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The WFO: Where have we been, where are we going?

By Lee W. Graber, D.D.S., M.S., Ph.D.

For the past 15 years, I have had the privilege to work in one capacity or another in, first, the support of a concept of an international orthodontic organization and, then, the actual development and building of what is now the WFO. I have been honored to work with an outstanding international group of orthodontists and support personnel. Through their combined efforts, I have seen the WFO develop, grow and mature. As with any nascent organization, there were initial doubts and opponents to the concept of such a group.

The first difficulties started even before the organization was chartered in 1995 and focused on what some questioned as the lack of need for a world organization. There were concerns that the development of a world federation of orthodontists would detract from other organizations and would inhibit their growth and their autonomy. I am happy to report that not only has the WFO helped to increase the number of national and regional orthodontic specialty organizations but also all of these organizations are stronger and better serve their members than they did before the WFO was born. There are more organizations sponsoring more and better continuing education for their members — all which redounds to the benefit of the public we serve by way of providing better orthodontic care.
How are we fulfilling our stated objectives as ratified by the founding 69 associations in 1995? The following is a list of the seven goals of this organization.

  1. Encourage high standards in orthodontics throughout the world
    The WFO supports the opportunity for patients to be treated by an orthodontic specialist. The WFO has worked with associations to help them strengthen their own organizations and, in some cases, work with governmental entities to identify the orthodontic specialist as best qualified to provide the highest standard of orthodontic care. We continue to support and develop programs that allow credentialing agencies (orthodontic boards) to work together to develop mutually respected high standards of care.
  2. Encourage and assist in the formation of national associations and societies of orthodontists when requested
    This objective was a major focus of the WFO from 1995 to 2000 under the strong leadership of Dr. William DeKock, who then served as our president and is now the secretary-general of the WFO. Not only has the WFO been successful in nurturing new organizations but it has also provided support for “mature” orthodontic associations/societies, often helping coalitions to develop and better serve orthodontics in a particular country or region.
  3. Encourage and assist in the formation of national and regional certifying boards in the field of orthodontics when requested
    Those of us who also serve in national and regional organizations are well aware of the governmental and societal pressures being placed on professionals today. There are shortages in orthodontic practitioners (and educators) in many parts of the world. The public is seeking ways in which trained professionals will have better opportunity to move and serve in areas where needed most. The big question is this: How does the public know an individual is well-trained, especially when the training may have taken place outside their own educational sphere? The WFO supports specialty credentialing by way of boards, not only for the strengthening of national standards but also as a means by which, in the future, we may be able to credential on an international level as well. The recent 6th IOC was highlighted by a meeting of the major national and regional board representatives who met to discuss mutual concerns and enhanced development — all supported by the WFO.
  4. Promote orthodontic research
    While there is much more collaborative work being done today, in part due to improved communication and accessibility to meetings, the WFO has not, as yet, directly become involved in research. We continue to encourage collaborative studies. We also have promoted new areas of research with inclusion of these topics in our scientific sessions and in our journal, the World Journal of Orthodontics. Our new WFO president, Dr. Athanasios E. Athanasiou, has a rich international research background, which will help him to lead facilitation of the development of coalitions in the future.
  5. Disseminate scientific information
    The 6th IOC, under WFO sponsorship, was the most diverse and inclusive international orthodontic meeting ever held. This event was direct testimony to fulfillment of our WFO objective to marry solid science with quality clinical care. In addition to the 6th IOC, our affiliation with the World Journal of Orthodontics provides a great opportunity to share concepts across national and regional borders. We have been able to secure significant reductions in the cost of this journal to our members, further enhancing the ability of our members to see what is being done in all parts of the world. While subscription to the World Journal of Orthodontics is voluntary, orthodontic clinicians do themselves a disservice if they do not subscribe and read this excellent clinical journal.
  6. Promote desirable standards of training and certification for orthodontists
    During the first five years of the organization, a massive study was completed to better document the provision of services and education of orthodontic specialists. With this information as background, during the last five years we have promulgated the WFO Guidelines for Orthodontic Specialty Education. The guidelines were first formulated in draft format and then circulated to all of the WFO affiliate organizations. The final form was developed after considering input from our affiliate organizations. The WFO Guidelines for Orthodontic Specialty Education have been used both to start new training programs and help support the further development of existing training programs. Interestingly, we have also been informed that they have been used to successfully argue against cuts in orthodontic program content. Currently, we are in the middle of a multi-year project to develop prototypic curricula to better help those programs that are forming and need to be strengthened to meet international criteria. In the future, the WFO looks to facilitate the international use of education “assets,” i.e., the sharing of faculty in areas where we as a profession have insufficient personnel to teach important orthodontic subjects.
  7. Organize the International Orthodontic Congress to be held at least once every five years
    The 6th IOC in Paris was the third International Orthodontic Congress under the guidance of the WFO with the prior meetings in San Francisco and Chicago under joint sponsorship of the American Association of Orthodontists. Each time the meeting has been held, an international scientific committee has worked to establish the best of programs — and the 2005 Paris meeting was no exception. During the 6th International Orthodontic Congress, there were more presentations, provided by a broader international representation than had ever been provided at an orthodontic meeting.

In this time of “evidenced-based” decision making, there is much to document that the WFO is fulfilling its objectives. Our growth in new members continues at a good pace; however, we have been plagued by a lack of renewal of memberships. Some of this is due to the procedural aspects of international communication and finance, but most has been our inability to keep our members informed as to the benefits of this organization. The dues structure has been maintained at a very low level to encourage participation. Indeed, membership costs are often recouped by fee reduction in meeting attendance alone!

It is my feeling that this membership problem will need to take a new tack with individual affiliate organizations providing support in membership recruitment and retention for the WFO. The Taiwan Association of Orthodontists now makes WFO dues part of their own national dues, so that all of their orthodontic specialists automatically become members of the international orthodontic community. It is my personal opinion that this model would work in the majority of associations now affiliated with the WFO and would help us to improve more quickly and effectively than we have done to date.

The WFO Executive Committee and I personally have and continue to receive the hospitality of many of our associations and the personal hosting by many of our colleagues around the world. They are too numerous to name in this report, but for their genuine personal efforts, I am most thankful. All who travel know how important it is to see a friendly face and have a helping hand in a foreign country, especially if one does not speak the native language. The help of our colleagues during our travels has allowed us all to succeed.

In 2000, it was apparent that the growth of the WFO organization required a redirection in the leadership structure. This was accomplished by expanding the WFO Executive Committee so that all the regions of the world could have direct representation on the committee. It also allowed the “face” of the WFO to become a local one, with regional WFO leaders appearing at many of the national meetings within their area and helping those associations directly. My thanks go out to all of my WFO Executive Committee colleagues with whom I have served over the past 10 years. They have allowed the message of the WFO to ring much more clearly to our 6,700 fellows and prospective members. My thanks go out to each of them: Dr. Athanasios Athanasiou of Greece, Dr. Julia Harfin of Argentina, Dr. Roberto Justus of Mexico, Dr. Larson Keso of the United States, Dr. Jae Chan Kim of Korea, Dr. Takayuki Kuroda of Japan, Dr. Olivier Mauchamp of France, Dr. Robert Max of New Zealand, Dr. Francesca Miotti of Italy, Dr. Hideo Mitani of Japan, Dr. Donald Poulton of the United States, Dr. Per Rygh of Norway, and Dr. Abbas Zaher of Egypt. All of these individuals, international leaders in orthodontics, have served the WFO with no financial support from the organization. Thus, they have and continue to provide their time and talent gratuitously as a contribution to a better future for orthodontics. In our home office, we have been ably assisted most recently by Lorraine DuPont and now by Terri Wise, and we are grateful for their efforts in the management of such a diverse group.

All successful organizations have key people who help not only with the development of the ideas, but maintain the organization in a way that these ideas can be brought to fruition. For the WFO, no person has given more than Dr. William DeKock. I can personally attest that Dr. DeKock is thinking about and has worked on behalf of this organization since its inception. It has been a personal highlight in my professional career to work with him over the past 15 years and to have him as my confidant and friend.

Those who serve as volunteer leaders do so at the expense of other interests and obligations. It takes the help and understanding of colleagues, friends and, most of all, family. I have been lucky to have parents as role models, colleagues as mentors, friends as supporters and an immediate family that has granted me the privilege to serve this past five years as president of the WFO.
Successful volunteer organizations require time from their leaders, and the WFO has been no exception. There are no added hours provided in the day when one assumes responsibility for a particular position or project. The time has to come from some place and, for me, a great part has come from “family” time. Thus, I want to specifically thank my wife, Jane, and our three daughters, Katie, Megan and Molly, for allowing me the time to pursue my passion for orthodontics and the future of our specialty. Their names are not featured in our WFO rosters nor do they appear on stage, but their support and love have been critical in providing the underpinning for any success and recognition I may have achieved.

Finally, my appreciation goes to the many leaders in our affiliate organizations and our fellows who have provided this opportunity to serve. While each of us live, practice and serve in our own cities and countries, our shared membership in the WFO reminds us that we are all members of a broader world community. With increased membership and strength of the WFO, our shared goals will be more quickly transformed into mutually beneficial accomplishments.