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Talking to ourselves
EDITORIAL J Oral Maxillofac Surg
45:471,1987
Talking to Ourselves Fragmentation of the dental profession is becoming an increasingly serious problem. Nurtured by concerns of the membership about combating the lack of busyness, redefinitions of scope, recognition of new areas of specialization, and desires of various groups for political control, this lack of unity is gradually eroding the very foundation of organized dentistry. The American Dental Association (ADA), which historically has been the unifying force in the profession, is now facing serious challenges on several levels. Of particular concern has been the need for improvement of intraprofessional relationships, as well as relationships between the specialist and the generalist. To meet one of these challenges and to promote more effective communication between the various dental specialties, the ADA Board of Trustees recently established a Special Committee on Intraprofessional Relations to study the issues that thwart these communication efforts and to develop strategies to deal with them. It is important that there be a forum for representatives of the various dental specialties to meet because of the obvious difficulties that need to be identified and resolved. There are also key policy issues on which consensus is needed to reach a united front. However, resolving problems within the specialties is only one step in the unification process. It is equally, or perhaps even more, important to have a conduit whereby the general concerns of the specialties can easily be brought to the hierarchy of the ADA. A committee on intraprofessional relations or a council on specialties, as recommended by the ADA Special Committee on Fragmentation, does not resolve this situation. Such forums are helpful, but the major concerns of the specialties will never be addressed adequately by merely talking among themselves. It has been argued that since we are all dentists, the ADA House of Delegates and the Board of Trustees represent us all equally. Not only is this untrue for the specialist, but the establishment of a competing organization to represent the generalists would seem to indicate that even many of them have concerns about proper representation. This is not meant to imply that what is good for a group with a special interest is always good for the entire profession. However, such groups do have the right to be heard. If the ADA is to reestablish its position
471
of strong leadership and create unity, it must provide for this voice. Opportunity for input from specialty organizations needs to occur at an early stage in the decision-making process. Although the ability to provide written or verbal commentary on draft documents or policy statements may appear to be a democratic process, experience has shown that such efforts generally have very little effect on the ultimate outcome. To be effective, there is need for directed input on issues within the appropriate ADA Councils and agencies during the developmental stages. Just as there is specialty representation on the Commission on Dental Accreditation, there should also be an ad hoc member on every Council to monitor its activities and serve as a liaison person with the specialties. Furthermore, it is important to establish a permanent Council on Specialties to deal with intraprofessional relations and concerns on an ongoing basis; representatives to this council should be appointed by the specialty organizations and not the Board of Trustees. Direct input from the specialties to the ADA Board of Trustees is another issue that needs to be addressed. Again, one can look to the Commission on Dental Accreditation where each specialty serves for two years on a rotational basis as a pattern for implementation. At the other end of the governing process, there is also need for greater involvement of the specialties in the House of Delegates. Each recognized specialty should be allocated a delegate position so that there is easy access to the floor of the House. The fact that there are specialists already serving as delegates does not negate this suggestion, because it would be hoped that those who represent their state dental societies do so without a vested interest. By improving the input from the various dental specialties at all levels, the ADA can take a major step toward reestablishing a strong, unified profession. The early exchange of information, ideas, and opinions on critical issues will do much to avoid confrontation and to create professional harmony. While it is always gratifying to establish one's point of view, failing to have your way after reasonable discussion is not half as bad as never having the opportunity to be heard in the first place. DANIEL
M. LASKIN
45:471,1987
Talking to Ourselves Fragmentation of the dental profession is becoming an increasingly serious problem. Nurtured by concerns of the membership about combating the lack of busyness, redefinitions of scope, recognition of new areas of specialization, and desires of various groups for political control, this lack of unity is gradually eroding the very foundation of organized dentistry. The American Dental Association (ADA), which historically has been the unifying force in the profession, is now facing serious challenges on several levels. Of particular concern has been the need for improvement of intraprofessional relationships, as well as relationships between the specialist and the generalist. To meet one of these challenges and to promote more effective communication between the various dental specialties, the ADA Board of Trustees recently established a Special Committee on Intraprofessional Relations to study the issues that thwart these communication efforts and to develop strategies to deal with them. It is important that there be a forum for representatives of the various dental specialties to meet because of the obvious difficulties that need to be identified and resolved. There are also key policy issues on which consensus is needed to reach a united front. However, resolving problems within the specialties is only one step in the unification process. It is equally, or perhaps even more, important to have a conduit whereby the general concerns of the specialties can easily be brought to the hierarchy of the ADA. A committee on intraprofessional relations or a council on specialties, as recommended by the ADA Special Committee on Fragmentation, does not resolve this situation. Such forums are helpful, but the major concerns of the specialties will never be addressed adequately by merely talking among themselves. It has been argued that since we are all dentists, the ADA House of Delegates and the Board of Trustees represent us all equally. Not only is this untrue for the specialist, but the establishment of a competing organization to represent the generalists would seem to indicate that even many of them have concerns about proper representation. This is not meant to imply that what is good for a group with a special interest is always good for the entire profession. However, such groups do have the right to be heard. If the ADA is to reestablish its position
471
of strong leadership and create unity, it must provide for this voice. Opportunity for input from specialty organizations needs to occur at an early stage in the decision-making process. Although the ability to provide written or verbal commentary on draft documents or policy statements may appear to be a democratic process, experience has shown that such efforts generally have very little effect on the ultimate outcome. To be effective, there is need for directed input on issues within the appropriate ADA Councils and agencies during the developmental stages. Just as there is specialty representation on the Commission on Dental Accreditation, there should also be an ad hoc member on every Council to monitor its activities and serve as a liaison person with the specialties. Furthermore, it is important to establish a permanent Council on Specialties to deal with intraprofessional relations and concerns on an ongoing basis; representatives to this council should be appointed by the specialty organizations and not the Board of Trustees. Direct input from the specialties to the ADA Board of Trustees is another issue that needs to be addressed. Again, one can look to the Commission on Dental Accreditation where each specialty serves for two years on a rotational basis as a pattern for implementation. At the other end of the governing process, there is also need for greater involvement of the specialties in the House of Delegates. Each recognized specialty should be allocated a delegate position so that there is easy access to the floor of the House. The fact that there are specialists already serving as delegates does not negate this suggestion, because it would be hoped that those who represent their state dental societies do so without a vested interest. By improving the input from the various dental specialties at all levels, the ADA can take a major step toward reestablishing a strong, unified profession. The early exchange of information, ideas, and opinions on critical issues will do much to avoid confrontation and to create professional harmony. While it is always gratifying to establish one's point of view, failing to have your way after reasonable discussion is not half as bad as never having the opportunity to be heard in the first place. DANIEL
M. LASKIN