ADA Public Education Program: Reviewing 1975 and anticipating 1976

A D A P u b lic E d u c a tio n P r o g r a m : R e v ie w in g 1 9 7 5 a n d a n t ic ip a t in g 1 9 7 6

Public relations is som ew hat like detente.

The

T he majority support it in principle, debate

counsel, the Board of Trustees, and an

however, a num ber of larger contracts

specifics, and have divergent expecta­ tions about w hat it should accomplish.

advisory com m ittee of private practicing

loomed on the horizon.

dentists appointed by ADA president L.

Forem ost— both in num ber of bene­

Likewise with PEP, the American Dental

M. Kennedy were all com bined. By Sep­

ficiaries and trend-setting impact— was

A ssociation’s Public Education Program

tem ber

com mittee

the autom otive industry plan that provid­

which began in January. The ADA Board

had met four times to review the pro­

ed coverage for 2.8 million people begin­

of Trustees, which had authorized funds

gram 's progress and future. W hile the program includes com m u­

tries receiving dental benefits packages

to consider the feasibility of such a pro­ gram ,

approved

1975,

the

public

advisory

relations

W hile PEP was being designed in 1974,

ning in October 1974. Other major indus­

program

nication to the general public, it is de­

unanim ously. The House of Delegates, m eeting at the 1974 annual session, ap­

signed to reach specific key audiences. These include legislators and government

steel industry, with more than 1 million

proved the B o ard ’s proposal without de­

o fficials who control existing public sec­

employees, began coverage Aug 1, 1975.

bate.

tor health care program s and who will be

Early 1976 will see group dental pre­

T here seemed

the detailed

ideas of outside

shortly thereafter included meat-packing, alum inum , and can container. The

to be agreement on

instrumental in the design of future pro­

payment for almost 2 million com m unica­

w hat the PEP p ro gram ’s mandate should

grams, leaders in business and labor who

tions industry workers.

and should not be: It should address it­

seek to m axim ize prepaym ent plans for

PEP was designed to be ready for the

self to the positive aspects of private prac­

their m em bership and employees, and in­

impact of these plans in two ways. First,

tice, fee-for-service dental care delivery.

fluential members of the media concerned

It should not belabor negative aspects of alternative delivery systems. And rather

with health care delivery. Program im plem entation

a com puterized system was used to mon­ itor major prepaym ent plans and their im­

than trying to encom pass all areas of den­

pointed im portant messages that would

nities. In this way, towns that would feel

tistry and dental care, the program should

be brought to newly covered recipients

the greatest im pact could be identified

be confined to considerations of third

of prepaid dental plans and selected cities

for the purpose of providing on-site assis­

party care and its effect on dental prac­

in which on-site public relations assist­

tance, where possible. Such on-site pro­

tice. Furtherm ore, even though PEP is a

ance would be most needed. Also taken

grams augm ented public relations activ­

massive com m unications effort, unsur­

into account was the critical need to com ­ municate with the profession, both to

and, in all cases, relied heavily on dental

passed in scope in the Association’s his­ tory, it shou Id not be viewed as a panacea.

also

pin­

pact on individual states and com mu­

ity undertaken by local dental societies

chart the progress of the program and to

society leaders for direction of content

T he PEP program could not single-hand­

com m unicate the A DA’s policy stance on

edly m eet the challenges facing the pro­

im portant issues.

and tone. In this way, dental societies were able

fession. In fact, even to accomplish the public relations goals established, the program would have to be ongoing, not a one-tim e effort.

Iden tifying the a ud ience

to go on record as applauding the plans H elping dentists with p repaym en t The most salient of the influences on

for bringing more com prehensive care to m ore people, while also voicing any con­ cerns they may have had on any aspects

dental practice in 1974 and 1975 was ma­

of the plan that could dam age the ongoing

jor group prepaym ent plans. Even the

dentist-patient relationship.

largest group prepaym ent plans that went

Through a series of meetings early in the

into effect between 1970 and 1973 cov­

In Youngstow n-W arren, Ohio, where auto and steel industry plans affected

year, im plem entation began to take shape.

ered no more than 250,000 beneficiaries.

approxim ately 200,000 of the area's 550,-

750 ■ JADA, Vol. 91, October 1975

000 population, total media exposure of

only group that could provide sorely need­

1.9 million impressions was generated

ed inform ation, the dental profession dem onstrated its willingness to take the

both through PEP-assisted activities and through independent action of the local

lead in helping newly covered patients

dental society. Included w ere three major

obtain m axim um dental care. Most Im­

newspaper articles, tw o TV news inter­

portantly, the inform ation helped make

views, tw o television program appear­

the prepaym ent plans w ork— thus dem ­

ances, and three separate public service

onstrating that the private practice deliv­

announcem ents, aired every few days for

ery

about three months. All material reflected both national and local dentists' concerns

smoothly.

and priorities. Sim ilar activity in Buffalo, NY, and Allentow n-Bethlehem -Easton,

Pa,

pro­

system

is

capable

of functioning

The fourth com m unity action site is Stockton, Calif, where a program has been designed to help

private practi­

tioners cope with the im pact of a closed-

duced 1.8 million and 2.1 million expo­

panel clinic.

sures respectively. All media messages generated through this facet of the program were aimed at

cieties nationw ide,

To extend this technique to dental so­ a state-local

com­

munications plan was developed using

inform ing patients of plan details to foster

materials that were successful in areas

utilization and improve the dental health

where on-site assistance was provided.

of the community. In this way, the program

The plan includes inform ation on dealing

sought to alleviate confusion in the den­

with the news media, new releases, fea­

tal office. Also, by positioning itself as the

ture articles, radio and television public

service announcem ents, and speeches. This plan, along with other PEP material, is available from state dental societies or the A D A ’s Bureau of Public Inform ation. A m ajor s ta te m e n t for dentistry Prepaym ent is one of the most im portant issues facing the profession and the area

D r . K a r l S o lle r o f t h e C o r y d o n P a lm e r D e n t a l S o c ie t y d is c u s s e s d e n t a l b e n e f i t s o f th e n e w U n it e d S ta te s S te e l W o r k e r s c o n t r a c t o n A B C - T V in Y o u n g s t o w n . D r . S o ll e r a n d o t h e r c o m m u n i t y s p o k e s m e n a p p e a r e d o n t h e t h r e e T V n e t w o r k s a n d in r a d io p u b l i c s e r v ic e a n n o u n c e m e n t s .

of third party involvem ent raises many issues that must be addressed in an effec­ tive program . Som e of these issues are m anpow er distribution, alternate delivery systems, quality assurance, fees, and na­ tional health insurance. It is not enough to have a logical, reasoned position on these issues. That position must be clear­ ly explained to the public in terms of the p ub lic’s concerns and point-of-view rath­ er than those of the profession. Everyone associated with the program thought that dentistry needed a major statem ent to an influential audience. This took the form of a 12-page supplem ent in the Sunday, Oct 5, N e w Y o r k T im e s , which has a circulation of 1.5 million and is particularly well read by influential mem­ bers of Congress, governm ent, business, labor, education, and the professions. T he supplem ent contains articles on the major issues facing dentistry and dem on­ strates how dentistry has responded to make Am erican dental care the w orld ’s best and how the profession continues to work to meet the challenges of today and tom orrow . Reprints of the special supplem ent are being mailed to all ADA m em bers and to selected health care lead­ ers. Training le a d e rs to spe a k out Dentistry’s story on third party must be told often— in many places and by the ADA PUBLIC EDUCATION PROGRAM ■ 751

The result is a cadre of well-inform ed and articulate spokesmen for the profes­ sion. In 1975, seminars were held in Cleve­ land, Dallas, Des Moines, Chicago, Bos­ ton, Birm ingham , Scottsdale, Seattle, and New York City. At each site training was provided for participants from a num ber of states. In addition, a separate session was held for the ADA Board of Trustees. Following training of spokesm en, m edia interviews were arranged for selected "graduates.” As a dem onstration, 28 of these

trained

spokesmen

have

been

placed on television and radio programs in cities across the nation. Spokesm en training locally

Can Americans get the dental care they need?

Because of the success of spokesm en training sessions with regional dental leaders, condensed one-day sessions w ere held in the "com m unity ac tio n ” sites of

high-im pact

insurance

program s.

These sessions prepared dental leaders to undertake their media placem ent pro­ gram. The spokesmen training material has now been packaged to enable dental so­ cieties to conduct their own training ses­ sions. A one-day mini-sem inar has been distributed to all state dental societies. It concentrates on guiding participants through the most com m on— and some of the most challenging— situations they may face as spokesmen for the dental profession. Also available are video and audio tapes that set up situations to which

£t)e New ijork tim e s

the participating dentists can respond. Sessions are designed for 15 to 20 parti­ cipants. Included in the take-hom e material from the mini-sessions are two specially pro­ duced pamphlets, F a c ts f o r S p o k e s m e n and G u id e to A D A P o lic ie s f o r S p o k e s ­ m en,

which

help

further prepare the

speaker for program appearance, inter­ views, or speaking engagem ents. A

scripted

slide

presentation

titled

“ Profile of a profession” is adaptable to almost any program in which a dentist may be asked to participate. It cites the accom plishm ents of the private practice delivery system and the rationale for fa ­ best spokesmen available. To help in this

ened their knowledge of ADA policy and

voring that system over other unproven

regard, 265 national and regional dental

smoothed out their techniques for speak­

delivery mechanisms. “ Profile of a pro­

society leaders w ere invited to attend

ing out for dentistry. Dentists participat­

fession” is available from the Associa­

nine spokesmen training seminars, where

ing in the two-day session responded

tio n ’s Bureau of Audiovisual Service on a

they learned, by doing, how to meet the press and the public.

“on-cam era” to adverse interview situa­ tions w hile being critiqued by other par­

free-loan basis.

At each seminar, participants sharp­ 752 ■ JADA, Vol. 91, October 1975

ticipants.

M ore exposure: the b ro ad cast

Plans called for Dr. Reynolds to visit addi­

interview specialist

tional cities during 1975 including Hous­

Recognizing that television is the dom ­ inant media in the United States today and that the role of the housewife in health

ton, Los Angeles, San Francisco, andJMew York City. Reaching reg ion al leaders

care decisions is significant, plans were made for a broadcast interview specialist

Not all health care policy emanates from

to tour the nation’s major media centers appearing on TV and radio programs.

the n ation’s capital. Much is controlled on

Dr. Nancy Reynolds, of Colum bus, Ohio,

states and regions have varying prob­

a state or regional level and individual

was selected as the spokeswoman. Dr.

lems. To reach these regional policy lead­

Reynolds has an extensive background in

ers, two additional forum s were held—

private practice, dental education, and in

each dealing with a different aspect of

working within organized dentistry or,

dental care. The first forum was held May 5 in Pitts­

the state and local level. Dr. Reynolds began her national tour

burgh, headquarters of the steel industry,

in the nation’s capital. From there, she

and dealt with prepayment. The massive

dental Insurance, and quality assurance

has appeared on radio and TV programs

steel industry prepaym ent plan was given

and cost effectiveness.

in Cleveland, Colum bus, Akron, Canton, Ohio, Boston, Indianapolis, and Chicago.

particular emphasis. The meeting brought together 60 experts in various

the keynote address at this forum , stated,

By mid-August, Dr. Reynolds had ap ­

areas for panel discussions on such top­

“T he goal of all of us involved in prepaid

peared on 22 major broadcast programs.

ics as dental care for the needy, group

dental care is the same. We w ant to im ­

ADA President L. M. Kennedy, w ho gave

prove the level of dental health in the pop­

G e t t in g d e n t is t r y ’s m e s s a g e o n p r e p a y m e n t a n d o t h e r l o c a l d e n t a l is s u e s t o th e g e n e r a l

ulations we serve.” In addition to bringing

the

profes­

p u b l i c is th e p r im e o b j e c t i v e o f c o m m u n i t y a c t i o n . D r. S h e v a R a p o p o r t o f A l le n t o w n ,

sion's views to key health care leaders,

P a , w h o a p p e a r e d o n a f f i l ia t e s o f a l l t h r e e T V n e t w o r k s in P e n n s y lv a n ia , is s h o w n ( le f t )

the forum dem onstrated dentistry’s con­

a s s h e a p p e a r e d o n A B C - T V in P h ila d e lp h ia .

cern by virtue of its sponsorship. Insur­ ance com pany representatives reported the forum gave them a chance to meet with people they would have never other­ wise met, and expressed the hope they would be invited to future forums. A telephone sampling of 30% of the non­ dental attendees indicated overwhelm ing positive reaction and opinions that the forum

was

objective,

interesting,

and

worthw hile. Coping w ith p eer re v ie w With peer review clearly becom ing one of the most potent and positive tools of the profession in dem onstrating the quality of the care given to the Am erican people, PEP has becom e involved in helping d en ­ tal societies to establish effective peer review com mittees. PEP funds have supported the develop­ ment of a new film , P e e r R e v ie w : A D ia ­ lo g u e f o r D e n t is t s , which becam e avail­

able in the fall of 1975 for use by local and state dental societies. A peer review pro­ cedures manual that presents a uniform way of operating and strengthening peer review com m ittees is near com pletion. Both the film and manual have been developed In conjunction with the Asso­ ciatio n ’s Council on Dental Care Pro­ grams. In addition to their independent ADA PUBLIC EDUCATION PROGRAM ■ 753

M e a s u rin g re s u lts

delivery, national health insurance, man­ power distribution, and peer review.

In a program such as PEP, results are

These papers are designed to explain key

difficult to measure. What is the value of

aspects of dentistry to those not fam iliar

a favorable article in a nationally recog­

with the health care field and also are

nized publication? Of a favorable te le ­

available to dental societies.

vision interview? O f the goodwill and un­

Sp eak out for dentistry As com munity leaders, practicing d en­ tists are often asked to represent their

derstanding of dentistry’s position that results from a national symposium or re­ gional forum ?

profession by addressing local groups

Results in any of the individual pro­ grams of PEP cannot be considered

or clubs. In addition, they alone represent

alone. The design of the program and im­

the dental profession to all their patients.

plem entation to date has tried to create

Spokesmen training programs and the

a ripple effect by delivering sim ilar mes­

mini-spokesmen training kit can help pre­ pare som e dentists, but to reach even

sages in similar ways to national, region­ al, state, and community audiences. For

uses, they will form the nucleus of a series of workshops, undertaken by the Council

more members of the profession, a 25-

example, many of the same messages

m inute film called S p e a k O u t f o r D e n t is t r y ,

from dentistry’s special supplem ent to

during late 1975 and throughout 1976,

was produced. The film deals with na­

the N e w Y o r k T im e s will be made by a

that will be held in various regions of the

tional issues as they present themselves

practicing dentist in a TV appearance, by

country at the invitation of constituent

at various times and places in a d en tist’s

societies. These workshops will be con­

professional and social life. Six topics

a spokesman for the profession at a re­ gional forum , and by dentists working in

ducted by dentists w ho are experienced

covered in the film are peer review, pre­

local com m unity action programs.

in peer review techniques and w ho can offer concrete, practical advice to other

payment, alternate delivery systems, man­ power distribution, national health insur­

own clearly defined audience and pur­

practitioners and dental society leaders

ance, and dental accom plishm ents.

w ho will eventually be involved in peer review program s.

actor dem onstrate how a dentist m ight be

N a tio n al press support An im portant target audience in program planning is the national media— the re­ porters and editors who report on health care. In addition to generating publicity on dental issues, dentistry’s position has been put “on

The audience first sees a professional

record” with

influential

people of the media. Background sessions have been held

W hile each program section has its pose, there is a certain common ground that continually brings basic messages to different groups in different ways.

confronted with a question and how he

Another program design elem ent that

might answer poorly. A m oderator, usually

should reflect favorably on overall results is the application of successful tech ­

a spokesmen training sem inar graduate, then stops the film and invites members

niques. One example is the state-local

of the audience to discuss how the situa­

com m unications plan, which allows suc­

tion m ight have been handled better. Af­

cessful public relations materials related

ter the discussion the film resumes and

to third party issues to be used in hun­

shows a practicing dentist handling the same situation properly.

dreds of communities. Another is the mini-spokesmen training kit, which also

with the editorial board of U .S . N e w s & W o r ld R e p o r t and key editors at the W a ll S tr e e t

J o u r n a l,

W a s h in g to n

P o s t,

and

R e t ir e m e n t L iv in g . Contact and follow -up

also was made with major wire services — Associated Press, United Press Inter­ national, Reuters— and other news w eek­ lies,

including

T im e ,

N ew sw eek,

and

P e o p le . Another media target is a group

of influential financial publications in­ cluding F o r b e s , B a r r o n 's , D u n ’s R e v ie w , and B u s in e s s W e e k and financial colum ­ nist Sylvia Porter. And contacts have been made with major daily newspapers that have national impact such as T h e N e w Y o r k T im e s , the L o s A n g e le s T im e s , and

the C h ic a g o T r ib u n e . To help in meeting with the press, five editorial background papers have been produced on the following topics; prepaid dental care, econom ics of dental care 754 ■ JADA, Vol. 91, October 1975

F i e ld i n g a p o i n t e d q u e s t io n in a s i m u l a t e d P T A m e e t in g is D r . J o s e p h K e lly , p r e s i d e n t o f t h e M a s s a c h u s e t t s D e n t a l S o c ie t y . T h is s c e n e is f r o m t h e 2 5 - m in u t e f ilm Speak Out

for Dentistry p r o d u c e d b y P E P f o r u s e b y l o c a l d e n t a l s o c ie t ie s t o tr a in s p o k e s m e n .

brings a highly successful technique used

the profession, found it necessary to re­

on a national scale to the grass-roots level. In this way, not only are more

order some of the priorities. Thus, some

spokesmen trained, but dollars devoted

the supplem ent to the N e w Y o r k T im e s ,

to developing this com ponent of the pro­

and other program s w ere postponed until

gram are stretched.

1975 budgetary changes

new program s w ere developed, such as

1976, such as the Washington symposium on dental insurance. As stated in the orig ­ inal presentation to the House of Dele­

As the year progressed and various pro­

gates, PEP is innovative and it is unique

grams were planned and placed in oper­ ation, it becam e apparent that the budget

in the Association’s history. And, it is a m ajor experim ent in com m unications.

would not permit the accom plishm ent of all of the projects that were originally

ful; some parts w ere trium phantly so. A

conceived. At the same time, the advisory

few parts were unsuccessful, or at least

com m ittee, responding to the needs of

not as successful as originally hoped.

Many parts of the program were success­

Outlook for 1976 Two thirds of the way through 1975, PEP planning for 1976 has already taken shape. Since the design of PEP calls for a long-range approach that continually reinforces dentistry’s message in the pub­ lic mind, many of the 1975 program s will continue next year. Highlights of the 1976 proposal (subject to budget approval by the House of Dele­ gates) include the possibility of a library of m aterials and pam phlets being pro­ duced

to

help

the

practicing

dentist

bring the profession’s messages home to his patients. A com m on design will be used on all printed materials to ensure consistency of approach and provide im ­ pact on readers. Another highlight is a television d o c u ­ S o m e o f t h e m a t e r ia ls a v a ila b le

mentary film , produced by the ADA for

f r o m P E P : T o p le f t , S p o k e s m e n

both general public television viewing

W o r k s h o p K it e n a b le s l o c a l

and distribution to other key audiences,

s o c ie t ie s t o c o n d u c t o n e - d a y s p o k e s m e n t r a i n i n g s e m in a r s . S e m in a r m a t e r ia ls i n c lu d e a u d io a n d v id e o ta p e s f o r c r i t i q u e p u r p o s e s a n d th e P E P c o m m u n i c a t i o n p la n .

including congressional staffs and state and local dental societies. It is estim ated that such a film would reach 10 million viewers through TV distribution alone. The PEP advisory com m ittee is in the

T o p r i g h t , o n c e th e m e d ia h a s

process of reexam ining the entire 1976

b e e n a le r t e d to l o c a l d e n t a l is s u e s , s p o k e s m e n w i l l b e

program in light of the full experience of 1975. Final recom m endations will be pres­

c o n t a c t e d to p r o v id e in - d e p t h

ented to the ADA Board of Trustees at its

i n f o r m a t i o n . P E P p r o v id e s

meeting in late October.

s e v e r a l s o u r c e s f o r t h is i n f o r ­ m a t io n , i n c l u d in g Facts for

Spokesm en, Guide to ADA Policies for Spokesm en, a n d e d i t o r i a l b a c k g r o u n d m a t e r ia l o n t h e m o s t i m p o r t a n t is s u e s .

The primary message of PEP will re­ main unchanged: The private practice, fee-for-service system rem ains unsur­ passed in its ability to deliver quality, costeffective dental care.

L e f t, a s c r i p t e d s l id e p r e s e n ­ t a t io n , " P r o f i l e o f a p r o f e s s io n , " a id s d e n t is t s in e x p l a i n i n g th e b e n e f it s o f p r iv a t e p r a c t ic e to c o m m u n i t y o r g a n iz a t io n s .

ADA PUBLIC EDUCATION PROGRAM ■ 755