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Negro Dental Manpower
EDITORIALS Vietnam Project ■ ■ T h e c o n tra c t betw een th e U.S. A gency fo r In te rn a tio n a l D ev e lo p m e n t an d th e A m eric an D e n tal A sso c iatio n to assist th e U niversity o f Saigon in im p ro v in g its d e n ta l ed u c atio n al efforts has been in fo rce 9 m onths. I f one h ad to single o u t th e a re a in w hich th e m o st pro g ress has been m ade, it w ould h av e to be th a t o f id e n tifica tio n o f p ro b lem s, a n d they are m any. T h e p ro g ram has d ev e lo p e d a tinge o f th e flav o r o f fru stra tio n w hich c h a racterize s the w ar effort. T h e d ed ica ted A m eric an team , h ea d ed by M a rv in E. R evzin, is g ain in g c o n tro l o f som e o f th e p ro b lem s it faces, b u t p ro g ress is slow. T h e re is a sh o rtag e o f V ietn am e se d en tal e d u cato rs, an d th e ir salarie s are low. B ecau se they m u st su p p le m e n t th e ir incom es by sp ending an a p p re c ia b le a m o u n t o f tim e in p riv a te p rac tice , they a re un ab le to ap p ly to th e fullest extent th e d en tal school’s re so u rc e s to p u b lic h ealth p roblem s o f the n ation. In an effo rt to d e m o n stra te th a t th e d en tal school does have o b lig a tio n s to the com m unity , th e U.S. p ro jec t sta ff an d th e V ietn am e se d en tal fac u l ty are try in g to d ev elo p co m m u n ity services, such as o u tp a tie n t clin ic s in h o sp itals, a pu b lic d en tal health p ro g ra m , an d a p rev e n tiv e d en tistry p r o gram . T h e re is o n ly o n e d en tist to each 150 ,0 0 0 p e o ple in V ietn am , a n d alm o st all o f the d en tists are lo cated in tw o o r th re e u rb a n areas. A m a jo rity o f th e p eo p le h av e n o access to professio n al d en tal c a re an d n o h o p e o f g ain in g access in th e n ear, an d p e rh a p s even d istan t, fu tu re. T hus, th e U.S. d en tal co n su lta n ts an d th e V ietn am ese d en tists are faced w ith the w eighty decisio n w hether to rec o m m en d th e d ev e lo p m e n t o f a sub p ro fessio n al c a te gory o f d en tal p erso n n e l w hich could pro v id e the ru ra l citiz en ry w ith a t le ast som e form o f d en tal care. V ietn am a lre ad y has su b p ro fessio n als w ho deal d irec tly w ith th e p ublic. T h e se are th e so-called “ sidew alk d e n tists” w ho h av e n o fo rm al tra in in g in d e n tistry a n d w hose v alu e to th e h ea lth o f th e citizens o f th e m e tro p o lita n are as is at best q u e s tionable. T h e d en tal p ro fe ssio n in V ietn am ju s ti fiably fea rs th a t su b p ro fe ssio n a ls tra in e d fo r th e p u rp o se o f allev iatin g d en tal health p ro b lem s in
ru ra l areas m ay be a ttra c te d to th e p ra c tic e o f sid e w alk d en tistry in th e cities. Y et, th e tra in in g o f p erso n s w ho co u ld allev iate p ain an d g iv e in stru c tio n in d en tal c a re co u ld p ro v e to b e a b o o n to th e ru ra l citizen s u n til such tim e as th e d e n ta l p ro fe s sion in V ietn am co u ld p ro v id e th e p ro p e r c a re fo r all its people. F in ally , th e U .S. d en tal te am in S aigon faces a th re a t to its re c ru itm e n t p ro g ra m im p o sed by r e stric tio n s on th e trav el o f team m e m b ers to th e p o sts w here th e ir fam ilies a re lo cated . I f th e e f fo rts o f the U.S. te a m are to be successful, it m u st h av e a co re o f d e n tists w ho a re w illin g to ac cep t rela tiv e ly lo n g -term assignm ents. A n d th e se d e n tists sh o u ld h av e th e o p p o rtu n ity o f v isitin g th e ir fam ilies (w ho a re sta tio n e d , say, in M alay sia) at fre q u e n t intervals. P re se n t reg u la tio n s lim it re im b u rsem e n t fo r such trav el to o n ly tw o trip s a year. T h is is h ard ly an in d u c em e n t fo r o n e w h o is th in k ing a b o u t v o lu n te erin g his serv ices to th e V ietn am project. O w ing to th e effo rts o f th e U.S. te am , d en tal e d u c atio n in V ietn am is p ro g ressin g , how ever. M ax illo facial an d o ra l su rg ery te ac h in g clin ics h av e been estab lish ed in tw o h o sp itals. By g o v ern m e n t d ecree, th e d en tal stu d e n ts w ill now fo r th e first tim e receiv e th e n ecessary tr a in ing in th e basic scien ces w hich h e re to fo re w as n o t p a rt o f th e d e n ta l c u rricu lu m . N ow th e m ed ical facu lty w ill te ac h b asic scien ces to d e h ta l a n d m e d ical stu d en ts jo in tly . A n d tw o V ie tn a m e se d en tists are en ro lled in g ra d u a te p ro g ra m s in th e d en tal schools at th e U n iv ersity o f K en tu c k y a n d T u fts U n iv ersity to b e tte r eq u ip th e m as te a c h e rs in th e U n iv ersity o f S aigon. T h e A m eric an D en ta l A sso c ia tio n /A ID p e rso n nel in V ietn am p ro b ab ly w ill fac e m a n y m o re d if ficu lt an d fru s tra tin g situ atio n s. T h o se o f u s w ho are fa r rem o v ed fro m V ie tn a m sh o u ld o ffe r th em o u r en c o u rag em en t to see a w o rth w h ile e ffo rt th ro u g h and o u r re sp e c t fo r th e ir w illin g n ess to h elp o th ers u n d e r th e m o st try in g o f circ u m sta n ce s.
Negro Dental Manpower I M i N eg ro es c o n stitu te 11.4 p e rc e n t o f th e U.S. p o p u la tio n , b u t o n ly 2 p e rc e n t o f th e n a tio n ’s d e n tists. R oughly th e sam e ra tio o f N eg ro es to w h ites exists in the m ed ical p ro fessio n , an d m e m b ers o f b oth p ro fessio n s h av e ex p re ssed th e ir co n c ern o v er th e p au city o f N eg ro es in th e se p ro fessio n s. T h e reaso n s fo r th e re la tiv e ly low n u m b e rs o f N eg ro d en tists a n d p h y sician s a re m u ltip le an d co m p lex . F irst, th e n u m b e r o f N eg ro a p p lic a n ts to 23
the health professional schools historically has been low er than the national ratio o f N egroes to whites. Second, the N egro applicant does not com pete as w ell scholastically as the w hite applicant for positions in th e freshm an classes. A nd third, the N egro student is less apt than the w hite stu dent to have the financial support necessary to com plete his education. T h e unfavorable ratio o f N egro to w hite den tists is worsening. Joseph L. Henry, dean, o f H ow ard U niversity’s School o f Dentistry, states that in 1967 only 75 potential N egro dental students ap p lied to his school. In 1961, 3 50 o f the total en rollm ent o f 4 0 0 at H ow ard w ere Negroes. D ean H enry’s concern is echoed by the deans o f other dental schools, many o f which have abol ished the requirem ent that applicants submit photographs. T h e deans say that they w ish to con tinue to provide p laces for N egro students in their freshm an classes, but w ith the selection o f students based alm ost exclu sively on academ ic performance, m any o f the w ould-be N egro dental students are passed over. T h is is an unfortunate boom eranging o f racial freedom . A t a tim e w hen the dem and for dental care is rising, especially by the low er incom e group, the d ecline in num ber o f N egro dentists is regrettable. Several approaches to the problem w ere highlight ed at a con feren ce on the N egro in m edicine. T h ese included financial support, special summer courses in prem edical studies, establishm ent o f prem edical program s in N egro colleges, spreading the freshman year o f m edicine over a longer span than on e academ ic year for certain students, im provem ent o f prem edical advisory programs, and recruitm ent o f m ore N egro w om en into m edicine. T here are m any parallels in dentistry and m edi cine, and the representation o f N egroes in the two professions is on e o f them. T he number o f N egro dentists and physicians should b e increased, and the solutions offered to the m edical profession can b e applied also b y the dental profession.
Opinion of Other Journals
/s private practice on its way out? M any prophets are heard about the land to day proclaim ing the doom o f private practice. T here is m uch fearful discussion concerning adopted and proposed legislation related to den tal care. A certain dem oralizing attitude has arisen w ithin our profession. Such words as, “T h e gov ernm ent w ill take over our practices. . .There will
be too much paper w o r k .. .T hey w ill tell m e how to run m y practice. . .1 don’t want to work for the governm ent,” are heard at alm ost any m eeting o f a group o f dentists. It is true that these federal programs, not fully understood and view ed with a negative attitude, m ay appear to sound the death-knell for private practice. T h ese sam e programs, however, view ed p osi tively and constructively could w ell b e the begin ning o f a great new era in dentistry. T h e leaders o f our profession have w isely adopted a positive approach to the problem . T h ey have seen the need for a C hildren’s D en tal H ealth Care Program. In stead o f blindly opposing suggested federal pro gram s as a matter o f principle, the A m erican D en tal A ssociation has w elcom ed the prospect o f pro viding a m uch needed service to our needy pre school and school age children. W ays are being sought w hereby this care w ill be rendered through the traditional private practice system. W hat a w onderful opportunity such a program cou ld offer! T h is program cou ld be an additional m eans for educating this and future generations o f children regarding the rewards o f regular and continuous dental care. It could be the w ay o f reaching the sixty per cent o f our population who never seek dental care o n a regular basis. T o o m any o f our young p eop le are h opeless dental cripples b efore they are old enough to vote. Let’s be realistic and consider w ho w ill render the additional care necessary to encom pass the large segm ent o f our society as envisioned under proposed federal programs. T h e m ost logical an swer is the private dentist and in his private o f fice. T he dentist m ay w ell have to change the na ture o f h is operations. H e m ay need m ore clerical help. H e w ill need m ore auxiliary personnel. T h ese are sm all adjustments w hen related to fu ture generations o f adults w ho have been trained from early childhood to value care for their oral structures through routine professional care. B lind resistance to change and an “I give up” attitude is foolish. Every segm ent o f our society is changing. A w illingness to change our w ays o f thinking and to w elcom e the opportunity to pro v id e dental care to an even larger and needy por tion o f our population w ill be rewarding in m any ways. T h e role o f the private dentist w ill be altered to include certain public obligations and this w ill greatly enhance the practice o f dentistry. N o , the private practice o f dentistry is N O T on its w ay out, and it never w ill be. A bright future lies ahead for the private dentist, he needs only to b e ready for it. Reprinted with permission of the editor, Harry L. Hodges, from the October, 1967 Virginia Dental Journal.
ru ra l areas m ay be a ttra c te d to th e p ra c tic e o f sid e w alk d en tistry in th e cities. Y et, th e tra in in g o f p erso n s w ho co u ld allev iate p ain an d g iv e in stru c tio n in d en tal c a re co u ld p ro v e to b e a b o o n to th e ru ra l citizen s u n til such tim e as th e d e n ta l p ro fe s sion in V ietn am co u ld p ro v id e th e p ro p e r c a re fo r all its people. F in ally , th e U .S. d en tal te am in S aigon faces a th re a t to its re c ru itm e n t p ro g ra m im p o sed by r e stric tio n s on th e trav el o f team m e m b ers to th e p o sts w here th e ir fam ilies a re lo cated . I f th e e f fo rts o f the U.S. te a m are to be successful, it m u st h av e a co re o f d e n tists w ho a re w illin g to ac cep t rela tiv e ly lo n g -term assignm ents. A n d th e se d e n tists sh o u ld h av e th e o p p o rtu n ity o f v isitin g th e ir fam ilies (w ho a re sta tio n e d , say, in M alay sia) at fre q u e n t intervals. P re se n t reg u la tio n s lim it re im b u rsem e n t fo r such trav el to o n ly tw o trip s a year. T h is is h ard ly an in d u c em e n t fo r o n e w h o is th in k ing a b o u t v o lu n te erin g his serv ices to th e V ietn am project. O w ing to th e effo rts o f th e U.S. te am , d en tal e d u c atio n in V ietn am is p ro g ressin g , how ever. M ax illo facial an d o ra l su rg ery te ac h in g clin ics h av e been estab lish ed in tw o h o sp itals. By g o v ern m e n t d ecree, th e d en tal stu d e n ts w ill now fo r th e first tim e receiv e th e n ecessary tr a in ing in th e basic scien ces w hich h e re to fo re w as n o t p a rt o f th e d e n ta l c u rricu lu m . N ow th e m ed ical facu lty w ill te ac h b asic scien ces to d e h ta l a n d m e d ical stu d en ts jo in tly . A n d tw o V ie tn a m e se d en tists are en ro lled in g ra d u a te p ro g ra m s in th e d en tal schools at th e U n iv ersity o f K en tu c k y a n d T u fts U n iv ersity to b e tte r eq u ip th e m as te a c h e rs in th e U n iv ersity o f S aigon. T h e A m eric an D en ta l A sso c ia tio n /A ID p e rso n nel in V ietn am p ro b ab ly w ill fac e m a n y m o re d if ficu lt an d fru s tra tin g situ atio n s. T h o se o f u s w ho are fa r rem o v ed fro m V ie tn a m sh o u ld o ffe r th em o u r en c o u rag em en t to see a w o rth w h ile e ffo rt th ro u g h and o u r re sp e c t fo r th e ir w illin g n ess to h elp o th ers u n d e r th e m o st try in g o f circ u m sta n ce s.
Negro Dental Manpower I M i N eg ro es c o n stitu te 11.4 p e rc e n t o f th e U.S. p o p u la tio n , b u t o n ly 2 p e rc e n t o f th e n a tio n ’s d e n tists. R oughly th e sam e ra tio o f N eg ro es to w h ites exists in the m ed ical p ro fessio n , an d m e m b ers o f b oth p ro fessio n s h av e ex p re ssed th e ir co n c ern o v er th e p au city o f N eg ro es in th e se p ro fessio n s. T h e reaso n s fo r th e re la tiv e ly low n u m b e rs o f N eg ro d en tists a n d p h y sician s a re m u ltip le an d co m p lex . F irst, th e n u m b e r o f N eg ro a p p lic a n ts to 23
the health professional schools historically has been low er than the national ratio o f N egroes to whites. Second, the N egro applicant does not com pete as w ell scholastically as the w hite applicant for positions in th e freshm an classes. A nd third, the N egro student is less apt than the w hite stu dent to have the financial support necessary to com plete his education. T h e unfavorable ratio o f N egro to w hite den tists is worsening. Joseph L. Henry, dean, o f H ow ard U niversity’s School o f Dentistry, states that in 1967 only 75 potential N egro dental students ap p lied to his school. In 1961, 3 50 o f the total en rollm ent o f 4 0 0 at H ow ard w ere Negroes. D ean H enry’s concern is echoed by the deans o f other dental schools, many o f which have abol ished the requirem ent that applicants submit photographs. T h e deans say that they w ish to con tinue to provide p laces for N egro students in their freshm an classes, but w ith the selection o f students based alm ost exclu sively on academ ic performance, m any o f the w ould-be N egro dental students are passed over. T h is is an unfortunate boom eranging o f racial freedom . A t a tim e w hen the dem and for dental care is rising, especially by the low er incom e group, the d ecline in num ber o f N egro dentists is regrettable. Several approaches to the problem w ere highlight ed at a con feren ce on the N egro in m edicine. T h ese included financial support, special summer courses in prem edical studies, establishm ent o f prem edical program s in N egro colleges, spreading the freshman year o f m edicine over a longer span than on e academ ic year for certain students, im provem ent o f prem edical advisory programs, and recruitm ent o f m ore N egro w om en into m edicine. T here are m any parallels in dentistry and m edi cine, and the representation o f N egroes in the two professions is on e o f them. T he number o f N egro dentists and physicians should b e increased, and the solutions offered to the m edical profession can b e applied also b y the dental profession.
Opinion of Other Journals
/s private practice on its way out? M any prophets are heard about the land to day proclaim ing the doom o f private practice. T here is m uch fearful discussion concerning adopted and proposed legislation related to den tal care. A certain dem oralizing attitude has arisen w ithin our profession. Such words as, “T h e gov ernm ent w ill take over our practices. . .There will
be too much paper w o r k .. .T hey w ill tell m e how to run m y practice. . .1 don’t want to work for the governm ent,” are heard at alm ost any m eeting o f a group o f dentists. It is true that these federal programs, not fully understood and view ed with a negative attitude, m ay appear to sound the death-knell for private practice. T h ese sam e programs, however, view ed p osi tively and constructively could w ell b e the begin ning o f a great new era in dentistry. T h e leaders o f our profession have w isely adopted a positive approach to the problem . T h ey have seen the need for a C hildren’s D en tal H ealth Care Program. In stead o f blindly opposing suggested federal pro gram s as a matter o f principle, the A m erican D en tal A ssociation has w elcom ed the prospect o f pro viding a m uch needed service to our needy pre school and school age children. W ays are being sought w hereby this care w ill be rendered through the traditional private practice system. W hat a w onderful opportunity such a program cou ld offer! T h is program cou ld be an additional m eans for educating this and future generations o f children regarding the rewards o f regular and continuous dental care. It could be the w ay o f reaching the sixty per cent o f our population who never seek dental care o n a regular basis. T o o m any o f our young p eop le are h opeless dental cripples b efore they are old enough to vote. Let’s be realistic and consider w ho w ill render the additional care necessary to encom pass the large segm ent o f our society as envisioned under proposed federal programs. T h e m ost logical an swer is the private dentist and in his private o f fice. T he dentist m ay w ell have to change the na ture o f h is operations. H e m ay need m ore clerical help. H e w ill need m ore auxiliary personnel. T h ese are sm all adjustments w hen related to fu ture generations o f adults w ho have been trained from early childhood to value care for their oral structures through routine professional care. B lind resistance to change and an “I give up” attitude is foolish. Every segm ent o f our society is changing. A w illingness to change our w ays o f thinking and to w elcom e the opportunity to pro v id e dental care to an even larger and needy por tion o f our population w ill be rewarding in m any ways. T h e role o f the private dentist w ill be altered to include certain public obligations and this w ill greatly enhance the practice o f dentistry. N o , the private practice o f dentistry is N O T on its w ay out, and it never w ill be. A bright future lies ahead for the private dentist, he needs only to b e ready for it. Reprinted with permission of the editor, Harry L. Hodges, from the October, 1967 Virginia Dental Journal.