In orthodontics, we have to make many decisions and find solutions in several aspects of our daily work. When we look at many facets of business and clinical work, we can consider decisions as upstream or downstream. Upstream solutions, being near the river’s source, impacts a greater part of our practice and systems. Meanwhile, downstream solutions are closer to the mouth of the river. In other words, closer to the end-user and more individualized based on specific circumstances.
Often when we effectively plan upstream solutions, we can optimize downstream execution. Many orthodontic teams focus on the daily work (downstream) operating in the business, forgetting the benefits of upstream planning that allow us to work on the business.
Upstream Planning
Upstream planning is looking at long-term solutions. When we are upstream, we are focused on the root of these solutions. Often this is work and strategy near the source of what we do and why we do it. For example, we could focus on the mission and principles behind our work. An orthodontic practice needs guiding principles on how we make decisions upstream of our day-to-day choices. Thus, at the core of our plans are these principles that we share across our team.
Upstream plans can also come from systems and protocols that guide our techniques. Developing a playbook and training systems works upstream of what we do each day. Planning these recipes for success impacts the long-term as they affect our teams performing tasks and the standards of care we wish to uphold.
Downstream Execution
Downstream solutions are more focused on execution and short-term plans. These are the tactics we can use day-to-day. When we customize a treatment plan for an individual patient, we deliver a final product to our patients that will allow us to create their appliances and implement the treatment regimen. Downstream execution in an orthodontic practice can include a new patient presentation, bonding appliances, developing a ClinCheck, patient instruction, finishing and detailing treatment, etc. All of this daily work we source out of training and plans developed over time. Downstream execution is near the end-user.
