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Retrospective: What a difference 10 years can make
CENTENNIAL GUEST EDITORIAL
Retrospective: What a difference 10 years can make Morris N. Poolea and Robert E. Varnerb Logan, Utah, and Roseburg, Ore
T
he French author Franc¸ois de la Rochefoucauld said, “The only thing constant in life is change.” This maxim is an apt description of the American Association of Orthodontists (AAO) during the past 10 years. When we first joined the AAO Board 10 years ago, members used e-mail but often still communicated with each other via fax and phone. The House of Delegates used a book of proposed resolutions that was a few inches thick. At each Board of Trustees meeting, we had a Board book that was also a few inches thick. Today, these methods have largely given way to frequent e-mails and the use of Dropbox and Sharepoint to circulate and collaborate on motions and documents. AAO members enjoy the convenience of reading the American Journal of Orthodontics and Dentofacial Orthopedics on ajodo.org and receiving association news via aaoinfo.org, the eBulletin, the member app, and social media outlets—in addition to the printed Bulletin. Technology has also made it possible for the AAO to offer many of its numerous marketing, practice management, and patient education materials as free downloads on aaoinfo.org, rather than requiring members to call the AAO office and purchase materials. Technology has definitely been our friend. Of equal importance, however, is the fact that a member who wishes to communicate with a person can still call the AAO office to ask about a meeting, contact the Legal Department or the Library, obtain guidance in customizing AAO marketing materials, or request help with other practice management needs. The AAO has always focused primarily on protecting the specialty and serving the needs of its members, while ensuring that members can provide the best possible a
President, American Association of Orthodontists, 2015-2016, Logan, Utah. President, American Association of Orthodontists, 2014-2015, Roseburg, Ore. Am J Orthod Dentofacial Orthop 2015;148:358-9 0889-5406/$36.00 Copyright Ó 2015 by the American Association of Orthodontists. http://dx.doi.org/10.1016/j.ajodo.2015.06.001 b
358
treatment for their patients. Those standards, set by all of the leaders who preceded us, have never changed. During the past 10 years, however, a perfect storm of intensified outside pressures, demographic changes, and new opportunities has posed challenges to leaders and brought out unprecedented strengths in the association. The AAO Board responded to the challenging environment facing the specialty first by deepening its strategic capabilities. During our early years on the Board, the AAO Strategic Plan was developed as a tool to keep our focus on the greatest concerns of the association and the specialty. We now include in the strategic plan a few critical issues to focus our efforts and marshal our resources. Each year during the annual Board planning session, the strategic plan and critical issues are evaluated and updated as needed. The plan is then reviewed and amended as needed by a committee of the Board of Trustees and the House of Delegates, and then finally approved by the House of Delegates. We believe that this focus on critical issues has enabled the AAO to maintain its relevance and better use its resources to serve members. The AAO educates the public about orthodontics
During the past 10 years, a major member concern has been the growing numbers of general dentists who, facing the economic challenges we have all endured and intrigued by the possibilities of clear aligners, have begun providing orthodontic treatment. Many patients thus began treatment from nonorthodontists. The Board of Trustees, the Council on Communications, and the House of Delegates realized that if we failed to tell our story to the public, others would tell it for us. The House of Delegates chose to respond to this challenge by mounting an intensive effort to position orthodontists as the specialists uniquely qualified to align jaws and straighten teeth. The current Consumer Awareness Program, begun in 2006, has used national advertising, public relations,
Poole and Varner
and social media programs to educate the public about both the training and qualifications of orthodontists, and the benefits of orthodontic treatment. The consumer Web site, mylifemysmile.org, provides similar information to the site's approximately 300,000 information-seeking visitors each year. Expenses for the Consumer Awareness Program have been covered by a member assessment. To ensure that we were reaching our key audiences and spending our members' money in a useful way, we implemented consumer research. In 2009, we retained the research company Millward Brown and then recently retained Decision Analyst to conduct ongoing consumer research on orthodontic market share and consumer responses to the AAO's marketing communications. Member demographics are changing rapidly
From 2007 to 2014, AAO member demographic shifts included an increase from 1% to 6.9% of members in the millennial group (those born in 1982 or later). These members, facing a challenging job market, have responded by joining corporate and other nontraditional practices in growing numbers. Results of the 2012 AAO Member Practice Environment Survey indicated that nearly 32% of members in practice for less than 5 years entered the specialty as employees of large corporate or interdisciplinary practices offering orthodontic services. The AAO is working to understand and address the needs of our youngest members via multiple initiatives, including an annual meeting with representatives of corporate dental groups and a dialog with younger members at the annual Emerging Leaders Conference. From 2004 through 2014, international memberships in the AAO increased from 2426 to 2772. International student membership was introduced in 2008 and has increased from 93 to more than 500. As orthodontists around the world increasingly perceive value in AAO membership, the AAO will work to identify these members' unmet needs and to further expand programs and resources that will be of interest to them. As members' needs change, the AAO system of governance may need to be updated to ensure that the needs are met as effectively as possible. An intensive review of our governance has been underway since the fall of 2013. As the study continues, each year the House of Delegates will review the information produced and consider recommended changes.
359
We advocate for the specialty
For more than 20 years, an annual meeting has brought together members of the AAO who wish to advocate for public policy that is friendly to the practice of orthodontics. In 2009, this meeting was renamed the Professional Advocacy Conference. In addition, proposed laws are reviewed on an ongoing basis to assess their impact on orthodontic practice. The AAO has worked with other dental organizations on advocacy, often leading to outreach to legislators and the development of legislative fixes to problematic laws. Examples from recent years include the following. The AAO and other dental organizations worked together successfully in 2010 to secure exclusion of dental practices of all types from the Red Flags Rule. The rule was designed to extend the definition of a creditor to any entity that provides a service under a payment plan agreed upon by the provider and the customer. It also requires creditors to develop and implement written identity-theft programs. During 2011, the AAO and other dental organizations succeeded in persuading federal legislators to repeal a section of the 2010 Affordable Care Act that would have required all businesses to issue Form 1099 to vendors from which they purchase $600 or more of goods or services annually. During the past year, the AAO led the process of drafting a bill that was introduced in Congress in February, raising from $2500 to $5000 the annual cap on flexible spending account deposits per qualified employee (assuming that the employer offers these). Many orthodontic patients finance their treatment using these accounts. Where will we be in 10 years?
We have seen many changes in the past 10 years. We imagine that with the massive changes underway in AAO membership and the practice environment, the specialty will be vastly different in 10 years. This is a great specialty, and we must continue to do everything we can to protect it and our members. Although we will no longer be AAO leaders in 2025, we look forward to continuing to travel with our colleagues on what will undoubtedly be a fascinating journey.
American Journal of Orthodontics and Dentofacial Orthopedics
September 2015 Vol 148 Issue 3
Retrospective: What a difference 10 years can make Morris N. Poolea and Robert E. Varnerb Logan, Utah, and Roseburg, Ore
T
he French author Franc¸ois de la Rochefoucauld said, “The only thing constant in life is change.” This maxim is an apt description of the American Association of Orthodontists (AAO) during the past 10 years. When we first joined the AAO Board 10 years ago, members used e-mail but often still communicated with each other via fax and phone. The House of Delegates used a book of proposed resolutions that was a few inches thick. At each Board of Trustees meeting, we had a Board book that was also a few inches thick. Today, these methods have largely given way to frequent e-mails and the use of Dropbox and Sharepoint to circulate and collaborate on motions and documents. AAO members enjoy the convenience of reading the American Journal of Orthodontics and Dentofacial Orthopedics on ajodo.org and receiving association news via aaoinfo.org, the eBulletin, the member app, and social media outlets—in addition to the printed Bulletin. Technology has also made it possible for the AAO to offer many of its numerous marketing, practice management, and patient education materials as free downloads on aaoinfo.org, rather than requiring members to call the AAO office and purchase materials. Technology has definitely been our friend. Of equal importance, however, is the fact that a member who wishes to communicate with a person can still call the AAO office to ask about a meeting, contact the Legal Department or the Library, obtain guidance in customizing AAO marketing materials, or request help with other practice management needs. The AAO has always focused primarily on protecting the specialty and serving the needs of its members, while ensuring that members can provide the best possible a
President, American Association of Orthodontists, 2015-2016, Logan, Utah. President, American Association of Orthodontists, 2014-2015, Roseburg, Ore. Am J Orthod Dentofacial Orthop 2015;148:358-9 0889-5406/$36.00 Copyright Ó 2015 by the American Association of Orthodontists. http://dx.doi.org/10.1016/j.ajodo.2015.06.001 b
358
treatment for their patients. Those standards, set by all of the leaders who preceded us, have never changed. During the past 10 years, however, a perfect storm of intensified outside pressures, demographic changes, and new opportunities has posed challenges to leaders and brought out unprecedented strengths in the association. The AAO Board responded to the challenging environment facing the specialty first by deepening its strategic capabilities. During our early years on the Board, the AAO Strategic Plan was developed as a tool to keep our focus on the greatest concerns of the association and the specialty. We now include in the strategic plan a few critical issues to focus our efforts and marshal our resources. Each year during the annual Board planning session, the strategic plan and critical issues are evaluated and updated as needed. The plan is then reviewed and amended as needed by a committee of the Board of Trustees and the House of Delegates, and then finally approved by the House of Delegates. We believe that this focus on critical issues has enabled the AAO to maintain its relevance and better use its resources to serve members. The AAO educates the public about orthodontics
During the past 10 years, a major member concern has been the growing numbers of general dentists who, facing the economic challenges we have all endured and intrigued by the possibilities of clear aligners, have begun providing orthodontic treatment. Many patients thus began treatment from nonorthodontists. The Board of Trustees, the Council on Communications, and the House of Delegates realized that if we failed to tell our story to the public, others would tell it for us. The House of Delegates chose to respond to this challenge by mounting an intensive effort to position orthodontists as the specialists uniquely qualified to align jaws and straighten teeth. The current Consumer Awareness Program, begun in 2006, has used national advertising, public relations,
Poole and Varner
and social media programs to educate the public about both the training and qualifications of orthodontists, and the benefits of orthodontic treatment. The consumer Web site, mylifemysmile.org, provides similar information to the site's approximately 300,000 information-seeking visitors each year. Expenses for the Consumer Awareness Program have been covered by a member assessment. To ensure that we were reaching our key audiences and spending our members' money in a useful way, we implemented consumer research. In 2009, we retained the research company Millward Brown and then recently retained Decision Analyst to conduct ongoing consumer research on orthodontic market share and consumer responses to the AAO's marketing communications. Member demographics are changing rapidly
From 2007 to 2014, AAO member demographic shifts included an increase from 1% to 6.9% of members in the millennial group (those born in 1982 or later). These members, facing a challenging job market, have responded by joining corporate and other nontraditional practices in growing numbers. Results of the 2012 AAO Member Practice Environment Survey indicated that nearly 32% of members in practice for less than 5 years entered the specialty as employees of large corporate or interdisciplinary practices offering orthodontic services. The AAO is working to understand and address the needs of our youngest members via multiple initiatives, including an annual meeting with representatives of corporate dental groups and a dialog with younger members at the annual Emerging Leaders Conference. From 2004 through 2014, international memberships in the AAO increased from 2426 to 2772. International student membership was introduced in 2008 and has increased from 93 to more than 500. As orthodontists around the world increasingly perceive value in AAO membership, the AAO will work to identify these members' unmet needs and to further expand programs and resources that will be of interest to them. As members' needs change, the AAO system of governance may need to be updated to ensure that the needs are met as effectively as possible. An intensive review of our governance has been underway since the fall of 2013. As the study continues, each year the House of Delegates will review the information produced and consider recommended changes.
359
We advocate for the specialty
For more than 20 years, an annual meeting has brought together members of the AAO who wish to advocate for public policy that is friendly to the practice of orthodontics. In 2009, this meeting was renamed the Professional Advocacy Conference. In addition, proposed laws are reviewed on an ongoing basis to assess their impact on orthodontic practice. The AAO has worked with other dental organizations on advocacy, often leading to outreach to legislators and the development of legislative fixes to problematic laws. Examples from recent years include the following. The AAO and other dental organizations worked together successfully in 2010 to secure exclusion of dental practices of all types from the Red Flags Rule. The rule was designed to extend the definition of a creditor to any entity that provides a service under a payment plan agreed upon by the provider and the customer. It also requires creditors to develop and implement written identity-theft programs. During 2011, the AAO and other dental organizations succeeded in persuading federal legislators to repeal a section of the 2010 Affordable Care Act that would have required all businesses to issue Form 1099 to vendors from which they purchase $600 or more of goods or services annually. During the past year, the AAO led the process of drafting a bill that was introduced in Congress in February, raising from $2500 to $5000 the annual cap on flexible spending account deposits per qualified employee (assuming that the employer offers these). Many orthodontic patients finance their treatment using these accounts. Where will we be in 10 years?
We have seen many changes in the past 10 years. We imagine that with the massive changes underway in AAO membership and the practice environment, the specialty will be vastly different in 10 years. This is a great specialty, and we must continue to do everything we can to protect it and our members. Although we will no longer be AAO leaders in 2025, we look forward to continuing to travel with our colleagues on what will undoubtedly be a fascinating journey.
American Journal of Orthodontics and Dentofacial Orthopedics
September 2015 Vol 148 Issue 3