Exercising Your Voice in Organized Dentistry

Imagine a young dentist in 1968 who designed a state-of-the-art dental practice, fit with the top-of-the-line equipment, sleek mid-century design, a trendy avocado green color and wood panels throughout the office and began their practice with a business model designed on 1968’s best dental office management practices. Now imagine that same dentist continuing to practice in 2021 with that same design, equipment and philosophy.

Seems rather preposterous, right? What kind of business would be unwilling to change their business model to keep current with research, design and best practices? What aspect of a business model has not changed in 53 years that needs to be modernized?

What if I were to tell you that the business I am describing is not a dental office, but instead the governance of organized dentistry?

In many ways, the framework by which organized dentistry operates is built on the same “practice” philosophy of 1968 when the current structure was put into place - regionally elected trustees; component societies, each with their own corporate legal structure; a House of Delegates, which establishes all the organization’s policy, yet only meets to create policy once a year. Some of you are thinking because we want to make change means we want to take away your voice and your ability to engage in your association. That could not be further from the truth. We see inefficiencies in this design and better ways to ensure that your voice, along with every other voice, is heard.

Association management research has provided a business model for nonprofit boards of directors built on what is referred to as a “competency-based board.” We’ve floated this idea and some of the feedback we have received is members don’t like the word ‘competency’ because it implies that you are either competent to serve on the board or that you are incompetent. The term doesn’t refer to the individuals who serve, but rather to the needs of the board – the competencies it needs as a body to see and understand the full scope of organizational needs that we as an association and a non-profit corporation must resolve and oversee. These issues include direct dental practice concerns – workforce shortages, dental insurance, regulations – but also include understanding innovations driving changes in the operations of a dental practice from both the private sector and through dental education. It includes understanding how to protect and safeguard our intellectual property and IT framework, overseeing the association's investments and identifying new revenue sources, which enable us to keep your dues low. It includes linking the dental practice needs of each member to business solutions in the marketplace. The board of trustees must be the driving force in how we understand and react to a continuously evolving profession, the increasing external regulations and auditing requirements we face, and still provide the foresight that will allow the association to remain at the top of its profession for years to come.

These competencies we are talking about as a board include critical judgement and decision-making skills, exemplifying integrity, leading and managing change, risk management, and strategic vision and thinking. This framework is also called the “13 Best.” The idea that the members of the board are among the best leaders available to serve based on the expertise they contribute. These board members are sensitive to regional, special interest, and the high priority needs of the membership, but not seated based solely on geography. The objective is to leverage the boards’ competencies to drive the organization's performance.

Imagine a basketball team with thirteen point guards – you may be able to run a very fast and nimble offense, but you are most likely going to be a very poor rebounding team and good luck blocking shots from a seven-foot center. A board not only needs the competencies above, but also diversity in practice model, age, race, gender, unique knowledge such as dental school faculty, a background in understanding dental service organization operations plus a curiosity and understanding of the external drivers of change in the dental industry.

The Board of Trustees and your elected officers have tried to draw attention to these challenges and to build a new, modernized practice philosophy, to allow us to be a better association, representing all dentists. The board recently created a Council on Component Leaders. This council is designed to give the components true representation to the board and a larger voice to the concerns of the grassroots members. This council is in place so the needs and challenges of all members can be voiced through component leadership directly to the board or to the House of Delegates.

Additionally, we are working to draw attention to the powers and duties of the House of Delegates (HOD). The HOD has a critical role to play in organized dentistry. It creates the policy by which the board and councils operate. It’s the “what position does the CDA have on?” body. Without direction from the HOD, the board is limited in what it can do. The Board of Trustees is not a legislative body, it can only create organizational policy if it is necessary for the operations of the association. In other words, it can’t decide itself what the association’s position is on workforce expansion, dental insurance reform or even mid-level providers. This must come from the House of Delegates, not because the board doesn’t want to take this responsibility, but because it can’t. The bylaws created by the House of Delegates do not give the board that power.

Here is our challenge: Each one of you has an idea on how you think dentistry and the profession should operate: the laws that surround the profession, the way in which dental benefit plans intersect with patients and dentists, ideas on how to manage the supply of dental workforce. You may want your organization to be more diverse and its leaders to better reflect the dental school graduating classes. You may believe there is a bigger role the CDA can play in special needs population or have concerns about how the growing senior citizen population is going to receive and afford dental services in the future. Regardless of what your ideas are and what you are passionate about, we as a board and through the councils, can’t make those things happen on our own. Each of you belongs to a component dental society and you elect delegates who serve in that role until they are replaced. These delegates advocate for you and bring your thoughts, ideas and solutions to the CDA. If you have ideas take them to your component society. Ask they bring forward and support a resolution reflecting that policy change. Then it becomes the task of the board to carry forward the new policy.

The voice for you as a member is, and has been since 1968, through the House of Delegates and we’ve now added the Council on Component Leaders to create an even bigger voice. However, unless you exercise that voice, it’s very \difficult for the CDA to resolve your concerns. The board, more than anything else, wants you to exercise your voice through your delegates serving in the House of Delegates, so it can leverage its’ competencies to carry out these wishes in the very best way possible.

This practice philosophy is what the board is looking to accomplish to drive this organization forward in the future.

About the Author

Greg Hill, JD, CAE has served as the Executive Director of the Colorado Dental Association since June of 2014. Prior to joining the CDA, Greg was employed by the Kansas Dental Association for 15 years and served as the Assistant Executive Director of the CDA and Executive Director of its Foundation. Mr. Hill is a 1999 graduate of the Washburn University School of Law in Topeka, KS and a 1994 graduate of Kansas State University with a Bachelor of Science in Economics. He became a Certified Association Executive (CAE) in 2016. In addition, he serves as Co-Chair and Treasurer of Oral Health Colorado; on the Board of Directors for the Colorado Dental Lifeline Network and the Colorado Mission of Mercy; and is a member of the Denver Tech Center Rotary Club. He and his wife, Gwen, are the parents of daughter, Haven, and son, Camden.