By:Courtney Dunn, DDS, MS
Recently, I have had several conversations about the role of organized dentistry – and more specifically organized orthodontics in day to day practice. More and more doctors are considering dropping their memberships with the AAO. Why? The answer isn’t clear cut. I feel that we are living in a time period that is particularly unique in our profession. The great recession took its toll. Patients and practitioners are more price sensitive than ever. This, in combination with the number of orthodontists growing at a seemingly exponential rate is creating the perfect storm where costs are going up and fees are going down in many areas. So, many practitioners are looking at that annual bill and think, “Why am I paying this?”
In the past, organized dentistry has been particularly strong with a very high participation rate. When I graduated dental school in 2001, it was a given that I would join the ADA and subsequently the AAO. It was my professional responsibility and I knew my classmates felt the same way. Today’s graduate seems to have a different mentality than the people that graduated 15-20 years ago and it isn’t just affecting our profession. Organizations across the country from the Junior League to Girl Scouts to the local dental study group are seeing declining membership. So why is this happening?
- The millennial generation aren’t typically “joiners”. This generation is more connected than ever, but are more socially disconnected. They have 500 Facebook friends, text all the time, but rarely make phone calls or meet people face to face. Plus, there are very active dental message boards. These online communities are strong and somewhat negate the need for personal connections made with traditional organizations.
- The great recession put us in survival mode. Here in Phoenix, dental and orthodontic offices were going out of business. When you are worried about getting food on the table, thinking about the greater good of the profession is simply not going to happen.
- Increased student loan debt and a lack of job opportunities. Some new orthodontists are graduating with more than a half a million dollars in debt and then realize that getting a job will be harder than they expected. With monthly loan payments dwarfing their expected salaries, it’s not a surprise they don’t want to pay membership dues or have any interest in partaking with AAO activities.
- AAO annual session– The annual session has always been touted as an economical way to get maximum CE. I have always enjoyed attending the AAO, but I’ve started to notice some things. The speakers are the same every year. And although these speakers do a great job, the talks are starting to repeat themselves. Some of these lectures I heard as a resident. The same. Exact. Talk. Why am I paying to fly somewhere, pay the hotel, pay a registration fee and miss time from my practice and family to listen to the same people say the same things – and most of these things have nothing to do with running my business?
- Leadership that doesn’t represent or understand us– My first year in private practice, I needed to buy healthcare insurance for myself and my family. Touting great rates, I contacted the AAO. I was so disappointed to learn that the health coverage offered to AAO members didn’t cover any maternity care. “It’s too expensive” was the response when I questioned this fact. I looked at the board of directors at the time and realized this organization didn’t represent me. I’m certain the health insurance contained benefits for prostate care and Viagra, but most 65 year-old men could care less about maternity benefits. For better or worse, Obamacare has taken care of the maternity coverage, but that experience left a clear message for me – You have no voice.
- Public relations campaign that takes my money but does nothing– I realize that some of you may believe that this campaign is doing great things for the profession, and I believe everyone going in to this had the best intentions. But, it is expensive and ineffective. The PR company keeps showing results, but people need to remember that their ultimate job is to get you to rehire them. So, of course, they are going to make the numbers look good. I have yet to have one patient in my office from this campaign and I still hear the same number of, “My dentist is also an orthodontist” from educated people that should know better.
Due to these issues, and probably several more not listed, organized dentistry is losing market share. Organizations are now trying to buckle down and recruit new members. I have no problem with this, but this shift in gears pulls them away from their primary purpose of advocacy. So much time and money is being spent on selling the organization, the really important stuff is dwindling down to nothing. The unintended consequence of this is making the organization look more like they are trying to save themselves rather than represent our profession’s needs.
So, I can sit here and complain about all the problems and offer nothing when it comes to solutions, but here are some things the AAO should really start thinking about.
- Revise the archaic leadership structure. It shouldn’t take you your entire career to become a major player in the AAO. There needs to be some diversity in age, gender and ethnicity.
- Get rid of the public awareness campaign
- More advocacy against insurance companies dictating our treatment and lowering fees.
- Give a better meeting. We need the clinical and scientific lectures, but more business lectures by people who actually run their business well would be a welcome change.
- Address student debt before it happens. Offering better consolidation companies is not the answer. Education should be available to those in school and to those applying to school. You need to educate them on realistic salaries, the job market and how best to plan out their orthodontic education.
In case you are wondering – yes, I am still a member of the AAO. I still believe that we need proper representation in Washington DC. So please, AAO, listen and change so we can all have a brighter future.