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June 20, 2007

By Sheri Doniger, DDS

1. Please tell me a little bit about yourself.

Conicella: I am the national director of clinical operations at Aetna Dental. I received my DMD from Temple University School of Dentistry in 1987. I received my fellowship in the Academy of General Dentistry in Toronto in 2000. I was in private practice prior to joining Aetna in 1997, and I am on the faculty of the University of Pittsburgh School of Dental Medicine, where I have taught since 1992. I live in Pittsburgh. My professional affiliations include the American Dental Association, Academy of General Dentistry, the International Association for Dental Research, the Omicron Kappa Upsilon Scholastic Honor Fraternity, and the American Association of Dental Consultants. I've been married 23 years to Bruno, also a general dentist, and I have two children — Albert, 17, and Nancy, 15.

O'Loughlin: I have been a member of the Delta Dental of Massachusetts board for many years. One of my early career mentors, Dr. Howard Kassler, an oral surgeon in Medford and a colleague of my father's, brought me onto the board. My dad, Dr. John Treanor, was a graduate of Tufts Dental School and general practitioner who practiced for 30 years out of a home office. I attended dental school at age 28 after working in clinical research for several years at Massachusetts General Hospital. My father died very suddenly when I was a junior in dental school, and Dr. Kassler provided me with a tremendous amount of support and advice as my family struggled to handle the sale of my father's dental practice. He introduced me to Delta Dental and recommended me for a board seat. I served on the Central Professional Committee that he chaired before becoming a director. After serving many years as a director of the corporation, I was asked to consider becoming its president and CEO. Delta Dental of MA was undergoing a corporate reorganization and my predecessor, also an executive who had practiced dentistry for 20 years before becoming its president, was going to lead the for-profit subsidiary corporation, leaving an opening in the not-for-profit dental service corporation. After careful consideration, I left private practice and academia to take the position. I have been in my current role for nearly six years.

Riggs: I was appointed president and CEO of Delta Dental of Minnesota in July 2005. Delta Dental of Minnesota is one of the largest providers of dental benefits in the Upper Midwest, serving more than 8,300 Minnesota-based employers, comprising 3.2 million members nationwide. I've served as a member of Delta Dental's Board of Directors since 1999. Prior to my current position at Delta Dental, I was an officer at Wellmark Blue Cross and Blue Shield of Iowa and executive director of the Wellmark Foundation. An Iowa native, I received my first doctorate degree from the University of Iowa College of Dentistry and am licensed to practice dentistry in Iowa. I went on to earn a doctorate of medical sciences (DMSc) in epidemiology from Harvard University. I maintain faculty appointments at my alma maters, serve on the board of the YWCA of Minneapolis and Greater Twin Cities United Way, am an active member of the Minnesota Women's Economic Roundtable, and also a frequent guest speaker at local and national events.

2. Why insurance?

Conicella: As a dentist working in the insurance industry, I have the opportunity to contribute to policy development that can positively influence our members. It allows me to use my background in a much broader way. Aetna believes in educating members on the importance of dental care and its impact on overall health. Aetna also places a great deal of importance on health literacy and has taken steps to raise awareness of and find solutions to health literacy problems. As a member of Aetna's Health Literacy work group, I look for ways to specifically improve oral health literacy.

O'Loughlin: Delta Dental's mission is to improve oral health. After more than 20 years of private practice, I realized that public health and population health had the potential to impact many more people than I could impact in a private practice. I went back to school and received a Master's in Public Health from Harvard University. My practice was growing fast with more than 5,000 patients, and I had taken in two partners, both women I met while teaching at Tufts Dental School. When I was offered the position at Delta Dental, I sold my practice to my two partners, and they continue to grow the practice today along with more than 12 staff.

Riggs: There is so much we can learn from transactional claims data to help employers and employees achieve better outcomes for their oral and overall health.

3. Did you have a mentor?

Conicella: I've had the opportunity to work with brilliant, dynamic people in the dental profession and insurance industry. In preparing for my most recent role, I had the good fortune of being mentored by Patricia Farrell, senior vice president of Specialty Products and Medicaid for Aetna, who helped me augment my professional experience with an understanding of strategic planning and finance.

O'Loughlin: I have had many mentors in my life. My high school basketball coach taught me how to work hard and remain strong in the face of hardship. My first boss was a woman physician — the only female tenured department chair of Harvard Medical School. She taught me that if you want something bad enough and work hard enough, you can attain it, but there will be tradeoffs. She used to tell me that "medicine was a jealous mistress." When I was in dental school, one of a few women dentists befriended me and showed me that women can have successful private practices and be good in business. Dr. Barbara Kay was the first woman in Massachusetts to start a private practice from scratch, and she is extraordinarily successful. She helped me be appointed to the Tufts Alumni Association Board, my first experience as a director.

Riggs: Yes, I did. The CEO of Wellmark BCBS of Iowa, John Forsyth, came from the medical care delivery side to the medical insurance side, which was unusual. His experience and insights brought tremendous value to the organization and the customers we served.

4. Do you practice dentistry at all? If not, do you miss practicing and why?

Conicella: I do practice dentistry, and because my husband is a full-time practicing dentist, I have the luxury of using his office any time to treat family and friends.

O'Loughlin: Being in private practice for more than 20 years required that I be "on" 24 hours a day, seven days a week. I was on call all the time as a solo practitioner, and as I took on partners, I could truly be "off" periodically. In business, I get weekends off, paid vacations, and holidays. I get benefits such as health insurance, disability insurance, and retirement. I raised four children while maintaining a private practice. It worked because I had a home office, much like my dad, and I had a lot of help from my husband and a wonderful nanny. I had a lot more flexibility in private practice than I do in the business world. Raising children while being a corporate executive is incredibly difficult and demanding. I loved my patients, and they were my extended family. I loved teaching, which I did for nine years. The combination of private practice and teaching kept me sharp and focused. Although I love my corporate job, I miss my patients and students terribly. The instant gratification one gets in seeing a patient smile or student gain knowledge is not present in my current job, where often the results are a year away.

Riggs: I do not practice dentistry but was instrumental in setting up a free community dental clinic in Ames, Iowa, which over a period of years grew to serve several hundred people.

5. What obstacles did you have to overcome being a woman in the insurance world?

Conicella: None. Aetna is a great company for women and has even been recognized by Working Woman magazine for its efforts in creating a desirable working environment.

O'Loughlin: I have not encountered nearly the amount of obstacles in corporate life as I did as a young woman dentist in a very male-dominated profession. The business environment is very ordered, structured, and civilized. The biggest challenge I had in making the switch from private practice to corporate was to slow down, listen carefully, think before acting, and function as a disciplined team. Clinical practice requires quick thinking, quick decision-making, and self-reliance. That does not work in the business environment, where careful, slow, deliberate decision-making is the norm, but once the decision is made, one must implement quickly and expertly.

Riggs: None. I was fortunate that other women had helped pave the way.

6. Why would insurance be a great place for a woman dentist?

Conicella: I don't think of it in terms of gender. I just think working in the insurance industry is an enriching experience. I've learned a great deal.

O'Loughlin: Dental insurance removes a significant financial barrier to access to oral health care. People with dental benefits see their dentists more often and have fewer unmet oral health needs. Dental benefits are part of the solution to improving access to care.

Riggs: The insurance industry provides an intellectually stimulating set of challenges and gives you an excellent overview of dental trends. Also, bringing the clinical know-how can add considerable value to the dental care benefit side of the business.

7. Dental insurance has been in place for more than 40 years. Do you think it has changed the scope of the practice of dentistry, and why?

Conicella: The practice of dentistry, like dental insurance, is constantly evolving. I think there have been a lot of breakthroughs and that we have learned and continue to learn so much from each other. Our partnership with Columbia University College of Dental Medicine, for example, has given us more insight into dental care and its impact on overall health.

O'Loughlin: As a private practitioner, I had to deal with more than 500 dental plans, and I automated as much of the process as possible through state-of-the-art computer technology. The complexity of the payment system demands information technology. The days of manually managing dental claims is over if you are part of a large dental practice.

Riggs: Dental insurance is designed to encourage preventive care, especially as almost all dental plans cover basic preventive and diagnostic treatments, such as sealants for example. Countless studies have shown that dental insurance has been a key factor in driving people to visit their dentists for routine preventive care. I think it has given dentists an opportunity to play a very important role in helping individuals achieve and maintain better oral health. It has also proved to be one of the most valuable, cost-effective benefits offered to employees.

8. What is your greatest achievement with regard to dental benefits that enhance dental care?

Conicella: Participating in the development of the Aetna Dental/Medical IntegrationSM Program is an achievement I'm proud to have been part of. By offering this to members, we can educate them on the importance of regular dental care and help avoid potential risks that could negatively impact their overall well-being.

O'Loughlin: My greatest achievement is improving access to care for more than 2 million people through the provision of a dental benefit. As a dental service corporation, which is a nonprofit public charity, I have been able to direct surplus derived from the benefits business and reinvest it in public health through our Oral Health Foundation, which makes grants of $4 million per year in the Commonwealth of Massachusetts, to improve access to care for the uninsured and underinsured. We are using our market strength to increase the speed at which evidence-based care is provided in the private-practice setting, and to focus our customers and stakeholders on prevention and risk assessment, rather than the surgical treatment of the damage that oral diseases cause. We are raising public awareness of the importance of good oral health as an essential part of overall health. Our Watch Your Mouth campaign has resulted in essentially all oral-health-focused legislation that has been submitted for approval and funding. The state's Medicaid program is on its way to a vast improvement in access, especially for children, because of our efforts and a large state oral health advocacy task force that we have funded for more than three years.

Riggs: Delta Dental of Minnesota recently launched the nation's first interdisciplinary National Advisory Council on Oral and Medical Health. The Council, which is comprised of representatives from the dental, medical, public-policy, and employer communities, will examine current medical-dental research and determine how the research outcomes can be integrated into dental-benefit-plan designs. In addition, we are trying to open communication between dentists and physicians — most physicians have not thought much about the oral-medical connection, but when presented with some of the logic and ongoing research, have been receptive to more discussions. These are exciting developments in an industry that has seen little change in the last few decades.

9. What are your words of wisdom regarding advocating for our patients' dental benefits?

Conicella: It is important that our patients understand how dental care can be a part of an overall wellness regimen and dental professionals embrace their critical roles in the overall health care team. If we can succeed in getting more people to access preventive dental care, we will see an overall healthier population.

O'Loughlin: Dental benefits help remove the financial barrier to care for our patients.

Riggs: There are millions of Americans who still don't have dental coverage, and as a result, may not be able to afford dental care. My wish is to see more people with coverage, which in turn will encourage them to make dental visits part of their overall wellness routine.

Email:
Dr. Mary Lee Conicella, conicellaml@aetna.com
Dr. Kathy O'Loughlin, koloughlin@deltadentalma.com
Dr. Sheila Riggs, sriggs@deltadentalmn.org

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