From time to time material submitted as part of a district report is called out by Northwest Dentistry’s Editorial Advisory Board (formerly the Publications Committee) in order to call it to the attention of a greater number of our readers. Such is the case with the following piece by Saint Paul District Dental Society president-elect Paul Vollmer. It is most appropriate that it appear under the heading “Minnesota News” as it concerns each and every dentist in the state, and, we can hope, might create a ripple effect that could carry its message across our borders to the wider profession.
The word “resolution” has a variety of meanings. Feel free to consider them all, and allow the resolve to center itself in your thinking. It will, we feel, resonate with anyone who will listen to its counsel.
As we all start another new year, most of us think of some resolutions to set for ourselves: Exercise more or start some sort of diet, strive to spend less and save more for retirement or our children’s educations. Some of us might plan to spend more time with our families or to be more involved in our kids’ lives. We might even set professional goals like attending a particular continuing education course or working at perfecting a professional skill. Overall, many of us set resolutions that affect our personal lives.
But as we start the new year, should we not consider our profession as well? Sure, we make personal resolutions — even resolving to better our professional skills is still a personal goal. What about giving back to the very organizations that make our livelihoods possible? Perhaps we should consider that we might not be able to practice the way that we do without them!
Some among us might feel this statement overly bold or brazen. After all, many dentists out in the community who are not ADA tripartite members do just fi ne for themselves – right? I would disagree with this train of thought, and advise those dentists who feel as though they don’t need organized dentistry in the form of our tripartite membership that they would be far worse off without it. And I would also argue that we would have an even stronger stance if we had a membership rate closer to 100% of practicing dentists instead of the current 67%. So as we think about our New Year’s resolutions, would it be so awful to consider adding one or two dedicated to keeping our profession strong well into the future? If not keeping it strong for those of us in practice today, how about for all of those dental students who are racking up a tremendous amount of debt trying to enter our profession? After all, the average dental student graduates with upwards of $221,000 of student loan debt according to the American Dental Education Association. This is an increase of more than 66% in the last decade, and vastly exceeds the debt of students pursuing other fields of study. This ongoing steep rise may result in students picking other fields of study to enter over dentistry.
Also, one needs to keep in mind the demographics of the typical dentist in the U.S. and within our state today. According to a 2008 study by the Minnesota Department of Health’s Office of Rural Health and Primary Care, half the dentists in the state of Minnesota were 50 years or older, with 40% over the age of 55. And in rural areas, more than half the dentists are 55 years or older, with only 24% under the age of 45. The same study in 2002 found the average age of a dentist in our state to be 49 years. Clearly the majority of Minnesota dentists are continuing to age toward retirement.
It is my personal belief that our profession has potentially reached a tipping point that could lead toward a dip in the number of dentists. The combination of more retirees and the potential for fewer graduates makes this a strong probability. The American Dental Education Association conducted a study showing that the number of dentists relative to the U.S. population has changed from 1 per 38,000 in 1980 to 1 per 62,500 in 1990, and 1 per 64,000 in 2000. The Association projected that by 2020 dentistry might be able to maintain a ratio of 1 per 60,000, but only by making a number of assumptions. First, all dental schools need to maintain current enrollment levels. Second, all new dental schools under consideration would need to open and maintain an enrollment consistent with the current levels of existing schools. Finally, none of our current dental schools could see drops in enrollment or close under this projection. That constitutes a lot of assumptions, I thought — how about you?
Even if dentistry can maintain its numbers in the workforce, will those new dentists be able to practice in an environment like the one we enjoy today? An April 2012 report by the ADA revealed that the number of large dental practices has increased by 25% in just the previous two years! The Health Policy Resource Center concluded that solo dental practices dropped to 69% in 2010, down seven percent from 2006. How many of us know a practice that has been sold to a Midwest or Metro Dental group? How many reading this article have sold a practice to one of these groups?
Perhaps some of this move toward the growth of corporate dentistry is inevitable in the 21st century. Perhaps some dentists don’t care to be business owners. Perhaps some have the opportunity for ownership within the large corporate structure. But my primary fundamental concern for our profession is the potential lack of options that may exist for our upcoming graduates, and that such a decrease in options may adversely affect the practice of dentistry. Debt and the opportunity for practice ownership are key issues for all of us on some level. And all of this is occurring in the shadow of our ever-changing health care environment and the uncertainty of how the Affordable Care Act (ACA) will ultimately affect our profession.
So what resolutions can we all take to make a positive impact for the American Dental Association, the Minnesota Dental Association, and our local dental societies?
First, seek out one dentist you know is not a member of the ADA/ MDA/local society. If you are reading this, I am assuming that you are a member yourself. If not, this will be an easy task! Have a face-to-face conversation about the benefits of membership. The ADA has a list of the “150 Reasons to be a Member” readily available on its website. The good news is that we are 157,000 strong, with just over a 67% membership, in contrast to the American Medical Association, with just under 20% of practicing physicians as members. The bad news is that membership is likely to drop if complacency carries the day!
Second, consider getting involved in organized dentistry on some level. Just call Kathy Krauter or Mary Reiter at the Saint Paul District Dental Society or your local district society if you practice elsewhere. It’s not as painful as you might imagine. In fact, you might fi nd it a good way to network or get to know the other dentists in the Saint Paul area (or your local district). And you only need to participate as much as you would like.
Even if you don’t become involved in organized dentistry per se, consider attending a hosted event like Dental Day at the Capitol, a political open house, or a social event like our Dentispree in the Saint Paul District.
Finally, consider supporting a political action committee (PAC), such as ADPAC and MINDENPAC, to help support our collective lobbying efforts that support dentistry’s interests in Washington D.C. and Saint Paul. And for those of us who are specialists, don’t forget about supporting your specialty PAC!
So as you make your New Year’s resolutions for 2014, don’t forget about the ADA, the MDA, and the Saint Paul District Dental Society or your local district. Complacency is our enemy, and collectively we will continue to grow and provide strength for our profession for the many years to come.
*Dr. Vollmer is Northwest Dentistry’s Associate Editor for the Saint Paul District and its president-elect for 2013-14. He is an oral surgeon in private practice in Saint Paul, Minnesota. Email is firstname.lastname@example.org