EDITORIAL

Trustees mind the storeDavid L Turpin, Editor-in-Chief

Seattle, Wash

Do you ever wonder who is minding the store?You hear a lot about the AAO Board ofTrustees’ hard work in representing the mem-

bership, and I know the same is true for the leaders ofother professional orthodontic associations. But arethey monitoring the big changes taking place globally?Is anyone watching the trends that affect health care—changing demographics, economic disparity, and tech-nological innovations? Are policies being developed tosecure a preferred future for orthodontics?

We all know what we want for our practices in thefuture—more patients able to pay the fees, better-educated staff, and more leisure time away from thepractice. And don’t forget the importance of findingsomeone to take over the practice when we retire. Yes,that might be what most of us want, but can this futurebe assured? Is this dream attainable for residents nowgraduating from our educational programs?

Last February, the AAO Leadership Conference, un-der the direction of Trustee Raymond George and hiscommittee, gathered some talented people to challengeour professional associations, our educational institutions,and even our orthodontic practices to “think beyond theirexperience and plan beyond their tenure.” During the2-day session, Ed Barlow, a futurist and the president ofCreating the Future, Inc. (www.creatingthefuture.com),provided direction. He stressed an “ends” policy to char-acterize the desired state of the organization. Bram Brig-gance, from the University of California at San FranciscoCenter for the Health Professions, gave a global view ofthe access-to-care issue and how it relates to leadership.

The demography of an aging workforce means thatwe might not have enough workers to support agrowing health care system. Care demands and needsof an aging population will add to the financial strain.Economic disparity will also influence our future. Thegap between those who can and cannot afford treatmentchanged dramatically between 1979 and 2000. Asincumbents in health care become wealthier, healthpolicy and markets are driven to serve those withmoney rather than need.

And now we have technology. Intellectual property

Am J Orthod Dentofacial Orthop 2005;127:5250889-5406/$30.00Copyright © 2005 by the American Association of Orthodontists.

doi:10.1016/j.ajodo.2005.03.004

in biotechnology is booming, with more than 1300 newbiotech companies creating over 200,000 jobs. Tech-nology has made modern health care, including ortho-dontics, a knowledge-based service. Those who havethe knowledge and understand how to use it will havethe decision-making power. In medicine, the percent-age of adults accessing health information online hasrisen from 13.4% in 1997 to 88.5% in 2004. Supportedby this new source of information, consumers demandexcellent treatment at a reasonable cost.

Many issues concerning dentistry (and orthodontics)are not unique in health care. Population concerns andaccess to care are, for the most part, secondary to practicedevelopment. Some professions seek exclusive controlover the delivery of care; this can lead members tobecome too self-interested and reactionary. “The dentalprofession must ask itself whether it wants to be theleadership profession for the nation’s oral health concerns,or the leadership profession for bungalow solo privatepractices in the nation’s suburbs” (Ed O’Neil, 2004).

Dr Briggance suggested that orthodontists shouldbecome the “access champions” of the dental profes-sion. They should plan how to use their marketing skillsand public relations successes to advance the cause ofaccess. As a unified specialty, we should determinewhere services are most essential and concentrateefforts there; dentistry is effective when it focuses. Itsefforts are successful, its outcomes are measurable, andits value is clear. I believe we should celebrate Chil-dren’s Dental Health Month with free orthodonticexaminations. Our neighbors in Saint Louis, the Amer-ican Association of Optometrists, have just such apublic relations campaign that has enjoyed great suc-cess. But when the idea of free examinations to pro-mote increased access to orthodontic care is raised,some of our members call it a bad idea. I am remindedof a sign said to hang prominently in Edward H.Angle’s Pasadena school circa 1923, “If you think youcan’t do it—you probably can’t.”

Can you picture your future practice? Your Boardof Trustees takes governance very seriously in the faceof changing demographics and research findings thatinfluence how we will deliver treatment in the future.

For what it’s worth, I think the store is in good hands.

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