The President

The Music of Our Profession

Dennis K. Kalebjian, DDS

Copyright 2003 Journal of the California Dental Association.

Following is the text of Dr. Kalebjian’s incoming president’s speech to the 2002 House of Delegates, given Nov. 24.

One short year ago at this House, we as American dentists reflected and deliberated upon the state of our profession. The proper perspective was captured in Dr. Chan’s eloquent inaugural address. His observations were sobering and real, and a reminder to all that we live in an increasingly complex world defined well beyond the focus of our immediate needs.

For the past 12 months, we have been tuned to the harmonic melody of patriotism and good works; however, the music has become increasingly distorted by the background noise of corporate greed, plummeting stock portfolios, the unsavory politics as usual of an election year, and even a threatened strike upon our national pastime. Likewise, the music of our profession has been distorted by an increasing volume of aberrant noise. We have heard the drone of meritless lawsuits, the continued imposition of questionable regulatory practices, and the discord of a legislative agenda that seems (at times) to belie principle and reward gamesmanship. The clamor of Proposition 65, antifluoridationists, anti-amalgamists, and those who attack our peer review system is more than distracting. However, all of us in this room recognize the true music of our profession -- it is simply titled the Art and Science of Dentistry.

There is no greater purpose for the California Dental Association than to maintain clarity and pureness of sound for the music of our profession. Today, I wish to provide to you my own simple sense of how the music sounds -- especially when we:

* Compose our message from the heart,

* Create an organizational rhythm that reflects our mind, and

* Commit to a balance that preserves the soul -- of CDA and its members.

First off, the message about the Art and Science of Dentistry to our patients and to our members has been laid out in the strategic plan. Today, we see the early accomplishments of an ongoing effort:

* Are you a member with a problem or a question? If you are, you will receive the utmost in personalized service with on-the-spot answers from the CDA Contact Center. Their motto "Every member, every day" personifies CDA as an extension of every member’s office staff. Membership value is heightened by well-served customers, and this will strengthen our association.

* Is it difficult to find an assistant or hygienist to work in your office? If so, help is on its way as the allied dental health personnel action plan begins an aggressive campaign to alleviate the shortage. Included is a blueprint to restructure auxiliary licensure categories to keep skilled individuals within the profession, and articulate dental assistant and dental hygiene careers to potential candidates.

* How big is your imagination -- or even expectation -- for creative educational programs that will benefit the entire dental team? Open your eyes to the Learning Center business plan that will feature interactive online learning opportunities and will raise our stock among a new generation of Internet-reliant dentists -- adding value to membership, and keeping CDA, and its 32 component partners, on the cutting edge of an important stream of nondues revenue.

* Do you know a dentist who looks for reasons not to join the California Dental Association? There may be few reasons, but we know of at least 8,000 dentists who are not members. A streamlined universal membership application process provides no such excuse for nonmembership and will be a great first impression on tomorrow’s members.

* Perhaps you are a new dentist searching for the employment that will provide enough after-tax income to meet your nondeductible student loan payment of $1,800 per month? If you are, the CDA Foundation has a story for you. It’s a tale about Dr. Mao Her, who at age 5 came with her family to this great land. -- a storyline not far removed from the legacy of my own family tree. Work ethic and belief in education resulted in a young enthusiastic dentist; yet, like so many of her peers, the accumulated debt load from dental education stood in the way of a desire to "give back." The new CDA Foundation provided a student loan repayment model that empowered one dedicated individual to follow her heart. Dr. Her now provides dental care to an underserved rural community and is the model of how two problems -- access to care and high educational debt -- may be creatively combined into a model that works. It is no coincidence that Assembly Bill 982 established a state-sponsored loan repayment program linked to access that follows the Foundation model. A total of $3 million is now available to at least 30 California dentists who, like Dr. Her, agree to make the three-year commitment to provide dentistry to underserved populations. The CDA Foundation is making a difference.

Kent Farnsworth laid the groundwork for the accomplishments we are now beginning to see. Jack Broussard passionately developed the vision with the insight that the strategic plan would be a dynamic, evolving process. Steve Chan demanded the accountability that enabled the plan’s implementation. It will be my task to keep us centered on our course, facilitating new strategic directions as we go. I am excited to relate one such new direction -- an idea that has come to our joint policy council -- namely a postgraduate residency year as a pathway for licensure. New York recently adopted legislation that allows licensure to new dentists, in return for their one-year commitment to treat the underserved, at accredited residency sites. Pending the conclusions of an action team that I will appoint, and the ultimate authority of the House of Delegates, perhaps California (and one day the nation) may embrace a similar direction. Consider the power of California, together with New York, as magnets pulling this concept across the country. Perhaps this pathway to licensure can help alleviate the access issue once and for all. Food for thought, worthy of the critical analysis of our strategic planning process

Ladies and gentlemen, as you can see, the strategic plan is alive and well. The plan will evolve and advance under the leadership of Drs. Finney, Webb, Hobby, and Mead -- who in time will follow me in this position. Make no mistake about it, we have together -- all of us -- composed a plan from the heart.

The second item of importance is what I term "organizational rhythm" between the volunteer leadership and our dedicated staff. It is a timely topic as we carefully select CDA’s next executive director. It is critical for us to establish a cadence with our staff, whose time -- unlike ours -- is undivided. All volunteers in elected leadership have responsibilities -- we have families to support, practices to grow, communities to enrich. The realities become even more acute as we strive to involve younger members into the ranks of leadership. Simply said, we cannot afford to squander the time and talents of dedicated volunteers on items irrelevant to the big picture of dentistry. The solution is to create organizational rhythm built upon principles of knowledge-based decision making. The job begins with staff -- who provide the objective analysis for volunteers who will develop policy. The job ends with staff -- who become our advocates in policy, confidants in strategy, and agents in action. The end goal is an association that spends quality time on the priority issues that define the profession. Licensure and dental education, the dental auxiliary team, patient care, and the preservation of private practice -- all come to mind. As a consequence, the most valuable resource of this association, our members, begin to have a real voice in dentistry’s future. The leader who shares this vision will stand before you at next year’s House of Delegates -- his or her title will be executive director of the California Dental Association.

The final aspect of my music analogy involves a call for balance -- and here I will be specific to the legislative and regulatory arenas. First, we live in a political environment of term limits, which alters our ability to build relationships with legislators. Second, we are affected by legislative and executive branches dominated by one political ideology -- an ideology whose problem-solving method often runs countercurrent to our own. Third, we operate in a regulatory climate unsympathetic to dentistry’s concerns. What should we be thinking? What should we be doing? The thinking has long been that dentistry has influence when given a seat at the decision-making table -- however, in the current political landscape there is a difference between sitting at the table to influence credible direction, and sitting at a table, giving credibility to a direction. We must recognize the difference for what it is, especially when our identity and values become at-risk. A balance that reserves our seat at the table, yet maintains our association’s identity and professional values, must at all times be job one. This winter, CDA will be invited to discuss the creation of a separate board for dental hygiene. Additionally, we will see a renewed effort to promote a different slant on denturism called "medical denturity." There will be other issues as well. Volunteer leadership must create public policy consistent with dentistry’s values. That’s why I’m here, and that’s why you’re here. Our policy must be insightful of political reality, but exercise independence from politics. The identity of CDA -- the very soul of dentistry -- is in the balance.

We have talked about our message. We have talked about our organizational rhythm. We have talked of the need to maintain balance. We must not forget the importance to ALL play together, in one harmonious key. The Task Force on Corporate Operations made its final report and restated that opportunity exists when ALL members of the family participate in the organization’s mission and strategic vision. Exceptional dedication and extraordinary execution have been the hallmark of our subsidiary companies. Fritz Knauss has assembled a premier team of professionals who make TDIC No. 1. Even with today’s hardened professional liability marketplace, TDIC is well-positioned to grow its out-of-state business, strengthen its strategic position within the industry, and contribute to the stability and growth of CDA. And what about our other for-profit subsidiary? Bob Witt has successfully fashioned 1201 Financial and Insurance Services’ business plan to fulfill member needs and to capitalize on the CDA brand. This weekend’s declared million-dollar dividend is a testament that 1201 has arrived. As we look forward to the coming year, we will embrace many recommendations drawn from the corporate operations report. Our family-wide vision will be enhanced -- promoting an organization whose music is heard only in one clear key. The mission of the California Dental Association is to be the recognized symbol of excellence in education, advocacy, and innovation, serving its members and assisting the dental community in fulfilling their responsibility to the public.

Truly, we are the respected voice.

I thank you for letting me share with you my sense for how the music of our profession sounds. The California Dental Association is a special organization. It is so because you are all extraordinary and gifted people. I am honored and humbled to have this rare opportunity to serve as your president. Please join with me, as we together bring clarity and pureness of sound, to the music of our profession.