The future of standards of care in orthodontics

I have tried to offer a review of where we are in the current health care reform process and how we got there. Today, the name of the game is economic efficiency or cost/beneficiality. There is no shortage of resources in the Health Care System if the existing resources are allocated properly. The issue is not cost-containment or affordability; it is value. Besides cost, quality is the other key ingredient in the value formula. Our job for the future is to be able to give the American public assurances that we are providing a good value service. We cannot provide these assurances with traditional marketing tools because our assurances are now being scrutinized by very sophisticated judges. It is not the good feelings that some patient has, and it is not being able to assure a benefits clerk that we did such-and-such a procedure "x" number of times. Instead we are being judged by those that have giant databases, and if we are to be judged fairly, we are the ones who have to generate accurate databases. I can assure you that some potentially damaging databases already exist and they will continue to exist until we supply better data ourselves. We can no longer operate in a vacuum, alone or with one or two colleagues. I know this is disquieting for many because it means a change and because many of us entered the specialty on the basis of its promise of personal autonomy. Unfortunately, the past is already in the past and the future is today and tomorrow. We can be ready and we can not only survive but thrive. We have a lot of potential for improvement but we will only improve with a forward looking information age approach toward improvement. This should be our standard of care, rather than a rigid menu of activities (just the thing the legal system or actuaries are likely to misuse to our detriment), we need a flexible, constantly evolving, quantifiable, unassailably "good value" health care service. For readers who wish a comprehensive overview of this subject, I suggest Health Care Quality Management for the 21st Century, The American College of Physician Executives, Hillsboro Printing Co., 1991 edited by J.B. Couch.