I don’t know if you are aware of the national conversation going on about Wal-Mart, but if you pay attention, you will surely hear more about it. Legal cases are hitting the courtroom, and academic studies are beginning to reveal the deeper meaning of what has come to be called “The Wal-Mart Effect.” The effect deals with the high cost of low prices, and it cuts very deeply into the heart and soul of our culture. The conversation is more of a conversation “about priorities, about values, about what kind of country this is and what kind of country this is going to be. It is a conversation about power, and competing visions of the future,” as posed by Charles Fishman, the author of the book, “The Wal-Mart Effect.” Strangely, this is a conversation that many of us in dentistry have been having for years.
The conversation comes up just about every day. I take pride in the fact that I have eliminated insurance from my practice, but that doesn’t mean I still don’t engage in “the conversation.” The insurance conversation, you see, is the one about values and priorities.
One of the many issues Fishman writes about is that Wal-Mart has created the most elaborate, sophisticated ecosystem in the history of business. Because of size, scale, and power, Wal-Mart can set the metabolism of our culture. Fishman tells us that businesses fear “the more they do business with Wal-Mart, the deeper they end up inside the Wal-Mart ecosystem, and the less they are running their own business.”
For the longest time, I have wondered how Adam Smith would react to the way our health-care system works. I have wondered if the way our free market works is the way our founding fathers meant it to work. The free market was supposed to act on its own without manipulation and control. I don’t think Adam Smith would have wanted things to turn out the way they have. I don’t even think Sam Walton would have wanted this. His original concept was values-based. Frugality and hard work drove Walton, but the monster has taken control of the market. “Everyday low prices” means different meanings to different people.
We all want to save money, but at what expense? Do we have to commodify everything?
I was doing a bridge the other day on a patient who has been in my practice for many years. We can speak easily and nonjudgmentally with each other. My patient turned to me and said, “That’s a lot of steps just for a stinkin’ bridge.” I stopped what I was doing and said, “Well, no more steps than to build a stinkin’ house, or a stinkin’ car, or even a stinkin’ watch.” He responded, “You know what I mean.” Well, it’s too bad, but I do know what he means. Commodification. And I went to school a lot longer than the builder, the mechanic, and the watchmaker.
Whether you are for or against Wal-Mart doesn’t matter because Wal-Mart is here to stay. So are insurance companies. Saving people money is virtuous. At what point do we give up on quality and innovation? Shouldn’t the market be serving us rather than vice versa?
There is a classic scene from Star Wars where Luke Skywalker is unmasking his father, Darth Vader. Under the grotesque, black helmet he reveals an even more grotesque, faceless being. George Lucas, the writer who was influenced by the mythologist Joseph Campbell, said in response to that scene, “Man should not be in the service of society; society should be in the service of man. When man is in the service of society, you have a monster state, and that’s what is threatening the world at this minute.” I like to replace Lucas’ use of the word “society” with “the market.”
Today’s market has become the faceless creature that Lucas and Campbell described some years ago. I would like to morph a new face onto Darth Vader. That face would be the yellow smiley face of Wal-Mart. I would also like to place a thin moustache on it with the rapier that slashes the prices, like Zorro, Spain’s version of Robin Hood who steals from the rich to give to the poor.
Oh, how virtuous!
Our profession has actually waged war among ourselves, arguing about the various philosophies of dental practice that we should adopt. Some have fought the system. Some have turned to cosmetic dentistry in an attempt to kill the commodification. Some have barred the wolf from the door. We need to view dentistry’s problem from a new perspective. Look at “The Wal-Mart Effect” and see what it can do to the world of products and services ... and then think about our beloved profession.
Dr. Barry F. Polansky practices in Cherry Hill, N.J. He is the author of the book, “The Art of the Examination,” and publisher of Dental Life, a newsletter dedicated to finding balance and happiness in private dental practice. Founder of the Academy of Dental Leadership, (www.AcademyofDentalLeadership.com), which offers small group and individual practice coaching, Dr. Polansky is on the visiting faculty of The Pankey Institute. Reach him via e-mail at [email protected].
