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Dental Graduates Choosing Locations to Practice
O tto fy — Choosing Locations to Practice
In the days of old men were crucified for daring to stand apart— for daring to point the road to traveling homo. Moses never saw the promised land ; Christ was crucified; Pythagoras was hounded out of home and country; Ga lileo was jailed; Copernicus was in dis grace ; Harvey was ridiculed; and some great electrophysicists of today were thor oughly ridiculed ten or fifteen years ago. It is fortunate for some of us that the methods of old in fighting innovations have changed and that we can keep on at our task with just incurring displeas ure of our opposition, sometimes ex pressed in meaningless rhetorical exhor
913
tations to the profession to stand by the old order, and often in calumny and slander; but as I have said in the be ginning, opposition is a spur to careful conscientious effort, and I am thankful for it. I want you to know that if there is any credit due to any one for this labor, that credit belongs to you. Your need has been my inspiration, your woe my weal. I bring you this message today in all modesty, in all gratitude, in all faithful ness. M y reward comes with my serv ice to you, if serve I may.
DENTAL GRADUATES CHOOSING LOCATIONS TO PRACTICE By LOUIS OTTOFY, D.D.S., M.D., LL.D., F.A.C.D., Oakland, Calif.
N a short time, more than 2,700 young men and women who are graduating from the forty-two dental schools of the United States will be seeking favor able “ locations” to enter on the practice of their profession. T o them the accom panying' table will prove of interest.
I
NUM BER
OF DENTISTS
IN
PROPORTION
TO PO PU LATION
State C a lifo r n ia O r e g o n ............. D istrict o f C olu m bia . . . . M assachusetts . . W a sh in g to n . . . .. W is co n sin Illin o is ........... . .
N um ber o f N um ber P ersons of to E ach P opu lation D entists D entist 4,556,000 902,000
4,679 914
974 987
552,000 4,290,000 1,587,000 2,953,000 7,396,000
539 3,452 1,295 2,355 5,557
1,025 1,185 1,225 1,254 1,350
Jour. A . D . A ., M a y, 1929
M i n n e s o t a ........... 2,722,000 N e v a d a ................ 77,407* N ebrask a ........... 1,408,000 2,428,000 C o lo r a d o ............. 1,090,000 M issou ri .............. 3,523,000 U tah ..................... 531,000 N e w Y o r k ......... 11,550,000 I n d i a n a ................ 3,176,000 K a n sa s ................ 1,835,000 N e w Jersey .3,821,000 N e w H a m p sh ire 456,000 P en n sy lv a n ia . . . 9,854,000 M a in e .................. 795,000 M ich ig a n ........... 4,591,000 R h o d e I s l a n d . .. 716,000 F lo rid a ................ 1,411,000 6,820,000 546,000 C o n n e c t ic u t ......... 1,667,000 M a r y l a n d ........... 1,616,000 W y o m in g ........... 247,000 South D a k o t a ... . 704,000 V erm on t .............. 352,428*
1,972 56 996 1,717 752 2,419 339 7,329 1,992 1,065 2,213 262 5,644 450 2,540 393 740 3,538 282 848 802 122 347 172
1,380 1,382 1,404 1,414 1,450 1,456 1,566 1,576 1,594 1,723 1,726 1,740 1,748 1,767 1,808 1,822 1,917 1,929 1,936 1,966 2,015 2,025 2,029 2,105
914 N orth D a k o t a . . . M on ta n a ............. L ou isia n a ........... W e s t V i r g i n i a ... D e la w a re ........... T en n essee ......... O k lah om a ........... K e n tu ck y .............. T e x a s .................. V irg in ia .............. N orth ' C a r o lin a .. G e o r g i a ............... A r i z o n a ............... N ew M e x ic o South C a r o lin a .. A la b a m a ............. A rk an sas ........... M ississip p i .........
The Journal o f the American D en tal Association 641,m i 714,000t 1,950,000 1,724,000 244,000 2,502,000 2,426,000 2,553,000 5,487,000 2,575,000 2,938,000 3,203,000 474,000 396,000 1,864,000 2,573,000 1,944,000 1,790,618*
297 315 842 687 92 867 812 816 1,694 768 864 871 127 100 455 616 444 333
2,159 2,267 2,316 2,509 2,652 2,883 2,986 3,130 3,239 3,353 3,400 3,677 3,732 3,960 4,097 4,177 4,378 5,377
* 1920. f 1925. 1 1927.
The population given is the estimate of the United States Census Bureau as of July 1, 1928, except for Nevada, Ver mont, Mississippi, North Dakota and Montana. For these, no estimates were made. The figures are for 1920. The population of North Dakota is based on a state census of 1925, and that of M on tana on a similar census for 1927. The number of dentists is as given in Polk’s Dental Register, which was com piled last summer and fall. It contains the names of only a few of the 2,700 who graduated in 1928, the majority of whom at the time of the compilation had not established themselves or failed to report, or whose whereabouts after leaving col lege could not be ascertained. Hence, most of those 2,700 are distributed through the various states. The statistics relating to the number of dentists in each state is as nearly accurate as it is humanly possible for the publishers to make it. They spared no time or money to secure accurate data. I had personal experience in editing the last two editions of the Dental Register, and was afforded ample opportunity to learn something of the
trials and tribulations attending- an en deavor to secure accurate lists of dentists. In many of the states not even the board of dental examiners was able to furnish the information. Even during the time the Register went through the press, in so large a list containing the names of 67,000 dentists, many changes occurred ow ing to deaths, removals and other causes. Furthermore, such changes are taking place daily, and it is therefore impossi ble to make a list of dentists (or, for that matter, of any other professional or in dustrial group) which does not constantly change. However, for all practical pur poses, the figures are sufficiently accurate. A t first glance, it would seem that California is the least, and Mississippi the most desirable state in which to locate. As far as California is concerned, this is undoubtedly true; but this does not hold good for the many states in which there is but one dentist to more than 2,000 of the population. In fact, there are many other considerations than the proportion of den tists to the population which are impor tant governing factors in choosing a location. In California, which stands at the head of the list with one dentist to every 974 of its population, the situation is even more unfavorable than it appears. M ore than 200 dentists have established themselves in the state since last year. The foreign and alien population of the state should also be taken into considera tion. W ithout disrespect to any race, it may be stated that Indians, Japanese, Chinese and Mexicans may not be esti mated as an appreciable entity in the prospective clientele of the dentist. In a measure, this is also true of Europeans who become residents of this country, but who, by reason of their economic or educational status, do not constitute re munerative clients for the progressive ethical dentist. If these two elements
O tto fy — Choosing Locations to Practice
are subtracted from the total population, California has about 3,800,000 as a pros pective dental clientele, many of whom are living on ranches distant from the centers of population. The number of dentists having increased by about 200, the total in the state becomes 4,879, and the proportion of the dentists to the de sirable population becomes one to 779. There are two metropolitan districts in the state: Los Angeles and her environs, and San Francisco with the bay cities. In these, the combined population num bers 2,077,407, and the dentists 3,364, or one dentist to every 619 of the people, inclusive of Chinese, Japanese and M ex icans. The overcrowded fully apparent. I am observations without I am a resident of the shall never again be dental practice.
condition is pain able to make these bias, for although state, I am not and engaged in active
On the other hand, Mississippi ap pears to be the state least crowded with dentists. But the state contains nearly 1,000,000 Negroes. In fact, the Negro population should be considered in rela tion to all the southern states beginning with Louisiana in the foregoing table. In addition, Texas, Arizona and New Mexico have a large number of Mexicans of the unskilled laboring class. A study and analysis of the number of dentists in various cities, towns and vil lages of the country also shows remark able discrepancies between population and number of dentists. For instance, there are cities with a population of 8,000 and only two dentists, and again towns with a population of 3,000 with as many as eight dentists. This state of affairs is no doubt governed by local con ditions, such as proximity to other cities, the social condition of the people and
915
their economic and educational status, and the like. In justice to the approximately 2,700 dentists who have been graduated an nually since 1925, it seems to me that there should be a survey of the actual conditions prevailing among dentists, covering the following points: 1. Has the campaign of dental educa tion, which the dental profession fosters by means of the radio, the press and other agencies, increased the number of people who become substantial clients of the dentist ? 2. Is the necessity for complicated, and therefore remunerative, dentistry diminished on account of the increasing dental care given to children of pre school and school age; and if so, to what extent ? 3. Is less dental service required on the part of the people who have regu larly patronized the dentist, on account of the present day average excellence of dental operations? 4. Does the increase in the use of arti ficial dentures (which last a long time, if well made and properly adjusted) de crease the number who continue to re quire the services of the dentist? These observations are made because I note the constantly increasing attention given by dental societies to the economic problems of the dental practitioner; the frugal and businesslike conduct of the office; the exacting of adequate fees; the collection of outstanding accounts, and the method taught and recommended for increasing “ business.” It may be worth while to consider whether a saturation point has been reached, and whether those entering the field at the present time are justified in looking forward to that adequate prom ise of economic success to which they are entitled by reason of the expense in time
916
T he Journal o f the American D en tal Association
and money involved and the importance and maintenance of the high standing of the profession to which it is entitled. Finally, the only recommendation that can be made to those who are about to enter our ranks, is this: Choose a loca
tion where the people are intelligent, where the standard of education is high and where the economic conditions are sound and the people content, happy and prosperous. 175 V ernon T e rra ce .
In the days of old men were crucified for daring to stand apart— for daring to point the road to traveling homo. Moses never saw the promised land ; Christ was crucified; Pythagoras was hounded out of home and country; Ga lileo was jailed; Copernicus was in dis grace ; Harvey was ridiculed; and some great electrophysicists of today were thor oughly ridiculed ten or fifteen years ago. It is fortunate for some of us that the methods of old in fighting innovations have changed and that we can keep on at our task with just incurring displeas ure of our opposition, sometimes ex pressed in meaningless rhetorical exhor
913
tations to the profession to stand by the old order, and often in calumny and slander; but as I have said in the be ginning, opposition is a spur to careful conscientious effort, and I am thankful for it. I want you to know that if there is any credit due to any one for this labor, that credit belongs to you. Your need has been my inspiration, your woe my weal. I bring you this message today in all modesty, in all gratitude, in all faithful ness. M y reward comes with my serv ice to you, if serve I may.
DENTAL GRADUATES CHOOSING LOCATIONS TO PRACTICE By LOUIS OTTOFY, D.D.S., M.D., LL.D., F.A.C.D., Oakland, Calif.
N a short time, more than 2,700 young men and women who are graduating from the forty-two dental schools of the United States will be seeking favor able “ locations” to enter on the practice of their profession. T o them the accom panying' table will prove of interest.
I
NUM BER
OF DENTISTS
IN
PROPORTION
TO PO PU LATION
State C a lifo r n ia O r e g o n ............. D istrict o f C olu m bia . . . . M assachusetts . . W a sh in g to n . . . .. W is co n sin Illin o is ........... . .
N um ber o f N um ber P ersons of to E ach P opu lation D entists D entist 4,556,000 902,000
4,679 914
974 987
552,000 4,290,000 1,587,000 2,953,000 7,396,000
539 3,452 1,295 2,355 5,557
1,025 1,185 1,225 1,254 1,350
Jour. A . D . A ., M a y, 1929
M i n n e s o t a ........... 2,722,000 N e v a d a ................ 77,407* N ebrask a ........... 1,408,000 2,428,000 C o lo r a d o ............. 1,090,000 M issou ri .............. 3,523,000 U tah ..................... 531,000 N e w Y o r k ......... 11,550,000 I n d i a n a ................ 3,176,000 K a n sa s ................ 1,835,000 N e w Jersey .3,821,000 N e w H a m p sh ire 456,000 P en n sy lv a n ia . . . 9,854,000 M a in e .................. 795,000 M ich ig a n ........... 4,591,000 R h o d e I s l a n d . .. 716,000 F lo rid a ................ 1,411,000 6,820,000 546,000 C o n n e c t ic u t ......... 1,667,000 M a r y l a n d ........... 1,616,000 W y o m in g ........... 247,000 South D a k o t a ... . 704,000 V erm on t .............. 352,428*
1,972 56 996 1,717 752 2,419 339 7,329 1,992 1,065 2,213 262 5,644 450 2,540 393 740 3,538 282 848 802 122 347 172
1,380 1,382 1,404 1,414 1,450 1,456 1,566 1,576 1,594 1,723 1,726 1,740 1,748 1,767 1,808 1,822 1,917 1,929 1,936 1,966 2,015 2,025 2,029 2,105
914 N orth D a k o t a . . . M on ta n a ............. L ou isia n a ........... W e s t V i r g i n i a ... D e la w a re ........... T en n essee ......... O k lah om a ........... K e n tu ck y .............. T e x a s .................. V irg in ia .............. N orth ' C a r o lin a .. G e o r g i a ............... A r i z o n a ............... N ew M e x ic o South C a r o lin a .. A la b a m a ............. A rk an sas ........... M ississip p i .........
The Journal o f the American D en tal Association 641,m i 714,000t 1,950,000 1,724,000 244,000 2,502,000 2,426,000 2,553,000 5,487,000 2,575,000 2,938,000 3,203,000 474,000 396,000 1,864,000 2,573,000 1,944,000 1,790,618*
297 315 842 687 92 867 812 816 1,694 768 864 871 127 100 455 616 444 333
2,159 2,267 2,316 2,509 2,652 2,883 2,986 3,130 3,239 3,353 3,400 3,677 3,732 3,960 4,097 4,177 4,378 5,377
* 1920. f 1925. 1 1927.
The population given is the estimate of the United States Census Bureau as of July 1, 1928, except for Nevada, Ver mont, Mississippi, North Dakota and Montana. For these, no estimates were made. The figures are for 1920. The population of North Dakota is based on a state census of 1925, and that of M on tana on a similar census for 1927. The number of dentists is as given in Polk’s Dental Register, which was com piled last summer and fall. It contains the names of only a few of the 2,700 who graduated in 1928, the majority of whom at the time of the compilation had not established themselves or failed to report, or whose whereabouts after leaving col lege could not be ascertained. Hence, most of those 2,700 are distributed through the various states. The statistics relating to the number of dentists in each state is as nearly accurate as it is humanly possible for the publishers to make it. They spared no time or money to secure accurate data. I had personal experience in editing the last two editions of the Dental Register, and was afforded ample opportunity to learn something of the
trials and tribulations attending- an en deavor to secure accurate lists of dentists. In many of the states not even the board of dental examiners was able to furnish the information. Even during the time the Register went through the press, in so large a list containing the names of 67,000 dentists, many changes occurred ow ing to deaths, removals and other causes. Furthermore, such changes are taking place daily, and it is therefore impossi ble to make a list of dentists (or, for that matter, of any other professional or in dustrial group) which does not constantly change. However, for all practical pur poses, the figures are sufficiently accurate. A t first glance, it would seem that California is the least, and Mississippi the most desirable state in which to locate. As far as California is concerned, this is undoubtedly true; but this does not hold good for the many states in which there is but one dentist to more than 2,000 of the population. In fact, there are many other considerations than the proportion of den tists to the population which are impor tant governing factors in choosing a location. In California, which stands at the head of the list with one dentist to every 974 of its population, the situation is even more unfavorable than it appears. M ore than 200 dentists have established themselves in the state since last year. The foreign and alien population of the state should also be taken into considera tion. W ithout disrespect to any race, it may be stated that Indians, Japanese, Chinese and Mexicans may not be esti mated as an appreciable entity in the prospective clientele of the dentist. In a measure, this is also true of Europeans who become residents of this country, but who, by reason of their economic or educational status, do not constitute re munerative clients for the progressive ethical dentist. If these two elements
O tto fy — Choosing Locations to Practice
are subtracted from the total population, California has about 3,800,000 as a pros pective dental clientele, many of whom are living on ranches distant from the centers of population. The number of dentists having increased by about 200, the total in the state becomes 4,879, and the proportion of the dentists to the de sirable population becomes one to 779. There are two metropolitan districts in the state: Los Angeles and her environs, and San Francisco with the bay cities. In these, the combined population num bers 2,077,407, and the dentists 3,364, or one dentist to every 619 of the people, inclusive of Chinese, Japanese and M ex icans. The overcrowded fully apparent. I am observations without I am a resident of the shall never again be dental practice.
condition is pain able to make these bias, for although state, I am not and engaged in active
On the other hand, Mississippi ap pears to be the state least crowded with dentists. But the state contains nearly 1,000,000 Negroes. In fact, the Negro population should be considered in rela tion to all the southern states beginning with Louisiana in the foregoing table. In addition, Texas, Arizona and New Mexico have a large number of Mexicans of the unskilled laboring class. A study and analysis of the number of dentists in various cities, towns and vil lages of the country also shows remark able discrepancies between population and number of dentists. For instance, there are cities with a population of 8,000 and only two dentists, and again towns with a population of 3,000 with as many as eight dentists. This state of affairs is no doubt governed by local con ditions, such as proximity to other cities, the social condition of the people and
915
their economic and educational status, and the like. In justice to the approximately 2,700 dentists who have been graduated an nually since 1925, it seems to me that there should be a survey of the actual conditions prevailing among dentists, covering the following points: 1. Has the campaign of dental educa tion, which the dental profession fosters by means of the radio, the press and other agencies, increased the number of people who become substantial clients of the dentist ? 2. Is the necessity for complicated, and therefore remunerative, dentistry diminished on account of the increasing dental care given to children of pre school and school age; and if so, to what extent ? 3. Is less dental service required on the part of the people who have regu larly patronized the dentist, on account of the present day average excellence of dental operations? 4. Does the increase in the use of arti ficial dentures (which last a long time, if well made and properly adjusted) de crease the number who continue to re quire the services of the dentist? These observations are made because I note the constantly increasing attention given by dental societies to the economic problems of the dental practitioner; the frugal and businesslike conduct of the office; the exacting of adequate fees; the collection of outstanding accounts, and the method taught and recommended for increasing “ business.” It may be worth while to consider whether a saturation point has been reached, and whether those entering the field at the present time are justified in looking forward to that adequate prom ise of economic success to which they are entitled by reason of the expense in time
916
T he Journal o f the American D en tal Association
and money involved and the importance and maintenance of the high standing of the profession to which it is entitled. Finally, the only recommendation that can be made to those who are about to enter our ranks, is this: Choose a loca
tion where the people are intelligent, where the standard of education is high and where the economic conditions are sound and the people content, happy and prosperous. 175 V ernon T e rra ce .