I am overwhelmed with appreciation and admiration for the pioneers who forged and molded orthodontics from a trade to a learned profession. We can be proud of the changes in our educational system, the quality of our practitioners, the significance of our research, and the appreciation of the public for our professional services and care. Truly a remarkable story. We have been fortunate for decades to share in the dreams and vision of the pioneers of the profession. But what about the decade ahead? Truly a challenge, especially for dental education. There are significant challenges facing both public and private education. Can dental education continue to excel? Will private dental education maintain its excellence with rising tuitions? In the face of drastic state budget cuts, can public dental education continue to excel?
A significant challenge to the dental profession in the decade ahead will be our ability to sustain continued growth and innovation. The foundations of any profession are education and research. However, as a nation, we appear to be unwilling or unable to provide the necessary resources to sustain education and research at the highest levels of excellence. I have serious concerns about dental education’s ability to attract and maintain educators, to conduct the research so necessary for our continued growth, to teach the next generation of practicing dentists, and to lead the way in clinical innovations and scientific breakthroughs.
With the numerous challenges to our profession in the decade ahead, we need to find a better way. A better way to market our profession. A better way to reduce barriers to care. A better way to fund education and student aid, and better ways to increase dental health care awareness and to improve the dental health of all of our citizens. We need to enhance our technology, enrich our educational programs, elevate our innovation and research, which has been the source of our excellence, and heighten the standards and quality of care, which have made our profession, because of its value systems, the envy of the rest of the world. Our profession must not restrict tomorrow’s range of choices, and we must not dilute our capacity to solve tomorrow’s problems. I am convinced that we have the talent, ability, and determination to pay the price in dollars, time, and leadership to find a better way.
More than 10,000 years ago, a Sumerian found a better way. He invented the wheel, perhaps the world’s greatest single technological achievement. Since then, millions of people—some celebrated and some unknown, some by design and some by accident—have found better ways. Thomas Edison found a better way, the incandescent lamp; Henry Ford, the mass-produced automobile; Alexander Graham Bell, the telephone; Alan Turing, the computer; Bill Gates, Microsoft Windows; Mark Zuckerberg, Facebook; Steve Jobs, the iPhone and iPad. The desire and the motivation to find a better way are integral parts of human nature. We Americans are especially known for our “Yankee ingenuity.” We are a nation constantly striving to find, and sometimes obsessed with finding, better ways to do our jobs, to teach our children, to refine our goods, to sell our products, to interact with people, to maintain our health, to test our skills, and to stretch our endurance.
One movement that has the capacity to bring about the most drastic change for education is the philanthropic movement. Philanthropic endeavors in this country, large and small, have the ability to reach and change the lives of tens of millions. Let me take you on a brief history lesson over 100 years ago to the times of the great American industrialists who built their fortunes from the ground up. Andrew Carnegie was the wealthiest man in the world at the turn of the century. He built his fortune over time, and in 1900 at the age of 65 sold United States Steel Corporation for $480 million. In today’s dollars, this equates to over $11 billion. Carnegie was a staunch advocate of active community philanthropy. He believed that the rich have a moral obligation to give away their fortunes.
In his 1889 essay, “The Gospel of Wealth,” Carnegie reaffirmed this by encouraging wealthy families to keep only what was necessary and return the rest for the benefit of the community. He thought that it was irresponsible to pass large wealth to ill-equipped persons or organizations for fear that the money would be spent improperly, negating the positive impact it would have had on the community. It is estimated that during his lifetime Andrew Carnegie donated the 2015 equivalent of over $11 billion—approximately 72% of his personal wealth. Carnegie and other wealthy industrialists such as Mellon and Rockefeller also believed in this philosophy. Through the establishment of endowments and foundations, these philanthropists built a system by which their personal charitable giving could continue in perpetuity.
Dental education is one of the most costly professional training programs. Students graduate from dental school an average of $247,000 in debt, and many have more than $300,000 in accumulated debt. In addition to creating foundations and endowments, Andrew Carnegie also spent significant sums setting up libraries because he believed that education should be free. What a refreshing concept! Unfortunately, we do not have this luxury to offer to all of our dental students. But we can alleviate some of the stress and the cost of education that is placed on the shoulders of our graduates by creating scholarships and endowments.
Since the amounts of federal and state support have decreased, dental schools increasingly rely on tuition and, I hope, generous donations and fundraising campaigns to maintain operations at their current rate. But what happens when you want to grow a school and its program to prepare for the future? What happens when equipment needs to be updated and educational demands are not being met? Our dental school students are suffering and will suffer significant educational and medical training shortfalls, and they are the future generations of our profession.
In my experience, the top 3 reasons that people decide to make a donation are the following: returning something to society, a belief in a particular cause, and a desire to make a difference or a change. These reasons are closely aligned to those espoused by Andrew Carnegie. If we need a cause to believe in, how about our very own profession? It thrives on the dedication and support of an entire network of people, but it needs funding to survive. Proper funding is imperative, and it is the responsibility of dental school graduates who have been positively affected by the profession to give back. Dentists are generous with their time and talent. My hope is that they will be even more generous with their treasury and give serious consideration to creating endowments and scholarships. Endowments have built great universities and will build great dental schools.
By creating a culture for endowments and a passion for philanthropy within dentistry, we supply ourselves with the tools to create positive change for decades to come. To be successful, we must join together in this cause. As W. Edwards Deming, the great industrialist who guided Japan’s recovery after World War II, said, “Survival is optional. No one has to change.” The great Russian writer Leo Tolstoy reminds us, “Everyone thinks of changing the world, but no one thinks of changing himself.” It all starts with change: changing our perception of the needs of dental education; changing our relationships with dental schools, the dental industry, and the profession; changing our approach to charitable giving; and creating change within ourselves.
Dental education is the foundation of our profession, and this foundation is threatened. If we do not have a strong foundation in education, our profession risks losing its integrity. Some even say that if nothing is done to repair the system, it will eventually turn dentistry into a trade. There are overwhelming challenges facing the entire educational system, not just dental education. “Higher education, long viewed as the crown jewel of American education, is tarnished.” Our education has made all of us into the persons we are today. It has molded us into successful medical professionals, enabled us to provide care for those who need it, and given us respect and dignity. If it were not for the strong dental education that we received, the dental profession would cease to exist as we know it, with detrimental effects not only to the profession, but also to the health of the American public. As a learned and successful profession, we cannot afford to let education decline to mediocrity or worse. The educational foundations of our society are presently being eroded by a rising tide of mediocrity. Can we make a difference? We can be proud of our profession, the standard of care that our patients receive, and the quality of our educational programs, but we must continue our vigilance, our proactive commitment, and our support of the dreams of our pioneers—that a dental school is a building with tomorrow inside.
One of the most serious challenges for the leaders in the profession is our inability to motivate the unconcerned, the uninformed, and the uncommitted members of our profession. A free and productive society cannot afford the questionable luxury of too many observers. There must be a sense of responsibility among the majority. We must hold fast to our values and ideals, and those “in the trenches,” who carry the burdens, who face the “slings and arrows” for the decisions made, must continue their leadership. Let me quote from Teddy Roosevelt : “It is not the critic who counts, not the man who points out how the strong man stumbled and fell, or whether the doer of deeds could have done them better; the credit belongs to the man who is actually in the arena, whose face is marred by dust and sweat and blood; who strives valiantly; who errs and comes up short, again and again—who knows the great enthusiasms, the great devotions, and spends himself in a worthy cause; and at the best, knows in the end the triumph of high achievement; and who at the worst, if he fails, at least fails while daring greatly, so that his place shall never be with those cold and timid souls who know neither victory nor defeat.”
We will survive and excel as a profession in direct proportion to the commitment of our talents, time, and resources to the future of dental education, and to the lives of the students and the educators in those institutions. The future of dentistry is not uncertain. The future is what we choose to make it.
If not you, then who?