How the American Dental Association Advocates for Dentists Through the Pandemic and Beyond

Kathleen T. O’Loughlin, D.M.D., M.P.H. Executive Director American Dental Association www.ada.org oloughlink@ada.org

 

The Transcript

Art Wiederman, CPA And hello, everyone, and welcome to a very, very special edition of the Art of Dental Finance and Management with Art Wiederman, CPA. I'm your host, Art Wiederman, and I am very, very excited today, probably more excited for any podcasts that I've done. Today is my 100th podcast in the series of the Art of Dental Finance and Management. And we have an incredibly special guest for you today. We have Dr. Kathleen O'Loughlin, who is the Executive Director of the American Dental Association. I couldn't ask for a better guest for my 100th podcast.

Dr. O'Loughlin and I are going to talk about a lot of stuff. What's going on in dentistry today, what has happened in the last eight months with the COVID-19 pandemic and lots of other things. I'm very excited to have her on. Let me dispense with some business right out of the gate. Folks, I want you to take a look at our partner, Decisions in Dentistry magazine and go to the website, www.DecisionsinDentistry.com. They have great clinical content, great continuing education courses. And also our other partner is the Academy of Dental CPAs who we have partnered with ADA over the last eight months. We've been arm in arm with the ADA, working with them to get information out to you. So if you are looking for a dental specific CPA anywhere in the United States, my CPA firm Eide Bailly is in Southern California. But for the other 23 firms and we represent over 10,000 dentists in the country, go to www.ADCPA.org.

So let me let me introduce, I'll get to Dr. O'Loughlin in a minute, but I want to make a couple of comments. Number one, I want to thank all of you from the bottom of my heart for all of the support that you've given me for this podcast over the last two years. It has been an absolute joy. I have talked to hundreds and hundreds of dentists just from the podcast answered, I don't even know how many emails. And I look forward to doing this well into the rest of my career and helping dentistry and give something back to the profession that I have served for 36 years. So thank you for that.

So, as far as the American Dental Association goes, I've been a dental CPA for 36 years and I had interactions. I was honored to be invited many times to speak to their conventions all over the country where they're held. And actually, our ADCPA group got to visit the American Dental Association building in Chicago. And we got a tour and met a lot of the folks there. And it's been wonderful. But I really never fully engaged with the ADA until the middle to the end of March. And our president, Allen Schiff, who's in Baltimore, who's one of my dearest friends in the world, introduced us to one of the congressional lobbyists for the ADA And her name is Megan Mortimer. And Megan and I and the ADCPA and Allen have become bound at the hip, literally.

Megan has done dozens and dozens of webinars. I mean, this poor young lady, she lives in Washington, D.C. and I'd have her do a webinar, she'd be up to almost 11 o'clock at night because we're in California and she's in Washington. And she has just been, you know, we've been going back and forth with questions. Megan has been involved and Michael Graham also. Let me not leave out Michael. Michael has been also on our webinars and they've just been wonderful. And what I have seen, ladies and gentlemen, is the passion for the American Dental Association to help its 163,000 members. It has been absolutely eye opening and remarkable. And if you are not a member of the ADA, you should be. And if you are, which is most of you on this podcast that are listening, you are being very, very well served by your national organization. So with that, Dr. Kathleen O'Loughlin, Executive Director of the American Dental Association, welcome to the Art of Dental Finance and Management.

Dr. Kathleen O'Loughlin Thank you, Art. It's a pleasure to be here. And I have to agree with you. It's been a great working relationship between the ADA and the Academy of Dental CPAs. You helped us enormously about understanding a lot of the relief packages that as Congress was pushing them out at record speed with little definition and little clarity, you helped us enormously on understanding the impact on dental practices, on their financial status and their taxable status. And a million other questions we've asked you. So thank you so much. It's been a delight to work with you and the Academy.

Art Wiederman, CPA Well, your words are very, very kind. And it goes right back to what Megan and Michael have done. They're just absolutely remarkable, remarkable team members of yours. I neglected to give a little bit of your background, which I want to do here for a second. I'm so excited to talk to you, I just completely forgot. So, again, Dr. O'Loughlin's the Executive Director of the American Dental Association, which is the nation's leading advocate for oral health. She joined the ADA in 2009 after serving as the Chief Dental Officer for United Health Group and as the Chief Executive Officer for Delta Dental, Massachusetts. She is nationally recognized leader in the healthcare, nonprofit and education sectors. And she speaks around the country about the profession of dentistry, oral health care delivery and public health. And she was the first female dental school class president and valedictorian of Tufts University School of Dental Medicine. And what that means, Dr. O'Loughlin, is you're way too smart to be on my podcast. Way too smart. But tell us a little bit about your journey. I mean, with that as an opening.

Dr. Kathleen O'Loughlin Sure. You know, I come from a large family in Boston. I grew up in Medford, Massachusetts, and I was in the middle of seven kids. My parents put a lot of emphasis on doing well in school, behaving, playing sports. You know, I had a really happy childhood. When I got out of high school, women were kind of directed in three career paths - nursing, teaching or executive assistant. There weren't a lot of other options available. So I ended up starting out in nursing school and then switched to Boston University and completed my pre-med, pre-dent degree there, but I wasn't sure about what I wanted to do. So I ended up working about six years in a research lab in Mass General Hospital, which is where I had attended nursing school. So I didn't do a straight line to dental school or a straight line to corporate whatever. I zigged and zagged quite a bit and it was a discovery journey. I didn't wake up when I was seven years old and say, I'm gonna be a dentist and I'm gonna be the Executive Director of the ADA

Art Wiederman, CPA You didn't? I'm shocked.

Dr. Kathleen O'Loughlin No, I didn't wake up one day and say that. So, I loved what I did in the research lab. But there was a severe recession going on, very similar to the '09 recession. This was back in the late 70s, early 80s. And I decided I needed to advance my career. And it was a woman physician who steered me away from medical school and told me her sister had a very nice quality of life and I should think about dental school. So that's what I did. I ended up applying to the dental schools in Boston because my husband said I can't move, my job won't let me move.

Luckily, I got into Tufts and just loved it there. And I'm still close to the university. I served on the University Board of Trustees for a decade and I'm still very much close to the dental school in terms of being a member of their advisory committee. I care very deeply that dental students continue to have a great career path because that's what dental school did for me. It opened up a million doors and I don't know what I would've done if I hadn't decided to go to dental school.

Art Wiederman, CPA You know, it's funny, when I talk to, and I lecture to dental groups all the time. I tell dentists that, you know, you're not about fixing people's teeth or doing crowns and bridges. You're about a better life, a better self-esteem, a better career path for people and people who retire from dentistry, I tell them that they need to look back on their careers and say, I changed people's lives for the better. Isn't that what it's all about?

Dr. Kathleen O'Loughlin It is. I think that motivates me every day. And it isn't about mechanical technical challenges. It's about taking care of people. I mean, I would spend more time talking to my patients than doing the actual procedure. And that was a bond that you don't see in medicine anymore. I mean, dentists and their patients have incredible, powerful bonds. When you talk to most dentists, their patients love them. I know when I moved to Chicago for the ADA job, I had patients asking me if they could fly to Chicago so they could see me.

And I said, no, I don't have a dental office in the ADA building anymore. But I was very fortunate that my practice, I practiced for over 20 years, and I passed that practice on to Dr. Janis Moriarity, who I met as a student at Tufts, actually. And then years later, last year she was president of the Mass Dental Society. And she was in the House of Delegates yesterday, which we just finished. So we had our annual meeting yesterday with 500 very passionate delegates. And we managed to get the work done all virtually, first time ever. I don't want to ever do it again, but it was, got it done.

Art Wiederman, CPA I'm telling everybody, the next time, we had to cancel our two Academy meetings, one in Napa and one in Florida. And I told Allen the other day, the next meeting we have, we won't get anything done because we'll just be hugging each other for two and half days. I mean, it's crazy. Alright. So let's talk about, first of all, I want to talk before we get into the COVID and all that stuff. What does an executive director of the American Dental Association do and how many people work for ADA? Because there might be a lot of people who don't know about this.

Dr. Kathleen O'Loughlin Sure. So the American Dental Association is a volunteer led, volunteer owned association, much like any other association. There is 40,000 of them in this country. And they represent a particular point of view of the group that belongs. It was established back in I think 1921 in Boston, actually, I maybe wrong about that. But it was a small group of dentists who got together over 163 years ago and decided they needed a group of people to represent dentists' interests and the public's interest. So the ADA's mission is to enhance the art and science of dentistry and to improve the health of our population. So it's a bifurcated mission. Right? You have to do both. You can't do either or.

We represent 163,000 dentists, now there's about 204,000 dentists in the country. So we have enormous market share, about 64 percent. And our job is to watch out for them, to keep them thriving and to be successful and to help them minimize the risks they have to face every day. Whether it's financial or strategic or legal or reputational. And then we watch their backs for them. And that's what all of our work with COVID was, was to help practitioners and help regardless of their career path, by the way. We have lots of dentists that are in academia that practice public health dentistry, that work in community health centers, that work in government. Some of the finest people I know work in the federal government and state government. So there are lots of career pathways for dentists so we have to consider all of those folks with all of their diverse viewpoints. There are 12 specialties in dentistry now and we have to represent them. We represent over 24,000 dental students and we have a fairly sizable group of retirees that we also listen to. And believe me, they're a very vocal group, the boomer group. They like to let me know how I'm doing.

Art Wiederman, CPA Yes, we are.

Dr. Kathleen O'Loughlin So what do I do every day? Well, I have 500 employees or so. We operate on three campuses. You know, the group in D.C., their main function is lobbying advocacy. We also have a fairly sizable research enterprise in Gaithersburg, Maryland, over 20 bench scientists who are in the business of discovering scientific advances to benefit the profession and the public. And in Chicago, where most of our people are, we operate divisions that focus on different aspects of dentistry. And my job is to run the place. So the governing board is all volunteer dentist leaders. They are my bosses. I have 25 of them. We elect a new president every year. Just yesterday, Dr. Dan Clemmensen was elected president. He's an M.D. oral surgeon from Tucson, Arizona.

Art Wiederman, CPA From Arizona, right?

Dr. Kathleen O'Loughlin Yep. And we elected a new president elect, Dr. Cesar Sabates, from Miami. He's from Florida. And so we have lots of volunteer input and activism. 3000 dentists are actively involved in organized dentistry at any point in time. And basically, my job is to execute on what they want to do. Their goals, why they want to do it, when they want it done by, who they want it done by. And like Mike will tell you, we work for them. And my job is to make sure we're implementing on our strategic plan and that the performance is consistent and that we have the best talent we can get our hands on and that we keep them.

So I'm in the business of managing a large group of employees and I believe in the Southwest Airline philosophy. If you keep your employees motivated, happy, satisfied, treat them well, they will treat our customers really well. And our customers are the dental profession and the public. And so we have a terrific team. You've met some of them. Megan is fabulous. Mike is the best lobbyist I've ever seen in DC. He's got a heart of gold. He has tremendous integrity, which sometimes is an oxymoron in the political circles in D.C., but he manages to make it work. And he's done a tremendous job this year with COVID and all the legislation that was getting passed. He made sure dentists were not forgotten and he made sure dentists, you know, we're able to take advantage of all the relief that was critical to small business owners. People forget most dentists, 80 percent of our dentists are small business owners and 20 percent are divided into all those other categories. So, you know, we had a lot to look out for.

Art Wiederman, CPA Well, I will tell you again, Michael and Megan were just remarkable. I mean, both of them, when Allen or I or anybody else would ask them to be on a webinar, it didn't have to be a thousand dentists. I mean, we had some that had well over a thousand dentist. We had some that I did that were 50 dentists. And they didn't care. It was like, we're talking to dentists, we want to help them and get the information out. And again, our partnership was between the Academy of Dental CPAs and the ADA.

We have an information sheet we constantly update on these government programs. And it's been absolutely wonderful. And you guys, I just have so much respect for the ADA. And not that I didn't before, but in the last eight months, what I've seen, you know, you've got, and the Southwest Airlines analogy, Dr. O'Loughlin is a great analogy because that is exactly the way to run an organization. So you obviously get it. And that's great.

I want to get into kind of COVID-19 and what ADA did. And so, I mean, obviously, we all know that the dental offices and most of America shut down March 16, 17, 18, somewhere in that neighborhood. That's when most of my clients shut down and most of the dentists in America closed their offices with the exception of emergency procedures. So I'm assuming you had an inkling that this was going to happen beforehand. Walk us through what, ADA, when did you find out what you had to do? When did you start making a plan? What was the plan and how did you execute?

Dr. Kathleen O'Loughlin Well, fortunately, the ADA has a terrific global outreach. We have lots of friends among the global dental health community. And we started talking to dentists in Wuhan, China and started talking to the dental dean there in the dental school. And it was concerning. A couple of things. We knew little about SARS-CoV-2.

SARS, the previous SARS was not like this disease at all. It was easily transmitted through aerosols and droplets. And so all of the personal protective gear dentists were using was to protect them from blood borne pathogens, not aerosols. So we knew this was going to be a different game. Then we started talking to our friends in Italy at the early part of February. Their numbers were going off the charts.

Art Wiederman, CPA Yes.

Dr. Kathleen O'Loughlin And because of the way Italian communities live with extended families living in close quarters, these you know, these families would just have it run through extended family members, grandparents, little kids, parents, cousins, close quarters. You know, they live in small apartments. The numbers were staggering. And then the public health dentists and I would include CDC, our close relationship with them. We started asking some experts, expert epidemiologists at the University of Maryland and at Hopkins, what were we dealing with here? And what we found out was alarming, that we knew very little. All of the protective equipment in dental practices were not going to protect people from aerosol borne diseases. We were starting to understand that it could live on surfaces for a long period of time. That was frightening. We didn't know what the communication strategy was around, I mean, how much disinfectant are we going to need? We didn't have enough PPE to go around. The hospitals were gobbling it all up.

So we started to get really concerned, I would say the end of February, early March. And by the second week in March, because we didn't know enough science to protect practitioners, the ADA board made the decision to recommend that dental practices completely reduce their practice to only urgent and emergency care. And I got to tell you, we got a lot of angry dentists calling us up saying, what are you doing? Are you trying to put me out of business? But until we had knowledge, recommendations, personal protective gear, until we understood what the aerosol transmission risk was, until we started working with CDC and OSHA and HHS and talking to NIDCR and NIH about is there a vaccine out there? Is there potential for a vaccine? Is testing out there? Do we have enough tests to test? We just didn't know. So we made that bold move and then started managing what they were experiencing from day one. So we started sending out a routine surveillance under Marko Vujicic, who I hope you've heard of.

Art Wiederman, CPA Oh, absolutely. He's amazing.

Dr. Kathleen O'Loughlin And he within a week of March 16th, 90 percent of practices were reduced on a voluntary basis.

Art Wiederman, CPA Right.

Dr. Kathleen O'Loughlin God bless dentists. They are compliant and they watch out for their safety and their patients safety, which was issue number one. So where are we now as we've learned more? We've pushed more science out. We've got a paper that just came out last week indicating the variable.

Art Wiederman, CPA What you're what your basic?

Dr. Kathleen O'Loughlin Pardon me?

Art Wiederman, CPA Oh, sorry, no go ahead.

Dr. Kathleen O'Loughlin No. So we know a lot more now than we did in March. So now we've helped dentists reopen. We've sent toolkits to dental practices that we have them download that encourage them to reopen gradually to make sure they have the appropriate PPE, that they had enough money. As you know, through the provider relief, through the relief packages, the EIDL loans, the Paycheck Protection Program, we made sure they knew how to apply for that. We advocated for them. We would call banks and say, what do you mean the dentist can't get that loan? You know, they're not your biggest customer, but you need to lend them the money. It's a Small Business Administration program. So we advocated both on a macro level and on an individual level.

Art Wiederman, CPA In other words, what you did is you followed the science, because the danger of allowing dental offices to just continue business as usual after March 16 wasn't there serious repercussions?

Dr. Kathleen O'Loughlin We were concerned that they would become super spreader events. You know that some patient would come in asymptomatic. And we now know that asymptomatic carriers are about 40 percent of the transmissions and that concerned us greatly. We also began to understand that temperature taking was not as reliable as everyone thought. The fact that dentists could not get a test to try in their office because the Food and Drug Administration was making those only available to, you know, the front lines on medical, because there just weren't enough tests to go around.

So all of these things became crucial risk points that we had to step up and deal with quickly. So, you know, Mike will tell you, we got 2.6 million masks out to dentists. 54,000 dentists got shipments of masks. And we got over 500,000 gowns out to dentists. Because Mike talked FEMA into working with us and letting us distribute. And we also we have 163,000 dentists, well we had 150,000 dentists writing notes and sending e-mails to legislators saying, you know, you better not drop the ball here. Right. We need help.

It got to the point. And Mike will tell you this story that one of our congressmen actually told Mike to call the dentists off because he was getting inundated with e-mails and phone calls. And so our advocacy grassroots dentists were very engaged. And 600,000 dentists sent, 600,000 communications went to Capitol Hill. And that got Congress's attention. So we weren't on the list as a profession. And now we're fourth on the list of essential.

Art Wiederman, CPA That's what Megan was saying. So what were your members responses to everything that you were doing? I'm sure they were calling you in droves, right?

Dr. Kathleen O'Loughlin Well, they were going through the stages of grief like we all were. First reaction, angry. Why are you telling me to shut down? My practice is perfectly safe. Safe for bloodborne pathogens, but not for this new kid on the block. So we had to get them some science and get them some facts and data. They went through a period of sadness over the loss of what they had. You know, even now, practices are not back 100 percent. They're back to about 80 percent, which is where Marko and I think they'll plateau. And Roger Levin agrees with this, as well, by the way, with his customers. So we think until dentists can recoup the added costs of the additional PPE and the slower volume, they're going to be, you know, under some stress. And this will add to their burden of worries. You know, as they get through this year, it may take them another full year to kind of get back to whatever this new normal is.

Art Wiederman, CPA Well, the good news Dr. O'Loughlin, is that we are not hearing anything in the media or anything the public about, oh, well, dentistry is it's not safe to go to the dental office. I mean, I went to my dentist and I couldn't get in for two months, and it was one I felt completely safe going to my dental office, and I'm sure most people do.

So I want to jump on some other things. There's so much I want to talk to you about. So as the executive director, you guys have a lot of new initiatives like the ADA's Task Force on practice recovery. You have a COVID center for dentists on the website to help dentists find the latest guidance and expert advice. How is that? And you're also working with the state dental societies. How is that helping dentists understand this pandemic better?

Dr. Kathleen O'Loughlin Well, I think of those three levels in organized dentistry, as you know. There's the national group, which is the ADA, that's us. We lobby federally in D.C. We work very closely with 52 state's societies, and remember, Virgin Islands and D.C. are considered separate societies and Puerto Rico. So we supplied them with everything we could in terms of information, science, proven methods on how to stay safe. You know, recommendations on PPE, disinfectant, how long you had to wait between patients. We provided toolkits for everything. And just to show you the tool kit for the returning to work, which was how do you reopen safely? We had 35,000 downloads. And that included, we opened it up to nonmembers as well. And 18,000 nonmembers got the benefit of this information as well, because we felt it was a moral imperative to really keep everyone safe. And of course, we were hoping that nonmembers could see the value and think about joining.

So but the purpose really from the outset was to keep people safe. We did a hazard assessment working with OSHA so that practices would keep their employees safe, which was another worry for dentists. What if my dental assistant gets sick? Then what I do. And we pooled our resources on polling the public and we were very happy to know the patients 75 percent of patients were very happy to go back to their dentist. They do feel safe. There are 25 percent of the public that are gonna wait for a vaccine. And it's probably the same group that are still wary of going to a supermarket or having elective surgery done. And we are working very closely now with CDC and HHS on testing and vaccinations.

The ADA House of Delegates just passed policy yesterday that dentists should be part of that vaccination and testing cohort, depending on what the dentist is comfortable doing. But we think it would be a huge service to the public if you could acquire a vaccination in a routine dental visit and not have to make a separate appointment with a physician or a pharmacist or something. And we also want to make sure point of care testing is an option for dentists as well. Of course, dentists don't treat COVID, but they can certainly identify it and they can identify it right along with high blood pressure, diabetes. You know, dentists have that training that allows them make an identification or screen and then refer. So we think given the asymptomatic rates of COVID, this will be a great public health benefit to our communities.

Art Wiederman, CPA Well, I'll tell you that. I mean, that's all fantastic stuff. And from the from the financial standpoint, which is where we're I deal and the Academy of Dental CPAs deal, the PPP. I mean, we, you guys are first responders. We at the ADCPA ourselves, my good friend B.J. Kaucher coined this one, is that we're the financial first responders. I felt like I was saving the world starting March 16th, one dentist at a time. And we were talking to all of our clients about get in there and apply for this, get this money. And it was a lifesaver. And we're keeping our fingers and toes crossed, Dr. O'Loughlin, that you know, this this podcast won't air till after the election. So I can't, you know, I'm hoping that maybe by the time we get there, we'll have some stimulus.

Dr. Kathleen O'Loughlin Well, we're working. Mike will tell you, his team is still out there advocating for more relief.

Art Wiederman, CPA There's a second PPP that might come out. I know the HHS Provider Relief Fund was really helpful to some of our doctors, the EIDL loans, the PPP. But it was an absolutely remarkable thing and it really did help the dentists. So let's talk about going forward. We're now at the end of 2020. And you've been through 8 months of this,10 months because you probably started in January. What are you guys doing as far as helping the doctors for COVID-19 and pandemic relief going forward into 2021? What are some of your plans?

Dr. Kathleen O'Loughlin Well, we're going to make sure we keep our fingers on the pulse of how they're doing economically. And what we've uncovered is that employee dentists have not fared as well. And so we're really doubling down on more help and more resources for them. We also are starting to appreciate the mental health issues that have hit the profession very hard. Very, very hard. And shoring up our resources on how to stay well, how to stay mentally fit, how to deal with all of the stress they're under. We're also aware that some parts of the country are reporting hygienist shortages and that we're trying to put together some resources to help dentists attract and retain hygienists.

Many of them, because of COVID, simply either left the field or have been reluctant to come back to work. We're working very closely with OSHA to make sure hygienists and dental assistants feel safe coming back to work. And we've provided a lot of support to dentists on employee issues, employment matters related to if a team member does acquire COVID, what is your responsibility? What do you have to be financially on the hook for? And making sure we help dentists understand how they can stay compliant with the new laws and regulations.

So a lot yet to be done. We still don't know a lot about this disease and we're going to continue to work with the NIDCR and NIH on discovering more knowledge about SARS-CoV-2 and there could be another version of this. And how do we handle the next pandemic? We've learned an awful lot in this one. And ADA itself will continue to work remotely, probably well into April of 2021, at which time we hope there'll be population vaccinations going on and more accurate, reliable testing that's freely available.

Art Wiederman, CPA But you know there something interesting that my good friend, Dr. Paul Homoly and I have talked about a lot is the fact that, you know, a lot of disease starts in the mouth and this is an opportunity for dentists to educate their patients, say, listen, if you keep your gums and your teeth healthy and your mouth healthy, you're going to build up a better immune system. Now, I'm an accountant. So if I say something that is medically or dentally incorrect, doctor, please correct me. But, you know, if you keep your mouth healthy, that's going to strengthen your immune system and help you fight this COVID-19. And I think that's a great message. Do you agree?

Dr. Kathleen O'Loughlin It's great. And we know that high risk people who tend to be very susceptible to getting COVID, severe COVID, include diabetics. And we've got tremendous amounts of evidence that supports you can manage your diabetes much better if you are free of mouth infections and have healthy, just what you said, healthy gums. And so there's a lot of work to be done in educating the public because the dental I.Q. of the public is still incredibly low.

And so our mouthhealthy.org has been a site where we've seen more visits this year than ever before. And we're hoping we're getting that word out that, you know, you can't be healthy without good oral health. That was from the Surgeon General over 20 years ago. And we're hoping that access to information and a possible test and a vaccine in a dental setting could encourage the public to see the importance of oral health in terms of their overall health.

Art Wiederman, CPA And if we can get that other 20 or 25 percent of the public going back to the dentist and the dentist can use some of this government aid and maybe some good management techniques to keep their practices going, maybe sometime in spring, summer, fall 2021, they'll get another glut of people coming into their offices.

Dr. Kathleen O'Loughlin We hope. Only half of the population sees a dentist once a year. So there's huge opportunity to encourage more people to seek routine care. And yesterday, as a matter of fact, the House of Delegates passed policy related to our aging population, the 65 year olds and up and how important it is for them to have regular dental care and the means to access it.

Art Wiederman, CPA What's been what has surprised you the most through this whole pandemic process?

Dr. Kathleen O'Loughlin I think how much better we are when we work closely together. I call it hyper collaboration, hyper communication. You know, there in the past, I think states and local societies and the national society may have been competitors in some way, shape or form rather than all working seamlessly together.

And I would tell you, our close relationships with all the federal agencies has really paid off. So I think setting that stage years ago where we improved our relationships, we over communicated. We hyper collaborated. We've ended up coming out of this pandemic in much better stead than if we had stayed in our silos and stayed isolated. So I think all the work we've done over the last several years to be agile like, it's a way of thinking and it's a way of working that's far more inclusive, has prepared us well. You know, I forget this was in the Art of War, you know, a general prepares for battle during peacetime. And I think we did that over the last several years. And that's why we could hit the ground running with COVID.

Art Wiederman, CPA And it's also, isn't it, doctor, it's important, now more than ever, for doctors to become better leaders and become better business people and look at the numbers of their practices and see how they can improve their practices, because they've got, we've got to get everybody through the next year pretty much. If we can get everybody through the next year. And if this goes into two, three, four years, we don't want to have that conversation. But if we can get everybody through this next couple, next six to nine months and keep the practices going, it gives a good opportunity for doctors to start managing their numbers and looking at metrics and looking at what their reappointment percentage and all these things.

Dr. Kathleen O'Loughlin I think you're just spot on. I taught for many years at dental schools. And one of the chronic complaints younger dentist have is I never got enough financial management education. And I think you're spot on. If we could teach dentists how to be expert managers of their businesses. It'll go a long way to helping them get through this pandemic and recover fully.

Art Wiederman, CPA Well, I know that our Academy of Dental CPA members are speaking at virtually all the dental schools. I'm doing a series, a yearlong series with six local dental societies in Southern California on all of the business side of dentistry. We're trying to get, we're trying and trying to get that word out. It's really important.

Have you seen anything. I mean, I know this pandemic has been horrible for everybody, but something positive that's come out of this that you've seen maybe?

Dr. Kathleen O'Loughlin I think, seeing how resilient the profession is, how hopeful they are, how committed to their missions, whether it's a personal mission or their patients, has been remarkable. That's, it's been wonderful to see that they can recover so quickly and manage all these new procedures and new protocols flawlessly and have the almost zero incidents of COVID in their professional places of work. .3 percent prevalence is ridiculously low, considering OSHA has said dentists and hygienists are the most at-risk professions.

Art Wiederman, CPA Oh, absolutely. And that's what we're hearing. The good news is that there's no news coming out of that. 

Dr. Kathleen O'Loughlin Good news is that there is no news. That's right.

Art Wiederman, CPA That's what I mean. The good news is that there's no bad news coming out of dental offices and that it's a very, very safe place to go. And that's the messaging. So you mentioned a little bit earlier the emotional impact of the stress. What kind of things are you guys working with your members on there? And I mean, obviously, you can't send a psychologist or psychiatrist into every dental office. But what kind of things are you guys doing to help the dentists? Because it's hard enough to run a dental practice without all this. With all this, it just puts a layer of difficulty on.

Dr. Kathleen O'Loughlin It's a complicated question. And I think goal number one is to remove the stigma. You know, highly educated people don't like admitting they need help. So removing the stigma, stigma of depression, anxiety, suicidal ideation, you know, we want to make sure that dentists know, one, it's okay to talk about it. You need to talk about it. There are local societies and others have resources.

There's an emergence of tele psychology where you don't even have to go to an office where, you know, we're looking for partnerships with groups that can provide counseling remotely in private. You know, so the dentist feels like there's some protection and some anonymity with it. But making sure professionals feel comfortable talking about their mental health, because we did a survey four or five years ago and even at that time, the amount of anxiety and stress related symptoms was high. It's a stressful profession. So we want to make sure dentists know that they have access to resources when they need them.

Art Wiederman, CPA So what are some of your priorities in the coming months? I know you just had your board of delegates meeting and a lot of stuff's going to come out of that. What are the ADA's maybe your three top initiatives for 2021 that you're really trying to help the dental profession with?

Dr. Kathleen O'Loughlin Well, we have four goals.

Art Wiederman, CPA Okay, four. You can do four.

Dr. Kathleen O'Loughlin One is membership, you know, how do we attract members? Our big push there is to transform our digital capability to satisfy the expectation of the digital natives who are, you know, maybe the dentists under 50 who grew up with tablets and. We are also very much focused on diversity and inclusion. I think COVID has shown a very bright light on disparities, health disparities related to ethnicity and race. And so becoming an inclusive organization that truly represents all of our members and the diversity of our members is increasing logarithmically. 50 percent of all dentists now are women coming out of dental school and within that group the minority are white Caucasians.

Right. So suddenly we went from all white males to a minority. So I think those are two of our most important initiatives. And capturing the value of data, using big data and A.I. to help dentists practice better dentistry and safer dentistry. So we're launching a registry this year that will capture data on diagnosis and outcomes and provide support to dentists who say, you know, here's this patient with this condition, what are my best options and have that accessible through technology instantly chair side. So digital transformation, making sure we are diverse and inclusive. And I would say, you know, that capturing the power of big data the way medicine has. But we can do it better than medicine.

Art Wiederman, CPA Talk a little bit about some of the, I mean, the benefits of being an ADA Member. And again, I'm not turning this into an ADA commercial. Your organization does a great job for its members. Plain and simple. And you won't get me to change my opinion on that. Give us some of the benefits of being a member of the ADA

Dr. Kathleen O'Loughlin Access to the most credible, most trustworthy source of information, whether it's scientific or just related to the profession. We do all the clinical guidelines. You know, if you're a dentist and you want to know what to prescribe a patient who's going to have a hip replaced, we're your group. We set all the standards for the profession. You know, what would people have done through COVID without us lobbying at the federal level? Dentists would have been forgotten.

You know, we do a gazillion things. But what I'd like to do is one great thing. I would say are advocacy this year during COVID was our one great thing. We protected over 160,000 dentists from being left off of the table here. And they would not have survived their shutdowns.

Art Wiederman, CPA And I will tell you, you see on the news like I do, Dr. O'Loughlin, I mean, I think 10 to 15 percent of all restaurants are now no more. Large chains of restaurants like the Souplantation are no more. I have, I mean, I live in the dental profession, as do you. I have not heard of one of our clients or stories about any of our ADCPA members clients. I mean, maybe there's one or two, where they've had to shut their dental office down. That has not happened. So the dentist are still surviving, like you say there, maybe 80 percent capacity and things like that. But, you know, again, if you're not an ADA member, folks, you really need to look into doing that. There's just so many great things. Just their member kit for COVID, I went through it, it's remarkable.

I want to talk, doctor, a little bit about some of the younger people out there. Dentists that are in dental school. I lecture to the dental schools here in Southern California. I talk to young dentists all the time. I get emails from them like, I'm afraid of what's going to happen. I mean, I think the dental profession is wonderful going forward. This too shall pass. But what message do you have for young dentists that are either just, maybe they're thinking about going to dental school or they're in dental school. Like, what do I do? What's your message to them?

Dr. Kathleen O'Loughlin I would say number one is hope. The profession is still extremely highly respected, very effective at controlling and preventing disease. They are highly educated people. And what do they worry about? They worry about debt. Educational debt is a huge problem for them. So we're working really hard on helping them refinance their debt. We have a relationship with Laurel Road. But we also support Common Bond and SOFI is another company. We try and help them understand their debt number one.

And number two, we set up a program called ADAPT. ADA Practice Transitions. It's like eHarmony for dentists with a marriage counselor. And the goal of this new company is to match a dentist who wants to buy a practice with a dentist who wants to sell a practice. And match them in ways that go beyond their traditional marketplace and match them in philosophy of care and personal interests. So it really is more of a transition for patients to say, my old dentist and my new dentist think the same way. Right. They both have the right attitude and philosophy.

But I honestly think there's a lot more work to be done. I think younger dentists have very, they're very smart, very entrepreneurial. This is what's driving our digital transformation work where we are going to get ahead of technology and stay there for once, so that if they want to access anything from the ADA, it's on any device at any moment in time, instantly chair side. That's where we're going with that.

In terms of applicants. There's still a very healthy pool of applicants this year believe it or not. We have not seen a decline in dental school applicants. We do see their anxiety level increasing because of the uncertainty introduced by COVID. A lot of dental practices are not hiring young associates because of their slowdown. Right. So we're really focusing on that employee phase of their careers and helping them get through that first five year period. And that's what ADAPT hopefully will do. That's what our student loan refinancing program will hopefully do. We're working on the federal government to make sure that HRSA continues their loan abatement program if you work in a community health center.

And we're working with the feds right now on how do they determine health shortage? You know, HPSAs - health professional shortage areas, because right now their methodology is a little crazy. We think there's a lot more opportunity for loan deferment by dentists going to work in places where they're needed. So we're trying to do a lot, but there's a lot going on. I graduated in '81 during a terrible recession. And I couldn't sleep at night because I had no job. I thought I owed a lot of money, which was a lot of money back then, and nobody would hire me because I was a woman dentist with a baby.

So I feel for these kids. I mean, I remember not sleeping and go to the supermarket with exactly enough money to buy exactly what we needed for the week and nothing extra. So, but we got to help them through their first five years of their careers. And that's really important.

Art Wiederman, CPA So I know I've been talking to Megan a lot. I mean, Megan and I, we e-mail, we text about, she'll have a question for me, a member calls. And Allen Schiff and I have been the main contacts with Megan. And so what, do you have an idea of what kind of your initiatives going to Congress are? I mean, obviously, we want them to make this PPP forgiveness much easier. They took a step with that, Dr. O'Loughlin, by making loans of under 50,000 dollars, pretty much a slam dunk last week or two weeks ago. We're hoping that they make it for under 150,000. But I'm starting right now to go through the process and there's still a lot of uncertainties.

Dr. Kathleen O'Loughlin Yeah, even if, what's taxable, we'd like a clean answer on that.

Art Wiederman, CPA Yeah. And that's the other thing I was telling in the last podcast I recorded was, you know, they all, they made this law that it's not taxable. And they thought it was all going to be over this year. But then they changed the rules to 24 weeks. And then you have 10 months to apply. So do you deduct it in 2020? Do you not deduct it?

I talked to our number one PPP guy at our CPA firm Eide Bailly. You know, we don't know. And I, so I've actually mentioned to Megan, I said Megan, if you have anybody's ear at Treasury, just go to them and say, listen, if you don't want to make it deductible, that's fine. But just tell us how it interacts between 2020 and 2021. And that's been the great thing about working with Michael and Megan is that you know, we give them some ideas and they can go to congress. They go knock on the door.

My joke with Megan, Dr. O'Loughlin was, she e-mailed me, she says, I know that deducting PPP expenses is going to be great, but what can we do other than that? And I said, well, what if you ask Congress to make a tax credit, because a tax credit is better than a deduction. I told her, I said you need to make it Allen, Art and Megan's Awesome Dental Tax Credit. That's what it needs to be called, right? I don't think that's going to happen. But there is a proposal in Congress for 25,000 dollars, you know, tax credit. You know, right now we don't know what's going to happen. I'm sure, but again, by the time this comes out in the middle of November, we will know a lot more now.

Dr. Kathleen O'Loughlin And the reporting requirements are kind of all over the place. We're trying to keep those simple. So, just like you're thinking, you got to keep an eye on the government on multiple fronts all the time because once they do something, it's hard to go back and fix it. So you got to get in there and talk to them about the unintended consequence to small businesses like a dental practice, if you do X, Y and Z. So we're fighting hard for the tax credit, for the simple reporting. And this is a sad fact that government agencies don't talk to each other. Right? They don't talk to each other. We are the conduit.

Sometimes we're doing the talking between the agencies so they each know what the other one's doing. We found that to be the case with many of the federal agencies, FDA, CDC, HHS HRSA. We were telling them what was going on in the other agencies. So if that's a role for us to play, so be it. But we have to keep our eye on this. As you know, we're not out of this yet in terms of more relief. And then how hard is it going to be for the dentist next year when they're doing their accounting and paying their taxes? I don't want any unhappy dentists calling me up saying, what do you mean I've got to pay tax on this. You didn't tell us that, so.

Art Wiederman, CPA Oh, you did. I mean, you look at the ADA's website, you look at the ADA, news, you look at the stuff that we've put out jointly with you guys together. We've told everybody this. But I will ask my listeners and they know that I use this term. Please don't shoot the messengers. We don't make these rules. And, you know, it's great because we at the Academy are working very, very closely with Megan and Michael to try and get some initiatives. So other than the financial initiatives, maybe a second round, there is potentially a second round of PPP because there's 130 billion dollars left in the kitty. And I think the good news is and I promise, Doctor, we're not going to talk politics, but no matter what happens on November 3rd and then in January, one way or another, there's going to be a stimulus package I think. It's just whether it's going to be a 100 trillion dollar stimulus or three. We have one trillion dollar. We don't know what it's going to be. But I think that the good news, too, is that it's not only the ADA, but all the other trade organizations, or the other organizations out there, are pushing for a lot of the same things. So do you guys work with other organizations?

Dr. Kathleen O'Loughlin Yeah, all the time. So we're part of A.S.A.E.V. The Association for Society Executives that operates out of D.C. But we're working with the Ambulatory Care folks. We have very close relationships with the medical societies in D.C. and Chicago. So, yes. And whenever we can sign on to something with 100 other associations, we do it.

Art Wiederman, CPA Yeah, it's great. Well, I will tell you. Do you have anything else? Any other initiatives other than COVID-related that we haven't talked about that you might be looking at for 2021.

Dr. Kathleen O'Loughlin No. Let's see, we talked about the registry. We've talked about our digital transformation work, our focus on employee dentists, and trying to come up with a stronger value, better help for them, because they have not recovered and we are worried about them. We are working with the dental schools on how they recover. Their clinical incomes were hit severely and many of the dental schools are under some big stress. Their state government subsidies, whatever they were, had been on the decline for years and COVID may make that worse. So, you know, we have a lot of fronts we're working on. So it's hard to say, you know, here are the two or three most important things we're doing. I think they're all important and they're all different levers for us to pull to get past COVID, which I think will go well into the midyear of 21. And then what comes next? I think we continue to focus on the health of the public and helping dentists be successful, whatever that means to them.

Art Wiederman, CPA And I'm guessing that anything that you do meeting-related with the ADA until further notice is probably virtual, right?

Dr. Kathleen O'Loughlin All virtual, but we are hoping very much to be live in Las Vegas next October because that, I can tell you, running a virtual annual meeting, you're right. People just want to hug each other. And you can't do that through a camera. Dentists love being with each other. And we want to make sure we provide that opportunity for them as soon as possible.

Art Wiederman, CPA We're coming to the end of our time. And by the way, you're wonderful. You're a wonderful interview. You have great insights. You know what you're doing. And the American Dental Association is in very, very good hands with you and your team. And I'm just so pleased to have this opportunity to chat with you and to share this information with our listeners. Any final words of maybe encouragement, advice, caution for our listeners who might be listening? We have a lot of people listen to this podcast.

Dr. Kathleen O'Loughlin I think having optimism for the future and being so proud of the resilience that the dental profession has demonstrated is wonderful. I mean, you know, we've learned so much about ourselves during this horrible time. You know, we believe in the profession. We believe in what we do for our communities. We've been able to laugh quite a bit, Art. I mean, you have to have a sense of humor when it's the darkest. That optimism that the profession has really demonstrated is wonderful and they are certainly good at solving problems. I mean, in four weeks, they've figured out how to prevent aerosol spread in their practices. And that's a tremendous, not many other professions could switch gears that quickly.

Art Wiederman, CPA Well, I want to thank you on behalf of all the members of the Academy of Dental CPAs. We're going to continue to support your work. We're going to continue to be there. This Academy is, I mean, you've been members, a member of organizations. I've never met an organization of such unbelievably intelligent giving people as the ADCPA. We're honored that you would allow us to come into your world and help. We're here to help you. And thank you so much. And if a dentist has questions for any of the ADA folks, I know Megan's given their e-mails out. What would be the best way if a dentist has a question about anything, they don't know who to ask. I mean, obviously, you have resources and everything. What would be the best way for a dentist to contact the ADA and say, I have a question about infection control? I have a question about.

Dr. Kathleen O'Loughlin If they just go into ADA.org, there's a chat function there. They can just pose a question there. And our e-mail addresses are in the website. And any one of us are happy to take any questions from any member. My email address is my last name, first initial at ADA.org. Feel free to share it around Art. We're honored when dentists reach out to us. But honestly, our front door is, if they just Google their question, it'll come right into ADA.org and get into the chat room. And a person will get back to them immediately.

Art Wiederman, CPA Dr. Kathleen O'Loughlin is Executive Director of the American Dental Association. Please hang on as I kind of sign out of the show. And thank you so, so much for your time. I know how busy you are. And for all the hard work you've done for your 163,000 members across the United States. Thank you so much. I can't tell you. This was really, really cool.

Dr. Kathleen O'Loughlin Thank you for the opportunity. And you guys, the Academy's been absolutely great to work with this year.

Art Wiederman, CPA Well, thank you so much. And everyone, just to let you know, if you want to get a hold of me at my office in Tustin, I'm at 657.279.3243 awiederman@eidebailly.com. If you're looking at the Research and Development Tax Credit, go to our website www.eidebailly.com/dentalrd and we'll take a look and see if you're qualified for that. And this was just wonderful. This is just one of the reasons I do this, because I get to speak to wonderful, wonderful people. The dental profession, just wonderful people. When I get to refer people to dentists in my community, I just hear the caring and love, and trust that the dentists all have.

So anyway, ladies and gentlemen, that is it for this very, very special 100th episode of the Art of Dental Finance and Management with Art Wiederman, CPA. Thank you so much for listening. Please tell all your friends about our podcast. And we'll see you next time. Bye bye.