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The medium and the message of orthodontics
EDITORIAL
The medium and the message of orthodontics THE present concern of the health professions with improving their public image is not directed as much toward gaining sympathetic public understanding of their professional status as it is toward public appreciation of quality health care as a desirable end in itself. Although we have the knowledge and the means to reduce dental decay and malocclusion materially, we have not even begun to do SO. Dental and oral diseases, including malocclusion, still are the most prevalent disorders among the population. A World Health Organization proclamation states: “The enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic, or social conditions.” While the foregoing is true, the attainment of this goal depends on the individual’s health appreciation and the professional personnel available to meet the demand for care. The increase in prepayment and government-funded health service plans has disclosed that inability to pay, while an important stumbling block to lowincome families, is far from being the main reason for t,he general low level of utilization of health care by those for whom it now is a\:ailable without, regard to financial responsibility. The educational rnessage on the value of orthoclont,ic tare still has not been delivered to the consumer. The layman is not qua,lified to judge for himself when he needs treatment or bo evaluate the quality of care that he receives from the doctor hc consults. He cannot determine the qualit,y of t,ht services he rec,eivcs by the price or fee charged, and he cannot make quality comparisons in the marketplace, as he does when he purchases consumable or household commodities. Robert MS.Ball, Commissioner of Social SecuriQ-, United States Department of Health, Education and Welfare, speaking on costs of health care, point,ed out tha.t at. present we do not know how to promote the combination of qualit,y care and its economic and efficient delivery to the consumer. DC warns that we should guard against emphasizing cost that saves money but lowers the qualit,y of health service. i Recent studies indicate that the demand for medical care increases in proportion to income. However, the demand for dental care has been found to be more elastic in relation to income than the demand for medical service in gen-
470
Volume Number
54 6
Editorial
471
eral. The initiative for translating need for treatment into active demand still rests with the patient. In orthodontics, it depends mostly on the patient’s mother. Expenditure for dental care is related to (1) education, (2) environment, (3) way of life, and (4) genetic background. The subjective determinants that affect the degree of utilization of orthodontic service do not always apply to dental treatment in general. The incentive of toothache is practically absent in malocclusion. No one goes to the orthodontist because of an “acute attack of crooked teeth.” The demand for orthodontic treatment is motivated, as a rule, by the esthetic value of “a pleasant smile” as well as the general high degree of tooth consciousness of the American people, thanks to motion picture and television close-ups. A report of the Committee on Specialists and General Practice of the American College of Dentists points up the fact that there is a failure in communication between the general practitioner and the specialist in dentistry. Under present circumstances, it is extremely difficult, if not impossible, for them t,o communicate in depth. It took 1,750 years from the year A.D. 1 to double the world’s knowledge. The second doubling of knowledge took 250 years, to the year 1900. The third doubling of knowledge took only 50 years, to 1950, and the fourth doubling of our knowledge took only ten years, to 1960. It is now doubled every 7 years. In his keynote address at the Conference on Biomedical Communications, held at the New York Academy of Sciences, Dr. Leo J. Gehrig, Deputy Surgeon General, United States Public Health Service, stated the following : Better communication is indispensable to the practicing health professional, for his profession, whether it be medicine, dentistry, or any allied discipline, is moving so fast that his supply of working knowledge is made obsolete year by year unless it is constantly replenished. Finally, and most fundamentally of all, better communication is essential to the consumer of health services-for unless he knows when to seek help, where to seek it, and how to follow a prescribed course of action, all the marvels of modern medicine will pass him by.
An executive or a skilled worker would be lost if he did not learn anything new about his job for a period of 5 years or even 1 year, with technical progress proceeding as rapidly as it does today. If the family dentist, and the specialist are to communicate on a professional level, they must speak the same language. To accomplish this end, they must continue their education throughout their professional life and show more than a cursory interest in their cognate areas of practice. We must establish a wide band of communication with the general practitioner before we can put our message across to the public. Margaret Mead, one of the outstanding cultural anthropologists, states the case for the importance of communication with the public in the following words : “The human sciences occupy a peculiar position in this age of over-specialization and alienation of the scientist, because no human science can go very far, even with research, without intelligent support from the general public.‘12 To receive such support, health education must start with the child and should be included as one of the subjects, on a par with the “3 R’s,” taught
17 2
Editoriul
schoolchildren if health standards ilre I,(, be mai~~taincvl irl thrb faw 01’ irwrrasing demand for servire. REFERENCES 1. Ball, R. M.: Problems of Cost-As Experienced Conference on Medical Costs, Washington, 1967, and Welfare. 2. Mead, M.: Anthropologis,ts, Scientists and the Issue, 1967.
in Medicare, IT. S. I)epartment Laity,
Thr
Report of the National of Health, Education Rcifmcta,
Kesquiccntennitrl J. A.
Salzmnn
The medium and the message of orthodontics THE present concern of the health professions with improving their public image is not directed as much toward gaining sympathetic public understanding of their professional status as it is toward public appreciation of quality health care as a desirable end in itself. Although we have the knowledge and the means to reduce dental decay and malocclusion materially, we have not even begun to do SO. Dental and oral diseases, including malocclusion, still are the most prevalent disorders among the population. A World Health Organization proclamation states: “The enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic, or social conditions.” While the foregoing is true, the attainment of this goal depends on the individual’s health appreciation and the professional personnel available to meet the demand for care. The increase in prepayment and government-funded health service plans has disclosed that inability to pay, while an important stumbling block to lowincome families, is far from being the main reason for t,he general low level of utilization of health care by those for whom it now is a\:ailable without, regard to financial responsibility. The educational rnessage on the value of orthoclont,ic tare still has not been delivered to the consumer. The layman is not qua,lified to judge for himself when he needs treatment or bo evaluate the quality of care that he receives from the doctor hc consults. He cannot determine the qualit,y of t,ht services he rec,eivcs by the price or fee charged, and he cannot make quality comparisons in the marketplace, as he does when he purchases consumable or household commodities. Robert MS.Ball, Commissioner of Social SecuriQ-, United States Department of Health, Education and Welfare, speaking on costs of health care, point,ed out tha.t at. present we do not know how to promote the combination of qualit,y care and its economic and efficient delivery to the consumer. DC warns that we should guard against emphasizing cost that saves money but lowers the qualit,y of health service. i Recent studies indicate that the demand for medical care increases in proportion to income. However, the demand for dental care has been found to be more elastic in relation to income than the demand for medical service in gen-
470
Volume Number
54 6
Editorial
471
eral. The initiative for translating need for treatment into active demand still rests with the patient. In orthodontics, it depends mostly on the patient’s mother. Expenditure for dental care is related to (1) education, (2) environment, (3) way of life, and (4) genetic background. The subjective determinants that affect the degree of utilization of orthodontic service do not always apply to dental treatment in general. The incentive of toothache is practically absent in malocclusion. No one goes to the orthodontist because of an “acute attack of crooked teeth.” The demand for orthodontic treatment is motivated, as a rule, by the esthetic value of “a pleasant smile” as well as the general high degree of tooth consciousness of the American people, thanks to motion picture and television close-ups. A report of the Committee on Specialists and General Practice of the American College of Dentists points up the fact that there is a failure in communication between the general practitioner and the specialist in dentistry. Under present circumstances, it is extremely difficult, if not impossible, for them t,o communicate in depth. It took 1,750 years from the year A.D. 1 to double the world’s knowledge. The second doubling of knowledge took 250 years, to the year 1900. The third doubling of knowledge took only 50 years, to 1950, and the fourth doubling of our knowledge took only ten years, to 1960. It is now doubled every 7 years. In his keynote address at the Conference on Biomedical Communications, held at the New York Academy of Sciences, Dr. Leo J. Gehrig, Deputy Surgeon General, United States Public Health Service, stated the following : Better communication is indispensable to the practicing health professional, for his profession, whether it be medicine, dentistry, or any allied discipline, is moving so fast that his supply of working knowledge is made obsolete year by year unless it is constantly replenished. Finally, and most fundamentally of all, better communication is essential to the consumer of health services-for unless he knows when to seek help, where to seek it, and how to follow a prescribed course of action, all the marvels of modern medicine will pass him by.
An executive or a skilled worker would be lost if he did not learn anything new about his job for a period of 5 years or even 1 year, with technical progress proceeding as rapidly as it does today. If the family dentist, and the specialist are to communicate on a professional level, they must speak the same language. To accomplish this end, they must continue their education throughout their professional life and show more than a cursory interest in their cognate areas of practice. We must establish a wide band of communication with the general practitioner before we can put our message across to the public. Margaret Mead, one of the outstanding cultural anthropologists, states the case for the importance of communication with the public in the following words : “The human sciences occupy a peculiar position in this age of over-specialization and alienation of the scientist, because no human science can go very far, even with research, without intelligent support from the general public.‘12 To receive such support, health education must start with the child and should be included as one of the subjects, on a par with the “3 R’s,” taught
17 2
Editoriul
schoolchildren if health standards ilre I,(, be mai~~taincvl irl thrb faw 01’ irwrrasing demand for servire. REFERENCES 1. Ball, R. M.: Problems of Cost-As Experienced Conference on Medical Costs, Washington, 1967, and Welfare. 2. Mead, M.: Anthropologis,ts, Scientists and the Issue, 1967.
in Medicare, IT. S. I)epartment Laity,
Thr
Report of the National of Health, Education Rcifmcta,
Kesquiccntennitrl J. A.
Salzmnn