Book Review - Level the Curve

As orthodontists and practice owners, is there data we can look to for clarity and understanding on case fees, case acceptance, and financing? I've often asked, "Who is in our corner?" when we think about business challenges coming from so many directions, especially direct to consumer orthodontic treatment. Is there a company or group of experts who are 'in our corner' sharing data and analysis that we can use to grow our practices?

I am excited to share my review of the book Level the Curve by Dr Jamie Reynolds and Oliver Gelles which answers many of the above questions.

The book is built on the data collected by OrthoFi - a company Dr Reynolds cofounded and Oliver currently works as Chief Marketing Officer.

Orthofi is probably most commonly known as the company that brought 'The Slider' to our profession. The slider is a fee presentation tool that simply displays down payment and monthly payment options to the patient to allow them to interact and create their customized payment plan. Built into the slider and customized by the practice are incentives (discounts for payment in full or payments over the first few months) and disincentives (moving from interest free to interest bearing if the patient chooses to extend the length of payments beyond the estimated treatment time.)

Orthofi is a comprehensive financial management platform that recently acquired their main competitor, Orthobanc, and has already processed $5 Billion in orthodontic production. Their services bring digital solutions to several areas including new patient information, online patient forms, A/R and other aspects of billing and insurance collections.

Orthofi has processed over 1 million patients and they have collected data on fees, new patient exams, timing of appointments, estimated treatment lengths, financing, and more. The sharing of their interpretations of this data is a true gift to practice owners - free data driven guidance that is immediately useful.

What I believe to be Orthofi's strength is their collection of data from the 1 million cases they've processed and their interpretation of this data. Leaders from this company regularly share these gleanings with the orthodontic community through articles, webinars, and presentations. The power of their data and interpretations answers many questions that orthodontist practice owners consider as they build, grow, and develop their businesses. In this book, the authors take the data and break it into stories that are helpful and actionable.

The book is broken into 3 parts - Creating the Value Proposition, Intelligent Flexibility, and Conversion Deep Dive. Throughout the book, the authors share their acronyms which help to standardize the discussion of how this relates to an orthodontist's practice. Examples are SDS (Same Day Starts), SDC (Same Day Cash), PTL (Payment Percentage of Treatment Length), TPR (Total Patient Responsiblity), and VCM (Variable Contribution Margin).

The book is full of useful insights and practice management tips that are very current. Here are a few of my favorites:

1. They analyzed 4 and 5 star Google reviews of top ortho practices and DTC companies and compared the key words of each review. The results showed that consumers found both to be friendly, professional, and comfortable. The biggest difference was that the DTC company added Easy and Quick. This may be an eye opener as most orthodontists believe their practices to be superior in most categories, especially professionalism. Their data showed this was not the case, at least in consumer reviews. Easy and quick are categories uncommon to brick and mortar practices but they are extremely desirable for consumers. They summarize that orthodontists must improve their new patient processes and clinical efficiencies to meet the desires of consumers.
2. Undercutting your competitors fee is not the answer - according to the data. While we may believe that consumers only care about the cost of treatment, the authors show convincingly that consumers value affordability, flexibility, perceived quality and customization of payment plans. In fact, in a range of offices with fees from $5,000 - $7,000, the offices with the lowest fees often had the lowest conversion rates.
3. They showed a fascinating example illustrating how additional starts beyond those that cover the practice's variable production costs can bring tremendous financial growth. They answered a common question practice owners consider, "Is it worth financing treatment considering the risks of default?" Using their data they showed that an additional $210,000 of net revenue could be achieved at an average risk of $3,640 in default. This is a powerful example that should be considered by every practice.

The book is laid out with key takeaways at the end of each chapter. They also quote a lengthy list of useful business books (click here for a list) which helps to bring depth, utility, and deeper resources to their discussions.

While reading the book, I found many parallel business concepts to our company Retainer Club and our services. Here are a few.

• Orthodontists can use both OrthoFi and Retainer Club to outsource aspects of practice ownership that are typically dreaded or poorly managed (financing and retainer programs)
• Both provide orthodontists with technology- based solutions
• Orthodontists get to leverage how OrthoFi and Retainer Club collect, interpret and share data for the benefit of the profession
• As an orthodontist using companies like OrthoFi and Retainer Club, you get to solve 2 critical consumer demands that differentiate DTC from physical offices –?easy?and?quick
• OrthoFi and Retainer Club are both solving problems for orthodontists that take them from "good enough" to "best in class" via solutions that solve consumer desires, not just practice headaches.

This book is a great learning resource for any practice owner, especially for those who are more than a few years into practice ownership and have found initial successes and failures. Of course, the solution to many of the challenges posed by the authors is to use the services of Orthofi (I didn't find it to be too heavily promotional) but the information is helpful and universal and could be applied to whatever systems you currently deploy.