The October editorial on Dr Edgar R. R. Parker evoked memories of our dental history course at McGill University in Montreal (Behrents RG. Dr Edgar R. R. Parker: his time and now. Am J Orthod Dentofacial Orthop 2015;148: 521-4).

“Painless” Parker did some remarkable things right here in Montreal, Canada. On St. Catherine Street, a main thoroughfare in Montreal, he had a tightrope wire installed from a second-story window on one side of the street to a window on the other side of the street. He engaged a tightrope walker to cross the street. When the walker emerged from the first window to begin his walk, he cried out to the people below, “I am going to the office of Painless Parker because he extracts teeth painlessly.” For the return trip, he would yell to the people below he had just had his tooth removed painlessly at Dr Parker’s office. Sometimes, as a further marketing tool, the tightrope walker would release a bag of nickels in the middle of his walk, causing pandemonium as people rushed to pick up the change in the middle of the street—blocking traffic in the midst of all the mayhem. When the circus came to town, articles and a picture in the newspaper reported on how Parker, fearlessly, had removed a lion’s tooth. According to the legend, most people were unaware that the lion was very old and already toothless.

In Quebec and other provinces to which Painless Parker migrated, he was thrown out or forced to leave because the government and dental societies legislated against his marketing practices. The basic ethics of dental practice, incorporated in dental provincial legislation, still stand today. I believe this to be true in the U.S. as well. This was an important point not mentioned in the editorial.

I have practiced orthodontics for the last 48 years and taught the Practice Management course at the University of Montreal, Orthodontic Section, for the last 31 years, and my view is that new graduates today are challenged by the same factors listed in the editorial. The United States has always been 15 years ahead of Canada in orthodontic practice trends. Markets were much more open in Canada for young orthodontics in the past. My advice has been to practice where you want to live, treat people fairly, and do excellent work. Canadian orthodontists have managed to escape Health Maintenance Organizations, Medicaid, and much of corporate orthodontics. A new graduate today will most likely become an associate or open several satellite offices, compared with the graduates of the 1960s through the 1990s. Others will opt to purchase an existing practice.

Now, at age 74, I practice part-time with the young orthodontist to whom I sold my practice and I teach part-time, all with abundant passion. I tell the new residents that they have made a choice to join the best profession in the world despite all the changes occurring around them. Your editorial was “bang on.” Keep up the excellent work.