PRESIDENT'S ADDRESS AND ADMINISTRATIVE MATIERS
REPORT OF THE PRESIDENT
In this brief time I have with you I believe I have three responsibilities. The first is to publicly acknowledge those individuals and groups that have been supportive of me, this Association, and our profession this year. Secondly, I believe I have a responsibility to report to the House of Delegates on those issues you deemed important last year and how the Officers, Board of Trustees, Councils and Commissions responded. Finally, if you will indulge me, I would like to leave you with some personal thoughts and observations about several issues that I feel are important and will continue to be of a major concern to this Association and our profession as we enter the next century.
If I might I would like to do the Thank You's first.
Will each member of the ADA staff in the room please stand up (John, Carol, Jim, Barbara, Pat, senior management). And will those people who are not members of the ADA staff please find a seat. I want you to be able to clearly identify those members of the ADA staff that are in the room. I would like you to know something about our staff. The ADA and its subsidiaries employs 415 individuals, and 30 work in Washington, D.C. They are an exceptional group of people. Sixteen have been with the American Dental Association more than 25 years. Seventy one have been with the American Dental Association more than 15 years and 124 have been with the American Dental Association between 5 and 15 years. They are microbiologists, they are mailroom personnel, they are human resource specialists, toxicologists, they are dental
educators, staff assistants, security personnel, librarians and lobbyists, administrators and even a few dentists. They work tirelessly on our behalf. This year there were 48 weekend meetings held in the American Dental Association Building and they were all supported and staffed by
members of our staff. They are diligent, hard working, bright, well educated, pleasant, well trained, doggedly persistent, fiercely loyal and they will tell you, in a very nice way, when they think you're wrong. They are the substructure and the glue that on a daily basis hold the
American Dental Association together. I have gotten to know a great many of them and they are my friends-Please join me in thanking them for all the hard work and support they have given this Association and our profession this year.
Thank you to the Board of Trustees.
The third group of people I would like to publicly acknowledge is the members of the Ninth Trustee District, from the Wisconsin and Michigan Dental Associations. I have had an
opportunity to spend some time with you this morning and as I told you, I would not be standing here today without your friendship, your hard work and your support. For that I am eternally grateful. Thank you.
The fourth group is my partners, Todd and George, and the staff at Valley Periodontics. Todd, George, years ago when we talked about getting involved, I don't think any ofus had any
support I would not be standing here today. Thank you. To the staff at Valley Periodontics, what can I say? Thank you for changing appointments on short notice and explaining to patients why those changes were necessary. For working extra hours, for missing lunches, for doing all that rush typing and in general for making your schedule work with my schedule. I know it's been a strain and sometimes an aggravation, but Thank you. I know you can hardly wait, but I am coming back to practice, chiefly because Todd and George have told me I will be on call for the next year straight. Seriously, thank you all.
The last group, my wife, Ginny and our children, Kathy, Howard, Tom and Jim. I apologize for the occasions that I have missed, the soccer games, the swim meets, the pre-prom picture parties and I am sure there were many others. Your mother and I want you to know that along with Christina and TJ, you are the light of our lives and we are truly proud of whom you are, what you've become and what you have accomplished. And finally Ginny. We have shared the last 36 years, I truly thank you for your help, your support, your love, your counsel, and your sacrifice. I apologize for all those cold dinners, those trips to Milwaukee and Chicago, and Saturday
afternoons in airports. You have been a trooper, a supporter, my best friend and my love and for that I thank you.
My second responsibility is to report to you about those issues and resolutions that you passed on to the Officers, the Board of Trustees, the Councils and Commission of this Association. I want you to know that we made- an effort to try and deal with eae-h-of the-issues. A -great many of those projects have been completed and they appear in the agenda book of the House of Delegates. Some of them are still works in progress and you will get an updated report during the course of this meeting. In my mind they dealt chiefly in four areas: those issues that dealt with dental education and licensure, those issues that dealt with dental science and research, those issues that dealt with dental practice and those issues that dealt with the internal structure and management of the American Dental Association. It is not my intention to take you through each one of those issues, however I would like to comment on several. The first is Resolution 100-1998. As you remember, that was the compromised resolution on the public awareness campaign. The public awareness activities are a work in progress. You will see the final report next year, but I hope we can agree that our profession needs to expand and increase availability to talk to the public, our patients, on a regular basis about those issues that effect their oral and general health. Whether this is done and paid for at the local, state or national level is not important. However, I do believe the ADA needs to be the central clearinghouse for all of this activity and information. It makes no sense to have a message on a piece of video tape that was successfully used in
California, Oklahoma or Wisconsin sit in someone's closet when it might be shared and used by some other constituency in our profession. The ADA needs to coordinate all of the public awareness activities. It is simply a fact that as a learned profession we have a responsibility to communicate with the public about their oral health. We need to consolidate the process, focus the messages and expand our effort to reach every American.
This year we had several important meetings at the American Dental Association. The biannual licensure conference was a continuation of a process that was begun three years ago. I want you to know I believe we are making progress; all 50 states now accept Part 2 of the National Board.
PRESIDENT'S ADDRESS AND ADMINISTRATIVE MATTERS
Eight states will now accept a successful candidate from any one of the Regional Boards for licensure. We have established common criteria for calibrating examiners, we have started to define a common core examination, and we have begun to look at a common scoring system. These are works in progress. The ADA must continue to impact the examination process. Progress is being made, but very slowly. If, however, changes are truly to be made in the licensing portion of the process, those changes will have to be made at the state level. State dental associations will have to take the lead and create a relationship and a dialogue with their state dental boards. I encourage you to do so. The development of a fair, equitable, and safe system that will allow professional mobility in our changing society continues to be one of the highest priorities of our membership. It is simply a problem we must resolve if this association is to truly represent all of the members of our profession.
This year we also had several meetings at the ADA focused on the question of diversity within our profession. At the Special Forum on Membership Diversity, we asked representatives from all those groups within our profession who represent ethnic, racial and gender minorities their thoughts about what the ADA might do to speak to the diversity issue. It was an excellent meeting and from that meeting came a document that identifies those issues that the American Dental Association and the participating groups will try to impact promoting diversity within our profession. The Board of Trustees has accepted that document as a statement on the part of the American Dental Association about our belief in the importance of diversity in our profession. It too is one of those basic issues and opportunities. that we must seize on and accomplish if our Association is to prosper.
Our for-profit subsidiaries had a great year. ADAPCO, our publishing company, continued to publish a first rate journal-JADA. The ADA News continues to be the most read publication in the dental profession. The ADA Electronic Commerce Company (ECCo) has come of age. The number of members who use ECCo to electronically transmit insurance claims continues to grow on a monthly basis, more state dental associations continue to endorse the process, and with the launch of the ADA Market Place, through the ADA Web page, we have truly moved into the world of electronic commerce.
And finally, the ADA Financial Services Corporation (FINCO). As you know, we have changed our affinity partner from Mellon Bank to Citi Group. This will truly allow us to expand the financial services that will be available to members. Citibank is the largest issuer of credit cards in the world and they have a full range of unparalleled financial products. Beyond that, the sale and change allowed the American Dental Association to generate a very lucrative financial result that we have been able to use not only to support FINCO, but to directly support the American Dental Association and the ADA Holding Company. As an aside to that, the Board of Directors of ADA FINCO also contributed $750,000 to the ADA Health Foundation to establish a fund to support dental education in the future. I believe our support of dental education through this fund is one of the most significant things that we accomplished this year.
Finally, the ADA just published CDT3. This version is the year 2000 update on the ADA coding system. That coding system has become more than just an insurance coding system. It is now the
backbone of all dental practice management software systems we use on a daily basis in our offices. It is important that the American Dental Association continue to directly control and update that code on a very regular basis. At the time the new CDT3 procedure code was
published we also debuted the first portion of the SNODENT Diagnostic Code. The remainder of the SNODENT Codes will be deployed to the profession during the course of next year. We will be instituting a major educational process to insure that our members correctly use the
SNODENT Code. We will rely heavily on the state dental associations, the specialty
organizations, and the practice management software vendors to help us educate all American Dental Association members on the use of the SNODENT Coding System. We have also made dramatic strides within the ADA to build a computer system to compile and manage the data that this new coding system will provide. This data is the gold in the process. It is the very foundation of our future profession. This data can be used by the Association to represent the membership with insurance carriers, regulatory agencies, legislative bodies and the American public. In many ways that have not been possible in the past.
The third area I would like to talk with you about is the future of our profession and this Association. You have before you at this meeting a proposal to update the Future of Dentistry report. As you know, it was last done in 1984 and it is long past time this Association update that report. In the last several years a constant stream of reports have made suggestions about the current state of the dental profession and what should be done to change it. The IOM report spoke to the issue affecting our educational system and how .dental care should be delivered in the future. The 2010 report and the upcoming Surgeon General's report have and will outline the current overall health status of the American pubic and establish goals and suggested changes for the future. The Pew Commission raised questions about our licensure process and the ongoing competencies of practicing health care professionals- a second Pew Commission report also raised questions about the accreditation process used to validate our educational system. The Macy Study, which was released this summer, speaks to the issues about how and where we will train the dentists of the future. The dental profession has responded to the reports. I would suggest to you rather than respond we need to go on the offensive. I believe the Future of Dentistry report will allow us to do that. Further, it will allow us to clearly define our perception of the future of our profession. It should look at the forces and issues that will shape our
profession. It should establish priorities, define directions and clearly establish acceptable endpoints and expected results. The organizing committee has done an excellent job. The resolution before you clearly defines the report format and organization, the structure and function of the oversight committee and how technology will be used to enhance the process. It spells out the cost, which I would add is significantly less than some of the other reports that I have previously cited. It would be a bargain at twice the cost. But cost is not the issue, the future direction of our profession is. I am convinced that this is the single most important activity this Association should undertake. We must begin now to look at and define the future of our profession and this Association.
I would like to spend a moment with you and talk about several concerns I have with the governance structure of our Association. I am concerned about the ongoing inter-relationships within the tripartite. The very strength of this Association is the tripartite. We are the only health
PRESIDENT'S ADDRESS AND ADMINISTRATIVE MATTERS
care association with that type of structure and we are blessed and we must protect it. However, as the association environment continues to change and there is increased pressure on raising non-dues generated income, I believe the pressures of the tripartite will increase. I would suggest that before the pressures on the system become acute, representatives of all three levels of the tripartite sit down and have a frank discussion about the issues that are and might affect the tripartite relationship both now and in the future. This type of discussion, and an ongoing dialogue, will open a new level of communication and create, protect and enhance this most important part of our Association governance structure. It is a process we must start now. I am also concerned about the governance structure within the ADA. It simply does not work as well as it should. The reason for this is not people. I don't think we can ask much more from the volunteers and the staff. The problem we have is a structural issue. Our current system was developed and instituted years ago in a different time and in a different environment. It simply does not meet the needs of the ADA today. It is not as responsive as it should be and on many issues it makes the Association play defense. It needs to be changed. Please understand I am not suggesting that we diminish member input. Rather I am suggesting that we redesign the system to be more effective and to more efficiently use that member input to speak to those issues important to all members. The time is right. The Future of Dentistry report will help define the future direction of our profession and this Association. We should begin now to evaluate and develop a governance structure that will allow this Association to speak in an appropriate way to those issues in the Future of Dentistry report and to lead our profession into the next century. And finally I would like to raise one other governance issue that has bothered me for the last several years. That is the issue of trust! Or more directly the lack of trust. The lack of trust of the members we elect to represent us and make decisions for us, a lack of trust of the system, a lack of trust within the tripartite, a lack of trust in our staff, and in some cases a lack of trust in the very words that appear in reports we receive. I would submit to you that everyone in this room today, be they members or staff, are here for only two reasons: To do what is right for the public we treat; and to improve and advance our profession and this Association. I would suggest that a significant part of the problem might directly be related to you and me. As dentists we are very hands on people. We thrive on details and we spend an immense amount of our time managing those details in our practice. This same process clearly does not work as well in the larger association world. We simply spend too much time shuffiing paperclips when we should be planning our profession's future goals while continuing to evaluate the results of our
Association's activities.
We need to do a much better job of focusing on the big issues and evaluating the results of our activities. This will require a cultural change in our Association. It will not be easy to change our culture. We will have to leave our baggage at the door, put some faith in our people and a new . governance system and understand that our first priority is to lead this profession into the future. The Future of Dentistry report will establish the direction and a change in the governance structure will establish the process.
American Dental Association of the future. If this Association is to remain successful and to continue to represent the majority of the dental profession I believe we must offer an expanding array of value added services. Business as usual is not enough. The competition to supply services and products to the dental profession has become intensely competitive. There are two major forces that will impact that process and affect our profession and this Association. They are: economic changes in the practice of dentistry and the ongoing advancements in electronic technology and electronic commerce.
We all understand many of the economic forces that currently effect dentistry: the cost of dental education, dental student debt, the cost of going into practice, ongoing overhead, the economics of various practice styles, reimbursement issues. The list is endless and it will constantly change. Some of these issues we can substantially effect and some we cannot.
However, the genesis of all of these economic issues is the cost of dental education. As I indicated earlier, we. began to speak of this issue when we initiated the new fund to support dental education at the ADA Health Foundation. It is ironic that we talk about this issue in Hawaii: because it was exactly ten years ago, here in Hawaii that Dr. Art Dugoni, the then President of the ADA first raised the issue and concern about our educational system. It was his suggestion that we begin a trust fund to support dental education. It has taken us ten years to begin. The step we have taken with the ADA trust fund is but a small first step. The profession and the American Dental Association must commit to the ongoing regular financial support of this fund. I believe on an annual basis we should commit a percentage of our for-profit income to this process. I would also suggest to all of the state dental associations that they too take some of their for-profit income and create a similar fund to support dental education in their state. It is only with a major effort at all levels of our profession that we can expect to impact this very serious problem. I believe ifwe can find some answers to the economic problems that affect the dental education system, many of the other economic problems facing our profession will become less important.
These same economic issues and our response will largely dictate many of the services we offer our members in the future. I would submit to you that lower credit card rates, better insurance premiums and better home mortgage rates are a thing of the past. As enticements for
nonmembers to join organized dentistry, they are no longer a priority issue. The competition for our business is intense and as consumers we are a coveted group. We will, as an Association, have an increasingly difficult time maintaining our competitive edge in these areas. So where should we focus? I believe that the American Dental Association must become the center for electronic commerce for our profession. Several weeks ago a new term entered our vocabulary E-Life. Newsweek magazine said and I quote, "That we stand at the dawn ofE-Life, there is no turning back, once a novelty, the Internet is now transforming how American's live, think, talk and love; how we go to school, make money, see the doctor, and elect Presidents." This isn't just about the future, it's about the here and now. Fortunately because of some strategic decisions made several years ago, we have begun that process. Our electronic commerce company ECCo and the development of a very active and well done web page using the Internet are the
PRESIDENT'S ADDRESS AND ADMINISTRATIVE MATIERS
clearly provide a major opportunity for the American Dental Association. The development of a new series of products that provide new and unique opportunities for dentists must be one of the highest priorities ofthis Association. We often talk about the virtual dental practice, the
transmission of dental insurance information, the digitalization of images and x-rays and the computerization of the dental record; these and other applications are here and now today.
What does the future hold? Let's took for a moment at one example: Dental education- and the
application of electronic distance learning that would allow a series of courses to be transmitted over the Internet directly into your office. Those courses could, and should, originate at the American Dental Association. Our editor, Dr. Larry Meskin, has suggested that the ADA should develop the concept and a program that would allow for the creation of specific interest sections within the American Dental Association. Each section would focus on a specific area of interest: implantology, oral medicine, cosmetic dentistry, geriatric dentistry and you as a member could join as many of those sections as you wanted. Each of those sections would have its own
leadership and its own agenda. Courses within that specific section would be given real time over the Internet, and you as an end user could access those courses anytime that was most convenient for you. Members of a particular section could communicate through a chat room and questions could be asked and answers given by other members of the section through the Internet. As the process evolves, credit and recognition could be given to those who participated in this process and maybe sometime in the future this process, through the American Dental Association, could evolve into the virtual university for advanced dental education. A pipe dream-maybe, but this type of educational process is now going on through the Western Governors University-an online education experience with no course structure, but rather a set of competencies, which each student can individually master and for which recognition is ultimately awarded. Does this sound like life-long learning to you? I would suggest that it might be a way for the American Dental Association to develop a process that begins to speak to those professional competency issues that are now being focused on our profession. This process would allow the ADA to provide value added service. That could be used to recruit and retain new and existing members to this Association. I believe that the dental portion of our new E-Life should be developed and focused through the ADA.
In closing let me say thank you. It has been a magnificent time. We truly have enjoyed it. During our travels people often ask why do you get involved in this type of process. We would tell you there is only one reason: it is because of the great people you get to meet in the job. Ginny and I want to thank you for your support, your hospitality, and your friendship. It has truly been one of the high points of our professional lives and for that we thank you. I know you will give your unqualified support to Dr. Richard Mascola as he leads our profession into the next millennium. I wish you the best of Godspeed. Thank you.
