The New ADA Team
An Open Interview with President Dr. Eugene Sekiguchi 
and Executive Director Dr. James Bramson


Arkansas Dentistry:

Dr. Sekiguchi and Dr. Bramson: As one of the editors across the 17 districts I wish to thank you for the opportunity to conduct this dialogue so that dental societies and the individual dentist can be more closely linked to both the ADA president and its director.  To begin with, could you give a brief description of your backgrounds for our readers?

Dr. Sekiguchi:

I practice dentistry in Monterey Park, California, and am also a clinical professor and Associate Dean for International Professional and Legislative Affairs for the University of Southern California School of Dentistry.  I have served as president and interim executive director of the California Dental Association, president of the San Gabriel Valley Dental Society, and as an ADA trustee and on key ADA committees relating to the organization’s structure and budgetary process.   I received my D.D.S. and an M.S. in electrical engineering from the University of Southern California, Los Angeles.

Dr. Bramson:

My professional career has included private practice in Iowa, clinical teaching, implementing and administering key state and national programs and activities, and extensive publishing and lecturing.  Before becoming executive director of the ADA in 2001, I served four years as executive director of the Massachusetts Dental Society.  Before that, I was a member of the ADA’s staff for 11 years, with duties that included serving as director of the Council on Dental Practice from 1990 to 1997.  I originally came to the Association as a Hillenbrand Fellow.   My dental alma mater is the University of Iowa School of Dentistry.

Arkansas Dentistry:

Dr. Jones, our past ADA president, referred many times to “the new ADA” and “the new team.”  Can you share your perspective of these terms and how it will affect individual dentists?

Dr. Sekiguchi:

The “new ADA” Howard was referring to is one in which we’re proactive; able to operate on the offense when needed, rather than always on the defense; and willing to take calculated and prudent risks in the best interests of members and the public.  The “new team” is a reenergized staff of committed individuals who believe in their work, have a “can do” attitude, and are determined to deliver value to our members.

As I represent the ADA at dental meetings across the country, I’m seeing this same spirit and attitude throughout our organization, so that I believe it’s time for us to be talking about and celebrating “the new tripartite.”  The picture on the front of your magazine showcases this stronger unity!  

Dr. Bramson:  I first heard the phrase “the new ADA” from Dr. Al Guay on my  executive staff.  He was using it at the time to say, “Hey, take a look at us -- we’re not the same anymore.”  I also heard Dr. Mike Alfano, dean at NYU, describe us as “not your father’s Oldsmobile.”  I rather like that.  I think now we’ve moved past being “new” to considering innovative thinking as part of normal, ongoing  activity.   The new ADA is simply getting back to its roots with a sharpened focus on our members.  And I think that Gene and I and the rest of the Board really see ourselves as partners in moving this big ship forward.  The “new” ADA isn’t really anything more that what the “old” ADA was suppose to be.

Arkansas Dentistry:

In the past the ADA has been accused of “turning a deaf ear” to the needs of individual districts and its member, and this is considered to be one factor in the loss of membership in the past.   Do you have any comments on ways to improve the dialogue between ADA and its societies?

Dr. Bramson:

I’m glad you used the phrase “in the past” on both counts.  We won’t be a successful organization if we don’t listen well.  One of our staff core values is that “members are the purpose of our work,” and that means you have to take the time to listen well.  “Turning a deaf ear” to our districts and our members certainly doesn’t have anything to do with how we intend to conduct our business today.  Witness, for instance, our lawsuits against major insurance companies over practices that members have complained about for years.  Timely and necessary initiatives like that, combined with increased trust and cooperation among all the elements of the tripartite, have finally turned the erosion in our membership around.  Last year, we gained more than 2,000 members and saw our membership market share rise to 71 percent.  This increase in market share was the first one the ADA has had in a decade.

Dr. Sekiguchi:  The best way to keep dialogue between the ADA and its societies strong is for all of us to remember how much we have to gain by working as partners.  An example of what true dialog can bring is Give Kids a Smile.  I know we all donate care, quietly doing our part for access for underprivileged children in our private officers and clinics throughout the year.  But with Give Kids a Smile day, we bring national attention to access to care by showing dentistry’s charitable activities across the country.  We show that dentists and organized dentistry are doing our part, as are the dental suppliers and the dental schools.  To do more, we need the help of government and the payer industry and change in public policy.

Arkansas Dentistry:

Much emphasis has been placed on increasing the number of active dentists to organized dentistry, specifically the ADA.  What do you plan to do to attract new members, especially the young dentists, to organized dentistry?

Dr. Sekiguci:

Although we’re seeing an increase in our number of new dentist members --  894 new members from end-of-year 2002 to end-of-year 2003 --  our membership market share among new dentists, at 66.1%, still lags below our overall market share.  It’s important to work with our dental schools and the American Student Dental Association to reach out to dental students so they understand the value of ADA membership --  especially in those first few years after graduation as they transition into an active dental practice.  Most of all, we need to remember that today’s savvy young practitioners are not going to “follow the crowd” “or join the club” out of a sense of duty.  They’re not going to be impressed with us, or bother with us, unless we continually prove ourselves to be a vital organization that can make a difference in their lives.  We must also attract those who traditionally are underrepresented in our membership.  For all who are non-members, our relevance is the imperative to joining.

Dr. Bramson:  I think it’s also important to remember that the new dentist of today might look a lot different than the graduates of years ago.  This change in demographics  is central to our understanding of the factors and concerns  that are important to new dentists and developing the types of programs that will be meaningful to them. Gene is right -- they aren’t necessarily going to just follow the crowd, but they still care deeply about the profession that they are entering and what they want from it.  As long as we advocate well, collect and disseminate valuable information and give them meaningful professional community experiences, I think we will be seen as important to them and they will join and stay.  We just have to become more skilled at making sure that we are relevant to them.  

Arkansas Dentistry:

The federal issues involving interest on student loans continue to be a concern for young dentists.  Do you foresee any movement toward relaxing the requirements, and what is ADA doing in this regard?

Dr. Sekiguchi:

The ADA has joined other health care providers, health professions, educational institutions and health benefit providers in enthusiastically supporting tax relief provisions contained in the Higher Education Affordability and Equity Act of 2003.  One provision would expand student loan interest deduction to allow borrowers to deduct a greater amount of the interest payments on their student loans, while also increasing income levels for eligibility.  Another provision would exclude amounts received as part of a scholarship, fellowship or grant from taxable income if used for higher education expenses for undergraduate or graduate recipients.  Another option I believe needs exploration is connecting student debt relief to care for underserved children and other underserved populations.

The Higher Education Act, which contains all the provisions relating to federally guaranteed student financial aid programs administered by the U.S. Department of Education, must be reauthorized every five years to determine what modifications are needed.  In the current reauthorization process, the ADA and the American Dental Education Association strongly support eliminating the Single Holder Rule and allowing loan consolidation at any time to ensure that student borrowers can shop for the best consolidation loan in the marketplace.

Arkansas Dentistry:

Dentists of all ages frequently ask, “What has the ADA done for me lately?”   It seems that one current response would be to highlight the legal issues facing dentistry.  Dr. Bramson, would you elaborate on the legal pursuits of the various insurance companies and also the litigation concerning amalgam?

Dr. Bramson:

Our lawsuits against insurance companies have already resulted in a major settlement with Aetna.  We are hoping that the terms of the settlement may establish an industry norm, discouraging policies and practices that burden dentists unnecessarily and interfere with the doctor/patient relationship.

The vast majority of the lawsuits over dental amalgam, naming the ADA and other defendants including state dental societies, have been withdrawn or dismissed.  And the body of data supporting the safety and efficacy of dental amalgam continues to grow.

Arkansas Dentistry:

Many states, including Arkansas, have dealt with the issue of foreign-trained dentists.  Does the ADA see a trend toward a national policy that would result in more foreign-trained dentists coming to practice in the states?

Dr. Bramson:

No, we have not seen such a trend, although there is increasing interest in how services and professionally trained people can flow from one country to another.  For example, in the European Union, a dentist can freely move between any of the EU countries.  That is creating a desire to establish dental  educational standards across these countries to ensure that patient care is comparable.  Domestic workforce issues tend to be focused more at the state and local levels.  We do see individual states with areas of shortage or specific needs taking steps to provide expanded opportunities for licensure for out-of-state dentists.

Dr. Sekiguchi:

I am not concerned with the issue of foreign trained dentists per se.  My concern is for the patient, and those patients deserve to have their dentist meet a comparable educational standard.  For me, the dental education standard set by the Commission on Dental accreditation is the standard of education, and that is the one we ought to look to.

Arkansas Dentistry:

GKAS was a great success both for ADA and for the thousands of kids who were screened and treated.  Dr. Sekiguchi, what plans do you have to further this and/or other programs?

Dr. Sekiguchi:

This is a great program and I must tell you how proud of it we are.  We’re very fortunate that the ADA House of Delegates authorized continuing Give Kids a Smile as an annual event.  We’ve been able to build on what we learned from the initial event in 2003 and coordinate an even more successful event this year, with some 35,000 dentists, dental team members and other volunteers delivering care to underprivileged kids.  With the momentum of the program now firmly established, it can only grow stronger in coming years.

We’re also fortunate to have continuing strong support from the program’s corporate sponsors:  Sullivan-Schein Dental, Crest Healthy Smiles 2010, DEXIS Digital X-ray Systems, and Ivoclar Vivadent Inc.

The other half of the equation is to continue strongly advocating for public policy to address shortcomings in our delivery system that deprive some of our country’s children of necessary dental care.  Give Kids A Smile will continue to bring the problem to the attention of lawmakers and the public.  Our other job is to see to it that they understand the importance of oral health, so that they can take measures to ensure it for all children.  It is particularly imperative for dentistry to have a place at the table as the issue of access to health care is debated and public policy decisions are made.

In December, the ADA brought together more than 40 professional and government representatives to come up with fresh approaches for reforming the federal-state Medicaid program while countering cuts in the public dental budget.  A white paper from this symposium is in development.

Arkansas Dentistry:

In closing, could you each share your thoughts concerning the future of organized dentistry?

Dr. Sekiguchi:

My response to that one is necessarily personal, since my son Kevin and my daughter Jill are in private dental practice.  I want them to have good lives. I want the future of dentistry to be bright for them.  I want them to be free to counsel and care for their patients without unwarranted interference from third-party payers or other outside forces.  I want them to see constant progress in the profession through continuing dental research.  And I want them to know that the organization their dad is president of will always be there for them, looking after their best interests and those of  their patients, fighting the good fight, and never relenting in its determination to keep dentistry strong, inclusive and unified. 

Dr. Bramson: 

I can only say that I want for every member of our organization the same things Gene wants for Kevin and Jill and that the future of our profession and the future of our organization are very closely related.  As the ADA grows stronger, remains true to its core values and mission, strengthens relations with state and local dental societies, focuses on member’s needs, and directs resources to programs and activities that deliver maximum value to members, the profession also grows stronger.  The future of dentistry is ours to build, and I consider it a great privilege to be part of the process. 

Arkansas Dentistry:

A special thanks to each of you, Dr. Sekiguchi and Dr. Bramson, for your time and effort.  This has afforded a wonderful opportunity to bring the ADA to the dental societies and more importantly to personalize you for the individual dentist. 

Originally published in the Spring 2004 issue of Arkansas Dentistry.



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