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Features
Larger Than Whose Life?
The 2003 MDA President's Interview
When the editors of Northwest Dentistry gave this annual feature the working title of the traditional mid-year president's interview, they quickly discovered that each president, and each year, has its own impact on the traditions of the life of a dentist. Five years ago who could have imagined some of the topics readers will find in these paragraphs? But five years ago the MDA looked in the direction of Saint Paul's Dr. Scott Lingle to step onto its officers' ladder, reaffirming a strong tradition of talented leadership and professional dedication. Dr. Lingle often speaks in Italics, and, as you will see, he [laugs] - [a lot]. Another tradition we recommend.
The Editors
NWD: The Lingle family is synonymous with dentists and organized dentistry. Did you always know you'd be a dentist?
Dr. Lingle: I suppose when I was five I did want to be a firefighter. [laughs] But actually dentistry wasn't always on the radar screen. I always knew about dentistry, but the view my brother and I had of it was "from the outside" , shoveling snow off the sidewalk or hauling stuff to the basement! When manual labor was needed, that was our participation in dentistry! Every kid just knows what Dad's job is, and in a small town everyone knows who "Doc" is, and that was what I saw about dentistry: my father's personal involvement with thousands of people. Both he and my mother were very well known leaders in the community, so dentistry was not the focus in our lives.
I was always interested in science, so I took a biology major
in college, got interested in genetics, and started taking advanced
courses. I became something of a protégé of one
of the genetics professors at UMD. That was the closest I ever
came to getting kicked out of college! During one of the first
classes I took from him, I was called to his office, where he
accused me of cheating! He was going to have me expelled."No
one," he said, "has ever aced my test before", and I had to
re-take the mid-term orally. When I finished, he offered me
a job!
I worked for him with the thought I wanted to go into genetics research, and he allowed me to work with him on a genetics research project at the medical school with the single purpose of showing me I had absolutely no place in research , that I was an extrovert, that I had no patience for long-term results, and that I really needed to go into a science and people-oriented profession. I needed, he said, to go back and look at health care because that was where I really needed to be.
I knew dentistry somewhat. I liked the idea of being a small business owner. After looking at where medicine was going and the business side of it, dentistry just seemed a good fit and a natural process for me. It took a circuitous route, but I have loved it ever since.
Even in school, even in dentistry, I had to find my own special interests, such as the implant field. At that time, the mid 70s, we were being taught implants don't work. But I had a patient who had them, and I saw an inconsistency between what I was being taught and what the real world was showing me. Again I found a mentor: Dr. Ted Morstad, Chair of the Prosthetics Department at the University of Minnesota. Sitting and chatting in his office, he would give me a variety of international journals. "There are a lot of ideas out beyond Minnesota," he'd tell me, "and you need to look at those." He really fostered my interest in what turned out to be the opposite of what we were being taught "officially".
NWD:We didn't realize you had been involved in it that long. . .
Dr. Lingle: Those first few years you didn't really dare tell anybody. Then in 1984 Branemark published. Implants became accepted, and I became the expert, asked to lecture [laughs]. I went from charlatan to teacher very quickly.
Continuing education has always been a love of mine, and that led me to the Scientific Session Committee (SSC). Even right out of school, my education continued, and not just in the implant field. I found I enjoyed my geriatric and older patients more so than the children. I started in the suburbs in a family practice and found I liked it downtown with a practice of older patients. And I like the surgical part. I am a general dentist , no speciality, but I do have a focus that is unique and gives me an opportunity I enjoy. I encourage our younger members to be independent in their thinking. My classmates had to, in effect, "un-learn" that implant dentistry didn't work. Since I was never convinced of that, I never had to. Time unwinds all philosophies, so keep that open mind.
I was lucky to grow up as I did. My I was lucky to grow up as
I did. My parents were always officers of the multitude of organizations
they belonged to. While recognizing our different personalities,
that was still expected of us. College was an eye-opener. I
struggled the first year because I hadn't learned to study,
but I figured it out and graduated with honors. So I'd say figure
out what you do well (and what you don't!), make sure you enjoy
it, and direct your energy that way. Go where you'll be the
most effective, and you'll personally get the most rewards back.
Part of learning to say "no" is realizing where you are not
going to be effective , don't take a seat that could belong
to someone who could be much more effective. That's where our
association structure works so well. We have opportunities for
so many different people. Look at the people in those positions:
such a diversity of talent and interest. It's so important to
foster that. For younger dentists that can feel intimidating,
but give it a chance.
NWD: How did you get into organized dentistry, and how did that take you to the MDA presidency?
Dr. Lingle: [laughs] I don't really remember. My dad was a district president and an MDA trustee. He was always involved on the local level. It's so rewarding to meet dentists who tell me the first call they got when they arrived in the West Central District was my dad inviting them to go to a meeting with him. That personal outreach is deja vu with our current membership initiative. ADA President Chadwick, when he started this, said, "The number one reason people give for not getting involved is no one asked." After 40 years, it's nice to see that circle completed.
As for my being in organized dentistry, [laughs] that expectation came from the other dentists. "You're Dave Lingle's kid , you're going to be involved." And of course my family's expectation was that whatever you do, you will always be involved. It's yours, you give something back. It wasn't just organized dentistry, but volunteerism. I also think as you are more involved you will gravitate to the top , leadership positions aren't related to how much you know so much as to how much you talk! [laughs] It's also part of my personality that if I want something done, I'd better be willing to do it.
As for being president, when they asked, I said, "Boy , are you sure? There are a lot of good people out there that maybe you should consider before me." It is a responsibility, and yes, the world does seem busier these days. But my family has been very supportive. It's a process.The first year you are not expected to do much more than listen and learn. It's amazing what you learn about the multitude of issues and activities the MDA is addressing. The next years you become more informed, learn the background, and most importantly start to learn the many sides of the issues. Appreciating the different viewpoints allows you to be a much more critical thinker about valuing the different viewpoints. As president, the difference is, when push comes to shove, you get to make some decisions. The first thing I did as president was change committee structure, eliminating the Education and the Public Policy committees. With the access issue coming so much to the fore, the MDA had been accused (I think rightly so) of being somewhat single-focused in their mindset and representation on the subject. The new Access Committee has a real diversity of viewpoints. While harder to reach concensus, it is better to have discussion at the committee rather than the legislative level. Everyone would like results faster, but this looks to be an effective process with good support and direction.
NWD: As president, which activities are you most involved in? Or, as folks are inclined to put it, what does a president do?
Dr. Lingle: Well, you still have your day job. But there is a significant time commitment. Most meetings tend to be evenings, Fridays, weekends. . . [laughs] Very few are impromptu, but when they are, you realize how important a supportive staff and patients are. What do I do? I go to a lot of meetings, and then I go to some more. I'll visit the Publications Committee to show them I think what they do is very important, but I'm not going to get involved in their committee business. That is a committee with a very special role, and it functions very well. They are not looking for input from me. Like SSC, that's a working committee with a long history and direction. The Access Committee is new and was looking for direction. I have been involved with the amalgam separator project for years, and now there is bioterrorism and our new role with that issue. [laughs] I don't know that we've gotten rid of any old issues, but we sure have added some new ones! So what does the president do? Maintains those open corridors. Yes, close some, but be ready to open new ones. Create and monitor a focus.
The pleasures are, as always, the people you get to meet and deal with, such as my greater involvement with the rest of the Tenth District, the different viewpoints, the common concerns, meeting the top people in their states. I still get hassled by the West Central District about how I ended up in Saint Paul, but now my brother Phil is president-elect of the District so the pressure is off. Getting to know dentists throughout the state has been great. People think dentists just know each other, but we don't. We're in our offices eight to ten hours a day. Don't ever underestimate the pleasure of knowing so many people in our profession. Lose the mindset that you are going to have to do a lot of work, join, and avail yourself of that very basic and very real benefit.
NWD: Plans after this year?
Dr. Lingle: [laughs] I have no agenda. I'll always be involved. I intend to practice a long time and do more things there. I would like to get back to teaching. I had been a clinic instructor at the School , actually while I was a student. That was kind of unheard of. I really loved that. Implants have allowed me to fit teaching into my schedule.
NWD: Your first President's Message discussed issues and objectives for the year. Orient us on the mid-term status of those. How about membership?
Dr. Lingle: The personal commitment the ADA Membership Initiative has called for is something we have to do. You have to represent everyone, exclude no one, and yet you can never please everyone. But that's just people. Keep from becoming exclusive, impersonal, homogeneous. Minnesota's diversity is metro/rural, male/female, new and senior practitioners, increasing cultural diversity among both dentists and patients. We have to embrace this and our membership initiative is being very successful.
NWD:And the big one: access.
Dr. Lingle: We do need new ideas about this old problem. The frustration for me has been that we have had so many different voices speaking for dentistry , the community clinics have become a very strong voice, the health plans, certain legislators who see the concern but are getting information from many sources with too specific an agenda. It is important that we as the leaders of dentistry try to bring the voices together and debate among ourselves. With our knowledge and concern we can come up with a concensus statement and effective, prioritized ideas, take them to the legislature or other groups, and get much better results. We really have lost some control and focus in the legislative process.
Access is a hard term to define. It's more than "underfunded dental programs." The lines between it and workforce are blurring; they need to be embraced as a single topic. Access to care can be financial, availability of dentists, workforce shortage, transportationƒ Throw in a budget crisis, and we have to redefine yet again. We have to think much more broadly than in the past.
We need to work with the academic community on what we define as important. We don't have a definition for basic oral health care, as stated by Assistant Dean Gary Anderson. Define basic oral health, and you can address minimal oral health services and personnel to achieve that. We structured the Access Committee for that diversity. I'm looking to the MDA to be the conduit for concensus. We're dealing with the University of Minnesota, community clinics, volunteer clinics, the allied professions, but when we sit down together, we are all dental professionals. My goal is a forum where they feel welcome to bring in controversial viewpoints. In the past they felt they had to go to the legislature because they weren't welcome here.
We have innovative ideas such as emergency care clinics for dentistry. Now people without dental access are going to medical emergency rooms, using health care dollars yet not receiving definitive treatment. Our medical colleagues are a group we have not worked with, yet dental emergencies are "high on the radar" of hospital administrators and ER physicians.
NWD: Access is not just a rural issue, then, and that trend will continue?
Dr. Lingle: Minnesota is still dead last in recruitment and retention of dentists, a problem we have to address in the small business environment. In some small towns the dental office is one of the main businesses. We have to carry that view to the legislature too.
NWD:Amalgam safety, and amalgam recovery.
Dr. Lingle: While science has shown that amalgam is safe to use in the mouth, science changes too , we can measure things now we couldn't 20 years ago. We are constantly evolving in our practices based on consumer demand and good science. When we have good science, we have to defend it. Even an amalgam-free office has to be prepared to defend good science and our profession. We must monitor science, react to it appropriately, and defend the process.
Amalgam recovery is where Minnesota has taken a track different from a lot of states, and we've had a wonderful response. Rather than fighting the issue, we have recognized that whereas amalgam does not necessarily pollute, if you incinerate its waste, that does. We are providing raw material, and we have to be responsible for how we handle that. It is just the next generation of "the right thing to do". I have enjoyed nothing but support from the dentists of Minnesota, and many other states have told us they like the track we're taking , somewhat contrary to the ADA giving us all this information to fight it. We don't want to fight it. We want to be part of the solution. It is a very forward-thinking model, and not just for this issue. etropolitan Council Chair Ted Mondale called this a wonderful example of a government and private business partnership, showing cooperation will always be superior to just regulation. Everyone will benefit.
As for bioterrorism, it is rewarding to see the ADA and Northwest Dentistry articles. A lot of good people are involved, but there is a lot to do. We need to define the question. We want every dentist to put it on the list of "things I need to find out about" because dentists are going to play a very definitive role, one we simply cannot afford to learn after the fact.
NWD:The state budget deficit. . .
Dr. Lingle: From a solo entity the School of Dentistry has become part of the Academic Health Center. It is incumbent on the profession to be there for this very valuable resource. Yet we have to look at new tracks there too. Educational aid is a field that has been abused, and it needs change to get the most for the dollars that are there. We have the added challenge of
replacing the dean. We have to make sure the importance of the dental school and this position are understood. As for funding, alumni can and should be a big source of revenue for the School, but unfortunately there are some who do not come away with good feelings. That needs to be addressed.
Today's students are a force beyond what they have ever been in the past! They have a voice they've never used before, an organization that is one of the best in the country. Their leadership on the national level is unprecedented and is something all the dentists in Minnesota can be proud of. The Association is so proud of what they do. As a political force, they carry a different political message from what the practicing dentists can, and it has created a wonderful synergy.
I do have a real concern with the legislature taking on topics such as expanded duties and different delivery models and systems. That used to go through the Board of Dentistry with good discussion. I'm not impressed by the helter-skelter process that takes place in the legislature. It has set a bad precedent.
Workforce is a problem we cannot delay addressing. We have to continue to identify with good numbers what the problems are. Not just numbers of dentists, but productivity, practice style. . . Career opportunities for two-career families takes us right back to the climate for business and industry in rural areas. So we have to work with the state on economic programs and the School with not only numbers but exposure to different modes of dentistry, not just outreach but diversity
of experience , mobile situations, nursing homes. The picture is much bigger than just numbers.
NWD: What do dentists need to understand in order to move forward together?
Dr. Lingle: Communication is everything. We can provide so much information! This is your association , active or inactive, I want you to know what is going on. I would eventually like to see a weekly update online. . . Dentists have to understand the MDA is working for them. And we need the personal contact such as district events. Another area is staff , a dentist's office staff is a hugely important part of practice. The MDA has established relationships with the Hygiene
and Assistants Associations, but we are lacking educational opportunities for the business staff. We always have a few things at the Star of the North Meeting, but I often hear business staff say there isn't enough for a whole day. The SSC works hard looking for that, but it needs to be more than just a once-a-year shot. And dentists rob themselves of professional staff, making assistants receptionists and then complaining about the lack of assistants. We do not have a truly solid dental business person training program in Minnesota. We need that on a continuing
basis; perhaps a formal association we can support.
There is so much to do we need all our members on board. Take the experience and perspective of our older members. Their synergy with "new blood" and new ideas makes an irreplaceable combination. It's okay to take a break, but it's also okay to get involved again. You served on that committee years ago? Serve again! To our younger members I'd say gain experience, acquire transferable skills, make your mistakes, join the discussion. Age diversity is something we have to look at. Older members understand problems the younger ones won't even be aware of yet. We not only want our senior members to have the opportunity to participate, I think they have an obligation to do so, and to bring forward the concerns that most affect them. If they don't, who will?
NWD: You've put a lot on the table. What's next?
Dr. Lingle: This has been an evolution. What next? [laughs] I don't know! While I look forward to being able to focus on smaller areas again and to pick something that is going to be important to me, it has been a genuine honor and privilege to have had this opportunity. I wouldn't have missed it for anything. I thank all the members for their support, encouragement, and advice. I would add my thanks to the MDA staff. Members should understand what a dynamic group we have here and how much effort they put in on behalf of all our members. The Minnesota Dental Association is a dynamic and far-reaching organization, and I have enjoyed discovering its many aspects. I recommend it.
Copyright 2003. Minnesota Dental Association.
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