flipping the triangleYou can access Part I of this series by clicking on the link.

A 2010 article by Margolius and Bodenheimer notes that, "Somehow, there must be improvements in the attractiveness of primary care careers for physicians-in-training. Such a tall order cannot be met by minor tinkering. Transformation is the appropriate response," and that "primary care must accomplish these aims for the entire national population, even faced with the reality of a growing gap between the supply of primary care physicians and the demand for primary care."

Flipping the Triangle for Our Dental Patients

The good news: Dentistry can accomplish this with very little disruption and actually lead the way in healthcare. Sounds crazy, but true. In fact, we are well ahead of that game, especially when considering the focus that we embrace here, at Spear Education. The article suggests that, "The new primary care practitioner would function as team leader and clinical teacher rather than as healer to all who seek help." Been to a study club lately?

A 2009 article in the New England Journal of Medicine documents that, "In the United States, 10 percent of patients account for 70 percent of total expenditures. These patients tend to have multiple concurrent illnesses and frequent hospitalizations."3 Again, can you see the similarities with the patients in your practice? But we are already on our way to flipping the triangle.

What about insurance companies and the big money?

Remember, we're the little fish in this huge ocean – a pond doesn't quite do it justice, does it? The thought process for change in the big water is not new. Margolius and Bodenheimer have noted and understand that, "Primary care practices and payers need to enter into compacts by which the practices make the necessary improvements at the same time as payers reward those improvements. Because improved primary care can reduce emergency department visits and ambulatory care–sensitive hospital admissions, payers have a monetary stake in the practice of the future."

I will ask you for the last time (at least in this article), can you see the comparisons to dentistry?

We have the ability, today, to facilitate conversation and change with our patients, guide them to health, decrease the cost of healthcare, and continue to thrive as a profession. Small changes in your practice, your view, integrating interdisciplinary care, and study club interaction puts dentistry ahead of the game and we'll flip our own triangle.


  1. David Margolius and Thomas Bodenheimer. Transforming Primary Care: From Past Practice To The Practice Of The Future. MAY 2010 29:5 HEALTH AFFAIRS.

  2. Bodenheimer T, Berry-Millett R. Follow the money—controlling expenditures by improving care for patients needing costly services. N Engl J Med. 2009;361(16):1521–3.

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