Page 1
Page 2
Page 3
Page 4
Page 5
Page 6
Page 7
Page 8
Page 9
Page 10
Page 11
Page 12
Page 13
Page 14
Page 15
Page 16
Page 17
Page 18
Page 19
Page 20
Page 21
Page 22
201313thBubblthMakfodnalSvicsvs.hMakfodnaleucaionAkeypointmadebyPolveriniattheAnnArborDentalDeansForum2wasthatamotivationforthefoundingofnewdentalschoolsisthatashiftfromanemphasisonre-searchtoteachingisrequiredtoprovidemorecareforunder-servedpopulations.Itisimportantfordentaleducatorstounderstandthattherearetwoseparatebutinterrelatedmarkets.Oneisthemarketfordentalservicesthatisthepublicsde-mandfordirectdentalcare.Atthemomentthismarketisproblematicbecausegiventhesupplyofdentistsandthede-mandforservicessomepeoplearebeingleftoutthosewhocantpayandthereforeareunableeventoenterthemarketforservices.Publichealthdentiststhegovernmentandthemediaadvocateforsuchindividualstobecaredforoutsidethemarketsystem.Butthedentalservicesmarketisnotreallythemarketthatthenewerdentalschoolsareentering.Rathertheyareen-teringthemarketofpeopleseekingadentaleducation.Overthelongtermitmaybetruethatasthesupplyofdentistsin-creasesthecostofservicescoulddeclineandthepublicsin-terestwouldbeserved.Butmarketsarecomplexandthewaythemarketfordentalservicesandthemarketfordentaleduca-tionarerelatedmaynotconformtoexpectations.Aslongastherearemorepeopleseekingadmissiontodentalschoolthanthereareavailableseatsthemarketfordentaleducationcanbeveryprofitable.Theproblemisthatthetuitionandfeestruc-tureofnewschoolsisveryhighthusthegraduatesoftheseschoolsarenotlikelytobeinapositiontoprovidefortheneedsoftheunderservedwhorequireservicesoutsidetheex-istingmarketsystem.Inrealitynewdentistsarebeingaddedforthosepatientswhocanalreadypayforcareandforwhomtheresnotmuchofashortageofdentalservices.Addtothistheemergenceofdentaltherapistswhoovertimemayradicallychangethemarketfordentalservices.Ifarelationshipemergesbetweendentistsanddentaltherapiststhatiscomparabletotheonethatnowexistsbetweendentistsanddentalhygienistsitcouldmakedentalpracticeevenmoreprofitable.Alternativelyifdentaltherapistsbecomethebasisforafullycorporatizedmodelofdentalcareashashappenedinpharmacywiththelargechainsitsmoredifficulttoguesswhattheimpactonindependentdentalpracticewillbe.Itsnoexaggerationtosaythattodaysdentalstudentsarereallyspeculatorswillingtopayahighpriceforaneducationthatmayormaynotyieldthereturnontheirinvestmentthattheyexpect.Shouldthebubbleburstfordentaleducationevi-dencedbyasmallernumberofapplicantsthanavailableposi-tionsschoolswillneedtocompeteforstudentsmoreintensely.Drivenstrictlybyeconomicsthemostsuccessfulschoolswillbethosethatofferthefewestserviceshavethelowestexpensesatthehighestpossibletuition.Underthosecircumstancesallthingsbeingequalthemostsuccessfulandsustainableschoolswillbethenewestoneswiththemostrobustfinancialplans.Butmaybeallthingsarenotequal.Maybesomeschoolswillofferservicesthatwillcontinuetobevaluedbyapplicantsbeyondacquiringbasictechnicalskillsleadingtodentallicen-sure.Perhapssomeapplicantswillseethedifferentiatingvalueofaneducationthatconformstothehigheststandardsofthebestuniversities.Maybethosecontemplatingspecializationwillgravitatetothoseplacestheythinkwillhelpthemgainaccesstothebestpostgraduateprograms.ImnotreallysurethatthisistruehoweverIdothinkthataratingsystemofthesortIamproposingcouldbeastepintherightdirection.ThepurposeoftheAnnArborDentalDeansForumwastoframeawayofleadingtheprofessionintothefuture.Quitepossiblythehistoricalmomentforthatopportunityhadpassedbeforetheforumevertookplace.Theworryatthattimewasthatwewereonthevergeofmakingadangerousmistakeaboutthestandingofthedentalprofessiongoingforwardandthatwewillbegintolookmorelikeatradethanaprofes-sionaposturethatjeopardizesthelong-termprestigeandprogressofthedentalprofession.3Ibelievethatwearebe-yondthatpoint.Theleastwecandoistobehonestaboutit.Aratingsystemmighthelpusdoso.rfncs1.DonoffRB.CommentaryonBertolamiarticle.JDentEduc.2001658739-741.2.PolveriniP.TheAnnArborDentalDeansForumcraftingaresponsetotheemergingtieredsystemofdentaleducation.GlobalHealthNexus.201012224-27.3.RosovskyH.Theuniversityanownersmanual.NewYorkNorton1990.4.TheCarnegieFoundationfortheAdvancementofTeaching.TheCarnegieclassificationofinstitutionsofhighereducationInternet.Availablefromhttpclassifications.carnegiefoundation.org5.YankelovichD.Profitwithhonorthenewstageofmarketcapitalism.NewHavenCTYaleUniversityPress2006.6.Livy.Aburbecondita.FosterBOtranslatorGooldGPeditor.LoebClassi-calLibrary.CambridgeMAHarvard1919reprinted1978.