{"id":2613,"date":"2023-03-20T12:00:03","date_gmt":"2023-03-20T11:00:03","guid":{"rendered":"https:\/\/leanorthodontics.com\/?p=2613"},"modified":"2023-03-04T00:37:41","modified_gmt":"2023-03-03T23:37:41","slug":"stop-pushing-the-camel-through-the-eye-of-the-needle-the-pull-principle","status":"publish","type":"post","link":"https:\/\/leanorthodontics.com\/en\/blog\/stop-pushing-the-camel-through-the-eye-of-the-needle-the-pull-principle\/","title":{"rendered":"Stop pushing the camel through the eye of the needle: the pull principle"},"content":{"rendered":"

The pull principle is one of the core concepts of lean management whereby the flow of work is controlled by only replacing and replenishing what has been consumed. To better visualize a pull system, take a simplified example from orthodontics. Let\u2019s assume that you start 200 new treatments each year and one treatment lasts three years. This means that in the first year, you see 200 patients, 400 in the second year, 600 in the third. From the third year onwards you complete 200 treatments every year, but you also start 200 new treatments again.<\/p>\n

In other words, you have an even flow of 600 patients per year. For each patient you see off, you create a vacuum, a \u201cpull\u201d which can be filled with a new patient. Now you see every patient every 4 weeks for control with 600 checkups per month (150 per week). Substituting recalls and repairs would mean 200 appointments per week. You may need one day for administration, then you have four days with 50 appointments each lasting 15 minutes on average.<\/p>\n

Scenario 1:<\/h2>\n

Say you\u2019re working with an assistant on a treatment chair. If you\u2019re taking 50 appointments per day each 15 minutes long, you are working an average of 750 minutes (12.5 hours) per day nonstop.<\/p>\n