And I Quote: Revisiting a Decade of Charting Progress

Dr. Richard ValachovicIn this month’s letter, Dr. Rick Valachovic celebrates a decade of Charting Progress with a look back at some of his own observations as well as words shared by thought leaders and others in our community.

The clock is swiftly ticking toward the start of 2016—the year that will mark the 10th anniversary of this publication. The inaugural, May 2006 issue of Charting Progress, which was conceived as a vehicle for exploring topics of importance to ADEA members, focused on the challenge of changing demographics.  I wrote about the need to recruit talented individuals into academic dentistry as large portions of the faculty approached retirement age, the importance of enrolling underrepresented minority students to beneficially impact the quality of education and patients’ access to care, and the values of the millennial generation and its potential to positively reshape the access-to-dental-care landscape.

Next year I plan to revisit these and other topics—to reflect on what has occurred during the past decade and share fresh insights on where we stand today. Although much has changed and we’ve seen progress on many fronts, it is almost startling to note how relevant the topics discussed in these pages remain—two, five, even 10 years later.

With that in mind, I thought you might like to join me in looking back at some of the ideas expressed in this letter. The context or the timing of some of the quotes below may come as a surprise, but most of them seem as apt today as they were when first written. Mixed in with a few thoughts of mine, you may find some words of your own, although your title or affiliation may have changed. Do your comments still ring true? Has your perspective changed? I’d love to hear your current views as I prepare to revisit these topics in 2016.

Richard W. Valachovic, D.M.D., M.P.H.
President and CEO
valachovicr@adea.org

“What usually happens in dental education is somebody goes out on a limb, and everybody says well, we’ll watch and see how that works for a while before we dip our toes in that water. The fact is I don’t think we can wait any longer. Schools are going to have to start taking some educational risk and implementing things faster.”
– Dr. Todd Watkins, Assistant Dean for Dental Education and Informatics, East Carolina School of Dental Medicine. Jumping Into the Water with Both Feet, January 2012.

“Terror is a great motivator. When I was academic dean, I could always count on getting things done two years before a site visit.”
– Dr. Marilyn Lantz, Professor of Periodontics and Oral Medicine, University of Michigan School of Dentistry and Associate Director for Education, Career Development, and Mentoring, Michigan Institute for Clinical and Health Research. ADEA CCI: Curricular Change and Then Some, July 2012.

“As the Dr. Marcus Welbys of the world gradually disappear, it seems only logical to ask whether private practice dentistry will follow suit.”
– Dr. Rick Valachovic. From Bungalow to Big Box? How DSOs Could Change the Face of Dentistry, June 2014.

“Dental hygiene has to start focusing on public health. That’s where we started, working with children in the schools. Then we entered private practices, and now we are coming full circle.”
– Dr. Colleen Brickle, Dean of Health Sciences at Normandale Community College. Dental Hygiene Education Responds to an Evolving Oral Health Workforce, August 2011.

“I get feedback every time,” he told me, “from someone who says, ‘This has changed the way I do my practice. It’s changed the way that my patients behave, and it’s changed their oral health.’”
– Dean John Featherstone, University of California, San Francisco, School of Dentistry. Managing Caries Risk: A Paradigm for the 21st Century?, November 2013.

“There’s always the question of what are you going to do with your life, but then you wonder, am I capable of doing it? The program has given me a lot of clarity about where I’m going and confidence that I can do the work.”
– Dele Ajagbe, Summer Medical and Dental Education Program alum. Today’s Students—Tomorrow’s Colleagues, August 2007.

“These students can come in on a level playing field and perform at the level of our other students. The programs are effective. They work!”
– Dr. Ernestine Lacy, Director of the Office of Student Development, Texas A&M University Baylor College of Dentistry. Diversifying the Dentist Workforce, One Cohort at a Time, June 2012.

“Unless kids get math concepts earlier, they have nothing to build on. I’d like to see our schools become involved in the pipeline at an earlier age, middle school at least.”
– Dr. Jeanne Sinkford, ADEA Associate Executive Director for Equity and Diversity. Math Literacy: A New Civil Right for an Information Age, December 2008.

“Part of the demand for accelerated programs will come from students themselves. They are so adapted to controlling their lives and using information technology to get what they need quickly.”
– Dr. Steve Shannon, President/CEO, American Association of Colleges of Osteopathic Medicine. Just a Matter of Time? Maybe Not., March 2012.

“The information literacy of young people has not improved with the widening access to technology. In fact, their apparent facility with computers disguises some worrying problems.”
– Dr. Heiko Spalleck, Associate Dean for Faculty Development and Associate Professor at the Center for Informatics at the University of Pittsburgh School of Dental Medicine. Perhaps Old Dogs Can Learn New Tricks, March 2011.

“I see faculty using the same devices their students employ. They are exploring the Web, file sharing, using Twitter, and the like with equal enthusiasm.”
– Dr. Elise Eisenberg, Senior Director of Informatics, New York University College of Dentistry. Perhaps Old Dogs Can Learn New Tricks, March 2011.

“It’s the right thing educationally. As one of my colleagues puts it, if your mother or father asked, I can see a dentist who just graduated from dental school, or I can see a dentist who just finished his residency, which one would you recommend?”
– Dr. Todd Thierer, Director, General Practice Residency Program, University of Rochester. Where Does PGY-1 Fit In?, August 2008.

“There seems to be a misconception that all dental students are vehemently opposed to a postgraduate year.”
– Dr. Rishi Popat, ADEA Vice President for Students. Where Does PGY-1Fit In?, August 2008.

“People who are not informed still talk as though dentistry doesn’t have diagnostic codes. We do have codes; they’re just not widely implemented.”
– Dr. David Preble, Vice President of the ADA Practice Institute. What Big Data Could Mean for Dental Education, September 2015.

“There is still a desire on the part of some faculty to get to the answer, to tell students the right way of doing things or at least what they perceive to be the right way. That’s good for today, but what about tomorrow?”
– Dr. Frank Licari, Professor and Associate Dean of Academic Affairs, Midwestern University College of Dental Medicine-Illinois. A Visit to the Flipped Classroom, October 2012.

“We’ve been talking about change for almost 100 years. Let’s use these new schools as learning laboratories: Implement the best practices, document what we do, measure the outcomes, and see what works and what doesn’t.”
– Dr. Jim Koelbl, Founding Dean, Western University of Health Sciences College of Dental Medicine. Opportunities Abound for New Dental Schools. How Will We Seize Them?, August 2009.

“Even though we talk nuts and bolts and wires and so forth, the question you keep coming back to is function, what do you want to do? The purpose is to engage, whether it’s your patients, your students, your faculty or your staff, and in the best tradition of a university, to engage ideas.”
– Dean David Johnsen, University of Iowa College of Dentistry. New Bricks and Mortar Bring Welcome Change to Our Campuses, November 2012.

“Regardless of specialty, all residency programs should inculcate their residents with a sense of responsibility, a sense of diligence regarding the gamut of their patients’ oral health needs. That is the foundation of patient-centered care.”
– Dr. Bob Berkowitz, Chair of the Division of Pediatric Dentistry at the University of Rochester School of Medicine and Dentistry. Holding Ourselves to the Highest Standard: Doing What’s Best for Patients, October 2010.

“I worry that in those dental offices that are more production oriented, the patient-centered aspect of care sometimes may not be treated with the respect it deserves.”
– Dr. Ellen Grimes, Program Director of Dental Hygiene at Vermont Technical College. Holding Ourselves to the Highest Standard: Doing What’s Best for Patients, October 2010.

“I think most dentists are trying to do the right thing, especially pediatric dentists who I’ve found to be the most patient-oriented, but sometimes the risk-benefit balance gets lost in the hustle and bustle of taking care of lots of people every day.”
– Dr. Alan Lurie, Professor and Chair, Division of Oral and Maxillofacial Diagnostic Sciences, University of Connecticut School of Dental Medicine. How Gently Do You Image?, June 2015.

“I tell students, ‘You don’t want the best image. You want the worst image you can get away with.’”
– Dr. Bernard Friedland, Oral Maxillofacial Radiology faculty member at the Harvard School of Dental Medicine. How Gently Do You Image?, June 2015.

“Students used to turn to us and say, tell me if this is good enough. Now we ask them to think it through and evaluate their own work before the faculty give their appraisals.”
– Dean Ron Hunt, Virginia Commonwealth University School of Dentistry. Move Over, Multiple Choice. There Are New Assessments in Town, February 2010.

“Fifty boards require some type of CE, but you can ski in the morning and take a course in the afternoon. There’s no outcome assessment. Perhaps CE is a way to maintain your competency, but it is not a way to demonstrate your competency.”
– Dr. James Cole II, former officer of American Association of Dental Boards and the Western Regional Examination Board, and former Chair of the Commission on Dental Accreditation. Making Waves, One State at a Time, July 2011.

“When you have an ill person you care about, and you go from provider to provider and see that they don’t have a common language, and that the patients really suffer, it gives you the impetus and the drive to make [interprofessional collaborative practice] a priority.”
– 
Dr. Sandra Andrieu, Associate Dean of Academic Affairs at the Louisiana State University School of Dentistry. Paving the Road to Interprofessional Practice, February 2011.

“While interprofessional education is good and saves money, the magic in this revolves around the fact that there are about 40 million people in the United States who regularly access dental care but not other health care.”
– Dr. Michael Alfano, NYU Executive Vice President, New York University. Interprofessional Practice Can Play Leading Role in an Academic Setting, February 2009.

“Every year I get letters from people with high blood pressure saying, ‘Thank you. That dentist or that dental hygienist saved my life!’”
– Dean Leo Rouse, Howard University College of Dentistry. Paving the Road to Interprofessional Practice, February 2011.

“Opening a dental school every time some legislator or university administrator wants to serve an underserved group is the least efficient way of providing care to poor people that I can think of.”
– Dean Jerry Goldberg, Case School of Dental, and Interim Provost at Case Western Reserve University. New Dental Schools: Proceed, But Appreciate That They Are Only One of Many Answers to Our New Challenges, May 2008.

“It’s a house of cards, and Medicaid money is the key card. If we have to, we’ll offer certain treatments for free to be sure our students have the exposure.”
– Dean Mert Aksu, University of Detroit Mercy School of Dentistry. Troubled Assets? Perhaps, but Dental Education Is Holding Its Value in the Higher Education Portfolio, June 2009.

“It is startling to see how the job has changed even in the last six months. Most deans are looking at cuts to their budgets anywhere between 5% and 35% for the 2010 fiscal year.”
– Dr. Karl Haden, President, Academy for Academic Leadership. Wanted: Jack of All Trades and Master of Many, March 2009.

“For all of us, that’s the biggest challenge, to balance our budgets, not just to survive but to be great schools.”
– Dean Daniel Haas, University of Toronto Faculty of Dentistry. Reimagining Dental Education in Canada, October 2015.

“How supportive will the administration be if the number of applicants declines and alumni have difficulty finding work?”
– Prof. Phyllis Spragge, Director of the Dental Hygiene Program and Interim Dean of Biology and Health Sciences at Foothill College. Looking for Silver Linings Among Economic Storm Clouds, August 2010.

“It’s one thing to persuade campus leadership and the Board of Trustees that an idea has merit, but state-supported institutions also need to gain the approval of their Boards of Regents and their state legislatures. The political dimensions become immense, and every layer of bureaucracy can bring on a case of heartburn.”
– Dean Kenneth Kalkwarf, University of Texas Health Sciences Center at San Antonio Dental School. Communication→Trust→Collaboration→ Regionalization? July 2010.

“Our school will remain a good value for students even with the higher tuitions, and the board recognizes this.”
– 
Dean Huw Thomas, University of Alabama at Birmingham School of Dentistry. Troubled Assets? Perhaps, but Dental Education Is Holding Its Value in the Higher Education Portfolio, June 2009.

“The new campus allows us to be as efficient as we can be with the infrastructure for research, education, and clinical practice. We don’t duplicate, we collaborate.”
– Dean Denise Kassebaum, University of Colorado Denver School of Dental Medicine. Troubled Assets? Perhaps, But Dental Education Is Holding Its Value in the Higher Education Portfolio, June 2009.

“It always comes back to this: Is clinical education a byproduct of patient care, or is patient care a byproduct of clinical education?”
– Dr. John Reinhardt, former Dean, University of Nebraska Medical Center College of Dentistry. Dental Clinic Finances: Lessons From the Big Ten and an Innovative Five, March 2015.

“You are either at the table, or you are on the menu.”
– Dr. Larry Tabak, Principal Deputy Director, National Institutes of Health. Our Commitment to Research: Past, Present, and Future, October 2011.

“Most of our AADR members were busy writing grants in March and April. Even if many of these are not funded, the work that’s been done can be applied to future R01 and other grant applications. This is a tremendous opportunity that will pay dividends for years to come.”
– Dr. Chris Fox, Executive Director for the International and American Associations for Dental Research. When Opportunity Knocks, an Energized Dental Research Community Answers, July 2009.

“Everything is in flux. Nothing is predictable.”
– Jack Bresch, ADEA Associate Executive Director and Director, ADEA Center for Public Policy and Advocacy . Putting Some “Teeth” in Health Care Reform Bills, October 2009.

“The favorable alignment of current political realities with ADEA’s commitment to support policies that promote and enhance access to care creates an unprecedented opportunity for us.”
– Dr. Rick Valachovic. Policy and Politics: Necessary Bedfellows, December 2007.

“In our judgment, the benefits that our fellow citizens will accrue from this legislation certainly outweigh its imperfections.”
– 2011 ADEA Statement on the Affordable Care Act. Pediatric Dental Benefits—Less “Essential” Than Previously Thought, February 2014.

“We have over all pretty sluggish growth in demand…[s]o the key question for the dental education community is, are you training the ‘right’ kind of dentists? Are you training your graduates so that they can work in settings where the demand for dental care will grow?”
– Dr. Marko Vujicic, Chief Economist and Vice President of the Health Policy Institute at the American Dental Association. A Dentist Shortage? Maybe, Maybe Not., May 2014.

“Anyone who applies here understands this intent and emphasis in the curriculum. To the extent that there was any prior hesitancy, students asking, ‘why do we need to do this,’ those types of expressions are no longer heard.”
– Dr. Caswell Evans, Associate Dean for Prevention and Public Health Sciences, University of Illinois at Chicago College of Dentistry. Reaping the Rewards of Community-Based Education, September 2012.

“Every one of my students, 360 of them a year, graduate saying, ‘What do you mean fluoride for adults isn’t the norm?’ We’re changing it.”
– Dr. Mark Wolff, Professor and Chair of the Department of Cariology and Comprehensive Care and Associate Dean for Predoctoral Clinical Education at New York University College of Dentistry. Managing Caries Risk: A Paradigm for the 21st Century?, November 2013.

“Today, the problem is not acquiring genetic information, but what to do with it.”
– Dr. Tom Hart, Professor, University of Illinois at Chicago College of Dentistry. Ready or Not, the Era of Personalized Dentistry Is Here, September 2014.

“I came to recognize that the most significant advantage a dental school-based education program has is its ability to train to a single standard of care, thus ensuring public trust and the respect of the profession.”
– Dean Patrick Lloyd, University of Minnesota School of Dentistry. Absent a Dentist, What’s the Alternative?, May 2009.

“As the field of dentistry evolves, and as we become more integrated into the health care system overall, this is the direction we need to be heading.”
– Dean Cecile Feldman, Rutgers School of Dental Medicine. The Dental Office: A Portal to Primary Care, December 2013.

“From our current vantage points, none of us can truly see the shape of our profession 50 years from now. What we can be sure of is that there will be change.”
– Dr. Rick Valachovic. Commission on Change and Innovation in Dental Education, August 2006.

“There are very few schools that want to say, look, we need more American Indian dentists, so let’s make accommodations for them to succeed in school.”
– Dr. George Blue Spruce, Jr., Assistant Dean for American Indian Affairs, Arizona School of Dentistry & Oral Health. Number of American Indian Dentists Experiences Amazing Growth Spurt, December 2012.

“For me, it’s personal. I feel fortunate to have been given an opportunity to become a dentist, and I want to give that opportunity to my scholars.”
– Dr. Rosa Chaviano-Moran, Acting Director of Admissions for the predoctoral program and SMDEP Dental Program Director, University of Medicine and Dentistry of New Jersey. Can a Girl From the Caribbean Find Happiness in Nebraska? Tales From the AAMC/ADEA Summer Medical and Dental Education Program, January 2010.

“We want to make sure that people from all backgrounds have an opportunity to bring a range of perspectives to health care so they really reflect the diversity of our nation and benefit all Americans down the road.”
– Andrea Daitz, Program Associate, Robert Wood Johnson Foundation. Diversifying the Dentist Workforce, One Cohort at a Time, June 2012.

“The quality of your student body changes when you’re admitting people who are really engaged.”
– Dr. Venita Sposetti, Assistant Dean for Admissions and Financial Aid at the University of Florida College of Dentistry. Getting the Whole Story: A Holistic Admissions Process, March 2008.

“Education should be out in front of change, but too often it is struggling to keep pace and move forward as professional practice evolves.”
– Ms. Ann Battrell, Executive Director of the ADHA. Dental Hygiene Education Responds to an Evolving Oral Health Workforce, August 2011.

“You are so far ahead of the curve. You’ve had discussions that most of us are just beginning to have.”
– Dr. Bryan Cook, Director of the Center for Policy Analysis at the American Council on Education. ADEA CCI: Curricular Change and Then Some, July 2012.

“Ideas are transformative only when people grab hold of them and put them into practice.”
– Dr. Rick Valachovic. It Takes Ideas and Then Some to Spark Lasting Change, July 2008.

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