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Comments on Criticism
LETTERS TO THE EDITOR
The JOURNAL devotes this section to comment by readers on topics of current interest to dentistry. The editor reserves the right to edit all communications to fit available space and requires that all letters be signed. Printed communications do not necessarily re flect the opinion or official policy of the Association. Your participation in this section is invited.
Com m ent on article May I comment on the article, “G in gival grafting and gingival reposi tioning,” by H. E. Van de Voorde in your December issue? In it the au thor makes the statement on page 1415: “Periodontics does not offi cially join the reported group (graft ing) until Bjorn’s article in 1963.'' 1 think we have to recognize the late Harold E. Grupe's priority. The article by H. E. Grupe and R. F. Warren, Jr., “Repair o f gingival de fects by a sliding flap operation," J. Periodont 27:92, 1956, is a clas sic that must be mentioned in this connection by anyone who writes on the subject. It is true that these authors used a pedicle flap, not a free graft. How ever, Doctor Van de Voorde does not indicate in his title, his synopsis, or his historic background material that he wishes to discuss free grafts only. FRANK G. E V E R E TT , DMD, MD UNIVERSITY OF OREGON DENTAL SCHOOL
Comments on criticism I would like to comment on Chester Siegel’s letter, in which he criticized group practice, in the November 1969 JA D A . Doctor Siegel raises a number of
legitimate issues, but his general re action is emotional rather than fac tual. I will address m yself only to those issues on which I can speak, based on my own experience as a member o f a dental group practice. 1. Group practices are presum ably more economically efficient than is solo practice, as Doctor Sie gel says, but that is only one reason to practice in a group. 2. The underlying purpose of our group is to take care of all patients who come to us. Since we are in timately connected to the operation of a large private community hos pital, a significant part o f our prac tice is made up of the very patients whom Doctor Siegel says are gen erally eliminated from group prac tice— the chronically ill, debilitated, and aged. 3. The subject of “turnover” in group practice is no more o f a prob lem than it is in any private enter prise which involves numbers of people. 4. I’m not sure that I understand, personally, why it is so important to “define” group practice, as long as it is an honestly and ethically run oper ation. Obviously, the philosophy of patient care is different when groups o f professionals work together. The basic premise our group works on is that the combination of skills and personalities that only a group can provide justifies its existence. 5. Some of the finest group prac tices in the country, contrary to D o c
tor Siegel’s statement, exist in rural America. The location of a group, I am convinced from contacts with numerous people who work in groups, is irrelevant to the ultimate success of the group. What matters is the effectiveness o f the people who work collectively, and individually, to improve the quality of patient care. We all know that dental need is universal, and a well-organized dental group practice can exist al most anywhere. 6. All o f the virtues to which D o c tor Siegel refers, which he intimates can only exist in a solo relationship with a patient, can readily be instilled into the group environment. After all, as each doctor treats his indi vidual patient, the patient receives all the attention that that same pa tient would receive in a solo prac tice. As for all the other aspects o f a group operation which Doctor Siegel raises, they are irrelevant to the suc cess o f the group as long as they are acceptable to the members o f the group, and, indirectly, to the patients. Generally speaking, I am con vinced that group practice, if orga nized along sensible and humane lines, has virtues for the dentist and the patient which cannot be equalled in the traditional arrangement o f solo practice. The Chester Siegels are fighting windmills while thou sands o f others o f us are working to develop the group concept in a way that can provide patients with a type o f care that will only elevate den tistry in the eyes o f the public. DARRYL J . PIR O K , DDS CHICAGO
A ‘voluntary’ course Voluntary continuing education seems to me to be the most enlight ened course of action to follow. This is my reaction to the editorial in the October 1969 j a d a . As has been pointed out, of those responding, approximately half have attended courses at schools or hospi tals during 1967. How many more regularly attend scientific sessions of their constituent or state societies 251
The JOURNAL devotes this section to comment by readers on topics of current interest to dentistry. The editor reserves the right to edit all communications to fit available space and requires that all letters be signed. Printed communications do not necessarily re flect the opinion or official policy of the Association. Your participation in this section is invited.
Com m ent on article May I comment on the article, “G in gival grafting and gingival reposi tioning,” by H. E. Van de Voorde in your December issue? In it the au thor makes the statement on page 1415: “Periodontics does not offi cially join the reported group (graft ing) until Bjorn’s article in 1963.'' 1 think we have to recognize the late Harold E. Grupe's priority. The article by H. E. Grupe and R. F. Warren, Jr., “Repair o f gingival de fects by a sliding flap operation," J. Periodont 27:92, 1956, is a clas sic that must be mentioned in this connection by anyone who writes on the subject. It is true that these authors used a pedicle flap, not a free graft. How ever, Doctor Van de Voorde does not indicate in his title, his synopsis, or his historic background material that he wishes to discuss free grafts only. FRANK G. E V E R E TT , DMD, MD UNIVERSITY OF OREGON DENTAL SCHOOL
Comments on criticism I would like to comment on Chester Siegel’s letter, in which he criticized group practice, in the November 1969 JA D A . Doctor Siegel raises a number of
legitimate issues, but his general re action is emotional rather than fac tual. I will address m yself only to those issues on which I can speak, based on my own experience as a member o f a dental group practice. 1. Group practices are presum ably more economically efficient than is solo practice, as Doctor Sie gel says, but that is only one reason to practice in a group. 2. The underlying purpose of our group is to take care of all patients who come to us. Since we are in timately connected to the operation of a large private community hos pital, a significant part o f our prac tice is made up of the very patients whom Doctor Siegel says are gen erally eliminated from group prac tice— the chronically ill, debilitated, and aged. 3. The subject of “turnover” in group practice is no more o f a prob lem than it is in any private enter prise which involves numbers of people. 4. I’m not sure that I understand, personally, why it is so important to “define” group practice, as long as it is an honestly and ethically run oper ation. Obviously, the philosophy of patient care is different when groups o f professionals work together. The basic premise our group works on is that the combination of skills and personalities that only a group can provide justifies its existence. 5. Some of the finest group prac tices in the country, contrary to D o c
tor Siegel’s statement, exist in rural America. The location of a group, I am convinced from contacts with numerous people who work in groups, is irrelevant to the ultimate success of the group. What matters is the effectiveness o f the people who work collectively, and individually, to improve the quality of patient care. We all know that dental need is universal, and a well-organized dental group practice can exist al most anywhere. 6. All o f the virtues to which D o c tor Siegel refers, which he intimates can only exist in a solo relationship with a patient, can readily be instilled into the group environment. After all, as each doctor treats his indi vidual patient, the patient receives all the attention that that same pa tient would receive in a solo prac tice. As for all the other aspects o f a group operation which Doctor Siegel raises, they are irrelevant to the suc cess o f the group as long as they are acceptable to the members o f the group, and, indirectly, to the patients. Generally speaking, I am con vinced that group practice, if orga nized along sensible and humane lines, has virtues for the dentist and the patient which cannot be equalled in the traditional arrangement o f solo practice. The Chester Siegels are fighting windmills while thou sands o f others o f us are working to develop the group concept in a way that can provide patients with a type o f care that will only elevate den tistry in the eyes o f the public. DARRYL J . PIR O K , DDS CHICAGO
A ‘voluntary’ course Voluntary continuing education seems to me to be the most enlight ened course of action to follow. This is my reaction to the editorial in the October 1969 j a d a . As has been pointed out, of those responding, approximately half have attended courses at schools or hospi tals during 1967. How many more regularly attend scientific sessions of their constituent or state societies 251