PFA Dental World Newsletter March/April • 2002

	Dental World^®		March/April • 2002
	PIERRE FAUCHARD ACADEMY

	Thoughts From the President
	I hope that all of you and yours had a joyous holiday season. The old year of 2001 is in the past, and hopefully our new year of 2002 will be better. Often it takes a catastrophe to bring people together in spirit and purpose. May we Fellows in the PFA use our knowledge and influence worldwide to encourage leaders of governments to pursue peace. “Even when faced with the murderous madness of criminals, and in the presence of silent agony of their victims, it is incumbent on us to choose between escape and solidarity, shame and honor. The terrorists have chosen shame. We choose honor.” — Eric Wiesel.		May we all work to preserve the right to live where and how we choose with the purpose and conviction to further the work of our Creator. We must strive to do our healing work and further pledge ourselves to help those in need by our philanthropy. Our PFA Foundation is an arm of our organization, which can help some of those in need. We should be generous in furthering the work of the Foundation with our donations. May the coming year be a good one and a great one. May we all work together to become one in purpose and peace. May we also work together to nominate deserving Fellows into the PFA.
			Scott M. Welch, DDS President

Table of Contents - March/April • 2002

Presidents Message

PFA Web Site

Calendar

Foundation News

Service Above Self

Grant Awards

Desk of Past PFA President
Foundation Grant Awards

Independent Dentistry—UK Style

The Humanitarian Award

A Date With Fate Foundation News

U.S. Dental Policy Update Section News- International

Awards Reminder Section News USA

go to Page 1 — Page 2 — Page 3 —

Service Above Self
by Dr. George Higue

“He profits most who serves best.” This is the motto of Rotary International, as most Rotarians all over the free world are aware. But this motto is not just applicable to Rotarians. And Rotary International certainly deserves recognition for publicizing these words of service, as well as much more.

However, most of us have learned that this motto is not limited. The concept actually extends way beyond the meaning of the words. It is a Rule of Life of great significance. It is the “Golden Rule of Service” that reaches out to include various avenues of service.

For example, our leaders and Fellows in the Academy, in their dedication and zeal for serving, most certainly emulate this motto.

One is reminded of Pierre Fauchard, who is recognized worldwide as the Father of Modern Dentistry, and who most certainly is an example of “service above self.” Pierre Fauchard’s role started about 300 years ago, at a time when only the affluent and wealthy were privileged to receive dental care. This was a period when dentists functioned like tradespeople, jealously and tenaciously clinging to any dental skills they could exploit for personal gain. There was no such thing as sharing dental knowledge with others. The others were competitors, not colleagues. As a matter of fact, until Pierre Fauchard accumulated the dental knowledge of his time and put it into a written form for publication, there was no sharing at all.

Thus, Pierre Fauchard supplied the ethic of sharing the dental knowledge of his time with other professionally-inclined, ethical dentists. This laid the foundation for dentistry to develop into the high-level profession it is today, one that is highly respected and recognized throughout the world.

Rotary International supplied the motto, but the principle is a rule of life for the professional. Fellows in the Academy, our dental leadership, illustrate this concept. Through their continued efforts, they have attained high respect and recognition. As Pierre Fauchard started the ethic, the Academy named after him has continued his legacy and expanded the idea of service above self. For that we are recognized globally as one of the world’s great dental honorary service organizations.

(Dr. George Higue of Newport Beach, California, is a past President of the Academy (1974) and currently serves as the Treasurer of the PFA Foundation. Through his investment genius, the invested Foundation funds were protected from the recent stock market losses. Dr. Higue also funded the translation from French the book, The Life and Times of Pierre Fauchard.)

			Calendar 2002
	25 May 25-29 May 25-29 May 1-5 October 19–23 October		Canadian PFA Induction Luncheon, Montreal, Canada 100th Anniversary Canadian Dental Association, Montreal, Canada Les Journee Dentaire du Quebec 90th FDI Congress, Vienna, Austria 143rd ADA Annual Meeting, New Orleans, Louisiana (Have your PFA Event date put here. E-mail Editor Brophy at PFADWJMB@aol.com)

from the desk of past PFA President Nicholas Saccone…

As many of you may know, FEMA has pulled out of the recovery effort at the World Trade Center disaster Ground Zero. The participating firemen are becoming discouraged and rightly so. They have worked tirelessly under the most difficult circumstances for months now. They are physically and emotionally exhausted. Yet they vow to continue the recovery effort.

The media has spared us the worst details about the horrific conditions at Ground Zero, but the firemen have seen and experienced it all firsthand. In spite of the unspeakable things they must deal with, their recovery work continues. And will continue until the job is done.

What I should like to suggest is that we start a Card Writing Campaign. Go out to your local Hallmark store, or wherever you can buy some greeting cards. Purchase a card that expresses your feelings about the heroic efforts these workers are putting in. Send the cards to: New York City Fire Department, 1 Chase Manhattan Plaza, New York, NY, 10005.

Just think what a powerful influence you would make on these heroes of ours.

If you know some teachers, ask them to make it a class project. We could all show our solidarity for these people and lift their spirits. We can demonstrate that we have not forgotten their efforts just because the news coverage has drifted away.

Imagine them getting bags of mail from all over the world, just like that movie scene in Miracle on 34th Street. It would be some kind of small miracle. Like Kris Kringle in that movie, the firemen are in a time of trial.

They need to know that Americans, and people from around the world, have not forgotten. We believe in them and what they need to do. They need to feel our love, support, and encouragement.

Remember that this was the World Trade Center. Americans were not the only ones to die there on 9/11. Representatives of countries all over the world lost their lives in that terrorist attack. Even little Belize, with a population of about 220,000, lost two of its citizens. While this may be viewed as an attack on the United States, the terrorists picked the World Trade Center. They declared war on the entire world. But it is our men and women who are there daily searching and finding new horrors with every shovelful.

Please, everyone send those cards!

Truly Independent Dentistry—UK Style
by Dr. Amarjit Gill

Since 1948, the National Health Service (NHS) has dominated the control over the delivery of dental services in the United Kingdom. Then in 1992, the government slashed 20% off the dentists’ total income because dentists were “too successful in recruiting patients under a new contract” the government had introduced. You certainly can imagine the strong feelings this maneuver produced.

This pay cut was the beginning of the end for being solely reliant on NHS revenue. Thus began a move toward independent, private dentistry. Most of UK dentistry is still practiced under NHS. NHS views the dentist as an independent contractor. The dentist must buy his own practice and equipment, staff and supply his office, then agree to work on patients to a set of NHS rules that are two inches thick. Dentists receive no money until they recruit and treat patients.

Why do UK dentists do this? Why do they not just provide direct fee-for-service care and stay out of the NHS entirely?

The reason is that the NHS system dominated dentistry when most current dentists entered into practice. To become independent, a dentist must reduce his reliance on NHS over a period of time and develop a private practice concurrently.

The only methods to generate private fees are:

1. Limiting the access to the practice, that is, specific hours for private work only;

2. Limiting treatment types, such as bonded crowns, cosmetic dentistry on a private fee basis; and/or

3. Denying access to NHS dentistry by giving NHS a contractual three-month notice and limiting the practice to private dentistry only through capitation or third-party fee for treatment basis.

In most parts of the country, this movement toward independence was begun by dentists creating groups of like-minded dentists to share problems and benefits of breaking with the NHS system. Imagine the courage it takes to sever with a system that is all that you have ever known that supplies you with patients, to develop one where you must “sell” yourself directly to the patient. Over the last decade such groups met under the guise of IPG (Independent Practitioner Groups). They capably controlled the adventure into the new territory of fee earning as a self-help organization.

Our group in Nottingham began like that. We organize “hands-on” and “minds-on” courses to enable the development and consolidation of treatment standards, which we hope our patients will value.

The BDA (British Dental Association) realized that this movement was progressing without them, and despite their control. The BDA invited representatives of these various independent groups to participate in a meeting to discuss the issues and to help their members along the road to financial independence. This established a coalition, which produced some excellent literature.

There has been a comfort in knowing that we had a monopoly in supplying our services, as professionals, to the public. However, this was being threatened by:

1. The increasing tide of overseas colleagues joining the system. Last year, more dentists from abroad joined than were being graduated in the UK.

2. The introduction of auxiliaries who were able to perform more tasks traditionally done by the dentists;

3. Dental technicians were performing dental procedures with no one empowered to take effective action; and

4. Corporations invested £2 million to access the dental market by buying our dental practices and employing the dentists to work for them.

All of these groups were able to bid for and compete to provide a service within dentistry.

Quite a “doom and gloom” scenario was developing. Professional dentistry was faced with choosing (1) nationality of the profession by appealing to the government with innovative and effective ideas under them to control dentistry; or (2) locally exceeding the expectations of our patients in our practices.

Over the last five years, a great many dentists simply retired to avoid the headaches in facing these challenges.

NHS dentists need to address this “era of uncertainty” with the government to take the lead in devising a dental service that the government is willing to fund and that addresses the problems.

In the last decade, we have seen most of the world’s industries re-engineer themselves, reinvent their businesses, to remain competitive in the world of modern technology. UK dentistry’s NHS needs to realize that their traditional 50-year-old service cannot still operate under those conditions of 1948. One such example is that the NHS is set up to pay for dental treatment with no incentive toward prevention or controlling periodontal problems. You are paid for drilling and filling, not preventing decay and tooth loss. Caries therapy absorbs the most cost in the national system.

For those dentists who choose to accept the government as their paymaster, prevention services will be expected of them for the same, or less, funding than they are currently receiving. It is no coincidence that the per capita spent on dentistry in the UK is 12 times less than that spent in the United States. There is no incentive for any organization to want to pay more than necessary for any product or service. This means that those independent practitioners who can effectively care for their patients through prevention and maintenance, thus reducing the patient dental expenses in the long run, are in a position to take the leadership in demonstrating what services professionals can provide.

Dentistry in the UK is at a professional crossroads. To properly address the problems the NHS will need to (1) organize the dental services in the country, (2) provide better compensation to their providers, and (3) offer incentives for prevention and maintenance services. This will mean more funding and a change in their mind set.

The independent practitioner movement is growing because they can address these problems locally. Independent dentists can offer all the services provided for by NHS, auxiliaries, and technicians; can serve their patients with what they want, when they want it, at realistic prices; and can promote prevention and maintenance, at a fee for service, that will serve their patients best for the future.

Providing true professional care for our patients, as we were taught to do, will best be served by our independence of the system.

(Dr. Amarjit Gill, United Kingdom PFA Fellow, is Chairman of the BDA Private Practice Committee and Director on the BDA Executive Board. This article is meant to be informative and does not necessarily reflect the opinions of PFA.)

	A Date With Fate
	L-R, Helen Smolak, Richard Kozal, Vickie Cyhel		The interview, which appeared in the last issue of Dental World, covered the interesting stories of Vickie and Helen helping Walter keep the PFA records in a shoebox during his 1977 to 1985 tenure, and spreading out the dues notice mailings all over the dining room table. Each one hand to entered by hand, which took hours. Vickie was so pleased to attend the dinner to meet old friends and make new ones from her lifetime commitment to PFA. She and her sister Helen were so excited to remember the good times, they talked for over an hour telling stories to your editor and her husband’s successor Dr. Richard Kozal. How fortunate a moment we had in time. Vickie Cyhel went home and passed away a month later. Certainly one of her last thoughts was still about the warmth she experienced in spending a good portion of her life with PFA.
	The wife of our past International Secretary Walter A. Cyhel, Vickie Cyhel, attended our Kansas City President’s Dinner with her sister Helen Smolak last year. We reported the interview with her after that dinner.

	U.S. Dental Policy Update— by Congressman Charlie Norwood, PFA Fellow
	How the world has changed since our last update! 1. We have a new Assistant Secretary of OSHA; 2. OSHA has finally declared your office is not a high risk to public health; 3. We have passed out of the Commerce Committee a bill to reform Medicare Administrative procedures; 4. We are at war; 5. My Washington, D.C. Office is closed; 6. We have a new President-elect of the ADA; and 7. I have a new Congressional District to run in. No one ever said my job was boring! As indicated in my last update, the HMO Bill that the House passed in July achieves 100% of what we started out to obtain in 1995 and 95% of what we had in PARCA. There was no reason it should not have been signed into law this year. But then came September 11th. Obviously, the focus in this town is now on the war and bioterrorism. I intentionally left the Bill alone for 30 days after 9/11, but I am beginning to push again. The White House and the Senate Democrats must work together behind the scenes to reach a final deal. Talks are ongoing. I will keep you informed. I had a great meeting with the new OSHA Assistant Secretary John Henshaw. We disagreed on very little. Now that OSHA has finally realized that our offices are not dangerous, we can relax a little. We will continue to monitor this agency as we have been doing for the last seven years. We are now classified as “low hazard.”		I know you continue to be concerned about the new privacy rules. We are all over this. I have had meetings with the White House and HHS Secretary Tommy Thompson. We do not have this corrected, but we are on the job. The delay in this is one of the casualties of war. I realize most of you do not treat Medicare patients. However, the Medicare Reform Bill does address some of the problems we have in that system. My Washington Office in the Longworth Building was closed because of anthrax contamination in the building, though not in our office. It has been very inconvenient. The D.C. phone calls are forwarded to our Augusta Office. Our staff is at work, but spread around town. No one knows when we will start getting our mail again, but keep those cards coming. We are open, but a little slow. As for the war, let me say, thank God every day that President Bush and his team are in charge. They and our military are doing a great job. I congratulate all the good men that offered themselves for ADA President-elect. They are all fine professionals and worked very hard. I am especially proud of my good friend of 30 years, Howard Jones from Georgia. I look forward to working with him as ADA President. I have a new Congressional District in Georgia. The process was controlled entirely by the Democrats, which splits communities of interest in an effort to elect more Democrats. Of the 26 counties I am now to run in, I only represented nine of them before. I now go all the way to North Carolina! I made many enemies in working so hard for our patient protection bill, so I will need to depend heavily on your support. If you need any answers I can help you with, contact me at P.O. Box 499, Evans, GA 30809. Or E-mail me at www.NorwoodforCongress.com, phone me at 706/738-8400 or fax me at 706/738-0575.

	Table of Contents - March/April • 2002
	Presidents Message		PFA Web Site
	Calendar		Foundation News
	Service Above Self		Grant Awards
	Desk of Past PFA President		Foundation Grant Awards
	Independent Dentistry—UK Style		The Humanitarian Award
	A Date With Fate		Foundation News
	U.S. Dental Policy Update		Section News- International
	Awards Reminder		Section News USA

			go to Page 1 — Page 2 — Page 3 —

	Service Above Self by Dr. George Higue
	“He profits most who serves best.” This is the motto of Rotary International, as most Rotarians all over the free world are aware. But this motto is not just applicable to Rotarians. And Rotary International certainly deserves recognition for publicizing these words of service, as well as much more. However, most of us have learned that this motto is not limited. The concept actually extends way beyond the meaning of the words. It is a Rule of Life of great significance. It is the “Golden Rule of Service” that reaches out to include various avenues of service. For example, our leaders and Fellows in the Academy, in their dedication and zeal for serving, most certainly emulate this motto. One is reminded of Pierre Fauchard, who is recognized worldwide as the Father of Modern Dentistry, and who most certainly is an example of “service above self.” Pierre Fauchard’s role started about 300 years ago, at a time when only the affluent and wealthy were privileged to receive dental care. This was a period when dentists functioned like tradespeople, jealously and tenaciously clinging to any dental skills they could exploit for personal gain. There was no such thing as sharing dental knowledge with others. The others were competitors, not colleagues. As a matter of fact, until Pierre Fauchard accumulated the dental knowledge of his time and put it into a written form for publication, there was no sharing at all.		Thus, Pierre Fauchard supplied the ethic of sharing the dental knowledge of his time with other professionally-inclined, ethical dentists. This laid the foundation for dentistry to develop into the high-level profession it is today, one that is highly respected and recognized throughout the world. Rotary International supplied the motto, but the principle is a rule of life for the professional. Fellows in the Academy, our dental leadership, illustrate this concept. Through their continued efforts, they have attained high respect and recognition. As Pierre Fauchard started the ethic, the Academy named after him has continued his legacy and expanded the idea of service above self. For that we are recognized globally as one of the world’s great dental honorary service organizations. (Dr. George Higue of Newport Beach, California, is a past President of the Academy (1974) and currently serves as the Treasurer of the PFA Foundation. Through his investment genius, the invested Foundation funds were protected from the recent stock market losses. Dr. Higue also funded the translation from French the book, The Life and Times of Pierre Fauchard.)

	from the desk of past PFA President Nicholas Saccone…
	As many of you may know, FEMA has pulled out of the recovery effort at the World Trade Center disaster Ground Zero. The participating firemen are becoming discouraged and rightly so. They have worked tirelessly under the most difficult circumstances for months now. They are physically and emotionally exhausted. Yet they vow to continue the recovery effort. The media has spared us the worst details about the horrific conditions at Ground Zero, but the firemen have seen and experienced it all firsthand. In spite of the unspeakable things they must deal with, their recovery work continues. And will continue until the job is done. What I should like to suggest is that we start a Card Writing Campaign. Go out to your local Hallmark store, or wherever you can buy some greeting cards. Purchase a card that expresses your feelings about the heroic efforts these workers are putting in. Send the cards to: New York City Fire Department, 1 Chase Manhattan Plaza, New York, NY, 10005. Just think what a powerful influence you would make on these heroes of ours.		If you know some teachers, ask them to make it a class project. We could all show our solidarity for these people and lift their spirits. We can demonstrate that we have not forgotten their efforts just because the news coverage has drifted away. Imagine them getting bags of mail from all over the world, just like that movie scene in Miracle on 34th Street. It would be some kind of small miracle. Like Kris Kringle in that movie, the firemen are in a time of trial. They need to know that Americans, and people from around the world, have not forgotten. We believe in them and what they need to do. They need to feel our love, support, and encouragement. Remember that this was the World Trade Center. Americans were not the only ones to die there on 9/11. Representatives of countries all over the world lost their lives in that terrorist attack. Even little Belize, with a population of about 220,000, lost two of its citizens. While this may be viewed as an attack on the United States, the terrorists picked the World Trade Center. They declared war on the entire world. But it is our men and women who are there daily searching and finding new horrors with every shovelful. Please, everyone send those cards!

	Truly Independent Dentistry—UK Style by Dr. Amarjit Gill
	Since 1948, the National Health Service (NHS) has dominated the control over the delivery of dental services in the United Kingdom. Then in 1992, the government slashed 20% off the dentists’ total income because dentists were “too successful in recruiting patients under a new contract” the government had introduced. You certainly can imagine the strong feelings this maneuver produced. This pay cut was the beginning of the end for being solely reliant on NHS revenue. Thus began a move toward independent, private dentistry. Most of UK dentistry is still practiced under NHS. NHS views the dentist as an independent contractor. The dentist must buy his own practice and equipment, staff and supply his office, then agree to work on patients to a set of NHS rules that are two inches thick. Dentists receive no money until they recruit and treat patients. Why do UK dentists do this? Why do they not just provide direct fee-for-service care and stay out of the NHS entirely? The reason is that the NHS system dominated dentistry when most current dentists entered into practice. To become independent, a dentist must reduce his reliance on NHS over a period of time and develop a private practice concurrently. The only methods to generate private fees are: 1. Limiting the access to the practice, that is, specific hours for private work only; 2. Limiting treatment types, such as bonded crowns, cosmetic dentistry on a private fee basis; and/or 3. Denying access to NHS dentistry by giving NHS a contractual three-month notice and limiting the practice to private dentistry only through capitation or third-party fee for treatment basis. In most parts of the country, this movement toward independence was begun by dentists creating groups of like-minded dentists to share problems and benefits of breaking with the NHS system. Imagine the courage it takes to sever with a system that is all that you have ever known that supplies you with patients, to develop one where you must “sell” yourself directly to the patient. Over the last decade such groups met under the guise of IPG (Independent Practitioner Groups). They capably controlled the adventure into the new territory of fee earning as a self-help organization. Our group in Nottingham began like that. We organize “hands-on” and “minds-on” courses to enable the development and consolidation of treatment standards, which we hope our patients will value. The BDA (British Dental Association) realized that this movement was progressing without them, and despite their control. The BDA invited representatives of these various independent groups to participate in a meeting to discuss the issues and to help their members along the road to financial independence. This established a coalition, which produced some excellent literature. There has been a comfort in knowing that we had a monopoly in supplying our services, as professionals, to the public. However, this was being threatened by: 1. The increasing tide of overseas colleagues joining the system. Last year, more dentists from abroad joined than were being graduated in the UK. 2. The introduction of auxiliaries who were able to perform more tasks traditionally done by the dentists; 3. Dental technicians were performing dental procedures with no one empowered to take effective action; and 4. Corporations invested £2 million to access the dental market by buying our dental practices and employing the dentists to work for them.		All of these groups were able to bid for and compete to provide a service within dentistry. Quite a “doom and gloom” scenario was developing. Professional dentistry was faced with choosing (1) nationality of the profession by appealing to the government with innovative and effective ideas under them to control dentistry; or (2) locally exceeding the expectations of our patients in our practices. Over the last five years, a great many dentists simply retired to avoid the headaches in facing these challenges. NHS dentists need to address this “era of uncertainty” with the government to take the lead in devising a dental service that the government is willing to fund and that addresses the problems. In the last decade, we have seen most of the world’s industries re-engineer themselves, reinvent their businesses, to remain competitive in the world of modern technology. UK dentistry’s NHS needs to realize that their traditional 50-year-old service cannot still operate under those conditions of 1948. One such example is that the NHS is set up to pay for dental treatment with no incentive toward prevention or controlling periodontal problems. You are paid for drilling and filling, not preventing decay and tooth loss. Caries therapy absorbs the most cost in the national system. For those dentists who choose to accept the government as their paymaster, prevention services will be expected of them for the same, or less, funding than they are currently receiving. It is no coincidence that the per capita spent on dentistry in the UK is 12 times less than that spent in the United States. There is no incentive for any organization to want to pay more than necessary for any product or service. This means that those independent practitioners who can effectively care for their patients through prevention and maintenance, thus reducing the patient dental expenses in the long run, are in a position to take the leadership in demonstrating what services professionals can provide. Dentistry in the UK is at a professional crossroads. To properly address the problems the NHS will need to (1) organize the dental services in the country, (2) provide better compensation to their providers, and (3) offer incentives for prevention and maintenance services. This will mean more funding and a change in their mind set. The independent practitioner movement is growing because they can address these problems locally. Independent dentists can offer all the services provided for by NHS, auxiliaries, and technicians; can serve their patients with what they want, when they want it, at realistic prices; and can promote prevention and maintenance, at a fee for service, that will serve their patients best for the future. Providing true professional care for our patients, as we were taught to do, will best be served by our independence of the system. (Dr. Amarjit Gill, United Kingdom PFA Fellow, is Chairman of the BDA Private Practice Committee and Director on the BDA Executive Board. This article is meant to be informative and does not necessarily reflect the opinions of PFA.)