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    Why solo practice is a poor fit for the future

    Dentistry is only getting more complicated, and solo practices aren't equipped to handle the complexities.

    Nortel, formerly known as Northern Telecom Limited, was one of the largest manufactures of payphones. Their series 200 was a nickel-plated phone that gained huge acceptance in the 50s and early 60s.

    Nortel upgraded from rotary phones to the push-button phones in the late 60s with their Centurion series. Finally, in the early 90s, Nortel came out with Millennial, which could not only take coins but now also take credit cards. Their customers included Bell Canada, Telus, Qwest, Sprint, Sasktel, Telebec, Telephone de Nantes, Telephone de Warwick, US West Express, GTE, Nevada Bell and Embarq. They were biggest player in the payphone market.

    In 2009, Nortel went out of business.

    What happened? The answer is obvious. Cell phones happened, and Nortel could not adapt.

    Related article: What's next for the solo practice?

    The adjustment between organisms and their environment is referred to as evolutionary adaptation. Adaptation is the root concept that grew into Darwin's theory of natural selection. Organisms that cannot adapt become extinct.

    Given the rapid and dynamic changes occurring in the dental industry, both in the clinical, organizational and reimbursement domains, it is evident that solo practices cannot adapt rapidly enough to address these changes, while managed group practices have a much greater adaptation capacity. This inability to adapt quickly enough will cause the contraction and eventual demise of solo practice.

    Solo practice is based on a historical model of small business organizational structures and processes. These structures and processes may be executed better or worse in respective solo practices, but they are basically the same in each one. Yes, there have been drastic improvements via IT and technology in their structures and processes; yes, there are much greater efficiencies; yes, data analytics has enabled better management and control—but basically, solo practice is still solo practice, whether high- or low-tech, poorly or very well run.

    Related article: Why managed group practice will dominate the future

    Given the rising costs and complexity of operating a dental practice, the economics of solo practice dictate the dentist must be the producer, the leader, the manager, the team leader, the VP of marketing, the VP of facility management, the principal in R&D, the owner and a team player. In solo practice, the dentist must act as the CEO, the COO, the CFO and the VP of every department.

    Up next: What a group practice could do for you 

    Dr. Marc Cooper
    Dr. Cooper's professional career includes private periodontist, academician, researcher, teacher, practice management consultant, ...


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