This Thanksgiving: Give Thanks and Give Back to Your Future

Among all the holidays, Thanksgiving is uniquely American.  It is a celebration of gratitude for the blessings that have been bestowed upon us.  According to American lore, the first Thanksgiving took place in 1621 with the Plymouth colonists sharing a feast with the native American Wampanoag people. That meal is idolized as the epitome of gratitude and sharing with others.  American history continued that theme of idealism with the Declaration of Independence, Constitution, and Bill of Rights.  Those amazing documents created the foundation for a society that is an anomaly in history.  The American people are unique in that there is no national identity by race, religion or ethnic group.  Instead, the people are unified by the ideal set forth in those documents.

Unfortunately, historical facts do not support the intended idealism.  American history is replete with struggles for power, greed, cheating, theft and atrocities.   Sujata Gupta, Social Sciences writer for Science News points out that while our history is rooted in messy and uncomfortable facts, our memory is rooted in story.¹  These stories — with their half-truths, exaggerations, and omissions—embody our ideals.  They are expressions of the America we want to create; the America that we want to believe in.

America has been embroiled in a battle of survival against unfathomable evil, corporate greed, and government institutions that seek to harm the very citizens it is supposed to serve.  Injustice and treachery appear to be the rule rather than the exception these days.   No facet of American life has been left untouched, and the profession of Dentistry is no exception.  Dentistry does not exist in a vacuum, and it does not take a rocket scientist to see that the profession is under siege by the same ill winds that plague the entire country.

Like America, the profession of dentistry has its roots in idealism.  Conscientious practitioners banded together in 1859 to form the American Dental Association (ADA) in order to combat the rampant quackery that was plaguing the public and tarnishing the reputation of ethical practitioners.  The founding fathers of the dental profession modeled the ADA on the American ideal of representative democracy and codified this ideal in its constitution and by-laws².  Within this framework (Chapter XI), ADA members abide by a Code of Ethics:

“The professional conduct of a member of this Association shall be governed by the Principles of Ethics and Code of Professional Conduct³ of this Association and by the codes of ethics of the  constituents and components within whose jurisdiction the member practices or conducts or participates in other professional dental activities. The organizational conduct of a member of this Association shall be governed by the Member Conduct Policy of the Association.”

For more than a century, the profession of Dentistry has maintained an impeccable reputation for honesty and competence.  But today that reputation is in jeopardy.  Corporate entities that care more about their bottom lines than quality patient care have a major controlling interest in dental practice and dental education.  These entities are busy planning the future of the profession to enhance their own profits.  A major factor enabling this incursion is the generation of new dentists who have been forced to become overly concerned with economics. This is the generation that graduated from dental school with enormous debts—some debts in excess of half a million dollars.  These dentists—unlike previous generations of dentists—were forced to focus on productivity and profits at a time when they should have been focused on building knowledge and skills.  It should surprise no one that profits mean more to them than science, quality of care, and dental restoration longevity.

Sadly, the profession has done nothing to curb the rising costs of dental education and mentor new dentists to ensure that they follow a path that will make them great practitioners.  Where are the role models of today that new dentists should idolize?  Take a good look at what the educators of today are  promoting.  There seems to be a growing acceptance of mediocrity in the name of “workflow.” From my perspective, the dentistry of today—despite all the cool technology—does not compare to the dentistry that existed at the beginning of my career and I have the evidence to prove it.

As we approach Thanksgiving, we all know—in spite of the turmoil we see in the country and within the profession—that we have much to be thankful for. We are thankful for our health, our standard of living, our American heritage, our dental profession heritage, and the privilege to practice a profession that enables us to relieve suffering and change lives.

But there isn’t a doubt in my mind that both our country and our profession are on a runaway train speeding recklessly in the wrong direction.  I have lived long enough that I know what both were like when the train left the station.

We all bear responsibility for our Thanksgivings.  They are scheduled on every calendar, and we can expect Thanksgiving every year, no matter which direction our train is headed. We have to ask ourselves, “What will we be able to be thankful for in the future?  What will Thanksgiving look like for the next generation of dentists?

If we do not change course now, succeeding generations will have a lot less to give thanks for. Let’s reconnect with our foundational roots: ethics, science, quality of care, kindness and compassion, and serving others first.

What will you do this year to make next year’s Thanksgiving better for our country and our profession?

1Sujata Gupta, Science News; November 21, 2023; https://www.sciencenews.org/article/thanksgiving-myth-persists-history-memory-science]. 

2ADA Constitution and Bylaws, https://www.ada.org/about/governance/constitution-and-bylaws

3 Principles of Ethics and Code of Professional Conduct, https://www.ada.org/about/principles/code-of-ethics