A peer-reviewed journal that offers evidence-based clinical information and continuing education for dentists.

Guest Editorial: Busy, Profitable … or Effective?

Disruptions brought on by the COVID-19 pandemic provide the opportunity for oral healthcare teams to reassess and reinvent their approach to practice and patient well-being.


Practice consultant gurus have long differentiated between busyness and productivity. Clinicians who run from room to room like hamsters on a wheel — treating emergencies and putting out fires, without ever comprehensively addressing a patient’s concerns — find themselves exhausted, unproductive, and often disillusioned at the end of the day.

“Getting your house in order” has understandably been one of the key tenets of seminars on practice growth. These courses will typically cover appropriate team education to ensure everyone is able to address basic patient questions and concerns, as well as the implementation and strict administration of block booking, which has been shown to dramatically increase production from dentists and dental hygienists. After all, from a business standpoint, practitioners perform only two types of procedures: those which are profitable, and those which are less profitable. Advanced courses discuss a paradigm shift, advocating more thorough consultation visits and comprehensive patient care to “increase the bottom line.”

Is such an outlook appropriate? Does this approach benefit either the patient or practitioner? We do not believe so.

There is no doubt the majority of practitioners would benefit from instruction in basic business postulates to help increase profitability and ensure viability. However, understanding these concepts is of minimal value as a guiding practice paradigm.


At a time when concerns about patient health and well-being are understandably on everyone’s mind, the artificial splintering of dentistry from medicine (which began centuries ago) continues. Siloing within dentistry has also increased, as compared to when we were trained in multidisciplinary comprehensive care. Our good fortune in being mentored by Drs. Kramer, Nevins and others, in the context of the Boston University-Penn-Seattle triumvirate, has proven invaluable to our patients, our practices and our lives. This periodontics/prosthodontic training was grounded in thorough examination and diagnosis, culminating in multidisciplinary comprehensive care.

Today, the conscientious clinician understands that effective care mandates the reintegration of dentistry and medicine. The importance of managing the oral/systemic health dialectic cannot be overstated. Failure to do so will negatively impact therapeutic outcomes and patient well-being.

A thorough examination and diagnosis must include assessment of parafunction and possible sleep disorders, as well as consultations with a patient’s physicians regarding any other medical concerns that may be present. Only then can we formulate a treatment plan that will offer maximum benefit to the patient.


The impact of the COVID-19 pandemic on clinical practice and patient care cannot be overstated. There is no need to enumerate the ways in which we have been negatively affected — or, for that matter, the fallout for our patients, our teams and our families. Reams have been written and innumerable webinars and discussions have been held detailing the challenges we all face. However, today’s new normal affords a unique opportunity to transform our patients’ well-being — and our practices themselves.

In times of crisis, people tend to reassess their value systems, and many will elevate family welfare and personal health to the highest levels. Clinicians who have built trusting relationships with their patients, and reinforced this trust throughout the pandemic with timely and comforting communications will find their patients amenable to — and indeed, clamoring for — holistic care in the truest sense of the word.

Now is the time to look beyond mere busyness, beyond daily production, and beyond how many implants we place or how many crowns we insert.

It is time to improve peoples’ lives through our care, as true healthcare providers.

It is time to be effective.

The authors have no commercial conflicts of interest to disclose.

From Decisions in Dentistry. March 2021;7(3):23–24.

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