Dentists Must Adapt

dentists must adapt

Adaptation isn’t usually a choice—it’s usually a reaction. A change in environment requires the right traits for the new environment.

The dental industry is in the midst of an environmental change, and only dentists with the right traits will flourish in the new environment. Dental practices with the right adaptations will thrive; dental practices without them may perish.

A Unique Position

No one wakes up on a Saturday morning and thinks: “I think I’m going to adapt today.” In fact, adaptation isn’t usually a choice at all.

In natural selection, one population within a species will survive while another dies out because of a unique trait or traits that better suit the environment.

When the environment changes, the populations with the better-suited traits will survive long enough to reproduce when others don’t. Species don’t choose to adapt—they simply survive if they have adaptations that enable them to survive.

Dentists are in a unique position. Their environment is changing, and they actually have the choice whether to adapt.

Fear of Change

Most people resist change, especially when it comes to something really important, like they’re dental practice.

According to Rosabeth Moss Kanter, a professor at Harvard Business School, change can create powerful fear and resistance in us. Why?

  • Loss of control.
    • Change can make us feel as though we’ve lost control.
    • We’ll often choose stay in a bad situation rather than take a leap into an unknown one. (The devil you know…)
    • We’re creatures of habit, and change jolts us out of our routines, which can unsettle us.
  • Admission of failure.
    • To change something is to admit that it isn’t working. Those in charge of the current system may not want to admit it isn’t working.
  • Additional work.
    • Change requires work.
  • Ripple effects.
    • Change can create unintended or unforeseen ripple effects.

Perceived Loss of Control

Resistance to change manifests itself in many ways—from foot-dragging to petty sabotage to outright rebellions. In the dental industry, many dentists will simply resist changing their practices.

Why? People resist change when they perceive they will lose something. Like control.

Thomas Climo, a dental practice management consultant and former professor of economics at Britain’s University of Kent, says the current dental practice setup is a monopoly, and people don’t usually let go of a monopoly without a fight.

No one is shouting to stop the solo practice business model, a monopolist delivery system restricting both labor and ownership, to only a state-licensed dentist.

In contrast, everyone, from solo practitioners, the ADA, and government committees and subcommittees, wishes to tear down the dental practice management (DPM) or the dental support organization (DSO) business model.


This epicenter of control and power is coming under question. The solo practitioner model is harder to maintain every day, and many in dentistry are questioning whether it’s still relevant or wise for today’s environment.

Given that, it may be that the debate between the solo practitioner model and the group or support organization model is really about fear of competition on the part of those currently holding power.

Catalyst for Change

It’s human nature to resist change because we value equilibrium or, in the case of the dental industry, perceived equilibrium.

According to Harvard Professor Robert Kegan, humans have what he calls an “immunity to change…processes of dynamic equilibrium, which, like an immune system, powerfully and mysteriously tend to keep things pretty much as they are.”

What drives humans to change is disequilibrium and crisis. Without a death, a divorce, a serious illness or something similar, we don’t tend to make wholesale change.

This applies to the dental industry, which is undergoing a crisis of its own (LINK: 6 Ways Dentistry Is Changing infographic).

The dental and medical model has outlived its usefulness and needs updating to address the changing needs and desires of today’s patients as well as the changing face of dentistry and the new generation of dentists holding the reins.

The revolution of the dental industry is a mandate for change, and it will be uncomfortable for many.

Monopoly Mentality to Hive Mentality

The strategy is usually to say the monopoly is in the best interest of the customer, a breakup would mean worse service and cracks in a system that is perfect.

No mention is ever made of the monopoly assisting the monopolist in dictating pricing and policies and also creating an entry barrier that foils healthy competition, which would benefit the customer.

It took eight years to break up Bell and AT&T from 1974 to 1982. Can you imagine what the price of a long-distance call would be today if this breakup never happened.


The current environment is asking dentists to move from a monopoly mentality to a hive mentality. It’s not a small ask.

Most dental practices are, to this day, small practices with five or less employees. Group practices are on the rise, but they’re still the minority.

Yet group practices have shown that they can survive better in the current environment. Solo practitioners can in fact benefit from entering into group practices. It comes down to patient care…

The moment your business, whether solo practice or DSO, begins to deliver a bad product or bad service, the days are not long before loss replaces profit, closure replaces opening, and the fall-off in patient base which is the foundation of a practice’s goodwill, is fast at hand. The way to profit has never been greed or bad service, nor will it ever be.


Resilience Trumps Resistance

Humans tend to cling to the familiar, especially if they’re the ones calling the shots in that familiar landscape.

But adaptation is key to any species, and only populations well suited to new conditions are able to survive and thrive when environments change. Dentists, as a species, are no different.


By Quinn Dufurrena, DDS