Technology Will Change Everything by Mike Alan Gusching

Start Discussion
Categories: Orthodontics; Practice Management, HR and Accounting;
Technology Will Change Everything 

But not everything needs to change today

by Mike Alan Gusching

Let me share something with you: I’m a big nerd when it comes to selling.

While others rely on deep product knowledge, relationships, or charm to make a sale, I’m known to bust out a calculator. Instead of trying to talk someone into buying something, I’ll see if the math works. Which is why, for years, I loved using this famous equation when selling into orthodontic practices:
Equation: Patients per day times work days per year, divided by appointments per case, equals starts per year
 

The math works.

Five hundred patient starts, depending on how appointments are structured, could be completed in 180 days or 230 days. Layer in the hard data on how a new technology could change those numbers, and suddenly you’re mathing-out the future of the industry. A million-dollar practice, consisting of one doctor, a few staff, and AI handling the rest. Scanners, monitors, and virtual assistants are all outsourced so you can practice inside the square footage of a single-car garage.

Technology will change everything. All-digital is the future. Let’s get there now! I believed it. Proved it. Sold it. And I wasn’t entirely wrong. But I stumbled onto something else, something the equations weren’t showing me.

Let me explain: On a Tuesday morning a few months back, I walked into one particular practice armed with their hard data. By their numbers, this was a slam dunk. Implement the technology, appointments go down, doctor time goes up, and patient satisfaction follows. We sketched out the workflow on a whiteboard. The doctor was nodding. On paper, he was well on his way to the digital dream.

But something felt off.

The staff looked like they’d rather be anywhere else. The doctor, in private, spoke about them with barely concealed contempt. He wanted a few gone. The waiting room had chairs that were beaten and forgotten. And despite the poor cash flow, he was determined to pour even more money into technology to buy his way to a practice he couldn’t seem to have any other way.

He was doing exactly what the industry told him to do: Go all-digital, go fast, all now. And I was helping him do it because the equation showed he could get it. Which was part of the problem.

That experience forced me to confront something I’d been glossing over across hundreds of practice visits: Technology is not a culture fix. It is not a leadership upgrade. It cannot fix a team that has quietly checked out, or a doctor who has stopped investing in the people around him.

And yet the industry fueled this with people like me, all with something to sell. All because I believed I was helping streamline his workflow. I relentlessly focused on new tools, appliances, and platforms, all while leaving his foundational work unspoken.

No rep is consistently walking into your practice to talk about staff culture. No one is making a commission on the health of your team, the vibe of your front desk, or the tone you set on a Monday morning. So this all stays invisible … all while the fear of falling behind technologically grows louder every year.

Here’s the equation I wish I’d led with that Tuesday morning:
Equation: Practice greatness equals the team
 

I’ve visited practices that are still using paper charts and alginate impressions and are thriving. Genuinely, sustainably thriving. Not despite their low-tech approach, but because they’ve built something technology cannot replicate: a culture where people show up, patients feel welcomed, and the doctor leads with trust rather than transactions. They got this foundational equation right first.

So what does the right sequence look like? Start with people. That means an honest reflection on staff culture, on how patients are treated from the first phone call to the final debond, and on whether the doctor or leader is someone your team actually wants to follow. This is harder work than buying something new. It is also the only work that compounds.

Then, and only then, look at this equation:
Equation: Practice technology is preceded by strong cash flow
 

Before any technology conversation, the practice’s vision needs to be aligned with its P&L. If margins are tight and cash flow is strained, layering on new tech doesn’t solve the problem; it defers it, with interest. Vision matters. So does runway. These two things must be aligned before you sign anything.

Only then does the final equation apply:
Equation: Transformational change equals team culture rated 1 to 10 over new tech rated 1 to 10
 

The same tech, used in two different practices, produces two different outcomes. The same digital software, two different cultures, two different results. Technology amplifies what’s already there. If what’s already there is a disengaged team member and an overwhelmed doctor, the technology will amplify exactly that (and cost you way more).

But let me be absolutely clear: I am not anti-technology. I’ve made a career out of it, and I genuinely believe the all-digital future orthodontists are chasing is real and worth pursuing. But in more than a thousand practice visits, I’ve watched too many doctors invest in digital transformation from the outside in, when the real, lasting transformation moves from the inside out.

If you want to get to the technology, and you absolutely should, earn it first. Build the culture. Align the business. Then let the latest tools accelerate what you’ve already built with the team.

Technology will change everything. But not everything needs to change today. Let the right math equations do the work in the right order.
Author Bio
Mike Alan Gusching Mike Alan Gusching is an orthodontic sales professional, speaker, and author of The Peak Orthodontic Practice: 20 Lessons and Interviews from Over 1,000 Practice Visits. As the son of an orthodontist, he brings a unique perspective to the industry. His latest book became a category No. 1 best-seller in early 2026.
More In Orthodontics
Dental Pain Eraser
Dental Pain Eraser
October 2023
Expand Your Reality
Expand Your Reality
Dr. Michael K. DeLuke
CE Credits: 1.5
New Products
New Products
March 2024
Understanding the Mechanics of the MDA Appliance
Understanding the Mechanics of the MDA Appliance
Kay Gerety
CE Credits: 1.5
More In Practice Management, HR and Accounting
From Ordinary to Extraordinary: How to Create a Self-Managing Team... Filmed Live at Townie Meeting
From Ordinary to Extraordinary: How to Create a Self-Managing...
Paul Edwards
CE Credits: 1.5
Office Visit: Dr. Chris Teeters
Office Visit: Dr. Chris Teeters
by Kyle Patton
March 2024
Satellite Offices: Insight From the Inside
Satellite Offices: Insight From the Inside
by Dr. Kevin Baharvand
January/February 2024
Testing Your HR Armor: How To Identify and Avoid Common Compliance Traps
Testing Your HR Armor: How To Identify and Avoid Common...
Grace Godlasky
CE Credits: 2
Orthotown Magazine
July/August 2026
Orthotown Magazine July/August 2026 Read Current Issue Read Archived Issues
Sponsors
Townie® Poll
How do you handle screenings and first consultations?
  
Related Articles
From Underwater to Unstoppable
From Underwater to Unstoppable
by Dr. Jacquee Schieck
March 2026
Industry News
Industry News
January/February 2025
Why I Flunked Retirement
Why I Flunked Retirement
by Dr. Anoop Sondhi
July/August 2026