CDA Journal Volume 30, Number 12 Journal december 2002 departments 879 The Editor/Celebrating Leadership 883 Impressions/Dental Practice Patterns Add to Oral Health Disparity 964 Dr. Bob/Dumbing Down of America features 901 DENTISTS FAMOUS IN OTHER FIELDS Literature, business, sports, and politics are some of the arenas in which dentists have gained renown. Malvin E. Ring, DDS, MLS 909 DEBT AND PRACTICE PROFILES OF BEGINNING DENTAL PRACTITIONERS A UOP study finds that no association between educational debt and propensity to engage in unconventional procedures David W. Chambers, EdM, MBA, PhD; Alan W. Budenz, MS, MBA, DDS; Richard E. Fredekind, DMD, MA; and Nader A. Nadershahi, MBA, DDS 916 GEORGE FRANKLIN GRANT, DMD: RENAISSANCE MAN Dr. George Franklin Grant was not only the second African American dental graduate and inventor of the golf tee, he was also one of the pioneers of cleft palate and speech therapy and founder of the Harvard Odontological Society. John M. Hyson, Jr., DDS, MS, MA Editorhead cda journal, vol 30, nº 12 Celebrating Leadership Jack F. Conley, DDS ith the 2002 holiday Our purpose is not to describe season upon us and all, or even a significant part, of these with a new year quickly contributions; nor do we want to slight approaching, it is a any of the other important contributions particularly appropriate made by outstanding leaders during the Wtime to salute the leadership that is so several decades of our observations. important to achieving the mission of the Our purpose is only to highlight a few dental profession. notable accomplishments that have From our experience, colleagues been publicly recognized at American who have not actively participated are Dental Association and California Dental not always fully informed about the Association annual meetings in the past contributions of those who serve. In fact, two months. some have been inclined to refer to the Dr. Eugene Sekiguchi, CDA president service process that dental leadership in 1997, was the first to demonstrate engages in as “dental politics.” Such a label a new level of commitment when he does not fairly describe the importance of served as interim executive director after the contributions and the sacrifices often completing his term as CDA’s highest made by volunteers. For that reason, we elected officer in late 1997. Commuting would like to share some recent examples. from his home in Southern California to During the past few years in Sacramento on a weekly basis to oversee particular, the California Dental the operation of a 15,000+ membership Association has received exceptional organization brought significant sacrifice. contributions from those elected to lead. It required that he spend considerable This has been a time when the position of time away from family and an active the association’s executive administrative dental practice. officer has often been in a state of flux. Subsequently, in late 1998, Gene This reality has required an increased level turned to serving the American Dental of commitment from volunteer leadership Association as trustee from the 13th that is unprecedented in our many years District (California). Last October, he of watching leadership in action. It has announced his intention to seek the also come at a time when the dentist office of ADA president-elect. Because of business owner has been confronted with his outstanding record of service to his many more requirements and regulations profession, Gene Sekiguchi received strong that necessitate much more time if support from his leadership colleagues in a practice is to successfully meet the California, component dental societies, demands of an increasingly competitive and ethnic dental organizations within the dental marketplace. state, and his friends. december 2002 879 editor cda journal, vol 30, nº 12 His accomplishments, his leadership the safety of amalgam and peer review. abilities, and his commitment to Steve and his immediate predecessors his profession were successfully effectively balanced the demands placed communicated to the 410-member on them by the above challenges and, ADA House of Delegates. As has been in addition, organized ADA officer previously reported elsewhere, Dr. Gene campaigns. Finally, Steve Chan provided Sekiguchi was elected to the American extremely effective leadership during the Dental Association’s highest office and time when administrative change became will serve as president in 2003-2004. an important association matter. Dentistry throughout the country The year 2003 is rapidly approaching will continue to be the beneficiary of and is filled with challenges for new Gene’s untiring efforts on behalf of his President Dennis Kalebjian, who has profession. As an ADA trustee, he has already been a major participant in the already made important contributions management of the activities previously in such divergent policy areas as dental described. In addition, Dr. Kalebjian information technology and dental office chairs the search committee for a new wastewater. It is important that we honor executive director, an activity that should his achievements at this time and wish become one of the most important for him well as he challenges the extremely this association, not only for 2003, but time-intensive activities of the American also potentially for many years to come. Dental Associations two highest offices. Traditionally, contributions of the The presidents of the California leadership are shared and acknowledged Dental Association have been extremely each fall before the somewhat limited effective in helping to focus the efforts audiences of the CDA and ADA Houses of of staff and leadership at times when Delegates. staff administrative leadership was not Because we believe these contributions effective. Ken Lange, Gene Welling, Kent and accomplishments are so important to Farnsworth, Jack Broussard, and Steve the profession, our purpose here was to Chan and their respective teams have share and celebrate them with the larger been very responsive during these very segment of the membership that makes difficult times. up the readership of this publication. The last three volunteer administrations in particular have dealt with not only the tiresome issues of the day such as dental unit waterlines, amalgam, and wastewater, but also progressive new association initiatives such as the California Dental Association Foundation and the development and implementation of a comprehensive strategic plan. The year 2002 has been particularly remarkable as Dr. Steve Chan’s administrative year has been confronted by outside legal activity challenging the dental profession in the state over 880 december 2002 head Impressions cda journal, vol 30, nº 12 Dental Practice Patterns Add to Oral ratio: 58.41 per 100,000 in 1996. (In 1990, on dental services, nearly 50 percent as Health Disparity there were nearly 60 dentists per 100,000 out-of-pocket payments. By CDA Journal Staff population.) The physician-to-patient “Despite much recent activity at the fed- There is a growing chasm between the ratio currently stands at 286 per 100,000, eral level documenting disparities in oral practice of dentistry in the United States and between 1960 and 1998, the physician health and access to care, we have found and the oral health needs of the nation, population grew by 198.6 percent. In addi- that the dental public health system according to a recent study “The Grow- tion, the dentist workforce is aging, and a provides little funding for prevention or ing Challenge of Health Care in America” good portion of them will reach retire- oral health care of the underserved,” said published in the Sept. 5 issue of Health ment age in the next decade. There are co-author Edward O’Neil, MPA, PhD, di- Affairs. fewer young dentists in practice and few rector of the UCSF Center for the Health The researchers report that, while the dentists working past the age of 65. Professions and professor of family and dental professions have flourished, there In addition, the study found that gender, community medicine and dental public is “abundant evidence that a sizable seg- age, and racial composition of the dental health. ment of the population does not have workforce does not match that of the The authors conclude that only by moving access to oral health care” and that the general population and is even more mis- beyond the existing systems of finance, dental safety net is “poorly defined and aligned than the physician workforce. For reorganizing systems of dental practice, underdeveloped.” The article examines the instance, in a contrast of the racial com- and utilizing dental professionals in new oral health workforce and trends in dental position of the U.S. population in 2000 and innovative ways will the system be care delivery in relation to the physician with the dental and physician practice able to address the unmet health needs of workforce and trends in medicine. community and the entering dental and underserved populations. The UCSF study “The practice of dentistry has improved, medical student population in 1999, the recommends the following alternatives: becoming more lucrative and less time- racial/ethnic distribution of the dental nnExpand alternative organization consuming,” said Elizabeth Mertz, MPA, workforce is among the least diverse of structures for providing care such as lead author and project director at the health professions. Approximately 13 per- public dental clinics or through the UCSF Center for Health Professions. “In cent of dentists are nonwhite, compared use of dental vans and mobile dental comparison to physicians, dentists work to 22 percent of physicians and 28 percent services; more independently, have a higher rate of the population. African Americans, nnEducate the underserved populations of solo practice, and in some cases their Hispanics, and Native Americans are gen- about new programs in oral health to earnings have surpassed the net income erally considered to be underrepresented boost participation in existing and new of physicians,” Mertz explained.