is important to nurture growth. Efficiencies are certainly important in treatment, but think about implementing steps to gain productivity with your orthodontic team.

The Middle Seat

September 13, 2017 by Sean Holliday 3 Comments

Do you ever wonder why there are still middle seats on most flights? In a recent trip, I remembered the frustration boarding an overbooked flight and getting seated on the middle seat on the plane. The fact that most planes are a large sardine can stuffing as many people as possible takes away all the joys of travel. The airline business is the prime example of what can go wrong in a business culture. The service erodes, and with new travel bargain websites, the race to the bottom is in full effect. It wasn’t always this way. Many newer, nimble, airline companies are realizing that great service does not have to add incredible expense. By purchasing long, skinny planes, some airlines are getting rid of the least popular seat: the middle seat. There is a way to improve the flight experience outside of purchasing first class tickets. Soon, domestic flights continuing to force customers into the middle seat will perform what is equal to economic suicide.

Consider that the middle seat is a service or product a business offers that people don’t want, but are coerced to accept anyway. On a plane ride, all seats arrive at the same destination, but the experience sure varies. Seat selections often leave the middle rows to the last minute bookings or stand by passengers. Despite paying a similar fare, it’s a long frustration that many endure in order to make their destination.

Now think of what the middle seat means in orthodontics. Think about the areas of your practice that would be considered the middle seat. Beware of habituation, because most of us have not critically looked at the middle seats we have in our offices: The undesirable appointment times, the appliances patients would prefer to avoid, impressions that gag, separators that hurt, broken brackets, unavailable emergency visits, long wait times, inflexible financial arrangements, extended treatment or inefficiencies that add appointments to treatment. The list can get pretty long if we take the time and courage to critique our process.

Orthodontic treatment isn’t just about the outcome, or “destination,” it’s mostly about about the experience. Whether your service is “first-class” or you serve those who typically ride in coach, think about those middle seats that will not be tolerated in this new economy, and this educated consumer.