 Greetings, distinguished guests, President Rouse, Board of Regents, fellows, and friends of the American College of Dentists. Well, for the second annual meeting in a row, we're pandemic virtual, but I'm no less pleased to be with you. I'm truly proud and excited to have the opportunity to serve as your president during a time of great change. As we look forward to a future of new possibilities and reimagined potential. Congratulations to our new fellows, and thank you to the families and teams who have contributed to your impressive professional milestone. The American College of Dentists is the oldest and most prestigious dental organization of its type. Fellowship is a significant honor as we represent less than 4 percent of dentists. Your selection has been based upon your ability and your willingness to contribute and to enhance the profession. Can you sense that I'm going to give you an assignment? The American College of Dentists is not so much an honorary organization as it is a visionary, working body. The college has been the guiding light of the profession for 101 years as dentistry transformed from a guild to a profession. The college developed standards for education, for research, and for journalism when there were none. We have foreseen difficulties and inspired like-minded groups to action. We have advanced excellence, ethics, leadership, and professionalism for a century. Most of you don't know me, don't know why I'm here. I'm not a politician, not an academician, not ADA president, not a dean, not a colonel. I'm just a proud practitioner who's cared and believed in striving for the highest ideals. I entered my state dental school because I believed that I could be a professional that served the public. I completed a prosthodontic program at Indiana because I believed in excellence. I invented a model of care that defined the first full-time private practice of prosthodontics in my state because I believed that treating patients with the highest standard of excellence and professionalism was my calling. I served the Indiana Dental Association as chair of the Council on Peer Review for three decades because I believe that standards of care define a professional. I served on the American College of Prosthodontist Board of Directors for 14 years because I believed in the need for specialty expertise on the dental team. I've served many positions on the local, state, and national level, in each one because I believe in a sacred profession that serves the needs of the public, and I care enough to want to do my part. Over the past 50 years, my service is focused on the advancement of excellence, ethics, and professionalism for our noble profession of dentistry. Even as I express my profound gratitude for my bounty and for this great organization, we need to talk about a growing problem, the status of our profession. It's a real concern. As we enter our second century, we see profound change and challenge for dentistry, changes in education, funding, cost, and debt, challenges related to technology, the quantity and the quality of information, evolving practice paradigms, increasing overhead, supplies, equipment, salaries, stagnant insurance reimbursement, access to care issues, equality, commercialism, and relationships with the healthcare sector, government, and society are all contributing to a drift in our purpose. Ask yourself, where are we headed? So why are we here? What are our core values? We enter an exit dental school with the best of ideals, beneficence, non-maleficence, justice, and autonomy. As time passes, the reality of our dualistic healthcare profession slash business shifts our focus. At first glance, one might associate dentistry with a commercial venture, entrepreneurship, maybe high tech office, media savvy business, but if you go to a quiet place to reflect deeply on the core values of the profession, imagine you're writing the history of dentistry or preparing the eulogy. What will it say? What would your own practice experience reveal? Once we revisit dentistry's core values, we can recommit to practicing with dedication and consistency of purpose. We have viewed dentistry as a disciplined group who adhere to ethical standards and are accepted by the public as possessing special knowledge in a widely recognized body of learning derived from research, education, and training at a high level. And who are prepared to apply this knowledge and exercise these skills in the interest of others? And that these activities are governed by a code of ethics. Regrettably, there are those who envision dentistry as something less, in other words, not a profession, so much as a business opportunity. They see themselves as a business independent of professional concerns. So what is the value of being a profession? Why bother? There are many incalculable benefits to being ethical in having integrity. They include being trusted, having the privilege to apply unique expertise for the benefit of others, and to change lives. Members of a profession are automatically afforded opportunities for respect in the community to provide service, leadership, and even enhanced income and long-term stability of those benefits. But those incredible benefits may not be enough for some. The singular hallmark of being recognized as a profession is self-governance. Self-governance is a great responsibility and a remarkable privilege. The knowledge of dentistry is so unique and technical that only an individual with that specialized knowledge can accurately judge a dental professional and appreciate the scope of treatment systems and evaluating outcomes. What are the consequences of the loss of dentistry as a profession? On one hand, some might reap a short-term financial gain with loosened standards for treatment. This short-sighted approach, however, will produce the dire and irreparable repercussions of loss of respect and professional status in our society, even including increased liability and decreased income. But the most significant consequence of being just a retail business business is that of being judged and regulated by bodies that do not understand or appreciate the science, art, and challenges of dentistry. The consequence will hurt everyone, the good actors, the bad actors, and the patients. What are we supposed to be doing? Have our values changed? The benefits of being a profession have been so ripe and plentiful that organized dentistry and our educational system have been able to focus on enhancing clinical science and the evidence-based delivery of oral health care. Dentists have enjoyed incomes in the top 10 or even 1 percent without concentrating on practice efficiencies or high-production models. The responsibilities of operating a small business have not been emphasized. That has presented a significant profit opportunity that has not gone unnoticed by non-dentist entrepreneurs and the new dentist debt crisis has punctuated that income opportunity. And we've been slow to react to evolving values. We've been slow to react to rising economic, societal, and governmental pressures. We've been slow to use revolutionary communication systems. Our notice that paper is not read, and perhaps most detrimental that social media is replacing science with anecdote, even in dentistry. Practitioners are looking for clinical guidance online and on iPhone instead of from peer-reviewed sources. Standards of care define the professional. Evidence-based treatment is standard of care. Anecdotal influence is not. Providing treatment beyond training and experience is not standard of care. Providing treatment without diagnosis and planning is not standard of care. Treatment options based upon profit without adequate informed consent is not standard of care. Providing service outside the bounds of dentistry is not standard of care. Have you seen these activities in your community? When too many of us operate outside of the standard of care, the profession is jeopardized. All professions and occupations have a few bad actors. And regulatory systems deal with that small minority. But when trends encourage the proliferation of bad actors, the status of the profession is jeopardized for all, including our patients. And that is when we all must actively engage a chart of course correction. So how are we supposed to act? What are appropriate initiatives for the college and for you? Dentistry is at a crossroads. Which road will we take? Why will we take it? If you don't find the concept of retail dentistry appealing, don't lose hope. There are actions that you can take now to enhance the profession of dentistry. Integrity must matter more than income. Science, ethics, and inclusivity should undergird the effort. And there's much that you can actively support. And this is your job assignment. Mentorship should be revived in dentistry as a paradigm. You can find a mentee tomorrow. Large group practices, including dental service organizations, DSOs, are a reality of 21st century health care. They must be embraced and guided. In fact, we can develop DSO models based upon science, professionalism, and efficiency. Qualified leaders from all areas of the profession must be welcomed to the college, as they are all necessary to advance the mission. You can look beyond the usual sources to find outstanding contributors that deserve fellowship. A history of student leadership is a good indicator for fellowship. Outreach should include minority groups, specialty organizations, the Academy of General Dentistry, DSOs, and all other groups that are engaged in oral health care delivery. Access to care must become more universal. Dentistry should seek to integrate oral health into the health care team as allied members. We should adapt allied health practice concepts because they work and it's necessary for our future. Diagnosis in treatment planning must be emphasized as the defining skills of the clinician dentist. Evidence-based information must be presented in a usable and readily retrievable format that is easy to access as easy as social media. Peer-reviewed science and integrity must be demanded from continuing education providers. Qualified experts should be recognized as authorities. Anecdotal evidence from social media should be viewed with skepticism as it potentially deprives the patient of the information that is necessary to inform their consent. Social media should be used to disseminate relevant and validated clinical science. Critical thinking and rigorous evaluation of information, including continuing education, print, and social media should be mandated as a curriculum standard in education and also as a best practice. Providers should recognize limitations and know when to seek specialized expertise for the needs of the patient. Curriculum standards can provide guidance. We must strive to make it easier to be ethical and create a community that recognizes and rewards ethics and professionalism. Good actors should be offered continuous support and guidance and provide it with opportunities to lead the way. Bad actions must be reviewed and dealt with through professional processes and regulatory bodies. That act of self-governance is the keystone for being a profession and it must be a recognizable activity. Our three steps for continued success as a profession are first, revisit our core values and mission, why we are here. Next, use those values in an intelligent, intentional, and consistent manner to direct initiatives, education, communication, and practice concepts, the mission-directed approach, what we are supposed to be doing. And finally, find the appropriate balance of the science of dentistry, the art of practice, and the responsibility of business ownership with our societal contract as professionals, how we are supposed to act. The prospects for dentistry are brighter than ever before. The advances in science, technology, patient safety initiatives, patient care concepts, and practice efficiencies open the door for increased quality and access to care. And SPIA is our brightest light as they will become the guiding light for future generations of professionals. Throughout our long and laudable history, the college has flourished with the small core of dynamic leaders and large cohort of deeply committed fellows. Now, we all must actively embrace and advance the mission to enhance excellence, ethics, professionalism, and leadership. We all must reach out to students and new graduates. We must embrace all of dentistry. Many of us are dedicated leaders for other organizations, but the college mission must be our collective priority. And we must imbue our mission within all ranks. We all must imbue our mission within all ranks. We've benefited so much from dentistry, and our job now is to carry the guiding light forward. In the future, who practices dentistry and how they practice will be of great significance to the profession and to the public. Competence, compassion, and cultural sensitivity will be critical, and courageous advocacy will be required to ensure that dentistry remains a viable profession for the benefit of the public and for future generations of dentists. I believe in the future of the profession because I believe in you. I believe in our collective ability to lead the college in its second century of service to humanity. Please, all of you, take up the torch wherever and whenever you can.