The Immediate Past President

May You All Lead Interesting Lives

Steven D. Chan, DDS

Copyright 2003 Journal of the California Dental Association.

"All the world’s a stage. With every entrance there is an exit." William Shakespeare

Welcome to the 2002 presidential "testimonial, thank you, and tah tah" speech. The saga herein holds much -- but it is the song of many.

The traditional president’s message typically chronicles personal achievements during the year. It is testimonial. It thanks those who helped you through that journey. It offers blessings to the new president. It is ceremony. It is soliloquy. It is bidding adieu. It is soon forgotten. But, oh what a journey did we have!

Last November, you heralded the coming of a new president. Chinese lions pranced and drums rumbled. You trumpeted a new call to arms. We waved brave new banners. That was 12 months -- and a lifetime ago. Now, I’ve become a gray hair. We gather for this tradition of the president’s address -- to tell the stories of our journey.

We came -- to implement the strategic plan.

We came -- to defend the profession.

We came -- to make CDA -- better.

We are the volunteers on the integrated action teams; we are the councils and committees; we are the Board of Trustees; we are the boards of directors of the CDA companies; we are the Executive Committee, and we are the executive management, the directors, and 180 professional employees of the CDA family of companies: the California Dental Association, the CDA Holding Company, TDIC, 1201 Financial & Insurance Services, TDCMS, Rotunda Partners, the CDA Foundation, and CalDPAC.

We discovered many things in our journey; we discovered new relationships; we discovered new resolve; we discovered character; and we discovered exciting new possibilities for this association. 2002 was not the turning point of Hollywood proportions and 2002 was not pomp and high drama -- 2002 was motion.

Once upon a time, in CDA history, a new president would rise with a new agenda. For one year, the whole association rallied around the new president’s project. Then came a new president with a new project. CDA would have to shift gears year after year after year. Nothing was built to last. It is time for a change. It’s time for us to -- to create a New CDA.

"What makes a company -- good?" Jim Collins, a former Stanford business professor, studied more than 1,000 companies, studying the ingredients that make a good company. He found what makes companies -- Great. The opening line in his book, Good to Great, begins with: "Good is the enemy of Great."

He sees the journey to greatness not beginning with a big bang -- not with glitz, not with glamour, and not with grandeur. There is no one defining moment, no one superstar. The journey is incremental. It is cumulative. It is focus. It is a disciplined, passionate, relentless pursuit of becoming -- the best. He writes:

"Picture a huge heavy flywheel -- a massive metal disk mounted horizontally on an axle, about 30 feet in diameter, 2 feet thick and weighing about 5,000 pounds. Now imagine that your task is to get the flywheel -- rotating as fast and as long as possible. Pushing with great effort, you get the flywheel to inch forward, moving almost imperceptibly at first. You keep pushing and pushing ... and ... after two or three hours of persistent effort, you get the flywheel to complete one entire turn. You keep pushing, and the flywheel begins to move a bit faster. You keep pushing and it builds up speed. ... Then at some point -- breakthrough! ... Each turn of the flywheel builds upon work done earlier, compounding your investment of effort. ... The huge heavy disk flies forward with almost unstoppable momentum."

The flywheel known as "CDA" is before us. The crew of 2002 has pushed that flywheel forward. We are a good company. But we have not yet become -- a great company. We have all the ingredients. The crew of 2002 is forging a company built to last. Business as usual is just not good enough. Perhaps some day, someone will read of our names on that flywheel. Perhaps they will see that we were more than just a link. Perhaps they will see that the crew of 2002 moved that flywheel just a little further. Perhaps they will see that the Crew of 2002 added just a little more motion to that flywheel.

The president’s report to the House is a time capsule entry, a captain’s log if you will. It is more archive than achievement. It is a microscopic look into the year in the life of the association. It is nowhere near a view of the entire landscape. It cannot give the proper due to the hundreds of volunteers, managers, and staff in 2002 who made this association better. You’ll forgive this year’s myopic narrative -- it will likely be incomplete. It cannot tell all the stories of 2002. It is however, tradition.

The president’s address to the house is different. The president’s address is typically testimonials, thank yous and "tah tah." It is time for a change. It is not about what I accomplished -- 2002 is not about me. The entrance and exit of a president is simply a marker in time. He or she is simply a lucky one who you chose to sit in that driver’s seat -- to marvel the horizon. It’s the crew who moves that flywheel a little bit further, a little bit faster ,and a little bit better.

Let me tell you what the crew of 2002 did. Let me tell you what the volunteers and staff did to make this association better. 2002 is not about a president. It is about the men and women who passionately declared, "I can make it better!" I do not take credit -- but these events happened on my watch.

Advance the Strategic Plan

* Reconfigure the Plan: The goals and objectives of the Strategic Plan were streamlined. Five-year goals, transcending the five presidential administrations, are defined. Yearly marker goals are defined. Timelines for each integrated action team were defined. Progress markers were defined. Oversight of integrated action teams were placed under councils.

BOT Breakout Sessions

* Board proceedings integrate strategic issues into breakout sessions. The board is split into six lines of business teams. Knowledge-based methodology is expanded.

* Strategic Planning Committee functions are incorporated into the Board of Trustees.

* Joint Policy Council meetings: The experiment for the Council on Legislation, Council on Dental Research and Developments, Council on Dental Care, and Council on Community Health to meet jointly continues. Each brings a piece of the puzzle to public policy. The goal is to develop a system to bring expertise from each sphere and to efficiently develop public policy in a rapidly changing environment.

Execution and Implementation

* This transitional year moves the Applied Strategic Planning process from abstraction to concreteness. Operational protocols are developed. Execution moves to staff. (From a fortune cookie: Talk does not cook the rice.)

Actions

* Planned and completed for 2002 consistent with the plan/governance restructure recommendation: Treasurer position redefined. Comprehensive overview of governance. governance educational plan. Trustee term proposal debated and defeated. Learning Center -- needs assessment, business plan, implementation plan. Contact Center implemented. Marketing program research presentation. Allied dental health personnel action plan. Membership recruitment and retention plan. Corporate Operations Task Force recommendations. Foundation implements business plan. Council on Education and Professional Relations and CDA Foundation establish component dental hygiene funding program. Universal membership application.

Integrated Action Teams

Nine teams tackle ongoing development of goals and objectives of the Plan.

Defend the Profession

* Dental Material Fact Sheet: The Fact Sheet is fact. As of Jan. 1, compliance with SB 134 takes place. CDA sends informational letters to members, publishes articles in Update and to components, accessible from CDA Online. Opponents want to reopen the science.

* Lawsuits: CDA is the object of two lawsuits related to amalgam. One suit alleges complicity in perpetrating fraud on the public, the other linking autism to maternal exposure to amalgam. CDA is defending.

* Proposition 65: CDA continues negotiation under umbrella of the attorney general for solutions to satisfying provisions of Prop. 65 posting signs. Under Prop. 65, private bounty hunters can collect fines of $2,500 per day. Problem: After compliance of one material, bounty hunter could identify a new material to reopen enforcement of each new material. CDA settles on behalf of the entire profession. Nonmembers will pay more to buy into the settlement.

* Wastewater (guiding principles): A restorative conference at the ADA apprises state constituents of the current status of regulations surrounding wastewater around the country. California is the site of regulatory actions -- trends happen. Association strategy development referred to the CDA Public Policy Division and the Council on Education and Professional Relations.

* Food and Drug Administration: FDA issues a publication misstating that California has banned amalgam. CDA responds to the agency for corrections in their publication. California has not banned amalgam. They stand corrected.

* Watson Bill: California Rep. Watson introduces federal legislation to ban amalgam. National Dental Association partners with ADA to lobby to the Black Caucus of Congress against the bill.

* Dickerson Bill: Support of oral surgeon Dr. Sam Aanestad’s primary campaign for a Senate seat over Assemblyman Dickerson earned the angst for the profession. Supported legislation to ban amalgam, sought the attorney general’s opinion on the fraudulent use of the word, "silver filling," submitted public declaration resolutions in the Assembly against the profession and amalgam. He wanted all 500-plus copies of the scientific literature supporting the safety of amalgam. The articles are online -- Public Policy lobbied -- the bill died.

* Peer review system: The peer review system (CDA and all the components) is the object of a lawsuit by the same attorney who brings you the suits on amalgam. Alleges that the PR system defrauds patients into giving up the right to sue for malpractice. CDA is defending.

* ADA governance: On the ADA Board of Trustees, in nearly all other trustee districts, a trustee represents 6,000 members. In California, there are more than 18,000 members but only one trustee. There’s the crux.

* HIPAA: The Health Insurance Portability and Accountability Act looms with the implied threats of privacy protection. CDA Update publishes a multi-episode informational piece on what it really says. Scientific Session workshops continue to expand.

* Denturity: The word sounds like denturism, but they say they have a doctorate level of education. They seek "sunrise" legislation to create an independent practice to deliver dentures. We’re ready for them.

* Licensure by credential: Continues to wind through the regulatory process and gain definition. Legislation for LBC for dental hygienists is done.

* Importation of Mexican dentists: Legislation passes despite CDA opposition. The Hispanic caucus flexes its power. However, it is a limited pilot program with various stringent steps to accomplish before it can advance.

* National oral health policy: The feds gather testimony at a Western regional hearing on development of a national oral health policy. Of 30 invited participants, I was the only practicing dentist representing practicing dentists/organized dentistry. I was given only five minutes by the clock to state our case.

* Legislative Day: Budget crisis, soda tax, educating legislators on junk science vs. sound science, and sunset of the Dental Board is on the docket. Annual migration to the Capitol. Reception with legislators.

* Joint Policy Council: Learning the lingo and tools for developing public policy. Workforce analysis presentation and research on access to care variables are presented.

* Cal/OSHA: CDA came to the aid of a member who challenged a citation by Cal/OSHA on placement of sharps containers. Assistance provided this case is applicable to the profession as a whole.

* Dental Board: A new board is appointed. CDA continues to monitor the proceedings of the Dental Board of California as it affects the practicing dentist and patients. A series of new committees is formed. An attempt to reopen the Dental Material Fact Sheet is closely watched by CDA leadership and staff. Other issues closely watched are implementation of licensure by credential, provisional certification of the Universidad DeLaSalle Baiio Dental School in Mexico, attempts to limit entry into dental assisting, executive officer search, the bench test for foreign-trained dentists, a blue ribbon panel on general anesthesia, scope of practice for auxiliaries, examinations to overflowing, and critical summary of problems in the enforcement program. On a parallel path is the criminal prosecution and trial of a Pasadena pediatric dentist for negative outcomes resulting from a sedation case.

* CalDPAC: CalDPAC supports an independent expenditure campaign supporting Dr. Sam Aanestad in a primary election for state senator. Some controversy ensues. The bid is successful. Indirect pluses and minuses are added to the CalDPAC ledger.

Make it Better

* Refinance: The loan -- Refinancing the building loan for 1201 K Street was a year-long process crossing a calculus proof with poker. Series of actions dominated the senior staff and Executive Committee’s attention this year. The process of commercial refinancing is unlike any model with which to draw experience. The $39 million dollar deal had many players with divergent vested interests, unexpected variables, twists and turns -- changing the direction of the deal -- and brinkmanship. Refinance loan for 1201 K and 1215 K is complete -- after nine months’ gestation.

Ground lease -- An option to purchase remaining ground parcel arises. Partners are CDA/TDIC, the California Medical Association, and the Hospital Association. CMA wants out. Hospital association holds out. Stalemate.

Put option -- Proceeds from the refinancing loan is used to retire TDIC’s loan to CDA.

Due diligence -- 1201 K building valuation undergoing due diligence -- greater question forwarded. With changing tax laws, what is the role of real estate in the portfolio of the association and its companies? What are the choices of ownership?

Formation of Rotunda Partners, LLC -- (brings legal form of building ownership to contemporary specs).

Committee to Review the Executive Director -- New evaluation format, protocol and model developed -- three senior elected officers constitute the evaluation team of the executive director.

Change in management -- Tim Comstock separates from CDA, Bob Witt named interim executive director, and Executive Director Search Committee chaired by Dennis Kalebjian begins task. New contemporary recruitment model for executive director search adopted by the Board of Trustees; Executive Committee, executive management, senior staff conduct seamless transition; and search firm of Korn Ferry engaged, timetables, protocols developed.

Association CEO compensation -- An Association CEO Compensation Committee developed a new model based on "management by objective" methodology that is adopted by all CDA companies.

Leadership training -- Formal training session of incoming trustees and council chairs continues refinement. ADA caucus protocols are formalized and implemented. Ex Com members attend association management courses at the American Society of Association Executives annual meeting.

Corporate Operations Task Force -- Overall, we’re just fine. Analysis conducted over two-year year period. Multiple recommendations refining our overall operations are forwarded. Task complete.

* Relations/Outreach: Officers trips -- Greater New York Dental Meeting, ADA Presidents-Elect Conference, Western States Presidents’ Conference, ADA Presidents’ Conference, Hinman Dental Meeting, Texas House of Delegates and Florida Annual Session. More than just attending a meeting. Ex Com continues ongoing networking during the year to develop relationships.

Keynote speech/installing officer -- Indian Dental Association, Federation of California Dentists, Filipino Dental Practitioners of California, National Association of Filipino Dentists in America, South Bay Chinese Club, Citizens for a Better Community and Asian American State Employees.

Dental presentations/installations -- San Fernando Valley Dental Society, Harbor Dental Society, California Dental Assistants Association, California Dental Hygienists’ Association and Northern California Section of the Pierre Fauchard Academy.

California Primary Care Association summit -- PowerPoint presentation with CDA policy analyst David Pisani to statewide association of public health groups.

American Society of Association Executives Annual Session -- Attended by most Ex Com and senior staff. New skill sets and new resources to more effectively run the association.

Other dental meetings -- State section annual sessions of the Pierre Fauchard Academy, International College of Dentists and American College of Dentists.

* ADA campaigns: Dr. Gene Sekiguchi announces candidacy for president-elect of the American Dental Association at the close of the 2001 ADA House of Delegates. Campaign begins November of 2001. In a fairytale ending, Gene is elected as the next president-elect of the American Dental Association. He will be the 140th president installed, in October 2003. The last president from California was Dr. Art Dugoni 12 years ago. There are lots of stories. Among them, an emerging urban legend -- the gentle art of "transformation" leadership via verbal defibrillation.

It is custom for candidates for ADA office to announce their candidacy on the last day of the ADA House. ADA Speaker Dr. Fanno announces candidacy for ADA president-elect two months after the close of the House. CDA Speaker Dr. Sig Abelson announces candidacy for the vacant speaker position Fanno leaves behind, and a 10-month campaign begins. New mode of inviting Western States leaders as co-hosts for the two campaign receptions broke new ground in relationships with California. The bid, however, is unsuccessful despite his being the better candidate.

* Scientific Sessions: Spring Session -- Record attendance of 28,142; honors past ADA Vice President Dr. Dick Simms; entertainer Wayne Brady for sold-out Membership Celebration.

Fall Session -- Record attendance at 16,500; honors senior staffer Judy Babcock; gigantic tailgate party and 1,300 CDA fans attend pennant-race Giants game, Beach Blanket Babylon.

New collaboration with CDA Foundation -- Vendors donate show materials to S.H.A.R.E. program. The materials are then redistributed to access-to-care programs.

* Articles: Authored the following:

Presidential address -- Published Journal of the California Dental Association, January 2002.

"Crater in the Earth" (a perspective on the Greater New York Dental Meeting, events of 9-11, Ground Zero) -- Published in the New York State Dental Association Journal and Pediatric Dentistry Today (newsletter of the American Academy of Pediatric Dentistry).

"Monsoons and Chopsticks" (address to Indian Dental Association) -- Published CDA Update; July 2002.

"Tin Man’s Promise" (Relationship of foundations, philanthropy and development of health care policy) -- Published Journal of the California Dental Association, August 2002.

Marketing Awards -- CDA Online, SmileCalifornia Web site and Journal and Update win statewide awards. CDA Web site earns national award for excellence.

ADA 13th District Caucus -- Implemented an organizational structure for the largest district in the ADA House of Delegates. Mentorship training program begins. Formal procedure manuals published.

CDA Holding Company -- Association businesses and business infrastructure continue to provide support system for the association. High on the docket: refinance issues, information technology development, litany of legal issues, personnel policies, business expansion of the subsidiaries, new CDA company (CDA Foundation -- a new partner in the mix), and production of the "Year in Review Video" for the House.

Direct reimbursement business plan/market analysis -- Presentation by Bob Witt on the current market conditions for DR. Alternatives on the contemporary level of engagement by CDA on DR are presented to the board.

* Conferences:

Leadership Conference (Feb. 7-8): Empower, enrich, educate.

Legislative Day (April 1): Budget crisis, soda tax, Denti-Cal shortfall, junk science vs. sound science and sunset review process retiring the Dental Board.

Ethics Conference (April 19).

Early Childhood Caries Conference (April 26): CDA Foundation commissioned.

Membership/Marketing Conferences (Aug. 22 Sacramento; Aug. 23 Long Beach).

Conference for the New Dental Professional (Sept. 26 San Francisco): Your Journey of Success: Enrichment for the New Dentist.

* Dental Board of California: Dental Board is sunset as of Jan. 1, 2002. New board appointed. Dr. Alan Kaye named president. Issues: Delay in governor’s appointments to achieve a quorum, search for an executive officer, and oversight pressure by Department of Consumer Affairs and Legislative Sunset Review Committee on performance, enforcement, and examination limitations. Informal meeting with CDA leadership/staff and new Dental Board leadership to open dialogue.

* Legislation: Support legislation to create program for state to borrow reserve funds from the Dental Board to fund student loan forgiveness in exchange for serving in underserved areas. Negotiate with state to retain adult dental services for Denti-Cal despite budget deficit. Licensure by credential for dental hygienists. Supported Assemblyman Dr. Sam Aanestad in independent expenditure campaign for primary election. Will become the first dentist to be a state senator.

* Deans’ Think Tank: Reformatted agenda. Instead of the prior format of reporting current activities, organized dentistry and the five California dental school deans refocus direction of the Think Tank to strategically identify and tackle issues confronting the profession in California.

* Interdisciplinary Affairs Committee: Specialty groups defend and extend the borders of the profession.

* CDA Proprietary Dental Hygiene Educational Program: Work in progress.

* Access to Care Position Paper: Regional hearings on the National Oral Health Policy, the California Primary Care Summit and the Mexican dentist issue. The signs are clear -- participate in decision-making or it will be imposed on us. The Joint Policy Council began first steps in understanding how researchers arrive at conclusions to drive public policy. The Foundation is working on a portfolio of funded projects to gather experience in order to develop health policy.

* 1201 Financial & Insurance Services: celebrates 20th anniversary.

* TDIC Expansion Plan: New business plan adapting to marketplace changes is adopted by the board.

* CDA Foundation: Collaboration with 1201 on scholarship program for allied dental health professionals. Pilot program dental graduate loan reduction plan/shortage area service. Sophomore dental student scholarship program. Collaborate with TDIC to provide $81,290 to New York for the Sept 11 Relief Fund. Initiate health policy research into allied dental health workforce study. Commissioned Early Childhood Caries Conference -- 4/26. Healthy Californian Grants program.

* Territory: Sacramento District Dental Society and San Joaquin Dental Society are engaged in a dispute over jurisdiction on the city of Galt. Judicial Council has the authority to adjudicate. Request to the Executive Committee to re-examine the decision has been referred back to Judicial Council. Opens the question of population shifts with shared borders and perhaps a reevaluation of defining components.

* Chapters: As the last chapter of my tenure closes -- new chapters open. A new secretary (Ron Mead), a new speaker (Matt Campbell), a new president (Dennis Kalebjian), a new ADA trustee (Rod Feldman), a new ADA president-elect (Gene Sekiguchi), and a new CDA executive director are in the wings, and a whole new crop of volunteer leaders who have a chance to make CDA -- better.

* Epilogue: With apologies to the hundreds of staff and volunteers of the crew of 2002, I have probably left out a lot of their accomplishments and successes. Also left out are the hundreds of decisions made by the Executive Committee, Board of Trustees, councils and committees, boards of directors, and executive management of the various association companies that were not included but are no less appreciated. Remember that what you see in this report is the distillation of tons of staff hours of work.

Thanks to all the staff and volunteers, too many to name here, who are equal partners in the crew of 2002. It has been an honor and privilege to serve with you. It is the crew of 2002 who came to make it better. A year ago, in my installation speech, I spoke of my immigrant grandmother’s search for "Gold Mountain," which began some 80 years ago. I believe I found that wealth. It is the privilege you gave me to serve you.

Adieu

As the year 2002 fades to black, and on behalf of the entire crew of 2002, we bid you -- adieu.

To Dennis Kalebjian and the crew of 2003, we wish you – Good Journey.

To those with the fire in their bellies, who will someday take our seats, we wish you – your Gold Mountain.

To the association, we wish you -- Greatness.

May the Gods of Good Fortune smile upon you; may the Gods of Good Health watch over you; and may you live interesting lives.