Message Boards
Today's Active Topics Today's Active Cases Browse Forum Categories My Recent Activity My Messages Private Groups My Marked Threads My Subscriptions
Today's Active Images Today's Active Polls Most Active Topics Global Townie Map Advanced Message Board Search Message Board Terms of Use

The Perfect Storm by Dr. Ron Roncone

Start Discussion More by this author (2)

THE ORTHODONTIC VERSION
by Dr. Ron Roncone

Most of us have seen the movie The Perfect Storm where a fishing vessel in search of a large catch of fish goes to the outer banks and beyond to find them. The good part is they do find an incredible catch. The bad part is they find themselves in the middle of a convergence of multiple weather elements almost unknown in seafaring history. This convergence makes it impossible to escape in any direction. They are trapped.

I believe the last three years in orthodontics have a lot in common with that fishing boat. I have been practicing for 40 years, during which there have been choppy seas, ill winds and several “mutinies.” However, there has never been the combination of all of these events, and certainly not in the severe intensity that now exists. What is it that has created this foreboding climate for the orthodontic profession?

  • Pediatric dentists have always done some orthodontics. Now, however, they are hiring orthodontists within their practices, which have in many respects, cut-off the young patient referral source. Certainly pediatric dentists have always hired orthodontists, but never in the numbers that exist now.
  • The dental group practice is now intensifying to the degree that it is also creating a problem for the solo orthodontist. With more females entering the dental and orthodontic arenas, this is a perfect setting for those who wish to work at their profession and also spend time raising their children. This is not a condemnation of the problem; it is merely a statement of fact.
  • For the very first time in my 40 years of practice, general dentists performing orthodontics are impacting orthodontists. We claimed it was a problem before, but it wasn’t yet. Remember how we thought the “straight-wire” appliance was going to end the specialty? It didn’t! Remember we thought MSOs were going to bring down orthodontics? They didn’t! There have been many other threats. None of them damaged the profession – at least not by themselves anyway. The advent of “aligners” to orthodontics and then to dentistry has dealt a huge blow to traditional orthodontics. Give the patient aligners (which they want) and the teeth will move. The dentist just needs to give the aligners to the patient in the proper sequence and the magic happens. This is not a bashing of aligners. They certainly have their place in orthodontic tooth movement. It is the widespread use of these appliances in the hands of those who have not been trained in tooth movement that causes the problems, and the numbers in which the cases are done! There are now at least three companies marketing to general dentists with their version of straight teeth in six months or less. The result is many fewer referrals to orthodontists.
  • The great uncertainty of this current recession has created an environment which does not bode well for those in the orthodontic profession. Patients and potential patients have lost their jobs or are in fear of losing them. With that comes a reticence to call for an orthodontic consultation. Those who get consultations are not sure they should begin treatment or maybe they can obtain treatment cheaper (see GPs, clinics etc.). Add to this the fact that banks are refusing loans to qualified orthodontists and cutting lines of credit, and the fact that the recession might not have hit bottom.
  • The last major area of this perfect storm is the presence of what is called Generation X and Generation Y. What does this have to do with anything? The answer is everything! Haven’t you noticed the difference in patient attitude over at least the last 10 years? Gen X was different. Gen Y is really different! Gen X has partially raised Gen Y. Gen Y is being raised by technology and the Internet. They might seem independent but are, to a large degree, followers. They don’t read newspapers. They don’t watch the news (maybe a good thing). Their lives revolve around what they can look up on the Internet – Google, Facebook, MySpace, etc. They don’t believe in the same things as past generations. Their work ethic is different. And oh yes, you cannot market to them in the same way. Logic, great service and what we use to call “value” do not move them to choose an orthodontist as they did in past generations. I am not saying any of this is bad. I am saying that it is different and that we must recognize the differences.

So there you have it. Those are the major waves, storm clouds and winds all upon us at the same time. I believe that orthodontics will never return to the way it was in the past. So what should we do? Give up? Retire? No!

Some of the things which should be done will be described. But first I would like to warn you, especially if you are over 40 and consider yourself traditional, my suggestions might not sit well with you. Also, remember not every orthodontist will be affected in the same way by this perfect storm. Maneuvering your way out of the problems previously mentioned will require a multi-pronged response.

  • Everything possible must be done to quickly reduce overhead in a very significant way. Forty percent should be the target. Many of you will look at that number and think it is impossible to reach. It is not and it must be achieved very quickly. This has to be accomplished within two years.
  • Incredible efficiency must be brought into the management of your practice. This is especially true in your clinical area.
  • You must gain financial mastery of your practice.
  • Marketing must change from what has been the norm to something that is appealing to the Gen X and Y groups.
  • The Internet must play a large part in your marketing, but in a way that will not cost a significant amount of money (remember 40 percent overhead).
  • Any assistance from consultants should be reasonable and measurable in ROI.
  • You will be performing services which include more than just tooth movement.
  • A heart-wrenching decision will need to be made concerning fees – either very high fees with a select small number of patients or significantly lower fees with large volume. Remember, many orthodontists will not have a choice. We are now dealing with different times, different circumstances and different people.
  • Practices will need to have superbly trained smaller staff sizes.
  • It will be necessary to develop much better diagnostic skills and determine which technological advances are necessary versus those which are just nice to have. What is best for the patient? What is best for superb diagnostics? What is best for efficient and effective treatment? All of the items have answers beyond the scope of this article. But based on 40 years of experience, this is my opinion.
Author’s Bio
Dr. Ronald Roncone received his BA, DDS and MS in physiology from Marquette University and his postdoctoral Certificate in Orthodontics from Forsythe Dental Center and Harvard School of Dental Medicine. Dr. Roncone maintains a large practice in Vista, California, and has lectured extensively presenting more than 1,000 seminars around the world and is president and CEO of Roncone Orthodontics International (ROI). ROI offers Just Short of Perfect (JSOP) orthodontic seminars starting in March 2012. The year-long program consists of four four-day group sessions covering topics clinical, financial, marketing, scheduling, and patient enrollment. To take this opportunity with significantly reduced fees only offered this year, visit www.ronconeroi.com.
Orthotown Magazine
September 2025
Orthotown Magazine September 2025 Read Current Issue Read Archived Issues
Sponsors
Townie® Poll
Do you have a dedicated insurance coordinator in your office?
  
Site Menu
Message Boards Magazine Continuing Education Podcasts Blogs Classifieds News Events Townie® Poll Ebooks Townie Choice Awards
Company Info
Contact Us Advertise With Us Howard Farran DDS, MBA Policies and Agreements
Site Help
Sally Gross, Member Services Specialist
Phone: +1-480-445-9710
Email: sally@farranmedia.com
©2025 Orthotown, a division of Farran Media • All Rights Reserved
9633 S. 48th Street Suite 200 • Phoenix, AZ 85044 • Phone:+1-480-598-0001 • Fax:+1-480-598-3450