Who We Are and Where We Are Going

Ariane Terlet, DDS

Editor’s Note: Dr. Ariane Terlet was installed as the 2022 CDA president at the 2021 virtual CDA House of Delegates meeting. Her inaugural address is presented here in an adapted form.

My practice consists of two worlds: private and public health. All of us work in the service of the public even though our practice settings, payers and patient demographics may be different. Public health is the reason that I joined CDA. My decision to join CDA after five years of practice was in reaction to the threat of geographic managed care to both private practice and our public health clinics. I learned to appreciate the advocacy arm of our organization. Our dues do not come close to what it would cost us as individuals to hire attorneys to represent our practices in insurance and regulatory arenas. After 30 years, it is gratifying to see the working relationship that CDA has with public health and our state legislature.

Our profession is founded on responsibility and integrity. We are all members of a healing profession and have a covenant with the public to improve the oral health of our patients as well as the advancement of the profession of dentistry.

As individual members, we are the heart and soul of our association. Our CDA leaders and staff team members perform the magic behind the scenes. We work in collaboration to support and promote our successful practice in our service to our patients and the public.

As delegates and members of the CDA House of Delegates, we are the leadership of CDA. We are charged with making the best decisions for all of our collective and diverse members. The 2021 CDA House of Delegates gave direction for a new governance structure.

So, where do we go from here?

Max De Pree’s quote on leadership has guided me throughout this pandemic:

“The first responsibility of a leader is to define reality. The last is to say thank you. In between the two, the leader must become a servant.”

In order to be successful, we must have good communication. In order to have communication, we must share the same reality.

Our reality is COVID-19. It has imposed itself on practically every aspect of our lives. It has imposed itself on our plans. It has caused us to change course, adapt and in some cases delay our plans. Though COVID-19 is still impacting our lives and the practice of dentistry, it is now time to move away from the emergency mode and get back to business in this, our new normal.

Our strategic plan needs to be reviewed and updated. COVID-19 impacted several of our revenue streams. We need to continue to be fiscally responsible as we plan for the future.

We need to prepare for challenges to existing insurance reform legislation, the Medical Injury Compensation Reform Act (MICRA). This is a major threat to our practices and could lead to increased costs for our patients.

We need to explore the increased overhead costs that we are experiencing due to COVID-19.

We need to be more involved in grassroots actions. The ADA has reported that only 65% of dentists are registered voters and fewer actually vote. Please register and vote. Our collective futures depend on it.

We have increased costs that are not going away anytime soon. Our pre-COVID-19 concerns about thirdparty reimbursements continue. Sometimes the tax category “nonprofit” is mistaken for a business model that achieves no profit margin. In public health, our common saying is “no margin, no mission.” This is true for all of our practices. No margin, no mission.

We will explore ways that our governance structure might work more effectively to meet the changing needs of our members while continuing to be fiscally responsible.

We will continue to address dental practice staffing shortages by developing partnerships in recruitment and training. The pool of dental assistants must be grown to fill the critical need felt locally, statewide and nationally.

Our policy on diversity, equity, inclusion and belonging will be implemented and become an integral part of the fabric of our organization.

Our CDA leaders have had a long history of facing facts and making difficult decisions. Challenges to our profession have become opportunities for growth. A few examples are:

■ The formation of TDIC, in the face of skyrocketing insurance rates.

■ Addressing the access-to-care issue head on. Where would we all be without a state dental director during COVID-19 to advocate that while we are one of the professions with the highest risk for exposure, we are also the safest.

■ The formation of TDSC as a disrupter to the dental supply system. We learned a great lesson about the profit margins that leave us paying a premium for our supplies. TDSC resulted in more than $21 million in savings to members up to this point. While we no longer operate the company, we still hold an interest in it. This interest can provide us with a future source of nondues revenue as the company continues to provide value for members.

Scope-of-practice issues are ever present. As dentists we are perfectionists, but we might serve our patients and the public better if we as team leaders train our teams so their hands can be an extension of our hands. We should all be practicing at our highest level of licensure while maintaining the highest quality of care.

Moving forward, we have more challenges and opportunities. One in eight U.S. residents lives in California. In 2030, 30% of California’s population will be age 60 and over. Who will be providing their dental care?

This is a difficult and complicated question, but we will work to be on the right side of history.

In the end, it is important to remember that we cannot become what we need to be for tomorrow by remaining what we are today.

I am truly humbled and grateful to have been elected president of the most innovative and progressive organization in our country.

It is my pledge to you as the incoming president to carry out the directives of our house and work to ensure that the proper checks and balances are in place for the continued growth and strength of our association.

We have our work cut out for us. I look forward to serving with you and for you in 2022.