Odds and Ends, and White-Haired Guys

By Dr. John Callahan, NESO Trustee

As we reach the end of the summer, an update on some actions occurring at the AAO for the benefit of all our members seems in order.

Always near the top of questions I receive from members, is the one that has to do with our Consumer Awareness Program (CAP).

As many of you know, over the past few months we have been completely re-working the CAP to be more effective. This included moving much of the efforts to digital platforms. These are not only more cost effective, but also where most consumers are getting their information nowadays. Three main components of the new direction of the CAP include social media, search engines (aka Google), and improving the consumer website. Initial efforts displayed the following increases year-over-year: consumer website sessions up 468%, visitors up 397%, page views up 446%, Facebook fans are up 1150% (we hit 25,000 likes in August), and we’ve appeared in over 1.8 million search results relative to various orthodontic treatment options since May. All this and reducing our members assessment by $200!

And what is the message? That orthodontists are the specialists, and it is imperative that you see an orthodontist in person. Period. All of the campaigns drive traffic to the consumer site (we invite you to evaluate the new design at and the “Find An Orthodontist” feature that includes AAO member listings (make sure yours is up to date!).

The Council on Communications has been doing a fabulous job of moving this new initiative forward. They are creative and passionate and continue to find new and better ways to bring our message to the public.

A member asked me what we have been doing to support our profession in their state. A great question. As most members realize, the AAO is very active at the Federal level leading conversations that directly affect each and every one of us. Student loan support, tax issues, improving flex plans, etc.. But what about state issues?

One of the very active resources available to protect our member’s interests is the AAO’s component legal support fund. These are monies made available by the AAO House of Delegates to support component orthodontic associations in their efforts to address legislative and regulatory concerns on the state and local level. Two NESO components, Rhode Island and Massachusetts have used this resource this year. In Rhode Island’s case, the issue was proposed changes to duties of our orthodontic assistants. With the help from the AAO, both in financial assistance and with boots on the ground, the issue was resolved in favor of the RI Orthodontic Association.

Massachusetts is faced with new rules affecting state Medicaid program – in particular MassHealth. The new rules have the effect of causing increased patient visits and burdens without increased pay. The AAO is supporting the MAO by helping to cover professional lobbying costs and, if indicated, support with legal staff from the AAO. As of the end of August, feedback indicates that efforts are moving positively forward albeit slowly.

All state orthodontic associations at one time or another are faced with efforts on the part of legislatures or regulatory departments to negatively impact our members. Often the state associations lack the resources in either money or expertise to effectively combat these efforts. If your state needs support, reach out to Sean Murphy at and he’ll guide you through the process.

I also received a very interesting e-mail from one of our members that echoed comments I have seen on some of the orthodontic social media sites regarding AAO leadership. It essentially asked the question, “How can a bunch of old white haired guys possibly represent membership well?” The old white-haired guys referred to are the members of the Board of Trustees. Even though our President, Dr. Nahid Maleki is neither a guy nor has white hair, the point is well taken.

Our current membership demographics show some interesting statistics. Starting with gender, our membership is certainly trending to a more balanced male/female ratio. The current percentage of all members in active practice is 74% male and 26% female. When you only look at those in practice 10 years or less it becomes 60/40, and the most recent data show that residents in accredited orthodontic programs are at 51/49 male to female. Pretty clear trend.

Another trend in the type of practice modality our members are engaged.
Some data highlighting the changing trends in how our members are practicing include:

  • 85% of our total members are in a private or small group partnership arrangement.
  • But that changes dramatically in the 10-year or younger group where only 73% are in private practice or small groups.
  • 3.2% of our total membership currently practice in DSOs/Corporate Dentistry. That rises to 8.8% with those in practice 10 years or less.
  • When you reach down to those in practice 2 years or less the numbers are 65% go into a private practice or small group setting and 14% join DSO’s/Corporate groups.

It is clear that there are big changes in both the gender makeup of our profession and in how we practice. Thus, it would seem then that there should be greater representation on the Board of Trustees reflecting these changes. Yet, it is currently not true in practice.

Certainly part of the cause is our current governance structure that dictates a very long tenure. Efforts, in the House of Delegates, to change this have been met with significant resistance.

Experiencing a seat on the Board has given me a realization of how much effort it takes to do a very good job. Personally, I could not have represented our members well while I was focused on building my practice and growing my family. It would also be extremely difficult if I were in a solo practice. My partners’ understanding and support make this doable. It could also not be done without incredible support and understanding from my wife, Elet.

Fortunately, our governance structure does allow the Board to receive tremendous counsel and advice from the different Councils and Committees. Here is where currently there is great opportunity to accommodate diversity in age, gender, and practice modality. As trustee, part of my responsibility (in counsel with the NESO Executive Committee) is to populate these Councils and Committees with NESO leaders that are best suited for that responsibility but also represent the wide variety of members we have.

Each BOT member is focused on best representation, as our policy reads:

The AAO’s Critical Issue #1 recognizes that orthodontists are increasingly diverse in terms of age, gender, race and ethnicity and in how they practice. The Board of Trustees strives to reflect this diversity throughout AAO leadership.

The NESO Council representatives to the AAO are quite diverse with age and gender. Each individual brings excellent skills and passion to the table. In addition, our own NESO officers include Drs. Christina Carter (immediate past-president), Carrie Melita (current president), Sal Manente (President –elect), Michal Kleinlerer (Secretary) and Jeff Blasius (Treasurer). A great mix and all way younger than I am!

At the end of the day it goes back to when I was just graduating from my residency (1982). At that time 90+% of all graduates were male. Your choice of practice modality was essentially going into private practice or a small partnership. The current Board members are at the stage in our professional careers that we have created the time and space to be able to take on the full responsibilities of Trustee. Now our residencies are essentially in gender balance. It did not happen overnight. As we go forward, these shifting demographics will find there way to the Board of Trustees. In the meantime, this BOT is intentional about diversity at all levels.

So, the BOT is in fact mostly old white-haired guys. But we are young in heart and have high energy. And, even though we “look” the same, we are vastly different. We bring many varied ideas and skill sets to the Board. We listen to our Councils and Committees. We listen to our members. We are acutely aware of the evolving business opportunities and professional stresses our members face. Our actions are all focused on what is best for our profession and our members. It’s our duty.

–  John Callahan
Trustee, Northeastern Society of Orthodontics