When the son of the incoming president of the American Association of Orthodontists (AAO) expressed interest in orthodontics, his dad steered him away from biology-focused college majors in favor of business. More than a decade later, Morris N. Poole, DDS, the soon-to-be 108th president of the AAO, has no regrets about offering that advice.

Back then, he reasoned, his son could gain clinical understanding in dental school and orthodontic residency. Running a business and managing people, however, required a college degree. The decision paid off, and Morris L. Poole, DDS, eventually bought the Logan, Utah-based practice in 2010—now called Poole and Willis Orthodontics—from his dad. “I work for my son now,” says the elder Poole, “about one and a half days a week.”

Poole believes it is the job of orthodontists to prove to the public that an orthodontist, not a general dentist, is best suited to perform orthodontic treatment.

Poole believes it is the job of orthodontists to prove to the public that an orthodontist, not a general dentist, is best suited to perform orthodontic treatment.

Some might call it semi-retirement, but the 67-year-old Poole will have an incredibly busy 2015, starting with his official installment as AAO president in May at the association’s Annual Session in San Francisco.

For Poole, the honor caps a long and distinguished career in the professional trenches, as well as service on countless committees.

Above all, it’s a chance to maintain the strength of the specialty and leave it better than when he found it—for his own son, his 15 grandkids, and the countless orthodontists working hard to make a living. Emphasizing the business side of orthodontics is one way to make this happen.

The school of hard knocks is the only business school most of us go to,” Poole laments. “If young residents don’t have an understanding of how debt works, and how to repay it, they find themselves in serious situations, and I’ve always said desperate people do desperate things. AAO will continue to try to help these young residents.”

Starting Out

As a private practitioner since 1978, Poole knows the pressures of raising a family and tending to the countless responsibilities of running a business. By the time he completed dental school, he and his wife had three children, and that number had gone to four by the time he finished his orthodontic residency. “I had to go right into earning some money and making a living,” Poole says.

After dental school at the University of Southern California, that living was intended to be general dentistry back in the Mountain West region of Logan, Utah. “I learned [after undergraduate studies at Brigham Young University and dental school at USC] that five new dentists planned on being here in Logan,” Poole says. “I thought, ‘Hmm. Maybe orthodontics is the way to go.’?”

Shortly after, Poole became the first USC dental graduate to attend crosstown rival the University of California, Los Angeles, for his orthodontic residency. Beyond the competitive climate in Logan, the young Poole discovered an affinity for the profession that has served him well for almost 4 decades.

By 1999, at the age of 51 (now with six daughters and one son), Poole’s thriving practice became too much for one orthodontist. A new business partner, Craig Willis, DDS, eased the workload considerably, and Willis stayed with the practice when Poole sold his half of the business to his son.

Some of the People Some of the Time

No president of any organization can please all of the people all of the time, but Poole is not one to dismiss opinions that come from AAO members. One of those strong opinions concerns competition from dentists. “There are those who would like to say that we as orthodontists must declare that we are the only ones who can do orthodontics, and general dentists should not be doing orthodontics—and they want us to say it long and loud,” Poole muses. “But that is hard to do, because we have a Federal Trade Commission, and you open yourself to legal concerns.”

Almost as if on cue, the Supreme Court, no less, ruled in February 2015 that a regulatory board, largely run by dentists, had violated federal law against unfair competition when it “tried to prevent lower-cost competitors in other fields from offering teeth-whitening services.” While it’s not exactly apples to apples, Poole believes it is more ammunition for orthodontists who would prefer to fight the dentistry/orthodontics battle on the PR front, and stay out of courtrooms.

“It’s our responsibility as a profession to prove to the public that we do orthodontics with a better understanding than our dentistry colleagues, and I understand that there are those who want us to say more,” he says. “But it’s a fine line. If you bad-mouth a person or a profession, you are putting yourself in a precarious position. It comes down to we have an ethical responsibility to do the best we can for the patients we treat. For 115 years now we have been an association, and in all that time that has been the best way to proceed.”

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AAO 2015 Critical Issues

1) Consumer Awareness
2) Transition of Recent Graduates to Practice
3) Advocacy (Government Affairs)
4) The Business of Orthodontics

Poole’s stance on this hot topic should not be mistaken for an unwillingness to engage on the political front. Like his colleagues before him, he has made several trips to Capitol Hill. Most of these trips can be compared to wearing retainers, because legislatively speaking, the profession is in good alignment. The idea is to keep it that way.

For a profession that actually wants very little, is it really necessary to take the time and expense to visit Washington, DC? For Poole, the answer is an unequivocal yes. “Every year we have an advocacy conference, and usually our cry is leave us alone,” he explains. “One year we went in and said, ‘We are happy. Just keep leaving us alone.’ The staff member said, ‘You mean you came here to tell us you don’t want anything from us?’ I just smiled and said, ‘That is correct.’?”

Most recently, the AAO has been working hard to define what is “medically necessary” under the Affordable Care Act. “We’re helping the insurance companies to understand what orthodontics does, and how it can be paid for,” Poole says. “They want to save all the money they can, but also take care of their clients.”

This type of deep AAO involvement has never been easy, but Poole nonetheless views it as necessary. And his son, Morris L. Poole, has picked up the political bug, so it’s not inconceivable that another Morris Poole could someday lead the AAO.

The 35-year-old Poole chuckles at the notion, but he has already served as president of the Cache Dental Society in Utah and as a board member for the Utah Association of Orthodontists. “There is kind of a dearth of people right now who are willing to take the time to volunteer and help,” admits the younger Poole, who was often called “Mo” as a child. “On the other hand, a lot of young orthodontists are taking the time to be involved, and making sure we can take care of the profession. I’ll take it a day at a time. As for my dad, it is truly impressive what he has done.”

Add it all up, and the real challenge for the incoming president—aside from local and national media requests—is the pressure that comes with maintaining a successful organization that boasts a remarkable 90% membership rate. Poole puts it this way, “Being AAO president is a matter of keeping the things that are good going, and where you see a need, causing other good things to begin. The hardest thing in an association is recognizing when something needs to be sunsetted, and when something new needs to take place.”

“Being AAO president is a matter of keeping the things that are good going, and where you see a need, causing other good things to begin,” Poole says.

“Being AAO president is a matter of keeping the things that are good going, and where you see a need, causing other good things to begin,” Poole says.

Maintaining financial fairness with regard to member dues is high on Poole’s priority list, as well as building on the positive PR generated from the “My Life, My Smile, My Orthodontist®” campaign. Poole explains, “If we stayed the same as we are, we’d be falling behind. We must continually look forward—and again, for those who want us to say with more force that we should treat all orthodontic patients, they may have some good ideas that will help us achieve that goal as being the sole go-to clinician—but patients must realize that fact, without us knocking the other health professions.”

Establishing Loyalty

An early bit of help from the AAO contributed to Poole’s loyalty, ultimately putting him on the track to the presidency many years later. In his first years in practice, he had requested help in determining what type of dental insurance Utah State University (USU) should carry. The AAO sent someone to talk with USU officials, fully explaining the options. “I always thought it was quite something that they would take the time to do that,” Poole says. “So when I was asked to join the Council on Orthodontic Healthcare in 1991, I said yes. When I finish, it will be 25 years of traveling to the AAO’s St Louis headquarters.”

The commitment to AAO goals and values is thankfully shared by the overwhelming majority of orthodontists in America, and the unified front is undoubtedly part of the reason the profession has stayed strong for more than a century. And yet, not all orthodontists choose AAO membership. Poole wants them in the fold, but he is also keen to address any dissatisfaction among existing members.

“It’s true that our high rate of membership is unbelievable to most professional organizations,” he says. “As for that remaining 10%, they question AAO’s policies, or financially they believe they can’t afford it. Or they just are not interested in being involved and feel there is no benefit. There are members who question us, but I am glad that they do. I want members to express their concerns. I want everyone to be aware of the membership advantages and want to join the AAO.”

Building Relationships

Poole’s family of six daughters and one son is a great source of pride for the incoming AAO president. All of his children have graduate degrees, and, of course, one is an orthodontist.

Since 2010, the elder Poole has worked for his son about one and half days a week after selling him his share in the Logan, Utah-based practice

Since 2010, the elder Poole has worked for his son about one and half days a week after selling him his share in the Logan, Utah-based practice

Much like a large family, Poole believes that running a successful business requires a commitment to a team approach. It’s an ethos that Poole learned in high school basketball at a high level. In fact, it was almost the highest level when his Preston High School team in Preston, Idaho, played in the semifinals of the state championship tournament.

“We easily could have taken the title,” says the 6-foot, 1-inch Poole, who played as a forward on the team. “But the flu swept through our team at the worst possible time. I did not have the flu, but was just getting it. We had eight seniors on that team and a couple of juniors. Three got the flu really bad, and one was our 5-foot, 7-inch point guard who ran the offense.”

He may not have gotten the state title, but Poole did meet his future wife at a Preston High School exchange assembly, and later rekindled the relationship at a rodeo in Preston where she was the rodeo queen. The two were married a few years later, and despite their time in sunny Southern California, always planned to move back to the Utah/Idaho area.

Even in a 150,000-person area like Cache Valley, just walking into a store can take quite a bit of time, especially if you’re a successful orthodontist who has treated hundreds of kids in the community and met with countless parents. “When I was very busy in the practice, my kids would not go shopping with me, because it would take me twice as long to get out of the store,” Poole says.

The younger Poole backs up this version of events, adding that, “Everybody always stopped him at grocery stores and basketball games, and he would always make sure they were wearing their retainers. As a punk kid, I just wanted to go home. Now I find the same thing happening to me. Looking back on it, it was cool to see people stop and respect my father in the community.”

Morris L. Poole (left) has seen firsthand his father’s career-long commitment to the AAO. “It is truly impressive what he has done,” the younger Poole says.

Morris L. Poole (left) has seen firsthand his father’s career-long commitment to the AAO. “It is truly impressive what he has done,” the younger Poole says.

These days, the respect flows freely from father to son, and that level of trust has led to a smooth business relationship and a strong father-son bond. Poole credits a lesson learned many years ago with helping him to relate better to his son. “I coached Little League baseball, and my son was on the team,” Poole explains. “We were coming home from practice, and my son asked, ‘Dad, why are you always mad at me?’ And I said, ‘I didn’t know that I was.’

“My son replied, ‘Every time something goes wrong with the team, you look at me.’ It taught me a lesson,” Poole continues, “and the lesson was, you expect so much of your children that sometimes you show disappointment without really realizing what you are doing. And my son has never disappointed me.”

As a professional who dealt so well with other people’s children, the incident served to remind Poole that the complex juggling act of orthodontist, father, coach, husband, and AAO advocate could occasionally become overwhelming.

“Sometimes when I came home, I would ask my wife for just 30 minutes to wind down, because I made so many decisions in one day,” he remembers. “Orthodontists often appear like ducks—smooth on the water above, but paddling like heck underneath. Fortunately, it’s a wonderful profession that has so many rewards. And now it’s truly a privilege to lead the AAO, and I look forward to the task.” OP

Greg Thompson is a freelance writer for ?Orthodontic Products. He can be reached at awerner@allied360.com.