 I am delighted to introduce a dear and old friend of myself and so many of you in this room, Dr. Lawrence P. Gretto. Dr. Gretto is professor emeritus of oral pathology, medicine and radiology at Indiana University School of Dentistry and an affiliate instructor at the University of Washington School of Dentistry. He received a bachelor's degree from the University of California San Diego at Ravel College, a master's degree from Boston University's Sergeant College and his PhD in physiology from the Boston University School of Medicine. Dr. Gretto completed a fellowship in clinical ethics at the Charles Warren Fairbanks Center for Medical Ethics and served as a faculty member in this program. He was the founding chair of the Indiana University School of Dentistry Professional Conduct Committee and served as advisor to the Student Professional Conduct Committee, a peer review group in the School of Dentistry throughout its existence. He also served as the principal advisor to IUSD's chapter of the Student Professionalism in Ethics Association, SPIA. He is past president of the American Society for Dental Ethics and in that role served as an ethics liaison to the Board of Regents of the American College of Dentists. Dr. Gretto's scholarly work centers on the ethical nature of clinical reasoning. Dr. Gretto, would you please come forward? Thank you, Dr. Jones. Fellows of the College, members of the Board of Regents, honored guests and families, I feel honored to be asked to share a few thoughts with you this afternoon. At this meeting of an organization that I believe is tremendously important. Once again, congratulations to the new fellows who have just been inducted into the American College of Dentists. This ritual of induction is one that represents in a symbolic manner a binding together of those of you present today as well as those across time as a unique group of colleagues. It is an acknowledgement for some of you of your many accomplishments across years of service to the profession and for some of you who are closer to the beginning of your professional life, the recognition of the potential you have already shown for continued contribution to this esteemed and respected health care profession. If you were able to attend the presentations this morning and certainly if you listened earlier to this afternoon, you heard that the college was founded 102 years ago. This induction ceremony in which you have just participated is a tradition that goes back 101 years, even to the point of having similar academic garb to that you are wearing right now. You are part of a long tradition here. Rituals and symbols are important in professions. Ceremonies like this bind us to each other and serve as tangible reminders that you are not just individuals, but part of a collective. Colleagues who share esoteric knowledge, specialized skills, and especially for this ceremony, important values at the top of which is the calling to provide care for a fellow human being whose health may be compromised in some way. And you are expected to do so without any consideration of self interest. You were nominated for fellowship by two colleagues who were already fellows of the college. And in doing so, they had to describe very specifically how you met the four principles of fellowship. Excellence, ethics, professionalism, and leadership. And meet them you did or you would not be sitting here today. Now I would like to take us back for a minute to another ceremony that routinely occurs at the beginning of professional life. A ceremony that many of you may have participated in, especially if you graduated from dental school in the past 20 years or so. The white coat ceremony. It too is a binding ceremony like this one you have just experienced. But of course it's different as well because it can be viewed as the induction of lay people into a profession. Why do we do such a ritual at school? And why a white coat? Certainly in this day and age white coats are not typically worn during patient care. Why not just pull a scrub top over their head and be done with it? Well we're back to that concept of ritual that is symbolic. The white coat is symbolic of a long history of care providers who have come before you, who have built the profession into one that is trusted and valued by society. Think about it. Why in the world would a patient, a person whose oral health is compromised in some way, perhaps significantly, and who may be in pain, someone who may not know you well at all? Why would they trust you to invade their physical space, to literally get in their face, to invade their privacy by asking them questions about very personal details of their life and health? Why would they allow someone they may not know well at all to put sharp pointy instruments into their mouths and move about? Why? Well I believe it's because of the trust that has been developed by those of you sitting in this room today being honored not just for who you are, for what you have demonstrated in your commitment to service to other human beings who are in need, as well as to the long line of clinicians who have come before you. You benefited from them. You stood on their shoulders as our current students and new colleagues now benefit from you. It is because of the institution to which you belong and the trust and respect that has already accrued and is acknowledged by society, but it's so important to recognize that you not only benefited from this initially when you began your life in the profession, but that you have now become the next generation of those who came before us to subsequent cohorts of fellows who have not yet been nominated or inducted. I also have to say, this one's gonna be hard, that I'm so happy today to see among your ranks some of my own students. Students, I have always viewed as colleagues. While in some respects it makes me feel my age, I could not be prouder of you than to see you sitting here among the finest clinicians and scholars that dentistry has produced. Well, today you're not wearing a white coat. You're wearing an academic gown that represents the mantle of fellowship recognizing you for your accomplishments. But this honor comes with strings attached. Certainly you have the continued responsibility, as you've already heard, of upholding the principles of a college in clinical excellence, in ethical and professional nature of your practice, and in the leadership you demonstrate by being an empathetic, compassionate healthcare provider for all those who are in need. But even more so, you must recognize your responsibility to actively model the principles of fellowship to all colleagues, including our students and young practitioners. Now, this word and concept of colleague is an interesting one. As an ethicist, and at this stage in my life as a seasoned educator, it may surprise you to know that I do not believe our students become our colleagues upon graduation from dental education programs. And I will respectfully, but strongly, argue that point with anyone who does think it. I believe they became our colleagues the moment they crossed the threshold into dental school to begin their studies. Why do I think that? Because beginning at that moment and going forward until the end of their careers as healthcare providers, when they are recognized for doing good works at school or in the community, they are not just recognized by society as an individual, but as a member of a community of practitioners. And because of that, the entire profession is honored. But there's an even more powerful reason. When it comes to light that a student and an individual or indeed a class of students were to behave in a manner that is dishonorable, even at the very earliest stages of their education, the entire profession is detrimentally affected. Therefore, if one's actions positively or negatively affect the view society has of the entire profession, then by default, they are our colleagues. And we must work to make it for the better, not the worst. Why do I spend the limited time we have together speaking about this? Because an important component of your leadership in the profession, your leadership as a fellow involves modeling and mentorship about the role that one has in a profession. Professionalism is not innate to the person. It has to be learned and internalized, accepted and acted on. Frankly, I believe it to be a skill not much different in character than the esoteric technical skills you all learned. And like those skills, one continues to learn them and to do them better as time goes on. As well, at this meeting, we have heard about the challenges that the profession must face regarding the justice of care and about the disparity of care. Our voices, your voices, have to be heard on these challenges. Ignoring the ethical dimension of professional life and even not adequately paying attention to it results in a downward path away from that of a profession. And it has the potential to harm patients. I would like you to consider this mentorship and modeling as an essential component of what we term self-regulation and peer review. And I view these as something we do for someone, not to someone, for the profession. Peer review. Hold your schools accountable as well. Recently, we had a very disturbing example at a Midwestern medical school white coat ceremony of newly arrived students disrespectfully turning their back on an esteemed physician before she had the opportunity to speak because they disagreed, they disagreed with a viewpoint she held. This is intolerance. Disagreement is normal and reasonable and reasoning individuals may certainly hold different views. Intolerance is anathema to life as a professional and should be called out. Otherwise, that we espouse tolerance and respect as virtues of professionalism is contradicted and overwhelmed by our acceptance of such behavior. One has to ask the question as to whether or not these students will do that to patients who do not share their views or look like them or value the same things they value. Which, by the way, was the very topic of that physician's address to them that day. I would like to close by asking you to reflect that the academic robe you wear today, much like the white coat we invest our students with, represents a symbolic mantle of professional life as a health care provider and more importantly that it represents a promise that each of you have made and continue to make to each other in front of colleagues and very importantly in front of your family and friends that you will continue to do the work you did that allowed you to develop into a skilled practitioner and leader who every day demonstrates your calling to care for fellow human beings in need. I believe it is an awesome responsibility to hold the profession to these ideals, to hold our young colleagues to these ideals and I challenge each and every one of you to view this recognition you have received today as emblematic of the obligation to hold each other to that promise. They are you as they go so go you. You are not just individuals but a community of practitioners. You are colleagues whose integrity and reputation are integrally bound to each other. What you permit you promote. The greatness of a profession does not consist of having great wealth or in the high intelligence of its members or in power over other people or in high status or fame. Its greatness consists of the spirit of service and the servant leadership seeking always the well-being of those people for whom you care. You have achieved an honor today but you are honored every day when you care for the well-being of another human. Let's keep things in perspective and remember that is the greatest of your honors. It has been my honor to be with you today to celebrate this wonderful occasion and once again I congratulate you. Thank you.