In Our Best Interest?

Jack F. Conley, DDS

The moment of decision is now three months away for the 1998 American Dental Association House of Delegates. The major issue before it? The proposed ADA National Public Awareness Campaign.

On two previous occasions, our comments here have focused on the importance of every member becoming familiar with the rationale for the campaign and the TV spots and print ads it would comprise. The 1997 ADA House approved a full year membership education initiative that would enable informed members to convey either their acceptance or rejection of the proposal to those who will represent them as delegates at the 1998 House.

The proposal has resulted in discussions in component society board rooms throughout this state as well as throughout the country. Letters carrying member opinions have been shared in the ADA News and other publications. Many members strongly support the concept of this campaign, believing that this activity by the organized profession to strengthen the image of dentistry and potentially bring more patients into the dental office is a member benefit that will bring needed meaning and value to their tripartite professional membership. Others have said that the price tag for the campaign is too steep.

The CDA Board of Trustees confronted the issue head-on at its meeting in May. The result of those deliberations, as previously reported, was a vote against support for the national campaign. The quality of the program and the need for it never did become major issues for debate. Ultimately, the major issue was cost -- not necessarily of the program, but the cost of total membership dues and its impact on individual members and their decision to renew their membership during the three years of the proposed campaign, 1999 through 2001.

It must be emphasized that the impact on individual membership dues, currently projected at a $304 increase for the first year, might be acceptable to a significant number of CDA members. However, what about the collective impact of additional unknown variables such as the following, which could emerge this fall?

It has been reported that ADA may ask for additional dues revenues (spread over one to three years) for necessary renovations for the ADA headquarters building.

The 1998 House may deliberate on some issues with unanticipated expense, which will push the preliminary 1999 operating budget above that planned by the ADA Board.

The CDA Board considered the effect of a potential ADA dues increase of $304 plus the two items above. The actual impact of such a significant dues increase is unknown. However, even the most supportive member of the profession would acknowledge that at least a small loss of members from the tripartite system should be anticipated. Further, there is always a potential for CDA and component society dues increases if issues arise or new programs are directed by the members. Positive local efforts and programs are critically important to members seeking value from their support of organized dentistry.

While the American Dental Association was reluctant to project membership losses if the campaign is approved, the CDA Board clearly believes that the potential exists for a significant erosion of the CDA membership base. Even if CDA or a component society could delay a dues increase for one or more years, the effect of the ADA dues increase alone could be substantial enough to result in losses of the current membership base.

The problem would become even more formidable in 2000 and 2001 when the loss in dues revenues from resigned memberships in the first year (1999), and then the second year, is added to the dues burden of remaining members. This could have a devastating impact on California component dental societies and CDA, requiring substantial dues increases or a reduction in services to compensate for the loss in dues revenues.

These concerns were clearly on the conscience of members of the CDA Board when they voted to recommend to 13th District ADA delegates that they not vote to support the campaign. However, CDA members should be reminded that the 13th District delegates are not obligated to vote for positions taken by the Board. Individual member input is still important!

Members who review the concerns detailed here should note that I have refrained from using any numbers suggesting specific percentage loss of members or total dues level for the tripartite membership. No one really knows what the actual losses and dues level could become. The only given that can be expressed with confidence as this is written is an additional $304 (above the 1998 level) for 1999 if the campaign is approved and there are no other increases for ADA, CDA, or your local component society. To project specific numbers at this time would be an inappropriate and unwarranted fear tactic.

In making its decision, the CDA Board sent a clear message that it does not wish to risk losing the current membership market share of organized dentistry, which stands at approximately 75 percent of the profession. Loss of any significant portion of this share, in terms of its effect on dentistry's strength in the legislative arena may be far more critical, in our opinion, than a few more percentage points in public image surveys! Because California represents such a sizable portion of the total ADA membership, CDA and its 32 component societies appear to be at far greater risk for losing market share than would many other constituencies within ADA.

We support the CDA Board position, believing that it is in our best interest as a profession. If you have a different view, share it either directly with the leadership who will serve as ADA delegates or via feedback to CDA publications.