Organized Dentistry: A Seat at the Table
“If you’re not at the table, you’re on the menu.” This famous quote originated in Washington D.C. In April 2018, our local Midwestern ASDA chapter sent twelve students to D.C. to ensure that we had a seat at the negotiating table. There is no shortage of people in this country making decisions that affect others and proposing solutions to problems they may not understand. Like it or not, laws will be written that affect our profession whether we show up or not.
Organized dentistry ensures that the politicians and lobbyists in Washington consider our opinions before drafting legislation that affects us. It is easy to be a part of organized dentistry. All you have to do is be a member of ASDA, and eventually, the ADA. You don’t have to travel to Washington or the state capitol unless you want to. You don’t even have to write letters or make phone calls–that’s what the ADA, ADPAC, and ASDA are for. There are plenty of dental professionals who are willing to represent you in Washington, but they need the financial support that comes from our membership dues.
What Happens Behind the Scenes
In Washington, we introduced the first by-laws and recommendations from any health professions organization regarding opioid use and prescribing practices for our members. We are also leading the charge on forcing health insurance companies to abide by federal anti-trust laws that regulate us as dentists, but which health insurance companies have long been immune to. We cannot legally discuss our fees with each other, but health insurers do it all the time. There is nothing fair about that for us or our patients.
We asked Congress to support a new bill that would allow dental organizations access to grant funding from Health and Human Services for events like Mission of Mercy, or Team Smile. On behalf of all dental students we proposed many changes to higher education loans, including making federal Direct Subsidized Stafford Loans accessible to dental students, reducing interest rates, and an increase to Indirect Unsubsidized Stafford Loans. Finally, we asked Congress to prevent insurance companies from dictating reimbursement rates, and to forbid unfair practices like nominal payments that allow an insurer to claim that a procedure is covered when they reimburse almost nothing for it.
Here in Arizona, AzDA and our local ASDA chapters have reinstated Medicaid dental benefits for expectant mothers and emergency dental benefits for impoverished adults. We also amended licensure requirements that benefit recent graduates, and we have prevented multi-billion dollar foundations from forcing mid-level providers with woefully inadequate training to operate on Arizona patients. All of this was accomplished in the last two years, and much of the work was done by dental students at Midwestern and ASDOH.
Some dental students and even dentists question the value of joining ASDA or ADA. Some have jokingly quipped that the membership is only good for the subscription to JADA. These people may not be aware of how hard the ADA is working behind the scenes to maintain this great profession. The dentists who accompanied us in Washington took time off from their busy practices to represent the rest of us in Washington.
Many of us chose to become dentists because of the autonomy, the lifestyle, or perhaps the ability to earn an honest living from an honest day’s work. All of these things were hard won by dentists in generations before us who lobbied and petitioned their lawmakers to create the favorable conditions that make dentistry what it is today.
Preserving the Profession
The AMA has far less influence in Washington than the ADA, despite the fact that there are far more medical doctors than dentists. This is due mostly to the fact that their membership hovers around 15%, while 161,000 of the 198,000 dentists in the United States belong to the ADA.
When Congress and the Obama Administration drafted laws that would drastically affect health care in this country, the AMA had very little influence over the final legislation. Physicians were on the menu. We may be next if we do not maintain a strong presence in Washington and at our state capitols. If our membership continues to decline as they have been recently, then dentistry will follow medicine and be left at the wayside.
I have great hope that the future of dentistry is bright because many of my classmates have taken it upon themselves to get involved. I hope that you too will choose to be a part of organized dentistry, even if that means just being a member of the ADA.