Shoot the Messenger

Never hire a futurist to be a featured conference speaker if you aren’t prepared to listen to the possibility of alternative futures you might prefer to ignore.

This Washington Post story about the political power of the American Dental Association (ADA) and its strong resistance to alternative models of care reminded me of the presentation that dampened any desire I might have had to earn a living as a public speaker. The year was 2011 and the conference designed for young dentists, so naturally the planners thought they should invite a futurist to talk about the future in which these young professionals would practice.

Up before me was the chief elected officer who spoke passionately about why these young dentists need to be part of the ADA to fight for their right to practice as dentists always have. Read the WP story if you are unfamiliar with the outlines of this argument. Not much has changed in six years.

I was quite aware of the lack of adequate dental care for many people and proposals like dental therapists from respected health policy organizations. I knew a little about Alaska and other places that were pursuing alternative care delivery models Moreover, the best way to see how the future might unfold is to look at what has happened in analogous fields, and nurse practitioners and physician assistants were gaining deep acceptance in medicine.

I decided in the moment that my integrity as a futurist required me to keep these issues in my presentation as I had planned. Maybe it wasn’t just the fear of dental care extenders. Perhaps the other changes I described like the growth of corporate practices or the incursions of disruptive technology were just as unsettling. I did have some welcome forecasts like better integration of dental care into overall healthcare and great technologies they might have to provide better patient care.

The only bright spot that day were the three young dentists who came up to me at the conclusion to thank me. They said the day before they too had raised the same issues and been pilloried by their peers. Then I slipped away home to await what proved to be abysmal speaker evaluation scores. It was evident that most of these young dentists had already been indoctrinated by their elders, or perhaps they simply resented a non-dentist outsider suggesting changes they might want to anticipate.

The future can hold what Al Gore calls “inconvenient truths”. The job of the futurist is to help organizations anticipate change and consider best how to adapt to future conditions. Shooting the messenger does not work. Maine passed the legislation despite an intense fight. Other states are lining up to consider similar proposals. The precedent for change is hard to resist when the need is real.