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DECEMBER EDITORIAL
LETTERS
LETTERS JADA welcomes letters from
readers on topics of current interest in dentistry. The Journal reserves the right to edit all communications and requires that all letters be typed, doublespaced and signed. The views expressed are those of the letter writer and do not necessarily reflect the opinion or official policy of the Association. Brevity is appreciated.
OBITS
A number of years ago, I wrote in complaining that The Journal had ceased publication of its necrology or “in memoriam” listings. I pointed out that, for many reasons, those of us in practice want to, or need to, know of the passing on of classmates, our teachers from dental school, our friends from long ago, etc. The Journal reinstated the listings for a while, but I must tell you that your efforts to slip this deletion past me again have been a failure. I noticed. (Only my preoccupation with other matters has delayed my taking up the cause again.) Please, as a valuable service to the members, reinstate this feature. We want to know these things, and JADA is the place to read them. If you don’t do it, who in the blazes will? Subsequent to the listing of my own name, which I hope you will not be able to do for many more years, you can do what you darn well please. But in the meantime, please reinstate the listing of deceased members. John Allan Bier, D.D.S. San Francisco Editor’s note: When we 142
ceased publishing the obituaries in 1994, our readership survey indicated that it was the least-read column in JADA. Because of limited space constraints, we decided to oblige the majority opinion. However, the ADA’s membership division has created another mechanism for mailing obituaries to all interested members. If you wish to be included on an automatic mailing list, contact the ADA Membership Services Department. MODERN DENTAL PRACTICE
The series of articles in the December JADA about the modern dental practice requires discussion. The expert recommendations may be suitable when an ideal untreated patient population exists. The real world of dental care is too complicated for simplistic generalizations. People remain untreated for various reasons. The authors agree that traditional care can no longer provide sufficient income for a practice. Their solutions reflect marketing approaches of elective dentistry. Has the profession forgotten the infamous Reader’s Digest article? The difference between a $1,100 fee and a $26,000 fee for the same patient is the marketing of elective treatment. If the profession accepts marketing elective procedures as modern practice, it tarnishes our reputation as a trusted health profession. There are better ways to practice. Murry Helfman, D.D.S. Rochester, N.Y. PLEDGE ALLEGIANCE GENERATION
I just finished reading your
December editorial, “The Pledge Allegiance Generation.” I couldn’t agree with you more. In my job as director of membership and student affairs, I often hear young dentists say things like “I don’t get anything for my membership. What do I get for my money?” Your article, I believe, is right on target. Drew Eason Director of Membership and Student Affairs Michigan Dental Association DECEMBER EDITORIAL
I recently finished reading your editorial in the December 1997 issue of JADA and found it very interesting. After thinking about it for a while, I thought that I might provide some perspective from the “young dentist” point of view. I still consider myself a young dentist. Some background on myself to provide a frame of reference: I am 38 years old and graduated from dental school in 1985. I have been a member of the ADA since graduation and was a member of the ASDA all four years as a dental student. I have been in practice in the Navy since graduation, first as a general dentist and then as an oral and maxillofacial surgeon. I was trained in oral and maxillofacial surgery in a civilian institution as a Navy-sponsored resident. I fall squarely in your stated group of 13,000 graduates. I agree with your statement about joining the ADA because that’s what professionals do. I feel that, as a professional, I have an obligation to myself and to my patients to belong to the ADA.
JADA, Vol. 129, February 1998 Copyright ©1998-2001 American Dental Association. All rights reserved.
LETTERS That having been said, it is quite possibly the main or only reason that I do belong to the ADA. I feel that the ADA possessing the need to entice membership is an error in philosophy. I think the truth lies somewhere in between your comments when quoting President Kennedy. It’s not only about what your organization can do for you. I would truly like to believe that all our fellow professionals would join if the organization’s focus was correct. I don’t believe that more credit cards, financial services, mortgage opportunities and financial credits are what attracts membership. What attracts membership is a true response by the organization to pertinent key issues. Rhetoric only, from the national organization, won’t get it done. All those various services can be obtained elsewhere in the community and at a reasonably comparable advantage. What can’t be obtained in the local community are things like licensure by credentials, a licensing examination that more closely aligns with the everyday practice of dentistry, nationwide acceptance of a licensing examination or the present requirement that trained specialists must take a general dental examination in a state in order to practice their specialty in that particular state. If the ADA, for example, spent its money lobbying Congress on those key issues instead of looking for another credit card to endorse, membership would naturally follow for a very high percentage of our fellow professionals. As a given, there will always exist a very small percentage of people who will not belong to the national
organization no matter what is provided; however, the organization must stay in tune with its population. I have watched the same issues, bantered back and forth the entire time that I have been associated with the ADA, proceed without any significant change or progress. If the ADA wants to get something done, it can get it done. It boils down to a simple matter of priority and focus of resources. It is time for organized dentistry to move ahead. For example, if our medical colleagues can competently practice nationwide, as a specialist or general practitioner, from a nationwide certifying examination, so can dentists. Thank you for the opportunity to communicate my feelings with you and allowing me, in some small way, to voice an opinion for the young dentist. Because of my military affiliation, I must provide this disclaimer that the opinions expressed in this letter are mine alone and are not to be misconstrued as those of the Department of Defense, U.S. Navy or the U.S. Navy Dental Corps. As I said at the beginning of my comments, I believe membership in the ADA is a must for all in our profession. The way to accomplish that is through the proper focus. Thank you. David A. Bitonti, D.D.S. National Naval Medical Center Bethesda, Md. BEST CLINICAL PRACTICES?
In response to the letter from Dr. Joseph R. Leben of the Alliances for Best Clinical Practices in Dentistry (October
JADA), I think it is important for the profession to realize just who this alliance is. This is an alliance of educators and thirdparty payers (insurance companies) who have proclaimed themselves as those anointed to determine what the “best clinical practices” are. In my opinion, this is a very unhealthy alliance. I personally question their “contribution” to the profession. As third parties increasingly interfere with the doctor-patient relationship, we will see more and more groups begin to impose their standards on the private practitioner of dentistry. I am personally very suspect of “alliances” such as this. Just because the name sounds good, it behooves us to know who these people are and what their agenda is. I doubt very seriously that the best patient care is their agenda. As dentists, we need to question the need for this group and any other group that is purporting to establish and force “standards” to further enslave the profession. The American Dental Association has developed the Parameters of Care for Dentistry. These parameters were very carefully constructed to maintain the sanctity of the professional judgment of the attending dentist, for a specific patient at a specific time. The issue of dental caries is thoroughly covered in these parameters and allows the attending dentist to determine the need and type of treatment. This allows for the best clinical practice of dentistry unencumbered by interference by any third party. If dentists have not read and fully understood the Parameters of Care for Dentistry as adopted
Copyright ©1998-2001 American Dental Association. All rights reserved.
LETTERS JADA welcomes letters from
readers on topics of current interest in dentistry. The Journal reserves the right to edit all communications and requires that all letters be typed, doublespaced and signed. The views expressed are those of the letter writer and do not necessarily reflect the opinion or official policy of the Association. Brevity is appreciated.
OBITS
A number of years ago, I wrote in complaining that The Journal had ceased publication of its necrology or “in memoriam” listings. I pointed out that, for many reasons, those of us in practice want to, or need to, know of the passing on of classmates, our teachers from dental school, our friends from long ago, etc. The Journal reinstated the listings for a while, but I must tell you that your efforts to slip this deletion past me again have been a failure. I noticed. (Only my preoccupation with other matters has delayed my taking up the cause again.) Please, as a valuable service to the members, reinstate this feature. We want to know these things, and JADA is the place to read them. If you don’t do it, who in the blazes will? Subsequent to the listing of my own name, which I hope you will not be able to do for many more years, you can do what you darn well please. But in the meantime, please reinstate the listing of deceased members. John Allan Bier, D.D.S. San Francisco Editor’s note: When we 142
ceased publishing the obituaries in 1994, our readership survey indicated that it was the least-read column in JADA. Because of limited space constraints, we decided to oblige the majority opinion. However, the ADA’s membership division has created another mechanism for mailing obituaries to all interested members. If you wish to be included on an automatic mailing list, contact the ADA Membership Services Department. MODERN DENTAL PRACTICE
The series of articles in the December JADA about the modern dental practice requires discussion. The expert recommendations may be suitable when an ideal untreated patient population exists. The real world of dental care is too complicated for simplistic generalizations. People remain untreated for various reasons. The authors agree that traditional care can no longer provide sufficient income for a practice. Their solutions reflect marketing approaches of elective dentistry. Has the profession forgotten the infamous Reader’s Digest article? The difference between a $1,100 fee and a $26,000 fee for the same patient is the marketing of elective treatment. If the profession accepts marketing elective procedures as modern practice, it tarnishes our reputation as a trusted health profession. There are better ways to practice. Murry Helfman, D.D.S. Rochester, N.Y. PLEDGE ALLEGIANCE GENERATION
I just finished reading your
December editorial, “The Pledge Allegiance Generation.” I couldn’t agree with you more. In my job as director of membership and student affairs, I often hear young dentists say things like “I don’t get anything for my membership. What do I get for my money?” Your article, I believe, is right on target. Drew Eason Director of Membership and Student Affairs Michigan Dental Association DECEMBER EDITORIAL
I recently finished reading your editorial in the December 1997 issue of JADA and found it very interesting. After thinking about it for a while, I thought that I might provide some perspective from the “young dentist” point of view. I still consider myself a young dentist. Some background on myself to provide a frame of reference: I am 38 years old and graduated from dental school in 1985. I have been a member of the ADA since graduation and was a member of the ASDA all four years as a dental student. I have been in practice in the Navy since graduation, first as a general dentist and then as an oral and maxillofacial surgeon. I was trained in oral and maxillofacial surgery in a civilian institution as a Navy-sponsored resident. I fall squarely in your stated group of 13,000 graduates. I agree with your statement about joining the ADA because that’s what professionals do. I feel that, as a professional, I have an obligation to myself and to my patients to belong to the ADA.
JADA, Vol. 129, February 1998 Copyright ©1998-2001 American Dental Association. All rights reserved.
LETTERS That having been said, it is quite possibly the main or only reason that I do belong to the ADA. I feel that the ADA possessing the need to entice membership is an error in philosophy. I think the truth lies somewhere in between your comments when quoting President Kennedy. It’s not only about what your organization can do for you. I would truly like to believe that all our fellow professionals would join if the organization’s focus was correct. I don’t believe that more credit cards, financial services, mortgage opportunities and financial credits are what attracts membership. What attracts membership is a true response by the organization to pertinent key issues. Rhetoric only, from the national organization, won’t get it done. All those various services can be obtained elsewhere in the community and at a reasonably comparable advantage. What can’t be obtained in the local community are things like licensure by credentials, a licensing examination that more closely aligns with the everyday practice of dentistry, nationwide acceptance of a licensing examination or the present requirement that trained specialists must take a general dental examination in a state in order to practice their specialty in that particular state. If the ADA, for example, spent its money lobbying Congress on those key issues instead of looking for another credit card to endorse, membership would naturally follow for a very high percentage of our fellow professionals. As a given, there will always exist a very small percentage of people who will not belong to the national
organization no matter what is provided; however, the organization must stay in tune with its population. I have watched the same issues, bantered back and forth the entire time that I have been associated with the ADA, proceed without any significant change or progress. If the ADA wants to get something done, it can get it done. It boils down to a simple matter of priority and focus of resources. It is time for organized dentistry to move ahead. For example, if our medical colleagues can competently practice nationwide, as a specialist or general practitioner, from a nationwide certifying examination, so can dentists. Thank you for the opportunity to communicate my feelings with you and allowing me, in some small way, to voice an opinion for the young dentist. Because of my military affiliation, I must provide this disclaimer that the opinions expressed in this letter are mine alone and are not to be misconstrued as those of the Department of Defense, U.S. Navy or the U.S. Navy Dental Corps. As I said at the beginning of my comments, I believe membership in the ADA is a must for all in our profession. The way to accomplish that is through the proper focus. Thank you. David A. Bitonti, D.D.S. National Naval Medical Center Bethesda, Md. BEST CLINICAL PRACTICES?
In response to the letter from Dr. Joseph R. Leben of the Alliances for Best Clinical Practices in Dentistry (October
JADA), I think it is important for the profession to realize just who this alliance is. This is an alliance of educators and thirdparty payers (insurance companies) who have proclaimed themselves as those anointed to determine what the “best clinical practices” are. In my opinion, this is a very unhealthy alliance. I personally question their “contribution” to the profession. As third parties increasingly interfere with the doctor-patient relationship, we will see more and more groups begin to impose their standards on the private practitioner of dentistry. I am personally very suspect of “alliances” such as this. Just because the name sounds good, it behooves us to know who these people are and what their agenda is. I doubt very seriously that the best patient care is their agenda. As dentists, we need to question the need for this group and any other group that is purporting to establish and force “standards” to further enslave the profession. The American Dental Association has developed the Parameters of Care for Dentistry. These parameters were very carefully constructed to maintain the sanctity of the professional judgment of the attending dentist, for a specific patient at a specific time. The issue of dental caries is thoroughly covered in these parameters and allows the attending dentist to determine the need and type of treatment. This allows for the best clinical practice of dentistry unencumbered by interference by any third party. If dentists have not read and fully understood the Parameters of Care for Dentistry as adopted
Copyright ©1998-2001 American Dental Association. All rights reserved.