In going over the critical path to independent practice, we have had to really look at all of the factors involved. We talk about marketing, advertising, public relations, but you know the one critical factor that seems to make the difference between independence and non-independence?  It’s who writes the treatment plan. We are taught diagnosis and treatment planning. That’s part of our residencies, but what I have discovered and I have shared this with you before, but what I received as a definition of diagnosis and treatment planning and what you may have received may be two different things, particularly if we are in different generations. Diagnosis and treatment planning has everything to do with control of the practice and control of the patients’ outcomes.  What do I mean by diagnosis and treatment planning? I mean full diagnosis and full treatment planning. It isn’t just the perio treatment planning. It is the full treatment planning. If the patient needs a MODBL or a buildup and a crown, that’s part of treatment planning.  If the patient needs a four surface restoration, that’s part of treatment planning.  If the patient needs endo, that is part of treatment planning and the better you are at doing the restorative treatment planning, the better you can communicate with the patient, the better you can communicate with the referring doctor, and the better your opportunity for case acceptance.  So what’s the exercise? The exercise is to look at the patient. Yes, do your periodontal probing, check recession, check mobility. Do all of the things that we ordinarily do, but take it a step further. How would you restore the case?  And then come up with the sequence of treatment that you would exercise in order to be able to accomplish completion of the case. Let’s look at full diagnosis and treatment planning as the key element of independent practice and see what more you can do to get close to that goal of full treatment planning.


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