Volume 7 • 2020 • Issue 7

James Armstrong BSc, MBA, DMD president@cda-adc.ca TheValueof Ingenuity The views expressed are those of the author and do not necessarily reflect the opinions or official policies of the Canadian Dental Association. T he pandemic has created an unpredictable and often volatile economic context for dentists across the country. In late October, Tiff Macklem, governor of the Bank of Canada, said, “It may take quite some time for the economy to recover from the COVID-19 pandemic…the country’s economy will not fully absorb slack until 2023.” He warned that the economy could slow toward the end of 2020 after authorities across the country implement new restrictions on businesses amid a surge in coronavirus cases. As a colleague and business professor, I’ve been thinking about solution-oriented strategies for how to weather uncertainty in the short to medium term. I’m confident about the health of our profession in the long term, because we provide an essential service that will always be in demand. Our profession has persevered through challenging times in the past. I’m reminded of the recession and high interest rates of the early 1980s, when I began my career in dentistry. The year I graduated, interest rates were 21%, which made starting a practice a high-risk experiment in thrift and ingenuity. A classmate and friend of mine paid himself less than his certified dental assistant for the first seven years of his practice. He did his own hygiene until he could afford to hire a dental hygienist. He drove a used truck. I remember going with him to pick up used equipment for his practice that he had refurbished at an auto-repair shop. Another colleague, who set up a practice in downtown Toronto in 1983, was in more debt after his first year of practice than he was at the start, because interest rates were so high and business was relatively slow. He took on extra part-time work in a busy suburban practice and in an orthodontic practice performing hygiene, until he could pay down some debt and build a solid patient base. At moments, these kinds of challenges were actually invigorating because they required that we be creative and flexible. At other times, it was daunting to work so hard without knowing how our efforts would pan out. Ultimately, my colleagues and I were able to build fulfilling careers that have spanned many decades. I don’t believe that the last 20 years were the norm for dentistry; they’ve been halcyon decades that allowed a significant increase in the percentage of large associate-driven or auxiliary-driven practices in many provinces. I expect that we are returning to the practice style most common from the 1950s through the 90s: small, efficient and dentist-driven. An economic downturn will be harder for those who rely on discretionary income. Job losses due to COVID are almost double compared to those in the recession of 2008. Patients facing financial uncertainty may avoid discretionary spending, even on health care. Luckily, most dentists I’ve met during my career were drawn to dentistry because it offers purposeful work, autonomy and time for friends and family, which have always been more important to professional fulfillment than financial rewards. This year has asked so much of dentists, and, in response, we have all worked harder and been more resourceful. I expect that the coming year may hold more challenges. Here at CDA, we will continue to advocate on your behalf and provide resources and support to help weather the storm. In closing, I read a study recently about what factors increase a patient’s positive experience of dental care. It isn’t the newest technology or the fanciest waiting room (or parking lot, these days!). The biggest factor: a dentist who really listens and acts on a patient’s concerns. This tells me that what our patients value most isn’t something that you can buy; what they value is you. From the President 7 Issue 7 | 2020 | CDA at W ork