Bill Klaproth (Host): This is AAOMS On the Go. I'm Bill Klaproth. And joining us are two recipients of the AAOMS Challenge Coin. The AAOMS Challenge Coin recognizes oral and maxillofacial surgeons who have made significant advocacy contributions on behalf of the Association. The distribution of these challenge coins not only acknowledges members for their extraordinary service, but also provides an inspiration to others to promote the specialty through advocacy. Recipients are nominated by their state societies, state lobbyists or members of the AAOMS Committee on Governmental affairs and affirmed by the AAOMS Board of Trustees.

And today, I am honored to have with me Dr. Mark Degen from Nevada, who was awarded the coin in 2025, and Dr. Mark Oghalai from North Carolina, who was awarded the coin in 2020. Dr. Degen and Dr. Oghalai, welcome.

Mark Degen: Hey. Thanks, Bill. Thanks for having me. It is great to be here.

Mark Oghalai: Hey, Bill. It's my pleasure. Thank you so much.

Host: Well, thank you. And I'm honored to have two Challenge Coin recipients on the podcast today. Let's start off with why you each received the Challenge Coin. Dr. Degen, what advocacy efforts in Nevada were you involved in? And tell us about your role.

Mark Degen: So, about 15 years ago, the medical board instituted anesthesia regulations for surgeons in the state of Nevada. Previous to that, the MDs had no regulations; whereas the oral and maxillofacial surgeons on their dental licensure did. And the reason why they instituted that MD regulation was for hep C outbreak that occurred in 2008 in Las Vegas. And that was due to the nurse anesthetists who were using syringes between patients. And so, because of that, the legislature got involved and they regulated the MDs. Unfortunately, the few dual licensed/dual degreed oral and maxillofacial surgeons in Nevada got caught in the crosshairs. So, not only were we regulated by the dental board, which had always been the case since like the 1980s, now we had the MD regulations, which are a lot more onerous and redundant to work under. And that was instituted in 2010.

And so I actually brought that up to our oral surgery society's attention 15 years ago, but at that time, I think there were other pressing legislative issues that needed to be sorted out. And so that sort of fell into the background. And it turns out, last year, we had an assemblywoman – who was a physician  – who was colleagues with Dr. Steven Sachs here in town, a prominent oral surgeon, who has been here for many years, and along with Dr. Kathy Keely, also an oral surgeon who's been here for many years, very well-known; they had wanted to find an exemption to this MD regulation so that we wouldn't be double or dual regulated.

And so, I jumped in to help out when they needed testimony before the assembly committee in the legislature. And that's where I came in. I gave testimony and answered any questions that basically explained the fact that because of the dual regulation, not only did it take time away from patient care, but also diverted funds and monies to be under the regulations to be compliant with all the regulations. All of a sudden now you had extra time and money that needed to be spent on that when it didn't need to be, especially since we are already regulated by a specialty or a professional board. And so that went through the assembly, went through the Senate, and got to the governor's desk, which he signed last year in July.

Host: Well, congrats. You certainly played a part in this important change. And that's what advocacy is all about – taking your time, sacrificing and stepping up to the plate and trying to get things done.

Mark Degen: Yeah. And hopefully it allows more dual licensed oral surgeons to come into Nevada without the threat of being dual-regulated now with extra time, money and effort spent on that.

Host: Yeah, very important. Well, thank you for sharing that with us, Dr. Degen. I appreciate it. And Dr. Oghalai, can you share what advocacy issue you faced in North Carolina? And tell us about your role.

Mark Oghalai: We faced a challenge to our OMS anesthesia team model. The North Carolina Dental Board was instructed by a state senator to require a second anesthesia provider for all deep sedation and general anesthesia procedures. Well, my role as president of the North Carolina Society of OMS was several fold, really.

Most importantly, I believe it was to assemble a team of leaders among our state society members. Having assembled that team, we then coordinated with AAOMS and, specifically, our district trustee and governmental affairs. We reached out to our North Carolina Dental Society and we received their support. Finally, we contracted a lobbyist well-connected within our state legislature.

Then, having put all these parts together, we set forth to educate our North Carolina Dental Board and then North Carolina State representatives as to the safety of our OMS anesthesia team model and to the unintended consequences of limiting our ability to care for our patients. And fortunately, we were successful in this endeavor.

Host: Again, congrats. Great job on that. And Dr. Oghalai, let me stay with you. And obviously, we can all see how advocacy played a role in your efforts. How do you explain the importance of advocating for the specialty to colleagues who may feel unsure about getting involved?

Mark Oghalai: Well, I think, first of all, advocacy is critical to our specialty today and in the future as we'll continue to face challenges to our scope of practice. So the voices of our members are especially important in this endeavor. Without participation, we'll allow outside interests to shape our practice and the care of our patients.

No one has more knowledge of our specialty and the care we deliver than we do. And, you know, therefore, we must be the voice of it. And AAOMS has ample opportunities to assist anyone interested in advocacy. I know they helped us out tremendously. I highly encourage the listeners to reach out to them.

Host: You know, this is the old having the seat at the table, right?

Mark Oghalai: Exactly right.

Host: Dr. Degen, let me ask you this question, advocacy doesn't just happen, and you both obviously have day jobs. So, Dr. Degen, let me start with you. How do you balance clinical responsibilities with time spent advocating? You kind of alluded to the time that you had to spend on your project in Nevada.

Mark Degen: I think it's just like anything in life. You set priorities and you make time for them. This is extremely important for our profession, our livelihood. And so, whatever time that needed to be spent, I made sure that I made time for that. And fortunately, I have my own practice so I can set my hours and times of work. And I needed to shunt certain number of hours per week or per month, whatever it was, to ensure that we got the goal  –  at least we got over the goal line  – and did what we needed to do.

Host: Right. That is the important part. And Dr. Oghalai, how about you? How do you balance clinical responsibilities with the advocacy work that you do?

Mark Oghalai: That certainly is a challenge and I couldn't agree more with what Dr. Degen had just said. I'll say in my experiences, our team would typically hold Zoom meetings during our lunch hour so it didn't disrupt our clinical or family responsibilities. Now, there were some evening meetings that we would have to have as well, and those were typically scheduled around family obligations to minimize impact. So, there are ways to address it and still complete everything else that needs to be done in our lives.

Host: So I understand the AAOMS Challenge Coin was created to recognize those whose advocacy efforts might otherwise have been overlooked, and that's why the importance of doing a podcast like this to hear stories from you and your advocacy work and the difference that it's made. Dr. Degen, let me start with you. What does the AAOMS Challenge Coin mean to you?

Mark Degen: I didn't expect to be recognized, and I was greatly honored that I was the recipient of one. But I think the process and the result for me was enough to know that I did my best for my patients and my specialty. And that was good enough for me. The challenge coin was just an added bonus, which I'm very honored to have gotten.

Host: Dr. Oghalai, how about you? What does the AAOMS Challenge Coin mean to you?

Mark Oghalai: It's a humbling reminder of the incredible contributions a group of my colleagues made to step up when our backs were against the wall and the future of our specialty was in jeopardy. I really think it is a group effort. And I got the Challenge coin, and I'm certainly thrilled with it, but I really have to give credit to everybody involved. And it was a big group. I was just one cog in the wheel.

Mark Degen: I agree with that. I think it's a team effort. And the rest of the team deserves just as much credit, if not more.

Host: Yeah. And I like how you said, Dr. Degen, earlier. You weren't expecting to win the coin, you were just doing it because it was the kind of the right thing to do, but the coin was an added bonus on top. So, absolutely. I know both of you didn't do it just to be recognized as a Challenge Coin recipient, but doing it for the good of the society.

So, Dr. Degen, let me ask you this question, and I'll ask you both the same question. If you wanted your colleagues to take away one message about the efforts that led you to be recognized with the AAOMS Challenge Coin, what would that be?

Mark Degen: Always step up for what is good and right for you, your patients, and your specialty. And whatever time it takes, however much work it takes, it's important to step up to the plate if you have the opportunity, because as Dr. Oghalai said, if you don't step in and have a seat at that table, somebody else will tell you where to sit.

Host: Good way to put it. And Dr. Oghalai, how about you? What's your one takeaway message?

Mark Oghalai: Advocacy is essential to the future of our specialty. And I would say anyone willing to contribute can leave a lasting mark on it, and that really says something I think.

Host: So, let me ask you this. I think you're right. Anyone willing to contribute. We need more people, like both of you gentlemen, to contribute and advocate for the specialty. Well, final question to both of you, for someone listening to this again, why is it so important for them to advocate for the specialty, and what's the first step they can do to get involved? Dr. Oghalai, let me start with you.

Mark Oghalai: If we don't do it, if you don't do it, who will? It's going to be an outside interest group, and it won't be in our favor. As far as getting involved, I would say reach out to AAOMS. I mean, they have tremendous resources for this. And they will help you every step of the way. I think it's intimidating to think about approaching this. But if you go through them, they've got it all dialed in. Now, they're tremendously helpful.

Host: And then, Dr. Degen, how about you? Just final message on the importance of advocacy and where someone should start.

Mark Degen: I would agree with Dr. Oghalai, exactly what he said. Start with AAOMS. They have our best interests at heart, and they have tons of people there that will be supportive in whatever it is that we need to do to make the specialty better.

Host: That is for sure. Well, thank you both for your time. This has been great talking with two Challenge Coin recipients and the importance of advocacy and how we need people like you to advocate for the specialty. Dr. Degen and Dr. Oghalai, thank you so much for your time. I appreciate it.

Mark Degen: Thank you so much, Bill.

Mark Oghalai: Thank you, Bill.

Host: You bet. Once again, that is Dr. Mark Degen and Dr. Mark Oghalai. And to learn more about the AAOMS Challenge Coin – including a list and pictures of past recipients – visit AAOMS.org/Challenge. You can also visit AAOMS.org/Advocacy to learn about ways to get involved with AAOMS's advocacy efforts. Thanks for listening.