Someone out there

Feb. 1, 2004
I started out with the plan to write an article where I would explore the ADHA. I would collect facts and firm evidence that would explain why hygienists need to be a member of their professional organization.

By Cathleen Terhune Alty

I started out with the plan to write an article where I would explore the ADHA. I would collect facts and firm evidence that would explain why hygienists need to be a member of their professional organization.

Unfortunately, getting a straight answer from the ADHA is like trying to nail Jell-O to the wall.

If you ask them what percentage of licensed hygienists are members, they don't want to say. Why? Is it because so few hygienists are members — that it is downright embarrassing? Do they think we'll lose our clout and be laughed out of the legislative process, if the ADHA is viewed as not truly representing the dental hygiene profession?

Besides, the ADA may be watching, and we don't want them to know what the real numbers are.

Excuse me, but I think the ADA already knows. Anyway, I can do the math. There are roughly 120,000 licensed dental hygienists, and an estimated 100,000 are practicing. The ADHA financials reveal income from dues at about $3.6 million. At $155 per person, that adds up to about 23,000, or roughly 23 percent of licensed hygienists as members. OK, so 23 percent doesn't sound too great.

But before we hang our heads in shame, let's do some comparisons.

How do these numbers compare to the American Dental Association? The ADA claims to have 121,106 "active, dues paying" members, or 70.4 percent of licensed dentists. We are not told how many are retired, or are students, but it is still a very impressive number.

The ADA claims the membership increase is due to a "Grassroots Membership Initiative" designed for recruitment and retention of ADA members. Nah, it's probably due more to the fact that to join most of the dental "academy" groups, dentists also have to be a member of ADA. Want to be in the American Academy of Periodontology? You have to be an ADA member. Want to be in the American Academy of Implant Dentistry? You have to be an ADA member. Want to be in the American Association of Oral and Maxillofacial Surgeons?

Well, you get the idea. There are over 30 dental professional organizations and many of them require ADA membership. No wonder their numbers are so high!

Can we look at other organizations to compare? Why not. How about nurses vs. physicians: the American Medical Association versus the American Nurses Association?

Linda Jahan Rashid of the AMA told me that out of 777,859 licensed physicians in the United States, 236,327 are AMA members, which is roughly 30 percent. Of these member numbers, roughly 40,000 are students, 26,000 are residents, and more than 44,000 are retired. So out of the regular dues-paying physicians, about 125,500, or 16 percent, are members. So the AMA represents only about 16 percent of actively practicing physicians. Yet they have tremendous clout as a professional voice for the entire medical community.

I checked the ANA web site and discovered there are about 2.7 million RNs licensed in the United States. And 180,00 are what they call "supporting members" of the ANA, which translates to about 7 percent who pay dues. Not very impressive, but it was very interesting to note they claim to represent the interests and are "workplace advocates" of the entire 2.7 million RNs, not just the 7 percent who are actually supporting the association with their dues. I read in their annual report they were quoted more than 500 times in the media in 2001.

In my research, I could find no other professional organization in the United States with such high membership percentages as the ADA. It is absurd to compareour association's membership to the ADA's. The ADHA's membership percentages are very much in line, if not higher than, most other professional organizations.

Instead of debating numbers, maybe the real issue to explore is effectiveness.

The ADHA should be held accountable for the effectiveness of their work on our behalf. There should be no secrets or hidden information. There shouldn't be fear of reprisal when talking about the organization's and profession's weaknesses or its strengths. We should expect the organization to produce tangible results on behalf of the profession and be forthcoming about the results of their efforts — positive or negative.

The results should benefit dental hygiene as a whole. How effective is the ADHA in representing hygiene to legislators and in protecting the interests of hygiene in general? The answer is mixed. While in some states small chunks of battle ground have been gained, it appears that we are losing the overall war. In most states, the very ground we stand on is being taken from right under our noses. As dentistry's profits are squeezed, dental hygiene salaries will always be a target.

Since the ADHA has its problems, is there anyone else out there looking out for dental hygiene?

In a word, no. There is no other organization concerned with legislation supporting independence and access to care for hygienists. There is no other organization questioning preceptorship, loosening direct supervision requirements, working on direct Medicaid reimbursement, allowing anesthesia, insisting on a hygiene voice on state dental boards across the country, and examining what the future of dental hygiene could become.

If we don't have "someone out there" looking out for the interests of dental hygiene as a profession, you can bet "someone else is out there" ready to sacrifice dental hygiene as we know it to satisfy their own interests. We know there are organizations out there working against hygiene as a whole with more money to fight their causes.

Our very profession is on the line if someone doesn't speak up for us. So, if the ADHA is the only one in town looking out for our profession, then why don't more of us join?

"It's too expensive."

Compared to what? To pay national dues, it would be the equivalent of the average hygienist working one day a year. How many of us would give up one day of practice to help the unserved dental population? How many of us give up one day of work to go into the local school to give oral hygiene instruction? How many of us give up one day to attend continuing education? Unless we support the organization, there may not be a job to go to, or at least not at the level of compensation we deserve.

"It's too political."

Politics are a way of life. It's the process of how things get done. If you don't like politics, what better reason to join and let someone else do your politicking for you! Some hygienists feel that they do nothing but fight the dental association. Unfortunately, the dental association has shown they are there to protect the profession and income of dentists, not the dental profession community as a whole. It's naive to think that the ADA has the best interests of anyone but dentists at heart. It's true that the ADHA often appears to be just reacting to the latest bad news the ADA is handing out, but there is no doubt the ADA is active, well funded, well staffed, and looking for ways to get what they want.

"What's in it for me"

If we can't perceive the benefit in a personal, tangible way, we don't see the value of it. Are we really so self-centered? I don't think so. Too many of us sacrifice for our spouses, children, parents, and friends. I think giving to others is the epitome of hygiene.

We heal with our hands, for heaven's sake. We sometimes sacrifice our comfort and pieces of our body to perform our job: back and neck injuries, carpal tunnel, etc. Talk about selfless! All for a paycheck? Never. There's more to it than that for most of us.

The issue boils down to commitment to the profession. Taking personal responsibility for the profession and the welfare of our patients is the main reason to support ADHA. Too many of us want to take the easy way out. Until we are proud enough to take responsibility of our own success we will continue to be driven by fear, secrets and negative energy. We need, more than ever, to band together and protect what we have now.

The only option is to join the ADHA and stand firm while there is still time and ground to be held. It's that important.

Cathleen Terhune Alty, RDH, is a frequent contributor of articles to RDH magazine. She is based in Clarkston, Mich.