The tools of a dentist, the tools of change

Commencement exercises for the Class of 2024, University of Utah School of Dentistry

Dr. Jennifer Strohecker, PharmD
Utah Department of Health and Human Services
Director, Division Of Integrated Healthcare and
State Medicaid program

“Thank you to the University of Utah School of Dentistry, including Dean Hume, Vice Dean Hanson, Dr. Bekker, and Dr. Powell, for the invitation to be here. 

To the class of 2024, you stand on the doorstep of the future. You are coming into practice at a time when we can deliver the best scientific care that has ever been possible, and you will live to see medical advances we only dream of. Furthermore, with hockey coming to Utah in a big way, you dental professionals are going to be busy!

But the world needs another kind of advancement that has nothing to do with digital dental impressions, 3D printing for custom implants, or AI visualizations of how a treatment plan will affect a person’s smile. 

Something inside you is driving you to do this work. You need to follow this drive, find this something…. So I want to talk about your ability to not just transform the mouth, but to transform lives. This vision, if you choose to accept it, will require you to deliver a higher level of care beyond what your academic curriculum has prepared you for. It requires a commitment. It requires us to receive people, not just to perform dental work, but to invest in the whole person. 

Let me tell you about how this started for me.

I was 24 years old. 
He was 24 years old. 

We were in the same hospital at the same time, but for vastly different reasons. 

I was finishing pharmacy school, on my last rotation before graduation. He was in the emergency room, intubated with an Asthma exacerbation. 

When you are 24 years old, it should be one of the best parts of your life. When this young man should have been living the best part of his life, he was dying.

I saw him die… because he did not have access to an albuterol inhaler.

As medical professionals did everything they could do, I saw him. When I was 24 years old, I witnessed the preventable death of someone my age.  

Two thoughts have stayed with me since that time.

1: Why am I the lucky one?
2: I must do something about this. 

The profound effect of watching someone of my own age die from a preventable death cannot be understated. Our similarity in age was perhaps the one thing we had in common, as two very different paths brought us both to this place, with very different outcomes. Me, with the opportunity to afford higher education and blessed with the resources and support to succeed. My patient, seeking treatment in the ER for a common chronic disease that can be treated so simply, who didn’t have the resources to afford his proper medications.

I share this with you in order to ground you for the careers you are about to embark upon, and how to prepare yourselves to seek, find, and embrace the “strength in the differences” you will find across your patient population and communities you will serve.

Graduates, you are here, having reached a milestone in your life, and perhaps you too will encounter something bigger than yourself that you must change.   

I began to do something as a result of my experience in a poor Philadelphia neighborhood on that summer day in 1997.  The day I witnessed a young man… so like me, but so different than me…. Die an avoidable death.   As a clinical pharmacist providing direct patient care, I started listening more…I realized that it’s not what I said that mattered…but what the patient heard.  And I realized that the medicines I educated my patients on were no good if they could not afford them.   Additionally as a professor of pharmacy students and residents, I challenged them to identify barriers to medication compliance. I wanted to prevent another death like the one I witnessed. Every chance I had, I challenged my residents to be a part of the solution of compliance. Often this meant   going beyond filling a medication. It meant asking patients if they would have resources to fill this medication after their visit to an acute care setting. It meant making sure the patient understood how important consistently taking their medicines was.

This story never left me. I lived with it. Here and there it would pop up in my memory and each time it would move something deep in me: “I must do something…”;  

In many ways it is why I chose to work as the Director of Medicaid for the state of Utah.  I wanted to help those who had the greatest need or who had not been given the opportunities like I had.  Each day I work on high level issues: will funding come through for our new justice program? When will we get approval for the new adult dental services for the thousands who need it? And I am passionate about affordable (and accessible) care for all. But it is still that personal experience, that unnecessary loss of one life that still haunts me; drives me.  

Today, we celebrate you and an exciting milestone. But perhaps you too will find a moment of “I must change this..” Only you will know what that is or how that speaks to you. As we celebrate today, I want you to know that I am committed to working with you, as dental providers entering the workforce, to partner in compassionate care for vulnerable patients in your community. Since that day in 1997, I have constantly looked for ways to shape the future and to give back. 

I want to thank you for choosing dentistry as a profession. The mouth is such a vital organ for the way we experience the world. 

As you know, dental care and overall oral health can affect a person for life. A healthy smile is often the first thing you see in meeting someone!

Poor oral health or untreated conditions can lead to serious chronic problems. The way a person feels about their mouth affects their sense of dignity. A healthy smile is an individual’s advertisement to everyone they meet.  

Thank you, thank you for your willingness to help people be the best they can be physically, and emotionally. 

You will have amazing, though simple-looking, tools at your beck and call: Your mouth mirror, your probes, your suction device, and everyone’s favorite tool, the drill!

Each of these tools helps you in a way no other tool can help you. These tools allow you to see, work efficiently, maintain safety, and send a patient back into the world with a beautiful smile.  

But today, we’re going to talk about another set of  tools you will need in order to see and help the whole person.  These tools are the tools of change agents. 

Now that you know my perspective on health care and my story, you are probably asking yourself “why is the Medicaid Director talking in our commencement?”

First, it’s because you and I have something in common. There’s something that is driving us to be in these fields of work, with our unique gifts and tools, to help people who can’t help themselves.

Second, it’s because the School of Dentistry and the state Medicaid program have forged a partnership to continue serving people, especially those who are underserved, in special and meaningful ways.

For decades, Medicaid has been the access point for comprehensive medical care for Utahns. Today hundreds of thousands depend on this program to access care, prescriptions, and services. 

These are some of our most vulnerable friends and neighbors, children who are in foster care and youth in juvenile justice, individuals who experience homelessness, the elderly, and people with chronic physical and mental health disabilities. These are people who need help, dignity, and healing.

There was a pivotal moment in 2008 when adult dental care was removed from Medicaid coverage in our state. Think about that! Thousands of some of the most vulnerable Utahns left without essential dental care.

As a taxpayer-funded and legislatively controlled program, Medicaid could not help these adults on our own. After studying the needs, the University of Utah School of Dentistry, leveraging its resources stepped in to bridge this gap and fulfill its mission to serve the underserved. 

It was a pure moment of opportunity, where collectively our needs and resources met, with a common goal of providing high quality dental care for all Utahns on Medicaid.  This step in 2019 has led to many subsequent steps and a strong and strategic partnership rooted in our commitment to care for all members of our community. And it is thriving today!

Graduates, I’m here today to ask you to help us continue to become stronger. We need your talents, your inquisitive minds, your thoughtfulness, your attention to detail, and your ability to see the big picture.

I’ll ask you to pause and consider…why are you the lucky one… graduating with a doctorate in dental medicine…. And maybe…. Is there something that you too must change?? 

Alongside your tools as a dentist, I call upon you to leverage the tools of a change agent—your heart, an open mind, and a willingness to serve.

The core of this effort lies in recognizing the value of caring for vulnerable populations. In an economically affluent state like ours, true success is measured by how well we lift up the least among us. 

Consider an adult struggling with substance use disorder, or joblessness, or a child in foster care.  All of these individuals deserve your very best, and many times they need more than your best. By providing compassionate dental care, we not only address their immediate oral health needs but also support their path towards recovery, well-being, and their ability to lift and strengthen others.  This is how we do it in Utah, and I am counting on each and every one of you to carry that torch forward in your practices and in your communities. 

Martin Luther King Jr. once said “of all the forms of inequality, injustice in health is the most shocking and inhumane.”

But despite our state’s many opportunities, strong economy and world-class healthcare, including this TOP 25 school of dentistry, we must recognize that the journey to health is still NOT easily accessible for all.  Please join me in that work. 

In closing, I urge you, graduates, to find that moment in time where you were moved to become a dentist. Let that passion compel you to greatness. And maybe for some of you, there will be more. You will have a life changing experience that will forever shape who you choose to be and the lives you choose to serve even more. 

For me it was 1997 in an ER in Philadelphia where I felt the draw into caring for the underserved. That moment changed my life forever.

Choose today to influence the way our community benefits from dental care. Engage with empathy and heart, recognizing that our success is intertwined with the well-being of those around us.  Your commitment and compassion is the way to keep Utah strong.

With your tireless efforts, this work to serve people will be some of the most fulfilling work you will do. Choose the greater path. 

As humans it is our duty to serve all and serve generously, regardless of status, creed, or belief.

Let us move forward from this day not just as skilled dentists, but as change agents for equitable and accessible oral health care. Together, let’s redefine success by ensuring that no one is left behind. Let us each decide that when something is wrong, we will commit to be part of the solution.

Congratulations to the Class of 2024. May you carry the spirit of service and compassion into your careers, transforming lives and building a healthier, more inclusive world and future.

Thank you!”