February 2012, Volume 8, Issue 2
Published by AEGIS Communications
Hazel Harper, DDS, MPH
This physician’s daughter born to Guyanese parents overcame gender and racial biases to become a president of the National Dental Association and the first Project Director of The Deamonte Driver Dental Project Model.
Interview by James B. Bramson, DDS
Inside Dentistry (ID): What in your background made you see dentistry as the place for your talents?
Hazel Harper (HH): I was born in Washington, DC, to parents who were from Guyana, South America, and were healthcare providers, so I was genetically predisposed to healing professions but I also had great mentors who appeared at different points along my journey and made an enormous impact not only on my choice of dentistry as a career but how I handled the many challenges I faced during my education and career.
My father came to America on a cargo ship at age 27 with 50 cents in his pocket and a dream to become a doctor. His father had been a high school principal and his grandfather was a carpenter. My mother, who died when I was 3, was a nurse.
I always thought I would be a physician, like my father, but my stepmom, knowing how much I loved painting and working with my hands, convinced me to talk to her sorority sister, Jeanne Sinkford, before I took the MCAT. There, sitting in her living room, Jeanne, who was the first female dean of an American dental school and is now professor emeritus and dean emeritus of the Howard University College of Dentistry, recruited me into dentistry.
Jeanne has been a dear friend and mentor ever since. She and my dean, the late Dr. Joseph Henry, picked up where my dad left off, constantly pushing me out of my comfort zone, and raising the bar. As a dental student, they both saw in me hidden potential and energies that needed to be directed in a positive and productive way.
I would say that starting as a dental student, and throughout my entire career, I have benefitted from the devotion of the most superb mentors that God ever assembled. I am in absolute awe of all of them, and so deeply appreciative that, through their lenses, they saw something special in me, and took the time to nurture, guide, encourage, and support me.
ID: As both an African American and a woman, what were the key challenges you faced and how did you deal with them?
HH: Because of my upbringing and the self-confidence I gained by attending Howard University, I learned never to be intimidated by someone else’s ignorance or bigotry. It was their problem, not mine. But failure or backing down in the face of adversity was just not an option, and I had a lot of support from my mentors, role models, and family. My first role model was my father. He never allowed me to say, “I can’t,” and taught me to never take no for an answer, especially when I knew I was right. I was never alone. I always felt the presence of family, friends, and mentors who truly cared about me and supported me. Dean Henry prepared me for the outcomes, and was there for me every step of the way. Many times, when I thought I was on the brink of exhaustion, he let me know it was the threshold of excellence. The lessons I learned as a result included humility, the importance of friends, family, and the mentors I so treasure. I also learned it takes courage to care.
That said, I faced both sexism and racism while working part-time as an airline ticket agent throughout undergraduate and dental school. The job was often very stressful, but I loved it; I learned about customer service, working under pressure, and the art of dealing with irate passengers. In dental school, I was aware that as a female I would have to work three times as hard, be twice as smart, and that I would get half the credit. I was very outspoken and determined to dispel the myth that as a woman, I was taking up a seat that a male student should have. I had to learn the difference between being aggressive and being assertive, and benefitted from the advice of Dr. Sinkford, who emphasized “femininity, fortitude, and finesse.” I have since been delighted to witness during the past 25 years the dramatic increase in the number and contribution of women in the health professions. Globally, they are excelling in business, academia, research, public health, corporate, and organized dentistry. They and their mentors are to be recognized and applauded for the tremendous strides that have been made as a result of their leadership across the board.
ID: Recently, the American Dental Association apologized to the African-American dental community for many years of exclusion. What impact has that had?
HH: The “apology” is a good first step. It paves the way for healing. Decades of racial discrimination and social injustice cannot be erased overnight; but the seeds for forgiveness have been planted. My hope is that the ADA apology has been offered in good faith as a sincere expression of remorse.
When we can embrace different cultures and celebrate, not simply tolerate, diversity, we will then be able to move forward in a truly progressive, collaborative, and productive way. From what I see, our student leaders are definitely on the right track. America is a multi-cultural, multi-ethnic, multi-generational nation. To be reflective of our populations and responsive to our communities, the dental profession must represent that mosaic.
My deepest regret is that one of my mentors, Eddie G. Smith (the past president of the National Dental Association and a civil rights leader for the profession) did not live long enough to see the fruits of his labor—the coming together in unity of the National Dental Association and the American Dental Association.
ID: Based on your experiences and outreach within the dental profession, what are the major challenges and how do you see the profession responding?
HH: The way I see it, the major challenge confronting dentistry is the fact that it still remains separated from the world of medicine. The knowledge gap between health professionals is far too broad. Everyone must understand and accept the fact that dental care is medically necessary.
Oral health literacy is a goal for non-dental health professionals and the community at large. Dentistry must step up to the plate to lead the way in closing the gaps.
We must build stronger interdisciplinary teams with more focus on oral health in the medical school and nursing school curricula. Patients are confused, and rightfully so, because they are receiving conflicting information from their medical and dental healthcare providers. It is up to us to fix this.
Electronic health records will only make matters worse unless all healthcare providers (and pharmacists) are “on the same page” and know how to interpret the information that will be contained in those records. Today, dentists are poised to be the “gatekeepers” because their training in medicine as well as oral medicine is more extensive than the training that medical students receive in oral health. If America is truly serious about healthcare, we will address this disparity in knowledge, train physicians and nurses to conduct oral health screenings as an integral part of their basic health screening, and encourage them to refer patients to dental professionals for immediate and preventive care.
ID: In February 2007, Deamonte Driver died of a brain abscess caused by an infected tooth. Lack of access to dental care is typically cited as a major concern with many solutions posited. What is underlying dentistry’s inability to be successful in combating this lack of access?
HH: The tragedy of Deamonte Driver’s death from tooth decay was a turning point in my life. It led me to do a self-assessment of what I could do better as an individual. It challenged me to use all of my training, experiences, and skill sets to truly make a difference. No one should ever die from a preventable disease like tooth decay.
The entire state of Maryland went into a crisis mode and took immediate steps to correct the inequities. What has evolved in the 5 years since his death is the recognition that the problem is multi-faceted and the solution is multi-pronged. Lack of access is only part of the problem. Other contributing factors are: 1) America’s dental healthcare system places too much emphasis on rehabilitation and restoration and not enough on prevention; 2) there is a lack of understanding about the impact of healthcare disparities; 3) a high level of healthcare illiteracy; 4) there are too few underrepresented minorities in dentistry; and 5) cultural biases.
ID: Tell us more about the work that is exciting you these days.
HH: I am the co-founder and first project director of The Deamonte Driver Dental Project, a community- and school-based oral health program for children. I am committed to creating expansion programs that are replicable, sustainable, and successful in other parts of Maryland and across the nation. These programs must focus resources and attention on solving the problems of access to care, disparities in how that care is delivered, and healthcare literacy. I received the Courage to Care Award from the Foundation School, Deamonte’s school, but this crusade is not about me. It’s about the children and the grown-ups who care for them.
I have closed my practice and launched a second career, using my background in public health as well as dentistry in keeping with a desire to do more in the community. My second career will be dedicated to making a difference in communities where the need is greatest.
ID: What is your perspective on the dental provisions in the healthcare reform package and its impact on the delivery and financing of dental care, and how will this expanded care and programming be funded in the face of states’ service cutbacks?
HH: We must move rapidly toward the understanding and implementation of public-private partnerships. The landscape is changing for successful, sustainable programs. They can no longer be dependent on government subsidies, nor should they be. Successful programs will be community-driven and community-supported by a combination of resources from state and county, foundations, community businesses, and private donors. The non-profits and for-profits must come together in innovative ways to formulate blueprints for success in business and community health that are replicable.
Healthcare reform will require transformation and change in the ways we do things across the board. Transformational leaders will inspire innovations and collaborations that will yield unprecedented results.
Insurance companies must incent providers and consumers for prevention and wellness visits, by reimbursing providers for prevention services and lower premiums for consumers who regularly make appointments for prevention.
ID: You have been the president of the National Dental Association and a key opinion leader throughout your career. What’s been the secret of your leadership style in order to weather the ups and downs of being a role model?
HH: I stand on the shoulders of giants, and have always believed that in order to get where you are going, you have to know from where you have come. As mentioned previously, throughout my career, I have benefitted from the advice, guidance, and friendship of many mentors.
I have learned to be a good listener and to value the input of others, especially those with differing opinions. I believe in maximum inclusion and broad-based coalitions. I am solution- and outcome-oriented and relentlessly persistent. I live my life with a sense of purpose, and am here to help and mentor others, as so many others have helped me.
My mentors and the leaders I admire possess three main traits—courage, integrity, and compassion. The trust and loyalty of supporters and constituents should never be taken for granted or undervalued. Leaders must be willing and able to accept the criticism that comes with the territory. They must carve out their own time and their own space to explore new and non-traditional ideas. Transformational leadership requires one to be a non-conformist, and a risk- taker. Character and integrity must never be compromised. They are the impenetrable shield against adversity.
ID: What’s the most common question or concern that dentists talk about when you are out amid your professional colleagues, and how do you answer it?
HH: I don’t listen well to conversations that become “gripe sessions.” My motto is, “If you want something to happen, you have to make it happen.” Because I am solutions-oriented, I always ask, what are you doing to make it better? That question usually ends the conversation.
I just wish some of my colleagues would stop complaining about how much less money they are making, and redirect their attention to sharing some of what they have with others. I read somewhere that “what a person has is of less importance than what a person gives.”
It is for that reason that I plan to merge the two worlds of dentistry in which I live—private practice and public health. I have been a general dentist in private practice for 36 years, and I also have a master’s degree in public health. Throughout my career, I have listened to and learned from wonderful patients who are economically, educationally, racially, and ethnically diverse. I have also advocated for the underserved. Last year, I closed my practice and became an associate in another practice. As mentioned earlier, my desire now is to do more in underserved communities.
ID: If you had the chance to do anything over again, what would you change about what you’ve done or not done in your career?
HH: I would advocate for many changes in the dental curriculum, including cultural competency and community health as core courses in the dental school curriculum, because I believe that in the larger scheme of things, behavioral and social sciences are equally as important as biomedical science in the education of competent healthcare professionals. I would also urge placing greater emphasis on prevention, nutrition, health literacy, and community service. I would further encourage young dentists to explore different types of practice opportunities, teaching them more about business, including social entrepreneurism, non-profits, and mobile dentistry. Finally, I would push for the elimination of any state or regional board exams and instead lend my voice to an effort to implement national licensure.
About Dr. Harper
Hazel Juanita Harper, DDS, MPH, is a semi-retired associate in the practice of Dr. Floyd Keene in Washington, DC, and the former project director of The Deamonte Driver Dental Project. She is a visiting lecturer and assistant professor with the Department of Community Dentistry at Howard University College of Dentistry, and is a fellow in the American College of Dentists, a member of Omicron Kappa Upsilon, and served for 12 years as the first African-American national spokesperson for the ADA. She is a member of Alpha Kappa Alpha Sorority, Inc. and the Washington, DC, chapter of The Links, Incorporated.