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Interview with Ralph Barden, November 29, 2004 | UNCW Archives and Special Collections Online Database

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Interview with Ralph Barden, November 29, 2004
November 29, 2004
Phys. Desc:

Interviewee: Barden, Ralph Interviewer: Paul Zarbock Date of Interview: 11/29/2004 Series: Southeast North Carolina (SENC) Length 26:00

Zarbock: Good afternoon ... or, ah ... I'm sorry, Good morning! My name is Paul Zarbock, a Staff

person for the University of North Carolina at Wilmington's Randall Library. Today is the 29th of November, in the year of our Lord, 2004, and this interview will be part of the ... of the ... ah, "Health Care Delivery System" ... will also be cross-indexed as part of the "Military Reminiscence World War II".

Zarbock: Good morning, Sir. How are you?

Barden: Just fine, thank you, hope you are ...

Zarbock: I am. Doctor, please tell me your name.

Barden: Ralph Buckner (?) Barden.

Zarbock: And you're called "Buck"?

Barden: Right.

Zarbock: And where did you get the name "Buck"?

Barden: From my middle name, "Buckner" (?).

Zarbock: Was that a family name?

Barden: Ah, yes ... my Grandfather.

Zarbock: In the ... in the other ... ah ... "World War II Reminiscence" video tape we covered the ground

when you were in the Navy, you were going to be discharged from the Navy, you found out about

the "GI Bill of Rights" although you had some college before, is that correct?

Barden: Right, two years.

Zarbock: Ok, so lets pick up ... when you're just about ready to leave the Navy, you find out about the

"GI Bill of Rights", where were you and what did you do about it?

Barden: Gainesville, Georgia. I was ... ah... on temporary assignment from the Navy, after the War

was over, and I was ... ah flying ... getting in some flight time at Gainesville, Georgia, and I heard about the "GI Bill" and knew about the Dental School in Atlanta. So I went to Atlanta and ah ... signed-up for the ... Dental School after interviews, and ah ... anticipated the "GI Bill of Rights" was going to take care of most of the costs of it.

Zarbock: Why did you select Dental School, I mean why not, of course, but was there some... was

there something that tugged you in that direction?

Barden: Well, I wanted to go into medicine, at one time, and I was back home to my family physician one day and I said to him, "Would you go ... knowing what you now... know now, he was a physician, ... would you go into dentistry or medicine?" And, he thought for a minute ...

obviously he had had a long night, he said, "I believe I'd go into dentistry, your times better your own." So, I guess its partly what made up my mind.

Zarbock: Your... your father wasn't a dentist?

Barden: No, no. No, ah... health care professionals in my family.

Zarbock: Well...

Barden: (softly, under PZ's question) Before this time...

Zarbock: Did you have to finish your college before you got into Dental School?

Barden: Ah... finish... you mean four years? No, I got in with two years of a... of a... college and then I had to go on the campus of Emory... Emory University. I had a few subjects I had to get

in addition to what I had after two years, before I could be accepted into the four year dental program.

Zarbock: Science courses?

Barden: Yes.

Zarbock: It wasn't called Emory University, in those days was it, the Dental School?

Barden: The Dental School in those days was Atlanta Southern Dental College.

Zarbock: And later... ah...

Barden: And later, Emory took over the Dental School and it was then School of Dentistry at Emory University.

Zarbock: One of... one of... one of the aspects of life that I think that scholars and students find an interest in is the first days of... so, I'm going to say... you've been accepted in Dental School, ah... did you put on a white coat and walk in the front door? What did you do?

Barden: (laughs) No, you walked in front door dressed normally and ah... they would ah... ah... indoctrinate you a little bit and show you around and ah... then assign you to a group and you would come back the next day and then maybe... maybe you'd get a coat then and ah... be assigned to a group that would go with one professor through the program.

Zarbock: How many students in... in your year? In... in the beginning?

Barden: The year of my ah... class... in... Dental School? One hundred and two.

Zarbock: How may women?

Barden: Two.

Zarbock: That's changed hasn't it?

Barden: Quite a bit. Its about fifty percent now. Fifty percent women.

Zarbock: Tell me, what was the difference between the curriculum... now what... what year did you graduate?


Zarbock: And you retired...


Zarbock: And you said in that period of time you learned a few things?

Barden: (laughs) Couldn't help but learn by experience... quite a bit.

Zarbock: What was the difference between the curriculum as you experienced it and the curriculum in Dental School as you understand it to be, now?

Barden: Well, I suppose when I first went into dentistry, it was a matter of drill and fill and extract bad teeth and make dentures. Today, that's ah... still the case when its necessary but the emphasis today is on prevention... which in the long run, costs you less.

Zarbock: What was... what was the situation when you first went into Dental School about ah... sub...

um... specialties?

Barden: There were subspecialties... oral surgery, for one, orthodontics was one and ah... prosthodontics was another. There's always been subspecialties in dentistry... from I guess the very beginning... I can't give you dates as to exactly when they started.

Zarbock: No, but they did exist.

Barden: Yes,

Zarbock: Had... had the subspecialties increased in number?

Barden: I don't think so... I think they're basically the same.

Zarbock: But the subspecialties may have gotten (laughs) subspecialties.

Barden: That true. That's true.

Zarbock: I've... I've even heard of ah... of ah... dentists doing plastic surgery.

Barden: Oh yes... yes.

Zarbock: When did that come about?

Barden: Oh, a few years ago. I would say... the last ah... ten years. I'm sort of guessing... on what... I'm not sure exactly.

Zarbock: Could that make the plastic, the... the MD plastic surgeons happy?

Barden: (laughs) I don't think it bothered them very much. They have all the work they can do.

Zarbock: Well, back to your early training... How do... how do you teach somebody to be a dentist?

Barden: You just ah... show 'em one time and then tell 'em you got it, you do it next yourself.

Zarbock: Monkey see, monkey do?

Barden: Yeah.

Zarbock: I remember hearing...

Barden: Of course, you get a lot of didactic work and a lot of... of ah... of... lecture work before you ever get to the Clinic floor and you... its kinda' like flying an airplane, you fly it from a book for many ah... days and years even before you... even before you get into a plane and fly. But, like in

dentistry, you learn a lot from lectures and from people talking to you and what they can describe you're going to be doing and until you get on the Clinic floor and then you still are watched very closely as you do it, step by step...

Zarbock: How have the anesthetics changed over the years?

Barden: Not tremendously, we've always had... ah... I guess its different chemical versions of it... ah... but we always had to inject and ah... we learned different ways to do it. The greatest change in my practice, and I guess many others today, just before I finished, which is what... ten years ago now, I used a method of ah... what we call "ligma jet" (?) which ah... injected right down the periodontal membrane, very easily, and you would only anesthetize one tooth, instead of

having the whole side of your face ah... anesthetized, just to work on one tooth. That was the greatest advancement that I ever saw in anesthesia. That was wonderful.

Zarbock: But the chemical blocking did not...

Barden: Oh, they always improved 'em and made 'em less toxic and ah... made 'em sustain ah... their ah... um... viability and their effectiveness ah... always longer than it use to, at first.

Zarbock: As part of your... ah... training... did you have an internship, did you go out and practice, with a practicing dentist?

Barden: No, no internship.

Zarbock: Ok, then, which leads...

Barden: In the specialties, you had an internship and various places in the... and different amounts of time.

Zarbock: Which leads me to the next question... who taught you how to run the dental business?

Barden: (sighs) I hate to say this, but economics and practice management was very lightly touched on in dental education. We had to learn after we got out into practice how to run the practice.

Zarbock: How did you learn it?

Barden: Trial and error. Many mistakes.

Zarbock: What were some of the mistakes?

Barden: (laughs) Not anticipating that this person was not going to pay ya' or that person would not show up for an appointment. And you had to interpret... ah... first interview 'em whether or not they could live up to what they say they would do.

Zarbock: And you had to hire Staff.

Barden: Oh, yes...

Zarbock: Buy equipment.

Barden: Yes

Zarbock: Who helped you in the purchase of equipment and the location of the...

Barden: The banks had to do that, you had to borrow money to ah... buy equipment and it was expensive. Buying dental equipment is one of the most expensive ah... projects in setting-up a practice of any kind of health profession.

Zarbock: Without... without giving the dollar amount, what would be your guess as to the percentage increase over establishing a practice when you first started as opposed to now in the year 2004?

Barden: Percentage wise?

Zarbock: Yeah.

Barden: Probably the... ah... eighty to ninety percent difference today as was when I was first out.

Zarbock: And, that's not eighty to ninety percent lower...

Barden: No, oh overage. More. Correct.

Zarbock: So no one really gave you a leg up and said, "Look, this is how you bill people." How... how did you figure out how to charge people?

Barden: I don't know... I just... ah... picked a fee out of the air and felt like it was fair to what... I did and to the person I did it to... did it for...

Zarbock: It was really by the seat of your pants, wasn't it?

Barden: That's about right.

Zarbock: Did any of your... did any of your classmates come to Wilmington?

Barden: No, none of my classmates came to Wilmington.

Zarbock: Now, you were licensed to practice in Georgia.

Barden: In Georgia, in North Carolina, and Florida.

Zarbock: So there was reciprocity in these States?

Barden: Yes...

Zarbock: But, you wanted to come back home?

Barden: Yes, I figured that was the best place for me, 'cided I knew more people here and I figured I'd have more patients when I opened my doors. Plus, I had a lot of more... other interests in Wilmington, too.

Zarbock: Such as?

Barden: My wife.

Zarbock: Well, that's an interest...

Barden: (laughs) We married during... between my Junior... Sophomore and Junior year, in Dental School. And, she went to work to support me through Dental School.

Zarbock: What kind of work did she do?

Barden: She worked secretarial work at the Cocoa-cola plant and I guess that's the main place, in Atlanta.

Zarbock: The equipment... has the equipment changed?

Barden: Oh, boy... yes.

Zarbock: Give me an illustration of the change, over time...

Barden: High speed... and high speed hand pieces probably is the biggest change. We had... uh...

slow movin' hand pieces back when I first started out. I can't remember the rpm's exactly but ah... today the handpieces run at speeds that are so much faster, they cut so much quicker and easier with less pressure... makes it much better.

Zarbock: But a mistake can happen quickly, too.

Barden: Oh well, before or after, in low speed or the high speed... mistakes can happen.

Zarbock: What about the fillings, how have they changed?

Barden: Ah... the primary fillin' material, when I first got out of school... was amalgam, silver amalgam, everybody's familiar with that I'm sure. Today, there's a tremendous ah... ah... amount of composite fillin's which is a resin base composite and they produce a lot of fillin's that even though they do wear maybe faster than amalgam fillin's, they're still preferred because they're aesthetically, cosmetically acceptable.

Zarbock: Tooth... ah.. trans... implants, teeth implants, when did they come along?

Barden: They came along about the time I was getting out... I did not get into tooth implants before I had to retire.

Zarbock: Did you, in your practice, actually make ah... bridges and...

Barden: Oh, yes, all of us made bridges. There were different types of bridges and removable and fixed. If you made a fixed bridge it was made with crowns on abutment teeth and with removable bridges, where there were more teeth lost, you would have bridges with ah... ah... denture that was cast framework and the teeth put on it and you could take it in and out of your mouth.

Zarbock: But... but... you didn't have the laboratory capability of designing and... and manufacturing that, did you?

Barden: When I first started practicing I was still casting inlays, in my office, and that soon went by the way and we had laboratories to do that for us, the laboratory industry... ah... soon progressed fast and took over all that kinda' laboratory work and dentist had more time to see their patients and the laboratory work was done by a laboratory, dental laboratory.

Zarbock: Again... a very intrusive question, of one that I think would be of considerable interest to viewers. As time went along, how did you change your fees?

Barden: Well, that was dictated by what it cost you to run an operation. It cost you more to rent, it cost you more to buy materials and you had to up your fees... accordingly.

Zarbock: Where was your practice located?

Barden: I started in the Murchison Building in Wilmington which is now... the.. what is it... Third and Chestnut Street, I can't think of the name of it, First Union, isn't it? First Union Building there in Wilmington. That was in 1950.

Zarbock: In those days, many of the doctors and dentists' offices were downtown in big old buildings.

PB: In that building... most of them were in that building. Not all of them, but most of them were in the Murchison Building.

Zarbock: Marbled floors and elevators...

Barden: Yeah.

Zarbock: But that's changed, too...

Barden: Oh yes, its all... ah... a lot of it because cottage industries, they called it, where people would build an office out there as a little home, similar to a home and you'd build your office right out in the neighborhood.

Zarbock: And I also understand that some of the large ah... stores like Sears & Roebuck and others now offer dental services.

Barden: I'm not familiar with that. I've heard that also but I do not know what's going on there.

Zarbock: I... I guess that brings the people into the store in addition to getting the treatment.

Barden: Well, that's what... that's the effort I'm sure... they want more people in there, more traffic in there and they'll spend more money. Might come in to get a tooth filled but they're gonna' buy

a roll of tape or a lawnmower or something else.

Zarbock: And put the dental office in the back as far as you can so that you gotta' walk through the whole store to get to the dental office.

Barden: Right. Exactly. ..... That's called marketing.

Zarbock: Yeah. Are they ah... what change have women brought about in the practice?

Barden: Ah... women in the practice of dentistry haven't produced any major changes. They do a good deal of all of it. I'm sure they're in all areas, phases of dentistry but ah... they... they contributed a heck of a lot because people... a lot of people, want to do see a female dentist rather than a male dentist especially when they're women, of course, that's understandable. They do a good job.

Zarbock: I understand in Europe, and especially in Eastern Europe, most of the... I'm sorry... that dentistry is considered to be a ah... woman's profession.

Barden: Yes, I think I heard the same thing... I'm not familiar with the process...

Zarbock: I've also heard that dentistry is one of the premier professions for a woman because she can practice it part-time.

Barden: Well, that's true.

Zarbock: I don't mean part-time... I mean... can restrict the number of hours.

Barden: Well, if a woman's going into dentistry she's got to interrupt it to have children and things of that nature so it... it is ah... considered maybe a part-time job.

Zarbock: I'm going to really throw one at you, this time.

Barden: Oh me! Let me hear it.

Zarbock: Ready? Whose smarter, the men or the women dentists? I'm sorry, let me change that sent... who are more capable in the provision of dental care?

Barden: Men. Men.

Zarbock: Why?

Barden: I think because the long history behind it, they got a background that enables them to handle ... manipulate.. to manipulate equipment and... and... ah... ah... material, probably better than women who don't lend themselves to that naturally as much as men do. I guess that's a good answer, I don't know. But it has something to do with the difference between men and women and what they normally accept and like to do.

Zarbock: Doctor, who takes care of your ah... dental needs?

Barden: Welll, my nephew did until he retired... now I have to go back to the guy that sold my practice to and I'm into his office now.

Zarbock: Would you recommend him?

Barden: Oh yes, he's a good dentist. Very competent.

Zarbock: Well, I'm in search of one myself.

Barden: (laughs) I'll give you his name.

PZ Thank you. Was it worth it? Did you enjoy the practice?

Barden: Oh yes, I enjoyed the practice. There's times when you sort of got fed up with it mainly because of the reaction with some of the patients who didn't want to cooperate with the procedures and you had to talk 'em into it... or decide not to do it for them... and... but, it was enjoyable ah... ah... profession and very rewarding.

Zarbock: I once heard a dentist... once heard a dentist in a private conversation with somebody else, he wasn't talking to me, saying to another dentist, "I always have a feeling of failure when I have to pull a tooth."

Barden: Well... what... I don't know why... he said that because that wasn't necessarily his fault because he had to take the tooth out. If it was ah... ah... a tooth that he failed to save and had to take it out, that's a different story... But, if it was... if it was not his fault, he shouldn't have felt that way.

Zarbock: He's not "Mr. Decay" that go around and squirting stuff in your mouth. What about lawsuits, this is such a prevalent topic among all...

Barden: Never had any problems with lawsuits the whole time I was in practice, never had a lawsuit.

I was very fortunate and I sidestepped that all the way.

Zarbock: But they do exist.

Barden: Oh yes... yes. There are lawsuits anywhere you want to look for them. Somebody's got to sue somebody... all the time.

Zarbock: More jobs for attorneys.

Barden: Yeah... yeah. If it wasn't for attorneys what would we do?

Zarbock: I wonder what... on what basis are... are dentists... what would be the nature of a dent... of a legal ah... suit brought against a dentist, on what basis?

Barden: The fact that they were not satisfied with the results they got... and thought they were going to get and so they would want to sue him for what he charged them for. Simple as that.

Zarbock: The dentist is going to make me handsome and 21 years of age and by gosh he didn't make it.

Barden: (laughs) That's right.

Zarbock: That's as frivolous as... I read somewhere, a couple of years ago, where a family sued the high school because their son was not accepted at Harvard... and the basis was that the high school had prepared him properly, he'd been into Harvard. Well...

Barden: Prepared him?

Zarbock: Well... there's a gap in logic.

Barden: Well... today, you know, lawsuits are just increasing all the time... everybody's got to have something wrong or not to their liking, so they're going to sue somebody for it.

Zarbock: Now I'm going to drift away from dentistry ah... just a minute.. but I've noticed that very few attorneys sue attorneys.

Barden: (laughs) Yeah.

Zarbock: Well, back to dentistry... Was it a sad day when you hung up your coat?

Barden: No, I was... I was relieved... I knew I would miss... ah... the people, some of the patients... some of the patients I particularly hated to leave and I particularly hated to leave my Staff 'cause I enjoyed my Staff. I have a good relationship with 'em. I miss them more than anything.

PZ This is going to be another toughie... Tell me... what makes a good patient and tell me... what makes a bad patient?

Barden: (laughs) A good patient does what you ask them to do and they... they approve of what

you do when you talk to them about what you propose is the proper treatment for them. A bad patient will sit there and not respond but when you get through he wants to contest everything that you did and particularly if something didn't suit him... as particularly aesthetics.

Zarbock: Have you ever fired a patient?

Barden: (chuckles) No, you don't exactly fire patients. I guess you might refuse to give 'em ah... an appointment if they call back and that's the same thing as firing maybe, in general.

Zarbock: Have you ever done that?

Barden: I don't recall that I have.

Zarbock: But... in dentistry, if the dentist had a conflict in personality or any other... and thought this is not working for me and its not working for you... the way out is simply ah... not provide...

Barden: Not to give him an appointment.

Zarbock: Yeah. Well, anything else you'd like to add?

Barden: I think you've cover the waterfront... I don't think of anything except that dentistry is a mighty fine, reputable profession and I would urge anyone interested in it to pursue it.

Zarbock: And, I've been told by others that you're a darn good dentist!

Barden: Well, that remains to be seen. We'll see how many suits come out of this... (laughs)

Zarbock: Thank you, Doctor!

Barden: You're welcome.

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