Taking stock: assessing the present-planning the future 'you don't need a weatherman to know which way the wind...

In the past, the dual nature of orthodontics has presented practitioners with unique artistic challenges and scientific opportunities. As a result, orthodontists today are enjoying the 'Platinum Age of Productivity.' However, a disturbing trend that promotes neither art nor science has emerged. Health care reform in the United States has transformed health care from a service to a commodity. Some orthodontists and orthodontic practice management companies have capitalized on this change in thinking and are aggressively promoting orthodontic treatment as a product. This paper examines the impact of this paradigm shift on the future of orthodontics. Particular attention is paid to the interaction of three themes: first, orthodontics as a product, secondly, the current misconception that there is a shortage of orthodontic practitioners in the United States, and thirdly, the difficulty in defining 'excellence' in specialty training in orthodontics. In the near future, the collision of these three concepts will result in an orthodontic 'Perfect Storm'. The ability of our specialty to survive and thrive will be proportional to our professional behavior during these difficult times...caveat emptor.