Viewpoint on the future of dentistry: Will it be a profession in 2020?
Dr. North Shetter: "I have been lucky enough to practice dentistry for 40 years and to have known a number of excellent dentist role models who exhibited true professionalism. My early teachers and mentors would marvel at what we consider routine clinical care today. I believe that they would also notice significant change in the practice of the profession."
By North Shetter DDS, FAGD, FICD
Recently, Dr. Virginia Merchant, the editor of the Michigan Dental Association Journal, wrote a thought-provoking article that discussed the changing nature of the profession of dentistry. Are we about to experience the demise of dentistry as a profession?
I have been lucky enough to practice dentistry for 40 years and to have known a number of excellent dentist role models who exhibited true professionalism. My early teachers and mentors would marvel at what we consider routine clinical care today. I believe that they would also notice significant change in the practice of the profession.
In the 1970s and ’80s, the futurist Avrom King talked about a time when we would think of the cell phone as though it were a wristwatch – always there and always on. We laughed at him at the time, but we now know he was on the mark. He also talked about dentistry separating into tiers: fee for service, retail driven, and involuntary participation. Another item King talked about extensively was the word discrimination, as in the ability to understand the difference between an overnight at the Ritz Carlton or at a Motel 6, and to place value on the difference. This is the area where we see significant change in both the profession and the clients we serve.
The discrimination level of the average client has changed due to the modern business model of newer, faster, and cheaper. There is less and less value placed on deferred gratification, education based understanding of quality, and values based discrimination. Some practices have moved past delivering dentistry based on shared values. In many business and sales transactions, due to the Internet, there are literally no personal relationships at all. This has created a segment of dental consumers and providers that treat dental care as a commodity. Often they are not ready for or do not desire a true relationship with the dental office or provider that would involve personal commitment – something that the electronic world does not require and the new consumer has not been taught to value. This is part of the reason why it is so difficult for offices that are insurance dependent to move into a fee-for-service model.
As a profession, we have multiple areas where we can improve. Our dental schools need to be honest about the cost of earning a degree before putting a student on the acceptance list. Far too many young dentists are graduating with excess debt. We know of a recent graduate with over $250,000 in debt, a new wife, and a baby. As an associate, he was unable to meet the clinical standards or behavioral expectations of his employer and cannot find a job. We are not demonstrating a strong moral compass when we graduate subpar students and allow them to drown in debt. While clinical skills are very important, we need to develop behavioral skills early in the students’ careers. Early understanding of critical thinking and emotional intelligence would reduce learning stress and improve chances for success after graduation.
We must practice what we preach in our offices, relationships, and profession as a whole. We must support organized dentistry when it demonstrates professional values and hold it accountable when it adopts a relativistic approach. We must use the same approach with our peers. There is no excuse for not upholding and delivering the highest standards of care. If we are to retain our position as professionals, we must expect our leaders, educators, students, and graduates to demonstrate integrity, accountability, responsibility, and excellence in all that we do.
Dr. Shetter is the senior dentist in a small group practice in Menominee, Mich. He is a graduate of the University of Detroit Mercy in 1972, attended the Pankey Institute, and numerous other postgraduate courses. For an unabridged copy of this article, contact Dr. Shetter at firstname.lastname@example.org.