THE EDITOR'S CORNER

"Return with me now to those thrilling days of yesteryear..."

Does the conservative attitude expected of the next administration and the next Congress conjure up such an image for you? Are you hopeful that the days of confrontation between dentistry and various government agencies are now over? Do you go so far as to hope for a return to traditional concepts of professionalism, to the reestablishment of Principles of Ethics, to abolition of advertising for professional services, to an end to clinics, closed panels, capitation programs and franchises? Are we going to return to the Golden Age of Orthodontics?

The recent election will have important repercussions for the professions. A significant number of the electorate have signaled a right turn in the U.S. government. A right turn should mean a dampening effect on concepts of socialized medicine and dentistry; a further delay in broadening a National Health Plan (other than for catastrophic illness); a strengthening of private enterprise and individual initiative and responsibility in health care. Perhaps we will see a postponement of changes in dental practice acts to permit ownership and operation of dental practices by non-dentists. Since these are state dental practice acts and the recent election did not have as significant an effect on the lineup of state legislators, legislative hands may be stayed by a pervasive malaise over what may occur in elections two years hence to lawmakers who disregard the implications of the 1980 vote. Nevertheless, it would be folly for dentists to disregard the possible continuing influence of the Council of State Governments, which to a biased onlooker is a purposeful bureaucracy aimed in part at federalizing state dental practice acts.

At the federal level, there should be a significant reduction in the regulatory power of bureaucratic agencies. Indeed, the bill to remove the professions from the jurisdiction of the Federal Trade Commission, which narrowly missed passage in a much less conservative Senate, should now be ready for passage and should be strenuously advanced by dentists. Write to your representatives in the next Congress if you believe that dentists are not equipped by their training or by the nature of their profession to compete in the business world under the same rules as apply to commercial businesses and trades; and what may be restraint of trade in the business world can be in the public good.

Somewhere there must be an appreciation for the high levels of achievement of American dentistry and orthodontics and a reluctance to accept minimum satisfactory standards. Somewhere there must be an appreciation for the restraint of dental and orthodontic fees relative to the rest of our economy. Somewhere there must be an understanding that it is not price (sic) alone that is keeping Americans from going to the dentist and that advertising, retail business forms and franchising will not necessarily lower the cost nor improve the nation's dental health.

With such considerations, it is entirely possible that we may see some slowing in the bureaucratic efforts to change the traditional status of health professionals, but it would be unrealistic to believe that we will soon see a return to some previous state. The bureaucracy was joined by actions of the courts in legalizing advertising by professionals and in abrogating the Principles of Ethics. As long as dentists can legally advertise, we have a potential Domino effect. If it is legal, some will do it. As long as some will do it, others will feel a need to retaliate in kind--even if they never thought they would. If a new regulatory agency for the professions were to abolish advertising again and reinstate Principles of Ethics, there might truly be a significant turning back of what playwright Arthur Miller has called The American Clock. However, it would be unwise to overlook the fact that the chief basis for the turn to the right in the recent election was in bread-and-butter issues; and the cost of health care has become a significant bread-and-butter issue.

So, this is not a time for sitting back and waiting for the influence of a new conservatism to turn back the clock. This is a time to influence legislation to attempt to undo some of the dissembling of the professions by the bureaucracy. This is a time to redouble our individual efforts in our own practices to amplify helpful and informative communication with our patients and their parents. This is also a time to redouble our efforts at public education and public information through the media on a high professional plane. Let's stop referring to it as institutional advertising. And, let's not think of abolishing it as quickly as possible because of some hopeful signs that the professional climate may be more temperate. The public needs to know that orthodontic fees have not kept up with inflation. The public ought to know that dental insurance benefits may ease the payment of an orthodontic fee. And, above all, the public ought to know how orthodontics can change people's lives.