The Generalized Specialist vs. Specialized Generalist

Are You a Generalized Special(ist) or a Special Generalist? 


I’ll explain more on what I mean by this shortly. In our ever-evolving professional and economic environment, this is a question worth pondering as you navigate the turbulent landscape of dentistry. 


Several years ago, an old acquaintance of mine moved to Utah to start his specialist practice. He had the drive, the education and a great area to practice in. Unfortunately, within just a few years his practice was closed. What happened? 


In my view, he was trying to be a “General Specialist” by accepting every insurance plan, including Medicaid, which may have began compromising the quality of his work or his office environment. Not that he couldn’t accept Medicaid and treat people well, but being everything to everyone didn’t seem to align with the type of treatment he wanted to provide.


Many practices cater to the masses, such as providing nearly every dental treatment or accepting nearly every insurance plan. While others carve out their own niche and limit or specialize to certain procedures. 


Which direction is right for you? 


As I like to joke with my team and patients “we are all trying to figure out what we want to be when we grow up.” It is one of the great blessings of dentistry, that we have the opportunity and ability to redefine our vision and our practices throughout our career. 
Let’s start by acknowledging that there are successful dental offices that “do it all,” such as some large group or corporate practices. These establishments provide a wide range of services, appealing to a broad patient base. There’s nothing inherently wrong with this approach; in fact, it can be a valuable practice model. 


However, if you’re running a smaller practice, you have the unique opportunity to build your own niche and choose to attract and treat only the patients who align with your values and treatment modalities. You have the power of personality that no one else large or small can copy. 


A book I recommend on this topic of standing out is Setting the Table by Danny Meyer, the founder of Shake Shack and multiple  high end New York restaurants. It is a fun read and glimpse into the restaurant and hospitality business. Through anecdotes and practical advice, he discusses the significance of genuine connections with customers, empowering employees, and the concept of enlightened hospitality. Most importantly it has some great lessons on running your practice which in my view is a hospitality and service business because our number one role is to serve our patients.


One of my oral surgeon mentors during rotations in dental school once shared this with me: the embroidery on our white coat does not say “Superhero,” it simply says doctor.
This concept has stuck around in my mind for many years. It reminds us that we shouldn’t push ourselves to perform procedures we aren’t comfortable or confident with. Similarly, we shouldn’t feel obligated to treat patients who are perpetually dissatisfied, blame every dentist or someone else for their dental problems, or don’t pay and keep appointments. 


Instead, we should create and cultivate a practice model that specifically, kindly, and professionally repels those who don’t align with our values and give them options for what may be a better fit. This simultaneously allows us to focus on and take better care of the patients that align with our practice values, whether you run a general dental, specialty or combination practice. 


IT’S TOUGHEST TO COMPETE WITH A COMMODITY When I was studying undergraduate economics at the University of Utah, one of our professors assigned us to read and report on the book The World is Flat by Thomas J. Friedman. 


It left a lasting impact on me about the “race to the bottom” of commoditization which is happening faster and faster each year. In one of his other books he gave a great definition of commoditization which reads as follows:


“A commodity is any good, service or process that can be produced by any number of firms, and the only distinguishing feature between these firms is who can do it cheapest. Having your product or service turned into a commodity is no fun because it means your profit margins will become razor thin, you will have dozens of competi-tors, and all you can do every day is make that product or service cheaper and sell more of it than the next guy or die. ” -The Lexus and The Olive Tree


By focusing on a specific niche, you can establish yourself as an expert in a particular area of dentistry. Whether it’s cosmetic dentistry, orthodontics, or any other specialized field, you have the opportunity to refine your skills and deliver exceptional outcomes to a specific patient demographic. This focus allows you to attract patients who appreciate your expertise and are willing to invest in the services you provide.


It’s important to remember that carving out a niche doesn’t mean turning away all patients who don’t fit within that category. It simply means prioritizing your ideal patient base while still offering comprehensive care to those who seek your services. This approach allows you to strike a balance between your passion for a particular aspect of dentistry and providing quality care to a broader range of patients if you desire.
One of my favorite quotes from Setting the Table was when the author relayed the four for gifts we receive when we are brought into this world: 

  1. Contact
  2. A smile
  3. A hug
  4. Food

As healthcare providers and dental practice owners, we can profoundly impact at least two or three of those. 


As members of the Utah Dental Community, you have the power to shape your practice model however you choose within reason. The Pareto Principle (of 80/20) shows why this is so wise from a lifestyle and overhead point of view.


Whether you choose to be a general or specialty practice, it’s essential to align your values, treatment modalities, and patient base. Remember that your white coat symbolizes you as a doctor, provider and ethical caretaker, but not a superhero who has to save everything and everyone. Instead, build a practice that genuinely reflects your expertise and passions, and refer the rest to someone better suited either financially or clinically to take care of the patient. 


Dentistry is both an art and a science. By focusing on what you do best and attracting patients who align with your values, you can truly make a difference in their lives. By doing so, you can create a rewarding and fulfilling dental career by delivering exceptional care to patients who appreciate your unique skills.


Have a great week!

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