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Cui Bono? Who Benefits?

August 13, 2013



What did our dental forefathers know about professional advertising that we don’t know?  How did they know that dental advertising would be bad for the general state of the profession?

That’s a bold statement, and I am sure that there are many among you that would disagree.  I certainly understand the argument of free market capitalism, but there are many unintended consequences when people are looking out for number one.

Let start by saying that I am not an advertising dentist.  I have advertised during my forty year career…but never really experienced a positive cost-benefit ratio.

Let me also say that as a blogger I have written a few posts that didn’t put dentistry in a positive light.  

I try very hard not to do that because I truly love the profession and know how important it is to maintain the public’s trust.  That is why I find that some advertising belies that trust.

In a recent issue of the very popular Self Magazine, a periodical devoted to health and beauty, there was an article written to promote the American Academy of Cosmetic Dentistry.

The article is a splendid example of great writing…copywriting.  The purpose of the article is to promote the Academy of Cosmetic Dentistry.  I applaud the author.  She did her job well.

I only have one criticism…but it’s a major one.

She threw dentistry under the bus.  The article centered around what could go wrong if the patient is not in the hands of a competent cosmetic dentist (implied as a member of the AACD).  Unlike the publicity that the TV show Extreme Makeover brought to the world of cosmetics (all positive), this article focused more on the negative aspects of dentistry which could cause some readers to lose trust in the profession.

Just the headline and the first sentence explain what I mean:

                                                                                                                                               When Beauty Bites

“The latest quest for pretty: a perfect smile. But get the wrong dentist and you could wind up with Chiclets for teeth, pain and mega debt.”

You may pooh-pooh that thought but human psychology supports my claim.

There were studies done during WWII on the efficacy of propaganda.  What psychologist Carl Hovland, who led the study for the War Department found was that initially soldiers knew they were reading propaganda…but over time the influence increased.  He called this phenomenon the sleeper effect.

Basically the reasoning is that in time the source of the argument fades over time but the message fades slowly and even endures.  So even if the soldiers recognized the material as propaganda from an distrusting source the message remained.  But you may say that what was in Self magazine wasn’t propaganda.

That depends on how we define propaganda.  It is derogatory information that serves to promote or publicize a cause or point of view.  We see it used in politics a lot these days.

We also see it used in advertising, because it emotionally engages consumers.  But the message that remains here may not be the one that is good for dentistry in the long run.

There is a fine line between ethical advertising and propaganda…the AACD may have crossed that line and Self Magazine along with it.   Maybe the publishers of Self should rename their magazine to Self-Interest Magazine.

In the meantime maybe I will start a new publication and call it Think Magazine.


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  1. Just so you know that the AACD did not pay for this article. The AACD nor Susan were allowed to edit, review, or reject the content of the article – although they requested. You also stated that you are not an advertising dentist. Do you not consider your website advertising?

    Comment by Mark Absher — August 13, 2013 @ 12:01 PM

  2. Hi Mark – I don’t know anything about the genesis of the article. My ONLY point is that it didn’t make dentistry look good. As a writer I recognized that it was written as pure “copy.” Not that I haven’t seen this before and if it wasn’t dentistry I would have smiled and moved on. I have nothing against advertising. Yes, a website is advertising (so is this comment)—it’s the message that concerns me. My point is that –I like beautiful women — but they don’t look any better when they point out the ugliness of others.

    Comment by Barry — August 13, 2013 @ 1:51 PM

  3. Barry, I’m in the midst of a dizzying day, but I have to comment. From the time I was in my residency in 1981-82, I have seen signs of dentistry being turned into a regulated trade, rather than a profession.I saw what you saw in that piece about the AACD and it was truly disgusting. It kind of throws me back to the days of the old-style dental school instructor who belittled his/her students to make the instructor feel competent and powerful. There is no place for this type of dysfunctional thinking among enlightened professionals.I have met Susan Holler at Pankey and found her to have been a pretty classy individual with talent that is off the charts. I am glad Mark has said that the AACD hasn’t paid for the ad; nonetheless, the magazine put that well-intended organization in a very bad light.

    Regrettably, this conduct is tolerated- and almost expected- of contractors competing for our business. It is classless, destructive, and can lead to nothing good in the long run.

    We dentists have always marketed. As the public realizes that dentistry is, in fact, elective,it has become much tougher to get their dollars into our offices. If you’re a good guy of dentistry, you need to get your good message out so that the public gets exposed to what great things you can do for them. “If you build it, they will come” works in the movies; in a tough economy where people do not see a need to spend elective dollars on anything other than good shoes, nice cars, and mega homes, we need to put our best foot forward any way we can.
    Advertising adds to our overhead and inflates the cost of ALL health care. This is a sad fact of life and until the public realizes it (not in our children’s lifetime), there will be less money for care as we all will be spending on this. We can only do our best send a message of value, keep it all positive, and not act as judge and jury when we are neither qualified nor empowered to do so.

    Thank you for your thought-provoking-as-usual piece. Back to work

    Comment by Alan Stern — August 13, 2013 @ 2:15 PM

  4. I start the post off by asking what our forefathers knew about advertising. They created the original Code of Ethics. I feel this piece in Self would have violated that Code. Advertising– sales and marketing can be done ethically. You use the word “professional” a few times in your comment–at the heart of the matter I think it’s the professionalism that has been compromised. Third parties have no interest in professionalism—which means to put the other before oneself. I think that over the last 40 years – that is what dentistry has lost more than anything. Maybe we should really publish THINK Magazine.

    Comment by Barry — August 13, 2013 @ 3:46 PM

  5. Amen, Barry! And the problem with THINK Magazine is how many would read it 🙁

    Comment by Alan Stern — August 13, 2013 @ 3:50 PM

  6. Strange as it sounds, I think a lot would read it…they just wouldn’t talk about it much.

    Comment by Barry — August 13, 2013 @ 3:52 PM

  7. Think Magazine is a great idea. With 50% of the population (maybe more) not truly thinking beyond the moment you would still have a sizable and loyal readership. I’m in!

    Comment by Jim Craig DDS — August 13, 2013 @ 11:57 PM

  8. Thanks Jim…I agree. It certainly would make driving easier.

    Comment by Barry — August 14, 2013 @ 9:03 AM

  9. Great article! (and comments)

    Me magazine would be fly off the shelves.

    “Let start by saying that I am not an advertising dentist. I have advertised during my forty year career…but never really experienced a positive cost-benefit ratio.”

    You’re doing it wrong..

    Reach different segments with different tactics, the argument for or against advertising has long passed. Self mag reaches the bleachorexics…some practices rely on those cosmetically inclined thinkers.

    As stated previously,a provocative article. I enjoyed the read.

    Comment by Chris — August 14, 2013 @ 4:57 PM

  10. Thanks Chris– I don’t have any feeling about advertising. You are right – that ship has sailed. My only concern is the message in the article. As far as my own “advertising” i concerned– at my stage in practice (40 years in), I don’t look for any volume of new patients. I could go the rest of the way seeing 5 new patients per month. I spend most of my time these days doing complete cases. That is another roup of skills that I enjoy and spend time doing. I have kissed a lot of frogs in my career—it’s time to only work with the princesses and princes.

    Comment by Barry — August 14, 2013 @ 8:17 PM

  11. I was just reviewing this weeks blog post when a thought occurred to me. There seems to be, at least to me, some confusion as to who is responsible for the placement of the Self magazine article. Was it the dentists? I not leaning there. Was it Self? Maybe…or was it the AACD. If it was the latter, then why does the ADA sit back and allow this —obvious violation to its Code of Ethics take place…any thoughts?

    Comment by Barry — August 15, 2013 @ 11:22 AM

  12. We met with a ton of beauty magazine editors in NYC for several years trying to raise awareness for both dental health and cosmetic issues. It seems all they talk about is hair, nails, makeup, fashion, etc, but never talk about the importance of a nice, healthy smile. I would think that this article sort of stemmed from this and my book, The Naked Tooth. My only goal is help the consumer understand that cosmetic dentistry can be an amazing thing, but they do need to do their research to find a dentist that is good fit for them. I’m not sure how the AACD got involved, perhaps from reading about it in my book. I don’t see the article as negative, it’s just letting people know to ask questions before, not after. Of course, the editor needs to add some drama or no one will read it, we don’t have any say about what is actually published. The AACD does a great job trying to increase exposure for cosmetic dentistry; it is an awesome benefit for the members. Obviously there are many amazing dentists who chose not to affiliate with the AACD, but the AACD may be just one resource to help consumers with their research. What else do they have?

    Comment by Colleen Olitsky — August 15, 2013 @ 12:08 PM

  13. I don’t know that the ADA’s code of ethics would apply to another organization, anyway!
    In any case, the people I want to see are smart enough to see self promotion for what it is, and to be able to sniff out frauds and poseurs!

    Comment by Rick Coker — August 15, 2013 @ 12:08 PM

  14. Rick– I totally agree–but dentists can choose to practice any way they like. As far as the AACD being closely tied to the ADA–I don’t know–that’s why I posted this. But being a member of the Gran Torino Dental Society, having grown up with an official Code of Ethics— I was just wondering.
    and to Colleen
    That’s really all I am asking—because like chocolate and vanilla we seem to have different viewpoints about the message this article sends. I got two messages–one is for the public to be very aware that the dentist they may choose may not be competent—the other is that AACD members are competent. I’m not sure how truthful either of those statements are.
    And–yes magazines hire very skillful writers to get the attention of the consumer—that’s how they get paid.

    Comment by Barry — August 15, 2013 @ 12:27 PM

  15. well sure, I totally see your point. We are always so careful to defend to other dentists (not throw them under the bus), esp when seeing unhappy patients in our office. the cosmetics may be horrible but we bite our tongue and sorta say, well, you just don’t like the way this looks, it’s a matter of personal opinion or whatever. we stress that patients should first interview their own dentist since they already may have a relationship with them. I would never want to contribute to something that would make our profession look bad. but would you really just let any random dentist do veneers on you or a family member, without first researching to make sure they are awesome? so if the article just makes the consumer pause, raise their eyebrow, and maybe ask a few questions before proceeding with any cosmetic tx, is that so bad? and like you said, the editor could have written it in a not so “scary/bad” experience way but that’s what sells.
    and i’m sure their are sub-par dentists who are members of the AACD, I stress this point in my book, that basically my dog could be a member, it just means he paid his dues. They need to further research. So the AACD may be just a starting point to find a few dentists and go from there.

    Comment by colleen olitsky — August 15, 2013 @ 12:44 PM

  16. I have better starting points. Caveat Emptor wasn’t invented by the AACD or any other small businessman. What you are saying is common sense—in every industry– and well before the invention of veneers or lithium disilicate. We are not talking about cosmetic dentistry or advertising…it’s the message and the collateral damage it could create. Sorry to sound like that Colleen but my thoughts are simple—My mentors—have always taught me never to throw anyone under the bus—and most of my mentors I met before I started school.

    Comment by Barry — August 15, 2013 @ 1:44 PM

  17. I am 100% with Barry on this. If I can invoke my Judaism and some Talmudic principles on gossip and slander I learned from some pretty great rabbis: (By the way, I believe that Christian principles of decency are a mirror of what I have learned.). Speaking ill of anyone under any circumstance is verboten. Few of us can do this perfectly ; in fact, Jewish ritual calls on us to say a prayer 3 times a day asking the Almighty to keep us from speaking slander! I recently addressed the specific issue of bad doctors and public safety with my rabbi ( I was almost the victim of one ) He cautioned the class to warn people in a quiet , discreet way without passing judgment, because we are not in positions to do so.

    That said, for the AACD to identify itself as the good in a sea of bad – explicitly or implicitly- is a certain violation of basic morals.It is wrong and, frankly, offensive.

    Like Barry- and most of us- I have seen some pretty great dentistry and some dentistry that I was glad to not have done! We have ALL done dentistry that we are proud of and some dentitry we wish we could have been able to do differently. And I have seen patients twist and skew their stories to make their previous dentists look like bad guys in order to deny the fact that they were the victims of their own bad decisions. We see this all the time in all aspects of life.

    Most dentists are good people of good intent and decent training. Some are good, some are mediocre, some are outstanding , and some are downright awful. I believe that the two last categories represent a minority of dentists. I also believe that the majority of us do work that is good or better and that the majority of patients are, in perception and reality, well served.

    The AACD, by positioning itself this way, has implied to an unsuspecting readership that they are the only source of excellence- if not acceptability- in cosmetic dentistry. If the justification for this type of article is that this is the type of drama that sells magazines, I am led to believe that the public will eventually learn the truth , grow sick and tired of it, and eventually put it in the same category as the National Inquirer. It will also cast the AACD in a very bad light in the eyes of some very good dentists who choose not to belong to it.

    I’m sorry to sound harsh. That is NOT my intent. But we really need to reflect on who we are and how to best improve ourselves and make the world better WITHOUT hurting others, explicitly or implicitly.That, folks, is not easy, but it is imperative. Ask your pastor if you don’t believe Barry or me. Thanks for listening

    Comment by Alan Stern — August 16, 2013 @ 1:01 PM

  18. Amen Alan. Your comment brings to mind two things. This lesson was drilled into us in dental school…but the living, breathing application of it has always been exemplified by one of dentistry’s greatest men. The man who gave us WIDIOM…which at some level reflects the Golden Rule.
    Still…I haven’t heard one bit of contrition. It seems as if all’s fair in love and war. Welcome to today’s professional health care marketplace. Anyone can join…
    As far as the AACD’s role in this…well…that’s where I first saw the message…on their website. To think I used to me a member. Now I am reflecting back to the origin of the AACD…I thought they would have matured and attracted deeper thinkers.
    I read a quote this morning that made me think of the AACD:
    Ralph Waldo Emerson : Harvard teaches most of the branches of learning.

    Henry David Thoreau: Yes, indeed. All of the branches and none of the roots.

    Comment by Barry — August 16, 2013 @ 1:16 PM

  19. Hi,
    Thanks for sharing this great post with us. It is really informative blog and giving me a lots of ideas about dentistry. i really enjoyed to read this and i appreciated it. you are doing great job. keep blogging.

    Comment by Benedwin — August 30, 2013 @ 5:00 PM

  20. Thank you Trent.

    Comment by Barry — August 30, 2013 @ 5:57 PM

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