Last night, I received an email with a link to a survey from the ADA. Their records show I’m not a member and they want my input. It was obvious they are becoming concerned about declining membership.
Subject: Tell us what you think.
The American Dental Association is interested in your perceptions about member value and opinions about ADA membership. Upon completion of this survey, you will be entered to WIN one of five $100 Visa gift cards.
Your participation is voluntary, but we would very much like your opinion. Please note that your answers to this survey are completely confidential and are only reported in aggregate. This survey should take less than 10 minutes to complete.
We appreciate you taking the time to share your thoughts with us. If you have any questions concerning this survey, please feel free to contact me at 312.440.2864 or by replying to this email.
Please complete the survey by December 15. Thank you in advance for your assistance with helping us to collect this important information.
Chris C. Mitchell
Director, Membership Marketing and Research
The questions were fairly predictable… asking about my prior experience and satisfaction with what the ADA has done. They asked about my expectations of the ADA…. and so on. Rating them on various categories with a range from “disatisfied” to “very satisfied” or “Strongly Agree” to “Strongly Disagree.” At the very end, there was an opportunity to write additional comments in a text box.
This is what I wrote:
The ADA has abandoned me. You know who I am. You’ve read my blogs. You know where I stand. You know I’m very vocal. You even sicced your attorney on me for forgetting to remove my ADA membership from my website. He mentioned that he was aware of my derision for the direction the ADA has taken.
That said, it is dentists like me that you NEED as members. I have a rather big voice and presence in dental social media. When I like something people listen. When I don’t… they also listen. The ADA would do well to spend a bit of introspective time and think about why you’ve lost ground. You’d do well to gather a “focus group” of NON-members who are Key Opinion Leaders (KOLs) for a pow-wow with the ADA.
I was an enthusiastic member. I “got involved.” I served on the local affiliate board all the way to President. I got involved, but I found that I stood alone in trying to bring the association into reality. Instead, I found the majority on the board were the “old guard” that insisted we “sit at the table” with political forces to work on the fictitious political football known as “access to care.” They cared about fluoride. They cared about schmoozing local liberal politicians. They cared about things that dentists in the trenches didn’t care about. They promoted the so-called “Direct Reimbursement” scheme that was doomed to fail. They spent ENORMOUS amounts of time debating the inane details of a local membership directory. They spent a lot of time recruiting members to give talks at local school kids (who could not be less interested). I used to say we had to form a committee to meet to decide whether to convene a committee to do something. And, very little got done.
Some of the things today’s dentists are concerned about:
- The INSANELY high cost of dental school, leading to insurmountable debt by new dentists, most of whom will never be able to own their own practices. This has far-reaching effects, including a deleterious influence on the ethics of dentists.
- The growth of “corporate dentistry,” with non-dentists at the helm.
- The increasing interference by insurance companies in the doctor-patient relationship.
- Perpetually increasing regulations by local, state, and national gov’t.
- Our “reputation” or “standing” among professions.
- Increasing vilification of dentists as “greedy” along with increasing attitude that they are entitled to our services.
- The trend towards a possible “single payer” health system… that some would like to include dentistry (a really bad idea).
I could go on and on. I’ve gone on too long, already. I wish I could rationalize rejoining the ADA. I love Dentistry. I love being a dentist. My blog written for an audience of dentists averages 10,000 views per month. I am a dental cheerleader. But, I cannot cheer for the ADA. The ADA was lost a long time ago, and deeper in the weeds now than ever before. You’re in deep trouble with MY generation of dentists, and even worse for the younger generation. If you don’t get your shit together SOON, your organization is DEAD. Gone. Soon.
Two and a half years ago, I wrote an article “Why Can’t the ADA Be More Like the NRA?” Before you scoff or sniff contemptuously… before you dismiss it out of hand…. Take a moment to read it. It’s been read almost 3,000 times by my blog fans. And, it’s not as far-fetched or crazy as you might be prone to reflexively thinking. In particular, look at the financial numbers I present in the article. In that context consider the differences in the EFFECTIVENESS of the two organizations. https://thedentalwarrior.com/2014/04/28/why-cant-the-ada-be-more-like-the-nra/
That’s all for now. Best wishes and good luck.
A friend on the “inside” told me that ADA membership now stands at 52% of the profession. I remember when it was 80%. The iceberg was in clear view, yet it’s been “full steam ahead!”
Mind you, I assumed this would fall on deaf ears (and would bet money on it). So, my letter is hardly an exhaustive tome. My enumerated list of concerns is but a small vignette of the issues at hand. I could list many more, if I sat down and put my mind to it. I figured I made my point and didn’t see any reason to waste much more time writing a more comprehensive letter.
But, hey… I might win one of FIVE $100 VISA gift cards! The ADA values the opinions of non-members so much, they were willing to pony up a whole $500 to the effort! This is serious, folks!
It’s nice that the ADA is going through the motions of appearing to care. But, do they? Really? They are “investigating” why membership is plummeting. But, will they ACT on the information gathered? I admit to not being optimistic. When the leadership of the ADA is largely occupied by former insurance company executives, the conflict of interest is…. well… there it is.
Edit to add:
Hey everyone. Let’s add to the list I whipped up in the message to the ADA. I did that as stream of consciousness writing. Let’s focus a bit and come up with a thoughtful list. Add yours in the comments below, and then I’ll copy then to the article here:
8. “Foxes in the hen house”: Conflict of interest when our Executive Director and other executives have a conflict of interest such as a history of working for insurance companies and other corporate interests that are counter to the interests of practicing dentists.
9. The fact that dentists are the ONLY health professionals who are restricted from practicing anywhere in the country. No national reciprocity aka “licensure by credentials.” My brother, the neurosurgeon can practice anywhere. My sister the pediatrician can, too. Nurses, podiatrists, optometrists, veterinarians, etc… don’t have to take separate state board exams. They graduated from nationally-accredited programs and can practice anywhere. Wait… we also have nationally-accredited schools!
I can practice in ONE state. And, after 30 years of practice, if I want to move, I have to take another board exam! Crazy. It’s turf protection, plain and simple.
For more of my articles about the ADA, click on The Dental Warrior on the ADA.
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Great article….you are a better wordsmith than me. I dropped ADA several years ago as I had a lot of the same concerns as you.
As usual Mike, you hit the 10 ring. We are a 4 doc practice, and one of my partners teaches ortho for the USDI, so he has a membership. When you teach, you have to belong he tells me, but when we as a large practice have a question about the abuse by insurance companies or government agencies , they never seem to have an answer. I’m better off asking on Dental Town. In fact I think that the Townies and blogs like you have more information and more clout than the ADA. Like you I was involved early. I was the student counsel president at NYU for 2 years, and fought for my fellow students. All that got me was an extra 3 month stint in removable in the summer after graduation. But I’d do it all the same again. I really thought that I could get my local association to fight for us when I got out, but I still have a mark from banging my head against that wall.
Keep up the good work and shoot well.
Thank you for writing such a well thought out response. Even if it falls on deaf ears (deaf ears for now) you have stated EXACTLY what I feel regarding the ADA and I would guess there are many many many more like me who feel the exact same way. I see the ADA as part of the problem. Instead of being our advocate they are in bed with the enemy. Operating a successful dental office is extremely difficult (despite being publicized as “greedy” dentists as you correctly pointed out), and in my 30 years of private practice has only become more difficult no thanks to the very organization that is supposed to be helping us. The ADA will not be getting my money any time soon. I really feel for the younger generation of dentists just starting out who have been totally abandoned and thrown to the lions as were.
Dr. Mike and others, I fail to see how dentists have been publicized to the general public by the ADA as “greedy.” Laypeople view the ADA as an entity that advertises the importance of dental health and professional care. We are caught in the midst of your internal wars. From my personal perspective (not the public at large) it seems that there is so much competition (and battling) WITHIN your profession that I am left scratching my head. On a whole, I have never witnessed a more disgruntled profession (dentists and specialized dentists) from those that are speaking out against the ADA. It is like you are expecting a union leader to take care of your battles for you. One that will ban insurance companies, cap tuition, ban mid level providers from becoming a reality, insulate private practices from any sort of regulatory overview (in regard to safety, quality, and honest practices), while “outlawing” corporate dentistry. I understand it is not easy for many, but then again, my dentist seems perfectly happy and successful practicing 3 days a week. That to me, seems like a pretty good gig. Sorry if I am rubbing salt into a wound that I do not understand. Respectfully, an onlooker.
You could not be more mistaken in your analysis. I did not suggest that the ADA has painted us as “greedy.” Not sure how you got that idea. Read it again.
Nor, have any of us suggested that the ADA “ban” or take other regulatory actions, as the ADA has no such powers. To be clear, the ADA does not have ANY regulatory, legislative, or legal power.
We are asking the ADA to simply represent the interests of those practicing dentists that are paying or would pay dues (if they’d step up and do what they promised). Rather, what they are now doing is representing the interests of insurance companies and corporation. They have abandoned practicing dentists.
We’re not “disgruntled.” We’re simply leaving the organization. The ADA ASKED me to tell them “what I think.” And, so I did. Again. If they hadn’t asked, this article would not have been written. 🙂 They’re asking, but are they LISTENING? Time will tell. But, history says no.
When membership goes from 80% to 52% in just a few years, there’s a BIG problem. And, the problem isn’t “disgruntled dentists.” The problem is the organization. When the ADA’s leaders are former insurance and corporate executives, there’s a BIG conflict of interest. In order to serve the interest of the dental profession, the leaders need to be dental professionals, not insurance executives.
Well said. I am in total agreement with you. I would add 1 more point. When the ADA abandons practicing dentists, they are also abandoning patients and the quality of care that they deserve.
Good point, Angela.
Yes. It is a shame. Patients ultimately pay the price for the ADA not supporting it’s members and members not supporting the ADA.
Thank you for clarifying Dr. Mike. Who are ADA’s current “leaders?” Thank you.
I found these leaders on the ADA website:
President – Dr. Gary Larson
President Elect – Dr. Joseph P. Crowley
Executive Director – Dr. Kathleen T. O’Laughlin
Kathleen O’Loughlin, the Chief Operating Officer and Executive Director of ADA, served as Chief Dental Officer of United Healthcare and spent 5 years as Chief Executive Officer of Dental Services for Delta Dental of Massachusetts.
Yes, I saw that. She spent 20 years in dental practice and has a masters in public health. She appears to be quite accomplished and ambitious from an onlooker’s viewpoint. You could write her directly of you disagree with or question her intentions. 🙂
Dr Kathleen O’Loughlin also formerly served as director of DentaQuest (dental Medicaid administrator of dubious reputation). Her dealings w/ Craig Kasten (former CEO of the questionable Dural Dental- defunct Medicaid administrator) of Wonderbox Technologies shouldn’t be discounted. This is a troubling individual to serve in this capacity at the ADA.
BTW- Dr Mike has great insights & instincts. This is the type of individual we NEED leading organized dentistry. Sadly, such isn’t the case.
Michael W Davis, DDS
Santa Fe, NM
If the ADA was evaluated using Standard & Poor’s, it would be valued as a “HIGH RISK” or junk bond rating at best. When the sum of the investment is weighted with the potential “benefit”, it would receive a “C” or worst, that is unless they use the kz scale (Kazakhstan National Scale), then it would be an kz AAA investment. Face it, the amount of money we pay in and what is offered (i.e. payout/benefit) is horrific. An example is a dentist can pay a large annual sum to become a member and then be asked to pay more money (see any item in the ADA Catalog) for what would seem to be a product the organization should offer as benefit of membership. I can understand why so many professionals would rather invest their hard earned funds elsewhere. But hey, I’m just a dentist…
By the way, Dow Chemical (DOW) is a good investment right now:
Last Price: $57.71 Up + 0.28 Vol: 42313
Todd, My gut is telling me to go with Ruger, KFC and ExxonMobil.
When using a conversion factor, remember this: Your “brain” sits above the “heart” which is superior to the “gut” the lives just a foot away from your….
Well, I guess I made my point. Think, don’t feel money!
Todd, Thanks for the stock tip. I’ll try to remember that the next time I think about making a joke on Mike’s blog!
I really like your jokes!
Thanks Todd. Sometimes they are intentional…
Maybe when the ADA loses it’s membership it could reinvent itself as an organization that serves the “interested” public (just like the NRA does). Those citizens interested in maintaining their dental health and obtaining quality services would join the ADA for a nominal fee. Benefits would include access to accurate, transparent information for the consumer with information on pricing, quality and understanding of risks versus benefits of various procedures. Myth busters and truths so consumers can make educated decisions based upon a “trusted source.” Dentist could join of course (if they wanted to).
Perhaps the ADA could reinvent itself by running employment recruitment ads for the DSO (corporate dental) industry? Oh, wait! They already are doing just that.
Michael W Davis, DDS
Santa Fe, NM
I am envisioning a new association (built like the NRA) that focuses on the interests of the end consumer. In the case of the NRA, the people that want to own guns are the end consumers, not the gun manufacturers. In the case of dentistry (as the “product”), patients are the end consumers. I know it sounds far-fetched… but according to Mike the ADA will be dead in a few years. So perhaps it will be replaced by “The American Dental Consumers Association…” Maybe some retired dentists that want to champion a new movement… geared toward patients that want to buy quality care at reasonable prices. Just mulling some thoughts over. (Don’t shoot me)
Hi Mike. Your analysis and comments are spot on. Being a true visionary means being able to see past our current plight and predict how today’s decisions effect generations to come. None of us became dentists because it was an easy default decision. We all have tenacity, desire, and special talents that many do not possess. As well, these skills are really put to the test running our own practices. I am all for a free market and defend those who wish to practice in whatever way they desire. But what troubles me, as you, is the framework placed around us in which we have to do this. This is why a central voice is needed – one that just doesn’t represent certain individuals, but one that represents the group as a whole.
A strong central voice may not be able to accomplish a change, and individuals in the group may not always agree, but at least there is the perception of cohesion and that matters that are important to us as a group are being considered. Divide and conquer is an old battle strategy which works well and is doing the job on us. It’s just a matter of time. I speak as a solo guy in the trenches, just like you. I have to fight my daily battles myself because that’s what I signed up for. But look at the bigger picture, and it becomes clear why Mike and those who agree with him have valid concerns.
To the outside observer, we are not troubled with insurance because we are greedy. We are troubled because of how insurance companies have positioned themselves between doctor and patient. The insurance product is poor and doesn’t even operate according to today’s standards. Sometimes we practically have to beg for payment on a patient’s behalf. Really? The inscos. are now positioned as treatment decision makers and supposed watchdogs of our ethics. Individually leave plans and watch a potential vast percentage of your practice leave. Dental education is ridiculously expensive. Come out in that much debt and practically kiss owning a practice goodbye. Who saves the day for the new grads? Corporate. It’s not the new dentist’s fault – they have no other choice.
Ever wonder why dental technology is so expensive? Besides the obvious, spend more time talking to your reps. It’s lucrative for them to sell to corporate offices that have the financial clout to outfit a massive facility with state-of-the-art equipment. The cost is what the market will bear, and we all pay the price for it. And what about selling your smaller practice upon retirement? New grads may not be able to afford it and corporate may not want to acquire it as it doesn’t fit their business model.
What’s my point? We need a central voice to help us navigate these issues. We need an organization with balls that will at least make a stand and state a position. Society ultimately pays the price for decisions being made now. You can only eat rainbows and poop butterflies for so long. The whole system implodes without some type of intervention. I feel the free market system will take care of the bad doctors as you can only screw people over for so long. But I passionately hope that there are far more decent and dedicated doctors out there under the radar trying to safeguard their patient’s well-being. And this is why a central voice needs to back us up. Without one, we all end up paying the price. Keep fighting the good fight Mike.
Great post and comments, Brian! Thanks for chiming in! I have a feeling we’re being watched. I’m certain of it, actually. Whether change is on the horizon, or not, remains a question and major doubt in my mind.
Excellent article! I always like reading honest opinions even if they go against official organizations, like ADA. I guess that is the only way some old burocrats will start listening more closely what the professional actually practicing have to say and what their real problems are that need to be discussed more often.