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Wednesday, January 11, 2017

Jokes About Dentists

Having just returned from AALS, I have been thinking about all I saw and heard at the conference. I attended some outstanding panels and talks but it is Brad Smith's Plenary Program talk on Preparing a Diverse Profession to Serve a Diverse World that I can't get out of my head. Actually, Brad Smith, President and Chief Legal Officer of Microsoft Corporation, did not really speak on his assigned topic. His talk, though interesting, was really about how disruptive technologies have changed the world and will continue to change the world.  (If his remarks in the panel discussion following his formal  remarks were more focused on the announced topic, I cannot say as I regret I had to leave the Plenary Program just after the conclusion of his formal remarks.)

Brad Smith did briefly discuss the lack of diversity in the legal profession -- noting that law is the least diverse profession, followed only by dentistry.  This last observation about the lack of diversity in the dental profession,  earned Mr. Smith his biggest laugh of the speech when he added "why, I have no idea."

Of course, it was funny in an offhand way. But it was also a marker of how uncurious we can all be about things, how uncurious we can all choose to be, and how even those of us who pride ourselves on promoting innovation can think in remarkably static ways.

That roughly three and a half percent of all American  dentists are African American  can tell us some things about the legacy of exclusion on the basis of race from dental education and the dental profession in the United States.   That African American dentists overwhelmingly serve the African American community (with a reported 62 percent same race patient panel) can also tell us some things about patterns of dental practice.

A story could also be told about how dentistry's move from an apprenticed trade to a profession arguably made the dental profession less diverse. The rise of the university-affiliated licensed dental school in the late nineteen century (first at the University of Maryland) made the roughly 120 apprentice-trained African American dentists anachronisms. Only slowly did African American enrollment in these new style dental schools grow.

Dentistry, for some time, has been a contracting profession. For a considerable period of time, few new dental schools opened and a number of dental schools closed.  The profession contracted but not uniformly as African Americans disproportionately disappeared from dental schools and from the ranks of practicing dentists.

Of course, many factors are at play. Dentistry has grayed during this period. Dental education is now overwhelmingly debt financed making the path more challenging for those who will not move into a family-owned or associated practice.  Dental services are often uninsured in the United States and more often paid out of pocket. Even Americans with the best known "dental insurance" plans often have a form of coverage that might more accurately be described as pre-paid dental for prophylactic care or limited "dental coverage" for actual low risk, high cost dental events. In short, it is not an easy time to launch a dental practice. 

The Bureau of Labor Statistics predicts the demand for dental services will continue to substantially outstrip supply.  As most dental students form the intention to enter dental school through exposure to family members and friends in the field, we should all give a thought to how technology and innovation might play a role in opening the world of possibility for a more diverse dental profession.







Posted by Ann Marie Marciarille on January 11, 2017 at 11:00 AM | Permalink


"That roughly three and a half percent of all American dentists are African American can tell us some things about the legacy of exclusion on the basis of race from dental education and the dental profession in the United States. "

It can tell you nothing of the sort.

Professional-managerial occupations constitute about 13% of the workforce. In a normal distribution, the top performing 13% sits 1.12 SD (or more) above the mean. The top performing 3.5% sits 1.82 SD above the mean. A difference in performance scores of 0.7 SD between the general population and the black subpopulation is unremarkable and seen in a number of venues.

Andrew Young, former Mayor of Atlanta, is the son of a dentist. Andrew Young was born in 1932. He didn't grow up in New York. He grew up in New Orleans.

Take a lesson from Thomas Sowell: 'disparities' in ethnically fissured societies are quite normal, whether that society has a history of systemic discrimination or not. No policy response is necessary.

Posted by: Art Deco | Jan 11, 2017 2:38:04 PM

"we should all give a thought to how technology and innovation might play a role in opening the world of possibility for a more diverse dental profession."

No we shouldn't. The possibility is there for those who want it and can perform academically to that level. Blacks are as capable as anyone in choosing their occupation. They don't need self-aggrandizing liberal social engineers to tell them how to live their lives.

Posted by: Art Deco | Jan 11, 2017 2:41:24 PM

The content on this blog has been super boring lately.

No offense. But damn.

Posted by: YesterdayIKilledAMammoth | Jan 12, 2017 11:43:38 AM

The original post makes a good case for considering dentistry a dying profession, and this is without considering its practitioners' high suicide rates. Dentists core function of providing dental healthcare is increasingly obviated by better nutrition and hygiene. Dental insurance, which is rightly described as prepaid care, is what drives many Americans to the dentist's chair--not actual need. Dentists increasingly turn to alternate revenue streams such as cancer screenings and general oral health. Also

The American Dental Association has basically chosen to keep the number of dentists static so that they each keep their shares of the pie. Otherwise, dentistry would fall out of the ranks of the liberal professions. This may be happening anyway as dental healthcare chains proliferate and replace independent practices.

Technology and innovation will surely continue to make dentistry a less and less attractive profession to enter, particularly if it is understood as involving independent practice. Diverse candidates who could go to dental school could surely enter other professions where they'd have a better chance at material success and happiness.

Posted by: Sykes Five | Jan 12, 2017 12:19:49 PM

We see something similar with women in electrical engineering (just the electrical specialty, mind you, not engineering generally). The percentage of female EE grads was historically in the low single digits, then rose to about 13% in the early 90's, which was its peak. It has since has fallen to single digits again. (Numbers from memory, so they might be off, but that is the pattern.) Is anyone going to believe that such low participation today is due to some sort of discrimination? Or that women face more barriers today than in 1986, when the peak cohort first enrolled? If we are so quick to assume low participation rates in a profession are attributable to public policy, what policy implemented around 1986 would one propose reversing?

Those who react to these sorts of statistics with the urge to find discrimination somewhere, sometime, somehow, need to be introduced to the concept of a confounding variable.

Posted by: M. Rad. | Jan 13, 2017 4:33:27 PM

"content on this blog has been super boring lately."

Well, maybe to you.

But you killed a mammoth yesterday, so there's that.

As for, "...law is the least diverse profession, followed only by dentistry"

I'm having trouble parsing "least diverse" together with "followed" and "only". But in any event, note the ABA's stats put non-Hispanic Blacks at 5% of the lawyer population. Which is still pretty non-diverse, but not as low as the 3.5% number mentioned for dentistry.

Posted by: concerned_citizen | Jan 13, 2017 4:55:57 PM

"women in electrical engineering (just the electrical specialty, mind you, not engineering generally)."

Hi M.Rad. I'm a chemical engineer and have always thought women chemical engineers very few. Similarly, I've worked with many mechanical engineering groups and women seem sparse in that field as well. So your "just EE, not engineering generally" got me to checking.

According to the current web page of "National Girls Collaborative Project", which concerns itself with getting girls interested in STEM, this (pasted below) is the breakdown. I believe it's by degrees conferred rather than actual working engineers, which I suspect is considerably less in all categories for many of the same reasons that women JDs << women lawyers 10 years out. The only field where they even begin to come closer to parity is the ~ 34% in Env.E.

11.1% of physicists and astronomers are women;
33.8% of environmental engineers are women;
22.7% of chemical engineers are women;
17.5% of civil, architectural, and sanitary engineers are women;
17.1% of industrial engineers are women;
10.7% of electrical or computer hardware engineers are women; and
7.9% of mechanical engineers are women.

Posted by: concerned_citizen | Jan 13, 2017 5:04:08 PM

Oh my. Apologies. "...women JDs > women lawyers 10 years out".

Posted by: concerned_citizen | Jan 13, 2017 5:06:47 PM

"Those who react to these sorts of statistics with the urge to find discrimination somewhere, sometime, somehow, need to be introduced to the concept of a confounding variable."

The problem is that those who react that way are a critical mass in the legal profession (and academic administration) and they act to harass people and institutions going about their business.

Posted by: Art Deco | Jan 14, 2017 10:17:01 AM

In reply to Mr. concerned_citizen, I have to say I don't know enough to comment on the historical pattern for the other engineering specialties, and I think the numbers I am remembering are from IEEE and report on ABET-accredited programs which leaves out many "computer engineering" programs. Your numbers across the specialties do jibe with my experience though, with ChemE and CivE having the most women (though still a small minority) and EE and ME having the fewest. It appears the rule may be, the more get-your-hands-dirty lab work, the fewer women. (Look, I found a confounding variable!) I am assuming here that most CivE and ChemE field work involves objects too heavy to be much of a hands-on experience. Even those women within EE tend more toward the software side of things, and I have never seen a single woman in radio engineering until simulation software made it possible to replace much of the gritty lab work with computer models, and to this day every one I have encountered is under 35 and exclusively a simulation desk jockey. (Not that there is anything wrong with that, but the best teams have a mixture of lab rats, analysis people, and system-level big-picture types.)

Posted by: M. Rad. | Jan 15, 2017 10:09:22 PM

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