- Email: [email protected]
KEY PERFORMANCE INDICATORS
COMMENTARY
LETTERS
LETTERS
J
rights of the author in the letter sent become the property of The Journal. Letter writers are asked to disclose any personal or professional affiliations or conflicts of interest that readers may wish to take into consideration in assessing their stated opinions. The views expressed are those of the letter writer and do not necessarily reflect the opinion or official policy of the Association. Brevity is appreciated.
ADA welcomes letters from readers on articles that have appeared in The Journal. The Journal reserves the right to edit all communications and requires that all letters be signed. Letters must be no more than 550 words and must cite no more than five references. No illustrations will be accepted. A letter concerning a recent JADA article will have the best chance of acceptance if it is received within two months of the article’s publication. For instance, a letter about an article that appeared in April JADA usually will be considered for acceptance only until the end of June. You may submit your letter via e-mail to [email protected]; by fax to 1312-440-3538; or by mail to 211 E. Chicago Ave., Chicago, Ill. 606112678. By sending a letter to the editor, the author acknowledges and agrees that the letter and all
Dr. Roger Levin offers sound advice in his November JADA column on “The Importance of Key Performance Indicators” (JADA 2012;143[11]:12481249). In this complex world, confusion awaits any who are unclear about what matters most. It is especially important to focus on the leading indexes and to do so consistently over
242 JADA 144(3)
March 2013
http://jada.ada.org
KEY PERFORMANCE INDICATORS
time in order to reveal trends. As noted, we need systems that allow professionals to maintain “a strong focus on excellent clinical care for patients.” Dr. Levin suggests 10 key performance indicators (KPIs), such as collection percentage, gross revenue and profit. These are all “lagging indicators” that reflect decisions made in the past. They are not marketoriented in the sense of showing what drives patient care-seeking behavior. The suggested KPIs are, however, easy measures to understand because they do not require looking into patients’ mouths, and any staff member can be trained to diagnose them. The advice that dentists should “focus on what is critical” is worth following, but it must be paired with Dr. Levin’s additional admonition that office success should be tracked
Copyright © 2013 American Dental Association. All rights reserved.
COMMENTARY
LETTERS
“on what each dentist considers important.” David W. Chambers, EdM, MBA, PhD Professor of Dental Education School of Dentistry University of the Pacific San Francisco and Editor American College of Dentists Gaithersburg, Md.
BRUXISM AND MYOFASCIAL TMDs
Thank you for the November JADA article by Dr. Karen Raphael and colleagues, “Sleep Bruxism and Myofascial Temporomandibular Disorders: A Laboratory-based Polysomnographic Investigation” (Raphael KG, Sirois DA, Janal MN, et al. JADA 2012;143[11]:1223-1231). I think the conclusion that
244 JADA 144(3)
http://jada.ada.org
there is no relationship between the two may be overreaching. If we had a sore joint due to overuse, such as tennis elbow, our mothers told us to rest until we were better. Indeed, we were sore, and therefore had to rest. Measuring our activity after the fact might show little activity and mislead a researcher to make a broad statement about the relationship between overuse and soreness. The etiology of temporomandibular disorders is a difficult subject to study, but the temporomandibular joint is similar to other joints in our bodies and we need to keep this in mind. Gary D. Bishop, DDS
opportunity to emphasize points already highlighted in our article. We clearly state that “cross-sectional data from our study did not address the possibility that SB [sleep bruxism] could be involved in the initial onset or triggering of a myofascial TMD [temporomandibular disorder].” Nevertheless, we emphasize that treatment aimed at reducing sleep bruxism among those who already have a chronic myofascial TMD is clearly misguided, since myofascial TMD patients do not brux at excessive rates at night. Karen G. Raphael, PhD
Bloomington, Ind.
Author’s response: Dr. Bishop’s letter provides us an
March 2013
Copyright © 2013 American Dental Association. All rights reserved.
Professor Department of Oral and Maxillofacial Pathology and Medicine College of Dentistry New York University New York City
LETTERS
LETTERS
J
rights of the author in the letter sent become the property of The Journal. Letter writers are asked to disclose any personal or professional affiliations or conflicts of interest that readers may wish to take into consideration in assessing their stated opinions. The views expressed are those of the letter writer and do not necessarily reflect the opinion or official policy of the Association. Brevity is appreciated.
ADA welcomes letters from readers on articles that have appeared in The Journal. The Journal reserves the right to edit all communications and requires that all letters be signed. Letters must be no more than 550 words and must cite no more than five references. No illustrations will be accepted. A letter concerning a recent JADA article will have the best chance of acceptance if it is received within two months of the article’s publication. For instance, a letter about an article that appeared in April JADA usually will be considered for acceptance only until the end of June. You may submit your letter via e-mail to [email protected]; by fax to 1312-440-3538; or by mail to 211 E. Chicago Ave., Chicago, Ill. 606112678. By sending a letter to the editor, the author acknowledges and agrees that the letter and all
Dr. Roger Levin offers sound advice in his November JADA column on “The Importance of Key Performance Indicators” (JADA 2012;143[11]:12481249). In this complex world, confusion awaits any who are unclear about what matters most. It is especially important to focus on the leading indexes and to do so consistently over
242 JADA 144(3)
March 2013
http://jada.ada.org
KEY PERFORMANCE INDICATORS
time in order to reveal trends. As noted, we need systems that allow professionals to maintain “a strong focus on excellent clinical care for patients.” Dr. Levin suggests 10 key performance indicators (KPIs), such as collection percentage, gross revenue and profit. These are all “lagging indicators” that reflect decisions made in the past. They are not marketoriented in the sense of showing what drives patient care-seeking behavior. The suggested KPIs are, however, easy measures to understand because they do not require looking into patients’ mouths, and any staff member can be trained to diagnose them. The advice that dentists should “focus on what is critical” is worth following, but it must be paired with Dr. Levin’s additional admonition that office success should be tracked
Copyright © 2013 American Dental Association. All rights reserved.
COMMENTARY
LETTERS
“on what each dentist considers important.” David W. Chambers, EdM, MBA, PhD Professor of Dental Education School of Dentistry University of the Pacific San Francisco and Editor American College of Dentists Gaithersburg, Md.
BRUXISM AND MYOFASCIAL TMDs
Thank you for the November JADA article by Dr. Karen Raphael and colleagues, “Sleep Bruxism and Myofascial Temporomandibular Disorders: A Laboratory-based Polysomnographic Investigation” (Raphael KG, Sirois DA, Janal MN, et al. JADA 2012;143[11]:1223-1231). I think the conclusion that
244 JADA 144(3)
http://jada.ada.org
there is no relationship between the two may be overreaching. If we had a sore joint due to overuse, such as tennis elbow, our mothers told us to rest until we were better. Indeed, we were sore, and therefore had to rest. Measuring our activity after the fact might show little activity and mislead a researcher to make a broad statement about the relationship between overuse and soreness. The etiology of temporomandibular disorders is a difficult subject to study, but the temporomandibular joint is similar to other joints in our bodies and we need to keep this in mind. Gary D. Bishop, DDS
opportunity to emphasize points already highlighted in our article. We clearly state that “cross-sectional data from our study did not address the possibility that SB [sleep bruxism] could be involved in the initial onset or triggering of a myofascial TMD [temporomandibular disorder].” Nevertheless, we emphasize that treatment aimed at reducing sleep bruxism among those who already have a chronic myofascial TMD is clearly misguided, since myofascial TMD patients do not brux at excessive rates at night. Karen G. Raphael, PhD
Bloomington, Ind.
Author’s response: Dr. Bishop’s letter provides us an
March 2013
Copyright © 2013 American Dental Association. All rights reserved.
Professor Department of Oral and Maxillofacial Pathology and Medicine College of Dentistry New York University New York City